A SERVING OF BEANS A DAY KEEPS HEART DISEASE AWAY

A new review finds that eating a daily serving of legumes can help reduce "bad" LDL cholesterol as well as your risk for heart disease.  Canadian researchers examined 26 U.S. and Canadian studies that included a total of more than 1,000 people. Their analysis showed that getting at least one daily serving (3/4 cup) of legumes -- foods such as beans, chickpeas, lentils and dry peas -- was linked to a reduction in low-density lipoprotein (LDL) cholesterol by 5%.  A daily three-fourths of a cup is approximately double the intake of the average American.  

Why are beans so good for us?  They are high in protein, fiber, pre-biotics (substances that promote the healthy bacteria in the gut), natural plant sterols and stanols, healthy minerals such as magnesium and potassium, and antioxidant  polyphenols.  The high fiber and sterol/stanol content of beans acts like a sponge blocking the digestion of nutrients in other foods that raise cholesterol.  Their fiber and protein also make beans a slowly-digested, low glycemic food that does not cause spikes in blood sugar.  There is also some evidence that the potent antioxidant content of beans may help reduce risk of several cancers.

Some of the study participants reported stomach problems such as bloating, flatulence, constipation or diarrhea as a result of eating legumes.  Increasing intake gradually and soaking dry beans overnight helps to reduce the unwanted gastrointestinal effects of beans.  It has also recently been found that adding a supplement of probiotic lactobacillus bacteria to the soaking beans can further reduce the gas beans cause.

What to do:  Try to get a serving of beans each day.  Here are some ways to get more beans into your diet:

*Add cooked beans or chickpeas to green salads.

*Put them into soups, stews, and chili's.  Lentils cook quickly and make delicious hearty soups.

*Throw together a quick salad of beans and leftover rice, spring onions, bell pepper cubes, parsley topped with lemon olive-oil vinaigrette.

*Whip up a 3-bean salad.

*Make a bean and canned-fish salad (such as the classic Italian tonno e fagioli).

*Eat hummus or black bean dip as a snack with carrot sticks or celery or spread it on bread or pita.

*Mash warm beans, refried-bean style, with garlic, herbs and olive oil as a tasty side-dish.

*Saute cooked beans in olive oil with garlic and shredded greens (spinach, arugula, baby broccoli, kale, etc.) for a delicious, quick dinner.

*Have them in a breakfast burrito or soft tacos.

*Make them into a crunchy snack by roasting cooked chickpeas or edamame tossed  in olive oil and spices.

Adapted from articles available at:

http://www.integrativeoncology-essentials.com/2014/04/beans-beans-really-good-heart/

http://www.nlm.nih.gov/medlineplus/news/fullstory_145542.html

http://www.sciencedaily.com/releases/2014/04/140407122749.htm

http://www.examiner.com/article/new-health-benefits-found-for-beans-chickpeas-and-lentils

Source:

Ha V, Sievenpiper JL, De Souza RJ et al.  Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. CMAJ, 2014 DOI:10.1503/cmaj.131727

THE LINK BETWEEN SATURATED FAT AND HEART DISEASE IS QUESTIONED

One of the consistent nutrition messages in the last 50 years is that saturated fats found in dairy and meat raise blood cholesterol and therefore increase the risk of heart disease.  However, this time honored recommendation is now being called into question.  A recent editorial arguing limiting saturated fat does not curb heart disease risk by cardiovascular disease researcher Dr. DiNicolantonio  and a review of the current research by Dr. Siri-Tarino and colleagues have been generating a reexamination of the evidence on this subject.

 Dr. DiNicolantonio points out that the original findings that linked saturated fat and heart disease were based on epidemiologic (population) studies in which researchers cherry-picked the evidence for groups that matched their hypothesis while excluding populations for which there was contrary evidence.  And, the 2010 Siri-Tarino review of existing epidemiologic studies on the relationship between saturated fat and heart disease found no significant evidence saturated fat intake increases cardiovascular disease rates.  Another reason saturated fat has been linked to heart disease is the evidence that it raises LDL cholesterol levels but, increasingly, it is being recognized that LDL cholesterol is made up of a combination of artery damaging small dense LDL particles and comparatively benign light large LDL particles and it appears that saturated fat mostly increases the light large LDL rather than the dangerous small LDL in the blood.  Dr. DiNicolantonio argues the real drivers of increases in the small damaging LDL particles is over-consumption of carbohydrates especially in the form of sugars and refined grains.

