New World Record 2:01:39

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The marathon is 26.2 miles. If you’ve ever done one, you know what kind of effort it takes to just finish a marathon. For people who are better runners, qualifying for the Boston Marathon is a significant goal. It takes intense training to achieve that goal. This past weekend, a Kenyan named Eliud Kipchoge set a new world record for the marathon.

Set a world record? No. He shattered the world record by running it 1:18 faster in a time of 2:01:39. That’s an average pace of 4:38.4 per mile. For 26.2 miles! I run a half-mile loop in my neighborhood in about five minutes. To give you some perspective, he would complete over two laps in the time it takes for me to complete one.

While it’s an amazing physical achievement, what does it have to do with you and me and our health? In my opinion, a whole lot and that’s what I’m going to talk about the rest of the week. But for today, Kipchoge deserves our respect as the greatest marathoner in the world.

What are you prepared to do today?

Dr. Chet

 

Why I’ll Keep Taking My Probiotics

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One thing I try never to do is to take cheap shots at research studies. I’ve acknowledged that my expertise in the methodologies of microbiome analysis is limited. I think that these research groups did something unique in their approach to assessing the microbiome. That doesn’t prevent me from pointing out some obvious issues with the studies that could have impacted the outcomes.
 

The Problems

The first issue was the lack of diet control in either study; diets vary between people, and that could have significantly impacted the results. The foods you eat can directly impact your microbiome for hours, and what the subjects ate the days before the sampling may have skewed the results. Before the study, they used a Food Frequency Questionnaire and determined there were no unique dietary issues that could have impacted the results, but not using a diet record during the entire 28-day study is curious. For the thousands of data points they did collect, they ignored the most basic.

What shocks me is that they knew better: these are the same laboratories that have shown both foods and synthetic additives can substantially impact the microbiome. Without studying the diet of the subjects, and only eight subjects at that, you don’t know who had a diet conducive to the restoration of the microbiome after antibiotics or not.

Second, they used a novel approach. They collected samples from the digestive system using endoscopic techniques in addition to the fecal samples typically collected. Very interesting, but they also used the typical colonoscopy prep which means no food and the complete cleansing of the colon. To their credit, they did test two subjects with and without the typical pre-colonoscopy prep and found few differences. Two subjects. I don’t need to say anything more. While the prep is not going to erase all the bacteria and other microbes, it will eliminate the food supply and could impact what bacteria are growing at the time of the sampling.

Third, they gave healthy people antibiotics; that may bear no resemblance to the microbiome of someone who has a serous infection. The best we can say is that taking antibiotics when you’re not sick may not be a good idea.

Finally, I’ve read research by this group in Israel before. They’re developing a weight loss program based on their microbiome research. It may have no relationship to these studies but it does demonstrate a willingness to monetize their research results, and that always raises my suspicions.

Sure enough, the purpose of these studies was to support a patent application. It may be for the collection technique or more likely, a test to ascertain what probiotics might benefit specific groups of people while healthy or with specific conditions. While they claim no conflicts of interest in the paper, I can’t think of a bigger one than this. While there’s nothing wrong with establishing tests and treatments based on your research, the procedures need to be tested in other laboratories before rushing to market. This strikes me as premature.
 

The Bottom Line

I think these two studies illustrate where we are with microbiome research: at the very beginning. They contribute to the body of knowledge but little else. Probiotics will impact everyone differently, and they may not be desirable for everyone under every condition. But unless we get a radical change in our diet that encourages the microbiome to grow healthy and strong, taking a probiotic every day is still a good idea. My family and I, including my grandson Riley, will continue taking our probiotics because nothing in this research raises any questions about the safety or potential everyday benefit of regularly taking a probiotic supplement, preferably with a prebiotic.

What are you prepared to do today?

Dr. Chet

 

References:
1. DOI:https://doi.org/10.1016/j.cell.2018.08.041.
2. DOI:https://doi.org/10.1016/j.cell.2018.08.047.

