How Related Are Weight And Health?
August 14, 2008
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The conventional wisdom is that if you are normal sized you are healthy and if you are overweight you are unhealthy. However, a recent analysis has suggested that it is not that simple and that weight and health may not be related in a straightforward way.
More data from NHANES (National Health and Nutrition Examination Survey) suggests that some “normal weight” people are unhealthy and that some people considered overweight do not have signs of cardiac disease or other diseases that have been conventionally associated with obesity.
Of course being thin has never necessarily meant healthy. For instance, my mother who suffers form Crohn’s disease is thin due to her disease. However, in this analysis of the NHANES surveys, of those with normal weight there were a significant proportion who had what the authors called “metabolic markers of obesity”.
What were considered to be metabolic markers of obesity? They included high blood pressure, elevated triglycerides, high fasting blood glucose, high levels of C reactive protein (hsCRP) and low levels of HDL (the good) cholesterol.
The proportion of normal weight people with these markers increased with age, from 10.3% for ages 20 to 24 years , 16.9% between 35 and 49 years, 41.7% between 50 and 64 years, 54.7% between 65 and 79 years, and 56.2% 80 years and older.
Conversely, for those considered overweight and would be expected to have the metabolic markers, there were many who were in the optimal range. Healthy levels of the markers decreased with age, but represented a substantial proportion of the survey participants. The ranges were 47.7% between 20 and 34 years, 31.1% between 35 and 49 years, 20.4% between 50 and 64 years, 14.3% between 65 and 79 years, and 22.1% 80 years and older.
This sort of goes against what we are told. It will be interesting to see how the discussion of the data develops. The data does suggest that you need to go and get tested for cholesterol, glucose, triglycerides etc, whatever your size. Find out what your numbers are, then go from there.
Technorati Tags: weight, metabolic, obesity, NHANES
Popularity: 11% [?]
Low Fat vs. Low Carb vs. Mediterranean Diet
July 19, 2008
A new study compared low fat, low carb and Mediterranean diets. The findings were that those on the low carb and Mediterranean diets, lost more weight and had more improved cholesterol and triglyceride levels, than those on the low fat diet.
The study was conducted at a remote nuclear facility in Israel, so there was control over the diets of the participants. There were many more men than women in the study, so the findings for women may be less general. The low fat and Mediterranean were calorie restricted, the low carb diet was not calorie restricted.
All dieters lost weight, but those on the low fat diet lost the least. Men lost most on the low carb diet, whereas women lost most on the Mediterranean diet.
HDL cholesterol (the good cholesterol) increased most on the low carb diet, closely followed by the Mediterranean diet and the worst was the low fat diet. LDL cholesterol (the bad cholesterol) decreased the most on the Mediterranean diet, the low carb diet was intermediate and there was only a small decrease on the low fat diet. Triglycerides dropped most with the low carb diet, the Mediterranean diet had a slightly small drop and the low fat diet had a much smaller drop.
These results suggest that low carb and Mediterranean diets may be more effective than a low fat diet both for weight loss and improving cholesterol and triglyceride levels.
Since the low carb and Mediterranean diets are almost equally effective, then choosing the diet that suits your tastes and lifestyle, is going to be what is most successful.
The study is published in the New England Journal of Medicine 359:229-241, 2008.
photo credit: sethschoen
[tags]low fat, low carb, Mediterranean, diet, weight, cholesterol, triglycerides[/tag]
Popularity: 33% [?]
Vitamin D: Bones, immunity and heart
July 17, 2008
This from Science Daily. It says it all. Make sure you are getting enough of the sunshine vitamin
“Vitamin D is essential to strong bones. Inadequate vitamin D can lead to osteoporosis, a brittle bone disease. Recently, researchers have found that vitamin D may help reduce the risk of other diseases.
Fall prevention: With age, decreasing muscle strength can increase the risk of falls and bone fractures. Several studies have found that vitamin D supplements may benefit muscle strength and balance, helping older adults stay steadier on their feet.
Cancer prevention: Observational research indicates that low levels of vitamin D increase the risk of some cancers — including those of the breast, colon, rectum, ovary, kidney, lung and uterus. Although unclear why, vitamin D in adequate amounts appears to help regulate cellular growth, potentially preventing cells from becoming cancerous.
Chronic pain prevention: Vitamin D deficiency is increasingly recognized as an important cause of muscle pain and weakness.
Protection against autoimmune diseases: Evidence is mounting that vitamin D may offer protection from type 1 diabetes, multiple sclerosis and rheumatoid arthritis by reducing inflammation and strengthening the immune system. In one study, researchers found a 40 percent lower risk of multiple sclerosis in women who supplemented their diet each day with at least 400 international units (IU) of vitamin D.
