Energy Drink or Energy Drug?

 

 

"Energy" drinks are everywhere. The beverage makers sponsor models, music events and videos games. Advertisements for energy drinks are plastered on the walls at sporting events and on the jerseys of leading athletes. Red Bull, the market’s leading drink, even has its own television series and printed magazine. The makers of such drinks claim their elixirs will boost your immune system, enhance your performance and help you feel energized. They certainly are energizing the manufacturer's bottom line, with $53 billion worth of them being sold in 2018 alone.

In the US, almost 50 percent of adolescents and young adults say they buy energy drinks regularly. According to a study from the U.S. Centers for Disease Control and Prevention, 8 percent of young people drink energy drinks weekly, 20 percent think that energy drinks are safe drinks for teenagers and 13 percent think that energy drinks are a type of sports drink. But how safe are they, really?

Last fall, the parents of a 14-year old girl in Maryland sued the makers of Monster Energy drink after she drank two 24oz cans and then died of cardiac arrest. While that case is very unusual, more and more health risks are being linked to the drinks every week.

According to a 2019 study published in the Journal of the American Heart Association (JAHA), energy drinks can cause major health issues, including   increased blood pressure and a wealth of heart problems. Energy drinks have been "associated with cardiac arrest, myocardial infarction, spontaneous coronary dissection, and coronary vasospasm," says the JAHA study.

Energy drinks can also disrupt sleep patterns, cause heart palpitations and anxiety, contribute to digestive problems, increase blood pressure and lead to dehydration, according to the National Institute of Health (NIH). Energy drinks “can be dangerous because large amounts of caffeine may cause serious heart rhythm, blood flow and blood pressure problems,” the NIH warned.

Despite this mounting evidence of health risks, there is no requirement to disclose on the drink labels what you are actually getting. Caffeine content, for example, does not need to be disclosed, although it often is. And the marketing of these drinks is heavily concentrated on adolescents between the ages of 13 and 17. As the regulatory status of energy drinks continues to be debated, a growing number of consumers and public health advocates are asking why and how a product loaded with caffeine and other stimulants became so popular among young people. The reasons are a mix of lax regulation, the use of caffeine as a performance enhancer among adults, and a bit of scientific uncertainty.

In the meantime, make sure you and your children understand the risks.

Losing Weight May Eliminate GERD Symptoms

 

As if being overweight or obese did not already cause enough health problems, a 2013 study published in the journal Obesity adds GERD to the list.

Researchers assigned 332 overweight or obese adult men and women to a weight loss program that included reducing daily calorie intake to under 1,500 and exercising for 60 minutes per day. After six months the average participant had lost almost 30 pounds and four inches off their waist.

Of the 1/3 of participants who began the study with symptoms of GERD, 80% showed improvement by the end of the study, including 65% for whom the symptoms disappeared entirely.

The study concluded that "the overall prevalence of GERD symptoms is high (37%) in overweight and obese subjects. A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects."

If you suffer from GERD and you are overweight, you may be better off focusing on shedding pounds than looking for ways to manage the symptoms.

Vitamin D for High Blood Pressure?

 

A 2013 study published in the journal Hypertension suggests that taking high doses of Vitamin D may help to lower and control blood pressure in African-American populations. The prevalence of hypertension in African-Americans in the United States is among the highest in the world. More than 40 percent of non-Hispanic African-American men and women have high blood pressure. For African-Americans, high blood pressure also develops earlier in life and is usually more severe. 

Vitamin D deficiency has increasingly been recognized in the general population and especially in African Americans whose deep skin pigmentation makes vitamin D photosynthesis inefficient. In the study, 283 black men and women were randomly assigned to groups taking either a placebo or 1,000IU, 2,000IU or 4,000IU daily doses of Vitamin D for two years.

After three months of daily supplementation, systolic blood pressure (the first, higher number) dropped by 1.4mmHG for every 1,000IU study participants took. While this study does not proved that Vitamin D was the agent lowering participants blood pressure, it is suggestive. 

