Redefining the Risks of Extra Weight

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Studies show that 70% of the population is overweight; by definition, that means that their body mass index (BMI) is greater than 25 or more. But are all overweight people at the same risk? Just because you’re overweight, are you automatically at greater risk for cardiovascular disease and type 2 diabetes?

That’s what a group of researchers in the U.S. attempted to find out. They had the benefit of access to the U.K. Biobank, an independently funded databank that has collected biometric data on over 500,000 subjects in the U.K. and contains accurate measures of BMI as well as the waist-hip ratio (WHR) on all subjects. They also had one more thing: the genetic information on a large sub-group of subjects. They identified 48 genes that seemed to be associated with WHR and used a unique approach to tease out the effects of WHR from BMI. I’ll cover that the rest of the week.

In the meantime, check out your BMI and measure your waist and hip to calculate your WHR. Measure your waist about an inch below your belly-button and your hips at the widest point; divide waist by hips and you have your ratio.

What are you prepared to do today?

Dr. Chet

 

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

 

Should You Exercise During Pregnancy?

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While everyone wants a healthy baby, many women would like to control their weight gain and avoid gestational diabetes during pregnancy. That’s why I noticed one more article in the Medicine and Science in Sports and Exercise issue I read; in addition, I’ve recording the updated Healthy Babies: From Conception to Breastfeeding audio and want to include the latest research.

Researchers examined data from three studies on the effects of exercise on pregnant women. The first study included land-based exercises, the second was water-based exercises, and the third was a combination. They were compared with a control group of pregnant women who didn’t exercise. Here’s what researchers discovered:

  • Women who exercise in any way gained less weight; while it’s necessary to gain some weight while you grow a little person inside you, exercise helped women keep their weight from exceeding desirable levels.
  • Women who performed water exercises or a combination of water and land exercise had fewer cases of gestational diabetes. The authors theorized that because of the buoyancy factor of the water, women perceived water exercise as being less strenuous on the back and other joints and were able to exercise more.

The message is clear, ladies: it’s important to keep moving while you’re pregnant, under the guidance of your physician, of course. And it seems you can get even more benefits if you can work out in a pool. It’s a great investment in yourself and your life with your little one. And men, it wouldn’t hurt you to get in the pool, too—now that I have a two-year-old grandson, I have a new respect for the physical demands of fatherhood and you need to be ready.

What are you prepared to do today?

Dr. Chet

 

Reference: MSSE. DOI: 10.1249/MSS.0000000000001234

 

Can Vegetarian Protein Help You Build Muscle?

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People often ask me which is the best type of protein to build muscle when weight training. The reason for the question is bodybuilder and weight-training websites that condemn vegetarian protein as not good enough to build muscle. In the same issue of Medicine and Science in Sport and Exercise as the paper from Tuesday, a research study examined that question.

Researchers divided 54 men into three groups. One group got a vegetarian protein blend of soy and dairy, a second group got dairy-only protein, while the third received a maltodextrin placebo. They all performed the same weight training program for 12 weeks. The researchers then tested their strength as well as evidence of muscle growth after taking muscle biopsies.

All participants gained strength and muscle. Those who took the protein supplements gained slightly more muscle than the placebo group, but there were no differences in muscle gains between the soy-dairy blend and the whey-protein group.

This contributes to the body of research showing that it’s the protein that makes the difference, not whether it’s a vegetable or animal source of the protein. Use whichever fits your lifestyle better, but it’s doing the lifting that makes the real difference.

What are you prepared to do today?

Dr. Chet

 

Reference: MSSE. 2017 Feb 13. DOI: 10.1249/MSS.0000000000001224

 

Does Exercise Reduce Libido?

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A recent health headline said that strenuous exercise reduces a man’s libido. I would propose that nothing gets men’s attention—and probably quite a few women—more than sex. Should you be worried?

Researchers conducted an online survey targeting men that included questions about demographics, exercise habits, and sexual libido. What they found was that as exercise training increased, male libido decreased. The amount of exercise per week, the intensity of the exercise, and the number of years in serious training all seemed to play a factor in libido levels. The more serious their training for longer periods of time, the more affect on their libido.

Here’s the thing: this really applies only to serious marathoners or triathletes that spend over an hour training every day. What should have made headlines is that if men exercise at low or moderate levels, their libido is normal. What they didn’t even hint at was this: moderate exercise can increase energy and the all-important blood flow as well as making men and women feel better about themselves, all positives when we’re talking about libido. There’s nothing sexy about a couch potato.

This headline was based on just a survey with no hormonal measures, but it seems that a brisk walk or jog an hour a day is about right. It all comes down to this:

What are you prepared to do today?

