When and Who: Spotting Fake Health News

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Let’s continue our look at how to check health news that you aren’t sure is real or fake. I hope you’ve had a chance to read the article by Stephen Hedley; if not, click the reference below to see what he taught his fifth grade class. One of my readers said he passed the article along to his niece, and I think that’s a great idea. Our kids are living in a world of fake news, and anything we can do to help them learn to spot it will make them savvier citizens and consumers, but as Mr. Hedley warned, prepare to be fact-checked.

Let’s continue with questions three and four:

3. When was the news story published?
That seems simple enough but many fake health articles don’t have a date. In one article I recently checked, the author published it as though it were her own. The problem was that it just seemed way too familiar. Way at the bottom, it was something she had found on the Internet and reposted. I recognized it from 15 years ago. Dates also apply to research citations. Research should stand the test of time but if an author uses a single study from 20 years ago on a topic such as supplements or a disease, that’s a warning they may be picking research to suit the message.

4. This one’s a big deal: what is the author’s expertise and background with the subject?
That’s a big problem on the Internet. People lose weight or find a diet that “heals” their irritable bowel disease, they start a blog, and are now “experts.” Even if they do seem to have some credentials, are they talking about something within their area of expertise? Do they have the training in statistics and research methods to understand the research they’re using? I may be getting beyond what you can do, but you can check someone’s education, training, and resume online in places such as Linked-In. Be suspicious if you find nothing there or elsewhere.

One thing: you don’t have to do these in the order that I’ve presented them. Sometimes, it’s easier to check the date something was posted or do a quick search on the author. We’ll finish it up on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2ozc2kC

 

Spotting Fake Health News

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Would you like to know whether a health news story is fake? Should you be worried and stop eating the deadly food they’ve identified? On the other hand, should you be excited? You know, if you do this one thing, you can lose your belly fat, or this exotic fruit prevents Alzheimer’s disease!

This week I’m going to adapt what a teacher taught his fifth graders on how to spot fake news. He developed seven questions that his students should answer, but I think I can do it in six. He tells them that it won’t guarantee something is true, but it can eliminate the “fakiest” news. I’ll give you two questions per day and explain how to look for answers with the same goal in mind.

1. Can you verify what’s being said from multiple sources?
Fake health news is often passed from one fake website to another, so it’s a little more complicated. Check the bottom of the article to see if this was an author from the website posting the information or whether it was taken from somewhere else. Keep drilling down until you can find the source. That allows you to see whether the originator may be credible or not. Another way is to check it on Snopes or some other fact-checking website.

2. Is the source of the information credible?
Every legitimate article related to health should have references. The references may be scientific journals or press releases from journals; yes, there are fake journals, but they’re rare. Fake press releases exist, but you can check their source as well. The important point is that you can find and read the original sources. Sites such as WebMD and PubMed are almost always reliable, but check whether it’s a research report or just someone’s opinion. Government sites such as the National Institutes of Health publish legitimate health stories as do major organizations such as the American Heart Association.

That’s enough to get started. More on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2ozc2kC

 

Sleep More and Quit Eating Sooner

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Sleep more, eat the same, and lose weight. Seriously? That’s what researchers are going to try to find out. At this point, there’s little question that for most people, lack of sleep messes with the circadian rhythms and negatively impacts glucose metabolism.

But a different research team is looking at another element: how long you eat every day can impact your ability to lose weight. Researchers have done a pilot study looking at eating intervals: the time you eat your first meal until you stop eating for the day. For people devoted to their evening snacks, it can be 16 to 18 hours per day.

In the pilot study, subjects restricted their eating to a period of 10 to 12 hours per day. Over 16 weeks, subjects lost an average of seven pounds. One more thing: they didn’t have to restrict their eating. They ate what they wanted, just in a shorter time interval every day.

This was a pilot study using an app that the researchers developed; they’re recruiting 10,000 subjects to see if the idea will work on a greater scale while collecting additional data. Such as what? Well, maybe you actually eat fewer calories when you eat in smaller time frame even if you eat the same foods. By the way, if you want to be a subject, check out www.mycircadianclock.org to see if you qualify.

Back to the sleep portion. The part that interests me the most is the messed up carbohydrate metabolism by eating when your clock says it’s time to sleep. Getting more sleep is not easy these days, but it just might be worth it.

We’ve all heard people say they cannot lose weight no matter what they do. Well, maybe getting a little more sleep and eating over fewer hours may help. Of course, if you’re a diabetic or hypoglycemic, talk with your doctor. But here’s something simple and cheap you could do: sleep more and eat the same over fewer hours. Will you lose weight? We don’t know, but it’s worth a try.

What are you prepared to do today?

Dr. Chet

 

Reference: doi:10.1001/jama.2017.0653

 

Can You Lose Weight by Sleeping More?

