Can Vitamin C Reduce Colds In Children?

A Holistic Approach Is Best

Author: Dr. Stephen Chaney 

child with fluCold and flu season is here. And if you have children, that’s not good news. Children and adolescents are particularly susceptible to respiratory infections (colds, sore throat, sinusitis, pneumonia, and bronchitis). That’s because:

  • Their immune systems are immature.
  • Their diet and sleep patterns are far from optimal.
  • Increasing environmental pollution makes the problem worse.

And that’s a problem. The WHO says:

  • Respiratory diseases are the leading cause of childhood deaths globally.
  • RSV alone results in 3.6 million hospitalizations and 100,000 deaths each year.

The death rates are not as high in the US, but every day your child is sick at home:

  • They are not in school leaning.
  • One parent has to stay home from their job to take care of them.

If you want to protect your child from respiratory infections and do it naturally, you need to strengthen their immune system. And that requires a holistic approach which I have described in a previous issue of “Health Tips From The Professor”.

But ever since Dr. Linus Pauling published “Vitamin C and the Common Cold” in 1970, there has been a lot of discussion about the role of vitamin C in preventing respiratory infections. I don’t need to tell you this has been a controversial topic.

Several recent studies have confirmed the role of vitamin C in preventing and shortening respiratory infections in adults, and this did not require the mega-dose levels recommended by Dr. Pauling.

However, high-quality studies on the role of preventing respiratory infections in children and adolescents are lacking. The study (C Li et al, Frontiers in Nutrition, 12:1601218, 2025) I will describe today was designed to fill this gap.

How Was This Study Done?

clinical studyThe authors of this study used data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) in the United States. The NHANES study included 8,704 people, of which 1,344 were children or adolescents aged 6-19 years old.

At the time of enrollment:

  • Serum levels of vitamin C were determined by laboratory analysis.
  • The incidence of recent (within 30 days) respiratory infections was determined from a self-reported health questionnaire. In this study the most frequent respiratory infection was the common cold. But the term respiratory infections also included sore throats, sinusitis, pneumonia, and bronchitis.

Of the 1,344 participants, 238 (17.7%) reported a respiratory infection within the past 30 days.

The participants were divided into quartiles based on serum levels of vitamin C, and the highest versus lowest quartiles were compared for the risk of developing respiratory infections.

Finally, the data were statistically corrected for confounding variables like sex, age, race, obesity, asthma, and tobacco smoke exposure.

Can Vitamin C Reduce Colds in Children? 

The results were clear cut:

  • There was a significant negative association between serum levels of vitamin C and the risk of respiratory infections (In plain English that means as serum levels of vitamin C increased, the risk of respiratory infections decreased).
  • For every 10 unit increase in serum vitamin C levels, the risk of respiratory disease decreased by 7%.
  • Children and adolescents in the top quartile of serum vitamin C were 50% less likely to develop a respiratory infection than those in the bottom quartile.

Based on previous studies, the authors said the most likely mechanisms for the effect of vitamin C on the risk of developing a respiratory disease are:

  1. Vitamin C exerts antioxidant protection against free radicals generated by immune cells, which protects the integrity of cells lining the respiratory track.

2) Vitamin C strengths the ability of neutrophils to clear pathogens (bacteria and viruses) from the blood.

3) Vitamin C inhibits pro-inflammatory cytokines, thereby reducing inflammatory responses that can worsen and prolong respiratory infections.

The authors concluded,

  • “This study demonstrates a negative association between serum vitamin C and respiratory infection risk in a nationally representative sample of children and adolescents.
  • These findings highlight the protective role of vitamin C against respiratory infections and underscore the importance of maintaining optimal vitamin C levels.
  • Our findings suggest that vitamin C supplementation may be potentially used for the prevention and treatment of respiratory infections among children and adolescents.”

What Does This Study Mean For You? 

Questioning WomanThis study suggests that vitamin C supplementation may help protect our children and grandchildren from respiratory infections. However, we need to acknowledge the strengths and limitations of the study.

On the positive side, this study is fully consistent with previous studies showing that vitamin C supplementation reduces the risk of getting respiratory infections in adults – and reduces the duration and severity of respiratory infections when they do occur.

On the negative side, this is a single study. It highlights the need for more studies of the effect of vitamin C on respiratory infections in children.

You also may be thinking, “This study talks in terms of serum levels of vitamin C. It doesn’t tell me how much vitamin C my children and grandchildren should be getting.”

There is a good reason this study was based on serum levels of vitamin C. It’s the most accurate measure of vitamin C status.

  • Intake of vitamin C based on dietary questionnaires is often inaccurate.
  • There is not a linear relationship between dietary vitamin C and serum levels of vitamin C.
  • Serum levels of vitamin C can be influenced by obesity and other metabolic and disease states.

So, I have done a little research to give you an approximation of what vitamin C levels are appropriate.

The average serum vitamin C levels in the highest quartile (the one with the lowest risk of respiratory infections) was 87 µmol/L. To estimate the dose of vitamin C required to reach that level I turned to the NIH “Vitamin C Fact Sheet For Health Professionals”. From that fact sheet, I estimate that the dose needed to reach 87 µmol/L is:

  • 150-200 mg/day for children.
  • 200-300 mg/day for adolescents.

This is a very rough approximation, but it provides you with guidelines you can use. And those guidelines suggest you don’t need give your child a megadose of vitamin C – a chewable vitamin C supplement in the 250 mg range should be plenty.

A Holistic Approach Is Best 

Bullets

I don’t want to give you the idea that vitamin C is a “magic bullet” that will protect your children from respiratory infections. For that, your children will need a strong immune system, and adequate vitamin C is just one component of a strong immune system.

For a strong immune system, a holistic approach is best. That includes:

  • A balanced diet composed of whole, unprocessed foods without a lot of fat and simple sugars. Unfortunately, American children currently get an average of 67% of their calories from ultra-processed foods.
  • Adequate sleep. The recommendations are 9-12 hours for children aged 6-12 and 8-10 hours for adolescents aged 13-18. Unfortunately, 30% of school-age children and 75% of adolescents don’t get enough sleep.
  • Adequate exercise. Unfortunately, children and adolescents spend far too much time on their electronic devices and too little time exercising.
  • Ideal body weight. Unfortunately, ultra-processed foods and lack of exercise are packing on the pounds. Almost 40% of American children and adolescents are overweight or obese.
  • Supplementation. Because most children eat too much ultra-processed food, I recommend a high-quality children’s multivitamin and a protein supplement to make sure they are getting the nutrients they need to build a strong immune system. That is, of course, in addition to the vitamin C supplement I mentioned above.

I recognize none of this is easy. Our son is in his 40s now, but I remember his childhood and teenage years. My only advice is to:

  • Pick your battles.
  • Be the example.

The Bottom Line 

Although several recent studies have shown that vitamin C reduces the risk of respiratory infections in adults, few studies have looked at the effects of vitamin C on respiratory infections in children.

In this issue of “Health Tips From the Professor” I reviewed a study showing that vitamin C reduced the risk of respiratory infections by up to 50% in children and adolescents.

  • The authors concluded, “Our findings suggest that vitamin C supplementation may be potentially used for the prevention and treatment of respiratory infections among children and adolescents.”

For more information on this study, what it means for your children or grandchildren, and a holistic approach to strengthening their immune system, 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.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

What Diet Is Best For Healthy Aging?

What About Primarily Meat-Based Diets?

Author: Dr. Stephen Chaney

Pinochio

It’s so confusing. Everyone claims they have clinical proof that their diet is the best. You will be healthier and live longer.

But the diets are so different. They range from vegan to keto. They can’t all be equally healthy. What is the truth?

To answer that question, we first need to understand how the proponents of each diet can claim theirs is the perfect diet for health and longevity. It’s because they base their claims on:

  • Short-term studies. Most of their claims are based on studies that range from a few weeks to a few months. You need 20- or 30-year studies to measure the effects of a particular diet on health outcomes.
  • Biological markers (Things like cholesterol and triglyceride levels, blood sugar control, and/or inflammation). Biological markers can predict possible health outcomes. But without long-term studies on actual health outcomes, you don’t know whether those predictions are accurate.
  • Comparisons with the typical American diet. Any diet looks good compared with the American diet.
  • Elimination of highly processed foods. While these diets emphasize different foods, they are all whole food diets. Again, any diet that eliminates processed foods is an improvement.
    • It doesn’t matter whether you restrict calories, restrict certain foods or food groups, or restrict the time you allow yourself to eat. You unconsciously eat less.
    • And when you eat less, you lose weight.
    • And when you lose weight, your cholesterol and triglyceride levels fall, your blood sugar control improves, and inflammation decreases.
    • That’s why short-term weight loss and improvement in biological markers are virtually identical with vegan and keto diets. Those diets are as different as any two diets could be. But they are both highly restrictive diets.

The take-home lesson is clear. Don’t be confused by claims based on short-term studies. What you should look for is:

  • Long-term studies (20 years or more)…
  • that look at the effect of diet on health outcomes, and…
  • do not compare their diet with the typical American diet.

When I first reviewed this topic 8 years ago, I could only find a few studies that met these criteria:

  • One study showed that people consuming primarily plant-based diets weighed less than people who consumed primarily meat-based diets for 20 years or more.
  • Other studies showed that people consuming primarily plant-based diets had a reduced risk of diabetes and heart disease compared to people consuming primarily meat-based diets for 20 years or more.

These are valuable observations, but they are limited. That’s why I was so excited when I came across a recent 30-year study (A-J Tessier et al, Nature Medicine, volume 31, pages 1644-1652, 2025) looking at the effect of 9 different diets on longevity and health outcomes. In short, this study looked at the effect of different diets on healthy aging.

How Was This Study Done?

Clinical StudyThe authors of this study used data from 105,015 participants in the Nurses’ Health Study (NHS) and Health Professionals Follow Up Study (HPFS). Both studies enrolled participants in 1986 and followed them through 2016. In short, they were both 30-year studies. Participants with preexisting chronic diseases were excluded from the study.

  • Lifestyle factors and medical histories were assessed every two years.
  • A detailed dietary assessment was conducted every four years. The assessments measured the intake of 152 foods. Food intakes were averaged over the duration of the study for each participant.

[Note: This study did not measure how the diets of participants changed between 1986 and 2016, although that is an interesting question. Perhaps a future study is planned.]

Based on the foods eaten, the diets of the participants were evaluated for adherence to 9 dietary patterns, which I have described in more detail below.

[Note: To be clear, the participants were not trying to follow these diets. They ate what they ate, and the investigators subsequently compared their dietary pattern with various healthy diets.]

For each of the diets included in this study, participants were divided into quintiles based on how closely their food intake adhered to the recommendations for that diet. Then the highest quintile was compared to the lowest quintile to determine how well that diet predicted “healthy aging” after a 30-year follow-up.

The term “healthy aging” was based on 5 criteria:

  • Longevity – achieving an age of 70 or more.
  • Absence of the top 11 major chronic diseases (cancer, diabetes, myocardial infarction (heart attack), coronary artery disease, congestive heart failure, stroke, Parkinson’s disease, multiple sclerosis, and ALS).
  • No impairment of cognitive function.
  • No impairment of physical health.
  • No mental health issues.

In other words, these were not just individuals who survived 70 years or more. They survived and thrived. They were enjoying their golden years because they still had good health and excellent quality of life.

