Tag Archive for: nutrition

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

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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

The Bottom Line on Preschoolers, Probiotics, and Gastroenteritis

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“These studies are likely to have significant impact towards eliminating use of medications that don't seem to work.”

That’s a quote from a physician interviewed by NPR who wrote a commentary accompanying the two research papers on probiotic use for gastroenteritis or GE (1). I think it perfectly illustrates the fallacy of the pharmaceutical model of research on nutrition and its impact on health:

Nutrients are not medications.

They may come in pill form, they can be administered like medications, but they’re nutrients nonetheless.
Questions About the Studies
The . . .

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Did Probiotics Help Preschoolers with Gastroenteritis?

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The use of probiotics to stop diarrhea and vomiting for preschoolers with gastroenteritis (GE) was studied in two major studies published in the New England Journal of Medicine. In the U.S. study, 55 of the 468 subjects who got the probiotics had scores of nine or greater on the scale while 60 of 475 in the placebo group has scores of nine or greater for the two weeks after the study began. This was a 20-point scale and the higher the score, the worse the GE symptoms. No significant differences.

In the Canadian study, 108 of the 414 subjects in the probiotics group and 102 of the 413 subjects in the placebo group had scores of nine or greater for the two weeks after the study began. Again no significant differences were found.

This led both research groups to conclude that the probiotics used in the studies were ineffective in preventing negative GE outcomes compared to those who received the placebo.

The press releases and follow-up interviews were much harsher in their criticism of probiotics. One of the study leaders concluded that “These two probiotics did not work. They should not be used for GE.” I would emphasize “period!” was implied. But is that true? If you’re a regular Memo reader, I’ll bet you have an idea where this is going; I’ll explain on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Preschoolers, Probiotics, and Gastroenteritis

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Estimates are that close to two million preschool children will be taken to the emergency room for vomiting and diarrhea every year; the term generally used is gastroenteritis (GE). Two research groups, one from the U.S. and one from Canada, conducted studies to see if probiotics would have any impact on the course of GE from the time of the ER visit for at least two weeks after. Here’s what they did.

Researchers in Canada recruited close to 900 children and researchers in the U.S. had close to a thousand; all the children had symptoms of GE. The subjects were randomly assigned to a placebo or experimental group. The subjects in the experimental groups were given a five-day course of probiotics; the Canadian group used two strains and the U.S. used one strain. The subjects were then tracked to see whether there was a difference in the severity of the GE between those kids getting the placebo and the ones getting probiotics. Both research groups used the same GE symptom scale to monitor the severity of the GE.

Did the probiotics have any impact on the severity of the GE? We’ll check out the results on Thursday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Rising CO2 and Nutrition: The Bottom Line

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All of nature is a delicate balance; when any component changes, there will be some sort of effect—maybe good, maybe not. The mineral nutrient and trace element content composition of a plant, technically called the ionome, reflects a balance between carbon, obtained through CO2 in the air, and the remaining nutrients, obtained from the soil. If the CO2 increases in a disproportionate way to the nutrients available from the soil, it could create an ionomic imbalance. In other words, the balance of nutrients is disrupted. This imbalance in CO2 and soil nutrients could affect the nutrient content of the plant including the protein and micronutrients.

That’s exactly what scientists found in their research. Remember, they used a CO2 level in the FACE-field testing to mimic CO2 levels at the end of the 21st century. Most species of rice declined in protein, iron, and zinc, but that was expected based on prior research. But there were also consistent reductions in vitamins B1, B2, B5, and B9. On the upside, they did find an increase in vitamin E in some varieties of the rice.

Here’s the concern: rice is a staple for two billion people. In fact, it’s their primary source of nutrients because food is not plentiful in many of those countries. A 10% decline in protein could have a major impact on the growth and development of the people dependent on rice for their primary food source. The same is true for any of the other nutrients; they’re critical for the immune system and many other biochemical functions.

The Bottom Line—For Now

While this research is real, it’s most definitely not complete yet. The CO2 projections for the turn of the century may not be accurate; they could be lower or they could be even higher. What if they were higher? Let’s take it one step farther and consider the food supply in the U.S. and Canada right now. What if the current CO2 levels are having an impact on our food supply now, not just on rice, but in all the food that’s grown? What if our food is becoming less nutritious?

