Cancer

Can Red Meat Be Good For You?

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Everything You Wanted To Know About Red Meat 

Author: Dr. Stephen Chaney 

ArgumentNutrition is a bit like politics and religion. Everyone has an opinion, and there is not much grace for those with different opinions.

And everything is black or white. There is no middle ground. Red meat is a perfect example. Cardiologists tell us the saturated fat and cholesterol in red meat increases our risk of heart disease. Oncologists tell us red meat increases our risk of colon, breast, prostate, and pancreatic cancer.

The association with red meat consumption and colon cancer is so strong that the World Health Organization has classified red meat as a probable carcinogen.

  • Vegans and vegetarians tell you to avoid red meat at all costs and substitute plant proteins in its place.
  • Keto and carnivore diet enthusiasts tell you that red meat is healthy if you avoid any plant foods containing carbohydrates (which is most plant foods).

Who is right? Is red meat good for you or bad for you? As usual, the answer is somewhere in the middle. We also need to stop looking at individual foods and start looking at the overall diet. We need to ask how our overall diet alters the effect of red meat on our health.

But first, let’s explore:

  • Why red meat is good for us.
  • Why red meat is bad for us.
  • How diet can help us minimize the bad and maximize the good.

I call this section, “Everything You Wanted To Know About Red Meat”.

Everything You Wanted To Know About Red Meat

thumbs upWhy Red Meat Is Good For Us.

  • Red meat is an excellent source of protein, iron, and vitamin B12. Plus, the iron in red meat is primarily found in the heme molecule and heme iron is absorbed much more efficiently than other forms of iron.
  • Red meat contains creatine, which powers our muscles. You can think of creatine molecules as little power packs that are charged when we eat and release a burst of energy whenever we begin to exercise.
  • Red meat contains carnitine, which helps our muscles use fat as an energy source. This is particularly important for heart muscle.
  • But both creatine and carnitine also have a dark side, which I will discuss below.

Why Red Meat Is Bad For Us.thumbs down symbol

When we think about heart disease:

  • The traditional view is that saturated fat and cholesterol are the problem, and we can reduce our risk of heart disease simply by choosing leaner cuts of meat.
  • Other experts feel the link between red meat and heart disease is more complicated. For example, some recent studies have suggested that the carnitine in red meat can be converted by gut bacteria to TMAO, and TMAO increases our risk of heart disease. I have discussed this in a previous issue of “Health Tips From the Professor”.

SteakWhen we think about cancer:

  • When fat and juices from the meat drip onto an open flame, carcinogenic polyaromatic hydrocarbons are formed that stick to the surface of the This can be reduced, but not eliminated, by lower fat meat choices.
  • When red meat is cooked at high temperatures, amino acids in the meat combine with creatine, which is found in all red meats, to form carcinogenic heterocyclic amines. This can be reduced, but not eliminated, by cooking the meat at lower temperatures.
  • The nitrates and nitrites used as preservatives in many processed meats react with amino acids from the meat to form carcinogenic N-nitrosamines in our intestines.
  • Heme iron, which is found in all red meats, also combines with amino acids in the meat to form carcinogenic N-nitroso compounds in our intestines. This mechanism is inherent in all red meats and cannot be eliminated by choosing lower fat cuts or cooking at lower temperatures.

Finally, diets high in red meat increase several markers of inflammation, and inflammation increases the risk of both heart disease and cancer.

How Diet Can Help Us Minimize The Bad And Maximize The Good.

Question MarkI’m going to start this section with a provocative statement: “Plant foods are the antidote to all the bad effects of red meat.” Let me explain.

Plant foods are an excellent source of:

  • Antioxidants
  • Polyphenols and other phytonutrients
  • Fiber
  • Plus, the fiber and phytonutrients found in plant foods support the growth of beneficial gut bacteria.

Here is where it gets very complex:

  • Beneficial gut bacteria convert some of the foods we eat into compounds that are absorbed into the bloodstream and improve blood sugar control, reduce cholesterol synthesis, and reduce inflammation.
  • Polyphenols support the growth of certain gut bacteria, and those gut bacteria can convert these polyphenols into compounds that can be absorbed from the intestine. This necessary for many polyphenols to exert their beneficial effects in the body.
  • And, as you might expect, the gut bacteria of meat eaters and vegetarians is very different.

With this in mind, let’s come back to the concept of plant foods being the antidote for red meat.

strong heartIn terms of heart health,

  • You may remember that I said above that the carnitine in red meat can be converted by gut bacteria into TMAO which increases the risk of heart disease. The operative wording here is “can be”. It turns out this only happens with the gut bacteria of habitual meat eaters. Here is the study that showed that:
    • When habitual meat eaters were fed an 8-ounce sirloin steak, both carnitine and TMAO increased in their blood and urine.
    • When vegans were fed the same 8-ounce steak, only carnitine increased. No TMAO was detected.
    • When the meat eaters were treated with an antibiotic that wiped out their gut bacteria prior to eating the steak, no TMAO was detected. This showed it was the gut bacteria in the meat eaters that were responsible for converting carnitine to TMAO.
  • Fiber from whole grains, fruits, and vegetables binds to cholesterol and flushes it out of the intestine, preventing its absorption into the bloodstream.
  • Plant-based diets are anti-inflammatory.

CancerIn terms of cancer,

  • The fiber found in fruits, vegetables and whole grains binds to polyaromatic hydrocarbons and heterocyclic amines and flushes them out through the intestines.
  • Polyaromatic hydrocarbons require activation by the liver before they become carcinogenic. Indoles and isothiocyanates found in broccoli, cabbage, and other cruciferous vegetables inhibit the enzymes that catalyze this activation.
  • Antioxidants found in fruits, vegetables and whole grains reduce the formation of N-nitroso compounds in the intestines.
  • A largely plant-based diet appears to favor a population of intestinal bacteria that is less likely to convert compounds in meat into cancer-causing chemicals. [Note: This is a new area of research, so the data supporting this mechanism of cancer prevention are less definitive than for the other three mechanisms.]

These observations are based studies designed to identify the mechanisms by which plant-based diets negate the bad effects of red meat. For example, let me share a recent study (T Onali et al, Journal of Nutritional Biochemistry, 141, 109906, 2025) asking whether berries could negate the bad effects of adding red meat (pork) to a typical Finnish diet.

How Was This Study Done?

colon cancer studyThis study was conducted by a group of scientists at the University of Helsinki. They recruited 43 adults aged 20-68 and divided them into two groups. Each group was told to continue with their regular diet, except that consumption of any red meat or berries other than the foods they were provided with was prohibited.

  • Each group was given an extra 5 ounces of pork (minced pork, pulled pork, pork strips from fillet, cold cuts, sausages, and bacon) to eat each day.
  • One group was also given 1 cup of berries (bilberries, strawberries, cloudberries, raspberries, lingonberries, and blackcurrant) to eat each day.
    • Note: These are the foods most familiar to people from Finland in each category.
    • They were provided with these foods on a weekly basis.
  • This intervention portion of the study lasted four weeks.

Dietary intake was assessed in each group using 3-day food records (two weekdays and one weekend day) at the beginning and the end of the study.

Participants in the study collected stool samples on two consecutive days at the beginning and end of the study. These stool samples were analyzed in the following ways:

  • Bacterial DNA was extracted from the stool samples and used to determine which gut bacteria were present in the stools.
  • The stool samples were homogenized and filtered to:
    • Determine the polyphenols and polyphenol metabolites present in the stool samples.
    • Determine whether low molecular weight compounds present in the stool samples were able to inhibit the growth of human colon cancer cells in cell culture.

What Did The Study Show?

Questioning WomanThe dietary analysis found that total calories, protein, carbohydrate, fat, and saturated fat did not change significantly in either group. This indicates that the study participants likely substituted the pork they were given for other high-fat meats they were eating before the study.

However, in the group that was also given berries fiber, vitamin C, vitamin E, manganese, and several polyphenols increased significantly. This suggests that study participants likely substituted the berries for less healthy foods they were eating before the study.

The study found that:

  • In the red meat-only group the relative abundance of beneficial Roseburia and Fecalibacterium gut bacteria was decreased. This did not occur in the red meat + berries group.
  • In the red meat + berries group the concentration of several beneficial polyphenols and polyphenol metabolites was increased.
  • In the red meat + berries group, the filtrate obtained from stool samples inhibited the growth of several human colon cancer cell lines in cell culture experiments. These experiments did not identify which berry polyphenols were responsible for inhibiting the growth of cancer cells. It also did not determine whether the polyphenols came directly from the berries or were created when gut bacteria modified the polyphenol(s).

But these experiments did show that something in the intestines of people consuming a high berry diet inhibited colon cancer cell growth.

The author’s concluded, “Berry supplementation to a diet high in red and processed meat led to berry-derived polyphenolic metabolites in the feces, beneficially modified gut microbiota, inhibited the viability of colon cancer cells, collectively suggesting potential in cancer prevention.

The difference seen in gut metabolism was probably induced by the higher intakes of dietary fiber, vitamin C and E, manganese, and polyphenols by the berry diet.”

Can Red Meat Be Good For You?

This study is one piece of the puzzle to help us understand the effect of diet on the benefits and risks of red meat consumption. Here is what I mean by that.

We can think of scientific investigations in terms of solving a large puzzle with lots of little pieces. If you are a puzzle enthusiast, you know the best way to solve a complicated puzzle is to put the edge pieces together first and then fill in the rest of the puzzle.

In this context, the studies showing that small amounts of red meat are not harmful in the context of healthy, primarily plant-based diets like the DASH and Mediterranean diets are the edge of the puzzle. Smaller studies that define the mechanisms of this effect and provide proof these mechanisms are accurate are the interior pieces that fill out the puzzle. This study is one of those interior pieces.

So, what does that mean for you? It means that diet context is important.

Most of the studies showing the bad effects of red meat have been done in the context of the typical American diet. That might consist of an 8 or 12-ounce steak with fries and either a soft drink or iced tea. Fruits and vegetables, if present at all, are minimal. Dessert usually consists of some sugary treats.

In this context, red meat is bad for you.

In contrast, consider the place red meat occupies in a primarily plant-based diet. Red meat becomes a condiment rather than the main course. Think of 2-3 ounces of red meat as part of a green salad or stir fry with a variety of greens and other vegetables. You might have beans, whole grains, or another vegetable to round out your plate. Dessert would be whatever fruit is in season. And your beverage might be water, milk, or herbal tea.

In this context, the bad effects of red meat disappear. In short, there are no bad foods, only bad diets.

I started this blog with the question, “Can red meat be good for you?”  You may be wondering if I have answered that question.

At the beginning of this article, I listed the good things about red meat, namely that it is a good source of protein, iron, vitamin B12, carnitine, and creatine.

If you remove the bad, only the good remain. So, the answer is, “Yes. In the right diet context red meat can be good for you”.

The Bottom Line

You have heard that red meat is bad for you. It increases your risk of heart disease and cancer. You should avoid it at all costs.

But is that true? In the article above I:

  • Describe both the benefits and risks of red meat.
  • Discuss how plant foods negate many of the bad effects of red meat.
  • Share a study providing proof of that concept.
  • Share how you can enjoy the benefits of red meat while avoiding the bad effects of red meat consumption.

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 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 Methylfolate Myths

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The Lies Of The Supplement Industry

Author: Dr. Stephen Chaney

Pinochio

How do the myths of the food supplement industry originate? Some of them start innocently enough. They are often based on a kernel of truth which is misinterpreted by some well-meaning medical doctors.

It’s not their fault. We teach future doctors what I call “metabolism light” in medical school. There simply isn’t room in the medical curriculum to teach all the details and nuances of human metabolism.

We also try to teach them the basics of how to interpret scientific literature. However, it takes years of experience to get good at picking out the strengths and weaknesses of clinical studies.

The doctors form their hypothesis and test it on a few patients. If it works, they publish a paper. At that point their idea is picked up by the “sensationalist” bloggers. These are the bloggers who like to focus on the sensational. They delight in writing about “new findings” that go against what the medical profession has been telling you for years.