Diets Included In This Study

The diets included in this study were:

  • AHEI – Alternative Healthy Eating Index (A scoring system developed by Harvard researchers to measure overall diet quality based on its ability to predict lower risks of heart attacks, strokes, and diabetes).
  • aMed – Alternative Mediterranean Diet Index (The aMed diet index differs from the original Med index by separating fruits and nuts into different groups, eliminating dairy, emphasizing whole grains, and excluding red and processed meats in favor of chicken and fish).
  • DASH – Dietary Approaches to Stop Hypertension (The name speaks for itself. But I also sometimes refer to this diet as “the Americanized version of the Mediterranean diet’ because it features foods more familiar to Americans. For example, it allows more red meat options than most of the other diets in this list.
  • MIND – Mediterranean-Dash intervention for Neurogenerative Delay (It is a dietary pattern designed to reduce the risk of Alzheimer’s disease and other forms of dementia. It combines elements of the Mediterranean and DASH diets but differs from both by emphasizing berries as a major fruit source, among other things.)
  • hPDI – Healthy Plant-Based Diet Index (It is a scoring system that measures adherence to a diet rich in healthy plant-based foods and lower consumption of less-healthy plant foods and animal foods.)
  • PHDI – Planetary Health Diet Index (It emphasizes foods (primarily plant foods) that are healthy and are good for the environment. Of the diets on this list, it is the most restrictive and closest to a vegan diet)
  • EDIH – Empirical Dietary Index For Hyperinsulinemia (It is a scoring system that measures the potential of a diet to cause chronically high insulin levels, which is associated with type 2 diabetes and certain cancers.)
  • EDIP – Empirical Dietary Inflammation Pattern (It is a scoring system that measures the inflammatory potential of a diet.)
  • UPF – Consumption of Ultraprocessed Foods (Since recent studies have shown that most Americans get between 55 and 70% of their calories from ultraprocessed foods, this is fast becoming a measure of the typical American diet.)

Note: Except for the UPF diet, these are all whole food, primarily plant-based diets.

What Diet Is Best For Healthy Aging?

Here are the results of the study (drum roll, please):

  • Of the 105,015 participants in this study, only 9.3% achieved healthy aging.
  • Adherence to any of the 8 healthy diets improved the probability of achieving healthy aging.
  • The odds of achieving healthy aging ranged from 1.45 for the Healthy Plant-Based Diet to 1.86 for the Alternative Healthy Eating Index.
  • If you were to pick one winner, it would be the Alternative Healthy Eating Index. And if you were to define healthy aging as achieving an age of 75 or more with the other 4 criteria, the odds increase to 2.24 (more than double) for the Alternative Healthy Eating Index.
  • As you might expect, adherence to a diet high in ultraprocessed foods had the opposite effect. It decreased the odds of achieving healthy aging by 32%.

When you look at each of the criteria for healthy aging individually, the results were a bit more nuanced:

  • For survival to 70+ years, the Alternative Healthy Eating Index and the Planetary Health Diet Index were tied. Both increased the odds of survival by more than 2-fold.
  • The Alternative Healthy Eating Index and the Planetary Health Diet Index were also tied for surviving to 70 with intake cognitive health and intact physical function.
  • The Empirical Dietary Index For Hyperinsulinemia edged out the Alternative Healthy Eating Index for freedom from 11 chronic diseases.

The effect of healthy diets on the odds of achieving healthy aging is independent from BMI, smoking, and physical activity. This means that:

  • The effects of healthy diets on healthy aging were not because people consuming healthy diets weighed less, smoked less, or exercised more.
  • Even if some of your lifestyle choices are suboptimal, choosing a healthy diet will increase your odds of surviving and thriving.

Finally, the study looked at the effects of individual foods on healthy aging. The results were:

  • Higher intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products increase your odds of healthy aging.
  • Higher intakes of trans fats, sodium, sugary beverages, and red or processed meats decrease your odds of achieving healthy aging.

The effects of these foods on healthy aging aren’t novel. They are consistent with dozens of other studies that have looked at the effect of individual foods on long-term health outcomes. In fact, the diets included in this study were chosen because they included foods that positively affect health outcomes and minimize foods that negatively affect health outcomes.

What About Primarily Meat-Based Diets?

the paleo dietI have good friends who advocate for primarily meat-based diets such as keto, paleo, and carnivore. I’m sure they are going to say, “This study is a sham. It only included primarily plant-based diets, so, of course, it is only going to show benefits for primarily plant-based diets.” I can hear their their questions now:

  • Why didn’t this study include any of the primarily meat-based diets? My answer is: “All the popular meat-based diets exclude one or more of the food groups associated with health and longevity and emphasize one or more of the food groups associated with a shorter, less healthy life. And these food associations are consistent among multiple long-term studies looking at the effect of various foods on health outcomes. 

The authors could have constructed a similar index for each of the popular meat-based diets. But they would have been the inverse of the plant-based diet indices because the foods included and excluded from plant-based and meat-based diets are opposite. Therefore, just like the UPF index, they would have been associated with a decreased probability of achieving healthy aging.”

  • Why did the scientists designing this study ignore the proven health benefits of primarily meat-based diets? My answer is: “The “proven benefits” of primarily meat-based diets are based on short-term studies showing the effects of those diets on biological markers. Long-term studies looking at health outcomes are lacking.”
  • But modern primarily meat-based diets are a special case because they limit carbohydrates and cause ketosis. Why weren’t they included in the study? My answer is: “The Atkins diet limits carbohydrates and causes ketosis. It has been around for more than 50 years. And, to my knowledge, there are no studies showing it is beneficial long term. If the Atkins diet cannot be shown to have long-term health benefits, it is unlikely that modern diets that mimic it are healthy long term.

What Does This Study Mean For You?

confusionThe answer is clear. If you want to survive and thrive in your 70s and beyond, choose a whole food, primarily plant-based diet.

If you want the absolute best diet, follow the Alternative Healthy Eating Index recommendations. There are many online resources to guide you.

However, any whole food, primarily plant-based diet will do. The ones with the most online resources are the Mediterranean, DASH, and MIND diets. Choose the one that best fits your food preferences and lifestyle.

If you want to go more vegetarian, the Healthy Plant-Based Diet is a bit easier than a strict vegan diet.

If you are concerned about the environment, the Planetary Diet is best for you.

If you have specific health issues like hypertension, diabetes, or inflammation, there are diets designed just for you.

And if following structured diets is not your style, just:

  • Eat more fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products.
  • Eat less trans fats, sodium, sugary beverages, and red or processed meats, and ultraprocessed foods.

Finally, even if some of your lifestyle choices are suboptimal, this study shows choosing a healthy diet will increase your odds of surviving to your 70s and thriving.

The Bottom Line

A recent 30-year study looked at the effect of 8 whole food, primarily plant-based diets on healthy aging defined as:

  • Achieving an age of 70 or more.
  • The absence of the top 11 major chronic diseases.
  • No impairment of cognitive function.
  • No impairment of physical health.
  • No mental health issues.

The key findings were:

  • Adherence to any of 8 whole food, primarily plant-based diets improved the probability of achieving healthy aging.
  • The odds of achieving healthy aging ranged from 1.45 for the Healthy Plant-Based Diet to 1.86 for the Alternative Healthy Eating Index.

For more information on this study, why primarily meat-based diets were not considered healthy enough to be included in this study, and what this study 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.

 ____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Can Cosmetics Raise Your Blood Pressure?

Do Phenols And Parabens Raise Blood Pressure?

Author: Dr. Stephen Chaney

We live in a toxic world. While we are exposed to hundreds of toxic chemicals, most research in recent years has focused on two classes of toxic chemicals – phenols and parabens. They are widely used as antimicrobial agents and preservatives in personal care products, cosmetics, pharmaceuticals, and foods.

  • Almost 80% of personal care products contain parabens.
  • You find them in unexpected places like toothpaste, soap, and skin care products.
  • You won’t find them listed on the label of fragrances because fragrance ingredients are considered proprietary.

These chemicals are excreted in the urine, are incompletely removed during wastewater treatment, and end up in our drinking water.

With so many routes of exposure, it is no wonder our bodies have become toxic waste dumps.

  • Methyl and propyl parabens have been detected in the urine of 95% of adults and 99% of teenagers in this country.
  • Multiple phenols and parabens have been detected in the urine of most US adults.
  • Levels are higher in women than men because women use more personal care products.

And that is a concern because phenols and parabens:

  • Are endocrine disruptors.
  • Are associated with reproductive difficulties and developmental delays, pregnancy complications (hypertension and gestational diabetes), and birth defects.

The best evidence for these effects comes from animal studies. It has been difficult to reproduce these effects in human studies because it has been difficult to identify a large group of subjects with high enough phenol and paraben levels to give statistically significant results.

The study (JR Varshavsky et al, Journal of Environmental Health Perspectives, volume 134, Issue 8, August, 2024)  I will discuss today was designed to overcome those difficulties. It determined the effect of maternal phenol and paraben levels on blood pressure and hypertension during pregnancy in a high-risk group of women – women who live in a region of Puerto Rico with 18 Superfund sites that have high concentrations of phenols and parabens in the groundwater.

How Was This Study Done?

clinical studyThe investigators used data from the PROTECT Center that studies exposure to environmental contamination in drinking water in Puerto Rico and its contribution to adverse pregnancy outcomes.

A total of 1,433 pregnant women between the ages of 18 and 40 (average ~25 years old) were included in the study.

  • They lived in the heavily contaminated Karst region in the northern part of Puerto Rico.
  • They were evenly split between normal and overweight + obese.
  • Most of them had household incomes <$30,000 per year.

Women were excluded from the study if they:

  • Used in vitro fertilization or oral contraceptives within 3 months of the study.
  • Had any known medical condition.
  • Were already experiencing pregnancy-related high blood pressure or gestational diabetes at the time of enrollment.

They visited clinics within the region at weeks 16-20 (visit 1) and 24-28 (visit 2) of pregnancy.

Demographic information (e.g. age, BMI, income, etc) was collected at the first visit. Blood pressure and urine samples were taken at both visits. The blood samples were analyzed for 12 phenols and parabens.

The study participants were divided into two categories according to their blood pressure.

  • The non-hypertensive group (<120-129 mmHg systolic blood pressure and <80 mmHg diastolic blood pressure.
  • The hypertensive group (130->140 mmHg systolic blood pressure and 80->90 mmHg diastolic blood pressure.

The investigators then calculated the effect of each of these phenols and parabens on the odds (risk) that the pregnant mothers would have blood pressure in the hypertensive range rather than the non-hypertensive range.

Do Phenols And Parabens Raise Blood Pressure During Pregnancy?

high blood pressureWhen the investigators combined the data from clinical visits 1 and 2, the following phenols and parabens significantly increased the odds of maternal blood pressure being in the hypertensive range:

  • M-PB (methylparaben) – found in cosmetics (foundations, concealers, blushes, eyeshadows, mascara, lip liners, and lipstick), skincare (moisturizers, lotions, creams, serums, face cleansers, facial treatments, and sunscreens), haircare (shampoos, conditioners, hair color and bleaching products, and styling gels), and other personal care products (shaving creams and gels, aftershave, deodorants, baby lotions, and diaper creams).
  • P-PB (propylparaben – found in many of the same products as M-PB (often in combination).
  • TCS (triclosan) – found in toothpaste, mouthwash, soaps, shampoos, deodorants, and skin creams.
  • TCC (triclocarban) – found in antibacterial and deodorant soaps, cosmetics, deodorants and antiperspirants.
  • 2,4-DCP (2,4-dichlorophenol) – found in personal care products from the breakdown of triclosan.
  • 2,5-DCP (2,5-dichlorophenol) – a breakdown product of 1,4-dichlorobenzene.

When the effect of these phenols and parabens on maternal hypertension was analyzed individually, the increased risk of maternal hypertension (high blood pressure) was 10-50%.

But when the combined effect of all the phenols and parabens was analyzed, the increased risk of maternal hypertension was almost double.