Have your Vitamin D levels measured at your next physical and speak with your doctor about supplementation, if needed, to raise your blood level of Vitamin D to normal levels. Supplementation of 600IU daily (800IU if you are over age 70) is recommended for everyone, especially in winter.

What a Mediterranean Diet Is, and Isn't

 

The Mediterranean Diet is often held up as a foundation of healthy eating and one of the very few with solid observational and clinical evidence supporting it. But what is it, exactly? And equally important, what is it not?

A Mediterranean diet is not as simple as adding olive oil to what Americans typically eat. An American may think of any Greek or Italian foods as "Mediterranean" but many are not not.

A classic dinner of spaghetti and meatballs with Italian bread is a massive amount of refined white flour, fatty meat and cheese. Pizza may sound Mediterranean, but its not either. The crust is a gondola full of refined white flour and the toppings are loaded with sugar, saturated fat, salt and, most likely nitrates and preservatives. A Mediterranean diet does not include large amounts of refined sugar - whether you call it baklava or a cannolli or not.

So what IS the "Mediterranean Diet"? Well first of all we should understand that not everyone living around the Mediterranean Sea eats exactly the same foods. There is a lot of variation. But in general, we can define the diet as rich in vegetables, fruit, nuts, beans and fish. Whole grains are common as well as unsaturated fats - mostly from oils. Alcohol is consumed in moderation and red and processed meats are eaten rarely, if at all. It is low in saturated fats from animal sources.

Salads are often a main dish in Mediterranean countries, and pastas are served often but normally in small amounts as a side. Poultry and fish replace red meats. Fresh ingredients outnumber processed ones. Spices play a leading role.

Here is a "practical guide" to eating Mediterranean style from Harvard Medical School. As you will see, it does take some adjustment, but it is not a very difficult "diet" to follow.

Frozen Pizza's Less Awful Cousins

 

Pizza is never going to be a health food. But really, who doesn't want some every now and again? As processed foods go, pizza is certainly near the top of the list. It's highly processed. It is loaded with saturated fat, salt, cholesterol and carbs and devoid of vitamins or minerals. And remember this is all per serving, which is usually 1/4 of the pie (but might be more or less, check to see).

If you are going to treat yourself every once in a while, keep these two things in mind. 

First, as with just about every other food packaging on the planet, the manufacturer is going to lie and try to trick you into thinking you are buying something that is better for you than it really is. They do this in all sorts of sneaky ways, like manipulating the service size or bragging about some ingredient that it barely contains. Ignore all that.

Second, if you want a pizza that is a healthy as its possible for a pizza to be, there are a few things to look for. According to Prevention Magazine, look for whole grain or even cauliflower crusts, check the added sugar (3 to 4 grams or less is best) and the sodium content (some can have as much as 900mg per serving but you can find some with half that), no extra cheese and vegetable toppings rather than meat. Click on the link above for 11 recommended varieties.

Pizza should never become a habit, but there is no reason you can't enjoy some occasionally.

Sitting is the New Smoking

 

 

Studies done by the Mayo Clinic, Harvard Medical School and others show that prolonged sitting, such as millions of Americans do every day at work, can damage the heart, increase the risk of stroke, high blood pressure, diabetes and elevated cholesterol. Excessive sitting also raises the prospects of contending with obesity, your anxiety levels might rise, and you can also be faced with back issues. In addition to this collection of concerns, the risk of blood clots and the potential of certain cancers will also increase due to prolonged inactivity. This includes colon, lung and endometrial cancer, while older women also face greater risk of experiencing breast cancer. 

A 2019 study of 150,000 Australians over age 45 who were followed for nine years looked at how much exercise was required just to offset the effect of sitting for 6 or more hours a day, and the results were sobering.

“In our study, sitting time was associated consistently with both overall premature mortality and cardiovascular disease mortality in the least physically active groups – those doing under 150 minutes of moderate to vigorous intensity physical activity per week,” Professor Stamatakis, one of the study authors, said. That is about 20 minutes of "vigorous" exercise each and every day - just to offset the possible damage caused but so much sitting.

