Relief From Plantar Fasciitis Pain

What Causes Plantar Fasciitis Pain? 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Merry Christmas

Christmas GiftI love the Christmas season. The colors, the smells, the sounds of music. I’m a vegan so turkey isn’t happening for me, but the array of deliciously prepared vegetables, and the variety of desserts always make me excited for this month to get underway!

We give so much to others, especially during this season, that I want to remind you to take care of yourself too.  Like they say on the airplane, ”Put on your own oxygen mask first!”  One of the best gifts you can give to those you love, is a healthy and happy you!

Eliminate the aches and pains that can make you feel grumpy, and if you have someone who could benefit from eliminating pain, please feel free to send them my way.  That includes people who don’t live near me. I will give you information on how to set up Zoom consultations below. I’ll be happy to help you.

I hope you have a wonderful, blessed Christmas!

What Causes Plantar Fasciitis Pain?

It has been a beautiful time for being outdoors the past couple of months, whether you live here in Florida, or any of the northern states. With the cooler, dryer weather, runners are back out on the road, which can lead to our topic of the month.  Plantar fasciitis is a condition that is felt in the arch of the foot and can hamper, or even stop, runners from enjoying their sport.

The good news is I’ve found that there are four muscles that are key to releasing the pain in your arch. And they are easy to self-treat with just a little direction.  These muscles are:

The calf muscles:

 

 

Gastrocenmius & Soleus. These muscles both merge into your Achilles tendon and pull up on your heel bone so you can stand on your toes.

 

 

 

The Tibialis Anterior Muscle:

 

 

This muscle is on the outside of your shin bone.  It inserts into the inside of your arch and rolls your foot out toward your little toe.

 

 

 

The Peroneal Muscles: 

Actually  TWO muscles that are on top of each other with both of them going along the outside of your shin bone,and  behind your ankle.  One inserts into the long bone on the outside of your foot, and the other goes across your arch, inserting into the long bone on the inside of your arch.

That may sound a little confusing, but if it does, take a look at the muscle by doing an internet search and it will be clear.

Together these insertion points pull the outside of your foot UP so your roll in toward your arch.

Relief From Plantar Fasciitis Pain 

The important point to consider is that all four of these muscles insert into the bones that form your arch.

When your calf muscles are tight they are pulling back on your heel bone, but since your arch muscles originate on your heel bone, they are being stretched backward.

When the Tibialis Anterior muscle is pulling on the long bone on the inside of your arch, it’s causing pain on that bone so you feel pain in your arch.

When the Peroneals are pulling toward the outside of your foot, you again feel pain along that bone.

This all sounds confusing but just think about your  arch being pulled in three different directions: to the outside, to the inside, and back toward your heel.  Of course you’re going to have pain in your arch!

It would take the length of a long article to go into the details of how to treat each of these muscles so I’m only going to show pictures of how to treat the muscles on the front of, and next to your shin.

Use either the Perfect Ball that I sell on my website: www.flexibleathlete.com, or a used tennis ball.

Kneel on the floor as shown in the picture to the left and place the ball to the outside of your shin bone.

Move your leg forward so the ball rolls down toward your ankle.  If you start to feel a cramp in your arch, just curl your toes as shown in this picture.

You’ll find a tender spot about midway down the muscle.  This is the muscle spasm that is putting pressure on the inside of your arch.

Repeat until it no longer hurts.

To treat your Peroneals, sit as shown in the picture on the right. Place the ball as shown in the picture and put your hand so it presses your leg directly into the ball.

Move your leg so the ball rolls down the outside of your leg toward your ankle.

 

Be sure to always move your hand so it stays on top of the ball.

 

You’ll find a tender spot about midway down your leg.  Stay on the point for about 15 seconds and continue to roll down your leg.

 

Repeat until the muscle no longer hurts.

Next month I’ll be talking about Achille’s Tendonitis.  The treatment for the calf muscles is the same as you would use for Plantar Fasciitis, so stay tuned…

Zoom Consultations 

This past month I worked with two people via Zoom.  Both were successful at getting a total resolution to their issue.  I’ll tell you about them next month, but in one case it was a sudden attach of severe back pain at prevented the man from even getting out of bed.  In the other case, it was a young woman who is a sub-elite runner who had been in pain for three years, preventing her from running.

I’m happy to say in both cases the individual was able to be up and about in one case instantly, and in the other case it took 3 days for a complete reversal of the painful problem.

If you know anyone, anywhere in the world, who is in pain, please let them know that they can find a solution that isn’t offered by traditional pain-relief practitioners.  They can read more about it by going to www.FlexibleAthlete.com and searching on the shopping cart for Zoom Consultations.

Here’s To Your Health 

There is a tremendous amount of information on two of my websites: www.FlexibleAthlete.com and www.JulstroMethod.com.  I believe you’ll find a lot of answers by going through those sites, and by looking at the books and video programs that I’ve developed over the years.

There is a saying “God helps those who help themselves.”  These websites and my books are the tools you can use to help yourself to Treat Yourself to Pain-Free Living.

Wishing you well,

Julie Donnelly 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 

Can Unhealthy Eating Give You Colon Cancer?

What Are Ultra-Processed Foods, And Why Might They Cause Colon Cancer? 

Author: Dr. Stephen Chaney 

The new year is almost here. If you are like millions of Americans, you may already be making a list of potential New Year’s resolutions and “checking it twice”. If weight loss and a healthier diet are important to you, you may want to put cutting back on ultra-processed foods at the top of your list.

And that’s not easy to do. We love our junk foods and our convenience foods.

  • It’s so easy to just stop by the nearest drive-through to pick up a quick meal. And we are hardwired to desire sweet, salty, and fatty foods. That’s why we love the taste of junk foods.
  • We lead busy lives. It’s easier and quicker to pop prepackaged foods into the microwave or oven than prepare a meal from scratch.
  • Even when we go on a diet to lose weight or improve our health, we want quick and easy. And “Big Food Inc” is only too happy to grant us our wish. They offer ultra-processed meals for every weight loss plan and diet program.
  • Many of us are second or third generation junk and convenience food lovers. Junk and convenience foods have become normal. Ultra-processed foods now make up 57% of the daily calories consumed by most Americans.
    • For example, my mother believed in a balanced diet as long as the foods came from a can or a box. That was normal for me growing up. If my wife had not been brought up very differently, I would not be nearly as healthy as I am today.

Unfortunately, it is becoming increasingly clear that ultra-processed foods are bad for us. In recent issues of “Health Tips From the Professor” I have shared studies suggesting that ultra-processed foods make us fat, increase our risk of diabetes, and increase our risk of cancer. And if that weren’t bad enough, ultra-processed foods give us gas.

The cancer study referenced above showed that ultra-processed foods increased the risk of overall cancer and breast cancer but did not break it down into other kinds of cancer.

Colon cancer ranks third in overall cancers and second in cancer deaths for both men and women. And foods like processed meats are thought to increase the risk of colon cancer. This inspired the authors of a recent study to ask whether ultra-processed foods increased the risk of colon cancer.

What Are Ultra-processed Foods, And Why Might They Cause Colon Cancer?

Fast Food ExamplesUltra-processed foods:

  • Usually go through several physical and chemical processes, such as extruding, molding, prefrying, and hydrogenation that can lead to the formation of toxic carcinogens that may increase the risk of colon cancer.
    • One example you may have heard about recently would be acrylamide in French fries. Another example would be nitrosamines in processed meats.
  • Are usually high in added sugar, fat, and refined starch which contribute to increased weight gain and obesity, an established risk factor for colon cancer.
  • Are usually low in phytonutrients, fiber, calcium, and vitamin D, which are known to reduce the risk of colon cancer
  • Typically contain ingredients of little or no nutritive value, such as refined sugar, hydrogenated oils, emulsifiers, artificial sweeteners, thickening agents, and artificial colors. Some of these ingredients, such as emulsifiers and artificial sweeteners, have been suggested to cause inflammation in the intestine, which is known to increase the risk of colon cancer.
  • Have long shelf-lives because of added preservatives. This allows migration of carcinogens such as bisphenol A from the packaging materials into the food.

Examples of ultra-processed foods include:

  • Sodas
  • Chips
  • Candy and packages of cookies or crackers
  • Most breakfast cereals
  • Boxed cake, cookie, and pancake mix
  • Chicken nuggets and fish sticks
  • Fast food burgers
  • Hot dogs and other processed meat
  • Infant formula
  • Instant noodles
  • Most store-bought ice cream
  • Flavored yogurt

How Was This Study Done?

clinical studyThis study used data collected from:

  • The Nurses’ Health Study (NHS) which enrolled 121,700 female nurses aged 30-55 in 1976 and followed them for 28 years.
  • The Nurses’ Health Study II (NHS II) which enrolled 116,429 female nurses aged 25-42 in 1989 and followed them for 24 years.
  • The Health Professions’ Follow-up Study (HPFS) which enrolled 51,529 male health professionals aged 40-75 in 1986 and followed them for 28 years.

After excluding participants who had incomplete data or a previous cancer diagnosis, the investigators running the study ended up with 67,425 women from NHS, 92,482 women from NHS II, and 46,341 men from HPFS for analysis.

Ultra-processed food consumption was scored as follows:

  • The dietary intake of each participant in the studies was assessed with a food frequency questionnaire every four years.
  • Each questionnaire was scored for the percentage of ultra-processed foods.
  • Then each participant in the study was ranked in terms of the percent ultra-processed foods in their diet averaged over the entire time they were enrolled in the study.
  • The participants were then divided into 5 groups based on the number of servings of ultra-processed foods/day they consumed, ranging from a high of 9 servings/day to a low of 3 servings/day.

Every two years the participants were asked to report any cancer diagnosis in the previous two years. Study physicians reviewed the medical records and pathology reports to confirm a diagnosis of colon cancer. If the patient had died, death certificates and medical records were used to confirm a diagnosis of colon cancer.

The investigators then compared the incidence of colon cancer in the group consuming the most ultra-processed foods to the group consuming the least ultra-processed foods.

