"Once You're Through Learning, You're Through"
-John Wooden, the well-known UCLA basketball coach, who passed away at age 99-
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The research on the benefits of diet and exercise just continues to pile up on my desk!
There's no way to keep up with it all--so today I'm "downloading" just a few of the papers that caught my attention this week.
Nothing "earth shattering". Much of what you'll see here is just further confirmation of prior research.
Thumbs Up:
- A diet high in fiber-rich carbohydrates helps prevent type-2 diabetes & metabolic syndrome.
- Get your vitamin D level up to 33 or more, if you want your bisphosphonates to work.
- Bio-identical estradiol significantly improves the verbal memory of postmenopausal women
- Help to prevent dementia by avoiding diabetes & lowering your cholesterol.
- Avoid erectile dysfunction by making the necessary diet & lifestyle changes that improve cardiovascular health.
- Help to prevent stroke by steering clear of deli meats.
Thumbs Down:
- Deli-counter meats--yes, even low-fat turkey--contribute to an increased risk of stroke. Looks like salt & nitrites are to blame.
- High-cholesterol is bad news for the brain--contributing directly & indirectly to amyloid plaque formation in the brain.
- A diet high in animal protein can promote type-2 diabetes by increasing low-grade inflammation.
- Conjugated Equine Estrogen may not be good for the brains of women at risk for dementia
- There's a link between hot flashes and high cholesterol.
- Diabetes is a major risk factor for dementia because it increases vascular disease.
- Erectile dysfunction needs a diet & lifestyle makeover--not Viagra & Cialis.
1. Diet high in protein, processed meat raises risk of diabetes
High protein intake may facilitate type 2 diabetes and metabolic disturbances, mostly through the elevation of low-grade inflammation.
September 16, 2011. Presented in Lisbon, Portugal at the European Association for the Study of Diabetes (EASD) 2011 Meeting.
Excerpt from Medscape (to view you must register, but it's free): Results of a large population-based study (27,140 individuals) show that a high protein intake is associated with an increased incidence of type 2 diabetes.
In presenting their results at the recent European Association for the Study of Diabetes (EASD) 2011 Meeting, Swedish researchers suggest that replacing protein with carbohydrates, especially breads and cereals rich in fiber, may be preferable for avoiding incident diabetes.
The study participants with the highest intakes of protein were at a 37% increased risk of developing type 2 diabetes, compared to those with the lowest intake.
High intake of processed meat was also associated with an elevated risk of diabetes, as was intake of poultry and eggs. There was no association of diabetes risk with intake of fish or red meat, but when all animal sources of dietary protein were considered together, an increased risk was seen. "So this indicates that protein per se may be of importance," according to lead author Ulrika Ericson.
High protein intake may facilitate type 2 diabetes and metabolic disturbances, mostly through the elevation of low-grade inflammation.
In summary, Ericson said a protective association exists with a high intake of fiber-rich breads and cereals. And although high protein intake has been shown to be effective for short-term weight loss and glycemic control, it is associated with an increased risk of type 2 diabetes.
So, the results of this trial suggest caution when considering high-protein diets--although Ericson says it's too early to make dietary recommendations based on merely on the observed associations.
For a better understanding of how high-fiber low-glycemic carbohydrates help to prevent type 2 diabetes & metabolic syndrome, take a look at:
Tip: whole wheat bread may be high fiber, but it's also high glycemic. Find a better choice!
Bottom line: you want very grainy "kibbled" least-processed breads & carbs that move slowly through your digestive system. How do I find out which foods are low-glycemic? The University of Sydney maintains the most reliable database. Look for foods that have a glycemic index of 55 or under. Click Here for the database. Click Here for their excellent newsletter.
Also take a look at: Larrson, SC, Virtamo, J., Wolk, A. "Red Meat Consumption and Risk of Stroke in Swedish Men," Am J Clin Nutr 2011 Aug;94(2):417-21.
"The largest study to date on the relationship of stroke to red meat consumption suggests higher intake of processed meat, but not fresh red meat, is associated with an increased risk for stroke, including cerebral infarction.
The findings suggest meats that consumers often think are healthier, such as low-fat deli turkey, ham, and bologna, may actually increase the risk for stroke if intake is high enough, the study authors note.