The bloggers don’t stop there. They usually expand the claims. They ‘cherry pick” the scientific literature by quoting only studies that support their viewpoint and ignoring studies that refute it. In short, they put together a very compelling story. Soon the story is picked up by other bloggers who embellish it further. After it appears in enough sites, people start believing it. A myth is born.

Then supplement companies get in the act. They sense there is money to be made. They manufacture supplements to provide nutrients supported by the myths. They embellish the mythology even more and put together a compelling story to market their products.

This is where the mythology becomes deception. Companies have the responsibility to design their products based on the best science. They have an obligation to tell the truth about their products. When they make claims they know cannot be true, they are lying to you.

The saga of methylfolate is a perfect example of how observations based on a kernel of truth became myths and eventually became downright lies. Let me share that story with you.

The Kernel Of Truth About Methylfolate

Let’s start with one of the “kernel of truth” that launched the whole methyl folate saga. It started with a doctor who was having a very difficult time finding a solution for a patient with some significant health issues. The doctor ordered a genetic test and discovered the patient had a deficiency in the methylene tetrahydrofolate reductase (MTHFR) gene.

MTHFR ReactionThe doctor remembered the reaction catalyzed by MTHFR, and a light bulb went off. “Eureka”, he said. His patient must be unable to make N5-methyltetrahydrofolate (commonly referred to as methylfolate or methyl folate), and methylfolate is required for some very important methylation reactions in the cell.

He gave his patient methylfolate, and the patient’s symptoms got better. The doctor leapt to the conclusion that other patients with MTHFR deficiency needed methylfolate as well. Many of those patients responded to methylfolate as well. He didn’t bother to check whether they responded equally well to folic acid. He just assumed methylfolate was the magic elixir.

He wrote a paper on his clinical observations, and the methylfolate story was launched. It all seemed so logical.

However, the story was not nearly as straight forward as the doctor and the people publicizing his findings assumed. Let me walk you through some “Metabolism 101”. Don’t worry. There won’t be a quiz.

Why The Original Assumptions About Methyl Folate Were Misleading

MTHFR mutants only have a partial loss of activity.

  • Individuals with 2 copies of a mutation from A to C at position 1298 of the MTHFR gene (A1298C homozygotes) comprise about 5% of the US population. They have 60% enzyme activity and appear to be normal in clinical studies.
  • Individuals with 2 copies of a mutation from C to T at position 677 of the MTHFR gene (C677T homozygotes) have 30% enzyme activity. They comprise about 10% of the US population. C677T homozygotes often have elevated homocysteine levels. The homozygous C677T mutation is associated with depression, anxiety, and mood swings in some people, but not in others (I will come back to the significance of that qualifying statement later).
  • C677T heterozygotes (one mutant gene) have 65% activity and are normal.

We Don’t Need 100% MTHFR Activity

Our human body is wonderfully designed. For many of our most essential metabolic reactions we have built in redundancy. We don’t require 100% activity of key enzymes. This helps protect us from bad effects of mutations as they arise.

The best analogy I can think of is the US space program. Most space vehicles had built in redundancy so that if one system failed, the mission could go on. For example, you may remember the Hubble space telescope. It was launched with four gyroscopes to keep the telescope pointed in the right direction.

After a few years, one gyroscope gave out. That was not a problem because there were three left. A few years later the second gyroscope gave out. Again, there was no problem because there were still two gyroscopes left.

It was only after the third gyroscope gave out that Hubble became a bit “wonky”, and a space shuttle was sent up to replace the gyroscopes. It is the same with MTHFR. Only when you get down to around 30% activity, does it become a bit wonky”. (That’s about as non-technical as I get.)

Not Everyone With MTHFR Deficiency Experiences Symptoms

This is due to a phenomenon my geneticist friends refer to as penetrance. Simply put, that means that not everyone with the same mutation experiences the same severity of symptoms. That is because the severity of a mutation is influenced by diet, lifestyle, and genetic background.

Let me start with genetic background. In terms of MTHFR mutants you can think of genetic background as being mutations in a related methylation pathway. People who have a mutation in both MTHFR and a gene in a related pathway will experience more severe symptoms and are more likely to require methylfolate. Once you understand penetrance, you realize that individuals requiring methylfolate may represent only a small subset of people with MTHFR mutations.

Penetrance is a concept that most proponents of the methylfolate hypothesis completely ignore. The most severe MTHFR mutation (C677T homozygote) increases the probability that individuals will exhibit symptoms, but some individuals with that mutation are completely normal. Now that you understand the concepts of redundancy and penetrance, you can understand why that is.

When Did The Kernel of Truth Become A Myth?

Up to this point the hype around methyl folate could be chalked up to an honest misunderstanding.

  • The doctors who published the original papers may not have known that MTHFR mutations only resulted in a partial reduction in enzyme activity.
  • They probably didn’t know the concepts of redundancy (our cells don’t need 100% enzyme activity) or penetrance (the same mutation may cause severe symptoms in some patients and have no effect in others).
  • It seemed logical to assume that everyone with a MTHFR mutation might do better with methylfolate supplementation. That was incorrect, but it was an honest mistake.

However, the message was picked up by the bloggers who specialize in sensational stories, especially stories that contradict what experts have been telling you for years. They picked up the methylfolate story and distorted it beyond recognition.

  • They knew that “natural” is a buzz word, so they told you that methylfolate was natural and folic acid is synthetic.
  • They told you that methylfolate was better utilized than folic acid.
  • They told you that methylfolate was more effective than folic acid.
  • They told you folic acid was toxic. It was going to increase your risk of cancer.
  • Suddenly, it was no longer about people with MTHFR deficiency. You were told that everyone should avoid folic acid and use methylfolate instead.

On the surface, these pronouncements should not have passed the “If it sounds too good to be true…” test, or in this case, the “If it sounds too bad to be true…” test. You were being asked to believe that folic acid, which has been in use for over 80 years and is backed by hundreds of studies showing it is safe and effective, was neither safe nor effective. You were asked to believe that the government was poisoning you by fortifying foods with folic acid.cherry picking studies

However, to make their blogs sound more convincing, they listed clinical studies supporting their stories. The problem is they “cherry picked” the studies that supported their story and ignored the rest. Their bias was particularly outrageous when it came to the “story” that folic acid increases cancer risks. They ignored 10 or 20 studies showing no cancer risk and reported one suggesting it might increase risk. I call that deceptive.

Unfortunately, the myths created by the bloggers have been repeated often enough that many people now believe they are true. It is time for me to debunk the methylfolate myths.

The Methylfolate Myths 

Myth Versus FactsMyth: Methylfolate is natural. It comes from whole food. Folic acid is synthetic.

Fact: Methylfolate is chemically synthesized from folic acid. It is physically impossible to extract enough from whole foods. Here are the facts:

  • Methyfolate is only one of several naturally occurring folates in foods.
  • The best food sources of folates are beans, leafy greens, and broccoli.
  • To obtain the RDA of methyfolate for a single tablet you would need to start with 1 cup of lentils, two cups of cooked spinach, or 4 cups of broccoli.
  • You do the math! It just isn’t possible.

Myth: Methylfolate is better utilized by the body than folic acid.

Fact: This claim is based on levels of methylfolate in the blood after taking supplements providing equivalent amounts of methylfolate and folic acid. However, methylfolate has no biological activity in our blood. The measurement that matters is total folate levels (methylfolate plus other folates) in our cells.

If you take equivalent amounts of folic acid and methylfolate, you end up with identical folate levels in your cells (B.J. Venn et al, The Journal of Nutrition, 132: 3333-3335, 2002). In short, there is no difference in our ability to utilize methylfolate and folic acid.

Myth: If you have a mutation in the MTHFR gene, folic acid isn’t effective.

Clinically ProvenFact: MTHFR slightly increases the need for folic acid (from 400 ug to between 600 and 800 ug), but multiple studies show that folic acid supplementation is effective in people with MTHFR mutations.

For example, homocysteine levels are easily measured and are a reliable indicator of methylfolate status.

  • That study also showed that folic acid was more effective than methylfolate at lowering homocysteine in people who were C677T heterozygotes and in people with normal MTHFR activity.

At present, lowering of homocysteine levels is the only indicator of methylfolate status for which methylfolate and folic acid have been directly compared. However, there are other studies suggesting that folic acid is likely to be effective for people with MTHFR defects. For example:

CancerMyth: Folic acid causes cancer.

Fact: The few studies suggesting that folic acid supplementation might increase the risk of cancer were “outliers”.  By that I mean they contradicted many other studies showing no increased risk.

Scientists are accustomed to this. We know that studies sometimes come up with conflicting results. In some cases, we can point to an error in experimental design or statistical analysis as the cause of the aberrant results.

In other cases, we never know the reason for the differences, so we go with the weight of experimental evidence (what the majority of studies show). The weight of evidence clearly supports the safety of folic acid.

However, that is not enough. If there is the slightest possibility that something causes cancer, we investigate it further. Consequently, the scientific community followed up with larger studies.

Those studies showed either reduced cancer risk or no difference in cancer risk with folic acid supplementation. None of the studies found any evidence that folic acid increased cancer risk. I have covered this in detail for folic acid and colon cancer risk in a previous issue of “Health Tips From The Professor”.

There have also been a couple of small studies suggesting that folic acid might increase the risk of prostate and breast cancer. Although these were small, individual studies, they have been widely hyped by the methylfolate advocates. Once again, the definitive study has been done (S.E. Vollset et al, The Lancet, 381: 1029-1036, 2013).

It was a meta-analysis of 13 placebo-controlled studies involving over 50,000 subjects. The results were clear cut. Folic acid supplementation caused no increase in overall cancer risk, and no increase in the risk of colon cancer, prostate cancer, breast cancer, or any other individual cancer. Moreover, the average dose of folic acid in those studies was 2 mg/day, which is 5 times the RDA.

Of course, the bloggers and the companies selling methylfolate supplements ignore the definitive studies showing folic acid does not increase cancer risk. The myths and lies continue.

Myth: Folic acid can mask a B12 deficiency.

Fact: True but irrelevant if you use a supplement with folic acid and B12 in balance.

The Lies Of The Supplement Industry

deceptionIf you are writing a blog, you are covered by “freedom of speech”. You can say whatever you want. It doesn’t have to be true. However, if you are a supplement manufacturer, you are held to a higher standard. Ignorance is no longer an excuse. You can no longer cherry pick the “facts” you like and ignore the rest. You are ethically obligated to research all the available literature and be guided by the best scientific evidence.

Reputable companies have been guided by scientific evidence and have not jumped on the methylfolate bandwagon. They know folic acid is both safe and effective in a wide variety of clinical situations. They also know that, while methylfolate may be just as effective as folic acid, it has not been shown to be superior to folic acid for any clinical application.

They may offer a methylfolate option for people who believe they need it. But they make no claim that it is superior to their products containing folic acid.

Less reputable companies, however, sensed money to be made by capitalizing on the buzz around methyl folate. They repeated the myths of the bloggers and claimed their products were superior to others on the market. They call it marketing. I call it lying. They have an obligation to fact check their claims and only make claims that are true.

Let me give you an example. In preparing for this article, I looked at the claims of several companies that were promoting their methylfolate supplements. One in particular claimed they had studies showing:

1) Their methylfolate supplement was effective at reducing the risk of adverse pregnancy outcomes.

2) Their methylfolate supplement was twice as bioavailable as folic acid.

3) Their methylfolate supplement was able to lower homocysteine levels better than conventional folic acid supplementation.

All three studies were bogus.

  • With respect to the first study, it was likely true that their methylfolate supplement decreased adverse pregnancy outcomes. But there are dozens of studies showing that folic acid does the same thing.

And because they did not compare methylfolate and folic acid supplementation in their studies, they have no basis for claiming their supplement was superior.

