All of Us

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Would you like to be part of one of the largest studies ever attempted in the U.S.? I decided I would and I think you should as well.

The study is called All of Us, and it’s an attempt to gather health data from one million or more volunteers and then track them over many years. The purpose is to examine how genetics, environment, and lifestyle can impact health and disease. The goal is to provide a database that researchers can use to determine the factors that can impact the development of disease and eventually, the most effective treatment.

I think that’s the real goal. We have no idea what causes many diseases, whether it’s arthritis, cancer, auto-immune, or many others. The same holds true for treatments. Why does one treatment work well on one person and not at all on another? The genetics and environment as well as lifestyle may all have a role; with a database so extensive, just about every type of human subgroup will be represented.

What’s involved? I’ll tell you that on Thursday. If you want to read about all the details involved, check out the link in the References.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

The Bottom Line on Meatless Burgers

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There are a couple more differences between the meatless burgers and beef burgers. To get the red color, the Impossible Burger uses soy leghemoglobin from the roots of soy plants, while the Beyond Burger uses beet juice. Both are vegan and give the burgers their red color. The Impossible Burger also adds some B vitamins and minerals. The Beyond Burger seems to add only some iron.

Are the meatless burgers healthy or not? From a strict look at fat content, no. Cholesterol level, yes. Sodium content, no, depending on how much salt you add to your beef burger; if you add more than one-sixth teaspoon of salt to your burger, you’ve lost that advantage. In effect, they’re very comparable to 80-20 burgers you would cook.

The real difference is that the meatless burgers are sourced from vegetable protein. Even that may strike up a debate because one uses soy protein while the other uses pea protein. Some people try to avoid soy, although there’s no real reason for it with the exception of being allergic to soy. (Check The Bottom Line on Soy Protein in the Store).

The other difference is that they both have carbohydrates and fiber because they’re sourced from plants. While there’s not a lot of fiber, that’s an advantage over beef.

The critical factor is how the burgers are prepared and presented. The final fat count will depend on how long the burgers are cooked: the longer any burger cooks, the more fat it loses to the grill. The presentation also matters. Buns, mayonnaise, cheese (for vegetarians who eat dairy), ketchup, and other condiments can take a 250 calorie burger and explode it to 700 calories or more.

There’s no information available about the environmental effects of meatless burgers, but usually vegan foods are environmentally friendlier than animal products even with the shipping and processing necessary for faux foods.

Beyond Patties

You can find Beyond Meat burger patties in some grocery stores in addition to their brand of plant-based bratwurst sausage, Italian sausage, and meat crumbles. Would your chili or meatloaf taste different with faux beef? We’ve tried cooking with other brands of vegan “beef” and noticed only a lack of fat, although if we use beef, we usually rinse it after browning it to remove most of the fat. The lower cholesterol in the meatless beef would be a big nutritional plus, but of course all this scientifically created food comes at a price: expect to pay two or three times as much as for plain old ground beef.

The Bottom Line

On paper, the meatless burgers could potentially be healthier than beef burgers. Whether they’re healthy or not is a different story. I haven’t seen research on how the meatless burgers respond to flames and whether they may produce undesirable chemicals. On top of that, the presentation mentioned earlier also matters.

Most likely whether they’re successful or not depends on the taste. I haven’t tasted either yet but I’ve planned a tasting barbecue soon, and I’ll let you know what I find out. Until then, it’s beef burgers for me. It would be exciting to have a plant-based burger that meets the taste test. Let me know how you feel if you try them.

What are you prepared to do today?

        Dr. Chet

Defining Healthier Burgers

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Other than being plant-based, how do these burgers compare for being healthy? In order to know that, we must define “healthy.” Beef is criticized, no matter how it’s raised and processed, for having too much unhealthy fat. How about the Impossible and Beyond Meat burgers?

A burger generally uses 80/20 beef, which means 80% protein to 20% fat by weight. That isn’t how it turns out in calories. A typical four-ounce beef patty has 280 calories with 20 grams of protein and 22 grams of fat. There’s also 80 mg of cholesterol.

Both faux burgers offer 20 grams of protein, but then the differences begin. The Impossible Burger has 14 grams of fat in a four-ounce burger with no cholesterol. The Beyond Burger has 18 grams of fat and no cholesterol. There’s a little less fat in the vegan burgers, but it’s fat that makes a burger a burger so they’re about tied.

One difference is in sodium levels. Beef does not have sodium added, so it starts with about 80 mg of sodium while the vegan burgers come in with close to 400 mg of sodium each—but you know you’re going to salt that burger before you eat it, so to be fair, you need to factor in whatever salt you add. What I don’t know is whether the sodium is critical to the vegan burgers or not. Because it’s a manufactured product, does the sodium have to be there as a preservative or something to that effect? Could they be manufactured with less sodium without sacrificing taste?

