Dr. Steve Chaney, Author at Health Tips From The Professor

Protein Needs For Older Adults

February 10, 2015 by Dr. Steve Chaney

How Much Protein Do We Need?

Author: Dr. Stephen Chaney

What are the protein needs for older adults? In previous “Health Tips From the Professor” I have covered the optimal amount of protein for weight loss diets in high protein diets and weight loss and following workouts . In this issue of “Health Tips From the Professor” I will review the latest information about protein needs as we age.

To put this in perspective, many Americans suffer from sarcopenia (loss of muscle mass) as they age.

Some of you may be saying “So what? I wasn’t planning on being a champion weight lifter in my golden years.” The “So what” is that loss of muscle mass leads to loss of mobility, a tendency to fall (which often leads to debilitating bone fractures) and a lower metabolic rate – which leads to obesity and all of the illnesses that go along with obesity.

How Can We Prevent Loss of Muscle Mass As We Age?

Fortunately, sarcopenia is not an inevitable consequence of aging. There are things that we can do to prevent it. The most important thing that we can do to prevent muscle loss as we age is to exercise – and I’m talking about resistance (weight) training, not just aerobic exercise.

But we also need to look at our protein intake and our leucine intake. Protein is important because our muscle fibers are made of protein.

Leucine is an essential amino acid. It is important because it stimulates the muscle’s ability to make new protein. Leucine and insulin act synergistically to stimulate muscle protein synthesis after exercise. I have covered the evidence behind leucine’s importance in maintaining and building muscle mass in a previous “Health Tips From the Professor”, Leucine Triggers Muscle Mass.

Do Our Protein Needs Increase As We Age?

Interestingly, our protein needs actually increase as we age. Campbell et al (Journal of Gerontolgy: Medical Sciences 56A: M373-M380, 2001) showed several years ago that RDA levels of protein were not sufficient to maintain muscle mass in both men & women aged 55 to 77 years old.

Many experts recommend that those of us in our golden years should consume the amount of protein in grams that is equivalent to half our body weight in pounds every day.

When Should We Eat Our Protein?

When we consume the protein is also important. Forget that continental breakfast, salad for lunch and protein-rich dinner. As we age we increasingly need high quality protein at every meal.

In one study, young adults (average age = 31), experienced increased muscle protein synthesis when they consumed as little as 15 grams of protein at a meal, but older adults (average age = 68) experienced no increase in muscle protein synthesis in response to the same low protein meal (Katsanos et al, Am J Clin Nutr 82: 1065-1073).

However, when the amount of protein in a meal was increased to 30 grams (equivalent to a 4 oz piece of chicken or beef) both younger and older adults were able to use that protein to build muscle (Symons et al,Am J Clin Nutr 86: 451-456, 2007).

But, 30 grams seems to be about optimal. Protein intakes above 30 grams in a single meal resulted in no further increase in muscle protein synthesis (Symons et al, J Am Diet Assoc 109: 1582-1586, 2009), which means you can’t hope to get all of the muscle building benefits of protein in a single meal.

As a consequence of these studies most experts recommend that we “golden agers” aim for 20 to 30 grams of high quality protein with every meal.

How Much Leucine Do We Need?

The story with leucine is similar. 1.7 grams of leucine was not sufficient to increase muscle protein synthesis following exercise in older adults, while 2.7 grams was sufficient (Katsanos et al, Am J Physiol Endocrinol Metab 291: E381-E387, 2006). So the experts recommend that older adults get 3 grams of leucine in our diet following workouts to maximize the effect of the workout.

And, of course, if we want to maximize the effects of resistance training, both the protein and leucine need to be consumed after we exercise, not before (Fujita et al, J Appl Physiol 106: 1730-1736, 2009).

Where Do We Get the Protein and Leucine We Need?

So, where do we get the amount of protein and leucine that we are looking for?

If you want to get them from food alone, 4 oz servings of meat are a good starting place – with chicken being the best (35 grams of protein and 2.7 grams of leucine). Dairy, eggs and vegetable foods are much lower in leucine, protein or both.

Unfortunately, I keep running into seniors who are fully convinced that broccoli and tofu will meet their protein needs. I fully understand the rationale for choosing vegetarian protein sources, but you need a bit more than broccoli and tofu if you are going to meet your protein needs in your golden years.

For example, a 4 ounce serving of tofu provides only 10 grams of protein and 0.8 grams of leucine, and a 1.5 cup serving of broccoli provides only 4.2 grams of protein and a miserly 0.36 grams of leucine. That makes it very difficult to meet your target of 20-30 grams of protein and around 2.7 grams of leucine with each meal.

I’m not saying that you can’t get enough protein and leucine to maintain muscle mass on a vegetarian diet. However, you will need to plan that diet very carefully.

So, if you want to know what the old professor does, here it is:

I work out almost every day. On the days when I work out in the morning I rely on a protein shake immediately after the workout to meet my protein and leucine goals. On the days when I train at the gym in the late afternoon, I rely on 4 oz of chicken or fish with dinner to meet those goals.

Those of you who know me know that I will never be featured in muscle magazine, but at least I’m gaining muscle mass – not losing it.

The Bottom Line

As we age many Americans suffer from sarcopenia (loss of muscle mass). The loss of muscle mass leads to loss of mobility, a tendency to fall (and break things) and a lower metabolic rate – which leads to obesity and all of the illnesses that go along with obesity.

The most important thing that we can do to prevent muscle loss as we age is to exercise – especially resistance (weight) training exercise – at least 30 minutes every day. It is also important to make sure that we are getting adequate intake of protein and the essential amino acid leucine.

Our protein needs increase as we age. Recent studies suggest that the RDA levels of protein are not sufficient to maintain muscle mass in people over the age of 55. Many experts recommend that those of us in our golden years consume the amount of protein in grams that is equivalent to half our body weight in pounds every day.

