Diet

Posted on Diet, Vitamins

Vitamins and supplements are a waste of money for most people

There’s no ‘magic set of pills to keep you healthy.’ Diet and exercise are key

"Multiple sclerosis could be prevented through daily vitamin D supplements"
“Multiple sclerosis could be prevented through daily vitamin D supplements”
  • New guidelines say ‘insufficient’ evidence to support use of multivitamins or dietary supplements to prevent cardiovascular disease or cancer in healthy, non-pregnant adults
  • Pregnant people, those become pregnant still need essential vitamins (iron, folic acid)
  • More than half of U.S. adults take dietary supplements, a multi-billion-dollar industry

CHICAGO — Drawn to the allure of multivitamins and dietary supplements filling nutritional gaps in their diet, people in the U.S. in 2021 spent close to $50 billion on vitamins and dietary supplements. 

But Northwestern Medicine scientists say for non-pregnant, otherwise healthy Americans, vitamins are a waste of money because there isn’t enough evidence they help prevent cardiovascular disease or cancer.

“Patients ask all the time, ‘What supplements should I be taking?’ They’re wasting money and focus thinking there has to be a magic set of pills that will keep them healthy when we should all be following the evidence-based practices of eating healthy and exercising,” said Dr. Jeffrey Linder, chief of general internal medicine in the department of medicine at Northwestern University Feinberg School of Medicine.

Linder and fellow Northwestern Medicine scientists wrote an editorial that will be published June 21 in JAMA that supports new recommendations from the United States Preventive Services Task Force (USPSTF), an independent panel of national experts that frequently makes evidence-based recommendations about clinical preventive services. 

Based on a systematic review of 84 studies, the USPSTF’s new guidelines state there was “insufficient evidence” that taking multivitamins, paired supplements or single supplements can help prevent cardiovascular disease and cancer in otherwise healthy, non-pregnant adults. 

“The task force is not saying ‘don’t take multivitamins,’ but there’s this idea that if these were really good for you, we’d know by now,” Linder said. 

The task force is specifically recommending against taking beta-carotene supplements because of a possible increased risk of lung cancer, and is recommending against taking vitamin E supplements because it has no net benefit in reducing mortality, cardiovascular disease or cancer.

“The harm is that talking with patients about supplements during the very limited time we get to see them, we’re missing out on counseling about how to really reduce cardiovascular risks, like through exercise or smoking cessation,” Linder said.

More than half of Americans take vitamins. Why?

More than half of U.S. adults take dietary supplements, and use of supplements is projected to increase, Linder and his colleagues wrote in the JAMA editorial. 

Eating fruits and vegetables is associated with decreased cardiovascular disease and cancer risk, they said, so it is reasonable to think key vitamins and minerals could be extracted from fruits and vegetables, packaged into a pill, and save people the trouble and expense of maintaining a balanced diet. But, they explain, whole fruits and vegetables contain a mixture of vitamins, phytochemicals, fiber and other nutrients that probably act synergistically to deliver health benefits. Micronutrients in isolation may act differently in the body than when naturally packaged with a host of other dietary components.

Linder noted individuals who have a vitamin deficiency can still benefit from taking dietary supplements, such as calcium and vitamin D, which have been shown to prevent fractures and maybe falls in older adults. 

New guidelines do not apply to pregnant people

The new USPSTF guidelines do not apply to people who are pregnant or trying to get pregnant, said JAMA editorial co-author Dr. Natalie Cameron, an instructor of general internal medicine at Feinberg. 

“Pregnant individuals should keep in mind that these guidelines don’t apply to them,” said Cameron, who also is a Northwestern Medicine physician. “Certain vitamins, such as folic acid, are essential for pregnant women to support healthy fetal development. The most common way to meet these needs is to take a prenatal vitamin. More data is needed to understand how specific vitamin supplementation may modify risk of adverse pregnancy outcomes and cardiovascular complications during pregnancy.” 

Additionally, recent research from Northwestern has found most women in the U.S. have poor heart health prior to becoming pregnant. Cameron said that, in addition to discussing vitamin supplementation, working with patients to optimize cardiovascular health prior to pregnancy is an important component of prenatal care. 