  • These comparisons were adjusted for compounding factors like race, family history of cancer, history of endoscopy, physical activity, smoking status, alcohol use, aspirin use, menopausal status, and post-menopausal hormone use.
  • The comparisons were also adjusted for obesity and a healthy diet score called AHEI. I will explain the significance of these adjustments below.
  • Finally, the investigators looked at how various categories of ultra-processed food influenced the results.

Can Unhealthy Eating Give You Colon Cancer?

colon cancerHere is what the study found:

  • Men in the highest fifth of ultra-processed food consumption had a 29% higher risk of developing colon cancer than those in the lowest fifth.
  • No association between ultra-processed food consumption and risk of developing colon cancer was seen for women.

When they looked at subgroups of ultra-processed foods again comparing the top fifth in consumption with the lowest fifth:

  • Consumption of ultra-processed ready to eat products containing meat, poultry, or seafood increased the risk of colon cancer by 44% in men and 14% in women.
  • Consumption of sugar-sweetened beverages increased the risk of colon cancer by 21% in men but did not significantly affect risk of colon cancer in women.
  • Consumption of ultra-processed ready to eat mixed dishes increased the risk of colon cancer by 17% in women but did not significantly affect risk of colon cancer in men.
  • Consumption of ultra-processed dairy products decreased the risk of colon cancer by 17% in women but did not significantly affect risk of colon cancer in men.

The reason for the differing effect of poor diet on the risk of colon cancer in men and women is not clear, but it has been observed in previous studies.

The investigators concluded, “…high consumption of total ultra-processed foods in men and certain subgroups of ultra-processed foods in men and women was associated with an increased risk of colorectal cancer. Further studies are needed to better understand the potential attributes of ultra-processed foods that contribute to colorectal carcinogenesis.”

What Does This Study Mean For You?

There are several take-home lessons from this study:

1: The 29% increase in colon cancer risk reported for men probably underestimates the true risk. I say that because:

  • Ultra-processed food consumption increases the likelihood that you will gain weight, and obesity is a known risk factor for colon cancer. However, the 29% number was obtained after adjusting the data for obesity. Without that adjustment the increased risk would have been greater
  • Ultra-processed foods are low in the protective phytonutrients and fiber provided by fruits, vegetables, and whole grains. However, the 29% number was obtained after adjusting the data for a healthy eating index (which includes the amounts of fruits, vegetables, and whole grains in the diet). Without that adjustment the increased risk would have been greater.

2: While we don’t know the mechanism(s) for the increased risk of colon cancer reported in this study, we can make some informed guesses. I say that because:

  • Once you have removed obesity and fruits, vegetables, and whole grains from consideration, you are left with:
    • The effect of ultra-processed foods on your gut bacteria.
    • The additives, preservatives, and other potentially carcinogenic chemicals in ultra-processed foods.

3: Finally, don’t think you are off the hook if you are a woman.

  • As I mentioned in the introduction, ultra-processed foods also increase your risk of obesity, diabetes, and breast cancer.

And that brings us back to what I said at the beginning of this article, “If you are like millions of Americans, you may already be making a list of New Year’s resolutions and “checking it twice”. If weight loss and a healthier diet are important to you, you may want to put cutting back on ultra-processed foods at the top of your list.”

The Bottom Line 

A recent study showed that ultra-processed food consumption increased the risk of colon cancer in men, but not in women. The reason for the differing effect of ultra-processed foods on the risk of colon cancer in men and women is not clear, but it has been observed in previous studies on the effect of poor diet on colon cancer risk.

However, don’t think you are off the hook if you are a woman. Previous studies have shown that ultra-processed food consumption increased the risk of obesity, diabetes, and total cancers in both men and women and the risk of breast cancer in women.

The investigators concluded, “…high consumption of total ultra-processed foods in men and certain subgroups of ultra-processed foods in men and women was associated with an increased risk of colorectal cancer.”

That brings me to my recommendation. “If you are like millions of Americans, you may already be making a list of potential New Year’s resolutions and “checking it twice”. If weight loss and a healthier diet are important to you, you may want to put cutting back on ultra-processed foods at the top of your list.”

For more details on this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 

 

 

Relief From Stress Headaches

Treatment For Pain In Your Temples 

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney 

Happy Thanksgiving. A Time To Count Our Blessings

Count your blessingsIt’s hard to believe that the holidays are upon us, this year just flew by!

Thanksgiving has come and gone. But this is still a great time of year to recap what has happened and be grateful for all the good that has come your way.  It’s the perfect opportunity before the real hectic season that December brings our way.  I hope you will enjoy revisiting your year and looking forward to the upcoming holiday season.

Relief From Stress Headaches

headacheThere is bad stress and good stress. There has been a lot of bad stress this year-inflation, worries about recession, a heated political season, just to name a few.

And then there is “good” stress. It’s wonderful to have the holiday season before us, so many fun events to attend, time with family and friends, and delicious foods that are special for this time of year.

On the other hand, the holidays can also bring stress … and headaches!pain relief book

You can read what seems like hundreds of articles about handling holiday stress, so we won’t go into that here. What we will focus on is a quick treatment you can do for yourself when you are having a headache.

In my book, Treat Yourself to Pain-Free Living I share several techniques to stop headache pain, and I’d like to share one with you right now.  This is one of my favorite techniques because it brings relief quickly.

Treatment For Pain In Your Temples

If your headache pain is in your temples, it is likely that your temporalis muscles are the culprits. The temporalis muscle is the cause of the throbbing you get in your temples when you have a headache.  Fortunately, it’s easy to find, and easy to self-treat.

Place your fingers as shown in this picture.  If you clench your teeth, you will feel the muscle “pop out.”  Then move your fingers up a little bit toward the top of your head and repeat the clenching movement.

To treat the muscle, just press your finger into a painful point and stay there without moving.  After a minute or so, continue pressing on the spot but move your fingers up and down on the same point.

To find other points, simply move your fingers and clench your teeth.  If you feel the muscle bulge, that’s a point to treat.

Coming In December 

Foot pain can stop you in your tracks, regardless of whether you are a runner, or you just like to stroll along a garden path.

The discussion in December will be about foot pain that is diagnosed as plantar fasciitis.

Wishing you well,

Julie Donnelly 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

500th Issue Celebration

Nutrition Breakthroughs Over The Last Two Years

Author: Dr. Stephen Chaney 

celebrationIn the nearly ten years that I have been publishing “Health Tips From The Professor”, I have tried to go behind the headlines to provide you with accurate, unbiased health information that you can trust and apply to your everyday life.

The 500th issue of any publication is a major cause for celebration and reflection – and “Health Tips From The Professor” is no different.

I am dedicating this issue to reviewing some of the major stories I have covered in the past 100 issues. There are lots of topics I could have covered, but I have chosen to focus on three types of articles:

  • Articles that have debunked long-standing myths about nutrition and health.
  • Articles that have corrected some of the misinformation that seems to show up on the internet on an almost daily basis.
  • Articles about the issues that most directly affect your health.

Best Ways To Lose Weight

weight lossSince it is almost January, let’s start with a couple of articles about diet and weight loss (or weight gain). I have covered the effectiveness of the Paleo, Keto, Mediterranean, DASH, vegetarian, and Vegan diets for both short and long-term weight loss in my book Slaying The Food Myths, so I won’t repeat that information here. Instead, I will share a few updates from the past 100 issues.

My Tips On The Best Approach For Losing Weight: Every health guru has a favorite diet they like to promote. I am different. My book, Slaying the Food Myths, is probably the first “anti-diet” diet book ever written. Based on my years of research I can tell you that we are all different. There is no single diet that is best for everyone. In this article I have summarized my tips for selecting the weight loss diet that is best for you.

The US News & World Report’s Recommendation For the Best Diets: Each year US News & World Report assembles some of the top nutrition experts in the country and asks them to review popular diets and rank them for effectiveness and safety. In this article I summarize their ratings for 2022.

Does Intermittent Fasting Have A Downside? In previous articles in “Health Tips From the Professor” I have reported on studies showing that intermittent fasting is no more effective for weight loss than any other diet that restricts calories to the same extent. But does intermittent fasting have a downside? In this article I reported on a study that suggests it does.

Can A Healthy Diet Help You Lose Weight? Most investigators simply compare their favorite diet to the standard American diet. And any diet looks good compared to the standard American diet. In this article I reported on a study that compared two whole food diets that restricted calories by 25% to the standard American diet. One calorie-restricted diet was more plant-based and the other more meat-based. You may be surprised at the results.

Omega-3s

Omega-3s continue to be an active area of research. Here are just a few of the top studies over the past two years.omega3s

Do Omega-3s Oil Your Joints? In this article I reviewed the latest information on omega-3s and arthritis.

Do Omega-3s Add Years To Your Life? In this article I discussed a study that looks at the effect of omega-3s on longevity.

The Omega-3 Pendulum: In this article I discuss why omega-3 studies are so confusing. One day the headlines say they are miracle cures. A few weeks later the headlines say they are worthless. I discuss the flaws in many omega-3 studies and how to identify the high-quality omega-3 studies you can believe.

Do Omega-3s Reduce Congestive Heart Failure? In this article I review a recent study on omega-3s and congestive heart failure and discuss who is most likely to benefit from omega-3 supplementation.

Plant-Based Diets

Vegan FoodsWill Plant-Based Proteins Help You Live Longer? In this article  I review a study that looks at the effect of swapping plant proteins for animal proteins on longevity.

Can Diet Add Years To Your Life? In this article  I review a study that takes a broader view and asks which foods add years to your life.

Is A Vegan Diet The Secret To Weight Loss? This is an update of my previous articles on vegan diets. This article asked whether simply changing from a typical American diet to a vegan diet could influence weight loss and health parameters in as little as 16 weeks. The answer may surprise you.

Is A Vegan Diet Bad For Your Bones? No diet is perfect. This article looks at one of the possible downsides to a vegan diet. I also discuss how you can follow a vegan diet AND have strong bones. It’s not that difficult.

Anti-Inflammatory Diets

What Is An Anti-Inflammatory Diet? In this article  I discuss the science behind anti-inflammatory diets Inflammationand what an anti-inflammatory diet looks like.