 

New Probiotics Research Results

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The methodology used in the two studies I’m reviewing is complicated. I mentioned the endoscopic biopsies on Tuesday (and a big thanks to the people who volunteered for an endoscopy); subsequent analysis of the actual microbiome utilizes very complex techniques. I’m not an expert in those techniques so I can’t assess the results the way I normally would, but here are the results published by the authors.

The first study examined the changes in the microbiome when subjects were given either a placebo or commercially available probiotic for 28 days. The most significant finding was that the results were highly specific to the individual. That’s no surprise for one reason: no two microbiomes are the same, even in people who live in the same household. That a probiotic with 11 different bacteria would have different effects on the 14 subjects in the intervention group is no surprise. Some showed no growth of any of the strains of the probiotic, while other subjects’ tests showed strains that took up residence.

The second study examined the effects of antibiotics when taken by healthy subjects under three conditions: no intervention (seven subjects), the commercially available probiotics used in the first study (eight subjects), and a self-donated fecal transplant (six subjects). They found that the microbiome of the subjects who took the probiotics was not restored to their pre-antibiotic state; the supplemental probiotics seemed to colonize, leading the authors to suggest that they impaired the re-colonization of the original microbiome. The microbiome of the other two groups seemed to recover.

Should we avoid probiotics as a result of these studies? I’m taking mine and explain why I’ll keep taking them on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. DOI:https://doi.org/10.1016/j.cell.2018.08.041.
2. DOI:https://doi.org/10.1016/j.cell.2018.08.047.

 

Research Update on Probiotics

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Probiotics are the beneficial microbes that reside in and on our body. When a health headline suggests that taking probiotics may be hazardous to our health, that gets my attention. As a result, I spent the weekend going through two studies published in the journal Cell. That will form the basis of this week’s Memos.

The researchers used a different approach in assessing the microbiome of the subjects before and after the interventions. Typically this type of research uses fecal samples to assess changes in bacterial content. In this case, they used endoscopic procedures to sample the microbiome throughout the digestive system.

The studies had different purposes. The first placebo-controlled trial compared the change in the microbiome before and after administration of a commercially available probiotic. The second trial examined the microbiome before and after the administration of a course of antibiotics in a group of control subjects, a group given probiotics, and a group given a fecal transplant collected before the study began. We’ll cover the results on Thursday.

What are you prepared to do today?

Dr. Chet
References:
1. DOI:https://doi.org/10.1016/j.cell.2018.08.041.
2. DOI:https://doi.org/10.1016/j.cell.2018.08.047.

 

Let Me Save You Some Time

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Did you ever click on a photo that says, “This doctor gives you three foods you should never eat”? Evidently many of you do because it’s another question I get a lot. In this case, it takes you to a page that’s called an advertorial, a combination of a news release and an advertisement. In this case, you click on another link and a video by Dr. Steven Gundry starts.

Gundry is a former cardiologist turned health guru and a self-declared expert in digestive physiology; his discoveries “will change your life!” He has determined that plant-based lectins, a protein found in fruits and vegetables, are the cause of leaky gut syndrome. He has the solution: stop eating foods that contain lectin. Those top three? Let me save you some time, unlike the hour-long video which droned on and on, because of course, the magic foods weren’t named until the end. Those foods are wheat, which contains gluten, tomatoes, and eggplant. Actually, most vegetables and fruits contain some lectins so the list is extensive. The alternative solution? Buy his latest product, which will fix you up. You’ll lose weight, have no more gas or discomfort, your joints will feel better, and on and on.

Like all of these types of videos, there are more claims than science, and the supportive science is hand picked to support his position. He has picked a position, supported it under the guise of his expertise as a physician, and has written books and manufactured supplements that are the answer to just about every health issue you have. He has become yet another physician turned run-of-the-mill health guru who pushes pills. He should have stuck to what he knew, because by all accounts, he was an excellent cardio-thoracic surgeon.

What are you prepared to do today?