Eating healthy, and exercising is ‘easier said than done’

Dr. Jenny Jia, a co-author of the JAMA editorial who studies the prevention of chronic diseases in low-income families through lifestyle interventions, said healthy eating can be a challenge when the U.S. industrialized food system does not prioritize health. 

“To adopt a healthy diet and exercise more, that’s easier said than done, especially among lower-income Americans,” said Jia, an instructor of general internal medicine at Feinberg and a Northwestern Medicine physician. “Healthy food is expensive, and people don’t always have the means to find environments to exercise—maybe it’s unsafe outdoors or they can’t afford a facility. So, what can we do to try to make it easier and help support healthier decisions?”

Over the past few years, Jia has been working with charitable food pantries and banks that supply free groceries to people who are in need to try to help clients pick healthier choices from the food pantries as well as educate those who donate to provide healthier options or money. 

Posted on Cardiovascular disease, Diet

Adding high-quality plant-based foods to the diet decreases the risk of death from heart disease

Adding high-quality plant-based foods to diet decreases risk of deaths from heart disease
Adding high-quality plant-based foods to diet decreases risk of deaths from heart disease

 

As long as you don’t count French fries and soda as healthy choices, it’s never too late to increase your longevity and cut your risk of heart disease death by adding fruits and vegetables to your diet, according to preliminary research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2019, a premier global exchange of the latest advances in population based cardiovascular science for researchers and clinicians.

“Not all plant-based diets are equal, but boosting the intake of high-quality plant-based foods over time lowers the risk of death even among people who started off with poor-quality diets,” said Megu Y. Baden, M.D., Ph.D., lead author of the study and postdoctoral research fellow in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

Previous studies have shown that eating a high-quality plant-based diet can reduce the risk of diabetes and heart disease, but this is the first to look at how positive or negative changes in diet may influence a person’s risk of dying – no matter where they started. In the current study, researchers developed three diet scales that took into account the overall consumption of plant-based foods, the consumption of healthful plant-based foods (such as whole grains, fruits, vegetables and nuts), and the consumption of lower-quality plant-based foods (such as fruit juices, refined grains, potatoes and sweets).

The study included 47,983 women (average age 64 years) participating in the Nurses’ Health Study and 25,737 men (average age 64 years) participating in the Health Professionals Follow-Up Study. None had a history of heart disease or cancer when they entered the study in 1998. Using dietary reports, participants were assessed on changes in their diet over the 12 years prior to entering the study.

Compared to those who had fairly stable diets, during a 12-year follow-up period (1998-2014) the researchers found that deaths from all causes were:

  • 8 percent lower in those with the biggest increase in an overall plant-based diet;
  • 10 percent lower in those with the biggest increase in a healthy plant-based diet;
  • 11 percent higher in those with the biggest increase in an unhealthy plant-based diet.

A 10-point increase in score on the healthy plant-based diet scale (which can be achieved for example by replacing 1 serving/day intake of refined grains with whole grains, increasing fruit intake by 1 serving/day and vegetable intake by 1 serving/day, and decreasing sugary beverage intake by 1 serving/day) was associated with a 10 percent lower risk of death from cardiovascular disease, while a 10-point increase in score on the unhealthy plant-based diet scale was associated with a 6 percent high risk of cardiovascular-disease death.

“Over a period of time, consuming more whole grains, fruits, vegetables, while decreasing your intake of refined grains, sweets and desserts, and animal foods such as animal fat meat, and miscellaneous animal-based foods, may lower your risk of death from heart disease and other causes,” Baden said.

Results were adjusted for several factors, including age, race, initial diet score, body mass index, weight change, family history of diabetes, heart attack, or cancer, heart disease risk factors, medications, menopausal status and hormone use, initial and changes in smoking and other lifestyle influences, and weight change. Because the study was not a randomized trial, it cannot prove a cause-and-effect relationship between the dietary changes and the risk of death. Although there is no reason to think that consuming high-quality plant foods would not be good for everyone, these results in health professionals who were predominantly of European ancestry might not be generalizable to other groups of people.

The most recent dietary guideline, by the American Heart Association and American College of Cardiology, recommends that adults follow a dietary pattern that emphasizes vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts; and limits intake of saturated fats, sodium, sweets, sugar-sweetened beverages and red meats.