  • The second study compared levels of methylfolate and folic acid in the blood. As I mentioned above, methylfolate has no biological activity in our blood. The measurement that matters is total folate levels (methylfolate plus other folates) in our cells. And previous studies have shown that equivalent amounts of methylfolate and folic acid give identical amounts of methyfolate in our cells.
  • The third study compared their supplement, which contained B6, B12, zinc, and betaine in addition to methylfolate, to folic acid alone. That’s comparing apples to oranges. That is because there are three pathways for lowering homocysteine levels, and B6, B12, and betaine play important roles in each of these pathways.
    • B12 is an integral part of the enzyme methionine synthase, an enzyme that converts homocysteine to the amino acid methionine. Methylfolate transfers its methyl group to the enzyme-bound vitamin B12, and methyl B12 transfers the methyl group to homocysteine, which converts it to methionine. In other words, methylfolate cannot lower homocysteine levels by itself. It needs vitamin B12.
    • Betaine also serves as a methyl donor in another pathway for converting homocysteine to methionine by an enzyme called betaine-homocysteine methyltransferase.
    • B6 is essential for yet another pathway that lowers homocysteine levels by converting homocysteine to the amino acid cysteine.

You might argue that the company was simply ignorant of the importance of B6, B12, and betaine for lowering homocysteine levels. However, that is unlikely. Why else would they have included B6, B12, and betaine in their supplement?

They must have known the study they designed was bogus. That suggests they conducted the study with the sole purpose of deceiving you, the consumer. I call that lying.

Finally, in case you were wondering, I am not recommending you select a single supplement with folic acid, B6, and B12. I do recommend you get your folic acid from a multivitamin or B complex supplement that provides all three B vitamins in balance.

Betaine deficiency is very rare, so I don’t include betaine in my recommendations.

What Does This Mean For You?

Questioning WomanMTHFR mutations only result in partial loss of activity. Most individuals with MTHFR defects remain symptom free with the RDA, or slightly above the RDA, of folic acid.

However, there may be some individuals with a MTHFR defect and additional gene defects in metabolic pathways involving methylation who might benefit from methylfolate. This is due to a phenomenon that geneticists call penetrance and would likely represent a small subset of the population with MTHFR defects.

Finally,the claims that everyone would benefit from methylfolate instead of folic acid are false. They are contradicted by human metabolism and multiple published clinical studies.

In short, folic acid has been used for over 80 years. There are hundreds of clinical studies showing it is safe and effective, even in most individuals with a MTHFR deficiency. I can’t tell you whether the companies selling methylfolate are ignorant of basic metabolism and the published studies refuting their claims or whether they are purposely trying to deceive the public—but neither is a good thing.

The Bottom Line

Some supplement manufacturers are claiming that methylfolate is more natural and more effective than the folic acid that has been used in supplements for the past 80 years. In this issue of “Health Tips From the Professor” I debunk the methylfolate myths used by the supplement manufacturers to sell their methylfolate products.

I can’t tell you whether the companies selling methylfolate are ignorant of basic metabolism and the published studies refuting their claims or whether they are purposely trying to deceive the public—but neither is a good thing.

For more specifics, 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.

 

 

 

 

The Estrogenic Myth

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What Does Increase Breast Cancer Risk? 

Author: Dr. Stephen Chaney 

newspaper headlinesIt seems like every time you turn around there are new headlines warning us that a particular food or supplement increases your risk of cancer. If you believe all those headlines, there would be little you could eat. You might starve to death trying to avoid eating anything that increases your risk of cancer.

So, it’s important to ask which of those warnings are true and which are just myths.

For example, a few days ago, a friend called me and said, “I just heard that resveratrol is estrogenic and causes breast cancer. Should I read the labels of the herbal supplements I take and avoid anything with resveratrol in it.”

I assured her that this was just a myth. The likelihood that resveratrol and related polyphenols cause breast cancer is very low. And if she was concerned about breast cancer, there were much more important things to worry about.

But as I started to explain why it was a myth, I realized the explanation was complex. I was able to explain it to my friend in a 20-minute discussion. But it was then I realized I needed to write a “Health Tips From the Professor” article to help explain it to the general public.

Why Are We Concerned?

Questioning WomanYou might be asking, “Why is this such a big deal? Why do we care if something has estrogenic properties?” Let me start at the beginning.

When I first started teaching medical students in 1972, hormone replacement therapy (a combination of estrogen and progesterone) was thought to be a safe and effective treatment for menopausal symptoms and post-menopausal bone loss, and it was very widely prescribed.

That practice came to a screeching halt in 2002 when the Woman’s Health Initiative study showed that it increased the risk of breast, endometrial, and ovarian cancer. Today,

  • The hormone composition of hormone replacement therapy has been changed.
  • It is only prescribed for severe menopausal symptoms. And drugs are the treatment of choice to reduce post-menopausal bone loss.
  • It is prescribed for the shortest possible time to limit exposure.

These simple changes in hormone replacement therapy represent the single most important intervention for reducing breast cancer risk in the past 50 years. Yes, you heard that right. These changes were more effective than any other medication or preventative strategy for reducing the number of women developing and dying from breast cancer.

This lesson made a big impression on the medical community. So, it is easy to understand why anything resembling estrogen is immediately suspected of increasing the risk of breast cancer. But the reality is far more complicated. So, it’s time for another of my “Biochemistry 101” segments.

Biochemistry 101: What Does Estrogenic Mean?

professor owlLet’s start at the beginning with what polyphenols are. They comprise a diverse group of compounds with these common features.

  • If you look at their structures, they contain multiple rings (A chemist would tell you they have more than one phenol group, hence the term polyphenol. But that terminology is only useful if you are a chemist).
  • They are found in plants. Specifically, they are found in fruits, vegetables, herbs, spices and beverages (coffee, tea, and cocoa, for example).
  • They have antioxidant properties.

Types of polyphenols include flavonoids, phenolic acids, lignans, and stilbenes. I mention this only because soy isoflavones, which I will talk about later, are flavonoids.

Some of these compounds have structures that resemble estrogen. If they bind to estrogen receptors and have the same effect as estrogen in cultured human cells, they are said to have “estrogenic properties”.

That’s why you see blogs warning about foods and herbal ingredients we should avoid because of their “estrogenic” properties. Some of these blogs are written by people with “Dr” on front of their name. But they aren’t biochemists and don’t know what biochemists know.

Let’s dig a little deeper. Here are some of the complexities that most bloggers either don’t know about or ignore.

  • There is more than one kind of estrogen receptor.
  • Different estrogen receptors have different effects in the cell. For example, some estrogen receptors activate pathways that increase cancer risk. Other receptors activate pathways that decrease cancer risk.
  • The same estrogen receptor can have different effects in different cell types. That’s why estrogen replacement therapy reduced menopausal symptoms and post-menopausal bone loss AND increased cancer risk in other tissues.

The Estrogenic Myth

breast cancerA couple of weeks ago I talked about “The Soy Myth”, specifically the myth that soy isoflavones increase breast cancer risk. Of course, that myth was based on the observation that soy isoflavones have estrogenic properties and a simplistic interpretation of what that means. But in fact, soy isoflavones:

  • Are found naturally in most soy foods unless they are highly processed.
  • Bind strongly to the estrogen receptors that decrease cancer risk.
  • Bind weakly to the estrogen receptors that increase breast cancer risk.

In contrast, estrogen:

  • Binds strongly to the estrogen receptors that increase breast cancer risk.
  • Binds weakly to the estrogen receptors that decrease breast cancer risk.
  • Soy isoflavones compete with estrogen for binding to the receptors that increase breast cancer risks. This helps protect breast cells from the cancer-promoting effects of estrogen.

So, it is true that soy isoflavones bind to estrogen receptors, but on the balance, you would predict that soy isoflavones decrease, rather than increase breast cancer risk.

The key word here is “predict” breast cancer risk. If you are a woman, you don’t want a prediction, you want to know one way or the other.

That’s why multiple human clinical studies have been conducted to determine the effect of soy foods on breast cancer risk. As I told you two weeks ago:

  • Some studies showed no effect of soy consumption on the risk of getting breast cancer or breast cancer recurrence if you have previously had breast cancer.
  • Other studies found that soy consumption reduced the risk of breast cancer occurrence and recurrence.
  • No studies found that soy consumption increased the risk of breast cancer occurrence or recurrence.

So, for soy the answers are clear.

  • Yes, soy isoflavones have estrogenic properties.
  • No, soy consumption is not associated with an increased risk of breast cancer. That is a myth.

grape polyphenolsThe situation with resveratrol is similar:

  • It is found naturally in grapes and many other fruits.
  • It has estrogenic properties.
  • Cell culture experiments show that it activates pathways that reduce cancer risk.
  • Animal studies predominantly show that it reduces cancer risk. The only exceptions are a few animal studies with very high doses of resveratrol.
  • The few clinical studies that have been done show that it either has no effect on breast cancer risk or reduces cancer risk.
  • No human clinical trials have shown that resveratrol increases cancer risk.

The take home lesson is clear. Knowing that a food or herbal ingredient has estrogenic properties is meaningless unless you have data from human clinical trials on cancer outcomes.

So, the next time you see headlines telling you that you should avoid a food or herbal ingredient because it has “estrogenic properties” treat them skeptically. Unless the claim is backed up by human clinical trials showing an increased cancer risk, the claim is probably a myth.

What Does Increase Breast Cancer Risk?

American Cancer SocietyThe take home lesson is clear. If you are concerned about your risk of breast cancer or any other form of cancer you should ignore the social media posts, podcasts, and blogs about the cancer risks of estrogenic foods and herbal ingredients.

Unless they are backed by human clinical trials showing they increase cancer risks, the claims are likely to be mythical rather than real.

If they have any effect on cancer risk, it is likely to be small. Instead, focus on the important risk factors.

According to the American Cancer Society, the top 5 risk factor for breast cancer, and most other cancers, are:

#1: Overweight and obesity. The American Cancer Society recommends that you get and stay at a healthy weight.

Let me put this in perspective for you. Even if things like soy and resveratrol increased your risk of breast cancer, their effect is very small compared to estrogen and you are only exposed to them briefly once or twice a day.

In contrast, fat cells produce estrogen, and if you are overweight, fat cells accumulate in your breasts. Those fat cells are bathing your breast cells in a bath of pure estrogen 24/7.

#2: Inactivity. The American Cancer Society recommends that adults get at least 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.

#3: Alcohol use. The American Cancer Society says it is best not to drink alcohol at all. For women who do drink, they should have no more than 1 alcoholic drink a day.

#4: Hormone use after menopause. The American Cancer Society recommends talking to your health care provider about non-hormonal options to treat menopausal symptoms.

#5: Poor diet. The American Cancer Society recommends a diet low in fat, processed and red meat, and sugary drinks, but high in fruits and vegetables.

The Bottom Line 

It seems like every day you hear about another food or supplement you should avoid because it has “estrogenic properties” and is likely to cause cancer. I call this the estrogenic myth because those claims are generally mythological rather than factual. In this article:

  • I discuss why these claims are myths rather than facts using soy isoflavones and resveratrol as examples.
  • Tell you what the American Cancer Society tells you to focus on if you want to decrease your risk of breast cancer and other cancers.

For more details on these studies 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 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.

 

Are Our Healthy Years Getting Shorter?

by

What Does This Mean For You?

Author: Dr. Stephen Chaney

If you’ve ever traveled the subway system in London, you can’t have missed the “Mind the Gap” signs warning not to put your foot in the gap between the subway and the platform.

That warning is more important than ever in an age where people look at their cell phones rather than where they are walking. Of course, if they are looking at their cell phones, they might miss the sign and…

But today’s “Health Tip” is not about subway gaps. It’s about a far more important gap – the gap between our healthspan (how many years we enjoy good health) and our lifespan (how many years we live).

A recent study (L Gimeno et al, The Journals of Gerontology, Series B, 79(8), gbae113, 2024) suggesting that our healthy years are getting shorter caught my attention.

All of us imagine that our golden years will be ones of vibrant health. We’ll travel to exotic places. We’ll take long walks in the mountains. We’ll play with our grandchildren. Life will be wonderful.

