Health for life

Where do you get your protein? If its from red meat (steak and pork), processed meat (bacon and salami), and high-fat dairy foods, it may be increasing your risk of fatal and non-fatal heart attack.

That was the finding of a recent assessment of the very large Nurses Health Study which followed over 84,000 women for 26 years.¹

It found:

• Higher intakes of red meat, red meat excluding processed meat, and high-fat dairy were significantly associated with elevated risk of coronary heart disease (CHD).
  
  
• Higher intakes of poultry, fish, and nuts were significantly associated with lower risk.

And concluded:

"These data suggest that high red meat intake increases risk of CHD."

The study was unique in that it investigated how substituting one source of protein for another, e.g. nuts, fish, or poultry for red meat, affects heart disease risk. It found, for example, that substituting one serving of nuts for one serving of red meat reduced CHD risk by 30%; substituting a serving of fish for red meat reduced it by 24%.

Although the study was conducted on women, the researchers say men are likely to benefit from the findings as well.

Lead author of the study, Adam Bernstein:

"Our research adds to the growing and convincing body of evidence that red meat intake should be minimized or excluded from the diet in order to maintain cardiovascular health."

________
¹Major Dietary Protein Sources And Risk Of Coronary Heart Disease In Women, Circulation, August 2010

Shifting Protein Sources Away From Red Meats May Reduce Risk Of Heart Disease In Women, Harvard School of Public Health, Press Release, August 2010

After my self-revealing experience (see my last post: "Placing My Trust") where I discovered that I had placed my trust in the experience of eating rather than in Jesus, Ive been doing more observing. What I have since noticed is that I not only use binging (unscheduled eating) to assuage my feelings of fear, I have similar trust issues during regular meals. I suppose that would be obvious to others, but was still another revelation to me.

I consider myself to be a "big eater." I like my meals to be on the large side. I often have seconds. I noticed on Saturday when I tried out a new buffet restaurant, that in the middle of my second medium sized plateful my body suddenly signaled that I was full and I could not eat another bite. I then paused and felt confused. I did not know what to do with the rest of the food on the plate. I didnt know what to do. I tried to be aloof and stop eating, but I could not keep from finishing the plate. I then got a piece of pound cake, too.

I did not actually notice that the trust issue had showed up again until I had finished eating, paid my bill, drove home, and walked into my front door. I had been thinking about what happened on my trip home and when I walked in the door it dawned on me that I had not trusted or obeyed my bodys very clear message to me.

When the full feeling hit, I really did feel confused. I could see that I was really full, but could not respond to that feeling with trust, and just stop eating. I allowed me to ignore my body message, ignore what was good for my health, and continue eating, by desire or force of habit, I guess. I dont have this one quite figured out, yet, but I know I need to address this issue. I have seen it many times before.

I have had the experience of reaching the full point, putting my eating tools down, stating that I was completely full, waiting while my companion/s went on eating and talking, and then picked up my tools and started eating again. I just could not leave food on my plate. It was as if the food was starring at me. Perhaps, I was the one doing the starring.

This response is emotional, and very strong inside me. It is not logical and Ive often felt defeated by it, but Ive not found my way around it... yet. I know there has to be a way to deal with this, and it seems, in my mind, to be a trust issue, too. I think it could also be habit. I think I may need some kind of "permission" to actually rely on my bodys message of "Im full" in a new way.

I am not sure a plan to simply "stop" when the full signal goes off will work, but that appears to be the thing that would make the most sense. I have actually tried that in the past with very little success. I would like to respond to the full signal as if it were the final truth in the matter. I realize how odd this sounds but I know that when it comes to emotion, logic does not always enter in.

A picture of a childhood incident has popped into my mind two or three times as Ive been discussing this. I kind of did not want to share the incident because Ive shared it before and it is "boring" to me, now, but I also think it may be significant to this discussion so here is the incident:

I was sitting in a high chair eating a bowl of oatmeal. My mother was standing at the kitchen sink doing dishes. I was old enough to feed myself so my mother had left that to me as she went about doing her business. I had eaten all that I wanted and was playing in my food. My body had told me that I was full and I did not want any more food, so I had just moved on to this new activity. I was happily copying what my mother was doing. She was wiping plates in a circular motion, so I started to stir my food in a circular motion as I washed my dish. I felt I was doing what she was doing and I enjoyed this play.  I really did not want any more food and felt happy to just be with her doing what she was doing.

She turned her head, saw me stirring my unfinished oatmeal and became irritated. She, with very angry body language, stopped what she was doing, wiped her hands, came over, sat down and started forcing food into my mouth. I was suddenly frightened of her. I remember kind of backing up in my chair when I saw her anger and I just opened my mouth as she started shoveling the food in. As the heaping spoonfuls of food were shoved into my mouth, I would let it come out and kind of drip down my chin, I did not want to eat this food, I was full. She scraped my face with the spoon and shoveled that in too. Over and over again. My skin was starting to feel sore from the scraping. She was doing this caully and not intentionally hurting me, but the sheer force of her intention was frightening. I remember deciding that I should remember to clean my plate and eat all my food so I did not have to experience this violation again. I decided to eat all the food on my plate in the future so she would never be angry with me for not eating, ever again.

