A recent study published in the journal Diabetes Care has found that low doses of the omega-3 fatty acids eicosapentaenoic acid (EPA), docosaheaxaenoic acid (DHA), and alpha-linolenic acid (ALA) reduced the risk of heart arrhythmia-related events in diabetic patients who had previously suffered a heart attack.

1,014 diabetic patients, aged 60 to 80 years old, were randomized into four groups and consumed margarine that contained either 223 mg EPA and 149 mg DHA, 1.9 g ALA, both EPA/DHA and ALA, or no omega-3 fatty acids every day for 40 months. The group that consumed the margarine with EPA/DHA and ALA experienced an 84 percent lower risk of arrhythmia-related events and a 72 percent lower risk of arrhythmia-related events and fatal coronary events when compared to the group consuming the plain margarine. Heart arrhythmia is an irregular heartbeat, and can lead to cardiac arrest.

The authors of the study suggest a few possible reasons why these omega-3s might be helpful in diabetics with heart disease. One, they might play a role in regulating insulin sensitivity, an important factor in diabetes. Two, they may help to lower blood sugar levels. And three, their anti-inflammatory properties may help to reverse insulin resistance. All these factors can lead to heart disease if unaddressed.

More studies will be done to determine the precise role each omega-3 plays in heart arrhythmia and heart disease, but this study adds to the thousands of studies illustrating the heart-healthy benefits of omega-3 oils.

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A recent study published in the Journal of the American Dietetic Association found a three-fold increase in the metabolic syndrome in children eating the least amount of dietary fiber when compared to the group eating the most. There were no differences when consumption of saturated fat or cholesterol was analyzed however.

The researchers recommend focusing on increasing fiber in the diet, and not worrying so much about finding low-fat foods. That does not mean teens should fill their diets with fat-filled foods, but it does mean seeking out nutrient-dense foods high in fiber.

This makes sense to me. Most low-fat foods today are those processed foods that have been filled with sugar to make up for lack of taste that comes with low-fat options. Replacing fat with sugar in foods is what has contributed to the current obesity and diabetes epidemic this country now faces. Up to 30 percent of teen’s dietary intake comes from beverages and sugary snacks. This has to change.

But change can be tough. Joseph Carlson, the lead researcher, stated, “The trick is getting people into the groove finding the foods that they enjoy and that are convenient.”

The statistics are screaming at us from many different sources. Our diets and lifestyle have to change in order for us to see significant health improvements. This begins in childhood. I recommend that adults consume at least 35 grams of fiber daily. For children and teens, I recommend adding 5 grams to their age. So a 13 year old should eat 18 grams of fiber daily. How can you add fiber back into your diet, and the diet of your family?

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Every year, the United Health Foundation publishes its state health rankings, a report of data collected on 23 measures of health compiled by different federal agencies. The rankings take into account behavioral, socioeconomic, and other factors that predict good health of a state, like rates of binge drinking, smoking and obesity, and factors like air pollution, violent crime, childhood poverty, and low rates of health insurance.

Between 1990 and 2000, health measures improved, but over the last decade that improvement slowed. In 2011 there was no improvement. The poor economy has been blamed, a factor that may influence poor health habits. Overall the report finds that 27.5 percent of the population is obese, 17.3 percent smoke cigarettes, and 8.7 percent have diabetes, all preventable contributors to poor health.

The five most unhealthy states:

50. Mississippi

49. Louisiana

48. Oklahoma

47. Arkansas

46. Alabama

The five healthiest states:

1. Vermont

2. New Hampshire

3. Connecticut

4. Hawaii

5. Massachusetts

For the full report, click here.

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar.  Join us! 

The new MyPlate icon that represents the new U.S. Dietary Guidelines is a step in the right direction as far as food recommending goes, but it still falls short of what I call—and what many people call—healthy eating.

A recent study has found that Americans only achieve at least 70 percent of the guideline recommendations seven days each year. So if Americans are not even able to meet these guidelines, how difficult will it be to make even greater improvements in diet? Clearly, something has got to change.

A recent editorial in the New England Journal of Medicine criticizes the new MyPlate Guidelines, saying that the food industry greatly influenced the new recommendations. The editorial, which came from two Harvard public health professors, questioned the allowance for up to half of grains to come from refined grains. Refined grains are a big part of why over two-thirds of this country is overweight or obese, and why so many people have diabetes and heart disease. Refined grains should be eliminated completely, in my opinion.