I’ll finish this up this weekend so you can get the menu set for the 4th of July.

What are you prepared to do today?

        Dr. Chet

Are You Ready for Meatless Burgers?

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Grilling season is here and that means all kinds of meat get char-broiled. I love a good burger, but that leaves a growing segment of the population out of luck: vegans and vegetarians. Grilled vegetables are great, from asparagus to zucchini, but some people love the sensation of chowing down on a burger. They miss out.

There are veggie burgers out there. I’ve had Boca Burgers and black bean burgers as well. They may be shaped like a burger, but the taste often leaves me feeling cheated. That may not be the case any more with two new additions: the Impossible Burger and the Beyond Meat Burger. Even before I could dig into the background of each, there have been a number of articles questioning whether these burgers are actually healthier than regular burgers. That’s what we’ll focus on this week: what’s in these burgers and whether they’re healthier than a regular burger.

In checking the labels, one difference is the protein source. The Impossible uses soy-based proteins while the Beyond uses pea protein. One thing to note is that they’re both proteins because they have all the necessary amino acids or can make them from the essential amino acids contained within. I’ll get into the rest of the ingredients on Thursday to check whether they’re healthier than beef burgers.

What are you prepared to do today?

        Dr. Chet

Coordinating BPH Herbals and PSA

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Happy Father’s Day to all the fathers, father figures, and so on. Now let’s work on making you all healthier.

If you take one of the BPH medications, you have to work with your physician to determine how you’ll work out your PSA testing. What might not have been clear was that the medications don’t cause prostate cancer, but they can mask a rising PSA level by keeping it artificially low and that could delay detecting prostate cancer. I left you with the question: what about herbals that are used for BPH such as saw palmetto? Do they impact the PSA levels?

Based on a couple of studies, the answer is no. The mechanism by which the herbs help with prostate issues is different from BPH medications. So if you’re one of the many men who use saw palmetto, I wouldn’t be concerned based on current research to date.

However, I would be prudent. There are only a couple of studies that have looked at specific combinations of herbals and the impact on PSA levels. While they showed no impact on PSA levels, that’s not a completely free pass. What I would do is to stop using saw palmetto or any other type of herb or plant sterol a couple of weeks before your next PSA test. There’s no research to know how long it may take to clear the system, but two weeks seems reasonable. Once the blood is drawn, go back to using the product as before. That seems to be the best way to approach herbal treatments for BPH.

BPH can really mess with a man’s life and especially with sleep. If that’s you and you’re taking a medication or an herbal, there’s no reason to stop. Just be smart. Talk with your physician; understand how to deal with the potential issues and live your life. That’s a bottom line we can live with.

What are you prepared to do today?

        Dr. Chet

References:
1. Int J Cancer. 2005 Mar 20;114(2):190-4.
2. Prostate. 1996 Oct;29(4):231-40.

BPH Medication and Prostate Cancer

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The medications used for treating BPH can mask true PSA levels; based on prior research, the PSA value should be doubled. I didn’t know that and evidently neither do many of the men who take the medications known as 5-alpha reductase inhibitors. Does it have an impact on prostate cancer diagnosis and mortality?

Researchers examined a large group of men treated at the Veterans Administration to answer that question. They compared men that did and did not use one of the medications to see if there were differences in when men were diagnosed via biopsy, the severity of the cancer at treatment, and the death rate between medication users and non-users. The results showed that the men who were taking the type of medications known as 5-alpha reductase inhibitors were diagnosed later, had more advanced disease, and died at a higher rate than those who didn’t use those types of medications.

One type of 5-alpha reductase inhibitor, finasteride, has a familiar name: Propecia or Proscar, which is also used to treat male-pattern baldness. Taking one of those meds can affect PSA, so be sure to discuss that with your doctor.

Does this mean that men shouldn’t use the medication? That’s a personal choice. To me, it means that both the man and his physician should be aware of the problem, have regular PSA tests, and double the value of the results. That way, the prostate cancer won’t be masked by the medication and like every type of cancer, the sooner it’s diagnosed, the sooner treatment can begin if warranted.

And that raises another issue: what about men who take herbs for BPH? Are they at risk? I’ll let you know what I found on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA Intern Med. 2019;179(6):812-819. doi:10.1001/jamainternmed.2019.0280.

BPH Treatment and PSA

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One of the reasons I love what I do is that I learn something new just about every day. In this case, it may help some men sooner rather than later if they have benign prostatic hyperplasia (BPH).

The urethra runs right through the prostate gland. As a man ages, the prostate gland has a tendency to enlarge, and when it does, it can interfere with urine flow. The result is the inability to empty the bladder completely, which can cause frequent urination; a man may have to get up multiple times through the night to urinate.

