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.

 

Too Many Carbs vs. Too Few

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Yesterday I talked about a Lancet study that says too many carbs are bad and can kill you—but so can too few carbs. The logical question to ask is: what timeline are we talking about? Is it 10 years or 20 years or more? Based on the results of the study, let’s compare the extremes of carbohydrate intake with the mean intake of carbohydrate for a 50-year-old person.

If you ate fewer than 30% of your calories from carbohydrates, you might live up to 29 more years compared to the 33 years a person might live if they ate 50–55% from carbohydrates, so 79 vs. 83. What are four potential years worth to you? They’re only potential years because these are just hazard ratios; it could be as little as 2.5 years or as much as 5.5 years.

On the other hand, if you ate more than 65% of your calories from carbohydrates, you might live another 32 years compared to  33 years for someone who ate 50-55% from carbohydrates. At 82, do you care about one more year?

Only you can decide what those years are worth to you, and to compound the issue, we don’t know what our health will be like when we’re that age. But there may be a way to put the odds in your favor whether you want to eat more or less food high in carbohydrate. I’ll tell you about that tomorrow.

What are you prepared to do today?

Dr. Chet

 

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

 

Huh?

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That’s exactly what I thought when I looked at my health news feed pictured above. Carbohydrates will kill you—maybe. Too many are bad. Too few are bad. It’s all referencing the same study published in Lancet Public Health. What the heck is going on? You’ve heard that beauty is in the eye of the beholder? Evidently, so are provocative headlines.

Researchers examined the mortality rate of participants in the Atherosclerosis Risk in Communities (ARIC) study. The subjects had been followed for 25 years. At the beginning of the study and periodically afterwards, they completed an abbreviated Food Frequency Questionnaire using food models to estimate serving sizes. Foods were analyzed using the Harvard food database to estimate protein, fat, and carbohydrates as well as sources of fats and protein.

What did they find? Just what the headlines said: too many or too few carbohydrates are related to an increase in death. As always, the details are found in the data. We’ll take a look in tomorrow’s Memo.

What are you prepared to do today?

Dr. Chet

 

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

 

The Simplest Solution for Joint Pain

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Every joint in your body has a joint capsule and within the capsule is a liquid called synovial fluid. It’s made by the inner lining of the capsule and provides nutrients to the joint cartilage and other structures. It also provides cushioning to the joint. Even when we stand, the fluid in the knee joint prevents bone from touching bone—unless there isn’t enough fluid in the joint capsule.

You can probably guess where this is headed: the simplest solution for reducing joint pain is to drink more water. The less water and fluids we consume, the more likely cartilage, ligaments, tendons, and other structures will become brittle. In addition, there will be less fluid in the joints, which could allow nerves to be pinched in the spine and bone-on-bone contact in the hips and knees. And that does not feel good.

Joint pain is a complicated process, and inflammation has a significant role to play. The cumulative damage that we’ve done to our joints over the course of our lives has consequences; they may not heal as well or as completely as they should. There may be no permanent solution short of surgery to repair or replace structures.

The primary goal for any type of joint pain is to reduce pain levels. Drinking more fluids cannot repair the structures of a joint, but it can help improve the fluid levels within the joints so they get more nutrients and increase the natural fluid levels. That could decrease pain levels somewhat, allowing us to move more freely.

As I said when I begin this week, sometimes the simplest solution is the correct one. Drink up!

What are you prepared to do today?

Dr. Chet