Can Diet Cause You To Lose Your Mind? In this article  I discuss a study looking at the effect of an inflammatory diet on dementia. The study also looks at which foods protect your mind and which ones attack your mind.

Do Whole Grains Reduce Inflammation? You have been told that grains cause inflammation. Refined grains might, but this study shows that whole grains reduce inflammation.

Nutrition And Pregnancy

pregnant women taking vitaminsHere are the latest advances in nutrition for a healthy pregnancy.

The Perils Of Iodine Deficiency For Women. In this article I reviewed the latest data showing that iodine is essential for a healthy pregnancy and discuss where you can get the iodine you need.

Do Omega-3s Reduce The Risk Of Pre-Term Births? You seldom hear experts saying that the data are so definitive that no further studies are needed. In this article I reviewed a study that said just that about omega-3s and pre-term births.

Does Maternal Vitamin D Affect ADHD? In this article I reviewed the evidence that adequate vitamin D status during pregnancy may reduce the risk of ADHD in the offspring.

How Much DHA Should You Take During Pregnancy? In this article I reviewed current guidelines for DHA intake during pregnancy and a recent study suggesting even higher levels might be optimal.

Is Your Prenatal Supplement Adequate? In this article I reviewed two studies that found most prenatal supplements on the market are not adequate for pregnant women or their unborn babies.

Children’s Nutrition

Here are the latest insights into children’s nutrition.Obese Child

Are We Killing Our Children With Kindness? In this article I reviewed a recent study documenting the increase in ultra-processed food consumption by American children and the effect it is having on their health. I then ask, is it really kindness when we let our children eat all the sugar and ultra-processed food they want?

Is Diabetes Increasing In Our Children? In this article I reviewed a study documenting the dramatic increase in diabetes among American children and its relationship to ultra-processed food consumption and lack of exercise.

How Much Omega-3s Do Children Need? In this article I reviewed an study that attempts to define how much omega-3s are optimal for cognition (ability to learn) in our children.

Diabetes

diabetesHere are some insights into nutrition and diabetes that may cause you to rethink your diet.

Does An Apple A Day Keep Diabetes Away? You may have been told to avoid fruits if you are diabetic. In this article I reviewed a study showing that fruit consumption actually decreases your risk of diabetes. Of course, we are all different. If you have diabetes you need to figure out which fruits are your friends and which are your foes.

Do Whole Grains Keep Diabetes Away? You may have also been told to avoid grains if you are diabetic. In this article I reviewed a study showing that whole grain consumption actually decreases your risk of diabetes. Once again, we are all different. If you have diabetes you need to figure out which grains are your friends and which are your foes.

Heart Disease

Here is an interesting insight into nutrition and heart disease that may cause you to rethink your diet.

Is Dairy Bad For Your Heart? You have been told that dairy is bad for your heart AND that it is good for your heart. Which is correct? In this article I discuss some recent studies on the topic and conclude the answer is, “It depends”. It depends on your overall diet, your weight, your lifestyle, and your overall health.

Breast Cancer

Here are some facts about breast cancer every woman should know.breast cancer

The Best Way To Reduce Your Risk Of Breast Cancer In this article I review two major studies and the American Cancer Guidelines to give you 6 tips for reducing your risk of breast cancer.

The Truth About Soy And Breast Cancer You have been told that soy causes breast cancer, and you should avoid it. In this article I review the science and tell you the truth about soy and breast cancer.

Supplementation

Vitamin SupplementsSome “experts” claim everyone should take almost every supplement on the market. Others claim supplementation is worthless. What is the truth about supplementation?

What Do The 2020-2025 Dietary Guidelines Say About Supplements? Every 5 years the USDA updates their Dietary Guidelines for foods and supplements. In this article I discuss what the 2020-2025 Dietary Guidelines say about supplements. Yes, the USDA does recommend supplements for some people.

Who Benefits Most From Supplementation? Not everyone benefits equally from supplementation. In this article I discuss who benefits the most from supplementation.

Should Cancer Patients Take Supplements? Doctors routinely tell their cancer patients not to take supplements. Is that the best advice? In this article I review a study that answers that question.

Can You Trust Supplements Marketed on Amazon? Amazon’s business model is to sell products at the lowest possible price. But do they check the quality of the products marketed on their site? In this article  I review a study that answers that question.

Is Your Prenatal Supplement Adequate? In this article I reviewed two studies that found most prenatal supplements on the market are not adequate for pregnant women or their unborn babies.

The Bottom Line 

I have just touched on a few of my most popular articles above. You may want to scroll through these articles to find ones of interest to you that you might have missed over the last two years. If you don’t see topics that you are looking for, just go to https://www.chaneyhealth.com/healthtips/ and type the appropriate term in the search box.

In the coming years, you can look for more articles debunking myths, exposing lies and providing balance to the debate about the health topics that affect you directly. As always, I pledge to provide you with scientifically accurate, balanced information that you can trust. I will continue to do my best to present this information in a clear and concise manner so that you can understand it and apply it to your life.

Final Comment: You may wish to share the valuable resources in this article with others. If you do, then copy the link at the top and bottom of this page into your email. If you just forward this email and the recipient unsubscribes, it will unsubscribe you as well.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 

Is Your Prenatal Supplement Adequate?

What Should You Look For In A Prenatal Supplement?

Author: Dr. Stephen Chaney

pregnant women taking omega-3You want to do the best for your unborn child. So, you try to find the best prenatal supplement. You may ask your doctor to recommend a prenatal supplement. You may ask your best friend what supplement she used when she was pregnant. Or perhaps you scan online reviews of prenatal supplements by random dietitians or nutrition gurus to select the “best” prenatal supplements.

Then you read the supplement label or the company’s website and see claims like:

  • “Supports optimal nutrition before, during, and after pregnancy”
  • “Packed with 16 nutrients to support fetal development, immunity, energy metabolism, and more”
  • “Concise prenatal formula supports both bone and brain development”

It sounds so good. You think you have found the perfect prenatal supplement. “Right?”

Perhaps not. A recent study (JB Adams et al, Maternal Health, Neonatology, and Perinatology, 8:4, 2022) did an in-depth review of prenatal supplement recommendations and how well prenatal supplements on the market met those recommendations.

The results were not encouraging. The authors concluded, “[Our] analysis found that prenatal supplements vary widely in content, often only contain a subset of essential vitamins, and the levels were often below…recommendations.”

In other words, their study found that most prenatal vitamins may not be adequate to support your needs and the needs of your child through pregnancy and breastfeeding.

I know this is likely to be a topic of great concern for many of you. So, I will examine the study in detail and give you some guidelines for selecting the perfect prenatal supplement.

How Was This Study Done?

clinical studyThis study can be divided into two parts.

#1: What Should The Ideal Prenatal Supplement Contain:

The authors started off by reevaluating the optimal recommendations for prenatal supplements. They reviewed over 200 articles, focusing on articles that:

  • Provided insight into optimal dosage [of essential nutrients] such as treatment studies on the effects of different doses on outcomes and biomarkers.
  • Were larger, more rigorously designed, such as randomized double-blind placebo-controlled studies.

The studies included in their review fell into three categories:

  1. The association of low levels of vitamins with health problems [during pregnancy and in the child after birth].

2) Studies on the changes in [blood] vitamin levels during pregnancy [when the mother is either] un-supplemented or supplemented (The blood level of many vitamins decreases dramatically during pregnancy without supplementation).

3) Clinical trials on the effect of vitamin supplementation on health problems [during pregnancy].

They used these data to create their recommendations for what an ideal prenatal supplement should contain. In some cases, their recommendations were higher than current RDA recommendations for pregnant women.

#2: How Do Currently Available Prenatal Supplements Compare With Their Recommendations For The Ideal Supplement?

For this part of the study, they created a comprehensive list of the nutrients provided by 188 prenatal supplements currently on the market using databases created by the National Institutes of Health. Where these databases were outdated, the nutrient list for that supplement was updated using information on the manufacturer’s websites or labels on retail websites such as Amazon.

Finally, they compared the nutrient content of all 188 prenatal supplements with their recommendations for the ideal prenatal supplement.

Is Your Prenatal Supplement Adequate?

Questioning WomanThere are four points I wish to make before I review the results of this study.

  1. I suspect you are most interested in finding out how prenatal supplements on the market compare with their recommendations for an ideal supplement, so that is what I will discuss below.

2) As I mentioned above, some of their recommendations exceed the current Daily Value (DV) recommendations for pregnant and lactating women. I will point that out whenever it significantly affects the comparisons.

3) The authors of this article made the point that most women going on a prenatal supplement will probably discontinue taking their multivitamin supplement. Thus, their recommendations included nutrients commonly included in multivitamin supplements. This is a valid point, and something you should consider when choosing a prenatal supplement. However, in my discussion below I will focus on the nutrients that are universally recognized as important for pregnancy and lactation.

4) The authors focused on prenatal supplements that had less than the recommended amount of essential nutrients. They did not ask how many of those supplements had excessive amounts of certain nutrients. In my non-systematic review of prenatal supplements, I found several that had doses of some nutrients in thousands of percent of the DV recommendations. In my opinion, this is potentially unsafe for pregnancy and nursing. I will cover this topic in more detail in my discussion.

With that in mind, here are the results of their review.

Vitamins:

When you look at vitamins that have long been recognized as essential for pregnant women, the results are encouraging:

  • Vitamin D, folate, vitamin B12, and vitamin B6 are found in adequate amounts compared to the DV in most prenatal supplements.