I have recalled this incident many times before and thought I had dealt with it, but clearly my current eating actions still seem to be related to it and this decision of mine. I feel kind of weepy and tears are welling up in my eyes, so I guess I need to process this information until I find the break through. I remember a technique that Pastor James Chapman once taught me in a counseling session with him.

He showed me a way to think of a certain emotional response as an adult rather than as a child. If I step back and take on the parental adult role of counseling a child, I would probably tell that young girl that it is completely OK to stop eating when your body says it is full.

Stepping back to observe this scene with me as an older child that I can talk to, along with me as an adult standing side by side, watching me as a baby with my mother, I ask "adult me" what I would say to this child to comfort and help her gain understanding of it.

As I look back as an adult I recognize my mothers response. She was busy and had a lot on her mind. She may have had an appointment of some kind that she needed to get to and she wanted to finish these two chores (doing the dishes and feeding the baby) so she could move on to the next important thing. As I think about this, I realize that she may have been pregnant at the time, too. Maybe she was in pain and wanted to just sit down and rest. I have a younger brother who is three years younger than me, but there was also a baby that did not live in between my birth and his. So if I was anywhere from a year to eighteen months old, that would have been right during the time that she was either pregnant or had recently lost my baby sister.

Any one of those things would account for her short tempered actions. As I think about this and compare my older sisters babyhood to my babyhood, it is as if we were from two different families. There were four years between her birth and mine, and no babies that I know of between us, so she had four years of being the baby of the family. There was one very tragic event that happened between the time she was born and I was born, though. My oldest brother, Terry, had drowned two years before I was born. That was a stressful life changing event all on its own. So my mother (and father) had really gone through a lot, already. I also know that when I was born, my mother got pneumonia, and when I was about a month old, I got whooping cough. Near that time my father also had opened a small restaurant/cafe down town which was failing, causing additional stress in the family.

So what I might say to a toddler/child living through this would be something like: "Im so sorry that happened to you. That must have been very scary for you and you did the only thing you could think of. You made a decision that would help you avoid this kind of confrontation in the future. That was not only brave and thoughtful it was clearly the logical choice based on trying to manage a situation that a toddler should not have to manage.You lived through it, and made a plan for the future, too. Good job!

Sometimes we have to be patient with our adults. They are not perfect and your mom was definitely going through some tough times, then. Think about this: she did not beat on you, or yell at you. Look at what she did. She made sure you had enough to eat. She made sure you did not go without something essential to your health. Yes, it could have been done with a little more patience and tenderness, but your mom usually was very patient and soft spoken which is probably why it surprised and frightened you when she was less than her usual quiet self. You were barely a toddler when you made that life-long-lasting decision out of a seemingly dire situation. At least "dire" to a toddler.

Think about other toddlers that you know. They are pretty small. Do you think that letting toddlers make life long decisions is the best way to handle any situation? When you were a toddler, did you know that? No. You didnt. You used all the intelligence and information you could muster in that instant and in your baby mind, you did what you needed to do to survive. There was no one else there to help you, so you did what you needed to do. What a great kid you were, but dont you think that is too much responsibility for a toddler to have to take on? Why is that? Because toddlers cannot see the big picture. Toddlers are too young to be making major life-long decisions on their own. You would not leave that kind of thing up to a baby, now, and you dont have to leave that decision in the hands of the "toddler then," either.

That was a great solution, at that time, but that decision which helped so much in the past is no longer valid for your present reality. It is time to make a new decision about being full. Do you think it might be OK, for you, now, as a sixty-three year old woman, to give yourself permission to leave left overs on your plate? It probably would be OK for you to give yourself permission to leave the food alone whenever you, in your adult mind, can see that you are full.

Picture yourself getting the "full" signal and looking at your plate. First, relax. You are OK. You dont have to eat even one more bite. Being full is a perfectly valid response to having eaten your fill. Notice... this is YOUR fill and no one else has the right to decide whether you are full or not. 

Wow. That last sentence touched me deeply. I began to really cry and then remembered there is a little more to the story that I had forgotten. I remember telling my mother that I was not hungry. I was full, but she completely disregarded me and my state. This battle of wills was not going to be won by the toddler. My mother had reached her last straw and this little girl was not going to get her own way. My mother forced her way on me. She forced me to eat. Every. Last. Drop. No food escaped by dripping out of my mouth. She caully scraped that up too, and made me eat it. She was so angry and determined. She had become a force to be reckoned with. I was angry at this violation of me and so very frightened by her behavior, I never wanted to go through that again. I believed she was angry because I had not finished my food, but that may not really be the case. I believe she was angry because her plan had been side tracked. She may have been frustrated with her life and my childlike playing was just the last straw for her on that morning.