Dr. Chet
Reference: MSSE. 2017 Feb 13. doi: 10.1249/MSS.0000000000001235

Echinacea and the Immune System

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As I write this, there are 1,098 citations in the PubMed database for echinacea. I looked at every title to see if it was relevant to answering one question: should people who have an autoimmune disease use echinacea for allergies and colds? I examined at least 100 abstracts and downloaded five papers that seemed to be significant. Here’s what I found.

The research on echinacea is a mess. There’s no consistency in the preparations used in research, the subjects included in the studies, the outcome variables that were examined, or the combination of herbs, vitamins, or minerals used in the preparations with echinacea. That’s just to find out if echinacea has any effect on catching or treating a cold. Beyond that outcome, the research is even less clear.

I found two studies that give some perspective on whether echinacea is safe for anyone to use including those who have an autoimmune disease. The first paper is a case study on a patient who suffered a breakdown in the myelin sheath after taking an herbal preparation (1). The paper reviewed all similar cases of echinacea causing similar symptoms. Based on their conclusions, boosting the immune system with echinacea could have negative effects.

There are several problems with this case study and the conclusions the authors made. While they assigned blame to echinacea, none of the subjects used echinacea alone nor were they administered the same way. Some were given orally while two others were injections. They did not examine any measures of immune function in the patients. They did not test for metabolites of echinacea nor any other herb in the blood of the subjects. They deduced that echinacea had to be to blame because of its reputation as an immune booster. One more thing: with the millions of uses of echinacea every day around the world, there were just four cases in 16 years. You read that correctly: four in 16 years. Those are pretty good odds.

In another paper, researchers examined the safety of oral preparations of echinacea (2). This was an old-school approach: instead of selecting research papers to include in a meta-analysis, they examined all the pertinent research one article at a time. They used their knowledge of how drugs are metabolized by the body, how they interact with other medications, and many other indications related to the safety of medications including herbals. They concluded that echinacea does not interact with medications to any degree. While it may change how the medication is metabolized, echinacea doesn’t change how effective the medication is.

More important, they concluded that there’s no indication in the science that echinacea is harmful to those with autoimmune diseases. They explain the reasons why physicians have believed echinacea could have consequences, but there was no evidence it was harmful. There was also no time restriction for the use of echinacea. If you have an autoimmune disease, I urge you to download and read the second reference for yourself. It’s open access and while it’s tough reading, it’s the best resource I’ve found on the issue.

 

The Bottom Line

If you have an autoimmune disease, you must check with your physician before using echinacea; he or she knows the specifics of your condition. Based on my review of the research, there’s no reason you cannot use echinacea to help your immune system when it’s under attack from a virus or allergens for a few days. But that’s not my call to make; there’s always the possibility of an abnormal response or of an allergic reaction to the plant material itself. It’s something you need to talk with your healthcare professional about, but it should be a discussion, not a lecture.

I know you want clear answers, but that’s just not completely possible in this case. What you have now is information with which to make an informed decision.

What are you prepared to do today?

Dr. Chet
References:
1. Balkan Med J 2016;33:366-9.
2. Planta Med 2016; 82: 17–31.

 

Immune Boost 1-2-3 Cautions

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Someone recently asked an excellent question: “Is there any risk in taking higher amounts of echinacea?” I’ll extend that to include vitamin C, garlic, and probiotics. The answer is possibly. I’m not hedging, but it’s complicated. Let me give you some examples.

One factor that can apply to any supplement is allergies. Echinacea and garlic are plants, and you may be allergic to one of the components of the plant. Instead of reducing your allergic response, it may heighten the response, causing the watery eyes and runny nose you’re trying to avoid. There’s no way to know for sure other than trial and error. If something makes you feel worse, it goes without question that you’ll stop it immediately.

Another potential issue is your genetics; you may process a phytochemical from these plants faster or slower than typical. That means it could be metabolized out of your system before it really has a positive effect or it could take longer to metabolize and stay in your system longer. There are no genetic tests for how you’ll react to any supplement—it’s trial and error.

One other aspect that’s important is whether you take medications. No surprise that there’s incomplete research on the interaction of every plant with every medication, so there’s no way to know how an herb or nutrient will interact with your meds. Garlic may reduce the coagulation of your blood; if you’re on blood thinners, you may not be able to take garlic because it could thin your blood too much. Or you might be able to take it because of your genetics and how you metabolize it. See how complicated it gets?

What you should know is that most people will not have a problem using the 1-2-3 immune boost. If you do, do what any reasonable person would do and stop taking it. On Saturday, I’ll cover the issue of using echinacea if you have an autoimmune disease.