However, when you look at nutrients that have more recently been recognized as essential for pregnant women, the story is very different:

  • For vitamin K only 31% of prenatal supplements contain vitamin K and only 16% meet or exceed their recommendation for vitamin K.
    • Their recommendation (90 mcg/day) is identical to the DV for vitamin K. So, there is no doubt that most prenatal supplements do not provide adequate amounts of vitamin K.
  • For choline only 40 % of prenatal supplements contain choline and only 2% meet or exceed their recommendation for choline.
    • Their recommendation (350 mg/day) for choline is less than the 450 mg/day recommended by the NIH and the American College of Obstetricians and Gynecologists.
    • The average prenatal supplement only provides 25 mg of choline, which is wildly inadequate by any standard.
  • For DHA only 42% of prenatal supplements contain DHA and only 1% meet or exceed their recommendation for DHA.
    • Their recommendation (600 mg/day) for DHA is higher than the 200 – 300 mg/day recommended by the most health organizations.
    • However, the average prenatal supplement only provides 94 mg of DHA, so even at 200 – 300 mg/day a substantial percentage of prenatal supplements do not provide adequate amounts of DHA.

Minerals:

calcium supplementsThis study did not consider minerals, so I will draw on another source to estimate the adequacy of minerals in prenatal supplements.

Three key minerals for a healthy pregnancy are iron, calcium, and iodine (Yes, I realize that iodine is not a mineral, but it is usually listed with the minerals on supplement labels. And it is also essential for a healthy pregnancy). Fortunately, another recent study (LG Saldanha et al, Journal of the American Academy of Dietetics, 117: 1429-1436, 2017) looked at the adequacy of these nutrients in 214 prenatal supplements. This study found:

  • The iron DV for pregnant and lactating women is 27 mg/day and 95% of prenatal supplements contained iron at the recommended level.
  • The calcium DV for pregnant and lactating women is 1,300 mg/day. A high percentage (91%) of prenatal supplements contain calcium, but many prenatal supplements only provide 100-200 mg of calcium. That is far less than the DV.
  • The situation for iodine is even more alarming. Only 50% of prenatal supplements contain iodine. And for those that do contain iodine, the average iodine content is only 150 mcg (The DV for pregnant and lactating women is 290 mcg/day).

It is no wonder the authors of these two studies concluded that most prenatal supplements on the market do not provide adequate amounts of all the nutrients needed for a healthy pregnancy. The shortfalls are particularly acute for vitamin K, choline, DHA, iodine, and calcium.

What Should You Look For In A Prenatal Supplement?

Questioning WomanBy now you are probably wondering how you know a good prenatal supplement from a bad one. Here are six simple rules for choosing the ideal prenatal supplement.

  1. Don’t rely on health “gurus” to choose your prenatal supplement for you. I did a little “sleuthing” for you. I searched the internet for websites claiming to have identified the “best” prenatal supplements. I checked out the supplements they recommended, and here is what I found:
  • The supplements the gurus recommended checked all the boxes in that they had some of all the nutrients required for a healthy pregnancy.
  • However, the amount of those nutrients ranged from lows of 10-20% of the DV for pregnant and lactating women to thousands of percent of the DV for others.
  • In other words, they contained grossly inadequate levels of some nutrients and potentially toxic levels of others.

2) Don’t believe label claims or claims made on the manufacturer’s website. Remember the claim, “Concise prenatal formula supports both bone and brain development”, that I mentioned at the beginning of this article? The supplement associated with that claim had only 100 mg of calcium and no DHA. It is hard to imagine a supplement like that supporting either bone or brain health. The claim was bogus.

3) Don’t assume your doctor’s recommendation is the ideal prenatal supplement. A recent study (LG Saldanha et al, Journal of the American Academy of Dietetics, 117: 1429-1436, 2017) compared prescription (the kind your doctor is likely to prescribe) and non-prescription prenatal supplements. It found:

  • Compared with non-prescription supplements, prescription supplements contained significantly fewer vitamins (9 versus 11) and minerals (4 versus 8).
  • While prescription supplements contained more folic acid than non-prescription supplements, they contained significantly less vitamin A, vitamin D, iodine, and calcium.

4) Look for a prenatal supplement containing all the essential nutrients, not just those important for a healthy pregnancy. The authors of the first study made the point that most women will stop taking their regular multivitamin when they start their prenatal supplement. If that is you, your prenatal supplement should contain the nutrients you were getting from your multivitamin.

5) Look for a prenatal supplement that provide 100% of DV for all nutrients except the bulky ones. The ideal prenatal supplement should contain 100% of the DV for pregnant and lactating women for all essential nutrients. Avoid supplements with very low amounts of some nutrients and large excesses of others.

  • Bulky nutrients like calcium, magnesium, and choline are exceptions. It would be hard to get 100% DV for those nutrients in any supplement you could swallow.

6) Look for a prenatal supplement that “fills the gap” for bulky nutrients.

  • Fortunately, the NIH has estimated how much of these nutrients the average American woman gets in her diet. That allows us to estimate how much the average woman needs to get from her prenatal supplement to bring her total intake up to the DV for pregnant and lactating women. That amounts to 458 mg for calcium, 166 mg for magnesium, and 272 mg for choline.
    • That gives you a reasonable benchmark for assessing whether a prenatal supplement is providing enough of those important nutrients. When you read their labels, you will find most prenatal supplements are woefully inadequate for these nutrients.
    • You also need to ask whether your diet is “average”. For example, the average American gets 72% of their calcium from dairy foods. If you do not consume dairy, you may need to get more calcium from your supplement.

7) Avoid the excesses. Your unborn baby is precious. You don’t want to expose it to potentially toxic doses of vitamins or minerals. Avoid any prenatal supplement containing thousands of percent of the DV for some nutrients. And I would recommend caution with supplements containing over 200% of the DV for some nutrients if you are taking other supplements that may provide the same nutrient(s).

The Bottom Line 

Two recent studies have surveyed hundreds of prenatal vitamins and asked whether they provided adequate amounts of the nutrients that are essential for a healthy pregnancy. The results were shocking.

  • While most prenatal supplements provided adequate amounts of folic acid, vitamin B12, vitamin B6, vitamin D, and iron…
  • They were woefully inadequate for vitamin K, calcium, choline, iodine, and DHA – all nutrients that are essential for a healthy pregnancy.
  • Furthermore, prescription prenatal supplements (the kind your doctor is likely to prescribe) were no better than non-prescription supplements.

The authors of the first study concluded, “[Our] analysis found that prenatal supplements vary widely in content, often only contain a subset of essential vitamins, and the levels were often below…recommendations.”

In other words, their study found that most prenatal vitamins on the market may not be adequate to support your needs and the needs of your child through pregnancy and breastfeeding.

For more details on this study and my discussion of how you can select the ideal prenatal supplement for you and your unborn child, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease

 

Is Your Doctor’s Advice Based On Good Science?

You Need To Be Your Health Advocate

Author: Dr. Stephen Chaney 

ProfessorI taught medical students for 40 years. During that time, I did my best to emphasize the importance of basing their practice on “evidence-based medicine”. So, it broke my heart when I saw recent headlines claiming that more than 90% of healthcare interventions (drugs and medical procedures) were not based on high-quality evidence.

Even worse, the headlines claimed that the harm caused by healthcare interventions was not adequately investigated and may, therefore, be under-reported.

When I saw these headlines, I knew I had to investigate further to see if the claims were true and report what I found to you, my readers.

I would not have been surprised by headlines claiming that some healthcare interventions were based on low-quality evidence. For example:

  • Hormone replacement therapy was widely prescribed to manage menopause symptoms until it was discovered to increase the risk of breast cancer. Since then, the hormones used have been reformulated, it is only recommended for severe menopause symptoms, and only for the shortest possible time.
  • Antiarrhythmic drugs were widely prescribed to reduce mortality from heart attacks until a placebo-controlled trial showed they actually increased mortality.
  • A drug called oseltamivir was widely prescribed for the flu until a systematic review of clinical studies showed it was ineffective.

But I, like many of my colleagues, assumed that these cases were rare. However, recent reviews have called this assumption into question. But most of those reviews had a small sample size or did not adequately evaluate the quality of the studies included in the review.

The study (J Howick et al, Journal of Clinical Epidemiology, 148: 160-169, 2022) behind these headlines was designed to avoid those limitations and provide a more accurate estimate of the percentage of clinical interventions that are based on high-quality evidence.

It evaluated 1,567 healthcare interventions that had been studied in Cochrane Reviews, which are considered the gold-standard of evidence-based medicine (I will describe Cochrane Reviews in more detail below, so you can appreciate why they are considered the gold standard).

What Is A Cochrane Review?

certifiedAt this point you are probably wondering what the Cochrane Review is and why it is considered the gold standard of evidence-based medicine. I have covered this in previous articles. But I am not expecting you to remember it (I never told you there would be a quiz). So, I will repeat the information here.

The Cochrane Collaboration consists of 30,000 volunteer scientific experts from across the globe whose sole mission is to analyze the scientific literature and publish reviews of health claims so that health professionals, patients, and policy makers can make evidence-based choices about health interventions.

The Cochrane Collaboration reviews all the relevant studies on a topic, exclude those that are biased or weak, and make their recommendations based on only the strongest studies. They use a systematic approach called GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) that has been endorsed by over 100 organizations worldwide to assess the quality of the studies. The scientists writing Cochrane Reviews are trained in how to use the GRADE evaluation system before they are allowed to write a review.

In one sense, Cochrane reviews are what is called a “meta-analysis”, in which data from numerous studies are grouped together so that a statistically significant conclusion can be reached. However, Cochrane Collaboration reviews differ from most meta-analyses found in the scientific literature in a very significant way.

Many published meta-analyses simply report “statistically significant” conclusions. However, statistics can be misleading. As Mark Twain said: “There are lies. There are damn lies. And then there are statistics”.

The problem is that the authors of most meta-analyses group studies together without considering the quality of studies included in their analysis. This creates a “Garbage In – Garbage Out” effect. If the quality of individual studies is low, the quality of the meta-analysis will also be low. Simply put, the conclusions from some published meta-analyses are not worth the paper they are written on.

The Cochrane Collaboration also reports statistically significant conclusions from their meta-analyses. However, they also carefully consider the quality of each individual study in their analysis based on the GRADE system. They look at possible sources of bias. They look at the design and size of the studies. Finally, they ask whether the conclusions are consistent from one study to the next. They clearly define the quality of evidence that backs up each of their conclusions as follows:

  • High-quality evidence.Further research is unlikely to change their conclusion. This is generally reserved for conclusions backed by multiple high-quality studies that have all come to the same conclusion.
  • Moderate-quality evidence.This conclusion is likely to be true, but further research could have an impact on it.
  • Low-quality evidence.Further research is needed and could alter the conclusion. They are not judging whether the conclusion is true or false. They are simply saying more research is needed to reach a definite conclusion.