Wow. My mother was like that. Most of the time she was gentle and patient, but aloof. She did not hug us, nor kiss us, nor cuddle us. (She was raised that way, too.) She did not sit next to us on the couch. She never put her arm around us or even patted a hand. She rarely carried on a conversation with me, directly. She was always busy and preoccupied, and if she decided something was going to be a certain way, it was. This reminds me of the hair incident when I was about eight years old.

She wanted to give me a Shirley Temple hairdo. This was probably 1958 and Shirley Temple hair does had gone out of style before I was born, but she wanted me to have that stupid banana curl job on my head. I was completely embarrassed at the thought of it. I told her over and over that I did not want it. I begged her not to do that to me. I cried and begged some more. She told me over and over that it would be cute and I would look good. I knew I was going to end up looking and feeling like a putz. I already had to wear these horrible sturdy green shoes she bought for Susan and me, and also had to wear my sisters old clothes. I was not going to wear that hair do too.

She forced me to sit still in the chair while she did my hair. I gave in and folded my arms and waited, but I did not give up. I knew that I was not going to wear that hair out of the house. I knew I could not stop her from doing this, but I was not going to wear it, either. (By the way, my hair was very hard to style, it was not easy for her to make my thick straight hair look like it had curls.) Anyway. She finished fixing my hair and walked out of the room, I presume, to get some hair spray to keep it that way. As soon as she left, I took my hands and ran them through my hair pulling out all of her work. Then I sat there and waited. I knew I was going to be spanked but, frankly, my dear, I did not give a you-know-what. I would rather take a beating than to walk out the door with that hair do. When she walked back into the room, the other you-know-what, hit the fan. She yanked me out of that chair, began beating my bottom with her hand, and informing me that she would NEVER do my hair again. She never did it, again, either. I was on my own in the hair department after that.

There was the snow pants incident, too. She wanted me to wear them (My sister did not have to wear them.) I used. So she let me go to school that year without them. The next year I was wiser and wanted them because it was so cold without them. She used to get them for me. I knew I was screwed and I walked to school from then on with cold legs and feet. That was when all little girls wore dresses to school, so no matter the temperature my legs were bare in the ice and the cold. Pants were not introduced in high school until the year after I graduated in 1968. Snow pants were the only long pants that little girls were allowed to wear to school.

You know, not until this writing, did I ever fully recognize that my mother and I had battled like that. With her and me it was often a battle of wills and however it ended, "the decision was always final." When Mom made up her mind, or I had forced her to do something my way, she never changed her mind. She never gave in. She never repented. And she never forgave. She never said anything, either, but I knew what was going on. Looking back on this makes me feel really sad. I wish it had not been so difficult for both her and me.

I guess I must have been hard for her to raise. Drawing the line and taking a stand was not an every day occurrence, for sure, which is probably why I never noticed it before -- but I knew how to do it. I think she may have given in to me, much more than I realized before. But not until this writing did I recognize how much she resented that, too. In fact, I think she actually gave up addressing me directly -- although that could also simply have been her MO. I had not realized that, either. I know it must seem odd that I did not notice that, but Ive never looked at this in this way before. Perhaps that is why she used to say that it was easier to raise boys. Ha. Now I understand that statement.

I had not realized that I got my "draw the line" and "do battle" stance from dealing with her. I knew it was there, I just did not know where it came from. It was just, you know, part of me. I remember the foreman at the paper in Salt Lake City giving me a complement that I was both proud of and embarrassed by. He said with admiration in his face and a chuckle of pride in his voice, "You dont take s**t from anyone." I knew he was right. But, I also did not know what to do with that information.

One more thing. I know my mother resented my father, because she used to talk about him behind his back, all the time. As much as fifteen years after he had passed away, she was still talking bad about him like he was in the next room. Their relationship was not all one sided. My Dad had done some things that I find really harsh. I found out that both Susan and I told her we were tired of hearing it. I remember saying to her, that he was my father and I loved him, and that he had been dead for 15 years, when was she going to let go and forgive him? She just started to quietly cry. That was when she told me that Susan had said the same thing to her. I felt sad for her pain.

I had not realized that she resented me, too, or, at least, did not know what to do with me. She was often stern in odd places, but that is another story. I knew I did not trust her but I was never sure why I did not trust her. (Some incidents come to mind but that is for another time.) Perhaps that is why we did not have "conversations"... I remember being about 14 or 15 the first time she actually said anything to me in a conversational sort of way. Oddly enough, I dont recall what was actually said, I just remember being kind of flabbergasted that she had actually spoken to me like I was a person and I remember the exact place in the house that it happened, too.