Dr. Chet

Why You Need Prebiotics

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As kids go back to school, let’s start the week after Labor Day by answering some questions. You know about probiotics, the beneficial microbes that live in and on our bodies and compose our microbiome, but one question that seems to be on a lot of people’s minds is prebiotics: why do you need them?

Prebiotics are substances, typically found in plant-based foods, that can be used as food for probiotics. Two well-known types of prebiotics are plant fibers such as inulin and fructooligosaccharides, or FOS for short. There are undoubtedly many more types, but research in this area is really just getting started.

No matter. If you want to make sure you’re feeding your microbiome, eat your vegetables, fruits, and beans on a regular basis. You don’t have to worry about what the prebiotics are called; they’re in there. Still working on your diet? Take a probiotic with FOS. To back up the fruit sugars, take some soluble fiber such as inulin as well. That’s the way to keep your microbiome healthier and doing its job for your health.

What are you prepared to do today?

Dr. Chet
Reference: Curr Opin Biotechnol. 2016 Feb; 37: 1–7. doi: 10.1016/j.copbio.2015.09.001.

 

Be Wary of What You Read

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Did you think about Thursday’s Memo? Especially if you’ve gotten into heated discussions about health on social media? I feel bad for anyone who was a victim of bots and trolls. I generally get the aftermath of a discussion—people who read what I write about vaccinations or artificial sweeteners or some health issue and think I don’t know what I’m talking about because they’ve read something different online. If they’ve been victims of this intentional misinformation, I understand how they’ve been duped.

But don’t think that every bot or troll took the anti-vaxxer position. In order to maximize the argument, they sent out responses supporting vaccination as well. Once an argument began, bots and trolls continued to feed the fire on both sides.

There are two questions that are obvious. Who would do this? And why?

Why Health Information Is Weaponized

Even writing that subhead seems surreal. Who would weaponize health information? Here’s who: people who want to negatively impact our health. Based on the analysis by the researchers, a known Russian troll account from the Internet Research Agency was a major player in this effort to spread vaccine fights. They’re backed by the Russian government; that means they were using disinformation about health as a weapon to create arguments, and more than that, create doubt.

It really doesn’t take much to do that. We are already suspicious of the pharmaceutical industry, and it’s well deserved based on some of their behavior. But that doesn’t mean that they’re in the business of selling worthless vaccinations as has been suggested by many tweets, posts, and websites.

Harming Our Health

What would be the end game for Russian trolls? The goal of creating doubt and suspicion about vaccinations or any issue related to health is sowing discord among readers, but ultimately they want to harm our health. Think about how many people won’t vaccinate their children because they don’t believe in vaccinations for one reason or another. If that proceeds to enough parents, there will be outbreaks of diseases that might have been prevented with vaccinations. It’s already happening.

Think. What if the outbreaks that are occurring in various communities are just the beginning? You can find posts that seem to carefully explain that this is normal and not related to the lack of vaccinations. Now think about it as a post from someone intent on harming the health of the U.S. and other wealthy nations. Puts things in a different perspective, doesn’t it?

The Bottom Line

As someone who writes and speaks about health, I’m deeply troubled by health misinformation and how easily it can be spread. You have to be a wary consumer of health information in these days of social media and the Internet. If what you read or what you hear sounds too good to be true or feeds into some conspiracy theory, keep looking.

Nothing in health is simple, but let me go a step farther. I’ll do my part by checking the research to help keep you informed, and I’ll never push you in a direction I don’t believe in. That’s why I’ll never sell foods or dietary supplements on DrChet.com: I want you to know for sure that what I’m telling you is based on my best reading of science and research, not a ploy to increase my income.

What are you prepared to do today?

Dr. Chet
Reference: Am J Public Health. August 23, 2018: e1–e7. doi:10.2105/AJPH.2018.304567.

 

Of Bots and Trolls

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Have you heard any of these about vaccinations on social media or the Internet?

“Big Pharma only wants vaccine profits.”

“Natural immunity is better.”

“Vaccines cause autism.”