The authors concluded, “Our findings suggest that exposure to certain phenols, parabens, and their mixture may be related to maternal blood pressure differences during pregnancy, as well as to increased risk of hypertension, especially during the later stages of pregnancy.

This is important given the critical nature of cardiometabolic health during pregnancy on the future health of the both the mother and their children.”

Can Cosmetics Raise Your Blood Pressure?

Questioning WomanAt the beginning of this article I raised the question, “Can Cosmetics Raise Your Blood Pressure?”

The answer appears to be, “Yes, with a few caveats.”

1) It is the phenols and parabens in cosmetics that are responsible for the increase in blood pressure.

2) When you consider all the personal care products that contain phenols and parabens, cosmetics are just “the tip of the iceberg”

3) Most importantly, this study is what is called a “proof of concept study”. It simply shows that phenols and parabens can raise blood pressure in humans under the right conditions.

    • Because the investigators selected a population with very high exposure to toxic chemicals, there were enough women with high levels of polyphenols and parabens in their bodies to obtain a statistically significant association between phenols and parabens with hypertension.
    • The investigators also chose a population group (pregnant moms) that have a high risk of developing hypertension.

But what does this mean for you? That’s a hard question to answer.

  • If you are a pregnant mom with similar exposure to phenols and parabens, your risk of maternal hypertension is probably similar.
  • But if you’re not pregnant and your exposure is less, it is almost impossible to extrapolate your risk from these data. That’s what makes this field of research so difficult.

But let me just make these observations.

  • If you use personal care products, your exposure to phenols and parabens is not zero.
  • This, and other studies, show that we can’t just focus on the risks of individual toxic chemicals. In today’s world, we are exposed to hundreds of toxic chemicals, and their combined effects are much greater than that of any individual toxic chemical.
  • It’s not just blood pressure that is affected. These chemicals are endocrine disruptors that negatively affect our health in multiple ways.

In short, nobody can tell you the risks you will experience from phenol and paraben exposure, but that risk is not zero. It only makes sense to proactively limit your exposure. But how do you do that in today’s world?

How Can You Reduce Your Exposure To Phenols And Parabens? 

Here are a few simple tips for reducing your exposure to phenols, parabens, and other toxic chemicals.

  • Start By Choosing Personal Care Products With EWG (Environmental Working Group) Verification: EWG verification means the products are free of over 500 chemicals of concern (including phenols and parabens), have full ingredient transparency (what’s in the product is on the label), and meet rigorous health and safety standards based on the latest scientific research.
  • Use a Water Filter: This removes contaminants, including phenols and parabens, from your tap water.
  • Avoid Non-Stick Cookware: Switch from non-stick (PFOA/PFAS-free) cookware to stainless steel or cast iron to avoid potential exposure to other harmful chemicals.
  • Keep the Air Fresh: Let in outside air to maintain good indoor air quality and reduce exposure to various environmental chemicals found in drapes, upholstery, carpets, and mattresses.
  • Shop Fresh and Organic: Choose fresh, organic foods and reduce your consumption of foods in plastic containers, as they may contain these chemicals.
  • Limit Processed Foods: Reduce or limit your intake of fast food, microwave popcorn, and takeout food.

The Bottom Line 

Phenols and parabens are widely used as preservatives in cosmetics and other personal care products. Both are known endocrine disruptors and have been linked to a wide variety of adverse health consequences.

But most of the studies linking these chemicals to adverse health effects have been done with animals. It has been difficult to confirm these effects in human studies.

In this article, I describe a study with a high-risk group of women who were exposed to high levels of phenols, parabens, and other toxic chemicals. This study showed that phenol and paraben exposure increases the risk of maternal hypertension in this group of high-risk, high-exposure women.

This is what is called a “proof of concept” study. It clearly shows that phenol and paraben exposure can have adverse health effects in humans. But it is not clear how this risk extrapolates to low-risk, low-exposure populations.

In this article I discuss what the study means for you and how you can reduce your risk of exposure to phenols, parabens, and other toxic chemicals

For more information on this study, what it means for you, and how you can reduce your exposure to toxic chemicals, 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.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

_____________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

 

Can Protein Supplements Increase GLP-1?

What Is GLP-1 And What Does It Do?

Author: Dr. Stephen Chaney

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drugs they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. The most frequent side effects are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

These are side effects that aren’t life threatening and are easily detected. When someone experiences these side effects, they usually give their doctor a call, and their doctor either takes them off the drug or modifies the dosage.

However, more recent studies have identified two additional side effects that are much more troubling.

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors who struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

And, of course, the biggest drawback of GLP-1 drugs is that they are only a temporary fix. Unless someone changes their lifestyle, the weight comes roaring back as soon as they quit using GLP-1.

So. It’s no wonder some people are asking whether it is possible to increase their GLP-1 levels naturally without the side effects associated with GLP-1 drugs. I will discuss this below, but first I should review what GLP-1 is and what it does.

What Is GLP-1 And What Does It Do? 

Let me start by reviewing the hormones insulin and glucagon to create a proper perspective for understanding the role of GLP-1.

Insulin: Almost everyone has heard of insulin. It is released by the pancreas whenever we eat, and blood sugar levels start to rise. Its role is to lower blood sugar levels.

Glucagon: Glucagon is less well known, but you can think of it as the Yin to insulin’s Yang. It is released by the pancreas when blood sugar levels fall and continues to be present until the next meal. Its role is to increase blood sugar levels and make sure that our cells get the food they need until the next meal.

GLP-1: GLP-1 stands for glucagon-like peptide 1. With a name like that, you might expect GLP-1 to have significant sequence homology with glucagon, bind to the same receptors, and have a similar effect on our metabolism. You would be wrong!

Both peptide hormones are derived from a much larger peptide called proglucagon. This is the only way that GLP-1 is “like” glucagon.

One portion of proglucagon is processed to give glucagon in pancreatic alpha cells. Another portion is processed to give GLP-1 in intestinal L cells. [L cells are endocrine (hormone producing cells) found in the intestinal mucosa.] There is very little sequence or structural homology between glucagon and GLP-1.

Their function is also very different. You can think of GLP-1 as a partner to insulin. It is released by intestinal L cells in response to the presence of nutrients (primarily protein, fat, and carbohydrate) in the intestine. It binds to GLP-1 receptors on the…

  • Pancreas to stimulate insulin release and inhibit glucagon release. This is why it helps type 2 diabetics control their blood sugar levels.
  • Stomach to reduce the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Small intestine to reduce gut motility, which increases transit time through the small intestine. This also prolongs the feeling of fullness after a meal. But it can also lead to gastrointestinal side effects.
  • Brain to turn down your “appestat”. This reduces feelings of hunger between meals. But at high doses, it can affect the brain in negative ways (anxiety, depression, and suicidal thoughts).

Can Protein Supplements Increase GLP-1? 

Questioning WomanYou may be wondering, “Is it possible to increase GLP-1 levels naturally without side effects?” The answer is clearly, “Yes”. Every time you eat a meal, your GLP-1 levels increase naturally.

When you eat a meal, GLP-1 levels rise within 10 minutes and remain elevated for 1-2 hours. Then enzymes present in the bloodstream digest GLP-1 and it disappears. This is the way nature intended. There are no side effects to the natural rise and fall of GLP-1 after a meal.

And protein appears to play an important role in this process. High-protein meals result in higher and more prolonged GLP-1 levels than high-fat or high-carbohydrate meals. That’s because protein is digested to amino acids in the intestine. And some of those amino acids bind to receptors in intestinal L-cells and stimulate GLP-1 release.

You may be wondering what this has to do with protein supplements. Theoretically, protein supplements should offer the same benefit as a high-protein meal with fewer calories.

This hypothesis has been tested with a few protein supplements, and they have been shown to increase GLP-1 levels naturally. And, based on the limited data available, it appears that the increase in GLP-1 is proportional to the protein content of the supplement.

So, it appears that the answer I posed at the beginning of this article is,

  • Yes, it appears that protein supplements can increase protein levels naturally.
  • And it appears that the higher the protein content of the supplement, the greater the increase in GLP-1 levels.

However, there are many variations in the formulation of protein supplements, and we don’t know how these variations influence the effect of protein supplements on GLP-1 levels. Therefore,

  • We can’t yet say that all protein supplements increase GLP-1 levels equally.
  • When choosing a protein supplement, you should ask for clinical studies with their product showing it increases GLP-1 levels.

What Does This Mean For You?

If you can raise your GLP-1 levels naturally with high-protein meals and protein supplements, you might be asking, “What makes the GLP-1 drugs different?” To understand the answer to that question, you first need to know what GLP-1 drugs are.

  • GLP-1 drugs mimic the natural GLP-1 peptide.
  • However, GLP-1 drugs have been genetically modified to make them resistant to enzymatic digestion. They can stay in the bloodstream for up to 24 hours.

This is what makes them so effective as weight loss drugs. But it’s not nice to fool with mother nature. This is also why they have side effects.

And let’s remember that while GLP-1 drugs are effective, you will need to take them for the rest of your life unless you change your diet and lifestyle. And with long-term usage of the drugs, you are likely to experience one or more of their side effects at some point.

So, if you are willing to change your diet and lifestyle, it may be worthwhile looking at increasing your GLP-1 levels naturally. The effect may not be as strong as with the GLP-1 drugs, but it may help you suppress your appetite enough to successfully implement your lifestyle changes. You have lots of options.

  • Every time you eat a meal your GLP-1 levels increase. And the bigger the meal, the bigger the increase. But the bigger the meal, the greater the calories. So, that’s not an optimal way to increase GLP-1 levels.
  • That’s where protein supplements come in.
  • And since you are trying to maximize GLP-1 levels with the minimum calories, I recommend a 20–40-gram protein supplement with a minimum of carbohydrate and fat. Just be sure the manufacturer has done a clinical study to demonstrate their protein supplement raises GLP-1 levels.

The Bottom Line

In this article I asked the question, “Can protein supplements increase GLP-1 levels naturally without the side effects of GLP-1 drugs?” The answer is, “Yes”. In this article I tell you:

  • What GLP-1 is and what it does.
  • Why GLP-1 drugs have side effects.
  • How protein supplements can raise your GLP-1 levels naturally without the side effects of GLP-1 drugs.

For more details 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.

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

 

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Protein – The Longevity Nutrient

How Much Protein Do You Need?

Author: Dr. Stephen Chaney 

breaking newsIn 2016 the New York Times ran an article with the title, “Can You Get Too Much Protein?” The article asserted that most Americans were getting too much protein in their diet and that protein supplements were useless and perhaps dangerous.

At the time I wrote a “Health Tips From the Professor” article summarizing recent research showing that many people needed more than the RDA for protein and that those people were often consuming too little, rather than too much, protein.

In the 9 years since then the evidence that many Americans may not be getting enough protein has only gotten stronger.

  • The standard for protein intake used to be a “one size fits all” recommendation of 46g gm/day for women and 56 gm/day for men with slight increases recommended for pregnant and lactating women. Today we know:
    • That standard was based on outdated methodology from the 1930’s. Recent studies suggest protein intake should be at least 50% higher.
    • That standard was based on studies with healthy, sedentary adults (the adult “couch potato” crowd). Protein requirements are significantly higher for anyone who doesn’t fit that description.
  • We used to think in terms of total daily protein intake. Today we know that:
    • Protein intake should be divided equally between the 3 primary meals.
    • Protein quality is important. Protein requirements should be increased if low-quality proteins are consumed.
  • We used to worry that high protein intake might damage your kidneys. Today we know that:
    • Protein intake does not cause kidney disease. It is not a concern as long as hydration is adequate and excess alcohol is avoided.
    • Protein intake is only a concern if someone has kidney disease.

