The End of Constipation

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I had a question recently about the difference between a laxative such as Miralax and fiber. While they’re both safe, there are similarities and there are differences.

They are similar in that they draw fluid into the intestines. Miralax uses chemicals while fiber uses plant sources; both draw fluid into the gut to soften the stool.

Where they’re different is that fiber can help two more ways. It can add bulk to the stool to aid in transport and be used as a prebiotic and feed the probiotics or good microbes. And if those microbes are fed better, they work better.

If you have a chronic issue with constipation, time to check in with your healthcare provider. If it’s an occasional issue, as can affect us all, check out this Health Info titled The Constipation Solution. It has worked well for both adults and children.

What are you prepared to do today?

        Dr. Chet

The Keto Diet and Fiber

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More and more people are trying the ketogenic diet. If you do, the directions recommend that you eat plenty of green leafy vegetables for the vitamins, minerals, phytonutrients, and especially the fiber. The problem is that many people cut the carbs from all sources and that includes vegetables.

The simplest way to give yourself some insurance while doing the ketogenic diet is to get at least five or more grams of fiber per day from a fiber supplement. Remember, the grams of fiber do not count as carbohydrates because they’re not absorbed. Check out Your Fiber Insurance, a free Health Info on my website for more information on exactly how to get your fiber every day. Health Infos are posted in PDF format so they can be downloaded, printed, and shared with others.

But what if in spite of all you do, you get constipated? See Thursday’s Memo for the answer.

What are you prepared to do today?

        Dr. Chet

Food Is Better Than Supplements, But …

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Getting your nutrients from food by eating a healthy diet is the most desirable way of getting vitamins, minerals, and phytonutrients. Period. If we could all do it, no question that’s the best way. But you and I don’t live in some fantasy world. We’re busy. We don’t always have enough time to shop and cook healthy meals. Dietary supplements have helped fill the nutrition gap.

What should we think about this latest research? Should we stop taking supplements, especially calcium? Before I give you my opinion, I want to tell you that I emailed the corresponding author of the paper, a brilliant woman and a talented researcher. I had two questions about the study. She answered me the same evening—Saturday night before Easter. That I got such quick reply was remarkable; I’m still waiting for answers from other researchers I contacted months ago.

The first question I asked was a basic one: what was the mortality rate of the subjects in the study compared with the national cancer mortality rate? The national mortality rate is 156 deaths per 100,000 people per year. That works out to 1.6 people per 1,000. The rate in the study was about 3 people per 1,000. She replied that the study results are not directly comparable for complicated reasons.

But here’s something that can be directly compared. A 62% increase in cancer mortality would be transferable to national statistics because that’s the idea: to generalize to the entire population. A 62% increase means that 2.5 people per 1,000 would die from cancer in a given year instead of 1.6. When applied to the entire population that could be a lot of people, but it applies only to those who took over 1,000 mg of calcium per day.

The other question I asked was whether they had data on how long the people were taking the supplements; NHANES asked about the 30 days prior and recorded the prior 24 hours. How long were they taking the supplements? Weeks? Months? Years? Decades? That might have made some difference. The data were collected in the questionnaires used for two of the cycles that I examined, but that data was not used in the analysis.


The Bottom Line

I think we should eat the best diet we can. I also think we should use quality dietary supplements to complement our diet. This study was an exercise in statistics more than nutrition. It can tell us the statistical outcomes of the people in the study, but it can’t really be used to tell us anything about what we should do as individuals.

Not every person who took a higher amount of calcium died from cancer. On top of that, if supplementation did have a significant negative impact on our health, it stands to reason there would have been more negative results than just for calcium. Because the research questions were fitted to the available data, there’s just too much we don’t know about factors that can influence the results.

Another good question the study didn’t ask is why people were taking calcium. For instance, a woman with osteoporosis may take calcium for better bone health. Did those women have fewer broken bones with supplementation? If so, that might be worth any higher risk that exists. As with any nutritional intervention, it’s important to weigh the pros and cons. If you’re concerned, talk to your healthcare professional about what you should do; they know you and your health status and can help you make the right choices.

Supplement confusion is a good reason to get a copy of my new CD Supplementing Your Diet. Check out why at drchet.com.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Food vs. Supplements: A Closer Look

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There’s no question National Health and Nutrition Examination Survey (NHANES) has done the best job of collecting data on nutritional intake in large-scale studies. I’ve applauded it in the past, and I’m not going to change now just because there’s an NHANES-based paper that critiques the use of supplements. NHANES data were used by one of the co-authors of the current research paper we’re examining; in that study, they demonstrated regular use of a multivitamin-multimineral can compensate for deficiencies in our diet.

What could explain the same data showing potential benefits and hazards of supplements? Two reasons in my opinion. First, the research questions were not part of the original study; that’s supported by the fact that the lead author would have been six or seven years old when data collection began.

