Rethinking Fat in the Diet

With all the hype surrounding statin medications this past week (see http://www.nytimes.com/2012/03/05/opinion/the-diabetes-dilemma-for-statin-users.html), it’s a perfect opportunity to take a step back and discuss some basic diet fundamentals.  For the past 40 or more years, the “benefits” of low-fat diets have been ingrained in our consciousness, and advocated by a majority of the medical community.  The thinking behind this was simple: high fat in the diet must lead to a buildup of fat and plaque in the arteries, so the less fat you eat, the better.  In recent years, research evidence has overwhelmingly refuted this concept, yet it continues to be the mainstream recommendation for preventing heart disease.  Even the “Dairy” section in the USDA’s “My Plate” emphasizes low or non-fat sources of dairy.

A scientific analysis of 21 earlier studies showed “no significant evidence” that saturated fat in the diet is associated with an increased risk of coronary heart disease.  In fact, the dietary evidence collected from these thousands of participants found no difference in the risk of coronary heart disease, stroke, or coronary vascular disease between those individuals with the lowest and highest intakes of saturated fat.  The bigger issue appears to be the added amounts of sweeteners and carbohydrates that people are eating instead of fats.  More and more evidence is suggesting that it’s this continuous increase in carbohydrate consumption that is truly responsible for an increased risk in diabetes and coronary artery disease.

I think the main take-away message from this information is that you don’t have to be afraid of good quality sources of saturated fat.  We’ve been so trained to be suspicious of it for so long that it becomes difficult to change our perception of how healthy it can be.  Now, does this mean you should be eating nothing but cheese, bacon, and beef for the rest of your life?  Of course not!  If you’re already consuming low-fat sources of dairy (skim milk, low-fat yogurt, etc.), switch to organic whole milk sources, and use butter instead of margarine or other processed forms of fat.  In general, try to limit your saturated fat intake to 10% of your total diet, while discontinuing the consumption of hydrogenated oils, artificial sweeteners, and high-glycemic carbohydrates.  By doing this, and continuing to emphasize fruits and vegetables as a mainstay, you’ll be much better off in the long run!

ADHD and Essential Fatty Acids

In an observational study involving 810 children between the ages of 5 and 12 years of age who were referred for medical advice for “attention deficit hyperactivity disorder” (ADHD), supplementation with a combination of omega-3 and omega-6 fatty acids in combination with zinc and magnesium for a period of 3 months was found to be reduce symptoms of ADHD, as assessed via the SNAP-IV, reduce emotional problems, and reduce problems falling asleep. The authors conclude, “…considering the behavioural benefit in combination with the low risk due to a good safety profile, the dietary supplementation with PUFA in combination with zinc and magnesium can be recommended,” to children labeled as having “ADHD.”

With ADHD, there are also more extensive testing options available to assess nutritional and neurotransmitter status, allowing for more specific treatment options, and ultimately not having to depend on pharmaceutical interventions. The bottom line is that many “alternative” treatment options have been proven effective in the management of ADHD, and that medications aren’t the only option out there.

Pregnant Moms and Genes

This is a great article discussing how chronic stress during pregnancy can cause behavioral problems in children, especially because of epigenetics, or how the child’s genes influence their stress response:

http://www.economist.com/node/18985981

Work Causes Heart Disease

People who regularly work long hours may be significantly increasing their risk of developing heart disease, the world’s biggest killer, British scientists said Monday.

Researchers said a long-term study showed that working more than 11 hours a day increased the risk of heart disease by 67 percent, compared with working a standard 7 to 8 hours a day.

They said the findings suggest that information on working hours — used alongside other factors like blood pressure, diabetes and smoking habits — could help doctors work out a patient’s risk of heart disease.

However, they also said it was not yet clear whether long working hours themselves contribute to heart disease risk, or whether they act as a “marker” of other factors that can harm heart health — like unhealthy eating habits, a lack of exercise or depression.

The study, published in the Annals of Internal Medicine journal, followed nearly 7,100 British workers for 11 years.

“Working long days is associated with a remarkable increase in risk of heart disease,” said Mika Kivimaki of Britain’s University College London, who led the research. He said it may be a “wake-up call for people who overwork themselves.”

Cardiovascular diseases such as heart attacks and strokes are the world’s largest killers, claiming around 17.1 million lives a year, according to the World Health Organization (WHO). Billions of dollars are spent every year on medical devices and drugs to treat them.

The findings of this study support previous research showing a link between working hours and heart disease.

For this study, men and women who worked full time and had no heart disease were selected, giving 7,095 participants.

The researchers collected data on heart risk factors like age, blood pressure, cholesterol, smoking and diabetes and also asked participants how many hours they worked — including work during the day and work brought home — on an average weekday.

During the 11-year study, 192 participants had heart attacks. Those who worked 11 hours or more a day were 67 percent more likely to have a heart attack than those with fewer hours.

Of course, heart disease is a multi-factorial issue, but those working more than 11 hours per day need to take even further precautions to lower their heart disease risk. Talk to your naturopathic doctor about laboratory studies that can help to identify numerous cardiovascular risk factors, so the proper steps can be taken to help prevent heart disease and stroke in the future. 