Protein – Your Longevity Nutrient

If you want to delve into the latest protein research and what it means for you, I highly recommend the book, “Forever Strong: A New, Science-Based Strategy For Aging Well” by Dr. Gabrielle Lyon.

Her book is focused on helping each of us create adequate healthy muscle mass. She says, “Adequate muscle mass is essential for health and longevity. And muscle is the only organ over which we have voluntary and complete control.”

Of course, adequate muscle mass requires both exercise and adequate protein. Dr. Lyon covers both in her book, but exercise is not my expertise, so I will only cover adequate protein intake in this “Health Tips From the Professor” article.

In her book, Dr. Lyons details recent research on the amount of protein needed to optimize muscle mass. Dr. Lyon was the one who alerted me to the fact that the current protein RDA is based on outdated methodology from the 1930’s and that actual protein needs are much higher.

Dr. Lyon concludes that most Americans are not consuming enough protein to optimize their muscle mass and that adequate protein intake is essential for longevity, metabolic function, and quality of life. Specifically, she says that optimal muscle mass:

  • Improves strength and mobility.
  • Improves blood sugar control.
  • Decreases blood triglyceride levels.
  • Strengthens the immune system.
  • Improves bone mineral density and strength.
  • Reduces all-cause mortality (risk of dying) and morbidity (risk of disease).

I will use the latest science on protein needs described in her book and in recently published clinical studies to answer the important question, “How much protein do you need?” But first I want to help you understand the dynamics of protein metabolism.

The Dynamics Of Protein Metabolism 

ProfessorMost people associate muscle mass with strength and endurance. Many understand the important role muscle mass plays in burning off excess calories and keeping us slim. But few people understand the important role that muscle protein plays in our everyday energy metabolism.

Whenever we eat a meal containing protein, we store some of the protein we eat as increased muscle mass, especially when protein intake is coupled with exercise. But muscle protein plays other very important functions. It is a precious resource.

The synthesis of new muscle in the fed state is driven by:

  • Insulin, which is released into the blood stream whenever we eat a meal.
  • Exercise because it makes muscle more sensitive to the effects of insulin.
  • The amino acid leucine, which is most abundant in high quality protein sources.

In the fed state most of our energy is derived from blood glucose. This is primarily controlled by insulin.  As blood glucose levels fall, we move to the fasting state and start to call on our stored energy sources to keep our body functioning. This process is primarily controlled by a hormone called glucagon.

  • In the fasting state most tissues easily switch to using fat as their main energy source, but…
    • Red blood cells and a few other tissues in the body are totally dependent on glucose as an energy source.
    • Our brain is normally dependent on glucose as an energy source, and our brains use a lot of energy. [Note: Our brain can switch to ketones as an energy source with prolonged starvation or prolonged carbohydrate restriction, but that’s another story for another day.]
  • Because our brain and other tissues need glucose in the fasting state, it is important to maintain a constant blood glucose level between meals.
    • Initially, blood glucose levels are maintained by calling on carbohydrate reserves in the liver.
    • But because those reserves are limited, our body starts to break down muscle protein and convert it to glucose as well – even in the normal dinner/sleep/breakfast cycle.

Simply put, in addition to its other important roles in the body, muscle protein is also an energy store. You can think of it like a bank.

When we eat, we make a deposit to that energy store. Between meals we make a withdrawal from that energy store. When we are young the system works perfectly. Unless we fast for prolonged periods of time, we are always adding enough muscle protein in the fed state to balance out the withdrawals between meals.

But there are many physiological situations where protein metabolism becomes unbalanced, either because protein breakdown is accelerated or because protein synthesis is diminished. In each of those situations, our protein needs are increased.

I will describe each of these situations and how they affect our protein needs in the section below.

How Much Protein Do You Need? 

couch potatoThe Coach Potato Group: If this is you, I won’t be judgmental. But I highly recommend you read Dr. Lyon’s book. It may just inspire you to increase your fitness level and your protein intake.

As I said before the standard RDA recommendation for the coach potato group is 46 gm/day for women and 56 gm/day for men. That’s based on 0.36 grams of protein per pound of body weight and assumes that women weigh around 127 pounds and men weigh around 155 pounds.

There are two major problems with the standard protein RDAs:

1) The protein RDA should not be a “one-size-fits-all” recommendation. The standard used to calculate the RDA is based on weight. If you are a woman weighing 127 pounds or a man weighing 155 pounds, you are to be congratulated. But in today’s world the average woman weighs 170 pounds, and the average man weighs 201 pounds.

  • That means the average protein requirement should be 61 gm/day for women and 72 gm/day for men.
  • And that’s just the average. Your protein requirement is based on your weight.

2) As I mentioned earlier, the 0.36 gm/pound standard is based on outdated methodology from the 1930’s. Based on current technology, Dr. Lyon says the standard should be closer to 0.54 gm/pound.

  • If you use that standard and use the current average weight for men and women, the average protein requirement for the couch potato group is closer to 91.5 gm/day for women and 108 gm/day for men.
  • And since protein intake should be divided equally between meals, that amounts to 30 gm/meal for women and 36 gm/meal for men. If you weigh significantly more or less than the average American, you should adjust your intake accordingly.

The Over 50 Group: When we are young muscle protein deposits in the fed state and muscle protein withdrawals during the fasting state are in balance. And if we add exercise and increase our protein intake, it’s pretty easy to increase our muscle mass.

But once we reach our Golden Years things start to change. Muscle protein synthesis becomes less efficient. We need to increase the intensity of our workouts and increase our protein intake just to maintain our muscle mass.

If we fail to do that, we gradually lose muscle mass as we age, a process referred to as sarcopenia. Between 50 and 60 we lose 5-8% of our muscle mass, and the rate that we lose muscle accelerates with each subsequent decade. And that loss of muscle mass has severe consequences. For example:

  • It interferes with daily activities like playing with our grandchildren and engaging in activities we love.
  • It decreases our metabolic rate which increases our risk of obesity and obesity-related diseases.
  • It increases our risk of falls.

In short, our quality of life is diminished, and we become unhealthy and frail.

Dr. Lyon describes the training program needed to prevent sarcopenia as we age in her book Forever Strong. But we also need more protein.

On average older adults need around 35 – 45 gm of protein per meal to prevent sarcopenia. There are not enough published studies for me to provide more specific recommendations. But here are some guidelines:

  • If you are at ideal weight and in your 50’s or 60’s, you can probably do well at the lower end of the range.
  • If you are overweight or in your 70’s or 80’s, you should probably aim for the upper end of the range.
  • I recommend getting a body composition test on an annual basis and adjusting your exercise and protein intake based on your change in muscle mass. My doctor has a simple device for measuring my body composition as part of my annual physical. If your doctor doesn’t have a device like that, find out who does in your community.

Happy woman on scaleThe Weight Loss Group: If you are actively trying to lose excess weight, I congratulate you. But the sad fact is that up to 35% of weight loss on most diets comes from muscle, not fat.

That’s because your body interprets caloric restriction as starvation and increases the rate of protein breakdown.

But you can prevent that by adding resistance training to your diet plan and increasing your protein intake. By increasing your protein intake from 15% of calories (which is what most Americans get) to 30% of calories, you can rebalance muscle metabolism by increasing muscle protein synthesis. When you do this, you can reduce muscle loss to less than 10% of weight loss.

You may be wondering, “Why set the recommendation as a percentage of calories rather than gm/pound or gm/meal”. The answer is simple. Your caloric intake changes significantly you are on a diet, so expressing protein as a percentage of calories makes more sense.

For example, 30% of calories on a 1,000-calorie diet translates into 25-30 gm/meal. You might look at that recommendation and say, “That’s less than you recommended for the couch potato who is not trying to lose weight.” My answer would be, “Yes, but the couch potato is eating 2-3-times more calories.

So, the recommendation that’s easiest to understand if you are trying to lose weight is to aim for 25-30 gm of protein/meal/1,000 calories per day.  

  • Adjust your protein intake per meal based on the daily calories allowed on your diet. 
  • And if you are on a diet that restricts the kinds of food that you can eat or the amount of time you can eat, track your actual caloric intake for a few days. The “hidden secret” behind those diets is that most people eat fewer calories because of the restrictions.

Final thought: The latest data suggest that GLP-1 drugs accelerate the muscle loss associated with dieting. This is a significant concern, especially for people over 50. Some experts are recommending as much as 35-50 gm of protein/meal if you are using a GLP-1 drug to aid your weight loss.

Weight TrainingThe Fitness Group: The question I get most often from the fitness group is, “How much protein do I need after my workout to maximize recovery and muscle gain?” This has been well researched, and the answer is age dependent.

  • If you are in your 30’s, most experts recommend 15-20 grams of protein after your workout.
  • If you are in your 60s, most experts recommend 30-35 grams of protein after your workout.
  • While precise recommendations are not available for every age, you can extrapolate from these numbers.

Does Protein Quality Matter? 

I’m often asked whether all proteins are equally effective at building muscle mass or does protein quality matter? The answer is, “Yes. Protein quality matters, but not in the way that we have thought about it in the past.”

We used to think that protein quality was measured by the balance of all the essential amino acids. While balance is important, the increase in muscle mass is driven primarily by the amino acid leucine. That’s because leucine is the only amino acid that directly stimulates muscle protein synthesis.

Simply put, proteins that are high in leucine are used more efficiently by our bodies to increase muscle mass. In fact, Dr. Lyon measures protein quality solely based on its leucine content.

Many studies have looked at the optimal amount of leucine content in protein. The numbers vary somewhat from study to study, but they average around 1 gram of leucine for every 10 grams of protein.

If you look at the leucine contents of various proteins, it is clear that a 1:10 ratio is primarily found in animal proteins. Soybeans are the only vegetable protein source that comes close.However, there are many health reasons for consuming a primarily plant-based diet. Dr. Lyon doesn’t tell her patients to avoid plant proteins. But if they are consuming primarily plant proteins, she recommends that they increase their protein intake by 35-45%, so they will be getting enough leucine to maximize muscle protein synthesis.

What Role Do Protein Supplements Play? 

Protein SupplementRemember that New York Times article that said protein supplements were useless and perhaps dangerous? That’s outdated advice. In fact, you should view protein supplements as essential for reaching your protein goals.

That’s because our protein intake needs to be divided equally between our 3 major meals, but that’s not how we eat. Most of us have no trouble getting 30-40 grams of protein at dinner, but…

  • We only get around 15 grams of protein at breakfast, and…
  • 15-20 grams of protein at lunch.

But that’s assuming we eat a typical breakfast or lunch. If we eat…

  • An unhealthy breakfast of croissants and coffee or a healthy breakfast of cornflakes, skim milk, and fruit slices, we only get around 6 grams of protein.
  • A healthy green salad for lunch, we may get as little as 2 grams of protein.

A recent study has shown that adding a protein supplement to your low protein meals can help you increase your muscle mass in as little as 24 weeks.

What Does This Mean For You? 

how much protein do athletes needProtein is your longevity nutrient. My advice is:

  • Use the information in this article to set your protein goals (Talk with your doctor first if you have any health issues that may limit your protein intake).
  • Use a simple protein tracker to identify your low-protein meals.
  • Add additional protein foods or supplements to your low-protein meals to bring your protein up to recommended levels.
  • Focus on high-leucine protein foods and supplements. (If you eat more plant protein than animal protein, as I do, increase your recommended protein intake by 35-45% to make sure you are getting the leucine you need to maximize your muscle mass.)

As for what kind of protein supplement, I recommend a plant protein supplement with added leucine.

The Bottom Line 

In her book, “Forever Strong”, Dr. Gabrielle Lyon says, “Adequate muscle mass is essential for health and longevity. And muscle is the only organ over which we have voluntary and complete control.” She goes on to state that the current RDAs for protein intake are outdated. And if we look at protein needs based on the latest research, most Americans aren’t getting enough protein in their diet to achieve adequate muscle mass.