The investigators speculate that sodium in processed meats, which can contribute to the development of hypertension if intake is high enough, might contribute to a higher risk for stroke by promoting vascular stiffness or oxidative stress.
Nitrites used as preservatives may also contribute to increased stroke risk." Read more in Medscape (must register first--but it's free)
2. HIgh Cholesterol tied to Alzheimer's disease lesions
"Our study clearly makes the point that high cholesterol may contribute directly or indirectly to plaques in the brain," corresponding author Dr Kensuke Sasaki.
September 13, 2011. Matsuzaki T, Sasaki K, Hata J, et al. Association of Alzheimer disease pathology with abnormal lipid metabolism: The Hisayama study. Neurology 2011; 77:1068-1075.
Excerpt from Heartwire. Kyushu, Japan - A new study has found a correlation between dyslipidemia and the presence of amyloid plaques in the brain at autopsy, one of the key signs of Alzheimer's disease.
According to the analysis, levels of total and LDL cholesterol, as well as ratios of LDL to total cholesterol and LDL to HDL cholesterol, were significantly higher among subjects with increased numbers of neuritic plaques vs those with fewer plaques. No such relationship was seen with numbers of neurofibrillary tangles, the other cardinal pathological sign of Alzheimer's disease.
"Our study clearly makes the point that high cholesterol may contribute directly or indirectly to plaques in the brain," corresponding author Dr Kensuke Sasaki (Neurological Institute, Kyushu University, Japan) said in a statement by the American Academy of Neurology.
However, he added, "Failed treatment trials of cholesterol-lowering drugs in Alzheimer's disease mean there is no simple link between lowering cholesterol and preventing Alzheimer's." (My comment: Could changes in one's cholesterol that come from diet & lifestyle have more of a protective impact than those from statins? And don't forget that Alzheimer's & vascular dementia are years in the making!)
The study, published in the September 13, 2011 issue of Neurology, looked at autopsy brain specimens from 76 men and 71 women who had undergone clinical examination in 1988 and had total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides measured at that time. Of the 147 subjects, 34% had been diagnosed with dementia when alive.
For additional perspective read, Mayo Clinic Researchers Discover the Nitric Oxide Connection to Brain Health, Alzheimer's, and Cognitive Impairment. Better Keep Your Endothelial Cells Healthy with Diet & Exercise
3. Bisphosphonates Most Effective With Higher Vitamin D Levels
Women whose mean level of serum 25 hydroxy vitamin D (25[OH]D) was at least 33 ng/mL were almost five times more likely to benefit from bisphosphonates than those whose levels fell below that cutoff.
September 21, 2011. American Society for Bone and Mineral Research (ASBMR) 2011 Annual Meeting; Abstract #1137. Presented September 18, 2011
Excerpt from Medpage Today & Medscape: Bisphosphonate therapy for osteoporosis is much more likely to be effective among patients whose blood serum levels of vitamin D are elevated, according to research presented here at the American Society for Bone and Mineral Research (ASBMR) 2011 Annual Meeting.
Postmenopausal women with low levels of circulating vitamin D are much less likely to respond to treatment with bisphosphonates, researchers said here.Women whose mean level of serum 25 hydroxy vitamin D (25[OH]D) was at least 33 ng/mL were almost five times more likely to benefit from bisphosphonates than those whose levels fell below that cutoff (OR 4.53, 95% CI 2.17 to 9.48, P<0.0001), according to Amanda Carmel, MD, of Weill Cornell Medical College in New York City, and colleagues.
In addition, for each 1 ng/mL decrease in 25(OH)D level, there was a 5% decrease in likelihood of responding to treatment (OR 0.95, 95% CI 0.92 to 0.98, P=0.0007), Carmel reported at the annual meeting of the American Society for Bone and Mineral Research.
"The current study is the first to identify a threshold level of 25(OH)D that defines improved outcome to bisphosphonate therapy such that patients with a mean 25(OH)D ≥ 33 ng/mL had a substantially greater likelihood of responding to bisphosphonates," the authors wrote.
"This threshold value of ≥ 33 ng/mL for 25(OH)D is higher than the level considered adequate by the Institute of Medicine report for the general population, arguing that higher levels may be required for specific therapeutic outcomes."
According to coauthor Richard S. Bockman, MD, PhD, the results may help explain discrepancies in responses to bisphosphonates seen in controlled studies compared with the real-world environment.