But if this study is correct, none of that will happen for many young Americans. They will be too frail and sick to enjoy their golden years. They will be surviving rather than thriving.

So, in today’s “Health Tips From the Professor” I will review the study and tell you what it means for you.

How Was The Study Done?

clinical studyThe investigators used data on 114,526 adults >50 (average age = 63) from developed countries (the United States, England, and continental Europe). Specifically, they used data from people who participated in the Healthy and Retirement Study (26,939 people in the United States), the English Longitudinal Study on Ageing (14,992 people in England), and the Survey of Health, Ageing, and Retirement (72,595 people in continental Europe) between 2004 and 2018.

These surveys collected data on health-related outcomes every 2 years. The outcomes measured were:

  • Six activities of daily living (ADLs) such as eating, bathing, and walking.
  • Four instrumental activities of daily living (IADLs) related to essential tasks such as grocery shopping or preparing a hot meal.
  • Seven measures of mobility difficulties and motor coordination tasks such as walking one block, lifting 10 pounds, or picking up a small coin from a flat surface.

The assumption was that the severity of limitations was ADL > IADL > mobility difficulties. This is based on previous research showing that a person with ADL limitations is likely to have IADL limitations and mobility difficulties. And a person with IADL limitations is likely to have mobility difficulties. Based on this assumption, they classified participants in this study into 4 disability categories:

  • Mild disability: ≥1 IADL limitations and any number of mobility difficulties.
  • Moderate disability: 1-2 ADL limitations with any number of IADL limitations and mobility difficulties.
  • Severe disability: ≥3 ADL limitations with any number of IADL limitations and mobility difficulties.

The study also measured the prevalence (percent of the population) with:

  • Obesity
  • Heart disease.
  • Diabetes
  • Cancer
  • Lung disease.
  • High blood pressure.
  • High cholesterol.

Finally, the study also measured grip strength because loss of grip strength is considered an indicator of future disabilities.

The unique feature of this study is it compared the health and disability of people who were at the same age when tested but were born in different decades ranging from 1925 to 1955.

Because of the rapid change in diet and lifestyle following World War II, the health and disability of people born in the 1936-1945 decade encompassing World War II was used as the standard to which all other decades were compared.

Are Our Healthy Years Getting Shorter?

Some of you may have skipped over the previous section, so I will repeat the way these data were analyzed because it is crucial to your understanding of the study.

“The unique feature of this study is it compared the health and disability of people who were at the same age when tested but were born in different decades ranging from 1925 to 1955.

Because of the rapid change in diet and lifestyle following World War II, the health and disability of people born in the 1936-1945 decade encompassing World War II was used as the standard to which all other decades were compared.”

When looking at data from the United States, there were two distinct patterns.

The vertical line in the center of the graph represents the health and disability status of people born during World War II because all comparisons in this study were to people born in the decade encompassing World War II. A worsening of health and disabilities is indicated in red and an improvement in health and disabilities is shown in green. 

Pattern A was characteristic of a constant worsening of health and disabilities from people born in the decade starting in 1925 to people born in the decade starting in 1955.

This pattern was seen for:

  • Obesity
  • Heart disease.
  • Diabetes
  • Lung disease.
  • High blood pressure.
  • High cholesterol.
  • Severe disabilities.
  • Reduction in grip strength.

Remember, this study is measuring health and disability of people at the same age. The only difference is when they were born. It tells us people in their 50s, 60s, or 70s born in 1955 or later are in poorer health than people of the same age who were born in 1925.

And it’s not just the United States. For obesity and health parameters the pattern was the same for England and Europe. For severe disabilities the pattern was the same for England but was not as clear for Europe.

Two things should be noted for this pattern:

  • The worsening of health and the increase in severe disabilities comes despite the vast improvements in the health care systems in these countries and improved understanding of the causes of these diseases.
  • Obesity is likely a major driver of our declining health and increased disability. However, it is not the only driver. If the investigators had graphed the percentage of highly processed foods in the diet or the decline in regular exercise, the pattern would have been similar.

Pattern B shows an improvement in the period leading up to World War II and a deterioration in the period after World War II. The authors interpreted the improvement prior to World War II as due to improvements in health care and the deterioration after World War II as due to changes in diet and lifestyle.

This is the pattern seen for mild and moderate disabilities in the United States. The pattern for mild and moderate disabilities was not as clear for England and Europe.

The authors concluded, “In all regions, we found evidence for worsening health across cohorts [groups of people born in successive decades], particularly for those born after 1945.”

What Does This Study Mean For You?

QuestionsI don’t want to overinterpret this study. This study breaks new ground, but it has some limitations that I would characterize with three statements:

  • It is a very difficult study to do perfectly.
  • There are several factors that could affect the interpretation of the data and the outcome of the study.
  • The authors made a valiant effort to correct for any factors that could have affected the outcome.

For more details about the factors that might affect the outcome of the study and how the authors corrected for them, read the study.

However, this is the first study to use this approach to gauge the decrease in healthy years (healthspan) in developed countries over the past 40 years. It has its flaws, but it is consistent with several other studies documenting declining health in the current generation of young adults. For example, in a recent issue of “Health Tips From the Professor” I reviewed a study showing that colon cancer rates are increasing at an alarming rate for young adults in this country.

At the beginning of this article, I talked about the gap between our healthspan (how many years we enjoy good health) and our lifespan (how many years we live).

This study suggests that the onset of significant health issues and disabilities is occurring at a younger age today than for people born before World War II. In short, it suggests that our healthspan (the number of healthy years) is getting shorter.

This study did not look at lifespan, but numerous studies show that our lifespan is still increasing. So, the gap between healthspan and lifespan appears to be getting larger. In simple terms this means that when today’s young adults reach their “golden years”, they may spend more of those years in poor health than those of us born in the 1940’s.

But, what does this mean for you? The take home lesson should be, “This doesn’t have to be. You don’t have to be frail and sickly in your golden years. We know how to prevent this.”

  • It starts with a healthy diet – a whole food, primarily plant-based diet with lots of colorful fruits and vegetables, whole grains, nuts and seeds.
  • Add in a regular exercise program with a mixture of aerobic and resistance exercises.
  • Include an individualized supplement program.

You notice I didn’t list weight control as one of the top three prevention strategies. That’s because I don’t recommend fad diets and rapid weight loss programs. If you do the first three things well, your weight will come off naturally – a little bit at a time.

And once you have mastered all four things, you will increase your healthy years and narrow the gap between your healthspan and your lifespan. You can look forward to golden years filled with vitality and adventure.

The Bottom Line

A recent study used an innovative approach to quantify the deterioration in health and the physical ability to function well in daily activities as we age. The unique feature of this study is it compared the health and disability of people who were at the same age when tested but were born in different decades ranging from 1925 to 1955.

The study found a constant worsening of health and disabilities from people born in the decade starting in 1925 to people born in the decade starting in 1955 for:

  • Obesity
  • Heart disease.
  • Diabetes
  • Lung disease.
  • High blood pressure.
  • High cholesterol.
  • Severe disabilities.

The authors concluded, “We found evidence for worsening health across cohorts [groups of people born in successive decades], particularly for those born since 1945.”

In short, people born in recent years have fewer healthy years (a shorter healthspan) than people born before World War II. And since our lifespans are getting longer, this means the gap between our healthspan and our lifespan is increasing.

All of us imagine that our golden years will be ones of vibrant health. We’ll travel to exotic places. We’ll take long walks in the mountains. We’ll play with our grandchildren. Life will be wonderful.

But if this study is correct, none of that will happen for many of today’s young adults. They will be too frail and sick to enjoy their golden years.

For more details about this study and how you can increase your healthy years, narrow the gap between your healthspan and your lifespan, and look forward to golden years filled with vitality and adventure, 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.

600th Issue Celebration

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Nutrition Advances Over The Last Two Years

Author: Dr. Stephen Chaney 

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

The 600th issue of any publication is a major cause for celebration and reflection – and “Health Tips From The Professor” is no different.

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

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

Here are my picks from the last two years:

Weight Loss Diets

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

Is Time-Restricted Eating Better Than Other Diets? Time-restricted eating is one of the latest fads. But is it really better than other diets for weight loss and improved health? In this article I reviewed two studies that compare time-restricted eating with diets that do not restrict time of eating but cut calories to the same extent. You may be surprised at the results.

Can You Lose Weight Without Dieting? In this article I share 8 tips for losing weight without going on a diet. The article is based on research by Dr. Brian Wansink, a behavioral psychologist who specializes in studying how external clues influence our eating patterns. As you might suspect his 8 tips for losing weight have nothing to do with counting calories or going on restrictive diets.

Healthy Diets

dairy foodsIs Whole Fat Dairy Healthy? For years dietary guidelines have been telling us to select low fat dairy foods. But some health gurus are telling you that isn’t true. They claim whole fat dairy is healthy. So, you are probably wondering, “What is the scoop (as in ice cream) on whole fat dairy?” In this article I look at the study behind the headlines and answer that question. But the answer is not a simple “Yes” or “No”. The answer is more nuanced. It turns out that whole fat dairy is healthier in some diets than in others. 

Are Low Carb Diets Healthy? Are low carb diets good for you or bad for you? It depends on which study you quote. Two major studies in recent years have come to opposite conclusions. In this article I help you sort through the conflicting studies and rephrase the question. Instead of, “Are low carb diets healthy”, the question should be, “Which low carb diets are healthy?”

Are All Plant-Based Diets Healthy? Plant-based diets have acquired a “health halo” in recent years. Your mama told you to eat your fruits and vegetables. And many health gurus have been telling you not to neglect your grains, legumes, nuts, and seeds as well. But some of these foods require a lot of food preparation.

Never fear! The food industry has come to your rescue with a wide variety of processed plant-based foods. No need for food prep. But are they as good for you as the unprocessed plant foods they replace? In this article I review a study that answers that question.

You probably know what that answer is, but the article is worth a read anyway. That is because the study also asks whether vegan and vegetarian diets are healthier than other primarily plant-based diets. And you may not know the answer to that question.

Diet And Heart Disease

egg confusionAre Eggs Bad For You? For years we were told that eggs are bad for us because they contain cholesterol. Then we were told that eggs in moderation may not increase our risk of heart disease. And recently studies have appeared claiming eggs may be good for our hearts. What is the truth about eggs and heart disease? In this article I review a recent study claiming eggs are bad for our heart and put that study into the context of other recent studies to clear up the “eggfusion”.

Which Diets Are Heart Healthy? Every popular diet claims to help you lose weight, reduce your risk of diabetes, and reduce your risk of heart disease. All these claims can’t be true. Which diets deliver on their promises, and which are just pretenders? In this article I review a recent study that answered that question for heart disease.

This study was a very large metanalysis of over 40 studies with 35,548 participants that looked at the effect of different diets on heart disease outcomes. The study identified two diets that significantly reduced the risk of heart disease. There are other diets that might reduce the risk of heart disease, but their benefits have not been proven by high quality clinical studies. They are merely pretenders.

The Dangers Of Processed Foods 

In previous issues of “Health Tips From the Professor” I have shared articles showing that diets high in processed foods are associated with an increased risk of obesity, diabetes, and heart disease. But the story keeps getting worse. Here are two articles on recent studies about processed foods that appeared in “Health Tips From The Professor” in the last two years.

Why Does Processed Food Make You Fat? We already know that eating a lot of highly processed food is likely to make us fat. But what is it about processed food that makes us fat? In this article I review a recent study that answers that question.

This study is interesting for two reasons.

  • It identifies the characteristics of processed foods that make us want to eat more.
  • It identifies some minimally processed foods that have the same characteristics and suggests we should choose minimally processed foods wisely. Simply put, knowledge is power. We may want to avoid minimally processed foods that have the same obesity-inducing characteristics as processed foods.

Do Processed Foods Cause Cancer? Previous studies have shown that processed food consumption is associated with a higher risk of obesity, diabetes, and heart disease. Can it get any worse? In this article I review a recent study that shows processed food consumption is associated with an increased risk of several kinds of cancer.

