Nutrition

No surprises here

Published 8.12.2017
There’s nothing new here, but it’s nice that both sides of the energy balance are considered important. Adherence is key, so don’t adopt a way of eating that you can’t maintain for the rest of your days. Adding a bit of weight as you age can be protective— but not if you become obese. There is no obesity paradox. Risks increase when you are obese.

It’s not just age that slows metabolism (though I would argue that if you are not sedentary your metabolism doesn’t slow as much) drugs can also negatively affect metabolism. If you have a disease that must be treated with drugs, then continuing to move as much as possible is even more important.

No surprise here either. Blood vessels bring blood and nutrients to the entire body, including the brain. If the vessels are inflamed or blocked in one area, why would the expectation be that they wouldn’t be elsewhere in the body?

Middle-aged Americans with vascular health risk factors such as diabetes, high blood pressure, and smoking had a greater chance of suffering from dementia later in life, researchers reported.

According to a prospective cohort of Atherosclerosis Risk in Communities (ARIC) study, the association was most significant among people who were black (hazard ratio 1.36, 95% CI 1.21-1.54) and ages 60-66 (HR 8.06, 95% CI 6.69-9.72), reported Rebecca Gottesman, MD, PhD, of Johns Hopkins University in Baltimore, and colleagues in JAMA Neurology.

Absent a specific diagnosed health concern, supplements should always be unnecessary if you’re eating a healthy diet. However, even if you don’t think a healthy diet precludes supplements, you should avoid supplements because you never truly know what’s in the. Red yeast supplements are merely the latest problem supplement to be exposed.

Pieter Cohen (Cambridge Health Alliance), a leading researcher and expert on supplement safety, and colleagues tested 28 brands of red yeast rice supplements purchased at major retail chains in the U.S. to determine levels of the active ingredient monacolin K, which is identical to the prescription statin drug lovastatin. The paper was published in the European Journal of Preventive Cardiology.

Two of the 28 brands had no detectable levels of monacolin K. For the other 26 brands, monacolin K levels were wildly divergent, ranging from 0.09 to 5.48 mg per 1,200 mg of red yeast rice. This represents a 60-fold variation in quantity, and a 120-fold difference based on the manufacturers' daily serving recommendations.

Cohen said that the results also suggest that six of the products -- 21% -- could receive warning letters from the FDA, since the dosage exceeded the 4-mg/day limit established by the FDA.

Vitamin D is a bit of an exception to the supplement rule because it isn’t found in many foods. Sunlight on skin produces vitamin D, but you have to be out in the sun for that to work. If you take vitamin D, take the D3 form, not D2 (sorry vegans).

Vitamin D3 was more effective at raising serum total 25-hydroxyvitamin D [25(OH)D] levels in the wintertime than vitamin D2, according to British researchers.

Biscuits and juice fortified with 15 µg (600 IU) of vitamin D3 showed a significantly greater increase in total 25(OH)D levels among women compared those supplemented with 15 µg (600 IU) of vitamin D2 (74% versus 34% biscuit; 75% versus 33% juice), wrote Laura Tripkovic, PhD, of the University of Surrey in England, and colleagues, in the American Journal of Clinical Nutrition.

This is tough news for vegans. D3 is derived from animal products. D2 is what you get from plants.

Only calories and adherence matter. The article doesn’t mention that Gardner’s most recent work was funded by NuSi (Nutritional Science Initiative). NuSi never mentions it, mostly because it also didn’t show what Gary Taubes wanted it to show. There was no advantage to the low carb (LC) diet over low fat (LF) (and as they let people decide what LC and LF meant to them, neither diet would meet proponents definition), subject following both diets lost weight— unless they didn’t. The bottom line is that if you were randomly assigned a diet you can’t adhere to, you didn’t lose weight.

It’s not what you eat, it’s how much. Calories matter. The energy balance is always the bottom line.

Too much and too little weight are not good in pregnancy. Not sure why this would be a surprise to anyone, and the statement can be extended to health generally. It’s not good to be to think (no one argues with that) and it’s not good to be too fat (an ever growing number of people would take issue with that).

Based on a systematic review and meta-analysis, 47% of pregnancies reported an above recommended gestational weight gain based on data of over 1 million women, while 23% had a lower-than-recommended weight gain, according to the National Academy of Medicine (formerly Institute of Medicine, IOM) 2009 recommendations, reported Rebecca Goldstein, MBBS, of Monash University in Melbourne, and colleagues.

Nor is it shocking that many more women put on too much weight versus gain too little. It may be that advice to pregnant women is changing, but certainly when I was pregnant, all of the advice had me eating way too much food. The reality is that the amount of additional calories required when pregnant isn’t that different from when not pregnant. Beyond that, there is some evidence that the woman’s body becomes better able to get the nutrients from whatever food she eats. So even if she doesn’t eat more, she absorbs more.

My pregnancies were in the very early 1990s, and friends and family began having babies roughly five years before then. All of us were told to “eat for two,” with a few hundred extra calories a day. It doesn’t matter what those excess calories consist of, weight is going to be added, however, it is true that many women (and I include myself in this group) took the extra calorie mantra to mean that any all treats could be had. Cravings and all that, I guess I should call them.

I don’t remember having many cravings, I do remember developing a few aversions, in particular to coffee. Still, in my first pregnancy I put on the maximum amount of weight in the range my doctor suggested was optimal. Then struggled for more than a decade to take that weight completely off. Losing weight is never as easy as gaining it, and it certainly isn’t as much fun.

Were I advising a pregnant woman, (and I never would as I am not any sort of a medical professional) I would tell her to eat the same amount as she did before getting pregnant, perhaps making healthier choices. If a woman has been drinking alcohol regularly, there’s a bunch of calories that get dropped immediately. Rather than replacing those calories with ice cream of other calorie dense treats, just eat a bit more of a normal diet— within the constraints of cravings or aversions.

There are many ways to eat healthy while pregnant, the important point is not to increase the amount you eat. This is especially important if you begin the pregnancy already obese.