Imagine you apply for a loan. You’d give the bank all kinds of financial data: your total earnings, where you work, what you owe, and so on. Then imagine that researchers take all that very accurate data and estimate your hourly wage. They could be right on the money or way off, because they don’t know how many hours you worked; that wasn’t one of the questions. It’s the same with the data in this study; the researchers can make a great guess from the data they have, but the question they’re trying to answer wasn’t one of the original questions asked so their guess may be very far from correct. That happens often in these retrospective studies.

Second, the bulk of the researchers were experts in statistics and epidemiology. The statistical analysis accounted for 11 factors to numerically make the data comparable. We can’t really know what that does to modify the data instead of collecting data on actual variables.

Still worried? I’ll finish this up on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Food vs. Supplements

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Last week, the health headlines blared that nutrients from foods were better than nutrients from supplements—specifically that excess calcium from supplements was associated with an increased risk of dying from cancer. That will get your attention if you take supplemental calcium, especially if you’re taking calcium because your physician told you to take it because you have osteopenia or osteoporosis. Let’s take a closer look at this study published in the Annals of Internal Medicine.

Researchers examined data collected for the National Health and Nutrition Examination Survey (NHANES) on food intake and supplement use. NHANES data are now collected every two years, so they selected six consecutive cycles and tracked the all-cause mortality from subjects in those data. They found that in over 30,000 adults over 20 years of age tracked for six years, there were 3,613 deaths with 805 from cancer.

The researchers then examined the food intake and supplement use of the subjects from the prior 30 days of data collection with mortality data. That’s where they discovered that in the subjects who died from cancer, there was a 62% greater risk if they took more than 1,000 mg of supplemental calcium per day. The overall conclusion was that nutrients from foods are better than nutrients from supplements; in addition, some supplements may be hazardous.

Should you start chucking out your calcium supplements? We’ll take a closer look at this study the rest of this week.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Supplementing Your Diet

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Last week, a study was published that concluded that nutrients from food are better than nutrients from supplements. Does that mean you can throw out the supplements and just eat more? Short answer: no.

Did you ever notice that one week some vitamin is good for you and the next it’s supposed to be bad for you? Why is that? One reason is the way nutrition research is done.

One of the most popular audios I’ve ever made was Supplements Made Simple, so now I’ve updated all the tracks and included a section about the problems with nutrition research.

Introducing Supplementing Your Diet—Why, What, and Who. This CD examines the issues related to dietary supplements in the 21st century. The first question is simply why do we need them? Can’t we get enough nutrients from the food we eat? I’ll address that question from a variety of perspectives, including those based on your physiology and biochemistry.

What about the research that says supplements aren’t necessary and are a waste of money? As I said, I’ll tackle that issue head on with three specific reasons too much research on supplements is flawed and yields misleading conclusions.

If you do need to supplement your diet, where do you begin? I’ll explain the four supplements everyone should take and the reasons why.

Finally, how do you decide which company to buy supplements from? I’ll give you five characteristics that distinguish a high-quality manufacturer. That will help you choose the company whose supplements are best for you. This audio cuts through the forest of obstacles to help you see things clearly so you can make an informed decision on how to supplement your diet.

All this information is just $9.95 plus shipping and handling.

And if you’re in the supplement business, this audio will answer your potential clients’ questions about the basics. If you want to grow your supplement business, I’ve included special pricing on five copies of this CD so you can loan them to clients to help them make their decisions. You can point them to my online bio to show them why they can rely on my explanations.

Enjoy this holiday weekend, and I’ll be back Tuesday.

What are you prepared to do today?

        Dr. Chet

Subscriber Update

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How are you doing on the push-up challenge? I know some of you have begun with wall push-ups and are continuing to improve. Don’t forget to let me know when you make it. I finally got to 41 myself and continue to try to hit that number. No matter where you began, you can continue to improve. I admire so much the efforts people are putting into this, even with severe orthopedic problems. You can get there with a little effort every day.

I’m planning for the second half of the year and preparing to do nutrition and supplementation seminars throughout the U.S. I want to select areas where there are high numbers of Memo subscribers, but not all of you filled in your zip code. If you haven’t or don’t remember if you have, please take a moment and log in to your Subscriber account and do that, I would appreciate it.

Here’s how you do that. At the very bottom of the Memo you receive in your email inbox, there’s a link that says “update your preferences”; when you click there it takes you to a drchet.com page with your subscriber info where you can check to see if all the starred fields are filled.

Update

The Insider Conference call is tomorrow night. If you want the benefits of getting an hour seminar on topics in health and nutrition every month and get your questions answered, become an Insider today.

What are you prepared to do today?

        Dr. Chet

Finding Your Health Partners

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I finished Thursday’s Memo by saying there may be hope for physicians when dealing with overweight patients. It was another viewpoint written by two clinicians. They say learning about diet and nutrition and how to interact with patients were not priorities in medical school; I’ve confirmed that with physicians I know. The authors put together ABCs of steps to treat obesity in patients. The very first one was the most important.