Additionally, one of the chief reasons saturated fat has been linked to heart disease is the finding that diets high in red meat, which is generally high in saturated fat, are linked with higher heart disease rates.  This is especially true for processed meat.  In the past few years researchers have been uncovering other ways that meat may be contributing to heart disease.  It appears that the nitrites in processed meat can damage arteries and increase metabolic problems linked to diabetes.  Also, it has been found carnitine which is especially rich in meat may be metabolized into a substance that increases arterial damage by small LDL particles.

What to do:  While new questions are being raised about the role of saturated fat in heart disease risk, it is too early to make a definitive conclusion.  Stay tuned.  In the meantime, there is stellar epidemiologic evidence that a traditional Mediterranean diet rich in olive oil, nuts, fish, beans, fruits, and vegetables does help to prevent and improve cardiovascular disease.  At the same time there is also good evidence diets high in processed carbohydrates such as refined flour and sugar do increase the risk of cardiovascular disease.  

Adapted from articles available at:

http://www.sciencedaily.com/releases/2014/03/140305191429.htm

http://www.medicalnewstoday.com/articles/273528.php

Sources:

DiNicolantonio JJ. The cardiometabolic consequences of replacing saturated fats with carbohydrates or omega-6 polyunsaturated fats: do the dietary guidelines have it wrong? Open Heart. 2014;1. doi:10.1136/openhrt-2013-000032.

Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke and diabetes mellitus: a systematic review and meta analysis. Circulation2010;121:2271-83.  Available at: http://ajcn.nutrition.org/content/91/3/535?ijkey=2755fae85a1e0c716ad5d4419af2cd89c40e3388&keytype2=tf_ipsecsha&linkType=ABST&journalCode=ajcn&resid=91/3/535&atom=/bmj/347/bmj.f6340.atom

Siri-Tarino P, Sun Q, Hu FB, Krauss RM.  Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.  Am J Clin Nutr 2010; 91: 535-46.  Available at: http://circ.ahajournals.org/content/121/21/2271.full.pdf+html

FIVE SMALL MEALS NO BETTER FOR WEIGHT LOSS THAN HAVING TWO BIG MEALS

Many people are told that in order to boost their metabolism, consume five small meals instead of 2-3 regular meals.  However, a new small study challenges this notion, finding that metabolism is not impacted by meal frequency.

In the study, researchers provided 24 women with diets of a set calorie amount but one day they split the calories into five small meals and on another day they divided them between two meals.  They measured participants' metabolic rate and calories burned on both days and found that the metabolic rate (the rate at which individuals burn calories) did not significantly differ whether eating five or two meals. 

Researchers also took blood samples at the start and before bed on the treatment days to assess how different biomarkers of inflammation responded to the two dietary treatments.  Inflammation is linked to greater risk for heart disease and diabetes.  The researchers found that for lean women there was no difference in inflammatory response to the five-meal plan and the two-meal plan, but that for obese women, they had higher levels of inflammation after the five-meal plan than the two-meal plan.  So, the two-meal plan proved marginally better for obese women in this small study.     

What to do:  This study echoes the findings of previous work.  Weight loss mostly depends on what we eat, not when we eat it.  In this study the intake of participants was kept constant to see if meal timing and frequency influenced metabolism.  However in the real world where individuals choose how much they eat, for some adopting a small and frequent meal plan helps to cut down on total intake while for others more frequent eating translates into greater total intake.  Observe your patterns and choose an eating schedule that allows you to best moderate caloric intake and make healthy choices.   

Adapted from articles available at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_145347.html

Source:

Milan Kumar Piya, M.D., clinical lecturer, U.K. National Institute for Health Research, University Hospital Coventry and University of Warwick, England.  Press release for March 25, 2014, presentation, Society for Endocrinology meeting, Liverpool, U.K.