In this article, I summarize her findings. And based on the latest research, I provide protein intake recommendations for:

  • Adult couch potatoes.
  • Fitness enthusiasts.
  • People over 50.
  • People who are trying to lose weight.

I also discuss protein quality and protein supplements.

For more information on these topics and what they mean 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.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

The Soy Myth

Why Is There So Much Confusion About Soy?

Author: Dr. Stephen Chaney

soyWhat is the truth about soy and breast cancer? Does it increase the risk of breast cancer, or is that just a myth? If you are a woman, particularly a woman with breast cancer, it is an important question.

Some experts say soy should be avoided at all costs. They say that soy will increase your risk of breast cancer. Other experts say soy is perfectly safe and may even reduce your risk of breast cancer. Who is right?

If you are a breast cancer survivor, the question of whether soy increases or decreases your risk of disease recurrence is even more crucial. You have already endured surgery, chemotherapy, and/or radiation. You never want to go through that again.

Why Is There So Much Confusion About Soy?

Questioning WomanSoy isoflavones decrease estrogen production, strengthen the immune system, inhibit cell proliferation, and reduce the production of reactive oxygen species. These are all effects that might reduce breast cancer risk.

On the other hand, soy isoflavones also bind to estrogen receptors and exhibit weak estrogenic activity. This effect has the potential to increase breast cancer risk.

Cell culture and animal studies have only confused the issue. Soy isoflavones stimulate the growth of breast cancer cells in a petri dish. Soy isoflavones also stimulate breast cancer growth in a special strain of mice lacking an immune system. However, in studies in both mice and rats with a functioning immune system, soy isoflavones decrease breast cancer risk.

The confusion has been amplified by claims and counterclaims on the internet. There are bloggers who are more interested in the spectacular than they are in accuracy (Today we call this fake news). They have taken the very weak evidence that soy isoflavones could possibly increase breast cancer risk and have blown it all out of proportion.

Their blogs claim that soy definitely increases breast cancer risk and should be avoided at all costs. Their claims have been picked up by other web sites and blogs. Eventually, the claims have been repeated so many times that people started to believe them. A “myth” has been created. I call it a myth because it was never based on convincing scientific evidence.

In the meantime, scientists looked at the cell culture and animal studies and took a more responsible approach. They said “If this is true, it is an important public health issue. We need to do clinical trials in humans to test this hypothesis.”

What Have Previous Clinical Studies Shown?

breast cancerThe question of whether soy consumption increased the risk of developing breast cancer was settled a long time ago. Some studies have shown no effect of soy consumption on breast cancer risk. Others have reported that soy consumption decreased breast cancer risk. A meta-analysis of 18 previous clinical studies found that soy slightly decreased the risk of developing breast cancer (J Natl Cancer Inst, 98: 459-471, 2006). None of those studies found any evidence that soy increased the risk of breast cancer.

What about recurrence of breast cancer in women who are breast cancer survivors? There have been five major clinical studies looking at the effects of soy consumption on breast cancer recurrence in both Chinese and American populations. Once again, the studies have shown either no effect of soy on breast cancer recurrence or a protective effect. None of them have shown any detrimental effects of soy consumption for breast cancer urvivors.

A meta-analysis of all 5 studies was published in 2013 (Chi et al, Asian Pac J Cancer Prev., 14: 2407-2412, 2013). This study combined the data from 11,206 breast cancer survivors in the US and China. Those with the highest soy consumption had a 23% decrease in recurrence and a 15% decrease in mortality from breast cancer.

What Did The Most Recent Study Show?

Clinical StudyIn earlier clinical studies the protective effect of soy has been greater in Asian populations than in North American populations. This could have been because Asians consume more soy. However, it could be due to other population differences as well.

To better evaluate the effect of soy consumption on breast cancer survivors in the North America, a group of investigators correlated soy consumption with all-cause mortality in breast cancer survivors in the US and Canada (Zhang et al, Cancer, DOI: 10.1002/cncr.30615, March 2017).

The data were collected from The Breast Cancer Family Registry, an international research infrastructure established in 1995. The women enrolled in this registry either have been recently diagnosed with breast cancer or have a family history of breast cancer.

This study included 6235 breast cancer survivors from the registry who lived in the San Francisco Bay area and the province of Ontario in Canada. The women represented an ethnically diverse population and had a median age of 51.8 at enrollment. Soy consumption was assessed either at the time of enrollment or immediately following breast cancer diagnosis. The women were followed for 9.4 years, during which time 1224 of them died.

The results were as follows:

  • There was a 21% decrease in all-cause mortality for women who had the highest soy consumption compared to those with the lowest soy consumption.
  • The protective effect of soy was strongest for those women who had receptor negative breast cancer. This is significant because receptor-negative breast cancer is associated with poorer survival rates than hormone receptor-positive cases.
  • The protective effect was also greatest (35% reduction in all-cause mortality) for women with the highest soy consumption following breast cancer diagnosis. This suggests that soy may play an important role in breast cancer survival.
  • The authors concluded “In this large, ethnically diverse cohort of women with breast cancer, higher dietary intake of [soy] was associated with reduced total mortality.”

In an accompanying editorial, Omer Kucuk, MD, of the Winship Cancer Institute of Emory University, noted that the United States is the number 1 soy producer in the world and is in a great position to initiate changes in health policy by encouraging soy intake.  He said “We now have evidence that soy foods not only prevent breast cancer but also benefit women who have had breast cancer. Therefore, we can recommend women to consume soy foods because of soy’s many health benefits.”

The Soy Myth

Myth Versus FactsEvery clinical study has its limitations. If there were only one or two studies, the question of whether soy increases breast cancer risk might still be in doubt. However, multiple clinical studies have come to the same conclusion. Either soy has no effect on breast cancer risk and breast cancer recurrence, or it has a protective effect.

Not a single clinical study has found any evidence that soy increases breast cancer risk. It is clear that consumption of soy foods is safe, and may be beneficial, for women with breast cancer. The myth that soy increases breast cancer risk needs to be put to rest.

On the other hand, we should not think of soy as a miracle food. Breast cancer risk is also decreased by a diet that:

  • Contains lots of fruits and vegetables.
  • Is low in processed grains & sweets and high in whole grains.
  • Is low in saturated & trans fats and high in omega-3 and monounsaturated fats.
  • Is low in red & processed meats and high in beans, fish & chicken.

Furthermore, diet is just one component of a holistic approach for reducing the risk of breast cancer. In addition to a healthy diet, the American Cancer Society recommends that you:

  • Control your weight
  • Be physically active
  • Limit alcohol
  • Don’t smoke
  • Limit hormone replacement therapy unless absolutely necessary.
  • Reduce stress

The Bottom Line

  • It is time to put the myth that soy increases breast cancer risk to rest. This myth is based on cell culture and animal studies, and those studies were inconclusive.
  • Multiple clinical studies have shown that soy either has no effect on breast cancer risk, or that it reduces the risk.
  • Multiple clinical studies have also shown that soy either has no effect on breast cancer recurrence in women who are breast cancer survivors, or that it reduces recurrence.
  • The most recent clinical study is fully consistent with previous studies. It reports:
    • There was a 21% decrease in all-cause mortality for women who had the highest soy consumption compared to those with the lowest soy consumption.
    • The protective effect of soy was strongest for those women who had receptor negative breast cancer. This is significant because receptor-negative breast cancer is associated with poorer survival rates than hormone receptor-positive cases.
    • The protective effect was also greatest (35% reduction in all-cause mortality) for women with the highest soy consumption following breast cancer diagnosis. This suggests that soy may play an important role in breast cancer survival.
  • No clinical studies have provided any evidence to support the claim that soy increases either breast cancer risk or breast cancer recurrence.

For more information on this study and other things you can do to reduce the risk of breast cancer 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.

 ___________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Tips For Choosing The Best Multivitamin

Don’t Fall For Misleading Marketing Claims 

Author: Dr. Stephen Chaney

ConfusionThere are lots of multivitamin-multimineral products in the marketplace. Every company must differentiate their product from the competition to win their market share. When that differentiation is based on quality, purity, and clinical proof the product works, I am all for it. May the best company win.

However, the pressure to win market share is intense. Quality controls and clinical studies are expensive. All too often companies try to differentiate their multivitamin-multimineral products based on marketing hype and/or worthless ingredients that subtract money from your wallet without adding anything of value to your health.

With so many claims and counter claims in the marketplace, it has become almost impossible for the average consumer to know which claims are true and which are false. Everyone wants to get the best multivitamin-multimineral for their health at the least possible cost. Perhaps that is why I am so frequently asked for guidance on how to choose the best multivitamin.

In this week’s article, I will give you 6 tips you can use to select the multivitamin-multimineral product that is best for you. I will tell you what to look for in a good multivitamin and which marketing claims you should just ignore.

But first, we need to look at how nutritional standards are set.

How Are Nutritional Standards Set?

The standards for nutritional supplements are set in a two-step process.

Step 1: In the first step, The Institute of Medicine (IOM) of the National Academies of Sciences selects a committee of experts called the Food and Nutrition Board to set standards for a specific set of nutrients. They set 3 kinds of standards:

  • Recommended Dietary Allowances or RDAs are the average daily dietary intake level sufficient to meet the nutrient requirements of nearly all (97-98 percent) healthy individuals in a group.
  • Adequate Intakes or AIs are established when evidence is insufficient to develop an RDA and are set at a level assumed to ensure nutritional adequacy.
  • Where toxicity is a potential concern, Tolerable Upper Limits or ULs represent the maximum daily intake unlikely to cause adverse health effects.
  • Just to confuse things, all three standards are part of what is called Dietary Reference Intakes or DRIs.

Step 2: The DRIs are specific for age, gender, pregnancy & lactation. It would be hopelessly complicated to use DRIs for nutrition labels on foods and supplements. Therefore, the FDA sets a Daily Value (DV) for the purposes of food and supplement labeling. Originally, DVs were set based on the highest DRI for a specific nutrient. However, currently the DV is an average of DRIs for adults and children 4 years and older. It is not identical to the RDA or DRI for any specific group, but it is a useful standard for supplement labels.

With this information in mind, let’s get back to the 6 tips for choosing the best multivitamin.

#1: Good Product Design Matters

nutritional supplementComparing nutrition labels on multivitamin-multimineral supplements can be tricky. Some supplements only provide 5-10% of the Daily Value (DV) for some nutrients. Are those nutrients unimportant? Some supplements provide hundreds or thousands % of the DV for other nutrients. Is more better?

Often companies will quote some random scientist or one or two clinical studies to support the mix of nutrients they include in their multivitamin-multimineral supplement. Don’t fall for their marketing hype.

The only valid nutritional standards for multivitamin-multimineral products in the United States are the DV standards set by the Food & Nutrition Board of the Institute of Medicine. They are the standards you should look for in evaluating nutrition labels.

That’s because the National Academies of Sciences is the real deal. The National Academies represents the top 1-2% of scientists in the country. To be selected to the National Academies you must be nominated by an Academy member and voted on by the entire Academy. Selection is based on your research contributions over decades. (No, I am not a member of the Academy, but thanks for thinking that question).

The Institute of Medicine of the National Academies of Sciences selects the best of the best to serve on the Food and Nutrition Board. They are world renowned experts who review all the pertinent literature (not just one or two studies) They decide on which nutrients are essential and how much of them we need.

It always amazes me that some companies pretend they know more than the Food and Nutrition Board. It amazes me even more that some people believe those companies.

