Not all vegan or plant-based diets are equally healthy

Vegan Diet Vegetables

By HENA PATEL and KIM ALLAN WILLIAMS, SR

 

Move over, low-fat diets. More and more experts are recommending plant-based diets to reduce the risk of heart disease and other chronic conditions such as diabetes and cancer.

But are all plant-based diets equally beneficial? And must they be all-or-none eating strategies, or is there a role for a semi-vegetarian or “flexitarian” approach?

The term plant-based diet often conjures up images of vegetarian or vegan fare. But it really means a diet that emphasizes foods from plants — vegetables, fruits, grains, nuts, seeds, and the like — not one that necessarily excludes non-plant foods.

The results of studies on the health effects of plant-based diets have varied widely, largely due to how these diets were defined. Some focused on vegetarian or vegan eating habits, others included some foods from animals. Notably, these studies tended to treat all plant foods equally, even though eating certain foods from plants, such as refined grains and sugar-sweetened beverages, is associated with a higher risk of developing diabetes or having a heart attack or stroke, while eating whole grains and produce are associated with lower risks.

That’s why we were so interested to see the results of a recently published study performed by researchers at the Harvard T.H. Chan School of Public Health. Led by Ambika Satija, the team catalogued the diets of nearly 210,000 nurses and other health professionals based on their answers to food frequency questionnaires every two years for an average of 23 years. From these data, the researchers defined three versions of a plant-based diet: an overall plant-based diet that emphasizes the consumption of all plant foods and reduced the intake of animal foods; a healthful plant-based diet that emphasizes the intake of healthy whole grains, fruits, and vegetables; and an unhealthful plant-based diet that emphasizes the intake of less-healthy plant foods, such as refined grains.

In addition to detailing their food choices, the study participants also recorded other lifestyle choices, health behaviors, and their medical histories.

Over the course of the study, 8,631 participants developed coronary heart disease, which the researchers defined as a nonfatal heart attack or dying of heart disease. Those who followed an overall plant-based diet were slightly less likely (an 8 percent reduction) to have developed coronary heart disease than those who didn’t.

But here’s where things get interesting. Those who followed a healthful plant-based diet had a substantial 25 percent lower risk of coronary heart disease, while those who followed an unhealthful plant-based diet had a substantial 32 percent increased risk.

This study is certainly not the last word on the subject. As an observational study, it can’t prove cause and effect like a randomized trial can. And the diet data came from self reports, which aren’t always accurate at measuring an individual’s diet. However, these diet assessments were validated against multiple-week diet records and biomarkers. Overall, this work adds to the substantial evidence that a predominately plant-based diet reduces the risk of developing heart disease.

It has two important take-home messages. One is that a plant-based diet is good for long-term health. The other is that not all plant-based diets are equally healthy. The kind that deserves to be highlighted in dietary recommendations is rich in fruits and vegetables, whole grains, and unsaturated fats, and contains minimal animal protein, refined carbohydrates, and harmful saturated and trans fats.

In practice, this translates into eating mostly vegetables, fruits, whole grains, legumes, and soy products in their natural forms; sufficient “good fats,” such as those in fish or flax seeds, nuts, and other seeds; very few simple and refined carbohydrates; and little or no red meat, poultry, fish, eggs, and dairy. It also means choosing quality over quantity.

Click here to read the rest of this article origially published in StatNews,com

 

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Food & Drug Administration Warns of Gastric Balloon Deaths

by Kristina Fiore

7 reports of death tied to gastric balloon obesity treatment since 2016

The FDA sent a letter to healthcare providers warning of reports of seven deaths with liquid-filled intragastric balloon systems used to treat obesity.

In five cases, the cause of death was unclear, but all occurred within a month or less of balloon placement, the agency said. In three of those cases, the patient died within one to three days of having the balloon inserted.

Four of these reports involved the Orbera Intragastric Balloon System from Apollo Endo Surgery, and one involved the ReShape Integrated Dual Balloon System by ReShape Medical.