Maintaining Muscle Mass As We Age

As we age, we begin to lose muscle mass, a process called sarcopenia. Unless we actively resist loss of muscle mass it will eventually impact our quality of life and our health.

We can prevent this loss of muscle mass with resistance exercise, adequate protein intake, and adequate intake of the amino acid leucine. Previous studies have shown people over 50 need more of each of these to maintain muscle mass, but the amount they need has been uncertain until now. Three recent studies have given seniors better guidelines for maintaining muscle mass.

Can You Build Muscle In Your 80s? In this article I review a recent study that enrolled a group of octogenarians in a high-intensity exercise program to see if they could gain muscle mass. They were able to increase their muscle mass, but the intensity of the exercise required may surprise you.

Optimizing Protein Intake For Seniors. In this article I review two recent studies that looked at the amount, timing, and kind of protein needed for seniors in their 60s and 70s to maximize gain in muscle mass.

How Much Leucine Do Seniors Need? In this article I review a recent study that determined the amount of leucine seniors in their 70s need to optimize gains in muscle mass and strength.

The Benefits And Risks Of Supplementation

Omega-3s And Heart DiseaseIf you listen to Big Pharma or the medical profession, you hear a lot about the “risks” of supplementation and very little about the benefits. In “Health Tips From the Professor” I try to present a more balanced view of supplementation by sharing high-quality studies showing benefit from supplementation and studies that put the supposed risks into perspective.

The Good News About Omega-3s and Stroke. Multiple studies have shown that omega-3 supplementation reduces the risk of ischemic strokes (strokes caused by a blood clot). But it has been widely assumed they might increase the risk of hemorrhagic strokes (strokes caused by bleeding). In this article I review a meta-analysis of 29 clinical studies with 183,000 participants that tested that assumption.

How Much Omega-3s Are Best For Blood Pressure? Multiple studies have shown that omega-3 supplementation can reduce high blood pressure. But the doses used vary widely from one study to the next. In this article I review a meta-analysis of 71 double-blind, placebo-controlled clinical studies that determined the optimal dose of omega-3s for controlling blood pressure.

Omega-3 Supplements Are Safe. As I said above, it has been widely assumed that omega-3 supplementation increases the risk of bleeding and hemorrhagic stroke. In this article I review the definitive study on this topic. More importantly, it reveals which omega-3 supplements might increase bleeding risk and which do not.

Are Calcium Supplements Safe? Big Pharma and the medical profession have been warning us that calcium supplements may increase heart disease risk. In this article I review the definitive study on this topic.

Prenatal Supplements

prenatal dha supplementIf you are pregnant or thinking of becoming pregnant, your health professional has likely recommended a prenatal supplement. You probably assume that prenatal supplements provide everything you need for a healthy pregnancy. Unfortunately, recent research has shown that assumption is not correct.

Is Your Prenatal Supplement Adequate? In this article I review a study that should serve as a wakeup call for every expectant mother. It showed that most prenatal supplements were woefully inadequate for a healthy pregnancy.

What Nutrients Are Missing In Prenatal Supplements? In this article I review a study that identified additional nutrients that are missing in most prenatal supplements.

Prenatal Supplements Strike Out Again. In this article I review a study that looked at the diet of pregnant women to determine their needs and compared that to the nutrients found in prenatal supplements. Once again, most prenatal supplements were woefully inadequate. Is it, “Three strikes and you are out”?

Exercise

Walking FastWalking Your Way To Health. We have been told that walking is good for our health. But how many steps should you take, how fast should you walk, and does it matter whether these steps are part of your daily routine or on long hikes? In this article I review a study that answers all these questions.

Which Exercise Is Best For Reducing Blood Pressure? If you have high blood pressure, you have probably been told to exercise more. But which exercise is best? In this article I review a study that answers that question. And the answer may surprise you.

Did You Know? 

Question MarkIf you have been reading “Health Tips From the Professor” for a while, you probably know that I enjoy poking holes in popular myths. Here are two new ones I deflated in past two years.

Is Low Alcohol Consumption Healthy? You have probably heard that low alcohol intake (that proverbial glass of red wine) is good for you. But is that true? In this article I review a recent study that shows that myth was based on faulty interpretation of the data and provides a more nuanced interpretation of the data.

Is HDL Good For Your Heart? You have been told that increasing your HDL levels reduces your risk of heart disease so many times it must be true. But is it? In this article I review HDL metabolism and a recent study to provide a more nuanced interpretation of the relationship between HDL and heart disease risk.

How To Talk With Your Doctor About Cancer 

Because of my years in cancer research, I am often asked whether someone should follow their oncologist’s advice and go on a recommended chemotherapy or radiation regimen. Of course, it would be unethical for me to provide that kind of advice.

In this article I tell you the questions to ask your oncologist about the prescribed treatment regimen, so you can make an informed decision. However, I also recommend you only ask these questions if you can handle the answers.

The Bottom Line

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

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

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

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

_______________________________________________________________________________

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/lifestylechange/.

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.

Are All Plant-Based Diets Healthy?

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Why Are Plant-Based Diets Healthy?

Author: Dr. Stephen Chaney

Unless you are like Rip van Winkle and have been asleep for the past 30 years, you have probably heard that plant-based diets are good for you. In fact, that advice is sound. It is based on multiple long-term studies.

But you may still be hesitant to make the switch. You are probably wondering if you have to be a vegan purist to benefit from a plant-based diet. If so, you are wondering whether you can make that drastic a change in your diet. Or, you may have already decided “that is a bridge too far” and don’t want to even consider it.

So, one important question is, “Do you have to go vegan to benefit from a plant-based diet?”

On the other hand, “Big Food, Inc” has made it easier than ever to switch to more “plant-based” eating. After all, sugar comes from plants. And highly processed grains come from plants. Add a few chemicals and you can come up with an endless supply of highly processed plant-based foods.

So, another important question is, “Can a diet of highly processed plant-based foods be as healthy as a diet of whole, unprocessed plant-foods?”

The study (Y. Wang et al., Nutrition Journal, 22: 46, 2023) I am reviewing today was designed to answer these two questions. It also represents the first meta-analysis to combine data from studies on the effects of plant-based diets on diabetes, heart disease, cancer, and mortality into a single study.

How Was The Study Done?

clinical studyThe investigators performed a meta-analysis of 76 studies with 2,230,443 participants that looked at the associations of plant-based dietary patterns and the incidence of type 2 diabetes, cardiovascular disease, cancer, and mortality among adults 18 years or older.

The characteristics of study participants ranged from:

  • 25 to 87 years old.
  • BMI of 20 to 30.

And the duration of the studies within the meta-analysis ranged from 2 to 36 years.

The adherence to plant-based diets was defined as higher consumption of plant-based foods and lower consumption or exclusion of animal-based foods.

The meta-analysis also included studies looking at the effect of changing from a more animal-based to a more plant-based dietary pattern.

The meta-analysis included studies looking at the benefit of vegan and vegetarian diets. In terms of participants these studies represented just over 50% of the data in the meta-analysis. So, this meta-analysis was ideally positioned to determine whether vegan and vegetarian diets were more beneficial than other primarily plant-based dietary patterns that included some animal foods.

The methodology used to classify diets as primarily plant-based varied from study to study. But in each case the study participants were divided into quartiles ranging from consuming the most plant-based diet to consuming the least plant-based diet.

The study then compared study participants with the highest adherence to plant-based diets to those with the lowest adherence to plant-based diets with respect to type 2 diabetes, cardiovascular disease, cancer, and mortality.

Finally, the study also compared adherence to healthy plant-based dietary patterns (whole or minimally processed fruits, vegetables, whole grains, beans, nuts, and seeds) to unhealthy plant-based dietary patterns (foods and drinks with added sugar, highly processed plant foods, and starchy vegetables).

Are Plant-Based Diets Healthy?

When comparing highest to lowest adherence to plant-based dietary patterns the risk of:

  • Type-2 diabetes was reduced by 18%.
  • Cardiovascular disease was reduced by 10%.
  • Cancer was reduced by 12%.
  • Mortality was reduced by 16%.

In short, all the news was good for primarily plant-based dietary patterns.

Are All Plant-Based Diets Healthy?

Increased adherence to a healthy plant-based dietary pattern (That term is defined in the methods section above) was associated with an even better reduction in disease risk. For example:

  • Type-2 diabetes was reduced by 21%.
  • Cardiovascular disease was reduced by 15%.
  • Cancer was reduced by 13%.
  • Mortality was reduced by 14%, which was statistically indistinguishable from the reduction in mortality associated with all plant-based dietary patterns above.

Factory FarmIn contrast, increased adherence to an unhealthy plant-based dietary pattern was associated with increased risks of disease. For example:

  • The risk of type 2 diabetes increased by 8%.
  • The risk of cardiovascular disease increased by 14%.
  • The risk of cancer increased by 7%.
  • The risk of mortality increased by 16%.

In short, plant-based dietary patterns consisting of whole or minimally processed plant foods are good for you. Plant-based dietary patterns consisting of highly processed plant foods are not.

Are Vegan and Vegetarian Diets More Beneficial Than Other Plant-Based Dietary Patterns?

Mediterranean Diet FoodsTwenty seven of the studies within this meta-analysis compared vegetarian or vegan dietary patterns with animal-based dietary patterns. These studies had 1,343,967 participants, which amounts to 57% of the participants in the meta-analysis.

Thus, this meta-analysis was well positioned to determine relative benefits of vegan and vegetarian diets compared to other primarily plant-based dietary patterns that include some animal foods. The investigators reported that:

  • The risk reduction for type 2 diabetes was greater in studies with vegan and vegetarian diets than in studies with other primarily plant-based diets.
  • No other statistically significant benefits were observed for vegan and vegetarian diets compared to other primarily plant-based diets.

In short, you don’t need to become a vegan to experience the health benefits of a plant-based diet.

In contrast, increased adherence to an unhealthy plant-based dietary pattern was associated with increased risks of disease. For example:

  • The risk of type 2 diabetes increased by 8%.
  • The risk of cardiovascular disease increased by 14%.
  • The risk of cancer increased by 7%.
  • The risk of mortality increased by 16%.

In short, plant-based dietary patterns consisting of whole or minimally processed plant foods are good for you. Plant-based dietary patterns consisting of highly processed plant foods are not.

What If You Change From An Animal-Based To A Plant-Based Diet?

Food ChoicesIf you have been consuming an animal-based diet for years, you may be wondering whether it is too late to change. Has the damage already been done?

Six studies within this meta-analysis examined the effect of changing from an animal-based diet to a plant-based diet on type 2 diabetes and mortality. Changing to a more plant-based dietary pattern:

  • Reduced diabetes by 17% and mortality by 5%.

In short, it’s never too late to switch to a more plant-based dietary pattern.

Why Are Plant-Based Diets Healthy?

The short answer is that we don’t know for sure, but the authors mentioned several popular hypotheses.

  • Obesity is a risk factor for type 2 diabetes, cardiovascular disease, and certain types of cancer. And studies have shown that people consuming plant-based diets tend to weigh less.
  • The increased fiber content and higher ratio of polyunsaturated fats to saturated fats lower cholesterol levels and improve blood lipid profiles, which are associated with a lower risk of cardiovascular disease.
  • Plant-based diets are anti-inflammatory, which reduces the risk of all three diseases.
  • Plant foods are rich in polyphenols and other phytonutrients that are associated with reduced risk of cardiovascular disease, lower blood pressure, and improvements in insulin sensitivity.
  • Plant foods are metabolized by gut bacteria to metabolites that are associated with reduced risk of type 2 diabetes and cardiovascular disease.
  • Plant foods support healthy gut bacteria associated with a reduced risk of several diseases.
  • Finally, plant-based dietary patterns are associated with no or reduced consumption of red and processed meats, which increase the risk of type 2 diabetes, cardiovascular disease, and certain types of cancer.

For a more detailed discussion read the article).

What Does This Study Mean For You?