Recent studies show that it is important to spread that protein out through the day rather than consume one protein rich meal at the end of the day. If we are over 50 we should be aiming at 20-30 grams of protein per meal. However, more than 30 grams of protein at a single serving appears to provide no additional benefit.

Seniors also appear to need more leucine in each meal than younger adults if they wish to preserve muscle mass. Young adults need only around 1.7 grams of leucine per serving to stimulate muscle protein synthesis, while mature adults may need as much as 2.7 grams per serving.

Well-designed protein shakes and 4 ounces of lean meats are the easiest way for seniors to meet their protein and leucine needs. Vegetarian diets can provide the protein and leucine needed to maintain muscle mass in seniors, but those diets need to be very well planned. Broccoli and tofu just don’t make the grade if you are serious about preserving muscle mass.

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

Does Exercise Make You Live Longer?

January 27, 2015 by Dr. Steve Chaney

Run Long and Prosper

Author: Dr. Stephen Chaney

Does exercise make you live longer? If you are a fan of the original Star Trek series, you may remember the phrase “Live Long and Prosper”. That sounded great, but it was just a wish – a platitude. It said nothing about how you might accomplish the feat of living longer and prospering.

What if something as simple as increasing your exercise levels might help you live a longer, healthier life? A recent study provides pretty convincing evidence that exercise can increase longevity. If that is really true, maybe the proper phase should be “Run Long and Prosper”.

In my past “Health Tips From the Professor” I have talked about how hard it is to prove the value of any individual lifestyle change on improving our longevity – whether we are talking about more exercise, lower fat diets or individual nutritional supplements.

Most studies have too few subjects and last too short a time to show any significant effect. That’s why the study I’m featuring this week (Byberg et al, British Journal of Sports Medicine, 43: 482-489, 2009) is so remarkable.

How Was The Clinical Study Designed?

The study was designed to answer the question of whether exercise can actually help people live longer.

But what was remarkable about the study was the number of people enrolled in the study and how long the study lasted. The study enrolled 2,204 men aged 50 from the city of Uppsala Sweden in 1970-1973 and followed the men for 35 years!

At the beginning of the study the participants completed a survey on leisure time physical activity and were categorized into low, medium or high activity groups. Participants were re-examined at ages 55, 60, 70, 77, and 82 years and changes in physical activity were recorded.

Other information, such as body mass index, blood pressure, cholesterol levels, smoking status and alcohol use, was also collected at each survey. And, of course, the researches recorded how many of the initial participants were still living at each of those ages.

Is Living Longer One of the Benefits of Exercise?

After adjusting for other risk factors (obesity, smoking, excess alcohol consumption, elevated cholesterol or blood pressure), the researchers found that men who reported high levels of physical activity from age 50 lived 2.3 years longer than sedentary men and 1.1 years longer than men who reported medium levels of physical activity.

They also looked at what happened to men who started at low or medium levels of activity and increased their exercise level during the study. After 5 years of increased activity there was no apparent benefit. But after 10 years of increased activity the risk of dying had been reduced just as much as if they had always been exercising at that level!

I find that last finding particularly significant because most studies of this type last 5 years or less. If this study had been concluded at the end of 5 years, you might be tempted to say: “Why bother. If I haven’t exercised before, there’s no point in starting now.” But, this study did last more than five years – so the conclusion was completely different.

The Bottom Line

We’ve known for years that exercise reduces the risks of several types of diseases and improves the quality of life. This study clearly answers “Does exercise make you live longer?” with a yes.

If you haven’t exercised before, it’s never too late to start. Just don’t expect instantaneous results.

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.

Do Avocados Lower Cholesterol?

January 20, 2015 by Dr. Steve Chaney

Should Avocados Be On The Super Fruits List?

Author: Dr. Stephen Chaney

You may have seen the recent headlines suggesting that avocados lower cholesterol, are a miracle fruit, and reduce your risk of heart disease. Some of those articles are suggesting that you try to eat an avocado every day. Are those headlines true? Should you be eating more avocados?

If you are like me that would be a bit of a stretch. I prefer my fruits tastier and a bit less greasy, but I won’t let my personal preferences color my analysis of the data. Let’s start by looking at the rationale for testing the effect of avocados on cholesterol levels.

The 2013 American Heart Association Guidelines on Lifestyle Management to Reduce Cardiovascular Risk recommends reducing saturated fats to no more than 5% to 6% of total calories (In the typical American diet about 13% of calories come from saturated fat). The AHA recommends replacing the saturated fat with either monounsaturated fat or polyunsaturated fat (vegetable oils and fish oil).

In addition, a major clinical study has recently shown that a Mediterranean diet supplemented with either olive oil or mixed nuts (walnuts, hazelnuts and almonds) lowers cholesterol and reduces the incidence of major cardiovascular events by ~30% over 5 years in men and women aged 50 to 80 who were at high risk for cardiovascular disease (Estruch et al, N Engl J Med, 368: 1279-1290, 2013).

One avocado has about the same amount of oleic acid (a monounsaturated fat) as 2 tablespoons of olive oil or 1.5 ounces of almonds, so it is logical to suspect that avocados might have a similar effect as olive oil or nuts.

How Was The Clinical Study Designed?

Because there is still a lot of controversy as to whether diets in which the saturated fat is replaced with healthier fat or no fat at all (low fat diets) are better, this study (Wang et al, J Am Heart Assoc, 2015;4: e001355 doi:10.1161/JAHA.114.001355) compared 3 diets:

A low fat diet in which most of the saturated fat was replaced with carbohydrate (24% total fat, 7% saturated fat, 11% monounsaturated fat, 6% polyunsaturated fat, 59% carbohydrate, 16-17% protein).

A moderate fat diet in which most of the saturated fat was replaced with pure oleic acid (34% total fat, 6% saturated fat, 17% monounsaturated fat from oleic acid, 9% polyunsaturated fat , 49% carbohydrate, 16-17% protein).