Other recommendations were not made as clearly as they could have in the new MyPlate recommendations. The editorial stated, “A clearer message would have been that Americans must reduce consumption of red meat, cheese, butter, and sugar, but that message would have offended powerful industries.”

This week, when planning your meals, fill your plate with plenty of vegetables, lean proteins, and healthy fats. Snack on fruits like berries. Consume whole grains, as well, but don’t make them the focus of your meals. And get the sugar out of your diet—it really doesn’t belong there.

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The benefits of omega-3 oils from fish were first noticed in Inuit populations of Greenland. Researchers noticed that these people consumed high amounts of fat, yet did not develop heart disease or experience heart attacks like people in the Western world. Thus began studies of the Inuit diet in which beneficial omega-3 fatty acids from fish—EPA and DHA—were found to be the heart-protective components.

Many thousands of studies later, the benefits of omega-3 fish oil are still being found in many different areas of health. In a new study of Yup’ik Eskimos in Alaska, researchers evaluated the effects of a high-fat fish-based diet on disease markers in obese Eskimos. The rate of obesity in these people is similar to that in the lower US—the difference is the source of dietary fat. In the US, saturated and trans fats are high in the diet, and healthy polyunsaturated fats, like omega-3s, are low.  

In obese Yup’ik Eskimos with the highest blood levels of EPA and DHA, blood triglyceride and C-reactive protein (a measure of overall inflammation) were the same as normal weight people. In those Eskimos with the lowest EPA and DHA levels, however, blood triglyceride and CRP levels were high. High triglycerides and CRP levels are risk factors for the development of cardiovascular disease and possibly diabetes.

Results of this study suggest that omega-3 fatty acids EPA and DHA found in fish may have health protecting effects even in obese people. More studies are needed to confirm these results, but this study is promising.

Now, don’t get carried away and think you can eat all the fatty foods you want and just pop a fish oil supplement. Instead choose healthy fats as part of your diet with plenty of fish on the menu, and supplement that with omega-3s from fish oil to be sure you’re getting enough of these great fats. Just be sure to look for a fish oil that meets International Fish Oil Standards (IFOS—look for the IFOS seal on the bottle).

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Would you be surprised to know that eating a high-fat meal and/or high-sugar meal causes your arteries to not work in a normal manner? Let’s say we start the day with either coffee with cream/sugar and donuts, or same coffee/sugar with eggs and toast with butter/jam. And then for lunch or supper, we eat meals with high-fat meat, bread and butter, a baked potato with sour cream and butter along with an alcoholic drink (or even ice tea with sugar). Then we finish the meal with a nice dessert.

Each of these meals can cause your arteries not to function properly by the end of the meal which could last for several hours!¹ If you tend to eat this way, most of the day your arteries are constricted and not dilating normally in response to routine activities. The result, at the very least, is high blood pressure. This problem can be eliminated simply by cutting out the excess saturated fat and sugar, and adding probiotics or cultured foods high in bifidobacteria, in addition to eating plenty of vegetables throughout the day.

The above illustration of the diet-artery connection illustrates just one of the many ways to create a problem known as endothelial dysfunction, a condition that occurs when the cells lining the arteries, veins, and lymphatics don’t work properly.² There are a multitude of ways to cause the vessels to not dilate or constrict normally, and to cause the lining to leak (let’s call it leaky vessel syndrome). Endothelial dysfunction is a precursor to atherosclerosis.³ Here is a short list of endothelial dysfunction triggers:

1. Smoking, polluted air,⁴ food, and water⁵ – All of these create excess free radicals which are a major cause of endothelial dysfunction.

2. High blood sugar and/or high insulin levels – High blood sugar results in glycosylation (think of it like a sticky sugar coating) of the insulin receptor substrate, which eventually leads to an inability of protein kinase B (Akt) to increase endothelial nitric oxide synthase (eNOS) enzyme activity, resulting in low nitric oxide (NO) and poor blood vessel function.⁶

3. Microbes (bacteria, viruses, fungi and parasites), parts of microbes, and toxins made by microbes migrating from inside the intestinal lumen into the arterial, venous and lymphatic circulation – Microbes and their toxins activate white blood cells and they release bullets (anti-microbial peptides) named alpha-defensins that not only damage the microbes but the endothelial lining as well.