Most of my life I was "the victim" and I did not understand that, either. Anyway. I am really quite pleased to have remembered and recognized these things. I would never want anyone, including me, to think less of my mother. I still love her and miss her. She taught me some good things, too -- we did not have these stand offs all the time, which is probably why the ones I have mentioned stand out in my mind. She encouraged our creativity and wanted us to be independent. She taught me to cook. She is the one who taught me about God, too. Even though it was the Mormon way, which I later gave up for the truth, it was she, who taught me that God was important, and that prayer works. She really was an amazing woman.

Nobody has "June Lockhart" for a mother. Not even June Lockharts kids. June played the mother in the TV series "Lassie" when I was growing up. I remember wishing that she could be my mother. She spoke to Timmy with sympathy and understanding and treated him like he was a valid human being with authentic thoughts.  I thought she was a little sappy, too, but I really envied Timmy. I say that June Lockharts kids dont have that mother, either, because that was a role in a play and she only had to be Timmys mother for 30 minutes once a week. Somebody else wrote every word she spoke. Anybody can be a perfect angel of a mother for 30 minutes once a week if they have a script!  LOL The rest of the time she is a human being with all the faults and foibles of any other human being -- and no script and no director to say "cut" do over -- just like my Mom.

Im not sure where this revelation will take me in my eating adventures but I hope that I will be able to give myself permission to be full and enjoy the feeling, the next time it occurs. I will have to exercise these new muscles and learn what it is like to actually leave behind any food that I am too full to eat. I kind of like those words, "Too full to eat." Im happy with that.

Im also afraid that all this may have no consequence. What if the next time I feel full, I simply do what Ive always done? I suppose I will have to walk through that one, too -- maybe every time I eat, until I get it down pat.

To sum up where I am, I feel like now I have the "why" and all I need is the "what" as in what can I do with this information that will end up giving me the desired result which is to stop eating after Im full? I think I need to get back into my book and see what the expert says.

I really do have the right to be full... and act like it without fear! 

So odd that all this "stuff" got attached to food.

Thank you, Lord for opening my eyes.

(I just ate dinner, and am feeling nice and full. What an unusual feeling. Ive never experienced it so well, so fully, so deeply and so long before. Amazing.)

Be back soon,

Marcia

A high-fiber diet may have the clinical potential to control the progression of prostate cancer in patients diagnosed in early stages of the disease.

The rate of prostate cancer occurrence in Asian cultures is similar to the rate in Western cultures, but in the West, prostate cancer tends to progress, whereas in Asian cultures it does not. Why? A University of Colorado Cancer Center study published in the January 2013 issue of the journal Cancer Prevention Research shows that the answer may be a high-fiber diet.

The study compared mice fed with of inositol hexaphosphate (IP6), a major component of high-fiber diets, to control mice that were not. Then the study used MRI to monitor the progression of prostate cancer in these models.

"The studys results were really rather profound. We saw dramatically reduced tumor volumes, primarily due to the anti-angiogenic effects of IP6," says Komal Raina, PhD, research instructor at the Skaggs School of Pharmacy and Pharmaceutical Sciences, working in the lab of CU Cancer Center investigator and School of Pharmacy faculty member, Rajesh Agarwal, PhD.

Basically, feeding with the active ingredient of a high-fiber diet kept prostate tumors from making the new blood vessels they needed to supply themselves with energy. Without this energy, prostate cancer couldnt grow. Likewise, treatment with IP6 slowed the rate at which prostate cancers metabolized glucose.

Possible mechanisms for the effect of IP6 against metabolism include a reduction in a protein called GLUT-4, which is instrumental in transporting glucose.

"Researchers have long been looking for genetic variations between Asian and Western peoples that could explain the difference in prostate cancer progression rates, but now it seems as if the difference may not be genetic but dietary. Asian cultures get IP6 whereas Western cultures generally do not," Raina says.

A diet high in omega-3 polyunsaturated fat lowers levels of problem enzyme

Columbia University Medical Center (CUMC) researchers have found that a diet high in saturated fat raises levels of endothelial lipase (EL), an enzyme associated with the development of atherosclerosis, and, conversely, that a diet high in omega-3 polyunsaturated fat lowers levels of this enzyme. The findings establish a "new" link between diet and atherosclerosis and suggest a novel way to prevent cardiovascular heart disease. In addition, the research may help to explain why the type 2 diabetes drug rosiglitazone (Avandia) has been linked to heart problems.

The study, conducted in mice, was published in the October 4 online edition of Atherosclerosis, Thrombosis, and Vascular Biology.