A moderate fat diet in which most of the saturated fat was replaced with avocado (34% total fat, 6% saturated fat, 17% monounsaturated fat from avocado, 9% polyunsaturated fat , 49% carbohydrate, 16-17% protein).

The study subjects were 45 healthy overweight or obese men and women (age 21 to 70, average = 45). Each subject was put on all 3 diets sequentially for 5 weeks each in a random order. That way each subject served as his or her own control.

The diets were carefully controlled to keep the calories the same so that none of the subjects lost weight during the study (weight loss would have confounded the results because weight loss lowers cholesterol in most individuals). The subjects were also told not to change their exercise habits. In short, it was a small study, but it was very well designed.

When the low fat diet was compared to the moderate (healthy) fat diets, the results were pretty similar to a number of other studies:

Total cholesterol and LDL cholesterol (the bad type) were lowered to about the same extent by both types of diets.

Triglycerides were higher and HDL cholesterol (the good type) was lower for the low fat diet compared to the moderate (healthy) fat diets.

Because this has been shown in previous studies, I won’t discuss it further here.

Do Avocados Lower Cholesterol?

When the authors compared the diet in which saturated fat was replaced with avocados to the diet in which saturated fat was replaced with oleic acid there were a number of significant differences.

Both LDL-cholesterol and non-HDL cholesterol were significantly lower on the avocado diet than the oleic acid diet. The decrease was about 10%. Based on the metrics adopted by the American Heart Association this has the potential to translate into a 20% decrease in heart disease risk.

The avocado diet was the only one of the three diets that significantly decreased LDL particle number, small dense LDL cholesterol and LDL/HDL ratio, Many experts think that these parameters are better indicators of hearts disease risk than LDL cholesterol levels.

Do avocados lower cholesterol? The short answer is yes, eating an avocado a day can lower cholesterol levels and might possibly lower heart disease risk. But to understand the true implications of this study we need to dig a little deeper.

What Is the Significance of This Study?

This study has one important take home lesson and raises two important questions.

Take Home Lesson: Foods Are More Important Than Fats We often hear about the benefits of including more monounsaturated fats in our diet, but when you actually make a direct comparison, such as was done in this study, it turns out that it is the foods that contain monounsaturated fats that make the difference, not the monounsaturated fats themselves. The oleic acid diet was only marginally better than the low fat diet at lowering total and LDL cholesterol.

This was the major conclusion of the authors of the study. Everything else was made up by the non-experts who write the articles that you see in the papers and on the internet. It is yet one more example of the headlines getting ahead of the science.

The authors admitted that we have no idea why avocados are more effective at lowering cholesterol than an equivalent amount of oleic acid. They speculated that it could be due to the high content of phytosterols in avocados. However, while the 114 mg of plant sterols in an avocado makes it an excellent source of plant sterols, it is far below the 2,000 mg of plant sterols that the NIH considers optimal for lowering cholesterol levels.

The authors also mentioned soluble fiber and specialized sugars in an avocado, but none of those was present in sufficient quantities to explain the cholesterol-lowering effect of avocados by itself. It is likely that all of those constituents plus others that we have not yet identified are what make avocados more effective than oleic acid at lowering cholesterol.

Question 1: Do We Really Want To Eat An Avocado a Day?

We need to keep in mind that a single avocado weighs in at around 234 calories. That is:

2.5 times the calories in an apple
4.7 times the calories in a peach or a cup of strawberries
5.7 times the calories in a half cup of blueberries
7.3 times the calories in a half cup of raspberries or blackberries

You get the point. What made this study so effective is that all three diets were designed to provide exactly the same number of calories so that nobody gained or lost weight. If you are thinking of adding an avocado a day to your diet, you are going to need to significantly cut back on calories somewhere else, or your weight gain will drive your cholesterol levels in the wrong direction.

Question 2: What Are The Long Term Implications of This Study?

The bottom line is that this and previous studies suggest that avocados should rightfully be included along with olive oil and nuts as healthy sources of monounsaturated fats that can help you lower cholesterol levels and may reduce your risk of heart disease.

However, we need to keep in mind that while a major clinical study has shown that adding either olive oil or nuts to your diet can reduce heart disease risk, we don’t have a comparable study showing that adding avocados to your diet will have the same benefit. It is plausible, but has not yet been demonstrated.

The Bottom Line

A recent clinical study has shown that eating an avocado a day was more effective at lowering bad cholesterol than adding an equivalent amount of the monounsaturated fat oleic acid to the diet. This suggests that it is the foods that contain the monounsaturated fats that make the difference, not the monounsaturated fats themselves.

This and previous studies suggest that avocados should rightfully be included along with olive oil and nuts as healthy sources of monounsaturated fats that can help you lower cholesterol levels and may reduce your risk of heart disease.

However, we need to keep in mind that while a major clinical study has shown that adding either olive oil or nuts to your diet can reduce heart disease risk, we don’t have a comparable study showing that adding avocados to your diet will have the same benefit. It is plausible, but has not yet been demonstrated.

You also need to keep in mind that a single avocado contains 234 calories. What made this study work so well is that each diet was carefully designed to provide exactly the same number of calories. If you are thinking of adding an avocado a day to your diet, you are going to need to significantly cut back on calories somewhere else, or your weight gain will drive your cholesterol levels in the wrong direction.

Finally, the American Heart Association Guidelines are to reduce saturated fats to no more than 6-7% of total calories. So while the low-carbohydrate, butter, bacon, and steak diet may give you temporary weight loss, it is definitely NOT recommended if you want to reduce your risk of heart disease. For more on this important topic, see my previous health tip “Are Saturated Fats Good For You?”

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.

Vitamin D Deficiency

January 13, 2015 by Dr. Steve Chaney

What Is The Real Vitamin D Story?

Author: Dr. Stephen Chaney

If you are like most people, you probably don’t know what to believe about vitamin D deficiency. Some experts tout vitamin D as a miracle nutrient that will help you lead a longer, healthier life. They leave you with the impression that everyone should be supplementing with vitamin D.