Reduced risk of cardiovascular disease: Some research indicates that lower vitamin D levels are associated with a number of factors that affect cardiovascular
Recommendations from medical groups vary, but a daily intake in the range of 800 to 1,000 IU is likely to benefit most adults. The body produces vitamin D when exposed to ultraviolet rays, but many people need a supplement to reach recommended levels. Many multivitamins contain vitamin D. This nutrient also can be purchased alone or combined with calcium.
The July issue of Mayo Clinic Women’s HealthSource reports further information and guidelines on how much vitamin D is enough”
http://www.sciencedaily.com /releases/2008/07/080714162515.htm
Technorati Tags: vitamin D, immunity, cancer, heart disease
Popularity: 31% [?]
Off To Drink Red Wine And Eat Red Grapes
July 14, 2008
Even more reasons to drink red wine and eat red grapes. The compound resveratrol found in the skins of red grapes and hence red wine has been suggested to have even more health benefits.
Resveratrol has been suggested to have a wide range of health benefits in mice. How many of these results extend to humans will be interesting to see. However, the French Paradox suggests that resveratrol may have health benefits.
The French Paradox is, that though people in the south of France consume of high quantities of animal fat, the level of cardiovascular disease is quite low. One suggestion has been that the regular consumption of red wine was the explanation.
Research then suggested that humans did not consume enough resveratrol in wine or grapes to have an effect. Early research suggested that very large quantities of resveratrol needed to be consumed for any effect. This led to flood of supplements, most which contained Japanese knotweed, another source. (Note: Consumer Labs tested a large range of brands and found that the resveratrol content ranged from high to almost non-existent, and that price had no relationship to the content. Buyer beware.)
Recent research in mice, which previously had shown that only very high levels were effective, has shown that lower amounts improved health. Improvements were reduced cataract formation, better bone health, and improved balance and coordination. Further there was less inflammation in hearts, a sign of heart disease, in those mice whose diets included resveratrol. Let’s hope that studies in humans find the same thing!
Did you know that frozen red grapes make a great snack? Buy red grapes when they are cheap. After washing and letting dry, pull the grapes off the stems. Throw them in a Ziploc style bag and put them in the freezer. Just remove as many as you want for a snack. The freezing gives them a subtle change in taste.
photo credit: Zesmerelda
Technorati Tags: resveratrol, red wine, red grapes, French paradox
Popularity: 20% [?]
Eat Food With Herbs And Spices; Many Contain Beta-Caryophyllene
June 27, 2008
Food that is well seasoned with herbs and spices is probably good for you. A large number of herbs and spices including oregano, rosemary, thyme, cinnamon, ginger, clove and black pepper contain significant levels of beta-caryophyllene. Additionally many plants that are used in “folk medicine” throughout the world are often high in beta-caryophyllene.
Beta-caryophyllene is a volatile aromatic oil. This means that it evaporates (dies up) easily and it has a strong smell. It is used in the perfume industry, and also as a food additive. It is described as smelling like spicy pepper, woodsy with a citrus background.
Researchers have found that the compound beta-caryophyllene has several beneficial properties. Several years ago application to the skin was found to be somewhat numbing, so it may have use as a local anesthetic. There is also data for some antibiotic effects and anticancer effects, in particular, in combination with some anticancer drugs. It may also help slow osteoporosis. Another important property is this compound is that it is an anti-inflammatory. Recent research has investigated the mechanisms of the effects of beta-caryophyllene in the body.
The anti-inflammatory properties of beta-caryophyllene, may help reduce the development of inflammatory diseases. One important inflammatory disease is atherosclerosis (blockage of the arteries). Once atherosclerosis starts there is an immune cascade that causes the lesion to grow and change. It is possible that a significant intake of foods containing beta-caryophyllene may have an anti-inflammatory effect and slow the progression of atherosclerosis. Other inflammatory diseases such as inflammatory bowel disease, chronic obstructive pulmonary disease, osteoarthritis and rheumatoid arthritis may also be slowed by beta-caryophyllene.
Beta-caryophyllene is also found in some fruits including mango, guava, grape, raspberry and black currants. It is also found in cannabis, though it is not psychoactive.
So eat foods that are well flavored with herbs and spices, it may help your cardiovascular system.
Technorati Tags: beta-caryophyllene, atherosclerosis, herbs, anti-inflammatory
Popularity: 50% [?]