Posted on Diet

Your Gut Microbiome: The Most Important Organ You’ve Never Heard Of

Your Gut Microbiome: The Most Important Organ You've Never Heard Of | Erika Ebbel Angle | TEDxFargo - YouTube


Please do not look to this talk for medical advice. While some viewers might find advice provided in this talk to be helpful as a complementary approach, this speaker makes claims about nutrition and the human microbiome with too much certainty for the current state of research.

Dr. Erika Ebbel Angle discusses why the gut microbiome is the most important organ you’ve probably never heard of. The gut is the second brain, and gut health affects your overall health. This means that you are what you eat, but you are also the metabolites that live in your gut and produce the substances you need for emotional balance, energy level, and disease prevention.

Poor lifestyle choices cause gut imbalances, which can lead to neurodegenerative diseases, autoimmune diseases, and even anxiety and depression. Angle talks about three critical molecules and how they work in the body to affect your overall wellness. She also shares some tips about what you can do to maintain a healthy gut microbiome through diet and lifestyle choices.

Entrepreneur and biochemist Erika Ebbel Angle, PhD, has dedicated her life to studying the gut. Dr. Angle is the CEO and co-founder of Ixcela, the Internal Fitness™ company. Ixcela evaluates the gut microbiome using a blood sample, and then offers personalized recommendations to restore gut health. Angle shares her lifelong love of science in many ways, including through her nonprofit, Science from Scientists, which brings scientists into classrooms to promote STEM careers and science education. A graduate of MIT and Boston University School of Medicine, Dr. Angle is also a former Miss Massachusetts who used her platform to encourage students to pursue STEM careers and scientific discovery.


Posted on Arthritis, Diet, Pain Management

Vegan diet eases arthritis pain, finds new study

Veganism and Fibromyalgia

A low-fat vegan diet, without calorie restrictions, improves joint pain in patients with rheumatoid arthritis, according to a new study conducted by researchers at the Physicians Committee for Responsible Medicine and published in the American Journal of Lifestyle Medicine. Study participants also experienced weight loss and improved cholesterol levels.

“A plant-based diet could be the prescription to alleviate joint pain for millions of people suffering from rheumatoid arthritis,” says Neal Barnard, MD, lead author of the study and president of the Physicians Committee. “And all of the side effects, including weight loss and lower cholesterol, are only beneficial.”

Rheumatoid arthritis is a common autoimmune disease that typically causes joint pain, swelling, and eventually permanent joint damage.

At the outset of the Physicians Committee’s study, participants were asked to use a visual analog scale (VAS) to rate the severity of their worst joint pain in the preceding two weeks, from “no pain” to “pain as bad as it could possibly be.” Each participant’s Disease Activity Score-28 (DAS28) was also calculated based on tender joints, swollen joints, and C-reactive protein values, which indicate inflammation in the body. DAS28 increases with rheumatoid arthritis severity.

During the study, 44 adults previously diagnosed with rheumatoid arthritis were assigned to one of two groups for 16 weeks. The first group followed a vegan diet for four weeks, with the elimination of additional foods for three weeks, then reintroduction of the eliminated foods individually over nine weeks. No meals were provided, and participants handled their own food preparation and purchases, with guidance from the research team. The second group followed an unrestricted diet but were asked to take a daily placebo capsule, which had no effect in the study. Then the groups switched diets for 16 weeks.

During the vegan phase of the study, DAS28 decreased 2 points on average, indicating a greater reduction in joint pain, compared to a decrease of 0.3 points in the placebo phase. The average number of swollen joints decreased from 7.0 to 3.3 in the vegan phase, while that number actually increased from 4.7 to 5 in the placebo phase. For those who completed the study, VAS ratings also improved significantly in the vegan phase, compared with the placebo phase.

The vegan diet also led to greater decreases in DAS28 in a subanalysis that excluded individuals who increased medications during the study and another subanalysis limited to participants making no medication changes.

In addition to reductions in pain and swelling, body weight decreased by about 14 pounds on average on the vegan diet, compared with a gain of about 2 pounds on the placebo diet. There were also greater reductions in total, LDL, and HDL cholesterol during the vegan phase.