What are you prepared to do today?

Dr. Chet

 

Protect Yourself Before You Travel

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Paula’s cousin recently visited friends in Arizona, and after she flew home, she got a fever with all the trimmings of the flu. After last week’s posts on boosting the immune system to deal with colds and allergies, there’s a little more you need to know.

Spring break is right around the corner and if you’re traveling, you need to prepare for it. It’s especially true if you’re going to foreign countries but any time you travel, you should do one more thing besides use the 1-2-3 immune boost approach I gave you last week: take a probiotic supplement with prebiotics every day for a week before you go and every day you’re there.

Your immune system starts in the gut; if your gut is healthy, your immune system will be stronger. Probiotics are the good microbes that help us digest food and do thousands of other things to help our overall health. Prebiotics are the fiber and sugar that feed these bacteria. Adding a probiotic to the 1-2-3 regimen, beginning a week before you travel, will help when you eat foods you don’t normally eat and are exposed to viruses and bacteria that are not in your everyday environment.

After all, the idea is to relax and renew, not be forced to the sidelines.

What are you prepared to do today?

Dr. Chet

 

Immune Boost 1-2-3: Vitamin C

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The third part of our immune system boost is vitamin C. Also known as ascorbic acid, it’s best known as an antioxidant. From the research of Linus Pauling until today, vitamin C has been researched extensively. Even though vitamin C hasn’t been proven to prevent a cold, it does seem to reduce the symptoms of a cold. That may be the result of its antioxidant capacity to reduce inflammation.

When the body is exposed to viruses or allergens, the immune response is triggered. That’s desirable, of course, but what we don’t like are the symptoms associated with the response such a watery eyes, runny nose, congestion, and on and on. While the exact mechanism is unknown, what may be happening is that vitamin C may be clearing up the free radicals on immune response cells, thereby allowing them to function better. No one knows but it makes sense.

Take 250–500 mg three times a day. Some people increase their C to 10 times that amount, but my strategy is always to take the lowest amount to get the result I want.

CGE123Let’s summarize our immune boost 1-2-3:

250–500 mg vitamin C; usually 1 tablet
600 mg garlic; usually 2 tablets
500 mg echinacea; usually 3 tablets

Just remember C-G-E-1-2-3; check the label to make sure you have the right strength. Take this combo three times a day until the symptoms are resolved. Whether a virus or seasonal allergies, I’ve found this works best. Of course, genetics may make one immune booster more effective for some people; that’s where trial and error come in.

What are you prepared to do today?

Dr. Chet

 

Immune Boost 1-2-3: Garlic

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The second part of our immune boost supplements is garlic. Garlic has been noted to have beneficial properties for over 5,000 years. Garlic thins the blood, thereby benefiting blood pressure, and helps lower cholesterol. Garlic does many things, but what benefits our immunity is its ability to boost the immune system while reducing inflammation.

There is little question that garlic helps the immune system. It’s been used as a dietary treatment to help the immune system recover from chemotherapy; it’s also been used in supplement form to help the immune system get and stay stronger. That’s an obvious way it helps with viruses and allergies, but it also acts as an anti-inflammatory. It’s important to remember that inflammation occurs whenever our body is under attack—not broken-leg inflammation but the release of negative hormones. Garlic helps reduce that type of inflammation.

Just as with echinacea, it’s important to begin as soon as the first tickle occurs. The quantity would be 600 mg taken three times a day. That gets our immune system starting to work better, but there’s one more thing we need. I’ll cover that on Saturday.

What are you prepared to do today?

Dr. Chet

 

Immune Boost 1-2-3: Echinacea

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The cold and flu season is still around. The seasonal allergy season is right around the corner and may have started depending on where you live. When you feel that first tickle in the back of your throat, that first nasally sensation, that’s when you have to take action. That’s what we do in my house, and that’s what I’m going to cover this week.

It begins with echinacea. The research on echinacea is equivocal when it comes to treating colds, but when it comes to boosting the immune system at the beginning of immune challenges, the research supports its use. There are three key factors.

  • Echinacea must be started at the first hint of a symptom, as I suggested above.
  • The dose must be high enough to stimulate the immune system; I recommend 500 mg of echinacea derived from both the root and aerial parts three times per day.
  • Echinacea works best for those with a compromised immune system. Even the healthiest person will catch a cold or have seasonal allergies, but if you have a weak immune system to begin with, or it’s been weakened by illness or stress, echinacea will be even more effective.

That’s where you begin. There are two more to go coming the rest of this week.

What are you prepared to do today?

Dr. Chet
Reference: Adv Ther. 2015 Mar;32(3):187-200.