LDL Cholesterol Lowering Drugs: The Statins
June 20, 2008
Continuing from yesterday’s theme, I thought I would write a short explanation of the statin family of drugs, that are used for treating bad levels of cholesterol. Statins are the most prescribed drugs in the US. In fact, Atorvastatin (Lipitor), much of the time, has been the most prescribed drug for the last couple of years. (It was toppled by Viagra for a while, but came back.)
It is important to remember that your body has to have cholesterol. The major uses are; as part of the membranes of cells, and in the formation of a number of hormones.
No matter how much cholesterol you eat, your body (mainly the liver) will always make some cholesterol.
LDL (low density lipid) cholesterol contains cholesterol that is made by, or reprocessed by the liver. It is transported by the blood throughout the body, and cells that need some cholesterol will take what they need from the blood. So you need to have LDL cholesterol circulating in your blood. It is just that when there is too much that there may be problems.
Currently, the standard for treating high LDL cholesterol levels are the statins. The statins include lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor) and rosuvastatin (Crestor). The first name of each pair is the name of the drug, the second name in brackets is the commercial name for that drug. Yesterdays post about red yeast rice involves lovastatin.
These drugs are all inhibitors of the enzyme HMG CoA reductase. This enzyme is a major enzyme in the process of making of cholesterol by cells. When the enzyme is inhibited, cells in the body make less cholesterol. Then, when the cells get short of cholesterol they start to take up cholesterol from the blood to meet their requirements, then the level of LDL cholesterol in the blood drops.
(Statins are thought to have a number of other good effects too, independent of their cholesterol lowering ability. These are wide ranging and the subject of much research and controversy.)
To summarize, statins decrease the amount of cholesterol that the body can make, so then to meet requirements cells take up LDL cholesterol from the blood, which cause the level of LDL cholesterol in the blood to decrease.
photo credit: tellumo The sign is in Sausalito.
Technorati Tags: cholesterol, LDL cholesterol, drug, statin, lovastatin, atorvastatin, Lipitor
Popularity: 33% [?]
Red Yeast Rice For Cholesterol Lowering?
June 18, 2008
There has been quite a bit of news lately about red yeast rice and its use for lowering cholesterol. The short answer is yes red yeast rice can lower cholesterol. However, there are some important considerations when deciding whether to use this supplement for cholesterol lowering.
What is red yeast rice?
This is rice that has been mixed with red yeast (Monascus pupureus) and allowed to ferment. The resulting fermentation products include a group of substances that have cholesterol lowering ability. One of these substances is the compound known as monacolin K, also known as lovastatin (Mevacor). Lovastatin was the first of the prescription statins available for lowering cholesterol. The commercial synthesized statins also include Zocor, Lipitor, Pravachol, Lescol and Crestor.
What are the potential problems with taking red yeast rice?
Some brands do not control (or measure) the amount of the active ingredient. Different batches may have almost none, or huge doses of monacolin K. Almost none is obviously not going to be any help with lowering cholesterol. Too much can result in muscle damage, also known as myopathy. (PubMed)
If the red yeast rice fermentation is not properly controlled there can be harmful products made too. When a number of red yeast rice preparation were tested some of them contained citrinin, which is a toxin that will damage your kidneys. (PubMed above)
Red yeast rice can have interactions with other medications. Some which will increase the risk of muscle damage or other side effects. This list of medications that potentially may result in side effects includes all drug interactions and cautions listed for lovastatin. As with the commercial cholesterol lowering statins Mevacor, Zocor and Lipitor, no grapefruit or grapefruit-containing products should be consumed. Grapefruit, also, increases the risk of muscle damage. If you are taking any other medications fully investigate whether combined with red yeast rice there may be side effects.
The FDA has banned some brands of red yeast rice products. However, it is likely in the future that products with strict manufacturing guidelines and extensive analysis will eventually be available.
As always caveat emptor (buyer beware).
Technorati Tags: red yeast rice, lovastatin, citrinin, cholesterol lowering
Popularity: 36% [?]
Japan Aims To Measure 56 Million Waists
June 16, 2008
Japan now has a national law that all adults between 40 and 72 must have their waists measured. This is 56 million waists, or 44% of the population. Those whose waists are too big will get diet and exercise advice, and follow-up visits.
Like all countries Japan is concerned about the expanding waistlines of the population. The national program is an attempt to see if they can stop and reverse the trend. Read the good article about this in the NYTimes health section.
The article describes how the Japanese Health Ministry started to educate the populace about metabolic syndrome [where a person has 3 or more of the following, high levels of blood glucose, high levels of triglycerides, low levels of HDL (good) cholesterol, high blood pressure, abdominal obesity] several years ago. The aim being to try make sure that everybody knows about metaobolic syndrome.