A stands for Ask for Permission: permission to speak to an overweight patient about his or her weight before discussing ways for the patient to begin to address excess weight. I’ll take that any day as the best first step. If physicians will do that, it shows respect for the patient. They further recommend addressing the purpose of the visit first and then asking if they could address excess body weight. That’s the way it should be. You can read the full article at the link below.

Paula, my family, and I have been blessed with some pretty special physicians and healthcare professionals who always listen to us and work with us to reach our health goals. Based on the feedback from the Thursday Memo, so have some of you. Too many haven’t, but there’s hope based on recognizing that it’s a problem in medical training as expressed in the article I cited.

If your doctor isn’t a partner to you, find a different one; that goes for specialists, dentists, physical therapists, and others. (Maybe not surgeons—I don’t care if he’s a jerk, I want the best I can find.) Ask friends and family for recommendations and check reviews online; as with anything online, take it with a grain of salt and read as many reviews as you can. If you’re staying in the same practice, find a graceful way to explain your desire to switch; you’d feel more comfortable with someone older (or younger), someone male (or female), and so on. Don’t be rude and demanding, but you’re the customer and if your optimal health isn’t the goal of the practice, maybe it’s time to start over.


The Bottom Line

I’ve spent the past two weeks addressing a different way to look at our health based on the books of Jane Austen and learning to love and respect ourselves. I’ve talked about healthcare professionals changing how they treat obese patients. But make no mistake about it: part of learning how to love yourself the way you are is to gain the confidence to address the issue to improve your health—not with the idea of being rail thin or running marathons, but by becoming the best version of yourself you can be, because that’s also a part of loving yourself.

What I envision is finding the physician or healthcare professional who will be your partner in the journey toward better health. You both have the responsibility to put forth your best efforts to try to do that. In every audio I record, I always say your physician should be your partner in reaching better health. I mean just that. So when you find that doctor, do your part; keep an open mind, do what you say you’ll do, and don’t make promises you know you won’t keep.

It all comes down to one question: what are you prepared to do today?

        Dr. Chet

Reference: JAMA Online. doi:10.1001/jama.2019.2352

Respect Yourself

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I finished last week by talking about self image: you must accept your body, for better or worse, exactly where it is right now. I used the phrase that you have “to love yourself.” Along with that, you have to respect yourself as well. Maybe that’s even harder to do. Most of us aren’t able to get past the times we’ve failed in our weight loss efforts. We lost 30, 40, maybe even 100 pounds, and those pounds always seemed to find their way back. That can make us feel like we’ve lost self control.

With the loss of control comes the loss of respect. I wish I could snap my fingers and say “Stop that!” and it’s over, but it just doesn’t work that way. As you work toward loving yourself, learn to respect your prior efforts, even if they didn’t result in permanent weight loss. If you go back and examine it, you’ll find something that you learned. Chalk that up as a partial success and something you use to guide your efforts in the future if you decide to try again.

You have to think in a different way from society. There’s a lot of negativity out there and for some reason, people think they should point out that “You could stand to lose some weight—you’ll feel better.” That makes no one feel better.

There’s one place that seems to be more demotivating than just about any place else. Think on that until Thursday; I think you’ll be surprised where that is.

What are you prepared to do today?

        Dr. Chet

Improve Your Body Image

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In your mind, do you feel that thin equals healthy? Does how you think you look impact your life? Does it make you think less of yourself? Is there a bodyweight goal that you think will make your life better?

You’re not alone. Many women feel that way. So do many men, if the truth were known. Ironically, during Jane Austen’s time, the same thing was happening; the emphasis on thinness was an obsession. Did fashion play a part? Those high-waisted dresses are unflattering to all but the thinnest bodies.

Most of Jane Austen’s characters had a healthier attitude. They seemed to understand that health was not tied to a specific look or body weight; it was how you felt from head to toe regardless of a number on a scale. Vigor was important to her characters as was a positive body image.

When you think about it, what most people want is not to be satisfied about how they see themselves but how others see them. I’ve felt that way myself. You have to love yourself just the way you are first before any move toward becoming healthier can be permanent. In other words, no matter what you see when you look in the mirror, you have to love the person first. Then you can work at becoming healthier.

It doesn’t mean you shouldn’t try to lose weight if it means you’ll eat healthier. It doesn’t mean you won’t exercise, even challenging exercise, if you want to. But the purpose is to attain better health, not fit into the jeans you wore in high school. Did you ever stop to think you might actually exceed what you thought possible if you just improved your self image today? When you think better of yourself, what you eat and how you move is not a punishment. It’s moving toward a healthier life, regardless of a number on a scale.

Think about this for awhile. Can your self image stand some improvement in your mind? We’re going to continue the conversation from a completely different perspective next week.

What are you prepared to do today?

        Dr. Chet

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