With that in mind, this is what to look for when comparing nutrition labels:

  • The FDA has set Daily Value (DV) recommendations for 24 vitamins and minerals (23 if the supplement is for adult men or postmenopausal women and does not contain iron). Make sure your multivitamin-multimineral has all 24. Count them. If a company leaves out an essential nutrient, they are not required to list it on the label.
  • The Food and Nutrition Board has classified several other nutrients as essential but does not feel there have been enough studies to establish a DRI. Without a DRI, the FDA cannot set a DV. Those nutrients are represented with a “dagger” symbol on the label with the footnote “Daily Value not established”. These can be useful additions to a multivitamin-multimineral supplement, provided they are not present in excess.
  • Ignore anything companies list on their nutrition labels that does not have a %DV value or a “dagger” symbol. This is often just marketing hype. In some cases, the ingredients have no proven benefit. In many other cases, it’s just not possible to put enough of them in a multivitamin-multimineral tablet to provide any real benefit.

#2: Look For Balance

balance scaleThis is another area in which we need to be guided by the recommendations of the Food and Nutrition Board of the Institute of Medicine. One of the reasons many experts recommend that people get their vitamins and minerals from foods rather than from supplements is because many supplements are unbalanced. That’s a problem because there are many cases in which too much of one nutrient can interfere with the absorption or metabolism of related nutrients. For example,

  • Zinc and copper compete for absorption. For best absorption and maximal utilization by the body, the zinc to copper ratio should be close to 1:1 based on DV.
  • B vitamins should be in balance. Look for a multivitamin-multimineral supplement that provides 100-200% of the DV for all 8 essential B vitamins. (The levels can be higher in a B Complex supplement, but they should still be in balance.)

Some manufacturers will leave out the expensive B vitamins and load up on the cheap ones. This saves them money. It also allows them to use marketing terms like “mega” or “super”. A supplement that provides 50% or less of the DV for some B vitamins and 1,000% or more of the DV for others is ridiculous. There is absolutely no rationale for a ratio like that except to mislead consumers.

  • As for the other nutrients in multivitamin-multimineral supplements, they should not be significantly below 50% or significantly above 250% of the DV.
  • Calcium, magnesium, and phosphorous are a special case. They are bulky, so many manufacturers only provide 5-10% of them in their multivitamin-multimineral supplements. This is not ideal because many of the nutrients in a multivitamin-multimineral supplement are required for optimal utilization of calcium and magnesium in bone formation.

Many Americans get only 50% of the DV for calcium and magnesium in their diet. Thus, it makes good sense to provide 30-50% of the DV for calcium and magnesium in a multivitamin multimineral supplement. Most Americans get close to the DV for phosphorous from their diet, so the amount of phosphorous in a supplement is not particularly important.

#3: Don’t Fall For The Hype

companies that use deceptive food labelsIn their attempts to differentiate themselves, many companies claim that they use a more natural or a better utilized form of the vitamin or mineral than their competitors. Ignore those claims. They are just marketing hype. For example,

  • In previous issues of “Health Tips From the Professor” I have debunked the claims that folate and methyl folate are more natural, safer and more effective than folic acid. The claims that alternate chemical forms of other vitamins are more natural, safer, and more effective are equally bogus.
  • The claims by some manufacturers that they use a form of calcium that is more readily absorbed are not just misleading. That is the wrong question. Calcium in our bloodstream can do bad things (like calcification and hardening of the arteries) if it is not quickly utilized for bone formation.
    • Thus, the important question is how well the calcium is utilized for bone formation. Look for clinical studies showing that the calcium in their multivitamin-multimineral supplement is efficiently utilized for bone formation rather than hype about how quickly it gets into the bloodstream.
  • There is a good reason that many supplement companies continue to use ingredients like folic acid for B9, cyanocobalamin for B12, pyridoxine for B6, etc. All of them are supported by hundreds of clinical studies showing that they are safe and effective. I have no issue with companies choosing to use different forms of these vitamins. Just don’t fall for their hype that the forms they are using are somehow more natural, safer or more effective than the traditionally used forms of the same vitamin.

#4: Don’t Fall For Buzz Words

Pinochio

Some manufacturers attempt to differentiate their products by claiming they are natural, organic, non-GMO, or are made from food. The companies are attaching buzz words to their product that they know resonate with the American people. Don’t believe them. Those claims are all bogus. They are marketing hype. For example,

  • There is no standard for “natural” so companies are not required to provide any evidence to back up their claim. If they claim that their product is natural, ask for a detailed list of the source and processing method for all their ingredients. If they are unwilling or unable to provide you with that information, don’t believe their claim of natural.
  • “Organic” certification for a supplement simply means that ingredients come from crops raised using organic methods. It is no guarantee of purity. Organically grown crops can still be contaminated if the air, soil or water is contaminated from any nearby pollution source. For example, ground water pollution is the major source of heavy metal contamination often seen in rice-derived ingredients. It is far more important to select your supplement based on rigorous quality control standards that assure it is pure than to rely on “organic” on the label.
  • A “non-GMO” designation is useful for foods and for protein, but it is meaningless for the ingredients in a multivitamin-multimineral supplement. Those ingredients have been extensively purified. They contain no genetic information. They are chemically indistinguishable from purified ingredients obtained from GMO sources. If you would like more detailed information about the GMO controversy, I have provided a balanced perspective on GMO in a video.
  • Claims by some companies that their vitamins are derived from foods are completely bogus. That is a physical impossibility. For example, let’s look at what it would take to provide the DV for just 3 of the nutrients in a single multivitamin pill, assuming they started with the best food sources of those 3 nutrients:
    • It would take 1 cup of cooked lentils, 2 cups of cooked spinach, or 4 cups of cooked broccoli to provide the DV for folic acid.
    • It would take 1 cup of sunflower seeds, 1.5 cups of pistachio nuts, or 7 ounces of cooked tuna to provide the DV for vitamin B6.
    • It would take 5 ounces of cooked chicken breast, 1 cup of peanuts, or 6 cups of green peas to provide the DV for niacin.

That’s just 3 nutrients and one multivitamin tablet. You do the math. If they lie to you about their vitamins coming from food, they will probably lie about other things as well.

#5: Don’t Fall For Scare Tactics

Darth VaderSome companies try to scare you into buying their products by claiming their competitors are using unsafe ingredients. These claims are usually bogus, but it is useful to understand where this misinformation comes from.

There is a lot of unfounded hysteria on the internet about product ingredients. Much of this hysteria has been fueled by a few well-known bloggers. I believe their intentions were pure in the beginning. They started by warning the public about truly dangerous ingredients like artificial colors, flavors, preservatives and sweeteners.

However, blogging has a dark side. To capture a large audience, your blog posts need to be sensational every week. As the weeks go by it becomes harder and harder to find subject matter that is both sensational and accurate. That’s when some bloggers go over to “the dark side”.

They become more concerned about the size of their audience than the accuracy of the information they post. They start vilifying ingredients that are perfectly safe as long as the manufacturer purifies them correctly and tests them for purity. These are ingredients which might be of concern for products made by a company with poor quality controls but pose no concern for products made by a company with high quality control standards. In other words, they should not be spreading hysteria about the ingredient. They should focus on some of the real quality control issues in our industry.

To help you sort through all the hysteria about product ingredients, I have previously published a two-part series on ingredients in which I sorted through the claims and divided common ingredients into the good, the bad, and the ugly.

#6: Demand Proof

Clinically ProvenThis is the most important tip of all. Many companies make wild claims about their products but feel no need to back up their claims. Ignore their hype and demand they give proof to back up their claims.

  • If they claim their products are pure, ask how many quality control tests they run on their products.
  • If they claim their products work, ask for proof. Ask for clinical studies…
    • That have been done with people, not with animals, cell culture, or test tubes*
    • That have been published in peer-reviewed scientific journals.
    • That have been done with their product, not studies done with another product.

*Animal, cell culture and test tube studies are valid if they are used to identify a potential mechanism of action but should not be cited as proof the product works. For ethical reasons, I prefer companies that do not use animal studies.

The Bottom Line

Everyone would like to get the best multivitamin-multimineral for their health at the least possible cost. However, there are lots of multivitamin-multimineral products in the marketplace. The pressure to win market share is intense. Quality controls and clinical studies are expensive. All too often companies try to differentiate their multivitamin-multimineral products based on marketing hype.

With so many claims and counter claims in the marketplace, it has become almost impossible for the average consumer to know how to choose the best multivitamin-multimineral product. In this week’s article, I have given you 6 tips you can use to select the multivitamin-multimineral product that is best for you. I have told you what to look for in a good multivitamin and which marketing claims you should just ignore. In summary:

  • Start with the nutrition label. A good multivitamin-multimineral supplement should contain all 24 essential nutrients recommended by the Food and Nutrition Board of the Institute of Medicine (23 if the supplement is without iron). Anything else is probably marketing hype.
  • Make sure the nutrients are in the correct balance. Again, your evaluation should be guided by the Institute of Medicine.
  • Don’t fall for the hype. Many companies claim that they use a more natural, safer, or better utilized form of certain vitamins or minerals than their competitors. Ignore those claims. They are usually just marketing hype
  • Don’t fall for buzz words. Some companies attempt to differentiate their products by claiming they are natural, organic, non-GMO, or are made from food. The companies are attaching buzz words to their product that they know resonate with the American people. Don’t believe them. Those claims are all bogus. They do nothing to improve your health. They are marketing hype.
  • Don’t fall for scare tactics. Some companies try to scare you into buying their products by claiming their competitors are using unsafe ingredients. These claims are usually bogus.
  • Demand poof. This is the most important tip of all. Many companies make wild claims about their products but feel no need to back up their claims. Ignore their hype and demand they give proof to back up their claims.
  • If they claim their products are pure, ask how many quality control tests they run on their products.
  • If they claim their products work, ask for proof. Ask for clinical studies…
    • That have been done with people, not with animals, cell culture, or test tubes.
    • That have been published in peer-reviewed scientific journals.
    • That have been done with their product, not studies done with another product.

For more details about each of those tips, 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.

____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

The Low Carb Myth

The “Goldilocks Effect”

Author: Dr. Stephen Chaney

low carb dietThe low carb wars rage on. Low carb enthusiasts claim that low-carb diets are healthy. And they claim the lower you go, the healthier you will be. Let me start with some definitions:

  • The typical American diet is high carb. It gets about 55% of its calories from carbohydrates. [Note: The Mediterranean and DASH diets also get about 55% of their calories from carbohydrates. I’ll talk more about that later.]
  • Moderate carb diets get 26-46% of their calories from carbohydrates. Examples include the low carb Mediterranean diet and the Paleo, South Beach, and Zone diets.
  • Low carb diets get <26% of their calories from carbohydrates. The Atkins diet is the classic example of a low carb diet.
  • Very low carb diets get <10% of their calories from carbohydrates. Examples are the Keto and Carnivore diets.

And I don’t need to tell you that the Keto and Carnivore diets are receiving a lot of favorable press lately.

But some health experts warn that low carb and very low carb diets may be dangerous. For example, several studies have reported that low carb diets increase the risk of mortality (shorten lifespan).

As a consumer you are probably confused by the conflicting claims. Are low carb diets healthy, or is this another myth? In this issue of “Health Tips From the Professor” I am going to discuss two very large studies that came to opposite conclusions.

Both were what we call meta-analysis studies. Simply put, that means they combine the data from several smaller studies to obtain more statistically reliable data. But as Mark Twain said, “There are lies. There are damn lies. And then there are statistics.”

The first study, called the Prospective Urban Rural Epidemiology (PURE) study, was published a few years ago. It included data from 135,335 participants from 18 countries across 5 continents. That’s a very large study, and normally we expect very large studies to be accurate.