The authors of this study concluded, “Higher adherence to plant-based dietary patterns, especially from healthy sources, may be universally beneficial for the primary prevention of type 2 diabetes, cardiovascular disease, cancer, and mortality. The current study provides further evidence in support of current recommendations that emphasize consuming high-quality plant-based foods for achieving optimal health.”

“Future studies are needed to elucidate…mechanistic pathways linking plant-based diets with multiple disease outcomes.”

I would just like to emphasize a few points:

  • These are all association studies. It takes decades for diseases like diabetes, heart disease, and cancer to develop. So, it is impossible to confirm these findings with double blind, placebo-controlled studies. However, when you have 76 studies with over 2 million participants all pointing to the same conclusion, it is hard to ignore the findings.
  • The good news is that you don’t have to become a vegan to experience these benefits. There are many healthy primarily plant-based diets available. Choose the one that best fits your food preferences and lifestyle.
  • Be aware that whatever diet you choose, Big Food Inc is only too happy to provide you with highly processed foods that fit that dietary pattern. Don’t fall for that trap. Stick with whole or minimally processed plant foods.
  • If your current diet isn’t the best, it is never too late to switch to a healthier primarily plant-based diet.

The Bottom Line

A recent meta-analysis of 76 studies with 2,230,443 participants looked at the associations of plant-based dietary patterns and the incidence of type 2 diabetes, cardiovascular disease, cancer, and mortality among adults 18 years or older.

The authors of the study concluded, “Higher adherence to plant-based dietary patterns, especially from healthy sources, may be universally beneficial for the primary prevention of type 2 diabetes, cardiovascular disease, cancer, and mortality. The current study provides further evidence in support of current recommendations that emphasize consuminh high-quality plant-based foods for achieving optimal health.”

Other key points from the study are:

  • These are all association studies. It takes decades for diseases like diabetes, heart disease, and cancer to develop. So, it is impossible to confirm these findings with double blind, placebo-controlled studies. However, when you have 76 studies with over 2 million participants all pointing to the same conclusion, it is hard to ignore the findings.
  • The good news is that you don’t have to become a vegan to experience these benefits. There are many healthy primarily plant-based diets available. Choose the one that best fits your food preferences and lifestyle.
  • Be aware that whatever diet you choose, Big Food Inc is only too happy to provide you with highly processed foods that fit that dietary pattern. Don’t fall for that trap. Stick with whole or minimally processed plant foods.
  • If your current diet isn’t the best, it is never too late to switch to a healthier primarily plant-based diet.

For more details about how the authors came to these conclusions 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 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.

Do Processed Foods Cause Cancer?

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How Can You Reduce Your Cancer Risk?

Author: Dr. Stephen Chaney 

We are facing a food crisis in this country. Big Food Inc is taking over our diet. Currently, 73% of our food supply is processed. And because these are manufactured foods, not real foods, they are 52% cheaper than the whole unprocessed foods we should be eating.

And Big Food Inc has seduced us. They know our weaknesses. The foods they make are convenient and easy to prepare. They also know our bodies were created with an ingrained craving for sweet, salty, and fatty foods. These cravings served us well in prehistoric times, but in today’s world Big Food Inc has weaponized them. Their foods are designed to satisfy every craving. They have done their best to make their processed foods irresistible!

The result is no surprise. In 2018 (LG Baraldi et al, BMJ Open, 2018, 8(3) e020574 60% of the calories the Average American consumes came from processed foods, and the percentage has only increased since then.

This is alarming because higher consumption of processed foods has been linked to increased risk of obesity, diabetes, and all-cause mortality.

Some studies have suggested that higher consumption of processed foods may also be linked to increased risk of cancer. The authors of the current study (K Chang, eClinicalMedicine 2023;56: 101840) set out to test this hypothesis.

How Are Processed Foods Defined In This Study?

Before I proceed with describing the findings of this study, I should probably contrast the common definition of processed foods with the current scientific definition of processed foods. The scientific community has recently developed something called “The NOVA food classification system” to describe the various levels of food processing.

The NOVA system categorizes foods into four groups according to the extent of processing they have undergone:

  1. Unprocessed or minimally processed foods.
    • This category includes foods like fruit, vegetables, milk, and meat.

2) Processed culinary ingredients.

    • This category includes foods you might find in restaurants or prepare yourself to which things like sugar, vegetable oils, butter, or cream were added in the preparation.

3) Processed foods.

    • This category includes foods like canned vegetables, freshly made breads, and cheeses.

4) Ultra-processed foods.

    • This category includes foods like soft drinks, chips, packaged snacks, most breakfast cereals, chicken nuggets & fish sticks, fast food burgers, hot dogs, and other processed meats.

The actual list is much longer, but you get the idea. What we call processed foods, scientists call ultra-processed foods. Since the term “ultra-processed foods” has not yet entered the popular vocabulary, I will use the term “processed foods” in describing the results of this study because it is more understandable to the average reader.

How Was This Study Done?

clinical studyThe authors of this study started by using data from the UK Biobank study. The UK Biobank study is a long-term study in the United Kingdom that is investigating the contributions of genetics and environment to the contribution of disease.

The authors focused on 197,426 (54.6% women) participants in the study who completed up to five 24-hour dietary recalls between 2009 and 2012. The participants were age 58 (range 40 to 69) when they entered the study and were followed for an average of 9.8 years. None of the participants had been diagnosed with cancer at the time of their enrollment in the study.

The purpose of this study was to examine the correlation between percent of “processed food” in the participant’s diets and both the frequency of newly diagnosed cancer and the frequency of cancer deaths during the 9.8 years of follow-up.

More importantly, the size of this study allowed the authors to examine associations between processed food consumption and both the risk of cancer and cancer mortality for 34 site-specific cancers – something most previous studies were unable to do.

  • The percentage “processed food” in their diets was calculated from the 24-hour dietary recalls using the NOVA scoring system.
  • The frequency of newly diagnosed cancers and cancer deaths was obtained by linking the data in this study with the national cancer and mortality registries, provided by the National Health Service.

Do Processed Foods Cause Cancer?

CancerThe authors started by dividing participants into four equal quartiles based on their consumption of processed foods:

  • For quartile 1 processed foods made up between 0 and 13.4% of calories (average = 9.2%).
  • For quartile 2 processed foods made up between 13.5 and 20% of calories (average = 16.7%).
  • For quartile 3 processed foods made up between 20.1 and 29.4% of calories (average = 24.3%).
  • For quartile 4 processed foods made up between 29.5 and 100% of calories (average = 41.4%).

They started by looking at the risk of developing cancer during the 9.8-year follow-up period. A total of 15,921 participants developed cancer during that time. When the authors compared the group consuming the most processed foods with the group consuming the least processed foods:

  • The risk of overall cancer of any type increased by 7%.
  • The risk of lung cancer increased by 25%.
  • The risk of ovarian cancer increased by 45%.
  • The risk of diffuse large B-cell lymphoma increased by 63%.
  • The risk of brain cancer increased by 52%.

Furthermore, every 10% increase in processed food consumption was associated with:

  • A 2% increase in overall cancer incidence…and…
  • A 19% increase in ovarian cancer incidence.

A total of 4,009 participants died from cancer during that time. When the authors compared the group consuming the most processed foods with the group consuming the least processed foods:

  • Overall cancer mortality increased by 17%.
  • Lung cancer mortality increased by 38%.
  • Ovarian cancer mortality increased by 91%.

Furthermore, every 10% increase in processed food consumption was associated with:

  • A 6% increase in overall cancer mortality.
  • A 16% increase in breast cancer mortality.
  • A 30% increase in ovarian cancer mortality.

The authors concluded, “Our UK-based study suggests that higher [processed food] consumption may be linked to an increased [frequency] and mortality for overall and certain site-specific cancers especially ovarian cancer in women…These findings suggest that limiting [processed food] consumption may be beneficial to prevent and reduce the modifiable burdens of cancer.”

How Can You Reduce Your Cancer Risk?

American Cancer SocietyLet’s start with the American Cancer Society recommendations to limit cancer risk:

1) Avoid tobacco use. 

2) Get to and stay at a healthy weight.

If you are already at a healthy weight, stay there. If you are carrying extra pounds, try to lose some. Losing even a small amount of weight can reduce your risk of cancer and have other health benefits. It is a good place to start.

3) Be physically active and avoid time spent sitting.

Current recommendations are to get at least 150-300 minutes of moderate intensity or 75-150 minutes of vigorous intensity activity each week. Getting to or exceeding 300 minutes is ideal.

In addition, you should limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment. This is especially important if you spend most of your working day sitting.

4) Follow a healthy eating plan.

A healthy eating pattern includes a variety of vegetables, fiber-rich legumes (beans and peas), fruits in a variety of colors, and whole grains. It is best to avoid or limit red and processed meats, sugar-sweetened beverages, highly processed foods, and refined grain products. This will provide you with key nutrients in amounts that help you get to and stay at a healthy weight.

5) It is best not to drink alcohol.

It is best not to drink alcohol. People who choose to drink alcohol should limit their intake to no more than 2 drinks per day for men and 1 drink a day for women.

This study adds an exclamation point to the American Cancer Society’s recommendation to avoid or limit “processed meats, sugar-sweetened beverages, highly processed foods, and refined grain products”.

You may be asking, “What is so harmful about processed foods?” The most obvious harm is that they are replacing healthier foods that reduce cancer risk, such as “a variety of vegetables, fiber-rich legumes (beans and peas), fruits in a variety of colors, and whole grains” that the American Cancer Society recommends for reducing cancer risk.

But there are other reasons as well. In the words of the authors:

  • “Evidence has been accumulating on the strong obesity and type-2 diabetes-promoting potential of [processed foods], both of which are risk factors for many cancers including those of the digestive tract and some hormone-related cancers in women.
  • Emerging research has suggested other common properties of [processed foods] that may contribute to adverse cancer outcomes, including the use of controversial food additives, contaminants such as acrylamide that form during [food processing], and toxic contaminants such as phthalates and bisphenol-F that migrate from food packaging [into the food].”

The Bottom Line 

You probably know that processed foods are bad for you. But do processed foods cause cancer? A very large study (197,426 people followed for 9.8 years) suggests the answer to that question appears to be yes.

When the authors of the study compared the group consuming the most processed foods with the group consuming the least processed foods:

  • The risk of overall cancer of any type increased by 7%.
  • The risk of lung cancer increased by 25%.
  • The risk of ovarian cancer increased by 45%.
  • The risk of diffuse large B-cell lymphoma increased by 63%.
  • The risk of brain cancer increased by 52%.

And when they looked at cancer deaths and did the same comparison:

  • Overall cancer mortality increased by 17%.
  • Lung cancer mortality increased by 38%.
  • Ovarian cancer mortality increased by 91%.

The authors concluded, “Our study suggests that higher [processed food] consumption may be linked to an increased [frequency] and mortality for overall and certain site-specific cancers especially ovarian cancer in women…These findings suggest that limiting [processed food] consumption may be beneficial to prevent and reduce the modifiable burdens of cancer.”

These results are alarming because the most recent study shows that 60% of calories in the American diet comes from processed foods, and the percentage is increasing each year. We need to reverse this trend!

For more information on this study, why processed foods increase your risk of cancer, and what the American Cancer Society recommends to reduce your risk of 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

 

 

Which Vitamins Reduce Breast Cancer Risk?

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How Can You Reduce Your Risk Of Breast Cancer?

Author: Dr. Stephen Chaney 

Breast cancer is scary. The good news is that treatment has gotten much better. Breast cancer is no longer a death sentence. But most women would prefer to avoid breast cancer surgery, radiation, and/or chemotherapy if they could.

Could something as simple as supplementation reduce your risk of developing breast cancer? If so, which vitamins should you be taking? Or, put another way, which vitamins reduce breast cancer risk?

If you ask your doctor, they will tell you, “Supplementation is a waste of money. Vitamins don’t reduce your risk of getting cancer.” And they will be correct! That’s because these are the wrong questions.