PMS and Essential Fatty Acids

Yet another case of naturopathic medicine being way ahead of the curve when it comes to using treatments for years before they’re eventually “proven” effective. 
Up to 95% of women suffer from at least one PMS symptom, and more than a third of these women have PMS severe enough to interrupt their routine activities. Fortunately, a new study may offer a way for women to get some much-needed relief from monthly bouts of PMS.
PUFA vs. PMS
The exact causes of PMS aren’t known, but health experts suspect that certain essential dietary fats, called polyunsaturated fatty acids, or PUFAs, may play a role. Not getting enough of and the right types of PUFAs may worsen PMS symptoms.
Researchers set out to test this theory by enrolling 120 women into a six-month study. The study authors randomly selected the women to receive a daily 1- or 2-gram PUFA supplement, or a placebo (no fatty acids).
Blood levels of cholesterol and prolactin, a hormone produced in the body that may affect PMS, were tested before and after the study. The women kept symptom diaries to track the details and severity of their PMS from month to month.
After 6 months, the researchers found that compared with the initial PMS ratings:

• Women taking the PUFA supplements had significant decreases in PMS symptoms at three and six months.

• Women taking 2 grams of PUFAs, the highest amount given, experienced the largest decrease in PMS symptoms over time.

• Women taking the placebo h
ad a small decrease in PMS symptoms at three months, but no improvement of symptoms at six months.

None of the women in the study experienced significant changes in blood levels of cholesterol or prolactin. This suggests PUFA supplements do not raise cholesterol in otherwise healthy women experiencing PMS, nor exert their anti-PMS effects through changes in prolactin levels.

Getting your essential PUFAs

If you are interested in trying a PUFA supplement, keep the following tips in mind:

• Talk to your doctor about whether PUFA supplements are right for you. Dietary supplements can interfere with medications, so err on the side of caution when adding new supplements to your self-care routine.

• The 2-gram PUFA supplements used in the study provided 420 mg of gamma linolenic acid, 350 mg of oleic acid, 690 mg of linoleic acid, 500 mg of other PUFAs, and 40 mg of vitamin E. Ask your doctor or dietitian to help you find a supplement with a similar mix of PUFAs.

• You can get more PUFAs from the food you eat as well. Try walnuts and other nuts and seeds, ground flaxseed, green leafy vegetables, tofu and other soy foods, and fatty fish, such as wild-caught salmon.

• Other lifestyle changes that may help ease PMS symptoms include getting enough sleep (seven to eight hours), exercising regularly, limiting intake of caffeine, alcohol, and sweets, and eating a healthy diet based around vegetables, fruit, whole grains, and legumes.

(Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study. Accessed January 20, 2011; Available at: NewsRelease_Essential_oil pill_prevents_PMS.pdf)

More Evidence That Olive Oil and Veggies Lower Heart Disease Risk

It’s no secret that eating well is good for both body and mind, so it may not come as a surprise that a new study finds women who eat more olive oil and leafy vegetables such as salads and cooked spinach are significantly less likely to develop heart disease.

A group of Italian researchers found that women who ate at least 1 serving of leafy vegetables per day were more than 40 percent less likely to develop heart disease over an average of eight years, relative to women who ate two or fewer portions of those vegetables each week.

Women who downed at least 3 tablespoons of olive oil daily – such as in salad dressing – were also 40 percent less likely to be diagnosed with heart disease, compared to women who ate the least olive oil.

It’s not exactly clear why specifically leafy vegetables and olive oil may protect the heart, study author Dr. Domenico Palli of the Cancer Research and Prevention Institute in Florence told Reuters Health. “Probably the mechanisms responsible for the protective effect of plant-origin foods on cardiovascular diseases involve micronutrients such as folate, antioxidant vitamins and potassium, all present in green leafy vegetables.”

Folate reduces blood levels of homocysteine, Palli explained, which is thought to increase the risk of cardiovascular disease by damaging the inner lining of arteries. Other studies have shown people who eat more potassium have lower blood pressure, which can protect the cardiovascular system. Virgin olive oil may be particularly effective at lowering heart disease risk because of its high level of antioxidant plant compounds, he added.

This is not the first study to link olive oil or vegetables to good heart health. Most famously, the traditional Mediterranean diet — rich in vegetables and monounsaturated fats from olive oil and nuts, but low in saturated fat from meat and dairy — has been tied to a decreased risk of heart disease.

Mediterranean-style eating has also been credited with lowering risk for some cancers, diabetes, and, more recently, with slowing brain aging.

Cardiovascular disease is a major killer, responsible for 30 percent of all deaths worldwide and the leading cause of death for both men and women in the U.S.

To look more closely at the role of foods in protecting against heart disease, Palli and colleagues reviewed dietary information collected from nearly 30,000 Italian women participating in a large national health study. Researchers followed the women, whose mean age was 50 at the beginning of the study, for an average of 8 years, noting who developed heart disease.

In that time, the women experienced 144 major heart disease-related events, such as heart attack or bypass surgery, the authors report in the American Journal of Clinical Nutrition.