Now perhaps you understand why Cochrane Reviews are considered the gold standard of evidence-based medicine.

How Was This Study Done?

The authors started with 6928 reviews that compared a healthcare intervention with either a placebo or no intervention between January 1, 2008, and March 5, 2021. They then randomly selected 1,567 reviews for this study. They asked the following 3 questions for each Cochrane Review:

  • Was the evidence for a positive outcome high-quality, as rated by the GRADE system?
  • Were the results statistically significant?
  • Did the review authors consider the intervention to be effective?

Is Your Doctor’s Advice Based On Good Science?

Doctor With PatientAs I said earlier, the results were unnerving to say the least. When the authors applied their 3 criteria to the 1,567 Cochrane Reviews they found:

  • Only 10% of the medical interventions (drugs and medical procedures) were supported by high-quality evidence.
    • In other words, 90% of the time the evidence wasn’t good enough to determine whether the intervention worked or not.
  • Only 6.8% of the interventions studied had a positive, statistically significant outcome.
  • Only 5.6% of the medical interventions studied were judged to be effective by the Cochrane Review authors.
  • The harm of medical interventions was poorly studied. Only 36.8% of clinical interventions were evaluated for potential harms of the intervention, and most of those data were of low quality.
    • Of the Cochrane Reviews that evaluated potential harms, there was evidence of statistically significant harm in 22% of the interventions.

The authors concluded,

“Using rigorous methods for judging quality of evidence, more than 9 in 10 healthcare interventions studied within Cochrane Reviews do not have high-quality evidence to support their effectiveness and safety. This probably can be remedied by high-quality studies in priority areas.”

“Potential harms of healthcare interventions were measured more rarely than benefits…These studies should measure harms as rigorously as benefits.”

“Practitioners and the public should be aware that most frequently used interventions are not supported by high-quality evidence.”

Putting This Study Into Perspective 

SkepticI should start by saying that this study does not reflect poorly on your doctor. They have your best interest in mind, and they are doing their best to keep up with a constantly changing medical landscape.

In most cases, the advice your doctor gives you is based on clinical guidelines issued by medical societies and government agencies. This study is an indictment of those agencies for not evaluating the quality of the clinical studies used to formulate their clinical guidelines.

With that out of the way, it is fair to ask whether criteria these authors used were too strict. And, in fact, the authors gave this quite a bit of thought. Here are some of the questions the authors asked.

  1. Were the authors of the Cochrane Reviews biased in their evaluation? While you can never eliminate the possibility of bias:
    • The Cochrane Collaboration puts a great deal of effort into training reviewers in how to use the GRADE system without bias.
    • If the opinions of the review authors were removed as a criterion, it would have a minimal impact on the outcome of this study. As reported above, only 6.8% of healthcare interventions had a positive outcome that was supported by high-quality data.

2) Is the GRADE system for evaluating the quality of clinical studies too stringent? The authors considered this possibility, but:

    • Prior to GRADE individual meta-analyses used different methods to evaluate the quality of clinical studies, so it was difficult to compare the conclusions of these meta-analyses.
    • The GRADE system was designed, evaluated, and accepted by top experts around the world to unify how the quality of clinical studies is evaluated.
    • This study found that only 30% of the healthcare interventions were supported by even moderate quality evidence according to GRADE. In other words, even when less stringent standards are used, a high percentage of healthcare interventions may be ineffective.

3) Does relying solely on Cochrane Reviews underrepresent the percentage of healthcare interventions based on high-quality evidence?

    • Cochrane Reviews are primarily undertaken for interventions that are controversial and/or a least one major study suggests the intervention may be ineffective or harmful. Since Cochrane Reviews are less likely to have been conducted on well-established, non-controversial healthcare interventions, it is possible that this study underrepresented the percentage of healthcare interventions backed by high-quality studies.
    • However, a recent study that did not use Cochrane Reviews or the GRADE system concluded that only 22% of healthcare interventions were likely to be beneficial. Once again, even when less stringent standards are used, a high percentage of healthcare interventions may be ineffective.

However, the authors did point out that there may be situations in which high-quality evidence is not needed to recommend a particular healthcare intervention. For example, when inaction leads to dire consequences and there are no other treatment options, a healthcare intervention supported by moderate or low-quality evidence might be preferable to no action at all.

You Need To Be Your Health Care Advocate 

questionsYou are probably wondering what this study means for you. Unfortunately, the authors of this study did not provide a list of healthcare interventions that were not supported by high-quality evidence. So, I can’t provide you with a list of interventions to avoid.

At one point, the authors of this study said, “Patients, doctors, and policy makers should consider the lack of high-quality evidence supporting the benefits and harms of many interventions in their decision-making.” However,

  • Doctors are very busy. They don’t have time to read and evaluate the quality of clinical studies. They rely on the clinical guidelines issued by policy makers (medical societies and government agencies).
  • Policy makers don’t like to admit they were wrong and are very slow to revise their clinical guidelines.

That means you must be the advocate for your health. I’m not suggesting that you question every recommendation your doctor makes. However, you should research major healthcare interventions and discuss the pros and cons with your physician.

  • Dr. Google can be wildly inaccurate, but it is a place to start. You can look up the side effects of drugs your doctor is recommending, downsides of medical treatments they are recommending, and/or other treatment options for your medical condition. I like to focus on reliable sites such as the Cleveland Clinic, Mayo Clinic, and the NIH. WebMD is often, but not always, a reliable source.
  • Ask other health professionals about alternative approaches and/or other doctors they may recommend for your condition. Ask friends who have had the same condition what medical interventions worked for them and if they have other doctors they recommend.
  • Then discuss some of these with your doctor. He or she should be willing to discuss the pros and cons of their recommendations and alternate approaches. If not, ask for a second opinion or consult other doctors.

Of course, you should always be open to the possibility that no other good options exist, and some intervention is essential. I’m just suggesting you evaluate your options fully and discuss them with your doctor before starting any major healthcare intervention.

The Bottom Line 

A recent study evaluated quality of clinical studies supporting many common healthcare interventions (drugs and medical treatments). The study found that:

  • Only 5.6% of healthcare interventions studied were supported by high-quality evidence.
  • This study is not an outlier. Previous studies have come to similar conclusions.
  • The evidence of harms caused by healthcare interventions has not been adequately studied and could be as high as 22%.

As someone who taught the importance of evidence-based medicine to medical students for 40 years, I was appalled by this finding. And as patients trying to navigate the medical system, you should be appalled as well.

The authors of this study said, “Patients, doctors, and policy makers should consider the lack of high-quality evidence supporting the benefits and harms of many interventions in their decision-making.” However,

  • Doctors are very busy. They don’t have time to read and evaluate the quality of clinical studies. They rely on the clinical guidelines issued by policy makers (medical societies and government agencies).
  • Policy makers don’t like to admit they were wrong and are very slow to revise their clinical guidelines.

That means you must be the advocate for your health. I’m not suggesting that you question every recommendation your doctor makes. However, you should research major healthcare interventions and discuss the pros and cons with your physician.

For more details on this study and my discussion of how you can research major healthcare interventions recommended by your doctor, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Does Magnesium Protect Your Heart?

Do You Need A Magnesium Supplement?

Author: Dr. Stephen Chaney 

Getting an adequate amount magnesium from our diet should not be a problem. Magnesium is found in a wide variety of foods with the best sources being legumes (beans), nuts, seeds, whole grains, green leafy vegetables, and dairy foods.

The problem is:

  • None of these foods contain enough magnesium by themselves to provide the RDA (420 mg/day for men and 320 mg/day for women) for magnesium. We need to consume a variety of these foods every day – something most Americans aren’t doing.
  • These foods are decent sources of magnesium only in their unprocessed form. And most Americans consume more highly processed foods than whole, unprocessed foods.
  • Two to three servings of dairy provide a decent amount of magnesium, but many Americans are cutting back on dairy. And plant-based dairy substitutes often provide much less magnesium than the dairy food they replace.
  • Finally, green leafy vegetables (iceberg lettuce doesn’t count) don’t make it into the American menu as often as they should.

As a result, recent studies find that at least 50% of Americans are not getting enough magnesium in their diet. In fact, the average magnesium intake in this country is 268 mg/day for men and 234 mg/day for women. And the figures are not very different in other developed countries.

Does it matter? Recent studies have shown that an adequate intake of dietary magnesium is associated with lower risks of cardiovascular diseases (CVD) and all-cause mortality. This may be because of the of role of magnesium in supporting heart muscle contraction, normal heart rhythm, and blood pressure regulation. Adequate magnesium intake is also associated with lower risk of type 2 diabetes.

But what if you have already had a heart attack? Is it too late for magnesium to make a difference? A recent study (I Evers et al, Frontiers in Cardiovascular Medicine, August 12, 2022) was designed to answer this question.

The authors examined the effect of magnesium intake on cardiovascular disease (CVD) mortality, all-cause mortality, and coronary heart disease (CHD) mortality in patients who had experienced a recent heart attack.

[Note: CHD is defined as heart disease due to clogged coronary arteries, such as a heart attack. CVD includes CHD plus diseases caused by other clogged blood vessels, such as strokes and peripheral artery disease].

How Was The Study Done?

clinical studyThe authors used data from a previous study that had enrolled 4,365 Dutch patients aged 60-80 (average age = 69) who had experienced a heart attack within approximately 4 years prior to enrollment and followed them for an average of 12.4 years. All patients were receiving standard post-heart attack drug therapy.