Let me explain. These are “one size fits all” questions. Studies to answer these questions start with healthy women and asks if vitamin supplementation reduces breast cancer risk for all of them. The answer to that question is, “No”. Multiple studies have confirmed this.

But the truth is more complicated. We should be asking, “Who benefits from vitamin supplementation”, instead of, “Does everyone benefit from supplementation?”Supplementation Perspective

I have summed up this concept with the Venn diagram on the right. Every woman does not need supplementation. But those with poor diet, increased need, genetic predisposition, and/or certain diseases may benefit from supplementation. That is why we should be asking, “Who needs supplementation?”.

Unfortunately, while this concept of individualized treatment has led to dramatic advances for cancer drug development, it has been virtually ignored for studies on supplementation and breast cancer risk.

The current study (H Song et al., Nutrients, 14: 2644, 2022) is an exception. It asks whether obese women who wish to reduce their risk of breast may benefit more from certain micronutrients than women of normal weight.

How Was This Study Done?

Clinical StudyThe data for this analysis came from the KoGES study. This was a study administered by the Korea Agency for Disease Control and Prevention between 2004 and 2016. It was designed to provide a scientific basis for personalized prevention of chronic diseases in the Korean population.

Of the 211,721 participants enrolled in the original KoGES study, this study included data from 41,593 women who:

  • Underwent a health examination at 38 health examination centers upon enrollment between 2004 and 2013 and a follow up health examination between 2012 and 2016. The average follow-up period was 4.9 years.
  • Were cancer-free when they enrolled in the study and developed breast cancer prior to their follow-up health examination.
  • Had reliable diet data.

Dietary intake was based on a food frequency questionnaire administered during their initial health screening. Dietary intake of 15 micronutrients (calcium, phosphorous, iron, potassium, vitamin A, sodium, vitamin B1, vitamin B2, vitamin B6, niacin, folic acid, vitamin C, vitamin E, zinc, and cholesterol) and 4 macronutrients (energy, protein, fat, and carbohydrate) was determined from the food frequency data and compared to the Korean Dietary Reference Intakes (KDRIs). [Note: The Korean DRIs are slightly different than US standards.]

  • The women were then divided into two groups based on whether they consumed more or less than the Korean DRIs for each nutrient.

Which Vitamins Reduce Breast Cancer Risk?

Vitamin SupplementsThere were two major findings from this study.

1) When the investigators grouped all the women in the study together:

    • none of the 15 micronutrients and 4 macronutrients analyzed in this study influenced breast cancer risk.
    • This confirms most previous studies that have been designed as a “one size fits all” study. So, if your doctor was relying on this kind of study, they were technically correct in saying that vitamin supplements don’t appear to reduce breast cancer risk.

2) But when the investigators separated the women by weight, an interesting dichotomy was observed:

    • For obese women (BMI ≥ 25 kg/m2):
      • Vitamin C intake above the recommended Korean DRI (100 mg/day) reduced the risk of breast cancer by 46%.
      • Vitamin B6 intake above the recommended Korean DRI (1.4 mg/day) reduced the risk of breast cancer by 52%.
    • For women of normal weight (BMI < 25 kg/m2) neither vitamin C nor vitamin B6 had any effect on breast cancer risk.

The authors concluded, “In obese women, exceeding the recommended daily intake levels of vitamin C and vitamin B6 was associated with a lower risk of breast cancer. However, other micronutrients were not associated with breast cancer risk in these women.” [Note: Supplement use was not included in the diet survey, so above recommended intake of C and B6 was from foods consumed, not from supplements.]

What Does This Study Mean For You?

Questioning WomanThis study is a perfect example of why we should be asking, “Who benefits from vitamin supplementation”, instead of, “Does everyone benefit from supplementation?”

In terms of the Venn diagram I introduced above, some people consider obesity a disease.

But whether you consider obesity a disease or not, it does increase the need for many nutrients. So, it is conceivable that extra vitamins C and B6 might provide benefits in obese women that are not seen in non-obese women.

This is, of course, a ground-breaking study. It is the first study of its kind and deserves to be followed by other studies to confirm this observation. Ideally, these studies would test whether the same effect is seen in other population groups and determine the optimal dose of vitamin C and B6 to reduce breast cancer risk.

However, I am not optimistic that these studies will be done. It is easy to get funding for the “do vitamin supplements benefit everyone?” studies that confirm the existing prejudice against vitamin supplementation.

It is much harder to obtain funding for “who benefits from vitamin supplementation?” studies that challenge the existing paradigm. But these are the kind of studies that are needed most.

How Can You Reduce Your Risk Of Breast Cancer?

As I said, this is the first study of its kind, so you could consider the results as preliminary. However, assuming it might be true:

  • I do not recommend megadoses of vitamins C and B6. The above average intake of C and B6 in this study came from food alone. And we do not have any dose response studies that might define an optimal dose of C and B6.
  • I do recommend balance. Based on this study, multivitamins should provide enough C and B6 to have a meaningful effect on breast cancer risk. And multivitamins are inexpensive and risk-free.

In addition, there are things you can do that are proven to reduce breast cancer risk. Here is what the American Cancer Society recommends:

  • Get to and stay at a healthy weight.
  • Be physically active and avoid time sitting.
  • Follow a healthy eating plan.
  • It is best not to drink alcohol.
  • Think carefully about using hormone replacement therapy.

I provide more detail about each of these recommendations in a recent article in “Health Tips From the Professor”.

The Bottom Line 

Most doctors will tell you that supplementation does not reduce your risk of breast cancer. And that opinion is backed up by multiple published clinical studies.

But the problem is that these studies are all asking the wrong question. They are asking, “Does supplementation reduce the risk of breast cancer for all women?”. A better question would be, “Which women benefit from supplementation?”

A recent study asked both of those questions. They looked at the effect of 15 micronutrients on breast cancer risk.

  1. When the investigators grouped all the women in the study together:
    • None of the 15 micronutrients influenced breast cancer risk.

2) But when the investigators separated the women by weight, an interesting dichotomy was observed:

    • For obese women (BMI ≥ 25 kg/m2):
      • Vitamin C intake above the recommended intake reduced the risk of breast cancer by 46%.
      • Vitamin B6 intake above the recommended intake reduced the risk of breast cancer by 52%.
    • For women of normal weight (BMI < 25 kg/m2) neither vitamin C nor vitamin B6 had any effect on breast cancer risk.

The authors concluded, “In obese women, exceeding the recommended daily intake levels of vitamin C and vitamin B6 was associated with a lower risk of breast cancer. However, other micronutrients were not associated with breast cancer risk in these women.”

For more information on this study, what it means for you, and proven methods for reducing breast cancer risk 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

 

How To Talk With Your Doctor About Cancer

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How Can You Partner With Your Doctor?

Author: Dr. Stephen Chaney

CancerFew things in life are more devastating than a cancer diagnosis. One day life is going on smoothly. The next day everything is in doubt. And before you know it, you are listening to your cancer doctor recommend a frightening treatment protocol.

Because of my 40-year career in cancer drug development at the University of North Carolina, people who are newly diagnosed with cancer often contact me for advice.

Let me start by making it clear that I am not a medical doctor, much less an oncologist or radiologist. Thus, I am not qualified to give medical advice on cancer treatment.

However, I worked with many oncologists and radiologists during my career at UNC, so I can offer perspectives about the advice your doctor is giving you and counsel you on what questions to ask your doctor(s).

I love helping people. But rather than have all of you calling me, I thought it would be best to put my advice in writing and send it to all my “Health Tips From the Professor” subscribers.

Is Your Doctor Being Honest With You?

doctor advising patientThe complaint I hear most often is, “I don’t feel my doctor is being honest with me. I feel that he or she is overselling the benefits of cancer treatment, whether it is chemotherapy, radiation, surgery, or some combination of them.”

There is some truth to that perspective, but you need to understand why that is. There are four reasons, and I will save the two most important reasons for last.

  1. People go into medicine to cure disease. Doctors are action oriented. They will recommend the best treatment available, even if its success rate is low because they feel the alternative is unthinkable. The idea of letting cancer run its course is abhorrent to them.

2) Cancer doctors focus on the cures, not the failures. In my time at UNC a couple of oncology residents rotated through my lab to gain some research experience. I was amazed that they were able to remain so positive when they had many patients who were dying. Then it hit me. They comforted the patients they weren’t able to help and took their joy from the cures they were able to obtain.

3) The worst thing a doctor can do is to take away a patient’s hope. Our minds are powerful. If a patient is to have any chance of defeating cancer, they first must believe it is possible.

4) Cancer is a fearsome opponent. There are spontaneous remissions. There are miraculous cures. But left untreated, the cancer usually wins. And that is your doctor’s greatest fear.

How To Talk With Your Doctor About Cancer

QuestionsSo, how do you find out the truth about your doctor’s treatment recommendations. You could Google it, but Dr. Google’s medical advice is often unreliable.

There is a simpler way. Your doctor(s) will be honest with you if you ask them the right questions and assure them you can deal with the answers they give. That last point is key. You should only ask these questions if you can accept whatever the answer may be.

If bad news would devastate you, you shouldn’t ask these questions. And your doctor may not feel he or she could be honest with you.

Before I give you the questions, let me share some definitions you need to know. These definitions give you a more precise definition of success of the cancer treatment your doctor is suggesting. Any treatment your doctor recommends will be supported by multiple clinical trials that provide data for each of these definitions.

Partial Remission is a decrease in the signs and symptoms of cancer. Your tumor has shrunk, but it is still detectable.

Complete Remission is a disappearance of all signs and symptoms of cancer. However, some cancer cells may remain.

Duration of Remission is the average time between the end of treatment and the return (recurrence) of the cancer.

Cure is usually defined as a complete remission that lasts 5 years or more.

With these definitions in mind, here are the questions to ask (only if you want to know the answers).

  1. What percentage of patients undergoing this treatment achieve remission? Is the remission partial or complete? How long does the remission last on the average? If the cancer does recur, can it be treated successfully a second time?

[Even if remission is relatively brief, it may give a chance to put your affairs in order and check a few items off your bucket list. This knowledge is important for many cancer patients.]

2) What percent of patients are cured?

[Every patient receives this information differently. But at least you, rather than your doctor, are making the choice of whether likelihood of being cured is worth the downsides of the treatment.]

3) What are the side effects of the treatment? How much does the treatment cost?

4) What is the prognosis if you do nothing? How long will you live? What will your quality of life be like?

[Sometimes the quality of life if you do nothing is better than the quality of life during treatment because of treatment side effects. This can be an important factor for treatments that have a short duration of remission and/or a very low cure rate.]

As you can appreciate, the answers to these questions can lead to some heart wrenching decisions. That’s why I caution you to only ask these questions if you can handle the answers.

Finally, it is important to remember that the answers your doctor gives you represent the average response of thousands of patients. None of us are average. Your response to treatment and your response to doing nothing depend on your age, overall health, lifestyle factors, genetics, and factors that none of us understand. That makes your decision even more difficult.

How Can You Partner With Your Doctor?

Doctor With PatientThe second most common complaint I hear from patients going through this process is that their doctor isn’t listening to them. They would like to explore treatments with fewer side effects or alternative therapies with no side effects. But their doctor refuses to even consider those possibilities. He or she will say there is no proof those treatments work. It’s their way or the highway.

If you search the internet, many alternative health gurus will tell you this is because:

  • Big Pharma has doctors in its pocket. It spends a lot of money convincing doctors their drugs are the best treatment available.
  • The medical profession is prejudiced against supplementation and alternative therapies.
  • The AMA controls what treatments doctors can and cannot recommend. It can yank the medical license from doctors who dare recommend anything except the AMA-approved treatment.

There is some truth to each of these statements. But there are two other factors that are overlooked by most of these “health gurus”:

  • The proof is much greater for conventional treatment than for alternative therapies. Conventional treatments are supported by multiple clinical studies involving thousands of patients.

This is the standard of proof for conventional treatments. But this kind of proof can cost millions of dollars. Pharmaceutical companies can undertake these kinds of studies because they can recover that cost with a successful cancer drug. But there is no financial incentive to provide that level of proof for alternative therapies.