It showed a linear relationship between carbohydrate intake and mortality. Simply put, the more carbohydrate people consumed, the greater their risk of premature death. The results from the PURE study had low carb enthusiasts doing a victory lap and claiming it was time to rewrite nutritional guidelines to favor low carb diets.

SkepticWhenever controversies like this arise, reputable scientists are motivated to take another look at the question. They understand that all studies have their weaknesses and biases. So, they look at previous studies very carefully and try to design a study that eliminates the weaknesses and biases of those studies. Their goal is to design a stronger study that reconciles the differences between the previous studies.

And this study had two glaring weaknesses.

  • The percent carbohydrate intake ranged from 40% to 80%. It showed that a moderate carbohydrate intake might be healthier than a high carbohydrate intake, but it provided no information about low carb or very low carb diets.
  • The data was primarily from Asian countries. It was not clear whether it was relevant to the kind of diets consumed in North America and Europe.

A second study published a year later (SB Seidelmann et al, The Lancet, doi.org/10.1016/S2468-2667(18)30135-X) eliminated these weaknesses and resolved the conflicting data.

How Was The Second Study Done?

clinical studyThis study was performed in two parts. This first part drew on data from the Atherosclerosis Risk in Communities (ARIC) study. That study enrolled 15,428 men and women, aged 45-64, from four US communities between 1987 and 1989. This group was followed for an average of 25 years, during which time 6283 people died.

Carbohydrate intake was calculated based on food frequency questionnaires administered when participants enrolled in the study and again 6 years later. The study evaluated the association between carbohydrate intake and mortality.

The second part was a meta-analysis that combined the data from the ARIC study with all major clinical studies since 2007 that measured carbohydrate intake and mortality and lasted 5 years or more. The total number of participants included in this meta-analysis was 432,179, and it included data from previous studies that claimed low carbohydrate intake was associated with decreased mortality.

The Low Carb Myth

The results from the ARIC study were:

GravestoneThe relationship between mortality and carbohydrate intake was a U-shaped curve.

    • The lowest risk of death was observed with a moderate carbohydrate intake (50-55%). This is the intake recommended by current nutrition guidelines.
    • The highest risk of death was observed with a low carbohydrate intake (<20%).
    • The risk of death also increased with very high carbohydrate intake (>70%).
  • When the investigators used the mortality data to estimate life expectancy, they predicted a 50-year-old participant would have a projected life expectancy of:
    • 33.1 years if they had a moderate intake of carbohydrates.
    • 4 years less if they had a very low carbohydrate intake.
    • 1.1 year less if they had a very high carbohydrate intake.
  • And the risk associated with low carbohydrate intake was affected by what the carbohydrate was replaced with.
    • When carbohydrates were replaced with animal protein and animal fat there was an increased risk of mortality on a low-carb diet.

The animal-based low-carb diet contained more beef, pork, lamb, chicken, and fish. It was also higher in saturated fat.which low carb diets are healthy

    • When carbohydrates were replaced with plant protein and plant fats, there was a decreased risk of mortality on a low-carb diet. The plant-based low-carb diet contained more nuts, peanut butter, dark or whole grain breads, chocolate, and white bread. It was also higher in polyunsaturated fats.
  • The effect of carbohydrate intake on mortality was virtually the same for all-cause mortality, cardiovascular mortality, and non-cardiovascular mortality.
  • There was no significant effect of carbohydrate intake on long-term weight gain (another myth busted).

The results from the dueling meta-analyses were actually very similar in some respects. When the data from all studies were combined:

  • Very high carbohydrate diets were associated with increased mortality.
  • Meat-based low-carb diets increased mortality, and plant-based low-carb diets decreased mortality.
  • The results were the same for total mortality, cardiovascular mortality, and non-cardiovascular mortality.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy and both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged.

Alternatively, when restricting carbohydrate intake, replacement of carbohydrates with predominantly plant-based fats and proteins could be considered as a long-term approach to healthy aging.”

Simply put, that means if a low carb diet works best for you, it is healthier to replace the carbs with plant-based fats and protein rather than animal-based fats and protein.

The “Goldilocks Effect”

Goldilocks EffectThis study also resolved the discrepancies between previous studies. The authors pointed out that the PURE study relied heavily on data from Asian and developing countries, and the average carbohydrate intake is very different in Europe and the US than in Asian and developing countries.

  • In the US and Europe mean carbohydrate intake is about 50% of calories and it ranges from 25% to 70% of calories. With that range of carbohydrate intake, it is possible to observe the increase in mortality associated with both very low and very high carbohydrate intakes.
  • The US and European countries are affluent, which means that low carb enthusiasts can also afford diets high in animal protein.
  • In contrast, white rice is a staple in Asian countries, and protein is a garnish rather than a main course. Consequently, overall carbohydrate intake is greater in Asian countries and very few Asians eat a truly low carbohydrate diet.
  • High protein foods tend to be more expensive than high carbohydrate foods. Thus, very few people in developing countries can afford to follow a very low carbohydrate diet, and overall carbohydrate intake also tends to be higher in those countries.

Therefore, in Asian and developing countries the average carbohydrate intake is greater (~61%) than in the US and Europe (~50%), and the range of carbohydrate intake is from 45% to 80% of calories instead of 25% to 70%. With this range of intake, it is only possible to see the increase in mortality associated with very high carbohydrate intake.ARIC Study

In fact, when the authors of the current study overlaid the data from the PURE study with their ARIC data, there was an almost perfect fit. The only difference was that their ARIC data covered both low and high carbohydrate intake while the PURE study touted by low carb enthusiasts only covered moderate to high carbohydrate intake.

[I have given you my rendition of the graph on the right. If you would like to see the data yourself, look at the paper.]

Basically, low carb advocates are telling you that diets with carbohydrate intakes of 26% or less are healthy based on studies that did not include carbohydrate intakes below 40%. That is misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.

In short, the ARIC study finally answered the question, “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough”.

I call this “The Goldilocks Effect”. You may remember “Goldilocks And The Three Bears”. One bed was too hard. One bed was too soft. But one bed was “just right”. One bowl of porridge was too hot. One was two cold. But one was “just right”.

According to this study, the same is true for carbohydrate intake. High carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But moderate carbohydrate intake is “just right”.

What Does This Study Mean For You?

QuestionsThere are several important take-home lessons from this study:

1) All major studies agree that very high carbohydrate intake is unhealthy. In part, that reflects the fact that diets with high carbohydrate intake are likely to be high in sodas and sugary junk foods. It may also reflect the fact that diets which are high in carbohydrates are often low in plant protein or healthy fats or both.

2) All studies that cover the full range of carbohydrate intake agree that low and very low carbohydrate diets are also unhealthy. They shorten the life expectancy of a 50-year-old by about 4 years.

3) The studies quoted by low carb enthusiasts to support their claim that low-carb and very low carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets. Their claims are a myth.

4) Not all high carb diets are created equally. As I noted above, the Mediterranean and DASH diets are just as high in carbohydrates as the typical American diet, but their carbohydrates come from whole fruits and vegetables, whole grains, beans, nuts, and seeds. And multiple studies show that both diets are much healthier than the typical American diet.

5) Not all low carb diets are created equally. Meat-based low-carb diets decrease life expectancy compared to the typical American diets while plant-based low carb diets increase life expectancy.

6) The health risks of meat-based low-carb diets may be due to the saturated fat content or the heavy reliance on red meat. However, the risks are just as likely to be due to the foods these diets leave out – typically fruits, whole grains, legumes, and some vegetables.

7) Proponents of low-carb diets assume that you can make up for the missing nutrients by just taking multivitamins. However, each food group also provides a unique combination of phytonutrients and fibers. The fibers, in turn, influence your microbiome. Simply put, whenever you leave out whole food groups, you put your health at risk.

The Bottom Line

The low-carb wars are raging. Several studies have reported that low carb diets increase risk of mortality (shorten lifespan). However, a study published a few years ago came to the opposite conclusion. That study had low carb enthusiasts doing a victory lap and claiming it is time to rewrite nutritional guidelines to favor low-carb diets.

However, a study published a year later resolves the conflicting data and finally answers the question: “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough”.

I call this “The Goldilocks Effect”. According to this study, high carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But moderate carbohydrate intake is “just right”.

Specifically, this study reported:

  • Moderate carbohydrate intake (50-55%) is healthiest. This is the carbohydrate intake found in healthy diets like the Mediterranean and DASH diets, and is the intake recommended by current nutritional guidelines.
  • All major studies agree that very high carbohydrate intake (60-70%) is unhealthy. It shortens the life expectancy of a 50-year-old by about a year.
  • All studies that cover the full range of carbohydrate intake agree that low carbohydrate intake (<26%) is also unhealthy. It shortens the life expectancy of a 50-year-old by about 4 years.
  • The studies quoted by low carb enthusiasts to support their claim that low-carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.
  • Meat-based low-carb diets decrease life expectancy while plant-based low carb diets increase life expectancy. This is consistent with the results of previous studies.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy and both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged.”

Simply put, the latest study means that the supposed benefits of low carb diets are a myth.

For more details, 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.

___________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Have You Winterized Your Immune System?

What Role Does Supplementation Play?

Author: Dr. Stephen Chaney

Winter WindWinter is just around the corner. Temperatures will plunge and winter winds will blow. And with the winter months come winter illnesses.

You probably have already winterized your car and have had your heating system checked to make sure it is winter-ready. But have you winterized your immune system?

We are being told to expect new strains of the flu and COVID this winter. RSV isn’t changing, but it is still hanging around. We are being told to get our shots now. But those shots don’t protect us from the common cold and other viral illnesses, so we are also being advised about which drugs to take if we do get sick.

But you may be wondering if there is a holistic approach for strengthening your immune system…

…A natural approach that might make improve the effectiveness of the shots or allow you to do without them.

…A natural approach that would improve your resistance to the illnesses that shots don’t touch.

My answer is yes! Here are my suggestions:

Have You Winterized Your Immune System?

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There are charlatans that will sell you specialized pills and potions to strengthen your immune system. Ignore them. For the most part their claims are bogus.

There are the “Dr. Strangeloves” of the internet that will recommend highly specialized and/or restrictive dietary programs to strengthen your immune system. Ignore them. They are more interested in audience numbers than in science.

I recommend a simple, common-sense approach. We don’t need specialized recommendations to strengthen our immune systems. In fact, there is one healthy lifestyle that benefits us in multiple ways. The same recommendations that reduce our risk of health disease, cancer, and diabetes also strengthen our immune system. 

  • Start by eating a balanced diet composed of whole, unprocessed foods without a lot of fat and simple sugars. A great place to start designing a balanced diet that is perfect for your age, gender and activity level is https://choosemyplate.gov.
  • Get plenty of sleep. The experts recommend 8 hours of sleep a night, but most Americans get far less than that.
  • Exercise on a regular basis. Both too little and too much exercise can weaken the immune system (You might have guessed that the problem for most of us is the “too little”, not the “too much”). The experts recommend at least 30 minutes at least 5 days a week. Twice that amount is probably optimal unless you want to run marathons or become a “muscle man”.
  • Maintain ideal body weight. Those excess pounds really zap our immune system.
  • Minimize your reliance on medications. Many common medications weaken the immune system (Just listen to the disclaimers in the TV commercials for examples). But you must work with your physician on this. Once your physician knows that you are willing to take personal responsibility for your diet and lifestyle, they will generally be willing to minimize the number of medications that they prescribe.
  • Focus on the positive. Studies show that optimists are healthier and live longer than pessimists. And the good news is that anyone can cultivate an attitude of optimism. For most of us it is a lifestyle choice – not something that we were born with.
  • Add a supplement program to assure that your immune system is functioning optimally. In the ideal world supplements wouldn’t be necessary, but there are very few “saints” who do a great job in all 6 of the areas that I mentioned above.