4. Stress – Stress increases cortisol, which can elevate blood sugar and insulin, again sugar coating receptors to result in low NO, and thus, endothelial dysfunction.

5 Aging – Aging decreases stem cells that help with repair processes, increases blood cortisol levels (see number 4), and decreases bifidobacteria levels in the colon. All of this leads to endothelial dysfunction.

6. Increased body fat, especially in abdomen – Even a modest gain of about 8 pounds (which can happen over a vacation) will cause endothelial dysfunction. “In normal-weight healthy young subjects, modest fat gain results in impaired endothelial function, even in the absence of changes in blood pressure. Endothelial function recovers after weight loss. Increased visceral (belly) rather than subcutaneous fat predicts endothelial dysfunction.”⁴

One of the mechanisms by which fat hurts the arteries is by releasing a cytokine known as resistin. Resistin has been shown to cause oxidative stress and decrease endothelial nitric oxide synthetase (eNOS) which is essential for nitric oxide (NO) production, itself essential for arterial health and function.

7. Physical inactivity – Merely by doing nothing, the process of ongoing free radical activity due to diet, stress and environment, will decrease nitric oxide (our natural vasodilator), superoxide dismutase (our own natural anti-oxidant) and citrate synthetase (the enzyme in our mitochondria involved energy production—essential to a healthy heart / blood vessel function). These natural sources of blood vessel protection return merely by walking briskly on a regular basis.⁵

8. Diabetes types 1 and 2 – Again, elevated blood sugar and either high or low insulin levels, as are seen in diabetes, will lead to endothelial dysfunction as described above.

9. Drugs which elevate or lower blood sugar and insulin – Many diabetic drugs can cause endothelial dysfunction by not maintaining steady levels of blood sugar and insulin. Insulin itself is one of the worst offenders.

10. Even children receiving second-hand smoke in a household with smokers, begin developing endothelial dysfunction at an early age.

References

1. Rudolph TK, et al., “Acute effects of various fast-food meals on vascular function and cardiovascular disease risk markers: The Hamburg Burger Trial.” Am J Clin Nutr. 2007 Aug;86(2):334-40.
2. Endemann DH and Schiffrin EL, “Endothelial dysfunction.” J Am Soc Nephrol. 2004 Aug;15(8):1983-92.
3. Davignon J and Ganz P, Role of endothelial dysfunction in atherosclerosis.” Circulation. 2004 Jun 15;109(23 Suppl 1):III27-32.
4. Romero-Corral A, et al., “Modest visceral fat gain causes endothelial dysfunction in healthy humans.” J Am Coll Cardiol. 2010 Aug 17;56(8):662-6.
5. Suvorava T et al., “Physical activity causes endothelial dysfunction in healthy young mice.” J Am Coll Cardiol. 2004 Sep 15;44(6):1320-7.
6. Wautier JL and Schmidt AM, “Protein glycation: a firm link to endothelial dysfunction.” Circ Res. 2004 Aug 6;95(3):233-8.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar.  Join us! 

Eating processed and red meat regularly may increase your risk of developing type 2 diabetes. Researchers from Harvard School of Public Health recently analyzed data from studies involving a total of over 440,000 people over 10 years. Over six percent, or about 28,000, of those people developed type 2 diabetes during the ten-year time span. After taking into consideration other factors like weight, physical activity level, smoking and family history diabetes, researchers discovered the following dietary links to diabetes:

Eating two ounces of processed meat per day (hot dog, bacon, salami or bologna) increased the risk of diabetes by 50%.

Eating four ounces of unprocessed red meat per day (hamburger, steak, pork or lamb) was associated with a 20% increased risk of diabetes.

And the good news…

Substituting nuts, whole grains and low-fat dairy (like yogurt) for these meats decreased the risk of developing type 2 diabetes by 16 to 35%.

The researchers attribute the high amount of salt, nitrites and nitrates in processed meats as possible reasons for the increased risk; and high amounts of iron may be the culprit in red meats. Further, people eating high amounts of processed and red meats may not be eating enough nuts, beans and fish, stated Vivian Fonesca of the American Diabetes Association, in response to these studies.