Other experts tell you that the supposed benefits of vitamin D are all hype. They tell you not to waste your money on vitamin D supplements.

When you pull back the curtain and look at the clinical studies behind the headlines, a pattern begins to emerge.

Most of the studies that support a role for vitamin D in preventing heart disease, preventing cancer and extending life have been population studies. They have compared populations with low vitamin D intake with populations with adequate vitamin D intake. While population studies are good for suggesting associations, they have their limitations:

Population studies are good at suggesting associations, but they do not prove cause and effect.

With population studies it is also very difficult to eliminate what scientists call “confounding variables”. Let me give you an example. Suppose someone had low 25-hydroxyvitamin D levels in their blood because they sat around all day watching TV and never got out in the sun. If they got sick you wouldn’t really know whether it was due to low 25-hydroxyvitamin D levels or due to inactivity. In this case, inactivity would be a confounding variable.

On the other hand, most of the studies that fail to find any benefit of vitamin D are double blind, placebo-controlled intervention studies in which one group was given supplemental vitamin D and the other group was given a placebo. While these studies are considered the most reliable clinical studies, they have their limitations as well.

In the case of vitamin D many of these studies were done with a cross section of the population in which most of the participants already had adequate blood levels of 25-hydroxyvitamin D at the start of the study. Those studies are incapable of telling us whether correcting a vitamin D deficiency would have been beneficial.

Even when the intervention studies focus on participants with low vitamin D status at the start of the trial they have another significant limitation. They are all short term studies. Typically, the best of these studies last no more than a couple of years. Longer term studies are far too expensive. In contrast, diseases such as heart disease and cancer take decades to develop. A one or two year intervention with vitamin D simply may not be sufficient to correct the damage caused by decades of vitamin D deficiency

This is the current dilemma that is creating all of the confusion in the vitamin D story. For the most part, population studies and intervention studies are coming to very different conclusions. And both kinds of studies have inherent limitations that are difficult to overcome.

Fortunately, a new kind of clinical study has been developed in recent years that overcomes the limitations of both population studies and intervention studies.

A New Kind of Clinical Study

The new approach is something called mendelian randomization. I apologize for the scientific jargon, but let me explain. In this case you are separating your population based on genetic variation rather than on the basis of biochemical or behavioral differences.

For example, in the clinical study I will describe in a minute the population was separated into groups based on genetic variations in the DHCR7 and CYP2R1 genes. The first gene is involved in the biosynthesis of cholesterol, which is a precursor of vitamin D, and the second gene converts vitamin D to 25-hydroxyvitamin D. Both genes affect blood levels of 25-hydroxyvitamin D.

This kind of study has several unique strengths:

Genetic variations are unaffected by confounding variables such as sun exposure, obesity, smoking, inactivity, and poor diet. If the study population is large enough, those confounding variables will be equally distributed among groups that are selected solely on the basis of genetic variations.

These studies are long term by definition. If someone has a genetic variant that lowers their 25-hydroxyvitamin D level, it will do so for their entire lifetime. They can increase their vitamin D status by sun exposure, for example, but their blood levels of 25 hydroxyvitamin D will always be less than someone with equal sun exposure who does not have that genetic variant.

Because these studies reflect lifelong exposure to 25-hydroxyvitamin D they are ideally suited for measuring the effect of vitamin D status on mortality and diseases that take decades to develop.

Do Vitamin D Genes Affect Mortality?

This study (S. Afzal et al, The British Medical Journal, 2014;p 349:g6330 doi: 10.1136/bmj.g6330) combined the data from three clinical studies conducted in Copenhagen between 1976 and 2013. The age of the participants ranged from 20 to 100 years and the follow-up was 6-19 years. 95,766 participants in these studies were genotyped for variants in the DHCR7 and CYP2R1 genes which were known to affect 25-hydroxyvitamin D levels. 35,334 of those participants also had blood 25-hydroxyvitamin D levels determined. By the end of the study 10,349 of the participants had died.

The individual genetic variants included in this study caused a relatively small (1.9 nmol/L) decrease in blood levels of 25-hydroxyvitamin D. However, because this was a very large study and the participants with those genetic variants were exposed to lower 25-hydroxyvitamin D levels for their entire lifespan, the decreased 25-vitamin D levels were associated with significant increases in all cause mortality and cancer mortality, but not with increased cardiovascular mortality.

When they extrapolated to a genetically caused 20 nmol/L decrease in 25-hydroxyvitamin D, the decrease in 25-hdroxyvitamin D was associated with a 30% increase in all cause mortality and a 30% increase in cancer mortality.

What Kind Of Studies Are Needed Next?

The authors noted that this is the first study of its kind, so it obviously needs to be confirmed by other large mendelian randomization studies that test the link between vitamin D status and mortality.

Ideally, it should also be verified by double blind, placebo controlled intervention studies, but that may not be possible. If one really wanted to verify this study, the intervention study should start with a population group with 25-hydroxyvitamin D levels at least 20 nmol/L below what is considered adequate and provide them with enough supplemental vitamin D to increase their 25-hydroxyvitamin D to the adequate range. That is difficult, but doable.

However, the intervention study would also need to be long enough (decades perhaps) to prevent cancer from developing. That kind of study will probably never be done.

The Bottom Line

The relationship between vitamin D status and mortality has been investigated with a new type of clinical study based on what is called mendelian randomization. Population groups were segregated based on genetic variations in two genes that affect blood 25-hydroxyvitamin D levels (a measure of vitamin D status).

This study concluded that a genetically determined decrease of 20 nmol/L in blood 25-hydroxyvitamin D was associated with a 30% increase in all cause mortality and a 30% increase in cancer mortality, but had no significant effect on cardiovascular mortality.