EXCESS INTAKE OF VITAMIN E, SELENIUM, OR BETA CAROTENE MAY INCREASE CANCER RATES

 A consensus statement released by the U.S. Preventive Services and the results of a new study both find that there are potential downsides to taking some vitamins and minerals. 

A panel of experts was recently convened to give Americans better guidance on supplementation.  The 16-member panel took an in-depth look at studies conducted over the past 10 years on vitamins and minerals and found  there was no conclusive evidence multivitamin improve health.  The panel also stated healthy Americans should not take vitamin E or beta carotene supplements to help prevent heart disease or cancer and that, for smokers, beta carotene supplements may actually increase the risk of lung cancer.  In two large studies taking beta carotene increased the risk of lung cancer in smokers by 24%.  There is also limited evidence that taking high levels of folate can increase colon cancer rates.

Additionally, a large supplementation trial found men taking selenium or vitamin E supplements can double their risk of prostate cancer.  The study, begun in 2001, was prompted by early research suggesting the supplements might protect against prostate cancer. But, researchers found that taking selenium increased the risk of high-grade cancer by 91% among men with already high selenium levels.  Among men with low selenium levels, taking vitamin E increased the risk of prostate cancer by 63% and the risk of aggressive cancer by 111%.

Men can still take their daily multivitamin without fear, however.  The levels administered in this study significantly exceeded the recommended daily intake and were higher than would be found in most multivitamins.  During the trial, men took 200 mcg of selenium and 400 IU of vitamin E daily, either separately or in combination.  By comparison, the recommended daily intake of selenium for adults is 55 mcg, and for vitamin E it is 22 IU. 

What to do:  If you want to take a multivitamin it is likely doing no harm but it also may be doing no good.  As the study findings reveal, taking large doses of supplements can increase cancer risk.  Certainly, supplements are no substitute for eating a healthy diet, getting regular physical activity, and controlling body weight.  Instead of supplements aim for healthy foods naturally rich in vitamins and minerals.  To get adequate vitamin E and selenium aim for whole grains, nuts, and dark leafy greens.

Adapted from articles available at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_144782.html

http://www.cancer.gov/newscenter/qa/2008/selectqa

Sources: 

Sources: 

Frankel PH, Parker RS, Madsen FC, Whanger PD.  Baseline selenium and prostate cancer risk:  Comments and open questions. Journal of National Cancer Institute. Available at dju060 doi:10.1093/jnci/dju060.

Kristal AR, Darke AK, Morris JS, et al.  Baseline Selenium Status and Effects of Selenium and Vitamin E Supplementation on Prostate Cancer Risk. Journal of National Cancer Institute.  Available at djt456 doi:10.1093/jnci/djt456 first published online February 22, 2014.

U.S. Preventive Services Task Force.  Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer.  Annals of Internal Medicine on 25 February 2014.  Available at: http://www.uspreventiveservicestaskforce.org/uspstf14/vitasupp/vitasuppfinalrs.htm#copyright

LEAVING THE WORKFORCE DETRIMENTAL TO HEALTH

A growing body of research indicates that leaving the workforce, whether one is retiring, going on disability, or simply cannot find work, has serious detrimental effects on mental and physical health.  Leaving the workforce changes one's physical environment as well as one's mental and physical activity patterns and researchers point out that these changes profoundly change individual's health behaviors, social interactions, psychosocial stresses.  

Retirement is often perceived as a golden opportunity to focus on healthy behaviors.  However, retirement, marked by reduced social interaction, less physical movement, and a loss of sense of purpose, actually increases the risk of health problems.  For example, a study published in 2008 by the National Bureau of Economic Research found retirement increased difficulties with mobility and daily activities 16%. A recent report published by the Institute of Economic Affairs in London concluded retirement , raises the risk of developing clinical depression by about 40%, increases the risk of developing at least one diagnosed physical condition by approximately 60%, and raises the risk of needing medication for a physical condition by 58%. 