“For example," Stanatakis adds, "people who were physically inactive and sat for more than eight hours per day had 107 percent higher risk for cardiovascular death compared to those who did at least one hour physical activity per day and sat less than four hours.”

According to a 2018 article in Time Magazine, only 23% of Americans get that much exercise while only half of Americans get any exercise at all.

If you are forced, for whatever reason, to sit for hours every day here are some step you can take to minimize the damage.

- Set a timer and get up and walk around for at least 5 minutes every hour.

- Do a few stretches while seated once or twice every hour.

- Find things you can do while standing like speaking on the phone.

But the bottom line is, when work is over, get moving.

Two Quick Tips for Minimizing GERD

 

 

Acid reflux is a difficult condition to cope with and the common pharmaceutical approaches such as PPIs can cause serious side effects and even dependence. Andrew Rubman, ND, has two recommendations that he believes can offer at least some people relief without drugs.

1. Drink less or nothing at all while taking a meal. Water - or any liquid for that matter - can dilute stomach acid and interfere with the proper digestion of food.

2 Try taking melatonin. "It seems to be able to have a calming influence on one of the major substances created in the GI tract," says Rubman, "which allows for the smooth movement of muscular contractions, opening and closing of valves, processing of foods, etc. So it’s really like getting a good manager in to run your factory, and things run more smoothly."

I can't say if either of these tips will be helpful for you, but they have worked for others so perhaps they are worth a try.

Just 300 Calories Less

 

It seems that there may be more health benefit to reducing our calorie intake than just losing weight - which is benefit enough in itself. A 2019 study done at the Duke University School of Medicine and published in The Lancet Diabetes & Endocrinology suggests that trimming just 300 calories from your diet each day is enough to reduce your risk of diabetes and heart disease. Even if you are already at a normal, healthy weight.

The study looked at 200 normal-weight adults under 50 years old who reduced their caloric intake by 300 calories per day over two years. After only six months participants showed significantly lower cholesterol, triglycerides, blood sugar and blood pressure. After two years, those who persisted on the lower calorie diet experienced a drop in measures of chronic inflammation associated with cancer, heart disease and dementia. They also dropped 10% of their starting body weight, 71% of which was fat.

"There's something about caloric restriction, some mechanism we don't yet understand that results in these improvements," said study author Dr. William Kraus, a cardiologist and professor of medicine at Duke University School of Medicine in Durham, N.C. "We have collected blood, muscle and other samples from these participants and will continue to explore what this metabolic signal or magic molecule might be."

The findings show "that even a modification that is not as severe as what we used in this study could reduce the burden of diabetes and cardiovascular disease that we have in this country," Kraus said.

For most of us, 300 calories comes down to skipping maybe one daily snack and drinking fewer sodas and sweetened juices. How hard is that, really?

 

Cows, Chickens and Breast Cancer Risk

 

A new study suggests that eating red meat may increase the risk of developing breast cancer, while poultry may actually have a protective effect.  The study followed 42,000 women for seven years. The women who ate the greatest quantities of red meat presented a 23% higher risk of invasive breast cancer than women who ate smaller amounts.

On the other hand, increased consumption of poultry was associated with a decrease in the risk of invasive breast cancer, reaching up to 15% in women who ate the greatest quantities. The women who swapped red meat for poultry reduced their risk by 28%. No link between various cooking techniques and cancer risk was observed.

Lead author Dr Dale Sandler, from the National Institute of Environmental Health Sciences, said: "Red meat has been identified as a probable carcinogen. While the mechanism through which poultry consumption decreases breast cancer risk is not clear, our study does provide evidence that substituting poultry for red meat may be a simple change that can help reduce the incidence of breast cancer."

Dr Mieke Van Hemelrijck, reader in Cancer Epidemiology, King's College London, said that despite the study showing a correlation rather than cause and effect, "the results could be used to help us further understand how diet may have an influence on the development of cancer".