This week, take a look at your meat intake. If you are eating processed meats try to cut back and replace these with healthier foods. One alternative might be nitrate- and nitrite-free meats like bacon and lunchmeats.  These options still pack a lot of salt, however, so don’t be too liberal with this substitution. Opt for nuts and whole grains instead. As for red meats, cut them back as much as possible. Higher red meat consumption is also associated with colon cancer risk, so it’s best to minimize this food. Further, meats like beef and pork require high-input agriculture. That means they require a lot more water and cropland to produce, especially when compared to a more plant-based diet.

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The Standard American Diet (aptly named SAD), also known as the Western diet, is full of processed and fried foods, refined carbohydrates and sugars, and saturated and trans fats. It is low in fiber, fruits and vegetables, whole grains, lean proteins and beneficial fats (like omega-3s).

This diet has been blamed (and rightfully so) for so many different health conditions, most notably, heart disease and diabetes. But cheer up! A change in diet and increase in exercise can reverse both these conditions. 

Another recent study links another condition to SAD. Attention-deficit hyperactivity disorder (ADHC, or as it used to be known ADD) is one of the most common childhood disorders, and may continue into adulthood. It involves difficulty staying focused, difficulty controlling behavior and hyperactivity. In adolescents, consumption of a Standard American Diet was found to more than double the risk of being diagnosed with ADHD when compared to a diet low in the foods found in the SAD diet.

The suggested reasons for this difference were:

• SAD diet has a less optimal fatty acid profile (too much omega-6 and not enough omega-3)
• SAD diet may not provide essential micronutrients needed for brain function
• SAD diet contains more artificial colors, flavors and additives linked to ADHD symptoms

More studies need to be done to figure out which came first, but I simply can’t wait that long to get the word out about how detrimental the SAD diet is to our children’s health. I know that children and adolescents are picky eaters, but it is essential that they get all the nutrients they need for the best start in life – one that will carry them through the years. The earlier they begin eating well, the more likely they will eat that way for life.

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A very interesting study was just published in the journal Archives of Internal Medicine documenting the association between high dietary fiber intake and lower risk of dying from some of the most common killers—heart disease, cancer, and diabetes. This was a huge study with over 388,000 participants aged 50 to 71.

The nine-year study looked at dietary fiber intake and found men’s intake ranged from 13 to 29 grams per day, and women’s fiber intake from 11 to 26 grams per day. Over a nine-year period, those who had the highest intake of fiber (29.4 grams in men and 25.8 grams in women) had a 22 percent lower risk of dying from certain diseases than those participants who consumed the lowest levels of fiber. Subjects with the highest daily intake of fiber were at lower risk of dying from cardiovascular disease and infectious and respiratory disease compared with the lower fiber intake group.

Researchers noted that fiber “has been hypothesized to lower the risk of coronary heart disease, diabetes, some cancers, obesity, and premature death because it is known to:

• Improve laxation by increasing bulk and reducing transit time of feces through the bowel;
• Increase excretion of bile acid, estrogen, and fecal procarcinogens and carcinogens by binding to them;
• Lower serum cholesterol levels;
• Slow glucose absorption and improve insulin sensitivity;
• Lower blood pressure;
• Promote weight loss;
• Inhibit lipid peroxidation; and
• Have anti-inflammatory properties.”

I recommend at least 35 grams of fiber daily for those very reasons noted above. High daily intake of fiber has so many health benefits. Unfortunately, however, the average American only consumes between 10 and 15 grams daily— and that’s not nearly enough.

It can be difficult to obtain 35 grams of fiber from the diet, so fiber supplements are a great way to increase fiber intake. In addition, consuming plenty of whole grains, fruits and vegetables (and fewer bad fats, refined grains and sugars) will help to boost your daily fiber intake.

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For over 60 years now, it has been recommended that baby’s first food be white rice cereal mixed with either breast milk or regular milk. Rice is known for being well-tolerated by babies’ sensitive digestive tracts due to its low allergen status.  Recommending white rice as baby’s first food is coming under scrutiny, however, and I agree.

White rice is a highly refined product. In processing, it is stripped of fiber, vitamins and other beneficial nutrients.  What’s left is little more than a simple carbohydrate—the very food that leads to the development of obesity, diabetes and cardiovascular disease. The risk of these diseases seems far off when we are talking about infants, but experts believe that starting off a baby’s diet with white rice cereal may be setting the stage for unhealthy eating habits to come.

So this week’s challenge is to substitute brown rice cereal for white rice cereal in the diet of a baby you know. This simple substitution could be the beginning of better dietary choices later in life.

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