4. 17β-Estradiol Improves Postmenopausal Memory Performance
"We found consistently that [CEE] may not be good for the brain, at least in women with increased risk of dementia. And 17β-estradiol had better effects," said Dr. Rasgon.
September 19, 2011. Wroolie, TA et al, "Differences in verbal memory performance in postmenopausal women receiving hormone therapy: 17β-estradiol versus conjugated equine estrogens" Am J Geriatr Psychiatry 2011 Sep;19(9):792-802. Click here for article
Hormone therapy compounds differ significantly when it comes to their effects on cognition in postmenopausal women, especially on verbal memory, new research suggests.
In a cohort study of almost 70 healthy women between the ages of 49 and 68 years who were at risk for Alzheimer's disease (AD), those receiving hormone therapy containing 17β-estradiol showed a significant improvement in verbal memory performance compared with those receiving compounds with conjugated equine estrogen (CEE).
"There is a differential effect of the type of hormone therapy on brain function," principal investigator Natalie Rasgon, MD, PhD, professor of psychiatry and of obstetrics and gynecology at Stanford School of Medicine in Palo Alto, California, and director of the Stanford Center for Neuroscience in Women's Health, told Medscape Medical News.
"We found consistently that [CEE] may not be good for the brain, at least in women with increased risk of dementia. And 17β-estradiol had better effects," said Dr. Rasgon.
She reported that the investigative team is now working on "even more exciting data" that she hopes can be translated into clinical practice.
Don't miss Cynthia Gorney's balanced ground-breaking article all about the beneficial effects of estrogen & the brain--The Estrogen Dilemma, that appeared in the Sunday April 18, 2010 New York Times Magazine. Click here for the article. Read more about it in this post.
5. Hot Flashes Linked to Higher Cholesterol
Several recent studies have linked hot flashes to an increased risk for heart disease, and now new research suggests a link between these menopause symptoms and increased cholesterol.
September 21, 2011. North American Menopause Society (NAMS) 22nd Annual Meeting, paper presented by Rebecca C. Thurston, PhD, assistant professor of psychiatry and epidemiology, University of Pittsburgh School of Medicine and Lori Mosca, MD, PhD, professor of medicine, Columbia University; director of preventive cardiology, New York-Presbyterian Hospital; past president, American Society for Preventive Cardiology.
Excerpt from Medscape article by Salynn Boyles (to access Medcape articles you need to register).
Several recent studies have linked hot flashes to an increased risk for heart disease, and now new research suggests a link between these menopause symptoms and increased cholesterol.
The study is being presented in Washington D.C. this week at the 22nd annual meeting of the North American Menopause Society.
Researchers followed more than 3,000 women in their 40s and early 50s for seven years as they transitioned through menopause.
After taking into account other heart disease risk factors they found hot flashes and, to a lesser extent, night sweats to be predictive of higher cholesterol The more hot flashes the women had, the higher their LDL "bad" and HDL "good" cholesterol.
"I think hot flashes and night sweats tell us something about women's cardiovascular risk and health, but it is also likely that this message is quite complex," study researcher Rebecca C. Thurston, PhD, of the University of Pittsburgh tells WebMD.
Columbia University professor of medicine Lori Mosca, MD, PhD, tells WebMD that it is not clear if hot flashes or other menopausal symptoms have any direct impact on heart attack and stroke risk.
One message that is clear, she says, is that menopause is associated with substantial alterations in heart disease risk.
6. More Evidence Links Diabetes and Dementia
"We have clearly demonstrated that diabetes is a significant risk factor for the development of dementia, especially of Alzheimer's disease, in (the) general public," said Dr. Yutaka Kiyohara, a professor in the graduate school of medical science at Kyushu University in Fukuoka.
September 19, 2011. Kiyohara, Y, Ohara, T. et al, "Glucose tolerance status and risk of dementia in the community: The Hisayama Study," Neurology, 2011 Sep 20;77(12):1126-34. (click here for the article)
Excerpt from HealthDay, Ellin Holohan:
People with diabetes are at significantly higher risk of developing all types of dementia, including Alzheimer's disease, finds a new study that bolsters previous research connecting the two illnesses.
The study of more than 1,000 people in Japan found that 27 percent of those with diabetes developed dementia, compared to 20 percent of people with normal blood sugar levels.