The typical treatment is to use a medication called a 5-alpha reductase inhibitor that includes finasteride and dutasteride. By reducing the production of a specific form of active testosterone, the prostate can stop enlarging and urination improves. The problem with using the medication is that it can reduce the protein specific antigen level, a marker that can indicate a man has prostate cancer. Could it impact the diagnosis, treatment, and even death from prostate cancer? We’ll look at a recently published study that examined those very questions on Thursday.

The monthly Insider conference call is tomorrow night. You can take part by becoming an Insider today at drchet.com; if you’re a Member, you can upgrade to Insider and the charge will be prorated.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA Intern Med. 2019;179(6):812-819. doi:10.1001/jamainternmed.2019.0280.

Does Fenugreek Extract Raise Testosterone Levels?

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“Do nothing and remain a shell of the man you could be!” That’s ad copy used for a popular brand of male virility product called Nugenix on their website. Nugenix is one of a number of products that try to address low testosterone levels in men; it contains fenugreek, among other substances.

Fenugreek has many documented uses: as a dietary supplement for diabetes, to stimulate milk production during breastfeeding, and for other health conditions. It has some positive research that suggests it will help reduce triglycerides and improve carbohydrate metabolism.

But what’s the connection with virility? What does fenugreek do for testosterone levels? Fenugreek extract may help increase testosterone levels slightly in the few human clinical trials that have been done. Based on quality of life assessments, men felt their overall sexual health had improved. The problem is that the products such as Nugenix all contained other ingredients that might have explained some of the effects, and of course there’s also the possibility of a placebo effect, especially in studies that ask for a subjective judgment of the substance’s benefits. And four clinical trials spread out over nine years isn’t exactly overwhelming clinical evidence.

There isn’t enough science to suggest whether products containing fenugreek extract will help raise testosterone levels, but there are two actions proven to increase testosterone: weight loss and exercise. If you want to do things naturally, that’s the way to do it.

What are you prepared to do today?

        Dr. Chet

References:

1. Aging Male. 2016 Jun;19(2):134-42.
2. Phytother Res. 2011 Sep;25(9):1294-300.

Can Medium-Chain Triglycerides Help with Alzheimer’s Disease?

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Medium-chain triglycerides are hot today. Derived from coconut oil or palm oil, they have the advantage of being used for energy without much processing by the liver. People doing the ketogenic diet use them, as well as athletes looking for more energy. From a medical perspective, MCTs are used for people with fat-absorption problems and to treat epilepsy in some people. For today, I’ll focus on the use of MCTs for preventing and treating Alzheimer’s disease.

From an examination of the research on those two specific areas, the research is sparse. There’s little to no research that MCTs will prevent Alzheimer’s disease. There are a couple of small studies that have been done to treat Alzheimer’s patients with coconut oil or MCTs, but the results are equivocal.

The reason MCTs may benefit the brain is energy production via a non-sugar-based pathway. Whether additional energy for the brain helps learning and memory is unknown. What seems clear is that prediabetes and type 2 diabetes contributes to the development of Alzheimer’s, so it seems more important to lower refined carbohydrates and eat a more plant-based diet. I think including extra virgin coconut oil in a better diet could be helpful. At this point, specific MCT products seem unwarranted due to the lack of research. They may prove to be useful for some groups based on genetics, phenotype, and microbiome. Just not yet.

What are you prepared to do today?

        Dr. Chet

References:

1. Lancet Neurol. 2018 Jan;17(1):84-93. doi: 10.1016/S1474-4422(17)30408-8.
2. Am J Alzheimers Dis Other Demen. 2014 Aug;29(5):409-14. doi: 10.1177/1533317513518650.

Will a Jellyfish Extract Help You Remember?

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For this week’s Memos, I’m reviewing products I get asked about frequently, all products that seem to have a large online or television presence. I’m going to review the base research on the product, and then you can decide whether you want to use it or not.

One of the most prevalent television commercials at this time is for a product called Prevagen, a dietary supplement whose tag line is “Improves Memory.” Prevagen contains an extract called apoaequorin from a type of jellyfish that appears to be well researched; however I found only a single clinical trial on the use of apoaequorin and memory. The 90-day trial of 211 subjects aged 40 to 91 showed no significant differences on a variety of cognitive tests between the placebo group and those using apoaequorin. However when a sub-group of subjects who were concerned about memory were tested using the AD8 test, there were statistically significant differences. When accounting for the actual differences in the reported percentages, the differences did not seem significant in the real world.

The product does appear to be safe in standardized toxicology tests on animals. Beyond that, there doesn’t seem to be any clear benefit for supplement use at this time because of the limited clinical research. It should not harm you, but it’s up to you to decide if the small chance it will help is worth your investement.

What are you prepared to do today?

        Dr. Chet

Reference: Adv Mind Body Med. 2016 Winter;30(1):4-11.