Advanced Mediterranean Diet

We’ve long known that the incidence of cancer is higher in people who are 40% or more over ideal weight.  Men are prone to prostate and colorectal cancers.  Women get cancers of the endometrium (uterus), gallbladder, cervix, ovary, and breast.  Overweight and obesity are associated with increased risk of kidney cancer and esophageal adenocarcinoma.

A recently published study from the University of Oxford in the United Kingdom recruited 1.2 million middle-aged women and monitored their cancer status over five to seven years.  What’s new with this study is that they found overweight women to have a higher incidence of leukemia, multiple myeloma, pancreatic cancer, non-Hodgkin’s lymphoma, colorectal cancer in premenopausal women, and breast cancer in postmenopausal women.  The effect of overweight and obesity depended on menopausal status for the following cancers: colorectal cancer, melanoma, breast cancer, endometrial cancer.

Studies with this many recruitees are rare and tend to be much more reliable than smaller studies.

The study authors attribute 5% of all cancers in postmenopausal UK women to overweight and obesity.  They attribute half of all endometrial cancers and esophageal adenocarcinomas in postmenopausal women to overweight and obesity.

A statistical association between cancer and overweight does not prove that overweight causes cancer, but the situation is certainly suspicious.

According to the American Cancer Society, overweight and obesity contribute to 14 to 20% of all cancer-related deaths in the U.S.  Over 500,000 people die from cancer yearly in the U.S.

Like smoking and inactivity, overweight and obesity are modifiable risk factors for cancer.  Lose your excess weight and you are likely to lower your risk of developing cancer.

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer   www.AdvancedMediterraneanDiet.com

Reference:  Reeves, Gillian K.,  et al.  Cancer Incidence and Mortality in Relation to Body Mass Index in the Million Women Study: Cohort Study.  British Medical Journal, 335 (2007): 1134.

Eighty-five percent of type 2 diabetics are overweight or obese.  Overweight either causes or aggravates many cases of diabetes.

For the last quarter-century, many U.S. government agencies and healthcare organizations have advocated a low-fat diet for overweight people, including type 2 diabetics.  Recent studies have documented that low-carbohydrate diets can also be effective in weight loss.  Low-carb diets replace carbohydrates with either fats or proteins, or both.  The A to Z Weight Loss Study compared the Atkins, Ornish, LEARN, and Zone diets in 311 overweight pre-menopausal women.  The Atkins group tended to lose a bit more weight. Changes in lipid profiles, waist-hip ratios, fasting insulin and glucose levels, blood pressure, and percentage of body fat were comparable or better with Atkins versus the other diets.

The Amerian Diabetes Association now gives the go-ahead for use of low-carb diets as a weight-control method for type 2 diabetics.  Previously, the organization had recommended against diets that restrict carbohydrates to less than 130 grams daily.  (A baked potatoe without the skin has 30 grams.)  Understand that the ADA does not endorse low-carb diets for weight loss or diabetes management.  They simply say that either low-carb or low-fat calorie-restricted diets might be effective for up to one year.

I caution you that low-carb diets may be deficient in fiber, minerals, vitamins, and phytonutrients that may be very beneficial in terms of long-term health and longevity.

The tide has been turning against low-fat diets for the last five years.

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer  www.AdvancedMediterraneanDiet.com

Reference: American Diabetes Association.  Clinical Practice Recommendations 2008.  Diabetes Care, 31 (2008): S61-S78.

Are your eventual health problems a matter of fate by the time you reach middle age?

A recent study from the Medical University of South Carolina asked whether middle-aged folks could improve their health and longevity by making healthful changes in lifestyle.  15,708 study participants, ages 45-64, were surveyed with regards to four “healthy lifestyle” components, namely: five or more fruits and vegetables daily, regular exercise, healthy weight range (BMI 18.5-29.9), and no current smoking.  When first surveyed, 8.5% of the participants had all four of the healthy lifestyle components.  When surveyed six years later, 8.4% of the remainder had adopted these four healthy lifestyle features.  Overall death rate and cardiovascular disease events were monitored over the next four years.  Compared to the study participants who did not adopt a healthy lifestyle, the new adopters had a 40% lower incidence of death from all causes and 35% less cardiovascular disease events.

So middle-aged people can improve their longevity and avoid cardiovascular disease by making healthy lifestyle changes.  These improvements are very significant in degree and comparable to, if not better than, results seen with many expensive medications and invasive medical procedures.