This kind of study is particularly strong because it measures the affect of lifelong exposure to 25-hydroxyvitamin D. This is important when assessing the effect of vitamin D status on mortality and diseases such as cancer that take decades to develop. In contrast, the double blind, placebo controlled intervention studies that are consider the “Gold Standard” for clinical studies may be too short term to adequately assess the effect of vitamin D status on cancer or all cause mortality.

This study supports the benefit of maintaining optimal vitamin D status, but it is the first clinical study of its kind and needs to be confirmed by other studies.

In the meantime, there is no harm to in maintaining your blood levels of 25-hydroxyvitamin D in the optimal range through diet, sun exposure and supplementation. This study suggests it just may help you live a longer, healthier life.

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.

No Viagra Side Effects?

January 6, 2015 by Dr. Steve Chaney

A Big, Fat Problem With Testosterone

Author: Dr. Stephen Chaney

You can’t turn on the TV nowadays without seeing ads for medications to prevent erectile dysfunction and allow you to be ready “when the moment is right.” You have probably also heard the ads for testosterone creams to treat “low T”. Similar ads seem to find their way into our email inbox almost every day. Evidently, we guys must have a problem. Drugs that increase sexual potency appears to be a topic of much relevance to many of us.

But if you listen to the ads carefully, you will discover that all of these drugs have serious side effects. Here are some of the viagra side effects.

Sudden drops in blood pressure
Sudden decreases or loss of vision or hearing
Chest pain, dizziness and nausea
And many more

What if there were a way to increase your testosterone levels and enhance your sexual potency without side effects? In fact, there is a proven way to do that, and it involves treating the cause of the problem – not just the symptoms.

Can Obesity Affect Your Sex Drive?

While millions of American women are on a diet at any one time, many men just ignore those extra pounds. Things like heart disease, cancer and diabetes seem to be much more distant threats to us. The male ego also allows us to stand in front of a mirror, pot belly and all, and visualize ourselves as we were in our college years.

But, what if obesity lowered your testosterone levels and caused erectile dysfunction? Would that get your attention?

That is why a recent study in the Journal of Clinical Endocrinology and Metabolism should be of great interest to all of us. This study looked at 1700 men of all weights and showed that weight gain of 30 pounds lowered testosterone levels as much as if the men had aged 10 years.

Low testosterone levels in men lead to depression, loss of muscle mass and bone density, feminization, and that all important loss of sexual drive and performance.

Viagra – Without The Side Effects

So guys, if you are concerned about your sexual performance, but don’t want to take drugs that may have viagra side effects, you have another option. Just take off some of that extra weight you have accumulated over the years. That may just increase your testosterone levels and your sexual performance naturally. And you won’t have any side effects, just side benefits.

The Bottom Line

So guys, if you are not motivated to lose those extra pounds by how you look or by the increased risk of heart disease, cancer & diabetes, now you have yet another reason to shed those extra pounds. Perhaps this should be the year that you actually stick to your new year’s resolution to lose weight.

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.

7 Easy Ways To Spot Fad Diets

December 30, 2014 by Dr. Steve Chaney

If It Sounds Too Good To Be True…

Author: Dr. Stephen Chaney

I think it was P. T. Barnum who said “There’s a Sucker Born Every Minute”. That’s particularly true in the diet world where hucksters seem to be all around us – especially this time of year.

You’ve seen the weight loss ads touting:

Pills or powders that suppress your appetite or magically prevent you from absorbing calories.

Fat burners that melt the pounds away.
New discoveries (juices, beans, foods) that make weight loss effortless.
The one simple thing you can do that will finally banish those extra pounds forever.

You already know that most of those ads can’t be true. You don’t want to be a sucker. But, the ads are so compelling:

Many of them quote “scientific studies” to “prove” that their product or program works.

Their testimonials feature people just like you getting fantastic results from their program. [You can do wonders with “computer enhanced” photographs.]
Many of those products are endorsed by well known doctors on their TV shows or blogs. [It is amazing what money can buy.]

So it is easy to ask yourself: “Could it be true?” “Could this work for me?”

Fortunately, the Federal Trade Commission (FTC) has stepped up to the plate to give you some guidance. Just in time for weight loss season, they have issued a list of seven claims that are in fact too good to be true. If you hear any of these claims, you should immediately recognize it as a fad diet and avoid it.

7 Easy Ways To Spot Fad Diets

Here are the seven statements in ads that the FTC considers as “red flags” for fad diets that should be avoided:

Causes weight loss of two pounds or more a week for a month or more without changing your diet and exercise routine.

Causes substantial weight loss no matter what or how much you eat.

Causes permanent weight loss without lifestyle change even after you stop using the product.

Blocks absorption of fat or calories to enable you to lose substantial weight.

Safely enables you to lose more than 3 pounds per week for more than 4 weeks.

Causes substantial weight loss for all users

Causes substantial weight loss by wearing a product on your body or rubbing it on your skin.

I’m sure you have heard some of these claims before. You may have actually been tempted to try the products or program. You should know that the FTC said that it considers these to be “Gut Check” claims that simply can’t be true.

The Bottom Line

There are no magical pills or potions that will make the pounds melt away. You need to change your diet, change your activity level and make significant lifestyle changes if you want to achieve long term weight control.

For more science-based health tips visit https://www.chaneyhealth.com/healthtips

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.

Do Diets Work?

December 16, 2014 by Dr. Steve Chaney

Obesity in America?

Author: Dr. Stephen Chaney

If you are like most Americans, you are either overweight yourself or have close friends and family who are overweight. That’s because 69% of Americans are currently overweight, and 36% of us are obese. Worldwide the latest estimates are that 1.5 billion adults are overweight or obese.

A new report, How The World Could Better Fight Obesity, estimates that obesity is a $2 trillion drain on the world’s economy. That is equivalent to the global cost of war & terrorism and of smoking – and is double the global costs of alcoholism and global warming!

If you are like most Americans you have tried a number of diets over the years. All of them promised that they had the “secret” to permanent weight loss. You lost some weight initially, but here you are a few years later weighing as much as ever.