Further, the study showed that pre-diabetes -- higher than normal blood sugar levels -- also raised the risk of dementia.
"We have clearly demonstrated that diabetes is a significant risk factor for the development of dementia, especially of Alzheimer's disease, in (the) general public," said Dr. Yutaka Kiyohara, a professor in the graduate school of medical science at Kyushu University in Fukuoka.
The study, conducted from 1988 to 2003, is published Sept. 20 in Neurology.
The study followed 1,017 men and women, age 60 and older, who took a glucose test to find out if they were diabetic or pre-diabetic. They were then tracked over an average of 11 years each. In all, 232 developed dementia, either Alzheimer's, vascular dementia, all-cause dementia or another form.
Of the 150 who had diabetes, 41 developed dementia, compared to 115 of the 559 people without diabetes. Among the 308 people with pre-diabetes, 76, or 25 percent, developed dementia.
Even having high levels of sugar two hours after taking glucose was linked to dementia, the researchers said, noting the importance of consistent blood sugar control.
Diabetes affects close to 26 million children and adults in the United States, with 7 million of them undiagnosed, according to the American Diabetes Association. Another 79 million have pre-diabetes. Obesity increases the risk of diabetes, and as Americans become heavier, more are developing diabetes.
While prior research has shown a link between diabetes and dementia, the Japanese study is important because of its size and duration, said another expert.
Another expert noted that diabetes could be connected to dementia because it contributes to vascular disease, disrupting the flow of oxygen to the brain and other organs.
"Diabetes is a major risk factor for vascular disease," said Dr. Spyros Mezitis, a clinical endocrinologist at Lenox Hill Hospital in New York City. "If the blood vessels are not allowing enough oxygen to get to the brain, you can get dementia."
The study will "change the way we practice medicine" and could lead to quicker referral of diabetics to neurologists when they show signs of memory loss or other cognitive problems, he said.
The goal for patients is to avoid the progression of vascular disease and to maintain proper blood sugar levels, he noted.
For more on the adverse effects of blood sugar spikes on the brain, click here.
7. Erectile Dysfunction May be Linked with Cardiovascular Trouble--an Independent Risk Factor for Heart Disease, Stroke and Death.
"A number of prior individual studies have shown that men with erectile dysfunction are at increased risk for fatal and nonfatal cardovascular events.
Men with erectile dysfunction should be aware of this significant increase in cardiovascular risk and take proactive steps to adopt a healthy lifestyle and better control their cardiovascular risk factors," Dr Greg Fonarow, MD, UCLA, commenting on the article.
September 14, 2011. Dong, YR, Zhang, YH, Qin, LQ , "Erectile dysfunction and risk of cardiovascular disease meta-analysis of prospective cohort studies," J Am Coll Cardiol 2011 Sep 20;58(13):1378-85 click here for the article
Excerpt from HealthDay:
Although it is well accepted that cardiovascular disease is a risk factor for erectile dysfunction, it has not been clear whether erectile dysfunction is an independent risk factor for cardiovascular disease, the researchers noted.
"Erectile dysfunction significantly increased the risk of cardiovascular disease, and the increase was probably independent of conventional risk factors," said lead researcher Dr. Li-Qiang Qin, from the department of nutrition and food hygiene in the School of Public Health at Soochow University in Suzhou.
As such, "erectile dysfunction may not only contribute to cardiovascular risk prediction, but also serve as a potential target for cardiovascular disease prevention," Qin said.
The report was published in the Sept. 13 online edition of the Journal of the American College of Cardiology.
For the study, Qin's team culled data on the relationship between erectile dysfunction and cardiovascular disease from 12 studies published between 2005 and 2011 that included a total of 36,744 people and an average follow-up of 4 to 16.2 years. This process, called a meta-analysis, tries to pool data from several sources to tease out a pattern that might not be obvious in a single study.
The researchers found a significant association between erectile dysfunction and the increased risk of cardiovascular disease, heart disease, stroke and death.
In fact, men with erectile dysfunction had a 48 percent increased risk for cardiovascular disease, a 46 percent increased risk for heart disease, a 35 percent increased risk for stroke and a 19 percent increased risk of dying of any cause, compared to men without the condition.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, noted that "erectile dysfunction impacts some million 18 million men in the United States."
Cardiovascular disease and erectile dysfunction share many common risk factors, including diabetes, obesity, smoking, hypertension and high cholesterol, he said.