Involuntary unemployment appears to be especially bad for health in the US where unemployed workers often lose health insurance.  It is estimated that in the United States, each percentage rise in unemployment leads to 6,000 deaths.  A review of more than 300 studies on mental health and unemployment found that unemployment was markedly linked to declines in mental health.  For instance, men who had lost jobs within the last four years were three times more likely than stably employed men to have recently abused alcohol. Likewise, women who had a stint of unemployment were three times more likely than other women to have suffered extended periods of depression.  According to a study out of Columbia University, long-term unemployment can reduce life expectancy by an average of 1 ½ years.   Parent’s unemployment even appears to have lasting effects on the success of their children.  A 2008 report based on a study that followed the earnings of 39,000 Canadian fathers and sons over 30 years beginning in the late 1970's found that when the sons of men who lost their jobs joined the workforce, they earned 9% less than the sons of otherwise comparable workers.

There is evidence that being out of the workforce is particularly damaging to heart and cardiovascular health.  A number of studies have found that persons in retirement or on disability decrease their amount of walking and other physical activity when they leave the workforce.  A recent study at the Harvard School of Public Health looked at rates of heart attack and stroke among men and women in the ongoing U.S. Health and Retirement Study. Among 5,422 individuals in the study, those who had retired were 40% more likely to have had a heart attack or stroke than those who were still working. The increase was most pronounced during the first year after retirement with mortality rates of the newly retired 50% greater.

What to do:  While the common perception is that if we could only quit our stressful jobs and focus on our health we would be better off, in fact, work is beneficial to health.  So, keep working as long as you can.  If you do leave the workforce, actively engage in behaviors that protect your health.  Foster a new social networks, pursue activities that keep you physically active and bring you joy, and continue to challenge your mind with structured and unstructured learning.  

Adapted from articles available at:

http://www.livescience.com/13578-unemployment-health-mortality.html

http://www.bloomberg.com/news/2013-06-11/retirement-will-kill-you.html

http://www.medicalnewstoday.com/articles/260622.php

http://www.health.harvard.edu/blog/is-retirement-good-for-health-or-bad-for-it-201212105625

http://consumer.healthday.com/encyclopedia/article.asp?AID=646671

http://economix.blogs.nytimes.com/2012/03/28/the-enduring-consequences-of unemployment/?_r=0

http://thinkprogress.org/economy/2012/04/02/456809/long-term-unemployment-decreases-life-expectancy/

Sources:

Centers for Disease Control and Prevention.  Current Depression Among Adults --- United States, 2006 and 2008. Mortality and Morbidity Weekly Report.  October 1, 2010 / 59(38);1229-1235

Paul K, Moser K. Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior. Volume 74, Issue 3 June 2009

Jin RL. The impact of unemployment on health: a review of the evidence. Can Med Assoc J. 1995 Sept 1; 153(5)529-539.

Warr, PB. Work, Unemployment and Mental Health.  New York, Oxford University Press. 1987.

Warr, PB. Self-esteem and unemployment among young workers.  Le Travail Human.  1983,

46,355-366.

INTAKE OF OMEGA-3 FATS FOUND IN FISH MAY HELP PRESERVE BRAIN HEALTH

A recent study found older women with higher blood levels of the fats found in oily fish (such as salmon and tuna) experienced less age-related brain shrinkage than women with lower levels of fish oil fats. Normally, with age, the brain shrinks about half a percentage point every year after age 70 and those with dementia experience much greater brain shrinkage. 

For the study, Dr. James Pottala and colleagues analyzed data from the Women's Health Initiative Memory Study that included 1,111 senior women who had no signs of dementia at the beginning of the study. Their blood levels of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were measured at the start of the study.  Eight years later, the women had MRI scans that measured their brain volumes. The researchers found women with the highest EPA and DHA blood levels at the study's outset had brains that were about two cubic centimeters larger overall than women with the lowest levels.  In addition, the hippocampus, a brain region critical in forming and storing memories and one of the first areas of the brain that shrinks with Alzheimer’s, was 2.7 % larger in women who had fatty acid levels twice as high as the average.  The analysis controlled for other factors that can influence women's brain size, including education, age, other health conditions, smoking and exercise.

While this study did not prove a causal relationship between omega-3 intake and brain preservation, it is plausible intake of these fats, which our bodies cannot synthesize but have to get from oily fish, could affect brain volume.  DHA accounts for 30%-40% of the fatty acids in brain cell membranes, and it is especially concentrated near the synapses where nerve cells communicate with one another. 