Like other lipases, EL plays a role in the metabolism of blood lipoproteins, which are complexes of lipids (fats) and proteins. EL, which is secreted by macrophages (a type of white blood cell) and other cells in arteries, was discovered in 1999. Studies have shown that elevated EL is associated with atherosclerosis and inflammation. Until now, however, little was known about how dietary fats might affect this enzyme, said study leader Richard Deckelbaum, MD, the Robert R. Williams Professor of Nutrition professor of pediatrics and of epidemiology and director of the Institute of Human Nutrition at CUMC.

In the current study, a strain of mice susceptible to atherosclerosis was fed a normal diet enriched with either palmitic acid (a common saturated fat) or eicosapentaenoic acid (an omega-3 fatty acid, or polyunsaturated fat, found in fish oil, among other foods). After 12 weeks, the mices aortas were examined for changes in the expression of EL and inflammatory factors. Aortas of mice fed the saturated fat diet showed a significant increase in EL and detrimental changes in inflammatory factors, while those of mice fed the polyunsaturated fat diet showed a significant decrease in EL and beneficial changes in inflammatory factors. Studies in cultured macrophages showed similar results.

"Our study identifies a new way in which the high-saturated-fat Western diet could lead to the development of atherosclerosis, though, of course, these results need to be confirmed in human studies," said Dr. Deckelbaum. "The findings might also explain some of the cardiovascular benefits that have been attributed to omega-3 fatty acids."

The researchers also found, in cell culture studies, that macrophages fed saturated fat showed increased expression of PPAR-gamma, a cell signaling molecule that plays a role in regulating lipid metabolism and inflammatory responses. This increase was blocked when the cells were fed an omega-3 fatty acid.

"These findings are intriguing, because we know that the diabetes drug rosiglitazone (sold under the brand name Avandia) is a strong PPAR-gamma activator and that it has been associated with an increased risk of heart disease," said Dr. Deckelbaum. "So we hypothesized that if rosiglitazone activates ppar-gamma, it might also activate EL, which would explain its effects on the heart."

In fact, when the macrophages were given rosiglitazone, the expression of EL increased markedly. The addition of omega-3 fatty acids to the cells blocked this increase. "This would suggest that besides raising LDL cholesterol levels, rosiglitazone can raise the risk of cardiovascular disease by increasing EL," said Dr. Deckelbaum. "In addition to its potential role in increasing arterial inflammatory responses, EL increases the anchoring of LDL to cell surfaces, which could be associated with increased LDL accumulation in coronary arteries."

Use of Avandia was severely restricted in 2010, when the drug was linked to the development of heart disease.

Below is another presentation from the American Association for Cancer Researchs annual conference last week. (I posted another one from their conference about diabetes link to colon cancer here.)

Dr. Irwin and her colleagues found that high levels of fasting C-peptide (a marker for insulin*) was associated with a higher incidence of death from breast cancer in women in their 40s whose cancer was at an early stage. That association decreased as women entered their 50s and 60s. The women did not have diabetes.

They analyzed data from 689 women with breast cancer who were enrolled in the Health, Eating, Activity, and Lifestyle (HEAL) Study. The women were followed for up to 9 years, until 2004.

Insulin has been shown in clinical studies to stimulate the growth of breast cancer cells. This epidemiological study supported that association.

When Do Insulin Levels Rise?

Often, before a diagnosis of diabetes, the bodys cells become increasingly resistant to insulin. That sends a signal to the pancreas to secrete more. It isnt until the beta cells of the pancreas lose their ability to respond that insulin levels drop off. By that time, blood sugar levels are high and type 2 diabetes is well established.

The authors of this study recommended that younger women with breast cancer adopt lifestyle changes, such as exercise, that can moderate insulin levels.


* C-peptide is a protein fragment that splits from proinsulin after proinsulin is released from the pancreas. C-peptide levels lect insulin levels.

________ You can find this abstract by visiting the AACR abstract page, selecting "Poster Session B", and paging down to Abstract B99: Fasting C-peptide levels and breast cancer death in women with breast cancer: The Health, Eating, Activity and Lifestyle (HEAL) Study.

A diet high in glycemic index foods and dairy products is now linked to acne, according to a new study published in the Journal of the Academy of Nutrition and Dietetics.

The study also suggests using medical nutrition therapy (MNT) as a form of acne treatment. The findings support rising evidence of a link between diet and acne.

Over 17 million people in the United States have acne, which generally occurs during their teen and young adult years. Acne can affect quality of life and lead to:

* anxiety
* depression
* social withdraw

Because of these unfavorable consequences associated with the skin condition, treatment for acne is crucial.

Previous studies have always associated diet to this common skin condition. Since the 1800s, research pinpointed chocolate, sugar, and fat as diet factors contributing to acne. However, starting in the 1960s, studies began disassociating diet from acne.

Jennifer Burris, MS, RD, of the Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education, and Human Development, New York University said:

"This change occurred largely because of the results of two important research studies that are repeatedly cited in the literature and popular culture as evidence to ute the association between diet and acne. More recently, dermatologists and registered dietitians have revisited the diet-acne relationship and become increasingly interested in the role of medical nutritional therapy in acne treatment."



