Losing Fitness over a Decade Doubles Risk of Death

A Finnish study presented in November 2012 at the American Heart Association 2012 Scientific Sessions showed that Finnish men who lost more than 15% of their cardiorespiratory fitness over a 10-year period fast a near doubling of their risk of acute myocardial infarction (heart attack) over the next decade and over twice the risk of dying of any cause. The men who were studies were between 42 and 60. During that period it would be quite easy to reduce fitness by 15% and one has to make a concerted effort to remain as fit. If you don't work at it, it will disappear far more quickly than in young people. 

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Diet and Colon Cancer

A study published online November 7, 2012 in the Journal of the National Cancer Institute found that in people with stage 3 colon cancer and whose BMI was over 25 a high glycemic load diet diet with high carbohydrate intake results in a significantly higher rate of recurrence of the cancer. High glycemic load meals cause larger spike in insulin levels, which have been associated with cancer. 

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Snack Food for Children

A study published online December 17, 2012 in Pediatrics found that children consumed fewer calories when served a healthy snack. A group of children were randomly assigned to one of four different groups while watching TV for 45 minutes: vegetables only, cheese only, potato chips only, or a combination snack of vegetables and cheese. The children were asked to evaluate their satiety (how full they were) before, during and after television viewing. Children who were offered vegetables consumed the fewest calories and those offered potato chips the most. The cheese and the combination group consumed about the same amount of calories: fewer than the potato chip group but more than the vegetable group. If you don't want your children to eat potato chips, don't keep them around!

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Fitness and Statins

The November 2012 issue of The Lancet had the results of a large study conducted over 10 years at the Veterans Affairs Medical Center in Washinton, D.C. The authors found that physical fitness boosted survival in patients on statins by up to 70%. The most fit participants with hyperlipidemia (high cholesterol) had a reduction in all-cause mortality of 60-70% compared to the least fit. Not only do those people taking statins who exercise benefit, but even those choosing not to take statins still had a 50% reduction in all-cause mortality if they exercised vigorously and regularly. Cholesterol is not the main player in cardiovascular disease. It only seems that way because there are pills available that can lower it. Ultimately you want to improve the health of your arteries and heart, not achieve some lab value. Exercise will help you maintain or achieve healthy arteries regardless of your cholesterol status. 

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Fat but Still Fit?

A study published online November 6 in PLoS Medicine pooled data from 6 prospective cohort studies and included 654,827 participants aged 21 to 90 years. Regardless of body mass index (BMI) those who exercised 75 minutes per week were likely to live 1.8 years longer. The more time spent brisk walking, running, swimming, cycling, or sweating in an aerobics class, they boost their life expectancy by 3.4 to 4.5 years. Interestingly, for sedentary people BMI made a larger difference with those at the higher end having the shortest lives. Within all BMI groups, exercising 150-299 minutes per week added 3.4 years to life expectancy, and 300-449 minutes per week added 4.2 years to life expectancy. On the other hand low levels of physical activity and a high BMI gave one the life expectancy of a smoker. Bottom line: exercise increases your  chances of living longer regardless of your body weight. Don't wait to lose weight before you exercise. Start now!

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NSAIDs and Intestinal Injury in Athletes

A study publsiehd in Medicine and Science in Sports and Exericse showed that ingesting ibuprofen before or during exercise has serious consequences for the intestines. During exercise there is less blood supply to the intestines. This makes sense, since you want the blood to be shunted to your muscles, your heart, and you lungs during exercise. Consuming ibuprofen during this period causes more damage to the gut than otherwise. The injury resulted in gut barrier dysfunction. In other words, when damaged, the intestines allow too much into the bloodstream that should really be kept out. This can have cause all sorts of sensitivity reactions from mild to severe. NSAIDs have also been known to cause ulceration, bleeding, perforation, and the formation of diaphragm-like strictures. Athletes are advised not to take ibuprofen before performing exercise. 

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Whole Grains and Prediabtes

A Swedish study published in the December 12 edition of the American Journal of Clinical Nutrition found that people who ate more than 59 grams of whole grains per day were 27% less likely to become prediabetic compared with people who at 30 grams less. 1/2 cup of brown rice is about 100 grams and is considered a whole grain, not a refined grain. this association was stronger in men than women. An interesting side note was that people with a genetic predisposition to diabetes did not have a reduced risk with whole grains. Many diets recommended for avoiding diabetes are very low in carbohydrates in general. What a study like this suggests to me, is that a low carbohydrate diet (with the carbs being consumed having a low glycemic index) is probably most suited to those with a genetic predisposition to diabetes. For others who are overweight and trying to avoid diabetes, a low glycemic load diet with at least 60 grams of whole grains per day, is probably the wiser choice. 