Why not make changes today?

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer.  www.AdvancedMediterraneanDiet.com

References: King, Dana E., et al.  Turning Back the Clock: Adopting a Healthy Lifestyle in Middle Age.  American Journal of Medicine, 120(2007): 598-603.

Kevin Trudeau, author of The Weight Loss Cure “They” Don’t Want You to Know About, is in trouble with the law again.  The twice-convicted felon was banned in 2004 from using infomercials to sell most products except for books and other publications.  The exception required that he not make false claims in infomercials.  The 2004 settlement regarding false claims also required him to pay $2 million.

Informercials for the aforementioned book began running in 2006.  In the commercials, Trudeau claims that his weight-loss plan is easy, simple, and you can do it at home.  “When you’re done, eat whatever you want and you don’t gain weight back.”

In reality, the book describes a complicated system involving daily intramuscular injections of human chorionic gonadotrophin, a prescription drug not approved by the U.S. FDA for weight loss.  You will have great difficulty finding a U.S. physician willing to prescribe this.  The plan involves specialized cleanses and supplements.  One phase involves eating only 500 calories per day for 21 to 45 days, which is considered severe caloric restriction even for someone on a diet.  [Most people eat 1,500-2,5000 cal/day to maintain weight.]  Trudeau recommends 15 “colonics”  from a licensed colon therapist.  The book lists severe dietary prohibitions for life.

Trudeau’s felony convictions were in the 1990s: depositing bad checks, and credit card fraud.

On November 16, 2007, U.S. District Court Judge Robert W. Gettleman found Trudeau in comtempt of court for violating the 2004 injunction.

The book at hand has made it onto bestseller lists of the New York Times, the Wall Street Journal, and USA Today.  Even today it ranks as a high-volume seller at Amazon.com.

Go figure.

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer  www.AdvancedMediterraneanDiet.com

References:

FTC, plaintiff v. Kevin Trudeau et al, FTC news release 9/14/07

U.S. District Court for Northern District of Illinois, Eastern Division, File # 032 3064, Civil Actions # 03 C3904 and 98-C-0168.

No doubt you have noticed the expanding girths of  U.S. youth.  What are the health implications?  A recent study  published in the New England Journal of Medicine suggests a disturbing answer.

Heavy youths tend to stay heavy as they age.  Researchers looked at the incidence of overweight adolescents in the year 2000 and then estimated the prevalence of obesity in the year 2020.  Thirty to 44% of 35-year-olds in 2020 are expected to be obese.  Using computer simulation, they estimated that by 2035 the prevalence of coronary heart disease will increase by 5 to 16% because of the increased obesity.  In other words, the increasing obesity in these young and middle-aged adults will result in over 100,000 excess cases of coronary heart disease.

That is, if current trends continue.  But I see nothing on the horizon likely to alter that societal trend in the near future.  I’m doing my part.  How about you?

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer.  www.AdvancedMediterraneanDiet.com

References:  Bibbins-Domingo, K, et al.  Adolescent Overweight and Future Adult Coronary Heart Disease.  New England Journal of Medicine, 357 (2007): 2,371-2,379.

I was going through my “interesting articles” file today and found this to share with you.  In 2007, the World Cancer Research Fund and the American Institute for Cancer Research jointly published a report having the potential to reduce cancer rates by at least a third, if their recommendations were adopted.  A multinational team of 21 respected experts was charged with analyzing over 7,000 studies relating to diet, exercise, body weight, and cancer.  The panel assumes everyone already knows to avoid smoking and chewing tobacco.  Here are their 10 basic recommendations:

1.  Be as lean as possible within the normal range of body weight (BMI or body mass index of 18.5 to 24.9).  Being overweight or obese promotes certain cancers.

2.  Be physically active every day.  Example: 30 minutes of brisk walking.

3.  Limit consumption of energy-dense (high-calorie) foods.  Avoid sugary drinks.  Water is the best alternative to sugary drinks.  Natural fruit juice is a reasonable fruit serving, but limit to one daily.

4.  Eat mostly foods of plant origin.  Fill at least two-thirds of your plate with vegetables, fruits, whole grains, and beans.

5.  Limit intake of red meat and avoid processed meats.  Red meats are beef, pork, and lamb.  Limit to 18 ounces of cooked red meat per week.