The characteristics of the patients enrolled in the study were as follows:

  • Male 79%, female 21%
  • Average magnesium intake = 302 mg/day
  • Percent magnesium deficient: 72% of men and 67% of women
  • Percent taking magnesium supplements = 5.4%
  • Percent on drugs to lower blood pressure = 90%
  • Percent on statins = 86%
  • Percent on diuretics = 24%

Upon entry into the study the patients were asked to fill out a 203-item food frequency questionnaire reflecting their dietary intake over the past month. Trained dietitians reviewed the questionnaires and phoned the participants to clarify any unclear or missing items. The questionnaires were linked to the 2006 Dutch Food Composition Database to calculate magnesium intake and other aspects of their diets.

The patients were divided into 3 groups based on their energy adjusted magnesium intakes and those in the highest third (>322 mg/day) were compared to those in the lowest third (<238 mg/day) with respect to cardiovascular disease (CVD), all-cause mortality, and coronary heart disease (CHD) mortality.

The comparisons were statically adjusted for fiber intake (most magnesium-rich foods are also high fiber foods), diuretic use (diuretics reduce magnesium levels in the blood), age, sex, smoking, alcohol use, physical activity, obesity, education level, caloric intake, calcium, vitamin D, sodium from foods, potassium, heme iron, vitamin C, beta-carotenoids, polyunsaturated fatty acids, saturated fatty acids, overall diet quality based on the Dutch Dietary Guidelines, systolic blood pressure, kidney function, and diabetes. In other words, the data were adjusted for every conceivable variable that could have influenced the outcome.

Does Magnesium Protect Your Heart?

When those with the highest magnesium intake (>322 mg/day) were compared to those with the lowest intake (<283 mg/day):

  • Cardiovascular disease (CVD) mortality was reduced by 28%.
  • All-cause mortality was reduced by 22%.
  • Coronary heart disease (CHD) mortality was reduced by 16%, but that reduction was not statistically significant.

They then looked at the effect of some variables that might affect CVD risk on the results.

  • Diabetes, kidney function, iron intake, smoking, alcohol use, blood pressure, most dietary components and overall diet quality had no effect on the results.
  • The results were also not affected when patients using a magnesium supplement were excluded from the analysis. This suggests the effect of magnesium from diet and supplementation is similar.
  • However, diuretic use had a significant effect on the results.
    • For patients using diuretics, high magnesium intake versus low magnesium intake reduced CVD mortality by 45%.

How Much Magnesium Do You Need?

Question MarkYou may have noticed that the difference between the highest magnesium intake group and the lowest intake group was, on average, only 39 mg/day. So, the authors also used a statistical approach that utilized data from each individual patient to produce a graph of magnesium intake versus risk of CVD, total, and CHD mortality. For all 3 end points the graphs showed an inverse, linear relationship between magnesium and mortality.

From this, the authors were able to calculate the effect of each 100mg/day increase in magnesium intake on mortality risk. Each 100mg/day of added magnesium reduced the risk of:

  • CVD mortality by 38%.
  • All-cause mortality by 30%.
  • CHD mortality by 33%, and these results were borderline significant.

The inverse relationship between magnesium intake was observed at intakes ranging from around 200 mg/day to around 450 mg/day, which represented the range of dietary magnesium intake in this Dutch population group.

This study did not define an upper limit to the beneficial effect of magnesium intake because the graphs had not plateaued at 450 mg/day, suggesting that higher magnesium intakes might give even better results.

The authors concluded, “We observed a strong, linear inverse association of dietary magnesium with CVD and all-cause mortality after a heart attack, which was most pronounced in patients who used diuretics. Our findings emphasize the importance of an adequate magnesium intake in CVD patients, on top of cardiovascular drug treatment.”

I might add that this is the first study to look at the effect of magnesium on long-term survival after a heart attack.

Do You Need A Magnesium Supplement? 

magnesium supplements benefitsAs I said earlier, the best dietary sources of magnesium are beans, nuts, seeds, whole grains, green leafy vegetables, and dairy foods. And:

  • None of these foods contain enough magnesium by themselves to provide the RDA (420 mg/day for men and 320 mg/day for women) for magnesium.
  • These foods are decent sources of magnesium only in their unprocessed form.

When unprocessed, each of these foods provides 20 to 60 mg of magnesium per serving. If we use an average value of 40 mg/serving, you would need in the range of 8-10 servings/day of these foods in their unprocessed form to meet the RDA for magnesium.

You could get a more accurate estimate of the magnesium content of your diet using the “Magnesium Content of Selected Foods” table from the NIH Factsheet on Magnesium.

Now you are ready to ask yourself two questions:

  1. Does my current diet provide the RDA for magnesium?

2. If not, am I willing to make the dietary changes needed to increase my magnesium levels to RDA levels?

If your answer to both questions is no, you should probably consider a magnesium supplement. A supplement providing around 200 mg of magnesium should bring all but the worst diets up to the recommended magnesium intake.

The current study did not define an upper limit for the beneficial effect of magnesium on survival after a heart attack but suggested that intakes above 450 mg/day might be optimal.

I do not recommend megadoses of magnesium, but intakes from diet and supplementation that slightly exceed the RDA appear to be safe. In their Magnesium Factsheet, the NIH states, “Too much magnesium…does not pose a health risk in healthy individuals because the kidneys eliminate excess amounts in the urine.”

The only concern is that magnesium from supplements is absorbed much more rapidly than magnesium from foods, and this can cause gas, bloating, and diarrhea in some individuals. For this reason, I recommend a sustained release magnesium supplement, so the magnesium is absorbed more slowly.

Finally, we should not consider magnesium as a magic bullet. The current study statistically eliminated every known variable that might affect survival after a heart attack, so it could estimate the beneficial effects of magnesium alone.

However, survival after a heart attack will likely be much greater if diet, exercise, and body mass are also optimized.

The Bottom Line 

Recent studies have shown that an adequate intake of dietary magnesium is associated with lower risks of cardiovascular diseases (CVD) and all-cause mortality.

But what if you have already had a heart attack? Is it too late for magnesium to make a difference? A recent study of heart attack patients in Holland was designed to answer this question.

The authors examined the effect of magnesium intake on cardiovascular disease (CVD) mortality, all-cause mortality, and coronary heart disease (CHD) mortality in patients who had experienced a recent heart attack.

When heart attack patients with the highest magnesium intake (>322 mg/day) were compared to those with the lowest intake (<283 mg/day):

  • Cardiovascular disease (CVD) mortality was reduced by 28%.
  • All-cause mortality was reduced by 22%.
  • Coronary heart disease (CHD) mortality was reduced by 16%, but that reduction was not statistically significant.

The authors went on to look at the inverse linear relationship between magnesium intake and mortality risk. They found that each 100mg/day of added magnesium reduced the risk of:

  • CVD mortality by 38%.
  • All-cause mortality by 30%.
  • CHD mortality by 33%, and these results were borderline significant.

The authors concluded, “We observed a strong, linear inverse association of dietary magnesium with CVD and all-cause mortality after a heart attack…Our findings emphasize the importance of an adequate magnesium intake in CVD patients…”

I might add that this is the first study to look at the effect of magnesium on long-term survival of patients who have suffered a heart attack.

For more details on this study and my discussion of whether you might benefit from a magnesium supplement, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Carpal Tunnel Pain Relief Without Surgery

How To Release Tight Muscles That Cause Carpal Tunnel

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

Fall, Glorious Fall

I love Florida, but I must say I really miss the changing of the leaves like I enjoyed when I lived in New York.  October was magical!  The trees painting a picture of red, gold, maroon, yellow, and green, and the smells that are so familiar to anyone who has ever lived in the north.

Fires burning to heat chilly homes, apple cider, baking pies and cookies because we could get back into the kitchen as the weather cooled down.  And of course, Halloween.

The world has changed so much.  Remember how we could go out in costume with our friends, no adults needed, and go from door to door, shouting “Trick or Treat!”  We’d come home with a pillowcase (or plastic pumpkin) filled with candy.  Such sweet memories.

In Florida we are entering our most wonderful time of year. It’s starting to get cooler, the humidity is going down, and hurricane season is almost over. Hooray!  It’s great to be outdoors again!

Carpal Tunnel Syndrome – It’s Not Just In Your Wrist

In 1997 I learned a serious consequence of having carpal tunnel syndrome – I had to shut down my therapy practice. I went to doctors, physical therapy, and massage, yet nothing worked. The pain just kept getting worse.

I couldn’t pick up a pen or open a door.  I couldn’t work. What would you do if suddenly you couldn’t use your hand because the pain was so great?

Happily, I was able to figure out which muscles were actually causing the problem, and after releasing the tension I was quickly out of pain.

It’s complicated, but incredibly logical.

The Symptoms Of Carpal Tunnel Syndrome (CTS)

carpal tunnel syndromeFor me, it eventually felt like someone was cutting my wrist with a razor blade, and I couldn’t even pick up a pencil or hold a glass.

If you’re like me, your symptoms came on slowly.  I had a twinge, like an electric shock in my wrist or fingers.  Nothing serious and I’d just shake it off.  Perhaps you’ve done the same thing.

Gradually it happened more frequently, and the intensity increased.  I was heading into a problem that almost ended my career.

While I was told I had CTS and I needed to have surgery, I knew that scar tissue would grow over the median nerve, and I could end up in worse condition than where I was already.

I was forced by necessity to find a solution. I concentrated on the path of the median because it is this nerve that is key to carpal tunnel syndrome.

The Median Nerve Pathway

It all starts with pressure on the median nerve.

 

The median nerve starts in your neck, innervating your arm and hand. When it is pressed upon it will cause burning and numbness somewhere along its path, especially into your wrist, thumb and first two fingers.

The Opponens Pollicis Muscle

The nerve passes under and through several arm muscles, through the carpal tunnel in your wrist, and finally a muscle of your thumb called the opponens pollicis muscle impinges on the nerve.

The tight muscles entrap the median nerve, but they also put a strain on your wrist and hand.  The analogy I use is pulling your hair and your scalp hurts. In the same way, the muscle pulls on the insertion points on your wrist and hand, and you feel pain.

I’m not trying to make anyone a muscular therapist, so I’m not mentioning the Latin names.  If you have the symptoms of carpal tunnel syndrome, and if you’re interested and would like more information, please contact me.