The FDA noted that for these five cases it doesn’t know “the root cause” of the problem. It also can’t determine the incidence rate of patient death, nor could it “definitively attribute the deaths to the devices or the insertion procedures for these devices” — meaning they couldn’t tell if death was due to gastric or esophageal perforation, or to intestinal obstruction, or to some other cause.

Two additional reports of deaths in the same time period — since 2016 — were also noted in the FDA letter. One was related to gastric perforation with the Orbera Intragastric Balloon System and one to esophageal perforation with the ReShape device.

The FDA said it’s working with both companies to better understand what’s causing these issues, and to monitor potential complications of acute pancreatitis and spontaneous overinflation. It also emphasized that it had mandated ongoing post-approval studies for the devices.

Article originally appeared in MedPage Today

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Do you Really Need These Vitamin Supplements?

By  Dr. Manny

According to 2016 consumer survey data, 71% of U.S. adults take some type of dietary supplement. And the appeal of supplements is obvious. We know vitamins are necessary for health, so why not make sure we’re covering our bases?

The darker side of dietary supplements is that many of the alleged health benefits are coming straight from people who stand to make big money from vitamin sales, and the research doesn’t always agree with the claims of vitamin manufacturers and retailers.

Here’s a look at four vitamins you may want to think twice about taking.

1. Vitamin E

According to the National Institutes of Health, the recommended daily allowance (RDA) of vitamin E for adults is 15 mg (or 22.4 IU). RDAs are based on what will meet the nutritional needs of 97-98% of healthy people, but supplements are widely available from 200 to 1000 IU per pill. When it comes to vitamin E, the research is clear that you can have too much of a good thing. A large review of the research by John Hopkins University found that people who took more than 400 IU daily faced a 4-6% increased risk of death. Another large study found that, despite health claims to the contrary, vitamin E did not decrease prostate cancer risk in study participants. In fact, men who supplemented with vitamin E were slightly more likely to develop prostate cancer than men who didn’t use the supplement.

2. Vitamin C

Pricey vitamin C supplements marketed for the prevention and treatment of the common cold and the flu have popped up in every grocery store and drug store. They come as pills, lozenges, and powdered drinks and typically contain 500-1000mg of vitamin C, at least 5-10 times the RDA of vitamin C for adults. Some people use supplements daily to prevent colds, and others use high doses at the beginning of a cold to shorten its duration. But a review of the evidence shows that vitamin C only impacts the common cold in one way – if you’re already taking daily vitamin C, your colds may be a little bit shorter. Despite the claims of manufacturers, people who supplement daily don’t get fewer colds, and starting supplementation at the beginning of a cold doesn’t affect cold symptoms. If you choose to take a daily vitamin C supplement to shorten your colds, keep in mind that mega doses can contribute to kidney stones.

3. Vitamin A

Vitamin A can be toxic in large doses, causing symptoms like nausea, vomiting, and abdominal pain. Most cases of vitamin A toxicity occur in adults using mega doses of vitamins to treat illness or in children who accidentally ingest supplements, but researchers are now wondering if smaller supplemental doses of vitamin A can cause health problems too. The RDA for vitamin A for adults is 700-900 mcg, and an article published in The American Journal for Clinical Nutrition notes that just twice this amount has been connected to osteoporosis and hip fracture in people without other symptoms of toxicity.

4. Multivitamins

Seventy-five percent of Americans who take supplements take a multivitamin, making it the most popular dietary supplement in the US. Multivitamins are all different, but most contain a long list of vitamins and minerals, sometimes in amounts well over their recommended daily intakes. Over the last few years, study after study has challenged the alleged health benefits of multivitamins, but there have also been a few that show some health benefit. In a large study of older women, multivitamin use was associated with increased mortality. An eight-year study showed no protective effect against cardiovascular disease or mental decline but a slight protective effect against cataracts and cancer. And most recently, a 2016 study has contradicted previous research by showing a slight benefit for heart health. The research surrounding multivitamin supplements isn’t clear-cut, and it’s possible that not all adults benefit from them.