Read more here: From the New York Times: For a Common Male Problem, Hope Beyond a Pill. Diet, Exercise, & Lifestyle Changes Improve E.D.
Crazy Busy Between Now & Mid-October
I'm not sure how much I'll be blogging in the upcoming weeks--with Rosh Hashanah/Yom Kippur starting tomorrow night--and soon after I'll be traveling out-of-town to help my kids with the arrival of grandchild #2. Woo Hoo!
In between work--I'll be busy cooking for the holidays, and planning & prepping meals to stock my kids' fridge! I want to spend time playing with the grandbabies--not stuck in the kitchen!
If I have any free time I just might be able to sneak in a post or two! No promises.
Lab Rat's written a terrific post on how to grow sprouts in your kitchen. I've got new recipes to share, the update on my new strength-training routine, more hot-off-the-press health news, and my promised follow-up post with my favorite tips, tools, snacks & pantry staples for a simplified plant-based kitchen!
I just wanted to tell you how helpful your posts have been to me. I have joined the "no oils" club and truly do feel better - I can tell when I don't pay attention to ingredients. I make many of ther receipes from your blog. Enjoy your grandbabies.
Posted by: Debbi | September 27, 2011 at 08:23 AM
L'shanah tovah and thank you. I've learned so much here and I'm making changes for the better. Best wishes to you and your family for a happy and healthy new year.
Posted by: Jerri | September 27, 2011 at 12:49 PM
Deb...have a wonderful time! Happy New Year to you and your family! We are all beginning this new year in better health thanks to YOU...seriously!
Posted by: Gael in Vermont | September 28, 2011 at 02:43 AM
L'Shanah Tovah and greetings from Jerusalem!
Thanks so much for all your hard work and amazing information.
I've been running back and forth between the laptop and the kitchen today. So much good stuff to read, so little time to sit down :)
We're having a plant-strong Rosh haShanah. I've just finished the pasta sauce with chard; I've put together the fixings for a total of seven holiday and Shabbat meals, all oil-free and plant-strong. Not you usual chicken schnitzel-cholent holiday meals, that's for sure.
Wishing you and yours a happy healthy New Year!
Posted by: Lisa in Jerusalem | September 28, 2011 at 06:46 AM
I have been following your blog for the last year. I love your posts! My husband and I are both in health care. Your evidenced based posts are excellent! In the past year I have adopted plant based protein, and my husband "converted" in the last 5 months. We have now moved to no oil. Both of us dropped our lipid numbers and I am now off of my BP meds. He had dropped 60 lbs before no animal protein through exercise and cleaning up the garbage diet, another 12 has dropped from no animal protein. Feels better and performance on the bike is amazing. He now believes all the vegan athlete comments of "improved recovery and decreased muscle aches post work out"
I am 6 + months recovery from an ACL replacement(donor graft) and meniscus repair. I am convinced my great recovery is attributed to my diet pre injury and post. Yes, I did have an excellent ortho and PT, however, I believe the diet had a great deal to do with my energy and stamina in the recovery phase! I am now back on the bike (50 or so miles a week), doing yoga 2-3 x/week (took your suggestion and am so pleased!) My doc said I can ski in December with my brace! Original time frame was march of 2012.
You inspire me with your health and embracement of life. I will be 50 this year and I plan to be the active 60,70, and 80 year old! Thanks for all you do!
Posted by: Sherry LaRose- Cooke | September 28, 2011 at 07:06 AM
Incredible how, generally speaking, a plant based diet and exercise prevent or diminish so many of our modern health scourges.
Posted by: Steven Rice Fitness | September 28, 2011 at 04:58 PM
HL, thanks so much for all the research you do and for sharing it with us! You are my favorite source for plant based nutrition info! My husband and I are vegan for the past 9 months, feeling healthy and strong, and loving our food!
Posted by: Karen | October 01, 2011 at 06:35 AM
What a great round-up of the healthy lifestyle literature. Your posts are seriously the best evidence based healthy lifestyle info on the web. I send my patients to your site to keep up on the good stuff they need to know, especially when they're asking about some dietary bypass misinformation they've run into elsewhere. Thanks for the great work.
Posted by: Cynthia Bailey MD, Dermatologist | October 18, 2011 at 09:41 AM