My experience showed me that I had to treat each muscle from my neck to my hand several times every day. My clients were the catalyst for my sharing the self-treatment process that has reversed the symptoms of CTS for hundreds of people over the years.

One Treatment That Helps

There are six muscle groups that need to be treated for the release of the median nerve.

As I worked on myself, I discovered how they all needed to be fully released or the relief was temporary.  Then again, at that point I welcomed any relief, regardless of how short-lived.

The following treatment is for the muscle of your thumb, called “opponens pollicis.” This muscle pulls your thumb into the center of your palm.

An important factor is the muscle originates on the ligament that goes across the top of the carpal tunnel. When it gets tight it is pulling hard on the ligament and it presses down onto the median nerve.  This causes your thumb and first two fingers to go numb.

Bend your middle finger of the working hand.

Press the knuckle into the thick muscle at the base of your thumb.

Close the fingers of the hand you are treating so you can direct your thumb. This is an important step, or your knuckle will keep flipping over the muscle.

Move deeply in a direction that goes from your thumb to the middle of your wrist.

If you find as especially painful point, stay on it for 15-30 seconds.

 

How To Release Tight Muscles That Cause Carpal Tunnel

As I mentioned above there are six muscle groups that need to be treated to release the tension on the median nerve.

I realized that the only people who were benefiting from the treatment I developed were people who lived no more than 25 miles away from my office.

As a result, I hired a videographer and asked Zev Cohen, MD to join with me to explain the entire process.  It’s easy to do as you watch the DVD (also available as an MP4) and use the specialized tool I developed since many people can’t do it the way I did it for myself.

There’s also a workbook with still pictures of all the    treatments, and a chart that shows exactly where to press.

Carpal tunnel syndrome can seriously alter your day-to-day living!  Yet it can be reversed in as little time as one-hour!

Please share this information with anyone you know who is suffering from hand/wrist pain and numbness.

For more information go to: https://julstromethod.com/cts/

Coming In November

Foot pain can stop you in your tracks, regardless of whether you are a runner, or you just like to stroll along a garden path.

The discussion in November will be about foot pain that is diagnosed as plantar fasciitis.

Wishing you well,

Julie Donnelly

www.FlexibleAthlete.com

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can Tomatoes Be Engineered To Produce Vitamin D3?

The Good And Bad Of Genetically Modified Foods

Author: Dr. Stephen Chaney 

GM FruitsThe Floodgates have been opened. The USDA has just approved a genetically engineered purple tomato that contains the anthocyanins found in blueberries, blackberries, and eggplant. It could be appearing in your supermarkets as early as next spring.

And that is just the beginning. Several other genetically modified tomatoes are waiting in the wings. One example is a tomato that has been genetically engineered to produce vitamin D3 (J Li et al, Nature Plants, 8: 611-616, 2022).

“Why would you want that?”, you might ask. The rationale is simple:

  • And vitamin D insufficiency is not a trivial matter. In the words of the authors, in addition to bone health, vitamin D insufficiency “impacts immune function and inflammation and is associated with increased risk of…cancer, Parkinson’s disease, depression, neurocognitive decline, dementia, and the risk of coronavirus disease…”
  • Add to that the fact that tomatoes are grown and consumed in more than 170 countries worldwide. The authors felt that increasing the vitamin D content of tomatoes could be a simple and effective way to improve the vitamin D status of millions of people around the world.

In their own words, “We have developed a new dietary source of vitamin D in plants to meet the increasing demand for ways to address vitamin D insufficiency, which is of particular relevance to those adopting plant-rich, vegetarian or vegan diets.”

But is that true and is it safe? That is the topic of today’s health tip. But before I cover those topics, I should give you some background on vitamin D metabolism in humans and in plants.

Metabolism 101: Vitamin D Metabolism In Humans & Plants

7-dehydrocholesterol is the precursor to vitamin D3 in both humans and plants, but the amount of 7-dehydrocholesterol and the metabolic pathways producing it are very different.

Human Vitamin D3 Metabolism:

  • In humans, cholesterol is the precursor to 7-dehydrocholesterol. About 70% of cholesterol is synthesized by the liver, with the remaining 30% coming from our diet.
  • 7-dehydrocholesterol is synthesized from cholesterol in the epidermis (outer layer) of our skin. It is present in large amounts there but is present in only small amounts in the rest of the body.
  • UVB light is a component of sunlight, and UVB light drives the conversion of 7-dehydrocholesterol into vitamin D3 in our skin.

Plant Vitamin D3 Metabolism:

  • In plants, the pathway is reversed. 7-dehydrocholesterol is synthesized from other plant sterols. And 7-dehydrocholesterol is converted to cholesterol.
  • Cholesterol, in turn, is used to synthesize glycoalkaloid compounds that protect the plants from pests.
    • The gylcoalkaloids differ from plant to plant. In tomatoes the major ones are α-tomatine and esculeoside A and B.
    • α-tomatine and esculeoside A and B protect tomatoes from fungal, microbial, insect, and herbivoral attack.
  • Normally, 7-dehydrocholesterol and cholesterol present in very low amounts in plants because they are used to synthesize protective glycoalkaloid compounds.
  • UVB light is still required to convert 7-dehydrocholesterol to vitamin D3.

Can Tomatoes Be Engineered To Produce Vitamin D3?

Using modern genetic engineering techniques, the authors knocked out (deleted) the gene coding for the protein responsible for converting 7-dehydrocholesterol to cholesterol in tomatoes (shown as the red X in the figure above).

TomatoesIn the fruit:

  • 7-dehydrocholesterol levels are undetectable in ripe fruit of the wild-type tomato but were substantial in fruit of mutant tomatoes lacking the gene for converting 7-dehydrocholesterol to cholesterol.
  • As expected, levels of α-tomatine and esculeoside A and B were substantially lower in the fruit of mutant plants.
  • 7-dehydrocholesterol was evenly distributed in the skin and flesh of the fruit, which limited the ability of UVB light to convert all the 7-dehydrocholesterol to vitamin D3.
  • Even so, a one-hour exposure of the fruit to UVB light produced about 2 μg of vitamin D3 in a medium sized tomato.
    • That is equivalent to the vitamin D3 found in two eggs or 6 ounces of tuna, which are both recommended sources of vitamin D3.
    • The only non-fortified foods that are better sources of vitamin D3 are salmon and trout, which provide about 15 μg of vitamin D3 in a 3-ounce serving
  • The authors further speculated that the vitamin D3 content could be increased even more by:
    • Cutting the fruit into slices and air drying them in sunlight.
    • Removing the gene that produces UV-protecting chalcones in the skin of the fruit, thus allowing UVB light to penetrate further into the fruit. This is typical thinking by some of my scientific colleagues. If one mutation is good, two or more would be even better.

The authors concluded, “We have developed a new dietary source of vitamin D in plants to meet the increasing demand for ways to address vitamin D insufficiency”

In the leaves:

  • Qualitatively, the results were similar to those seen with the fruit.
    • 7-dehydrocholesterol levels were very low in the wild-type tomato but were substantially increased in the mutant tomatoes.
    • Levels of α-tomatine and esculeoside A and B were substantially lower in the leaves of the mutant plants.
  • Quantitatively, however, the results were different.
    • The amounts of 7-dehydrocholesterol were 300 to 600-fold higher in the leaves than in the ripe fruit.
    • The amount of vitamin D3 produced by a one-hour exposure to UVB light was 1,000-fold higher in the leaves than in the ripe fruit.
  • While people don’t eat the leaves of tomato plants, the authors visualized a different use for this material.
    • They envisioned using what would otherwise be waste vegetative material from growing tomatoes to produce vitamin D3 for vitamin D supplements.
    • This would be particularly beneficial for vegans because most vegan sources of vitamin D are vitamin D2, which is less effective than vitamin D3.

In the words of the authors, “The leaves of the mutant plants are rich sources of 7-dehydrocholesterol…[and could be used] for the manufacture of vitamin D3 supplements from plants that would be suitable for vegans…”

The Good And Bad Of Genetically Modified Foods

good news bad newsLike much else in today’s world of social media and online blogs and podcasts, both the benefits and risks of genetic engineering have been greatly exaggerated. I have discussed this topic at length in a previous issue  of “Health Tips From The Professor”.

On the one hand, my genetic engineering colleagues tend to focus on the genetic alteration that is beneficial and ignore other changes in the genetically altered food that could pose some risk.

  • I would be the first to admit that most of the risks are very small and unlikely to occur, but I think each potential risk should be thoroughly investigated before we release the genetically altered plant into the world.
  • As an analogy, I will use the story of Pandora’s Box. Pandora was given the box by an angry Greek God, who told her never to open it. But her curiosity got the beat of her. Once Pandora opened the box, she released sickness, death, and other evils into the world. And once they had been released, there was no way to get them back into the box. We don’t want to run this kind of risk with genetically altered plants.

On the other hand, there are the “Chicken Little’s” of the world who assume every potential risk is real and warn us that, “The sky is falling”. Most of the risks are theoretical only. They may never happen. I am just saying they should be examined before we release genetically altered plants into the wild.

In this article, I will try to avoid both extremes. I will put on my “sceptic’s hat” (Every good scientist keeps one of those in his or her closet) and carefully evaluate the benefits and the risks associated with using both the fruit and the leaves of this genetically altered tomato plant.

Tomato Fruit Engineered To Produce Vitamin D3

The Benefit:

The benefit is obvious. As the authors said, tomatoes are a widely consumed worldwide. The availability of an inexpensive plant source of vitamin D3 could go a long way towards improving vitamin D status in third world countries where vitamin D3 supplementation may not be practical.

