Friday, January 9, 2015

Live Long and Prosper Newsletter December 2014

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.

1.   Body-mass index and mortality among adults with incident type 2 diabetes.
   This study refutes the so-called "obesity paradox" for diabetics. A previous study suggested that for diabetics, it is healthier be overweight or obese. This study found that the optimal BMI for diabetics is in the upper limit of the "normal weight" bracket (BMI 22.5 to 24.9). Stay tuned for round 2, fans of diabetes-obesity controversy!
February 5, 2014

2.   Processing of meats and cardiovascular risk: time to focus on preservatives.
   Processed meats are strongly associated with heart disease and cancer. Most of the harm is due to extra sodium causing higher blood pressure. Unprocessed meats (all types considered together) have no such association. Fish, nuts, legumes, and vegetables are associated with lowered rate of heart disease.
February 5, 2014

3.   Dietary patterns and total mortality in a Mediterranean cohort: the SUN project.
   Bor-ing. Another study looked at Mediterranean Diet (in Mediterraneans of all people). Those who ate it had close to half the death rate relative to those who did not.
February 11, 2014

1.   Intake of Long-Chain ω-3 Fatty Acids From Diet and Supplements in Relation to Mortality.
   Should I take omega-3 supplements like fish oil? This is a question I hear a lot. This smaller study finds that those who consumed the most DHA and/or EPA (the 2 key essential omega-3 fatty acids), had an 18% reduction in overall mortality. The effect on cancer reduction (23%) was greater than the possible benefit for heart disease. Of course, in correlation-finding studies like this you cannot be sure the correlation implies causation! So here is some evidence that you want to at least be the kind of person who would consume more omega-3s.
February 6, 2014

2.   Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials.
   For people with known coronary heart disease, do programs to modify lifestyle help? Yes! "Lifestyle modification programmes were associated with reduced all-cause mortality". Reduction was 34%.
February 14, 2014

3.   Do all health care professionals have a responsibility to prescribe and promote regular physical activity: or let us carry on doing nothing.
   The title says it all. This I believe is the direction we are headed with promotion of physical activity. In the near future, a sedentary lifestyle will be widely recognized to be almost as harmful as smoking.
February 20, 2014

1.   Dietary fiber intake and risk of type 2 diabetes: a dose–response analysis of prospective studies
   This is interesting. So the theory is that our highly refined, low-fiber American diet causes diabetes. The authors looked at all high quality studies to date on fiber and diabetes. Sure enough they found all types of fiber reduce diabetes significantly, like 20%. But interesting when they looked at the 5 studies that provided dosing data. They found that as your fiber intake goes from 0gm per day to about 20gm/day, we see not much reduction in diabetes. But as people's intake increases from about 20gm/day to 40gm/day, there is a steep reduction. So my takehome lesson is when we say fiber is important to help prevent diabetes, we mean you need to eat a lot of fiber. Shoot for 40 grams per day or more.
January 4, 2014

2.   Role of Bariatric Surgery in Diabetes
   Bariatric surgery (gastric banding, gastric bypass) may be our most effective treatment for diabetes. Studies have found that in 57% to 95% of cases, diabetes will reverse with such surgery. We have no nonsurgical treatment that is remotely as effective.
January 9, 2014

3.   Dairy products on metabolic health: Current research and clinical implications.
   Here is a study favorable toward dairy. They cite some evidence that dairy might reduce tendency to diabetes, obesity, or the metabolic syndrome which usually precedes diabetes. There is some research on each side of the issue, and it is not conclusive. But chalk 1 up in favor of dairy.
January 22, 2014

1.   Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary
   This trial found that top consumers of lowfat yogurt had 28% lower rate of diabetes compared with lowest consumers of lowfat dairy. Not clear what those who did not eat lowfat yogurt were eating instead. That's the key question.
February 7, 2014

2.   Adherence to the WCRF/AICR cancer prevention recommendations and cancer-specific mortality: results from the Vitamins and Lifestyle (VITAL) Study.
   6 major recommendations to prevent cancer were put to a 7 year test. The results? "Cancer-specific mortality was 61 % lower in respondents who met at least five recommendations compared to those who met none... Cancer-specific mortality was 10 % lower on an average with each additional recommendation met". What are the recommendations that might cut your risk of cancer by over half? (1) Stay as lean as possible without becoming underweight. (2) Be active for at least 30 minutes a day. (3) Limit consumption of calorie-dense foods and avoid sugary drinks. (4) Eat a plant-based diet that includes a variety of vegetables, fruits, whole grains and beans. (5) Limit intake of red meat (beef, pork, lamb) and avoid processed meat (ham, cold cuts, bacon, sausage). (6) If you consume alcohol, limit yourself to one drink/day for women, two drinks/day for men. Which of these had the biggest effect? #4, with an 18% reduction in cancer mortality risk.
February 24, 2014

3.   Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study.
   What's better - exercise or drugs? This study looked at the available evidence, and concluded that "exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes". In other words, exercise is about the same as effective as drugs for the diseases listed. And yes, typically the benefits are additive when you combine them both.
February 25, 2014

Thursday, January 1, 2015

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