4 Things to Look for to Be Sure your Hot Cereal is actually Good for You

Hot cereal is not just your mother's oatmeal any more. Now that it's been worked over by cereal companies and their marketing departments, its now possible to buy hot cereals that are every bit as crappy as the sugar filled garbage lining the cereal aisle. In addition to a confusing variety of oatmeal products, now you can get wheat, quinoa, amaranth, buckwheat, bulgar, faro, kamut, chia seeds and combinations thereof.

Whatever you decide to try, here are four ways to help you find the best cereals for  you.

1. Look for whole grain. This is easier than it usually is since most hot cereals are all or nearly all whole grain. Grits and Cream of Wheat or Rice are notable exceptions. Bran as an ingredient counts.

2. Beware of added sugar. As with most cereals, dumping lots of sugar into them can ruin even whole grain cereals. Most whole grain cereals come unsweetened. The notable exception is "instant" varieties which can be loaded with sugar. Skip them. Cooking most hot cereals only takes 10 minutes anyway. Better yet, make them overnight in a slow cooker and they are ready to go when you are.

3. Check the sodium content. Nearly all flavored varieties will have added salt and the rest will advise you to add it during cooking. Don't bother. Dress it up with fruit and nuts and you will not miss the salt.

4. Ignore the marketing BS. Promises to reduce cholesterol, provide antioxidants, deliver pre- and pro-biotics or fill you up with fiber and protein are, while not outright lies, generally much overblown. You would have to eat 3 or 4 servings of most hot cereals to count on them for a daily does of any of these things.

Still, as a rule, whole grain hot cereals that you prepare yourself and top off with fruit or nuts are one of the healthiest breakfast options in the market. They really do have a lot of protein and fiber that will help you feel full till lunchtime. Try a few different kinds, find the ones you like and include them on the menu several days each week.

For Women, Think Waist Rather Than Weight

 

A study published in 2013 in the journal Diabetes Care suggests that waist circumference my be a better indicator of the risk of developing Type-2 diabetes than weight. While the study included only women, there is no real reason to think the same advice would not apply to men. The researchers followed over 135,000 postmenopausal women over nearly 15 years before concluding that waist size predicted diabetes risk better than weight. A large waist circumference indicates an accumulation of fat in the intra-abdominal region - and fat in this area can impact internal organs and is more metabolically active than fat in other areas of the body. When used alone, a weight measurement is not especially accurate at predicting health and heart disease risk either. Used in conjunction with waist circumference, it provides a clearer picture.

In the cited study, women with a waist measurement between 31 and 35 inches had an almost 60% higher risk of developing Type-2 diabetes than those with a smaller waist. Women with a waist over 35 inches had nearly three times the risk as women with a waist under 31 inches.

A larger waist circumference is often caused by intra-abdominal visceral fat. Visceral fat is fat that develops between and around internal organs. This type of fat differs from "regular" fat that sits just beneath the skin and can be pinched. It is deep within the abdomen and is considered to have very high inflammatory activity.

There are several effective ways to reduce your waist circumference in a healthy manner.

• Lifestyle changes, including eating a healthy diet and getting regular exercise. This should be your "go to" approach.
  
• Quitting smoking. Which, lets face it, you should do regardless of your waist size.
  
• If you already have type 2 diabetes, metformin and thiazolidinedione medications may provide benefits in helping to reduce waist circumference

If this is a concern for you, speak with your primary care provider to determine the best method for you to reduce your waist circumference if you're over the recommended guidelines. 

 

Decoding Fish Oil Labels

 

If you use or plan to use fish oil supplements, it is important to know what you are getting and, unsurprisingly, the labels can be confusing. As you peruse the nutrition label in the store, keep the following things in mind.

It is the EPA and DPA fatty acids that provide the benefit, not the fish oil itself. The VITAL trail gave participants 460mg of EPA and 380mg of DHA so look for those amounts or better. Only about 25% of the fish oil is EPA plus DPA so use that as a guideline if they are not listed separately.

As always, make sure you check the serving size so that you are taking the dose that you think you are. It can vary among brands from one pill to three.

Mercury contamination in seafood is a valid health concern. Independent tests from Consumer Lab and others has never found detectable levels of mercury in fish oil supplements.