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That doesn’t seem to make any sense; you’re not going to be as active because you’re sleeping, so how can that help you lose weight? Well, if you’re sleeping you’re not eating, but there must be more to it than that. Let’s go back to the SCN, the pacemaker of rhythms.

Researchers have found that cortisol and melatonin aren’t the only hormones and organs tied to the light-dark cycles. Hundreds if not thousands of genes also respond to light-dark cycles. Glucose metabolism, the processing of sugars, is tied to these cycles; we seem to process sugars better during the light hours than at night. For some reason, eating carbohydrates in the dark hours results in slow processing of carbohydrates. Typically carbohydrate metabolism is a fairly high-energy process using 15 to 20% of the calories in digestion and absorption, but eating in the evening seems to decrease metabolism enough that it could theoretically result in gaining 12.5 pounds in a year.

Theory and life are two different things. Research on rodents shows that if researchers flip their cycle by feeding them in opposition to their rhythms—they’re day-sleepers, so they’re the opposite of us—they gain more weight when fed the same diet than mice fed during their normal cycle.

What about humans? Is there a solution? Skinny rats are fine, but what’s in it for us? We’ll wrap this up on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: doi:10.1001/jama.2017.0653

 

Could Your Rhythms Be Keeping You Fat?

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You eat well and you exercise, but you still can’t lose any weight. What if the answer was in the natural rhythms of your body? I’m not talking about dance moves; I’m talking about circadian rhythms, the natural 24-hour cycles based on day and night. Since we can pretty much control the amount of light indoors 24-hours per day, our natural rhythms can be in disarray.

I’ve talked about the pacemaker of the heart several times over the years. It turns out that there’s an area in the brain called the superchiasmatic nucleus (SCN) that acts as the central pacemaker for circadian rhythms. It’s found in the hypothalamus and for a small group of cells, it seems to do a lot.

In the mornings in response to daylight, the SCN sends signals to raise body temperature and produce hormones such as cortisol. Time to get up! The SCN also responds to light by delaying the release of other hormones such as melatonin that help us sleep. When it gets dark the eyes signal the SCN that it’s night. Melatonin levels rise in the evening and stay elevated throughout the night, promoting sleep.

What does this have to do with being fat and not being able to lose weight? Now that we know how this pacemaker works, it turns out it could be an important factor. I’ll cover recent research the rest of the week.

What are you prepared to do today?

Dr. Chet

 

Reference: www.sleepfoundation.org.

 

The Bottom Line on Folic Acid

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Based on the studies covered in the Tuesday and Thursday posts, you may be confused about what you should do when it comes to folic acid, especially if you’re pregnant or thinking about getting pregnant. I read a lot of research to come up with this analysis and here’s what I found.

There are three areas of concern:

  • Too much folic acid could mask a B12 deficiency during pregnancy; there’s no research to support that. It can happen in the elderly who have problems absorbing B12, but doesn’t seem to happen in women of child-bearing age.
  • Excess blood folic acid may be related to tumor acceleration; there’s some rodent research to suggest some relationship but nothing in humans. They have also cited research on folic acid supplementation and prostate cancer. I examined numerous studies and there’s no clear relationship; some show some type of relationship, others show a reduction in risk.
  • There may be some effect on the children of mothers who get too much folic acid; there’s one study that suggest an increase in asthma in offspring but most studies seem to demonstrate a protective effect.

Where does that leave us? Most of the studies are not done very well when it comes to folate and folic acid intake. The folic acid intake is dependent on Food Frequency Questionnaires, which have severe limitations. The methodology for determining blood folic acid levels vary from study to study. The associations between intake and problems are weak at best.

But when it comes to pregnancy, there may be a solution. In a recent study, researchers examined the relationship between neural tube defects and the red blood cell folate level. As the estimated levels increased, the risk of neural tube defects decreased. The level which seemed to provide the lowest risk of neural tube defects was greater than 1,000 nmol/L. This was a single study and used interesting statistical techniques, but it seemed to provide for more precise folic acid supplementation.

 

The Bottom Line

The benefits of folic acid on neural tube defects have been impressive, and the concern over excess supplementation may be legitimate or not. It could be that women process folic acid too well or not well enough and that could impact dietary and supplementation intake. Research on the MTHFR polymorphisms continue with no recommendation for its diagnostic use at this time.

If you’re concerned, talk with your physician about getting a blood folate test. Levels of RBC folate levels can be estimated from that result. One key point: the test would be most beneficial before conception because neural tube defects happen in the first month of pregnancy. Still it’s one way to be more cautious in spite of the limited risk.

Let me close by saying that in all the research I did, what I could not find is any association between reasonable folic acid intake and miscarriages or other issues during pregnancy. Folic acid appears to be safe and protective and should be a part of prenatal nutrition.

If you want to know more about having the healthiest baby you can, check out Healthy Babies: From Conception to Breastfeeding. It’s available as a CD or MP3 download.

What are you prepared to do today?