Posted on Diabetes, Diet

Nordic diet lowers cholesterol and blood sugar – even if you don’t lose weight

Corvus Corax - Sverker [Viking raid at Lindisfarne - 793] - YouTube


Berries, veggies, fish, whole grains and rapeseed oil. These are the main ingredients of the Nordic diet concept that, for the past decade, have been recognized as extremely healthy, tasty and sustainable. The diet can prevent obesity and reduce the risk of cardiovascular disease, type 2 diabetes, high blood pressure and high cholesterol.

Until now, Nordic diet research has primarily been linked to the diet’s positive health effect following weight loss. But a new analysis conducted by University of Copenhagen researchers, among others, makes it clear that a Nordic diet has positive health benefits – regardless of whether one loses weight or not.

“It’s surprising because most people believe that positive effects on blood sugar and cholesterol are solely due to weight loss. Here, we have found this not to be the the case. Other mechanisms are also at play,” explains Lars Ove Dragsted, a researcher and head of section at the University of Copenhagen’s Department of Nutrition, Exercise and Sports.

Together with researchers from Finland, Norway, Sweden and Iceland, Dragsted examined blood and urine samples from 200 people over the age of 50, all with elevated BMI and increased risk of diabetes and cardiovascular disease. The participants were divided into two groups – one provided foods according to Nordic dietary recommendations and a control group on their habitual diet. After six months of monitoring, the result was clear.

“The group that had been on the Nordic diet for six months became significantly healthier, with lower cholesterol levels, lower overall levels of both saturated and unsaturated fat in the blood, and better regulation of glucose, compared to the control group. We kept the group on the Nordic diet weight stable, meaning that we asked them to eat more if they lost weight. Even without weight loss, we could see an improvement in their health,” explains Lars Ove Dragsted.

The fat makes us healthy

Instead of weight loss alone, the researchers point to the unique composition of fats in a Nordic diet as a possible explanation for the significant health benefits.

“By analyzing the blood of participants, we could see that those who benefited most from the dietary change had different fat-soluble substances than the control group. These are substances that appear to be linked to unsaturated fatty acids from oils in the Nordic diet. This is a sign that Nordic dietary fats probably play the most significant role for the health effects seen here, which I hadn’t expected,” says Lars Ove Dragsted.

Fats in the Nordic diet come from fish, flaxseeds, sunflower and rapeseed, among other things. As a whole, they constitute a very beneficial mix for the body, although the researchers have yet to accurately explain why these fats seem to lower both blood sugar and cholesterol levels.

“We can only speculate as to why a change in fat composition benefits our health so greatly. However, we can confirm that the absence of highly processed food and less saturated fats from animals, have a very positive effect on us. So, the fat composition in the Nordic diet, which is higher in omega-3 and omega-6 unsaturated fats, is probably a considerable part of the explanation for the health effects we find from the Nordic diet, even when the weight of participants remains constant,” concludes Lars Ove Dragsted.

Facts about the Nordic Nutrition Recommendations

The Nordic Nutrition Recommendations were adopted by dietary experts in 2012 and will be updated this year.

The diet is adapted to the Nordic countries: Denmark, Sweden, Norway, Finland, Greenland, the Faroe Islands, and Iceland. The diet is based on ingredients that are produced locally and are thereby sustainable.

Recommended foods include vegetables such as peas, beans, cabbage, onions and root vegetables, as well as fruits, including apples, pears, plums and berries. Also recommended are nuts, seeds, whole grains, fish, and shellfish, as well as vegetable oils made from rapeseed, sunflower or flaxseed. Finally, low-fat dairy products are also recommended, as well as a significantly smaller proportion of meat than currently consumed.

The diet contributes to important fatty acids, minerals, vitamins, and plant materials that have a positive effect on our health and, among other things, reduce the risk of blood clots, type 2 diabetes, high blood pressure and cholesterol levels, as well as cardiovascular disease in general.

Weight loss in relation to a Nordic diet

The researchers stress that weight loss, which frequently results from a Nordic dietary pattern, remains very important for the diet’s overall health benefits.

“This study simply shows that it is not only weight loss that leads to the benefits of this diet. The unique composition of fats plays an important role as well,” says Lars Ove Dragsted.