You are probably beginning to wonder whether any diets work long term. According to the latest study, the answer may just be “no”.

Really, Do Diets Work?

This study (Atallah et al, Circulation Cardiovascular Quality and Outcomes, 7: 815-827, 2014) was a systemmatic review of all of the randomized controlled studies of the four most popular diet plans – Weight Watchers, Akins, Zone and South Beach.

In case, you are unfamiliar with these diets, here is their philosophy:

Weight watchers is a food, physical activity and behavior modification plan that utilizes a point system to control calorie intake and features weekly group sessions.
Atkins is based on very low carbohydrate intake, with unlimited fat and protein consumption.
South Beach is relatively low carbohydrate, high protein diet that focuses on low-glycemic index carbohydrates, lean proteins, and mono- and polyunsaturated fats.
Zone is a low carbohydrate diet that focuses on low-glycemic load carbohydrates, low-fat proteins and small amounts of good fats.

The investigators restricted their analysis to studies that were greater than 4 weeks in duration and either compared the diets to “usual care” or to each other. (The term usual care was not defined, but most likely refers to a physician giving the advice to eat less and exercise more).

Twenty six studies met their inclusion criteria. Fourteen of those studies were short-term (< 12 months) and 12 were long-term (>12 months). Of the long-term studies, 10 compared individual diet plans to usual care and 2 were head-to-head comparisons between the diet plans (1 of Atkins vs Weight Watchers vs Zone and 1 of Weight Watchers vs Zone vs control). The majority of participants in these studies were young, white, obese women. Their average age was 45 years and their average weight at the beginning of the studies was 200 pounds.

What Did This Study Show?

If you have struggled with your weight in the past, you probably won’t be surprised by the result of the study.

Short-term weight loss was similar for Atkins, Weight Watchers and Zone in the two head-to-head studies.
At 12 months, the 10 studies comparing individual diets to usual care (physician’s advice to eat less and exercise more) showed that only Weight Watchers was slightly more effective than usual care (physician’s advice to lose weight). The average weight loss at 12 months was 10 pounds for Weight Watchers and 7 pounds for usual care. That is a 3 pound difference for all of the additional effort and expense of Weight Watchers!
When they looked at the two head-to-head studies at 12 months, there was no significant differences between the diets. Average weight loss in these studies was 7 pounds for Weight Watchers, 7 pounds for Atkins, 5 pounds for Zone and 5 pounds for usual care. There was only one study comparing the South Beach diets with usual care. It was a study comparing the results with severely obese patients following gastric bypass surgery, and it also found no difference between the diet program and usual care. Based on hype about these diets, you were probably expecting more than a 5 to 7 pound weight loss 12 months later!
By 24 months 30-40% of the weight had been regained for the Atkins and Weight Watchers diets, which was comparable to the results for patients who were just told to eat less and exercise more. Not only was the weight loss modest, it also did not appear to be permanent.
Finally, many of the studies included in this review also looked at improvement in other health parameters such as HDL cholesterol levels, LDL cholesterol levels, triglycerides, blood pressure and blood sugar control. The Atkins diet gave slightly better results with HDL levels, triglyceride levels and blood pressure in the short-term studies, but there was no significant differences for any of these parameters in the long-term head-to-head studies. None of the diets were any healthier than the others.

The investigators concluded: “Our results suggest that all 4 diets are modestly efficacious for short-term weight loss, but that these benefits are not sustained long-term.

A similar study in 2005 compared the Weight Watchers, Jenny Craig and LA Weight Loss diets (Tsai et al, Annals of Internal Medicine, 142: 56-66, 2005) and concluded “…the evidence to support the use of major commercial and self-help weight loss programs is suboptimal”.

A Weight Loss Diet That Actually Works?

My personal recommendation for the initial weight loss is a high protein diet – one that provides about 30% of calories from healthy protein and moderate amounts of healthy carbohydrates and healthy fats. The protein should be high enough quality so that it provides 10-12 gram of the essential amino acid leucine because leucine specifically stimulates muscle growth. The combination of high protein and leucine preserves muscle mass while you are losing weight. That is important because it keeps your metabolic rate high without dangerous herbs or stimulants.

However, the high protein, high leucine diet is still just a diet. It is an excellent choice for the initial weight loss, but what about long-term weight control?

The authors of this study said: “Comprehensive lifestyle interventions aimed at curbing both adult and childhood obesity are urgently needed. Interventions that include dietary, behavioral and exercise components…may be better suited to [solve] the obesity epidemic.” I agree.

The Bottom Line:

Your suspicions are correct. Diets don’t work!

A recent systematic review of 26 randomized controlled clinical trials of the Weight Watchers, Atkins, Zone & South Beach diets compared to the usual standard of care (recommendations to eat less and exercise more) concluded:

1) Contrary to what the advertisements promise, after 12 months all four diets gave comparable and very modest (5-7 pounds) total weight loss. The results with the diets were not significantly different than for patients who were simply told to eat less and exercise more.

2) By 24 months 30-40% of the weight had already been regained.

3) A previous systematic review of the Weight Watchers, Jenny Craig, and LA Weight Loss diet programs came to a similar conclusion.

4) My personal recommendation for the initial weight loss is a diet that is high in protein and the amino acid leucine because that type of diet preserves muscle mass.

5) For permanent weight control the authors of the recent systematic review recommended comprehensive lifestyle interventions that include permanent changes in diet, behavior and exercise. I agree. Diets never work long term – lifestyle change does!

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

Can Resveratrol Improve Memory Performance In The Elderly ?

December 9, 2014 by Dr. Steve Chaney

Will Red Wine Make You Smarter?

Author: Dr. Stephen Chaney

It seems like every other day a new headline pops up telling us of yet another nutrient that might improve memory and slow cognitive decline. Perhaps it’s because we having a greying population. Lots of Americans are looking for that magic pill that will allow us to remember where we left the car keys.