Dr. Chet

 

Reference: BMJ 2014;349:g4554 doi: 10.1136/bmj.g4554

 

Prenatal Nutrition: More on Folic Acid

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The second study on folic acid supplementation before pregnancy examined similar blood and red blood cell folic acid levels at different times during pregnancy and in cord blood (1). The difference was that half of the subjects were randomly provided with 400 mcg folic acid to take during their second and third trimesters. As you would expect, the women who supplemented their diets had higher levels of all variables than controls.

The difference between the two studies I’ve examined was that even with supplementation, the unmetabolized folic acid levels were virtually undetectable in cord blood in this study. Moreover, the red blood cell levels of folic acid were considered to be in the normal range in spite of the supplementation.

Two studies. One suggests that prenatal supplements should consider reducing the amounts, while the other suggests that there’s no effect in the most common amount found in supplements. I’ll make sense of this in Saturday’s post.

What are you prepared to do today?

Dr. Chet

 

Reference: J Nutr 2016;146:494–500.

 

Prenatal Nutrition: Should You Worry About Folic Acid?

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I’ve been working on updating the research for the second edition of the Healthy Babies CD, and that includes nutrients such as probiotics, vitamin D, and one of the most important nutrients, folic acid. Since folic acid was added to cereal grains in 1998, there have been significant reductions in neural tube defects, but folic acid is not without controversy: the concern is getting too much folic acid from foods and supplements. There have been some studies suggesting a relationship between excess folic acid and an increased risk of some diseases. This week, I’m going to cover three studies that examine folic acid before and during pregnancy to help clarify things.

In a study published in 2015, researchers examined the levels of folic acid and unmetabolized folic acid (UFA) in the mother’s blood early in the pregnancy, at delivery, and in the umbilical cord blood. They found that folic acid and red blood cell (RBC) folic acid did not significantly change. There were differences between those who did and did not supplement with folic acid. They did find UFA in the blood and cord blood. The researchers felt that the RBC folic acid blood levels and the UFA were too high and that folic acid supplements should be changed to reflect the high readings.

Are their conclusions warranted? Let’s take a look at another study that examined the same variables the following year. I’ll let you know what a difference a year makes on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Am J Clin Nutr 2015;102:848–57.

 

BMI, WHR, and Lifestyle

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The study we’ve been examining is interesting on so many levels: large numbers of subjects; new statistical techniques due in large part to progress in computing capabilities; genetic analysis that allows for rapid analysis and identification of polymorphisms. It’s all very exciting. You’re probably anticipating a “but” coming and you’d be correct.

This study demonstrated that when using genetic information, WHR is a risk for CVD and type 2 diabetes even with a normal BMI. But there’s still at least two factors to consider that are dependent on each other.

First, just because someone has a mutated gene or genes, it doesn’t mean it will ever express itself, i.e., turn on. More than likely, the second factor has a role to play and that’s the lifestyle of the individual. Some studies refer to it as environment, but they’re intertwined. Where you live may limit or provide you with easy access to healthier foods. It may be easier to exercise in the suburbs than in a large city, or just the opposite given the park systems in different areas of the countries.

Then there’s the home environment: what foods you ate growing up and what your diet is now. All these can impact whether some genes may be expressed. Others may express themselves only when you get to a specific weight or fat intake. The variables are too numerous to consider.

I’m not attempting to confuse the issue. I just want you to know that while this study provides insight that we didn’t have before, you don’t have to be overly concerned. If you keep to a normal BMI and WHR, less than 0.9 for men and less than 0.8 for women, your risk for CVD and type 2 diabetes will not be high.

When all is said and done, it still comes down to three things. Eat less. Eat better. Move more.

What are you prepared to do today?

Dr. Chet

 

Reference: JAMA. 2017;317(6):626-634.

 

Waist-Hip Ratio vs. BMI

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In Tuesday’s message, I said researchers used a unique approach to answering the question of whether waist-hip ratio (WHR) is associated with cardiovascular disease and type 2 diabetes regardless of BMI. They found 48 genes which were associated WHR, a unique approach using the genetic information with Mendelian randomization of epidemiological data. If that isn’t a brain-full, I don’t know what is. Let me see if I can break it down for you.

As I’ve said many times before, epidemiological data cannot show cause and effect; they’re just observations. By using the genetic information related to WHR, researchers can analyze the data by statistically removing the effect of BMI. Because the genetic traits follow some randomization based on Mendel’s genetic work, if the WHR is still associated with the increased risks of disease, that means that where you carry your body fat is important, whether your BMI says you’re overweight or not.

They found that WHR is an independent risk factor for CVD and type 2 diabetes, confirming that the location of your body fat is important regardless of your BMI. That may be why people with a high BMI but low WHR have normal blood pressure and cholesterol levels while others with a normal BMI but a high WHR may have high numbers.

What are you prepared to do today?

Dr. Chet

 

Reference: JAMA. 2017;317(6):626-634.