The researchers, led by Burris, conducted a literature review to examine evidence for the link between acne and diet during three time periods: early history, the rise of diet-acne myth, and recent studies.

The investigators took information from studies between 1960 and 2012 that examined acne and diet. The study factors that were analyzed were:

* design
* participants
* erence
* intervention method
* results and conclusions
* primary outcome
* covariate considerations
* limitations

The study showed that a high glycemic index/glycemic load diet and high dairy intake are the primary factors in establishing the association between acne and diet.

A byproduct of cholesterol functions like the hormone estrogen to fuel the growth and spread of the most common types of breast cancers, researchers at the Duke Cancer Institute report.

The researchers also found that anti-cholesterol drugs such as statins appear to diminish the effect of this estrogen-like molecule.

Published in the Nov. 29, 2013, edition of the journal Science, the findings are early, using mouse models and tumor cells. But the research for the first time explains the link between high cholesterol and breast cancer, especially in post-menopausal women, and suggests that dietary changes or therapies to reduce cholesterol may also offer a simple, accessible way to reduce breast cancer risk.

"A lot of studies have shown a connection between obesity and breast cancer, and specifically that elevated cholesterol is associated with breast cancer risk, but no mechanism has been identified," said senior author Donald McDonnell, Ph.D., chair of the Department of Pharmacology and Cancer Biology at Duke. "What we have now found is a molecule – not cholesterol itself, but an abundant metabolite of cholesterol – called 27HC that mimics the hormone estrogen and can independently drive the growth of breast cancer."

The hormone estrogen feeds an estimated 75 percent of all breast cancers. In a key earlier finding from McDonnells lab, researchers determined that 27-hydroxycholesterol – or 27HC – behaved similarly to estrogen in animals.

For their current work, the researchers set out to determine whether this estrogen activity was sufficient on its own to promote breast cancer growth and metastasis, and whether controlling it would have a converse effect.

Using mouse models that are highly predictive of what occurs in humans, McDonnell and colleagues demonstrated the direct involvement of 27HC in breast tumor growth, as well as the aggressiveness of the cancer to spread to other organs. They also noted that the activity of this cholesterol metabolite was inhibited when the animals were treated with antiestrogens or when supplementation of 27HC was stopped.

The studies were substantiated using human breast cancer tissue. An additional finding in the human tissue showed a direct correlation between the aggressiveness of the tumor and an abundance of the enzyme that makes the 27HC molecule. They also noted that 27HC could be made in other places in the body and transported to the tumor.

"The worse the tumors, the more they have of the enzyme," said lead author Erik Nelson, Ph.D., a post-doctoral associate at Duke. Nelson said gene expression studies revealed a potential association between 27HC exposure and the development of resistance to the antiestrogen tamoxifen. Their data also highlights how increased 27HC may reduce the effectiveness of aromatase inhibitors, which are among the most commonly used breast cancer therapeutics.

"This is a very significant finding," McDonnell said. "Human breast tumors, because they express this enzyme to make 27HC, are making an estrogen-like molecule that can promote the growth of the tumor. In essence, the tumors have developed a mechanism to use a different source of fuel."

McDonnell said the findings suggest there may be a simple way to reduce the risk of breast cancer by keeping cholesterol in check, either with statins or a healthy diet. Additionally, for women who have breast cancer and high cholesterol, taking statins may delay or prevent resistance to endocrine therapies such as tamoxifen or aromatase inhibitors.

The next steps for research include clinical studies to verify those potential outcomes, as well as studies to determine if 27HC plays a role in other cancers, McDonnell said.

I hate to say I told you so.  But I did.  Like a million times.  Yet, the fear of cholesterol continues.  What is it?  Is it the Lipitor ads?  Is it your cholesterol-phobic doctor, determined to get your cholesterol under 200 mg/dl at all cost?  Whatever it is, its about time we stopped worrying so damn much about high cholesterol.  This new study, entitled "Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid?  Ten years prospective data from the Norwegian HUNT 2 study.", shows us why.  Did anybody hear anything about this one in the media??  I didnt think so, not with a catchy title like that.  At least now the 3 people that read my blog will be aware of it.  The researchers followed 52,087 Norwegians aged 20-74 who were free of cardiovascular disease (CVD) for 10 years, then assessed the relationship of total cholesterol with total mortality, CVD mortality, and ischemic heart disease mortality (IHD).  (Just to be clear, CVD mortality signifies deaths from any disease of the cardiovascular system, while ischemic heart disease ers only to diseases involving restricted blood flow to the heart.)  Lets jump straight into the data then, shall we?  And another note:  since this study comes from Europe, the units for blood cholesterol are shown in mmol/L, rather than the mg/dL that we are used to.  The researchers classified the participants into four groups, based on their blood cholesterol.  Here are the converted unit values in mg/dL for the four groups...  <193, 193-229, 230-269, and >270


First, the least shocking data.  This graph compares the association between cholesterol levels and death from ischemic heart disease.  For the men, it looks like theres not much variation.  Deaths from heart disease rose slightly along with cholesterol levels, but nothing dramatic.  Women, on the other hand, yielded a much more interesting result.  Clearly, by a LARGE margin, cholesterol below 193 mg/dL was most predictive of death from heart disease.  All other groups, including the group with cholesterol over 270 mg/dL, showed significantly lower risk.  Yes, seriously.  On to the next graph!