This week the banner headlines were about resveratrol, a polyphenol from red wine. The headlines suggested that resveratrol could improve memory performance in healthy older adults. Are those headlines true, and what does that information mean for you?

What is Resveratrol?

Resveratrol is a member of a very large class of compounds called polyphenols that are found in red wine, green tea, and a variety of fresh fruits and vegetables. Polyphenols are very diverse structurally, but most of them are excellent antioxidants. They are one of the reasons that we are constantly being told to eat more fresh fruits and vegetables.

However, resvertrol and a few structurally similar polyphenols are unique in that they also bind to proteins called sirtuins which regulate metabolic processes related to the aging process. In fact, resveratrol garnered a lot of attention a few years ago when Dr. David Sinclair at Harvard Medical School published a study showing that obese mice given resveratrol escaped many of the metabolic consequences of obesity and actually lived longer than mice who were not given resveratrol.

In animal studies resveratrol appears to improve insulin sensitivity and mitochondrial function, lower cholesterol levels and blood pressure, and reduce inflammation and oxidative damage. Human studies have been limited to date, but suggest that resveratrol may impart many of these metabolic benefits to humans as well.

A recent study showed that resveratrol improved memory performance in grey mouse lemurs, a non-human primate species. However, no one had previously looked at whether resveratrol might improve memory in humans.

Can Resveratrol Improve Memory In Healthy Older Adults?

In this study (A. V. Witte et al, The Journal of Neuroscience, 34: 7862-7870, 2014) investigators recruited 46 older (average age 64), overweight (BMI 25-30), adults from Berlin, Germany. All of the subjects were healthy and none of them had any sign of cognitive impairment. For a six month period half of them were given 100 mg of resveratrol twice a day, and half of them were given a placebo (sunflower oil).

At the beginning of the test period they were given a memory test which measures how many of 15 listed words they could recall 30 minutes later. They also underwent a MRI scan that measured brain volume and functional connectivity of the hippocampus, a key region implicated in memory function. Finally, hemoglobin A1c, a measure of long term blood sugar control was measured.

Here are the results:

There was a significant effect of resveratrol on retention of words over 30 minutes compared to placebo. Memory improved significantly in the resveratrol group, while it declined slightly in the placebo group.

There was no effect of resveratrol on brain volume compared to the placebo (most interventions showing significant effects on brain volume required 2-3 years to demonstrate a significant effect).

Subjects in the resveratrol group showed significant increases in functional connectivity of the hippocampus to other brain regions involved learning and memory compared to the placebo group.

Subjects in the resveratrol group had lower hemoglobin A1c (better long term blood sugar control) compared to the placebo group.

When they statistically evaluated individual patients, the degree of improvement in the word memory test correlated with the increase in functional connectivity of the hippocampus and both of those measures correlated with decreased hemoglobin A1c.

What Does This Study Mean?

This study is promising in that it is well done and is consistent with previous animal studies. However, we need to keep in mind that this is the very first study of this kind. Similar to most first studies, it is small (only 46 subjects) and short in duration (6 months). It also only tested one dose of resveratrol (200 mg/day).

Now that this study has shown that resveratrol might improve memory in healthy older adults, it provides a strong rationale for more clinical studies to test this hypothesis. There is a need for larger, longer term studies in other population groups. Future studies should also evaluate different doses of resveratrol so that we know how much is needed to positively impact mental function.

Can resveratrol improve memory?

The Bottom Line:

A recent study suggests that resveratrol, a polyphenol from red wine, improves memory (measured by a word recall test) and functional connectivity of the hippocampus, a region of the brain involved in memory function.

This is the very first study of its kind. It was small (46 subjects) and short (6 months). However, it was well designed and consistent with previous animal results. Thus, it should be considered preliminary, but promising. More studies are clearly needed to test this hypothesis.

If the results of this study are substantiated, it will not necessary mean that other polyphenols will exert similar effects on memory. The action mechanism of resveratrol is different than most other polyphenols.

It also does not necessarily mean that red wine will make you smarter. The 100 glasses of red wine a day that you would need to drink to get the amount of resveratrol used in this study would probably kill more brain cells than the resveratrol could help.

Finally, as I said in a recent “Health Tips From the Professor” , there are no “magic bullets” when it comes to preventing cognitive decline. Your chances of reducing cognitive decline are best with a holistic approach that includes healthy diet, exercise, socialization, mental exercises, maintaining a healthy weight, B vitamins and omega-3 fatty acids. If this study is confirmed by future studies, you may be able to add resveratrol supplements to the list.

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

Can Antioxidant Supplements Cause Cancer?

December 2, 2014 by Dr. Steve Chaney

The Truth About Vitamins C & E

Author: Dr. Stephen Chaney

I am always amazed at how certain nutrition myths take on a life of their own. A single study gets sensationalized. The study may not be very good, but some nutrition guru publicizes it even though it may be contradicted by other studies that come to the opposite conclusion.

Other blogs and news feeds pick it up. It gets repeated over and over until it becomes generally accepted as true. It becomes what I call an “urban nutrition myth”. Once these myths become well established they are hard to correct. When contrary information is published, it is ignored because everyone already knows the “truth”.

Can Antioxidant Supplements Cause Cancer?

The risks of antioxidant supplements are a perfect example. Most web sites and health experts warn that you should be careful about using antioxidant supplements. You are told that they may just increase your risk of cancer. They may just kill you!

The antioxidant vitamins C and E have generated the most scrutiny in recent years. There were a number of reasons to suspect that they might decrease cancer risk:

1) They destroy free radicals.
2) They decrease cancer risk in animal studies.
3) Increase consumption of vitamins C & E is associated with decreased risk of cancer in human population studies.

Because there was so much circumstantial evidence that vitamins C & E might decrease cancer risk, there have been a number of double-blind, placebo controlled human clinical trials to test that hypothesis.