6.  For pure cancer avoidance, don’t drink alcohol.  The panel recognizes, however, that alcohol likely helps in prevention of coronary heart disease.  If you drink alcohol for heart benefits, limit to two drinks daily if you are a man, and one daily if you are a woman.

7.  Limit consumption of salt (associated with stomach cancer).  Avoid moldy cereals and legumes (molds produce aflatoxins which cause liver cancer).

8.  Aim to meet nutritional needs through food intake rather than supplements.

9.  Mothers should breast-feed for six months (at least?).  Children should be breast-fed.

10.  Cancer survivors should still follow the recommendations for prevention of cancer.

Much of this is consistent with my book, The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer.  The AMD is a diet/weight loss book, with little reason to seriously address breast-feeding and cancer survivors.  The association between salt intake and stomach cancer is news to me.  Stomach cancer is not very common in the United States, where I and most of my audience live.  Overweight people following the Advanced Mediterranean Diet will be far ahead of the game if they get their BMI just down to 24.9.  I’m not convinced 18.5 would be any healthier, and many studies suggest the opposite.

-Steve Parker, M.D., author of The Advanced Mediterranean Diet   www.AdvancedMediterraneanDiet.com

References: Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective

In the U.S. between 1970 and 1990, consumption of high fructose corn syrup increased over 1000%.  During those two decades, the incidence of overweight and obesity nearly doubled.  Many wonder if this is more than just coincidental. Most of this fructose is in soft drinks.  Soft drink consumption per person in 1942 was two servings per week.  In 2000, consumption was two servings per day.  Of course, these drinks typically have few nutrients other than sugars.

We know that children’s consumption of high fructose corn syrup has increased dramatically.  We know that atherosclerosis (hardening of the arteries) begins in childhood.  We know that atherosclerosis complications are associated with small LDL cholesterol particle size.  A recent study in 74 Swiss schoolchildren found that high fructose intake reduces LDL particle size, potentially increasing their future risk of cardiovascular disease such as heart attacks.   We have learned over the last 10 years that dietary trans fats (aka partially hydrogenated vegetable oils) promote atherosclerosis.  That’s why the American Heart Association and others are working to reduce consumption of trans fats.  Connecting the dots, it’s starting to look like high fructose corn syrup may be the new trans fat.  As they say, “additional studies are needed.”  We may have a definitive answer in 10-20 years, but what do we do in 2008?

No worries, mate.  Both the traditional Mediterranean and Advanced Mediterranean diets are naturally low in fructose compared with today’s typical Western diet.

[Thanks to George Bray at the Pennington Biomedical Research Center for bringing this to my attention.]

- Steve Parker, M.D.
Author of The Advanced Mediterrranean Diet
www.AdvancedMediterraneanDiet.com

References:
Bray, George A.  How bad is fructose?  American Journal of Clinical Nutrition, 86 (2007): 895-896.
Aeberli, I, et al.  Fructose intake is a predictor of LDL particle size in overweight schoolchildren.  America Journal of Clinical Nutrition, 86 (2007): 1174-1178.
Vartanian, L.R, et al.  Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis.  American Journal of Public Health, 97 (2007): 667-675

Last Saturday morning I was reading the paper, drinking my coffee, and enjoying a Pepperidge Farm Apple Turnover.  I’ve loved these turnovers for years.  You buy them raw/frozen and bake in the oven when desired.  As is my habit now, I started reading the nutritional information on the box.  I can handle the 290 calories per turnover, as long as I don’t eat two - but I usually do.  Zero cholesterol - OK.  Only two grams of fiber - could be worse.  Five grams of trans fat - not good.  The real shocker was that #1 on the ingredient list was partially hydrogenated vegetable shortening: this is the source of the trans fat.

Most nutrition experts believe that trans fats cause atherosclerosis (hardening of the arteries), which eventually leads to poor circulation, strokes, and heart attacks.  I’ve never found a credible source to say that trans fats are fine as long as you don’t exceed “x” grams per day.  That’s why most food manufacturers are taking steps to avoid them.  Trans fats are often used to prolong the shelf life of baked goods.  Other fats go rancid sooner.  These turnovers are so tasty that they never sit around our house for over 24 hours.

I’m hoping the Pepperidge Farm chefs come up with an alternative to trans fats soon, like before this weekend.