This one here shows the association between cholesterol and cardiovascular disease, or CVD, which includes heart disease with stroke and any other disease of the cardiovascular system.  Again, lets begin with the men.  The lowest risk appears to lie in those with total cholesterol between 193 and 229 mg/dL, but a close second is the next range up, from 230 to 269.  If you know your erence ranges, you know that anything over 200 is considered dangerous.  Does anybody ever bother to check why this is considered dangerous, or do we just accept it without question??  Clearly, the data from this study suggests that a cholesterol level in men between 193 and 269 is optimal for CVD prevention.  As for women... oops, looks like they screwed up the data there!  They must have it backwards!  Except they dont... yes, the data shows that if youre a woman, the higher your cholesterol is, the lower your risk of death from CVD.  Id repeat it, but Ill be doing that again shortly.  Read on to all-cause mortality!


Here we are, all-cause mortality... the only statistics that really matter.  Deaths from IHD or CVD are cool, but not nearly as cool as all-cause mortality.  This one cuts through the bullshit.  Its not your risk of dying from one disease that really matters, its your risk of dying overall.  So, for men... the group with the HIGHEST risk of dying overall had the LOWEST cholesterol (below 193 mg/dL).  Even those with a cholesterol level over 270 fared better.  The sweet-spot, protective level here was shown to be 193-229, a level that, based on the current erence ranges, will likely get you prescribed a statin drug for being too high!  Its just not right I tell ya.  And for the women, we see another complete inverse relationship between blood cholesterol and all-cause mortality.  High cholesterol appears to be protective for the ladies!  Maybe I could incorporate that into a pickup line somehow... but I digress.

So, does this prove anything?  No.  Not really.  Although it happens to be in accordance with what I believe, its all just observation.  But this isnt the only study to show this kind of trend, just the most recent; there are at least 20 others like it if you just follow that link.  And it certainly makes a strong case for women... having low cholesterol, in the healthy erence range, mind you, just appears to be straight up deadly!  Despite the studys inability to conclusively prove anything, that didnt stop the researchers from letting loose a little on the drug industry.  And I quote from the conclusion of the paper... "Many individuals who could otherwise call themselves healthy struggle conscientiously to push their cholesterol under the presumed danger limit, coached by health personnel, personal trainers, and caring family members.  Massive commercial interests are linked to drugs and other remedies marketed for this purpose."  That may not seem so harsh, but for a group of researchers to say this and imply that massive commercial interests are wrongly influencing the clinical guidelines... thats a pretty strong statement.  And I agree wholeheartedly.  The guidelines need to be reassessed.

What does this mean, though, if having high cholesterol isnt a bad thing?  What are the implications?  Well, for one, maybe it will get people off these ridiculous statin drugs.  But even more significant, to me, are the implications for saturated fat consumption.  These days, everyone just "knows" saturated fat is bad.  But if I asked you, could you tell me why?  The standard answer is, because saturated fat raises your blood cholesterol.  Well... um... so what?  If you step outside of this cholesterol=bad paradigm for a while, things start to look a bit different.  What else is known about saturated fat?  Well, if you eat more of it, it makes up more of your cell membranes, and its highly resistant to oxidative damage.  So thats good, it protects your cells.  And... short-chain saturated fats like butyric acid, found in butter, are burned perentially as fuel and promote proper immune function.  And... saturated fats enhance calcium absorption, along with all the fat-soluble vitamins (A, D, E, K).  And dont forget, if youre a woman, having high cholesterol appears to be beneficial.  Wait a minute... could saturated fat be... healthy!?  So much for a French paradox...

Patients who consume high-fat dairy products following breast cancer diagnosis increase their chances of dying from the disease years later, according to a study by Kaiser Permanente researchers.

The study, published in the Journal of the National Cancer Institute, is the first to examine the relationship between high-fat and low-fat dairy consumption following a diagnosis of breast cancer and long-term breast cancer survival.

Previous studies have shown that higher lifetime exposure to estrogen is a causal pathway to breast cancer. Estrogen levels are believed to be elevated in dairy products consumed in the Western world, because most of its milk comes from pregnant cows. Estrogenic hormones reside primarily in fat, so levels are higher in high-fat than in low-fat dairy products.