SkepticMy Concerns:

  1. Are there health risks?
  • Most genetically engineered foods contain a protein sequence that is not found in the non-modified food. This raises the possibility of food allergies to the novel protein. The good news is that a protein has been removed in this mutant plant. There is no novel protein, so the chance of these tomatoes triggering food allergies is extremely small.
  • However, these fruits do contain altered DNA. As I said in my previous article, one could imagine scenarios in which this could pose a health risk. I also pointed out that this is a theoretical concern, not one that has been proven to occur.
  • In addition, these fruits have been irradiated with high-intensity UVB light for an hour. This converts some of the 7-dehydrocholesterol to vitamin D3. But what else does it do to the fruit? Are some of the changes harmful? The authors didn’t ask.
  • Finally, these fruits don’t just have higher levels of vitamin D3. They also have much higher levels of 7-dehydrocholesterol than normal tomatoes. In humans, 7-dehydrocholesterol is made in the skin epidermis and there is very little in other tissues.

Is dietary 7-dehydrocholesterol a problem? We don’t know. One recent study speculated that dietary 7-dehydrocholesterol may increase the risk of atherosclerotic cardiovascular disease more than dietary cholesterol. Perhaps more study is required before we assume that this genetic modification is only beneficial.

   2) Are there environmental risks?

  • The same genetic change that increases the 7-dehydrocholesterol content of the fruit decreases α-tomatine and esculeoside A and B levels. As I stated above, α-tomatine and esculeoside A and B protect tomatoes from fungal, microbial, insect, and herbivoral attack (In my yard, herbivoral attack would be deer).
  • The authors did not describe how these tomatoes were grown, but I would assume it was in a hothouse. That is customary for studies of newly genetically engineered foods.
  • This raises the question of how pest susceptible these tomatoes would be when cultivated outdoors. Would increased amounts of pesticides and fungicides be needed to raise them? If so, what would the environmental impact be? The authors gave no indication that they had thought about the environmental impact if, in fact, these modified tomatoes were widely grown to solve the vitamin D insufficiency, as they proposed.

3) Is there a risk of cross-pollination?

  • This is a major concern for any genetically modified crop. If the modified gene were easily spread to nearby fields by cross-pollination, it could decease crop diversity and create major problems for organic farmers. Again, the authors gave no indication that they had even thought about this issue.

4) Would these tomatoes be accepted in developed countries?

  • I ask this question because the genetically modified Flavr Savr tomato was introduced in the US in 1996 thumbs down symbolwith much fanfare, only to be withdrawn from the market in 1999 due to lack of consumer demand.
  • And this tomato is both genetically engineered and irradiated. I am guessing most consumers would simply prefer to take a vitamin D3

My overall evaluation. Despite what you may hear from genetic engineering gurus, I would give these genetically engineered tomato fruits a thumbs down. There are too many unresolved questions and concerns to consider them to be a beneficial addition to our food supply.

Tomato Leaves Engineered To Produce Vitamin D3

The Benefit:

Again, the benefit is obvious. As the authors said, most experts consider vitamin D3 superior to vitamin D2, and there are no plant sources of vitamin D3 that can be used to produce vitamin D3 supplements. Leaves from this genetically modified tomato plant could be an inexpensive vegan source of vitamin D3.

My Concerns:

1.  Are there health risks?

  • Despite what the “Chicken Little’s” of the world may have told you, there are no health risks when an individual food ingredient is purified from a genetically modified organism. For example, vitamin D3 purified from these genetically modified tomato leaves will contain no genetic material (DNA), no protein, no UV-damaged molecules, and no 7-dehydrocholesterol. It will be chemically and biologically indistinguishable from vitamin D3 obtained from any other source.

2)  Are there environmental risks?

  • The environmental risks are the same as for the fruit.

3)  Is there a risk of cross-pollination?

  • The risk of cross-pollination is the same as for the fruit.

thumbs up4)  Would this source of vitamin D3 be accepted in developed countries?

  • This should not be a concern. Nutrients from genetically modified microorganisms are widely used in natural supplements. And UVB irradiation is already used in the production of both vitamin D2 and vitamin D3 Any UV-damaged molecules are removed in the final purification steps.

My overall evaluation. I would give the tomato leaves a tentative thumbs up. If the environmental and cross-pollination concerns can be overcome, the leaves could be a valuable vegan source of vitamin D3.

The Bottom Line 

Vitamin D insufficiency is a major problem, both worldwide and in the United States. A group of scientists have attempted to solve this problem by producing a genetically modified tomato plant that produces 7-dehydrocholesterol, which can be converted to vitamin D3 by UVB irradiation.

Plant foods are not generally a good source of vitamin D3. Tomatoes are grown and consumed in over 170 countries. Therefore, the scientists proposed widespread cultivation of this genetically modified tomato plant as a solution to worldwide vitamin D insufficiency.

In addition, the leaves of these genetically modified tomato plants contain more 7-dehydrocholesterol than the fruit. Most experts consider vitamin D3 superior to vitamin D2, and there are no plant sources of vitamin D3. The authors of this study further proposed that the leaves from this genetically modified tomato plant could be an inexpensive vegan source of vitamin D3.

As I have discussed in a previous “Health Tips From The Professor” article, both the benefits and risks of genetically modified foods have been greatly overstated. In this article, I evaluated both the benefits and risks of using the fruit as a plant source of vitamin D3 and the leaves to produce vegan vitamin D3 supplements.

Based on a careful evaluation of benefits and risks I give the genetically modified fruit a thumbs-down. There are simply too many unanswered questions.

On the other hand, I give vegan vitamin D3 supplements produced from the leaves a tentative thumbs up depending on whether environmental and cross-pollination concerns can be overcome.

For more details on this study, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can You Trust Amazon Supplements?

Author: Dr. Stephen Chaney 

Question MarkI am often asked whether you can trust supplements purchased on Amazon. I have avoided answering that question publicly because I don’t wish to have any legal issues with Amazon.

However, I recently came across a published study (C Crawford et al, JAMA Network Open. 2022;5(8):e2226040 ) that partially answers that question. Normally, I review and comment on articles I share. However, today I will only use direct quotes from the article without comment to avoid any personal legal jeopardy.

Why Was The Study Done?

In the words of the authors,

Immune Support“Cold, flu, and immunity supplement sales have skyrocketed since the start of the COVID-19 pandemic…Supporting immunity or boosting the immune system has become an important reason for using dietary supplement products even though some of the claims may be misleading or not scientifically accurate. In addition, information regarding whether there are any risks associated with such products and ingredients is lacking.”

“The growth in e-commerce, sales, and manufacturing of dietary supplements, coupled with the limited resources for regulating dietary supplements, has created a challenge in keeping up with the market. Adulteration, misbranding, and misleading claims are regularly reported.”

“Since December 2020, Amazon has been requiring sellers to provide outlined quality control documentation and a certificate of analysis (testing results) for supplements sold on that platform. These new requirements could help ensure products are less risky and not adulterated.”

“In this case series, 30 products…marketed to support and boost the immune system…were selected and purchased from Amazon since the introduction of the new requirements by Amazon in December 2020. We tested the products to determine whether their product labels were accurate and whether any product was misbranded or adulterated.”

How Was The Study Done?

In the words of the authors,

clinical study

“On the Amazon website, we searched the key word immune in ‘all departments’ and then sorted results by ‘featured’. The first 30 dietary supplement products that appeared as results with 4 or more stars [highest rated] were eligible and selected for analysis in May 2021.”

“One sample of each selected product was purchased and sent to the University of Mississippi’s National Center for Natural Product’s Research for product analysis. Liquid chromatography-mass spectrometry was used to determine the quality of the 30 dietary supplement products…The list of ingredients detected through analysis for each product was compared with the ingredients on the product’s Supplement Facts label to determine whether the product’s label was accurate.”

 

What Did The Study Show?

In the words of the authors,

Shocking“Seventeen of the 30 products tested had inaccurate labels based on the product analysis. Of the 17 products with inaccurate labels:

  • 13 had ingredients listed on the labels that were not detected through analysis, such that their labels were misbranded. Ingredients missing from products ranged from 1 to 6 ingredients from any single product.
  • Nine products had substances detected but not claimed on the product label…some of which may be considered adulterated. [For example] One ingredient not claimed on the label but found in 3 products marketed as containing elderberry was Orza sativa (black rice seed).
  • Five [products] were misbranded and contained additional components not claimed on the label.”

“The 30 immune health dietary supplements tested and analyzed had claims related to immune support, immune defense, and bolstering of the immune system.

  • Examples of such claims included “all seasons immune support”, “immune strengthening ingredients,” “a powerhouse immune system booster”, and “booster up your immune system”.
  • Fifteen of the products tested additionally had scientific sounding claims by using terms such as “research-based” or “research supported”, “clinically studied”, “scientifically proven”, “supported by…gold-standard clinical studies,” and “backed by science.”

“The price of these products ranged from $11.93 to $90.48 for an approximate 30-day supply with the median cost of $25.33 per month…The mean price of the 17 products scoring less than 4 [This is a different scoring system than the one used on the Amazon website. It is a scoring system based on the quality of the product. Less than 4 represents lower quality products] was approximately $25 for a 30-day supply, and the mean price for those scoring 4 or more [higher quality products] was $31.”

What Did The Authors Say About The Results?

Scientists-ConversingIn the words of the authors,

“Dietary supplements, which consumers buy to improve their health can be costly…The public has a right to know that they are buying what is stated on the label when spending money on dietary supplements. This is certainly not always the case, as we found that only 13 of the 30 products were accurate…Although we cannot assume any product will confer a benefit, we would certainly not expect any harm; however, there is a risk that misbranded and/or adulterated products could cause harm.”

“Claims made on the labels of most dietary supplement products [in this study] seem to stretch what would be considered as allowable claims, which can by statute and/or FDA regulations be made for dietary supplements. Some other claims sounded scientific but did not have any peer-reviewed publication cited. Therefore, it is unknown how or whether these claims were substantiated.”

The Bottom Line 

The authors concluded,

“This case series analysis suggests that quality control measures have not been sufficient for most immune health dietary supplements advertised and sold on the Amazon website. Moreover, some claims made on most of these immune support products do not appear consistent with any of the categories of claims defined by FDA regulations. Most products tested had inaccurate labels, and the claims made on these labels may mislead consumers into purchasing products when information on whether they are actually beneficial is limited. Consumers should be aware that these products may potentially not contain what is stated on the label.”

For more details on this study, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Health Tips From The Professor