You can find vegetarian EPA and DHA that has been extracted from algae, and there may be even more reason to look for it than just preferring a non-animal source. Most will have double the fatty acids of fish oil products.

Avoid brands that contain only DHA. This is one case where less is not more.

VITAL Trial and Omega-3s

 

A few days ago we looked at the results of the VITAL trial on the effect of Vitamin D on cancers and cancer deaths. The study concluded that Vitamin D had no real value as a preventative measure but that it showed promise as a component of cancer therapy in that reduced cancer deaths were observed among those given 2,000IU daily.

The same study also looked at how effective fish oil was as a preventive measure against heart attack, stroke and cardiovascular death from any cause. The trial included nearly 26,000 healthy men and women who were given 1g of fish oil, 2,000IU of Vitamin D, both or a placebo for roughly 5 years. Earlier research, mostly observational studies, suggested that eating fish may lower the risk of heart disease and stroke.

The study found no statistically significant reduction in a composite of heart attacks, strokes and cardiovascular deaths among those getting the omega-3 fatty acid from the fish oil. But wait! There's more.

When heart attacks, strokes and deaths from cardiovascular events were examined separately there was no effect on strokes or deaths. But a 28% reduction in heart attacks was observed. "Our findings add to the biological plausibility that omega-3s have benefits for heart health," said study co-author Dr. JoAnn Manson in an interview in Nutrition Action newsletter. 

Among those who began the trial eating little or no fish, heart attack risk was reduced by 40% compared to those taking a placebo. For those who began the trial consuming 2 or more servings of fish per week, the supplementation had a negligible benefit.

Based on VITAL results, the bottom line on omega-3 supplements seems to be that they have little or no impact as a preventive measure for strokes or for reducing death from cardiovascular events. If you eat little or no fish, the supplements may be valuable in lowering your risk of heart attack. Better yet, just include 2 servings of fatty fish in your diet and don't worry about it.

Less Annoying Calorie Counting

 

If you are serious about losing some weight, you are going to have to consume fewer calories than you burn off between your resting metabolism and your activity. Its that simple, if not necessarily easy. But calorie counting can be a cumbersome, time consuming and, lets just say it, annoying chore. So much so that most people simply won't do it. This is a shame because it works.

But today you can find a host of apps that take most of the drudgery out of counting calories. Yes, you still have to enter what you eat and your activities each day. But the modern herd of apps have such improved user interfaces and large databases of foods and activities that you can do so in just minutes per day. Also, most apps will track your progress (motivating!) and report your overall nutritional status as well (educational!). They will usually allow you to create custom foods or activities for things that you enter often and most offer a free version that is probably all you will ever need..

Here are four of the most popular apps for you to consider. (I have used Chronometer for almost 2 years, lost 30 pounds, am stable at my goal weight and spend maybe 15 - 20 minutes a day using it - but I am a retired engineer and enjoy that sort of stuff. All four offer a free version with the option to upgrade to Premium for a cost. Personally, I think the free version is all you will need. In any case you can try the free versions and see which is the best fit for you.

MyFitnessPal

All Data Verified?            No.
All Entries Complete?     No. Mostly just the info on the nutrition label.

Pros: Extensive chain restaurant data, built-in local restaurant locator, free syncing with popular health and fitness apps and tools.

Cons: Calorie estimates for non-chain restaurants can be grossly inaccurate, the "projected weight loss" feature is simplistic and not very accurate.

Lose It!

All Data Verified?            No.
All Entries Complete?     No. All contain calorie counts but some nothing else.

Pros: Very easy to adjust the serving sizes to what you actually eat, desktop and mobile versions that are automatically synced and nearly identical.

Cons: Pushy ads for the company's other products can be annoying, tool that is intended to match photos of your food to the database is unreliable (its new so likely will get better).

Nutritionix Track

All Data Verified?            Yes.
All Entries Complete?     Yes. Some entries do have more detail than others.

Pros: easy to search for common foods both generic and brand name, Freeform feature lets you type in what you ate rather than searching for it item by item, and it has a voice entry feature.