If you’ve read those articles, they seem to be full of truth about vaccinations, don’t they? Did you ever get into a conversation with someone who posted these types of articles? How did it go—especially if you disagreed with them?

Would you be surprised to learn it might not even have been a human doing the answering? It may have been bots or if actual humans, trolls.

Bots are social media accounts that automate content promotion. Trolls are people who misrepresent their identity and post inflammatory remarks with the express purpose of creating discord. The idea is to amplify the arguments to fever pitch so people end up angry at each other. They draw in friends and relatives to get them at each other’s throats with false narratives about health. You could use the same approach with cancer treatment or cholesterol levels.

Researchers at the George Washington University examined Twitter posts between July 2014 and September 2017 and did a computer search of close to two million tweets about vaccines and vaccinations. The most stunning revelation, at least to me, was that 9.3% of all tweets were sent by accounts that could not be verified as automated bots or trolls, yet exhibited malicious behavior by spreading misinformation about vaccines.

We’ll continue this on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Am J Public Health. August 23, 2018: e1–e7. doi:10.2105/AJPH.2018.304567.

 

Are Prenatal Vaccinations Safe?

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Vaccinations for infants and children always inspire debate. Sometimes, fierce debate. Today I’m going to look at a study that examined whether it’s safe for pregnant women to get the tetanus, diphtheria, and acellular pertussis (Tdap) vaccination or if it increases the risk of autism spectrum disorder (ASD) in their babies.

Researchers examined the records of over 81,000 mothers and offspring who were continuously in the care of the Kaiser Permanente Southern California Hospitals. They determined which pregnant women were vaccinated with Tdap. Those women and their children along with the women who were not vaccinated with Tdap and their children were monitored for four to seven years.

The rate of ASD diagnosis was 1.4% of the total subjects. The rate for the children was 3.78 out 1,000 per year for those who were exposed to the vaccination and 4.05 per 1,000 per year for those who were not. In other words, there was no impact on the children of the Tdap vaccination during pregnancy. The researchers concluded that the use of Tdap vaccinations was supported during pregnancy.

But my focus isn’t really on the use of vaccinations; you can look at the data and decide for yourself. It’s on the controversy around vaccinations.

Debate is good, especially as it relates to health, and nothing inspires more debate than vaccinations. But are all debates a real discussion of the issues or are they an attempt to create discord? A recent study may give us some insight. More on that Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: PEDIATRICS 14(3) September 2018:e20180120

 

More Carbs? Better Choices

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Have you decided whether the extra years you may get by eating too many or too few carbohydrates are worth the effort? How about if you don’t have to make that choice at all? What if you could eat more or fewer carbs and not have to worry about it? Here are the other significant results of the study we’ve looked at this week.

When the researchers considered what people would eat to replace carbohydrates if they chose a low-carb diet, they assumed it would be animal protein such as beef, pork, lamb, and cheese as well as chicken with and without the skin. Likewise when they considered the extra carbs if people ate over 60% carbohydrates, they assumed people would choose more refined carbohydrates. They concluded correctly the additional refined carbs would contribute to metabolic disorders such as type 2 diabetes. They suggested that, based on other studies, if a low-carbohydrate diet used plant-based sources of protein, fats, and oils, there was no increase in mortality on a low-carb diet.

I’ll take it a step further and it’s something you’ve heard before: eat better. It doesn’t matter whether you want to eat a high-carbohydrate or a low-carbohydrate diet. That’s your choice. You just have to eat your vegetables and fruits first, and I’m not talking about just peas, corn, and bananas; there are hundreds of other choices to explore. You can increase the carbs in your diet without hurting your health as long as you make the right choices. Lead with vegetables and you’ll get the fiber and phytonutrients your body needs.

High carb or low carb, it all comes down to eating better. The key to living longer? Eat less. Eat better. Move more.

What are you prepared to do today?

Dr. Chet

 

Reference: http://dx.doi.org/10.1016/ S2468-2667(18)30135-X.