It’s important to consult with your doctor before taking a new supplement and to know that adding more fruits and vegetables to your diet is the most evidence-supported intervention you can make for your own health. Fruits and veggies can lower your risk of cardiovascular disease, cancer, diabetes, and high blood pressure without any dangerous side effects. And a cart full of produce is much more affordable than a cabinet full of supplements.

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Upping coffee consumption could help you live longer

A new study suggests that higher coffee consumption could reduce the risk of death from all causes

As one of the world’s most popular beverages, it is clear that us humans do love a good cup of coffee. And a new study drawing on data from over half a million Europeans suggests that this penchant for a little pick-me-up could have a range of health benefits, by revealing an association between higher coffee consumption and a reduced risk of death from all causes.

The research was carried out by scientists from the International Agency for Research on Cancer (IARC) and Imperial College London, who analyzed cancer and nutrition data from more than 500,000 Europeans over the age of 35. These subjects hailed from 10 different European countries, each with their distinctive styles of coffee consumption, such as the espresso sippers of Italy and the cappuccino-lovers of the UK.

This in itself revealed a few interesting insights. The people of Denmark, it was found, boast the highest level of coffee consumption by volume, at 900 mL (30 oz) per person per day, while the Italians consumed the least at around 92 mL (3.04 oz). The more coffee people drank, the more likely they were to be smokers, drinkers, meat-eaters, younger and not huge fans of fruit and vegetables.

Following up with the same participants 16 years later, the study found that 42,000 deaths had occurred from causes including cancer, circulatory diseases, heart failure and stroke. Adjusting for factors such as diet and smoking, the team says that subjects in the highest quartile of coffee consumption had significantly lower mortality rates than those that didn’t drink coffee.

“We found that higher coffee consumption was associated with a lower risk of death from any cause, and specifically for circulatory diseases, and digestive diseases,” said lead author Dr. Marc Gunter of the IARC. “Importantly, these results were similar across all of the 10 European countries, with variable coffee drinking habits and customs. Our study also offers important insights into the possible mechanisms for the beneficial health effects of coffee.”

Among these insights was evidence that coffee drinkers may have healthier livers and better glucose control, something the researchers uncovered by analyzing metabolic biomarkers in a subset of 14,000 people. While coffee is know to contain compounds that interact with the body such as caffeine, diterpenes and antioxidants, the researchers say further research is needed pin down which ones in particular offer these apparent health benefits, along with how much would actually be a healthy amount to consume.

“Due to the limitations of observational research, we are not at the stage of recommending people to drink more or less coffee,” says Gunter. “That said, our results suggest that moderate coffee drinking – up to around three cups per day – is not detrimental to your health, and that incorporating coffee into your diet could have health benefits.”

The research was published in the journal Annals of Internal Medicine.

Source: Imperial College London

 

 

Study Boosts Case for Over-the-Counter Hearing Aids

OTC hearing aids performed nearly as well as prescription devices, but not yet legal for sale

In a highly controlled comparison study, several over-the-counter hearing assistance devices performed almost as well as a conventional hearing aid that cost thousands of dollars more.

Three of five selected personal sound amplification products (PSAP) were found to improve speech understanding among participants with mild-to-moderate hearing loss to a degree that was comparable to results obtained with a hearing aid, Nicholas Reed, AuD, of Johns Hopkins School of Medicine, and colleagues wrote in the July 4 issue of JAMA

Hearing aids for both ears typically cost around $4,500, while PSAPs cost several hundred dollars or less.

The Over-the-Counter Hearing Aid Act of 2017 is being sponsored in the Senate by Elizabeth Warren (D-Mass.) and Charles Grassley (R-Iowa) and in the House by Joseph Kennedy (D-Mass.) and Marsha Blackburn (R-Tenn.).

Reed told MedPage Today that the study findings lend support to the creation of the new regulatory classification for hearing aids.

“Some of these devices did about as well as the hearing aid in our controlled environment, suggesting that some PSAPs are pretty good,” he said. “Perhaps we should support the movement to get these in the hands of more people and to regulate them to improve the quality of the products.”

Click here to read entire article published in MedPage Today