  • As I said before, cancer is a deadly foe. More importantly, left untreated it can rapidly progress from a highly treatable stage to a stage where any treatment is unlikely to be successful.

This is the greatest fear of your cancer doctor. If you tell them you want to explore an alternative therapy, they are worried that they won’t see you again until your cancer has become untreatable.

With that in mind, let me suggest how you might partner with your doctor.

  • Start by stating that you would like to try an alternative therapy or a less aggressive medical treatment before you try the treatment your doctor recommended.
  • But also tell your doctor that you would like him or her to monitor you on a frequent basis to determine whether your approach is working.
  • And if your approach isn’t working, you will consider again the treatment your doctor recommended.

This is what partnership with your doctor looks like. And it allays their greatest fear that they won’t see you again until your cancer has become untreatable.

If your doctor says no, listen very carefully to their reasoning (You may want to bring a relative or friend with you because they may hear your doctor’s response differently than you do). For example, it could be that your kind of tumor is so aggressive it doesn’t allow a window of opportunity to explore other options.

However, if you are unsatisfied with your doctor’s answer, that is what second opinions are for.

The Bottom Line 

Few things in life are more devastating than a cancer diagnosis. One day life is going on smoothly. The next day everything is in doubt. And before you know it, you are listening to your cancer doctor recommend a frightening treatment protocol.

You are being asked to make the most important decision of your life.

I spent 40 years of my life working on cancer drug development. I’m not a medical doctor. I can’t tell you what to do. But in this article, I tell you:

  • What questions to ask your doctor, and…
  • How to partner with your doctor…

…to help you navigate the most difficult decisions of your life.

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.

Walking Your Way To Health

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How Much Should You Walk? 

Author: Dr. Stephen Chaney 

Overweight People ExercisingThe new year is almost here. If you are like millions of Americans, you may already be making plans to join a gym, get a personal trainer, or join a spin class.

The problem is these are all expensive options. And a good portion of that money is wasted. To put it into perspective, let’s look at some statistics

  • Around 6 million Americans buy gym memberships every January.
  • 67% of those memberships are never used.
  • For those memberships used in January, another 50% are not in use 6 months later.
  • Americans spend about 1.6 billion dollars on unused gym memberships every year.
  • And that doesn’t include those gym memberships that are only occasionally used.

If you want to get fit and healthy in the new year, perhaps you should consider a less expensive option – like walking. Your only investments are a good pair of walking shoes and a device that keeps track of the number of steps you take (eg, Fitbit, smart watch, or smart phone).

You still may give up on your New Year’s goal of getting fitter at some point. But you won’t have wasted so much money.

Of course, you probably have some questions about the benefits of walking, such as:

  1. Is walking enough to significantly improve my fitness and health?

2) How far (how many steps) should I walk?

3) How fast should I walk?

Fortunately, two recent studies (B del Pozo-Cruz et al, JAMA Internal Medicine, 182: 1139-1148, 2022; J del Pozo-Cruz et al, Diabetes Care, 45: 2156-2158, 2022) have answered all three questions.

How Were These Studies Done?

clinical studyThe first study (B del Pozo-Cruz et al, JAMA Internal Medicine, 182: 1139-1148, 2022) followed 78,500 participants (average age 61, 55% female, 97% white) enrolled in the UK Biobank study for an average of 7 years.

At the time of enrollment, each participant was given an accelerometer (a device that measures the number and frequency of steps) to wear on their dominant wrist for 24 hours/day for 7 days. The investigators used the accelerometer data to categorize several types of physical activity.

  • Daily step counts (the average number of steps per day for 7 days). These step counts were further subdivided into two categories:
  • Incidental steps (It was assumed that ˂40 steps/min represented steps taken that were incidental to normal daily activities).
  • Purposeful steps (It was assumed that ≥40 steps/min represented steps taken as part of planned exercise).
  • Stepping intensity (the highest frequency of steps/min averaged over 30 min intervals for all 7 days).

At the end of the study, each of these variables was correlated with the risk of premature deaths due to all causes, cancer, and heart disease.

The second study (J del Pozo-Cruz et al, Diabetes Care, 45: 2156-2158, 2022) was similar except that it:

  • Used data from 1687 adults (average age = 55, 56% male, with diabetes or prediabetes when the study began) in the 2005-2006 National Health and Nutrition Examination Survey in the US.
  • Followed participants for 9 years instead of 7.
  • Only measured total steps/day
  • Correlated total steps/day with premature death for participants who already had prediabetes or diabetes when they entered the study.

Walking Your Way To Health

Study 1 looked at the effect of walking on health outcomes in multiple ways.

woman walking dog#1: Increase in number of steps/day:

  • On average study participants took an average of 7200 steps per day, but this ranged from a low of 3,200 steps/day to a high of 12,200 steps/day.
  • Each increase of 2,000 steps/day was associated with a:
    • 8% decrease in all-cause mortality.
    • 11% decrease in cancer mortality.
    • 10% decrease in heart disease mortality.
  • Overall, increasing from 3,200 steps/day to 10,000 steps/day decreased all-cause, cancer, and heart disease mortality by around 36%.
  • There was no minimum threshold to this beneficial effect of walking on the risk of premature death.
  • The benefits of walking appeared to plateau at 10,000 steps/day.

#2: Increase in number of incidental steps/day (steps taken that are incidental to normal daily activities):

  • On average study participants took 3240 incidental steps/day, but this ranged from a low of 2,100 steps/day to a high of 4,400 steps/day.
  • Each 10% increase in incremental steps/day was associated with a:
    • 6% decrease in all-cause mortality.
    • 6% decrease in cancer mortality.
    • 10% decrease in heart disease mortality.

#3: Increase in number of purposeful steps/day (steps taken as part of planned exercise):

  • On average study participants took 4,600 purposeful steps/day, but this ranged from a low of 1,600 steps/day to a high of 8,600 steps/day.
  • Each 10% increase in purposeful steps/day was associated with a:
    • 7% decrease in all-cause mortality.
    • 8% decrease in cancer mortality.
    • 10% decrease in heart disease mortality.

#4: Increase in speed of walking or cadence. The measurement they used was “peak-30 cadence” – the Walking Fasthighest average steps/min during a 30-minute interval within a day:

  • On average study participants had a “peak-30 cadence” of 76 steps/min, but this ranged from a low of 47 steps/min to a high of 109 steps/min.
  • Each 10% increase in “peak-30 cadence” was associated with a:
    • 8% decrease in all-cause mortality.
    • 9% decrease in cancer mortality.
    • 14% decrease in heart disease mortality.
  • The benefits of walking rapidly (increase in “peak-30 cadence”) were in addition to the benefits seen by increasing the number of steps per day.
  • Overall, increasing from a “peak-30 cadence” of 47 steps/min to 109 steps/min decreased all-cause, cancer, and heart disease mortality by an additional 34%.
  • There was no minimum threshold to this beneficial effect of increasing “peak-30 cadence” (the speed of walking) on the risk of premature death.
  • The benefits of increasing “peak-30 cadence” appeared to plateau at 100 steps/min.

#5 Effect of walking on the prevention of heart disease and cancer: The investigators measured this by strong heartlooking at the effect of walking on the “incidence” of heart disease and cancer (defined as new diagnoses of heart disease and cancer) during the study. They found.

  • Each 2,000-step increase in the total number of steps/day decreased the risk of developing heart disease and cancer by 4% during this 7-year study.
  • Each 10% increase in the number of purposeful steps/day decreased the risk of developing heart disease and cancer by 4% during this study.
  • Each 10% increase in “peak-30 cadence” decreased the risk of developing heart disease and cancer by 7% during this study.

The authors concluded, “The findings of this population-based…study of 78,500 individuals suggest that up to 10,000 steps/day may be associated with a lower risk of mortality and cancer and CVD incidence. Steps performed at a higher cadence may be associated with additional risk reduction, particularly for incident disease.”

Study 2 extended these findings to diabetes. They started with participants that had either prediabetes or diabetesdiabetes and followed them for 9 years. They found that:

  • Study participants with prediabetes ranged from a low of 3,800 steps/day to a high of 10,700 steps/day.
    • Prediabetic participants walking 10,700 steps/day were 25% less likely to die during the study than participants walking only 3,800 steps/day.
  • Study participants with diabetes ranged from a low of 2,500 steps/day to a high of 10,200 steps/day.
    • Diabetic participants walking 10,200 steps/day were also 25% less likely to die during the study than participants walking only 2,500 steps/day.
  • Even small increases in the number of steps per day decreased the risk of premature death for both prediabetic and diabetic participants.
  • Once again, 10,000 steps/day appeared to be the optimal dose to lower the risk of premature death for both diabetic and prediabetic patients.

The authors of this study concluded, “Accumulating more steps/day up to ~10,000 steps/day may lower the risk of all-cause mortality of adults with prediabetes and diabetes.”

How Much Should You Walk?

Walking CoupleThat was a lot of information. You are probably wondering what it means for you. Let’s start with the big picture:

  • Going from couch potato to 10,000 steps per day may reduce your risk of premature death due to all causes, cancer, and heart disease by 36% (24% if you are already prediabetic or diabetic).
  • Increasing the speed with which you walk from 47 steps/min to 109 steps/min sustained for 30 minutes may reduce your risk of premature death by an additional 34%.

In other words, simply walking more and walking faster can have a significant on your health. I am not recommending walking as your only form of exercise. I’m just saying not to consider it inferior to other forms of exercise.

  • There is no lower limit to the benefits of walking. Even small increases in the number of steps/day you take and the speed with which you walk may have a beneficial effect on your health.

In other words, you don’t need to speed walk 10,000 steps/day to reap a benefit from walking. Even small increases are beneficial. That’s good news for those of you who may not be able to speed walk long distances. It also means that if you are a couch potato, you don’t need to attempt 10,000 steps at high speed from day 1. You can work up to it gradually.

  • Incidental walking (walking that is incidental to your daily activities) is almost as beneficial as purposeful walking (walking as part of a planned exercise).

That’s good news for those of you who may not have time for long walks. It also means that advice like “park your car at the far end of the parking lot and walk” or “take the stairs rather than the elevator” can have a meaningful impact on your health.

  • The benefits of walking appear to max out at around 10,000 steps per day and a cadence of 100 steps/min sustained for 30 minutes.

That means once you get to those levels, it’s time to consider adding other kinds of exercise to your regimen. More and faster walking may offer little additional benefit.

Finally, in the words of the authors, “This information could be used to motivate the least active individuals to increase their steps and the more-active individuals to reach the 10,000-step target.”

The Bottom Line 

The new year is almost here. If you are like millions of Americans, you may already be making plans to join a gym, get a personal trainer, or join a spin class.

If you want to get fit and healthy in the new year, perhaps you should also consider a less expensive option – like walking.

Of course, you probably have some questions about the benefits of walking, such as:

1) Is walking enough to significantly improve my fitness and health?

2) How far (how many steps) should I walk?

3) How fast should I walk?

Fortunately, two recent studies have answered all three questions. They found:

  • Going from couch potato to 10,000 steps per day may reduce your risk of premature death due to all causes, cancer, and heart disease by 36% (24% if you are already prediabetic or diabetic).
  • Increasing the speed with which you walk from 47 steps/min to 109 steps/min sustained for 30 minutes may reduce your risk of premature death by an additional 34%.
  • There is no lower limit to the benefits of walking. Even small increases in the number of steps/day you take and the speed with which you walk may have a beneficial effect on your health.
  • Incidental walking (walking that is incidental to your daily activities) is almost as beneficial as purposeful walking (walking as part of a planned exercise).
  • The benefits of walking appear to max out at around 10,000 steps per day and a cadence of 100 steps/min sustained for 30 minutes.

In the words of the authors of these studies, “This information could be used to motivate the least active individuals to increase their steps and the more-active individuals to reach the 10,000-step target.”

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

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

 

Health Tips From The Professor