This raises two points. If there were ever a reason to complement your diet with dietary supplements, this would be it.

Take it a step further. I get more queries on what people can and cannot eat because they have issues with specific foods such as wheat. What if it’s not the gluten in wheat that’s the problem? What if it’s the changes in nutrient content that upsets the balance of amino acids? Or the B vitamins? That imbalance may be the actual culprit. Only more research will tell.

This one is far from over. I’ll keep watching to keep you informed.

What are you prepared to do today?

Dr. Chet

 

Reference: Science Advances: DOI: 10.1126/sciadv.aaq1012.

 

How Researchers Determined the Effect of CO2 on Nutrition

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An international group of researchers wanted to know how higher CO2 levels would impact the nutrient content of a staple in the diet of over two billion people: rice. If the nutrient levels change substantially, that could have an impact on the nutritional status of many people who might already be undernourished.

Over several years the researchers grew 18 strains of rice that are raised throughout the world. They used an interesting technique called FACE, which stands for free-air CO2 enrichment. The technique uses tubing to emit CO2 near the plants. The amount emitted is dependent on the CO2 levels on the plot of land and controlled by sensors. That allows them to keep the CO2 levels constant just as they would be when grown in fields while the plants grow in a natural outdoors setting.

The researchers used the CO2 levels that are estimated to occur by the end of this century. True, none of us will likely be alive by then, but most of us know people who will be. The knowledge gives agricultural scientists time to develop plants that can grow with adequate nutrient content in those CO2 levels. CO2 may not increase as expected, but future generations can be prepared if they do.

What did they find? I’ll let you know on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: Science Advances: DOI: 10.1126/sciadv.aaq1012.

 

Does Carbon Dioxide Affect Nutrition?

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Carbon dioxide is a waste product of energy metabolism. When we burn the food we eat, the protein, carbohydrates, and fat will be eliminated as carbon dioxide and water. When we use the gasoline in our cars or lawnmowers, CO2 and water are also released during that form of metabolism (called combustion) as well. The benefit for us and our cars is that we get energy. The problem is that we’re producing too much CO2 from gasoline and other fossil fuels.

CO2 levels have risen and fallen over the millennia in response to global trends, but since the invention of the internal combustion engine, the atmospheric CO2 levels continue to rise. As the number of uses for engines has increased, so have CO2 levels; they’re now 100 ppm higher than the previous highest level.

What does this have to do with nutrition? After all, don’t plants need CO2 for photosynthesis? They combine CO2 and H2O together to make sugar, right? Correct. But what researchers wanted to know is whether the excess CO2 would affect the nutrient content of specific crops. Are we growing supercrops? That could have immense implications for global nutrition. I’ll talk about what they discovered on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: https://go.nasa.gov/2zkpdjL.

 

Supplements: Helpful or Harmful?

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About a week ago when a press release about a study published in the Journal of American Academy of Cardiology stated that vitamins and minerals don’t seem to help the health of those people who use them; they should stick to getting nutrients from the food they eat. As you can imagine, I got questions from many readers.

For those of us who use dietary supplements, have we been wasting our money? Or maybe as part of the study showed, we’re doing ourselves harm? Don’t throw out your supplements just yet.

The study was a meta-analysis that examined randomized controlled trials (RCT) since the U.S. Preventive Services Task Force (USPSTF) Recommendations for Dietary Supplements was published in 2012. They examined RCTs that used multivitamins, vitamins and minerals, and antioxidants to determine their affect on health variables related to cardiovascular disease and overall mortality.

Was the study done well? Yes and no. They included RCTs that examined the use of specific supplements and health outcomes. The problem is that they didn’t examine the quality of the supplements used in those studies. That’s a significant problem but not the only one. More on this Saturday. Until then, regardless of the headlines, take your supplements if you know why you’re taking them.

What are you prepared to do today?

Dr. Chet

 

References: Jenkins, D.J.A. et al. J Am Coll Cardiol. 2018;71(22):2570–84.