• 6 clinical studies showed no effect of vitamin C and/or E on cancer incidence.
• 1 study suggested that vitamin E might decrease prostate cancer risk, and another study suggested that vitamin E might decrease colon cancer risk.
• 1 study (Kristal et al, Journal of the National Cancer Institute, doi: 10.1093/jnci/djt456, 2014) suggested that vitamin E alone might increase prostate cancer risk, but when vitamin E was combined with selenium there was no increased risk. I have discussed a likely explanation of those confusing results in a previous “Health Tips From the Professor” (https://www.chaneyhealth.com/healthtips/selenium-vitamin-e-increase-prostate-cancer-risk/).

That’s it. Six clinical studies show no effect of vitamins C & E on cancer risk, two studies suggest that vitamin E decreases cancer risk and one study suggests that vitamin E increases cancer risk. Yet all the “experts” are warning that antioxidant supplements might increase your cancer risk. It has become an urban nutrition myth.

You may remember that I said that the final characteristic of an urban nutrition myth is that when contrary information is published, it is ignored. In fact, an excellent study showing no effect of vitamins C and E on cancer risk has just been published – and it is being ignored because it doesn’t fit the “truth” that most experts have come to believe.

What Does the Latest Study Show?

The study in question (Wang et al, American Journal of Clinical Nutrition, 2014; doi: 10.3945/ajcn.114.085480) was a post-trial follow-up to the Physicians’ Health Study II. It followed 14,641 US male physicians (average age 64 at the beginning of the trial) for 10.3 years. The subjects were randomly assigned to receive 400 IU of vitamin E every other day, 500 mg of vitamin C daily, or their respective placebos.

The investigators in charge of the study recognized that cancer takes many years to develop and that the effects of supplementation might not be recognized until years later. Because of that, the subjects were followed for an additional 2.8 years after the close of the trial to allow additional time for cancers to develop.

The results were clear cut:

• Vitamin E supplementation had no effect on the incidence of prostate cancer or total cancers.
• Vitamin C supplementation also had no effect on the incidence of prostate cancer or total cancers.
• Vitamin C supplementation decreased the incidence of colon cancer during the post-trial period by 46%, which was marginally significant.

The Bottom Line:

1) Can antioxidant supplements cause cancer? You can ignore the dire warnings that antioxidant supplements may increase your risk of cancer. The only case where this appears to be true is for high dose beta-carotene supplements in smokers. The weight of evidence for vitamins C and E suggests that they are unlikely to increase your risk of cancer.

2) As I have said previously if there is any risk of antioxidant supplements, it is most likely to arise from using high purity individual antioxidant supplements. I recommend vitamin E supplements containing the full spectrum of tocopherols and tocotrienols, carotenoid supplements containing all the naturally occurring carotenoids, and supplements that combine complementary antioxidant nutrients – vitamin E and selenium, for example.

3) That doesn’t mean that you should run out and stock up on antioxidant supplements in the hope that they will prevent cancer. The same clinical studies that showed no harm from vitamin C and E supplementation also showed no consistent benefit.

4) This is also consistent with my comments in previous “Health Tips from the Professor”. For example:

• It is very difficult to prove, and unreasonable to expect, that supplementation will have a measurable effect on risk of a particular disease like cancer for everyone. People who are healthy and have very low risk of cancer, may experience other benefits from supplementation but are unlikely to experience a measurable decrease in cancer risk.

• Supplementation is most likely to be advantageous in select populations, generally populations with increased need for a particular nutrient or at highest risk of disease. It is clinical studies looking at the effect of supplementation in these select populations that often show the greatest benefit of supplementation.

• Supplementation is just one component of a holistic approach for reducing disease risk. Diet, weight control, exercise, adequate rest and stress reduction all play a major role as well. You can’t weigh 250 pounds and eat all your meals at McDonalds and expect supplementation to save you from disease.

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.

Healthy Thanksgiving

November 25, 2014 by Dr. Steve Chaney

The Holidays Don’t Have To Be Unhealthy

Author: Dr. Stephen Chaney

While “Healthy Thanksgiving” doesn’t quite have the appeal of the more familiar “Happy Thanksgiving” greeting, I used it here to make the point that Thanksgiving dinner (and many other holiday meals) doesn’t have to be an unhealthy affair.

After all, there is a lot to like about the ingredients in Thanksgiving dinner. Turkey can be a healthy, low- fat meat, if prepared correctly. Sweet potatoes, yams, winter squash and pumpkin are all loaded with vitamin A and other important nutrients. And cranberries are a nutrition powerhouse.
Healthy Thanksgiving

Here are some healthy Thanksgiving ideas:

1) Skip the basting. Choose a plain bird and cook in a bag to seal in the moisture. Remove the skin before serving.

2) Refrigerate the turkey juices and skim off the hardened fat before making gravy and use a gravy cup that pours from the bottom to minimize fat.

3) Use ingredients like whole wheat bread, vegetables, fruits (cranberries, raisins, dates or apples), nuts and your favorite spices for the stuffing and bake it in the oven rather than in the turkey.

4) Serve your sweet potatoes or yams baked rather than candied and let your guests add butter to taste.

5) Use skim milk or buttermilk rather than whole milk and skip the butter for your mashed potatoes.

6) Give your meal gourmet appeal by cooking your green vegetables with garlic, nuts and herbs rather than creamy or fat-laden sauces.

7) Don’t serve the meal on your largest plates. By using smaller plates you ensure smaller portion size and even that second helping isn’t quite so damaging.

8) Use the Shaklee 180 meal replacement products for one or more meals the day before and/or after Thanksgiving so that your total caloric intake over the three day period is not excessive.

By now you have the idea. There are lots of little things that you can do to make your Thanksgiving dinner one that your waist and your heart will thank you for. Bon Appetit and have a Happy, Healthy Thanksgiving!

The Bottom Line

• If you make healthy food choices and choose your portion sizes wisely, you can make this a Healthy Thanksgiving as well as a Happy Thanksgiving.

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.