Women who ate at least one daily serving (about two ounces) of leafy vegetables – such as raw lettuce or endives, or cooked vegetables like spinach or chard — had a 46 percent lower risk of developing heart disease than women who ate at most two portions per week.

Consuming at least an ounce of olive oil per day lowered their risk by 44 percent relative to women who consumed a half-ounce or less daily, the authors found.

The women’s intake of other types of vegetables, such as roots and cabbages, and their consumption of tomatoes or fruit did not seem to be linked to their risk for major heart events.

When visiting your Naturopathic physician, make sure you request homocysteine, cardio-CRP, and fractionated lipid levels, to make sure a thorough evaluation of your cardiovascular health is being performed. You can then use these levels to track your progress, especially if you’re just transitioning to a Mediterranean-style diet. 

Gluten and the Nervous System

This is something my colleagues and I have been familiar with for quite some time, but a new report published in the Lancet Neurology demonstrates further proof that an intolerance to gluten containing foods can cause much more than just digestive symptoms.

Sensitivities beyond celiac

“Celiac disease is only one
aspect of a range of possible manifestations of gluten sensitivity. In
some individuals, gluten sensitivity is shown to manifest solely with
neurological dysfunction,” the authors of the new report explain.

Neurological
disorders that might be tied to a gluten sensitivity include a lack of
muscle coordination leading to instability (ataxia), tingling and
numbness (neuropathies), and migraine-like headaches (encephalopathy).
The authors go on to say that the tests that help to establish a
diagnosis of celiac disease may not reliably show if a person has a
gluten sensitivity that affects only their nervous system. For this
reason, they suggest other tests that may help uncover a hidden gluten
sensitivity in people suffering from certain neurological disorders.

The
report’s authors recommend, “To improve diagnosis rates, the perception
of physicians that gluten sensitivity is solely a disease of the gut
must be changed.”

If you think you have a gluten sensitivity


Get medical support. Identifying and treating a gluten
sensitivity can help you avoid serious complications.

Be
proactive
. Ask your naturopathic doctor if he or she is familiar with the tests
that are useful for identifying different types of gluten sensitivities,
or if he or she can refer you to someone who is.

Pay
attention
. If you think your symptoms might be related to gluten,
consider a six-week gluten-free diet trial. If you’re going in for lab
work, though, eat your normal diet so your test will gauge your regular
reactions.

Living with a gluten sensitivity

Gluten
sensitivity is in the spotlight, so there’s never been an easier time to
go gluten-free. New food packaging requirements mandate that
gluten-free foods be accurately labeled, and gluten-free cookbooks
abound on bookstore shelves. Ask your grocer whether they can recommend
books, recipes, and other resources to help.

(Lancet Neurol
2010;9:318-30)

Weight Loss and Natural Medicine

Naturopathic Medicine can offer a number of options for helping people to lose weight. From hormonal imbalances to underlying food allergies, the causes of abnormal weight gain are varied, so it’s important to seek an individualized approach to losing weight. Consulting an experienced naturopath will help you identify obstacles to weight loss, allowing you to lose weight in a safe, medically supervised fashion. 

In the meantime, here are some general tips to help you lose or maintain your weight: 

Talk with a professional. Being overweight increases a person’s risk of a number of medical conditions such as type 2 diabetes, high blood pressure, and high cholesterol. If you are overweight, talk with a knowledgeable doctor to come up with a good program for you, and work with a nutritionist who can educate you about what to eat and help you stay motivated and on track for a healthy weight. As this study showed, people who attended more dietary counseling sessions lost greater amounts of weight than those who attended less.

Identify triggers that lead to cravings or overeating. It is important to ask yourself questions such as “Why do I choose foods that are not healthy for me?” and “What feelings or circumstances lead me to crave unhealthy foods or to overeat?” Answering such questions can help you learn how to manage the cravings and feelings that lead to overeating, and help you plan ahead with healthier alternatives in situations where you might normally make unhealthy choices.

Choose the right foods. You know the recommendations by now, but have you taken specific steps to improve your diet? The body needs an abundance of fruits and veggies–at least 5 servings every day–and a source of protein every day in order to optimize health and prevent disease. Eating foods high in sugar increases cravings, so reach for low-sugar, low-fat, nutrient-dense foods when eating regular meals and when snacking.

Plan ahead. Sit down and plan your meals for the week. Try grocery shopping on a Sunday in order to stock the refrigerator with healthy foods to get you through the week. Don’t bring high-sugar, high-fat foods into the house, which may increase the temptation for overeating, but keep looking for healthy foods that you really enjoy so you have options if a snack attack hits.

Exercise regularly. Guidelines recommend 60 minutes of exercise every day for healthy adults and 90 minutes for children. Exercise helps reduce cravings and overeating and also improves risk factors for chronic disease such as high blood pressure, glucose and cholesterol levels. If the optimal amount is too overwhelming either because of your schedule or fitness level, remember that everything helps. Get the all-clear from your doctor, and then start slowly and build over time. As your fitness improves, you will naturally enjoy longer exercise sessions, rather than slogging through. Exercise buddies and cross-training are also good tricks for keeping yourself going.