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An Apple a Day Can Lower Bad Cholesterol

Low density lipoprotein cholesterol (LDL) in and of itself is not bad, although it is often referred to as the "bad" cholesterol. It becomes "bad" if is oxidized or glycated or otherwise compromised and thus smaller and denser. If you have a lot of LDL but it is not oxidized, then you have less cardiovascular risk than someone with not as much LDL but much of it is oxidized. LDL can become oxidized through a poor diet, a diet rich in meats, pollutants, stress, and many other ways. Most physicians just check for LDL but not oxidized LDL or for particle size (small and dense being bad). New research shows that an apple a day can lower levels of oxidized LDL even more so than a supplement containing polyphenols. This study was funded by the apple industry, so we don't know how other fruits and vegetables would fare. It certainly wouldn't hurt to include organic apples in your diet on a regular basis when they're in season. 

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Diet is Important Even If You're on Medication

A large study with over 30,000 participants already suffering from cardiovascular disease and published in the journal Circulation showed that a good diet can improve outcomes. This large study was conducted in 12 different countries on people who were appropriately medicated for their condition. The researchers found that those who adhered more closely to a Mediterranean diet: high intake of fruits and vegetables, whole grains, nuts, and fish, low amounts of meat and eggs, reduced the relative risk of cardiovascular death by 35%, myocardial infarction by 14%, stroke by 19%, and congestive heart failure (CHF) by 28% compared to those eating the poorest diet. 

The bottom line is that it never hurts to eat right, even if you're on medication. The medication does not allow you to eat poorly. Some people think they can have a meal rich in butter and red meat because they're on statins anyway. This is not the case.

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Multivitamins and Cancer in Men

The October issue of the Journal of the American Medical Association had the results of a very large prospective randomized placebo-controlled study on the effects of multi-vitamins on men. The study was part of the the Physician's Health Study II, that included 14,641 male US physicians who were 50 years or older when the study began. The multi-vitamin that was used was Centrum Silver. At least they were all using the same multi-vitamin and were not relying on people simple stating in a questionnaire that they use a multi-vitamin. Centrum Silver is not the cadillac of multi-vitamins, so it would be interesting to see a comparison with a better multi-vitamin. But we know that's expensive and not likely to happen! The upshot of this aspect of the study was that those taking the multi-vitamin were less likely to get cancer. After 11 years there was an 8% reduction in total cancer. Prostate cancer was not affected at all, so if that is pulled out, there was a 12% reduction in cancer overall. Since this study was done on physicians who should know how to eat a good diet, the effect could be even stronger on groups of people who don't eat as well. 

Previous studies have shown mixed results with multi-vitamins. It is always important to know how the study was conducted to know if the results are at all meaningful. 

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Exercise and Parkinson's Disease

A prospective study with 67 Parkinson's Disease patients was published in the Archives of Neurology November 5, 2012. The patients, who all had gait and balance issues, were assigned to one of three supervised exercise groups 3 times per week for 3 months: (1) Higher-intensity treadmill for 30 minutes at 70-80% heart rate reserve, (2) Lower-intensity treadmill exercise (50 minutes at 40-50% heart rate reserve), and (3) Lower extremity stretching and strengthening (leg press, leg extension, leg curl). After 3 months they were evaluated by seeing how fat they could walk in 6 minutes compared to before the exercise intervention. Surprisingly, the group that did the best was group (2), the low intensity, 50 minute group. The researchers speculate that the longer duration probably had a beneficial effect. All three groups, however, did improve in the 6 minute walk, just not as dramatically. Only the stretch/resistance group improved in muscle strength. This study adds to a body of research showing that exercise is beneficial for people with Parkinson's Disease. 

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Psoriasis and Autoimmune Diseases

The November 2012 edition of the Journal of the American Academy of Dermatology found that people with psoriasis are 50% more likely to have another autoimmune disease, such as rheumatoid arthritis, multiple sclerosis, Hashimoto disease, Graves disease, systemic lupus erythematosis, Sjogren syndrome, Crohn's disease, and others. The current study also included two research letters. One stated that a chart review of 76 patients with psoriasis revealed 42% of them had a first degree relative with an autoimmune disease. The other research letter concluded that "the association among psoriasis and [celiac disease], and [inflammatory bowel disease] appears to be well described." Functional Medicine lends itself to treating autoimmune diseases by looking for triggers and mediators of these diseases that may have a genetic predisposition. Triggers can be food sensitivities, such as a gluten or a dairy intolerance, but is not limited to those. Other issues could be an impaired biotransformation system (colloquially known as "detox" system). 
I would recommend that anyone with an autoimmune disease look for a Functional Medicine doctor, as well as check out this website: http://www.terrywahls.com

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