Cons: Using Freeform requires additional inputs to adjust serving sizes, does not track progress over time (they are working on it).

Chronometer

All Data Verified?            Yes.
All Entries Complete?     Yes.

Pros: Most complete nutritional breakdown, very comprehensive database, graphically tracks progress over time, super easy set up.

Cons: Pop up ads can be annoying, not simple to set custom nutrition goals.

The odds are good that one of these will suit your needs and give you a powerful new weapon in your personal Battle of the Bulge. 

I'd love to have your feedback if you use any of these, and welcome other suggestions as well.

New Findings on Vitamin D

 

Vitamin D is touted for all sorts of health benefits, so it is no surprise that is it the subject of many studies and trials. For example a recent double-blind, randomized, placebo-controlled trial conducted in 2 sites in Sao Paulo, Brazil concluded that large doses on Vitamin D were ineffective in treating Covid-19 symptoms. 

In an interview published in the January/February edition of Nutrition Action newsletter, JoAnn Mason, a professor of medicine at Harvard Medical School and co-leader of the VITamin D and OmegA-3 TriaL (VITAL) delivered mixed news about the efficacy of Vitamin D for heart health and cancer prevention.

The VITAL study includes almost 26,000 men and women from across the U.S. and investigates whether taking daily dietary supplements of Vitamin D3 (2000 IU) or omega-3 fatty acids (Omacor® fish oil, 1 gram) reduces the risk for developing cancer, heart disease, and stroke in people who do not have a prior history of these illnesses.

First the bad news. Over the 5 year study period, no reduction in cardiovascular events was observed among those taking 2,000IU of Vitamin D. Even among those who began the study with a low blood level of Vitamin D, no benefit was observed. There was also no observed reduction in new cancers among the Vitamin D takers.

But there was good news too. Looking only at those who had been in the trial for at least two years, a significant 25% reduction in cancer deaths was observed. So while the study showed no reduction in new cancers, it did indicate a reduction in cancer deaths.

"If Vitamin D makes cancers less invasive, less aggressive, and less likely to metastasize, you might see a reduction in cancer deaths," Dr. Manson theorized.

While this was not a conclusive finding and additional research is needed, it suggests a possible role for Vitamin D as part of cancer therapies. And of course, it does not question the benefits of Vitamin D for bone health or its anti-inflammatory, antioxidant and neuroprotective properties. 

Next time we will take a look at what VITAL says about Omega-3 fatty acids.

High Blood Pressure Raises Dementia Risk

 

If you have high blood pressure in middle age, you have an increased risk of cognitive decline and dementia as you grow older, according to a meta-analysis reported in the Berkeley Wellness Letter. Mounting research suggests that having high blood pressure in midlife may harm your brain down the line and that taking aggressive measures to lower elevated blood pressure might help preserve cognition later in life. Indeed, the NIH and several Alzheimer’s disease associations list keeping blood pressure at healthy levels as one of the steps to help maintain cognitive health.

The studies included in the review linked high blood pressure (130/80 or higher) when 35 - 45 years old to increased risk for cognitive impairment at age 70. People who aggressively treated their blood pressure to keep it at 120/80 or lower developed fewer of the brain lesions associated with cognitive decline than those who's blood pressure remained higher. Systolic pressure (the first, higher number) appeared to be the most important factor with pressures above 140 especially risky.

It makes sense that high blood pressure is bad for the brain. After all, it can harm small blood vessels that nourish brain cells, resulting in damage that increases the risk of dementia as well as stroke. And vascular factors may affect amyloid and other neurodegenerative protein deposits in the brain that are a hallmark of Alzheimer's. If the latest findings are confirmed by other ongoing trials, that will be another reason to lower elevated blood pressure to as close to normal as possible—to reduce the risk of cognitive decline and dementia. 

The best option is to lower blood pressure via lifestyle changes such as losing excess weight, improving diet, exercising, limiting sodium intake, and not smoking. Such steps may make drugs unnecessary or, if medication is needed, allow you to take a lower dose or fewer drugs. Do it now, while you can still remember.