The name metabolic syndrome was shortened to “Metabo”. Apparently there are anti-Metabo songs, one of which includes “the warning against trouser buttons popping and flying away”.
I think Japan is to be congratulated for trying to do something about the growing problem (pun intended), before it becomes very serious. Investment now in the program may save them a lot of money in healthcare costs down the road.
An important question that may be answered by this is whether a program such as this one, actually has any effect on peoples behavior and whether in the long run it will make any difference at-all. Will Japan fall prey to the scourge of Metabo?
Technorati Tags: Japan, waists, metabolic syndrome, metabo
Popularity: 38% [?]
Garlic for Blood Pressure, Heart Disease, Stroke, Diabetes And Antioxidant Status
May 15, 2008
Garlic has long been known to be good for you. In the last few years it has been demonstrated that it may play a beneficial role in many aspects of health including lowering blood pressure, reducing the risk of heart attack and stroke, and improving antioxidant status.
Garlic has been shown recently to decrease blood pressure and to help lessen the risk of heart attack. The decrease in blood pressure is due to widening of the inside of blood vessels which makes the pressure drop.
There are several reasons why garlic may reduce both stroke and heart disease risk. One potential reason is that the antioxidant properties may reduce the oxidation of blood lipids, leading to a reduction in the rate of development of atherosclerosis (blocking of arteries). We are all developing atherosclerosis, so the aim is to make it slow enough that it never has any health impact. Garlic has also been shown to lower the level of platelet aggregation. Platelets are cells that circulate in the blood that are involved in clot formation, by sticking together and to cells in the walls of blood vessels. Lowering the level of platelet aggregation reduces the formation and growth of clots, which in turn lowers the risk of heart attack and stroke.
Garlic has several other suggested health benefit including reducing inflammation, neurodegeneration (including possibly Alzheimer’s), diabetes and cancer. It has been suggested that garlic can reduce blood sugar levels.
To get the most benefit from garlic it should be “aged”. This means that garlic should be crushed and then left for 10 to 15 minutes before use. The reason for this is that when the garlic cells are broken by crushing, an enzyme is released that converts alliin to allicin. Leaving the crushed garlic for a while gives the enzyme time to work. It is allicin that our body uses either directly or indirectly for most of the health benefits.
Eat more garlic!
Technorati Tags: garlic, allicin, blood pressure, heart disease, stoke, diabetes, antioxidant
Popularity: 86% [?]
Stanols and Sterols in Cholesterol Lowering Foods
March 28, 2008
We have heard a lot recently about cholesterol lowering foods, in particularly stanols and sterols. What are these phytosterols and how do they help with reducing cholesterol levels?
This is a topic about which I know quite a bit. Once a year I teach medical students about treatments for hyperlipidemias (high lipid or fats). Blood lipids are cholesterol and triglycerides. High cholesterol is associated with cardiovascular disease and contributes to atherosclerosis. I could say a lot more but the point of this post is cholesterol lowering foods, so perhaps another day I will give more information about cholesterol.
One group of foods that have cholesterol lowering potential is those that contain stanols and sterols. These are also known as phytosterols and are found in plants. The stanols and sterols have a structure similar to cholesterol.
Phytosterols block uptake of some of the cholesterol in the intestine, when foods that contain cholesterol are eaten. (Major dietary sources of cholesterol are meats, dairy and shrimp. Plants do not contain cholesterol.) Any cholesterol that is blocked form uptake by the phytosterols just passes on through the gut and out, with all the other stuff that is not absorbed. In this way less cholesterol is taken up by the body, and this may help lower blood cholesterol levels.
Which foods contain stanols and sterols? All plants contain phytosterols, however in many plants the levels are very low. Avocados are one of the foods with the highest level of sterol. They contain about 100 milligrams of beta sitosterol per 4 oz serving. Other foods that contain both sterols and stanols are vegetable oils including soy and corn oils and nuts. Grains contain smaller amounts.
Recently stanol esters have been added to a number of foods to help with cholesterol reduction. The original foods marketed that contained stanol esters were margarines (or often called spreads). The first margarine was Benecol which was first sold in Scandinavia, in Finland. The stanol esters in Benecol are from processing of pine trees. In the US the other spread that was early into the market was Take Control from Unilever, which is manufactured from soybeans. Stanol esters are now found in a number of products such as other spreads, yogurt and energy bars and will soon be incorporated into a wider range of foods including pasta.
Many of the foods containing significant levels phytosterols are quite high in calories so they should be eaten in moderation as part of a balanced diet.
Technorati Tags: cholesterol, phytosterol, stanol, sterol, avocado, margarine, stanol ester, spread
Popularity: 89% [?]
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