What Role Does Supplementation Play?

Immune SupportA well-designed supplement program fills in the “gaps”. We want to make sure that we are getting adequate nutrition to keep our immune system healthy. Here are the nutrients you need:

  • B vitamins and protein because our immune cells need to divide very rapidly when we have immune challenges.
  • Antioxidants because our immune cells create lots of free radicals.
  • Trace minerals, especially iron and zinc, because they are required by important enzymes of the immune system.
  • Vitamin D because it is vitally important for a strong immune system and most of us are not getting enough.
  • Probiotics (healthy bacteria) because 70% of our immune system reside in the gut, and “bad” bacteria and yeast in our intestines can weaken the immune system.
  • Omega-3 fatty acids to modulate the immune system once it has taken care of the invading bacteria or viruses.

We don’t need mega-doses. We just need enough.

One final thought: Remember that a holistic approach to strengthening our immune system is not an “either – or” proposition. Experts tell us that the flu shot is 66% effective in preventing the flu for people with a strong immune system and only 33% effective in preventing the flu for people with a weak immune system.

Optimizing Your Immune Response

OptimizeA group of experts recently published an exhaustive review of the role nutrition plays in preventing upper respiratory viral infections (PC Calder et al, “Optimal Nutritional Status For A Well-Functioning Immune System Is An Important Factor To Protect Against Viral Infections”, Nutrients, 1181-1200, 2020).

Their conclusions were:

1) “Supplementation with some nutrients in addition to a well-balanced diet is a safe, effective, and low-cost strategy to help support optimal immune function.”

    • They recommended ~100% of the RDA for vitamins a, B6, B12, E, folic acid, and minerals zinc, iron, selenium, magnesium, and copper.
    • They recommended 250 mg/day of EPA and DHA.

2) “Supplementation with above the RDA for vitamins C and D is warranted.”

    • They recommended 200 mg/day of vitamin C for healthy individuals and 1-2 g/day for individuals who are sick.
    • They recommended 2,000 IU/day for vitamin D.

3) “Public Health individuals should include nutritional strategies in their recommendations.”

The Bottom Line

This week I shared tips on winterizing your immune system, so you can withstand the worst that winter brings.

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.

 ____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

The Good Cholesterol Myth

Is Everything You Knew About HDL Wrong?

Author: Dr. Stephen Chaney 

HDL CHolesterolOver the past couple of weeks” I have talked about one of the greatest strengths of the scientific method – namely that investigators constantly challenge, and occasionally disprove, existing paradigms. That allows us to discard old models of how things work and replace them with better ones.

Two weeks ago, I shared a study that disproved the myth that low to moderate alcohol consumption is healthier than total abstinence.

Last week I shared a study that disproved the myth about chocolate helping you lose weight weight.

This week I tackle the “good” cholesterol myth. I will share several studies that challenge the belief that HDL cholesterol is good for your heart.

The belief that HDL is good for your heart has all the hallmarks of a classic paradigm.

  • It is supported by multiple clinical studies.
  • Elaborate metabolic explanations have been proposed to support the paradigm.
  • It is the official position of most medical societies, scientific organizations, and health information sites on the web.
  • It is the recommendation of most health professionals.
  • It has been repeated so often by so many trusted sources that everyone assumes it must be true.

Once we accept the HDL/heart health paradigm as true, we can construct other hypotheses on that foundation. For example:

  • Raising your HDL levels naturally takes effort. Pharmaceutical companies have been pursuing the “magic pill” that raises HDL levels without any effort on your part.
  • Low carb diets like the Keto and Paleo diets are high in saturated fat. The low carb enthusiasts claim this is a good thing because saturated fat raises HDL levels, and HDL is good for your heart.

But what if the paradigm that HDL is good for your heart isn’t true? What if it is a myth? These hypotheses would be like the parable of a house built on a foundation of sand. They will be washed away as soon as the paradigm is critically tested.

So, let’s look at experiments that have challenged the HDL/heart health paradigm.

Do Drugs That Increase HDL Levels Work?

The first hint that the HDL/heart health paradigm might be faulty happened when a pharmaceutical company developed a drug that selectively increased HDL levels.

The drug company thought they had found the goose that laid golden eggs. Just imagine. People wouldn’t have to lose weight, exercise, or change their diet. They could simply take a pill and dramatically decrease their heart disease risk. A drug like that would be worth billions of dollars.

The problem was that when they tested their drug (torcetrapib) in clinical trials, it had absolutely no effect on heart disease outcomes (AR Tall et al, Atherosclerosis, Thrombosis, and Vascular Biology 27:257-260, 2007).

The pharmaceutical company couldn’t believe it. Raising HDL levels just had to reduce heart disease risk. They concluded they didn’t have the right drug, and they continued to work on developing new drugs.

That was 18 years ago, and no HDL-increasing drug has made it to market. Have they just not found the right drug, or does this mean the HDL/heart health paradigm is incorrect?

Does Saturated Fat Decrease Heart Disease Risk?

Now let’s turn to two claims of low carb enthusiasts.

#1: Saturated fats decrease your risk of heart disease in the context of a low carb diet. I have debunked that claim in several previous issues of “Health Tips From The Professor”. But let me refer you to two articles here – one on saturated fat and heart disease risk and one on low-carb diets.

#2: Saturated fats decrease heart disease risk because they raise HDL levels. This is the one I will address today.

The idea that saturated fats decrease heart disease risk because they raise HDL levels is based on a simplistic concept of HDL particles. The reality is more complex. Several clinical studies have shown:

  • The type of fat determines the property of the HDL particles.
    • When polyunsaturated fats predominate, the HDL particles have an anti-inflammatory effect. When saturated fats predominate, the HDL particles have a pro-inflammatory effect.
  • Anti-inflammatory HDL particles relax the endothelial cells lining our blood vessels. That makes the lining of our blood vessels more pliable, which improves blood flow and reduces blood pressure.
    • Anti-inflammatory HDL particles also help reduce inflammation of the endothelial lining. This is important because an inflamed endothelial lining is more likely to accumulate fatty plaques and to trigger blood clot formation that can lead to heart attacks and strokes.

So, the question becomes, “What good is it to raise HDL levels if you are producing an unhealthy, pro-inflammatory HDL particle that may increase the risk of high blood pressure, heart attacks, and strokes?”

In short, these studies suggest it isn’t enough to just focus on HDL levels. You need to ask what kind of HDL particles you are creating.

Is HDL Good For Your Heart?

Once the studies were published showing that…

  • Drug-induced increase of HDL levels without any change in health habits is not sufficient to decrease heart attack risk, and…
  • Not all HDL particles are healthy. There are anti-inflammatory and pro-inflammatory HDL particles, which are likely to have opposite effects on heart attack risk…

…some people started to question the HDL/heart health paradigm. And one group came up with the perfect study to test the paradigm.

But before I describe the study, I need to review the term “confounding variables”. Here is a brief synopsis:

  • The studies supporting the HDL/heart health paradigm are association studies. Association studies measure the association between a single variable (in this case, increase in HDL levels) and an outcome (in this case, heart disease events, heart disease deaths, and total deaths).
  • Associations need to be corrected for other variables known to affect the same outcome (things like age, gender, smoking, and diabetes would be examples in this case).
  • Confounding variables are variables that also affect the outcome but are unknown or ignored. Thus, they are not used to correct the associations, which can bias the results.

The Good Cholesterol Myth

strong heartThe authors of this study (M Briel et al, BMJ 2009:338.b92) observed that most interventions that increase HDL levels also lower LDL levels. Lowering LDL is known to decrease the risk of heart disease deaths. But this effect had been ignored in most studies looking at the association between HDL and heart disease deaths.

They hypothesized that the change in LDL levels was a confounding variable that had been ignored in previous studies and may have biased the results.

To test this hypothesis the authors searched the literature and identified 108 studies with 299,310 participants that:

  • Compared the effect of drugs, omega-3 fatty acids, or diet with either a placebo or usual care.
  • Measured both HDL and LDL levels.
  • Measured reduction in cardiovascular risk.
  • Had a randomized control design.
  • Lasted at least 6 months.

They found that every 10 mg/dl decrease in LDL levels in these studies was responsible for a:Heart Disease Study

  • 1% reduction in heart disease events (both heart disease deaths and non-fatal heart attacks).
  • 2% reduction in heart disease deaths.
  • 4% reduction in total deaths.

After correcting for the effect of decreased LDL levels on these heart disease outcomes, the increase in HDL levels had no statistically significant effect on any of the outcomes.

The authors concluded, “Available data suggest that simply increasing the amount of circulating HDL cholesterol does not reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths. The results support reduction in LDL cholesterol as the primary goal for lipid modifying interventions.”

In other words, this study:

  • Supports the author’s hypothesis that LDL levels were a confounding variable that biased the studies supporting the HDL/heart health paradigm.
  • Concludes that increasing HDL levels has no effect on heart disease outcomes, thus invalidating the HDL/heart health paradigm.

In short, this study destroyed the “good” cholesterol myth.

Is Everything You Knew About HDL Wrong?

Peek Behind The CurtainDoes that mean that everything you knew about HDL is wrong? Not exactly. It just means that you may need to change your perspective.

Don’t focus on HDL levels. Peek behind the curtain and focus on what’s behind the HDL levels. For example:

  • Losing weight when overweight increases HDL levels. But the decrease in heart disease outcomes is more likely due to weight loss than to the increase in HDL levels.
  • Exercise increases HDL levels. But the decrease in heart disease outcomes is more likely due to exercise than to the increase in HDL levels.
  • Reversing pre-diabetes or type 2 diabetes increases HDL levels. But the decrease in heart disease outcomes is more likely due to the reversal of diabetes than to the increase in HDL levels.
  • High-dose omega-3 fatty acids increase HDL levels. But the decrease in heart disease outcomes is more likely due to the omega-3 fatty acids than to the increase in HDL levels.
  • The Mediterranean diet increases HDL levels. But the decrease in heart disease outcomes is more likely due to the diet than to the increase in HDL levels.

And if you want to go the drug route:

  • Statins and some other heart drugs increase HDL levels, but the reduction in heart disease outcomes is probably due to their effect on LDL levels rather than their effect on HDL levels.

On the other hand:

  • Saturated fats increase HDL levels. But saturated fats increase heart disease risk and create pro-inflammatory HDL particles. So, in this case the increase in HDL levels is not a good omen for your heart.
  • Drugs have been discovered that selectively increase HDL levels. However, there is nothing of value behind this increase in HDL levels, so the drugs have no effect on heart disease outcomes.

The Bottom Line 

In this article I discuss several studies that have challenged the good cholesterol myth – the belief that HDL is good for your heart.

For example, one group of investigators analyzed the studies underlying the HDL/heart health paradigm. They hypothesized that these studies were inaccurate because they failed to account for the effects of LDL levels on heart disease outcomes.

After correcting for the effect of decreased LDL levels on heart disease outcomes in the previous studies, the authors showed that increases in HDL levels had no significant effect on any heart disease outcome.

The authors concluded, “Available data suggest that simply increasing the amount of circulating HDL cholesterol does not reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths. The results support reduction in LDL cholesterol as the primary goal for lipid modifying interventions.”

In other words, this study:

  • Supports the author’s hypothesis that LDL levels were a confounding variable that biased the studies supporting the HDL/heart health paradigm.
  • Concludes that increasing HDL levels has no effect on heart disease outcomes, thus invalidating the HDL/heart health paradigm.

Does that mean that everything you knew about HDL is wrong? Not exactly. It just means that you need to change your perspective. Don’t focus on HDL levels. Focus on what’s behind the HDL levels. For more information on that, read the article above.

For more information 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.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

Health Tips From The Professor