What to do:  Fish high in omega-3 fatty acids include salmon, herring, mackerel, tuna, and sardines. To maintain blood levels comparable to the study’s participants with high blood levels, one would need to eat fatty fish or take a fish oil supplement most days of the week.    

Source: 

Pottala JV, Yaffe K, J. G. Robinson JG, Espeland MA, Wallace R, & Harris WS.  Higher RBC EPA DHA corresponds with larger total brain and hippocampal volumes: WHIMS-MRI Study. Neurology, online January 22, 2014. Available at DOI:10.1212/WNL.0000000000000080 

Adapted from articles available at:

http://www.sciencedaily.com/releases/2014/01/140122170541.htm

http://www.sciencenewsline.com/articles/2014012312480001.html

EVEN WITHOUT WEIGHT GAIN, CONSUMPTION OF ADDED SWEETENERS INCREASES RISK OF DYING FROM HEART DISE

A recent analysis from the Center for Disease Control indicates regular consumption of too much sugar and other added sweeteners increases the risk of dying from heart disease, even when one maintains a healthy weight. The study also concluded that most Americans are consuming far more sugar than is recommended.

The results are based on data collected from the National Health and Nutrition Examination Survey which has tracked the eating patterns of over 31,000 U.S. residents from 1988 through 2010.  The study found that over the period of the survey, the average adult took in about 16% of their calories from added sweeteners, and 10% of adults got more than 25% of their calories from added sweeteners.  The natural sugars in juice were not included in the study although it is likely these impact the body similarly to added sugars.

The study found that compared to people who got less than 10% of their daily calories from added sugars, those taking in 10-25% of their calories from added sugar were 30% more likely to die of cardiovascular disease during the study period. And, those who got 25% or more of their calories from added sugar were more than twice as likely to die of cardiovascular disease.  The relationship between sweetener consumption and cardiovascular related death rates was independent of other factors known to impact heart health including weight, smoking, age, gender, physical activity, socioeconomic status, and other aspects of an unhealthy diet.

Added sugars include all caloric sweeteners that are incorporated into foods including brown sugar, syrup, and honey.  Sugar-sweetened beverages are by far the single largest source of added sugar in the American diet, accounting for 37.1% of all that is consumed nationally.  A typical can of regular soda contains 35-40 grams of sugar (7-8% of a 2,000 calorie diet) while a 20-oz bottle has 65-75g of sugar (13-15% of a 2000 calorie diet).  How much sugar intake is too much?  This is still a matter of debate.  The Institute of Medicine recommends added sugars make up less than 25% of a person's daily calories, while the World Health Organization suggests the limit should be much lower, no more than 10% of caloric intake.  And, the American Heart Association sets the limit for added sugars at 100 calories per day for women (about 6 teaspoons) and 150 calories (about 9 teaspoons) per day for men.  This study's results corroborate the recommendations from the American Heart Association, limiting sugar to no more than 15% of caloric intake. 

Aside from leading to weight gain, excessive intake of added sugar appears to negatively affect health in several ways. It has been linked to the development of high blood pressure, increased triglycerides (blood fats), low HDL (good) cholesterol, fatty liver problems, as well as making insulin less effective in lowering blood sugar. 

What to do:  Avoid added sugar as much as possible.  Even at a healthy weight, a daily 20-oz serving of soda alone puts you over the limit of sugar intake.  Beware not only of foods we typically think of as sweets.  "Healthy foods" such as granola bars, cereal, sauces, canned & dried fruit, and yogurt contain substantial amounts of added sweeteners.   

Article adapted from:

http://www.medpagetoday.com/Cardiology/Prevention/44114

http://www.reuters.com/article/2014/02/03/us-sugar-diet-idUSBREA121IK20140203

http://www.usatoday.com/story/news/nation/2014/02/03/added-sugars-heart-disease-death/5183799/

Source:

Yang Q, Zhang Z, Gregg EW, Flanders W, Merritt R, Hu FB. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Intern Med. 2014;():. bit.ly/1bW7SpA