The researchers studied a cohort of women who were diagnosed with early-stage, invasive breast cancer between 1997 and 2000, primarily from Kaiser Permanentes Northern California region (83 percent) and the Utah Cancer Registry (12 percent).

Those consuming larger amounts of high-fat dairy (one serving or more per day) had "higher breast cancer mortality as well as higher all-cause mortality and higher non-breast cancer mortality," wrote lead author Candyce H. Kroenke, ScD, MPH, staff scientist with the Kaiser Permanente Division of Research, and co-authors.

"Specifically, women consuming one or more servings per day of high-fat dairy had a 64 percent higher risk of dying from any cause and a 49 percent increased risk of dying from their breast cancer during the follow-up period," said Kroenke. The category of high-fat dairy products researchers tracked included cream, whole milk, condensed or evaporated milk, pudding, ice cream, custard, flan, and also cheeses and yogurts that were not low-fat or non-fat.

In general, the women studied reported that they consumed low-fat milk and butter most often, and they consumed relatively limited amounts of low-fat dairy desserts, low-fat cheese and high-fat yogurt. Overall, low-fat dairy intake was greater (median 0.8 servings per day) than high-fat dairy (median 0.5 servings per day).

The study found an association between high-fat dairy and breast cancer mortality, but no association with low-fat dairy products and breast cancer outcomes.

"High-fat dairy is generally not recommended as part of a healthy diet," said senior author Bette J. Caan, DrPH, research scientist with the Kaiser Permanente Division of Research. "Switching to low-fat dairy is an easy thing to modify."

Women entered into the cohort approximately two years after their breast cancer diagnosis. At the beginning of the study, 1,893 women completed a self-administered food-frequency questionnaire, and 1,513 of these women completed a follow-up questionnaire six years later. They were followed for 12 years on average following study entry.

The women were asked how often they consumed dairy foods during the previous year; what portion sizes they generally consumed; which products they ate, including milk, cheese, dairy desserts, yogurt, and beverages made with milk (such as hot chocolate or lattes); and whether the dairy products were full fat, low fat or nonfat.

Of the total sample, 349 women had a recurrence of breast cancer and 372 died of any cause, 189 (50.8 percent) of them from breast cancer.

This research was part of the Life After Cancer Epidemiology (LACE) study, one of several efforts by investigators with the Kaiser Permanente Division of Research to consider the role of lifestyle factors such as nutrition, exercise and social support on long-term breast cancer survival and recurrence. While hundreds of studies have examined the role of lifestyle factors in cancer risk and prevention, this study is one of a small but growing number that focus on the role of lifestyle factors after a breast cancer diagnosis.

For example, the Pathways study of breast cancer survivorship, based at the Division of Research, is collecting and analyzing data about womens genetic background, tumor characteristics and lifestyle choices immediately after diagnosis. Findings from this study, along with the LACE study, are providing objective information to help guide women as they make decisions following a breast cancer diagnosis; among these findings are that soy decreases the risk of breast cancer recurrence, quality of life after diagnosis influences outcomes, and physical activity is beneficial.

Susan E. Kutner, MD, chair of the Kaiser Permanente Northern California Regional Breast Care Task Force, said that the new study bolsters the counseling that Kaiser Permanente gives breast cancer survivors about the importance of a low-fat diet, as well as exercise and weight management, in preventing recurrence of the disease. "Women have been clamoring for this type of information," Kutner said. "Theyre asking us, Tell me what I should eat? With this information, we can be more specific about recommending low-fat dairy products."

The issue of cholesterol is complex, to say the least.  You might not realize it from watching cholesterol-lowering drug commercials, or even from talking to your doctor.  But there is way more to the story than simply keeping your cholesterol low.  This will probably be a frequent topic on my blog, as there are so many aspects of it to be explored, but for today Id like to focus on total cholesterol.

Check out this very eye-opening paper.  Its an outstanding review of some of the more intriguing cholesterol research, and one of the few papers that Ive actually found difficult to put down.  I seriously couldnt stop reading it.  And it blew my mind.

According to several studies, older adults with higher cholesterol live the longest. In fact, groups with the lowest cholesterol levels typically have the highest morbidity rate.  Heres the breakdown from a couple of these studies...  Dr. Harlan Krumholz found in 1994 that old people with low cholesterol were twice as likely to die from coronary heart disease than those with high cholesterol.  Another study of 92 women aged 60 or over found that those with a total cholesterol level of about 270 mg/dl lived the longest.  Those with the highest cholesterol, over 300 mg/dl, were only 1.8 times more likely to die, while the lowest cholesterol group, 154 mg/dl, was 5.4 times more likely to die.

Interesting stuff huh?  That review paper discusses 20 studies just like these, where blood cholesterol levels were either not associated with cardiovascular disease or all-cause death, or there was an inverse relationship.  This quote from the paper sums up the situation quite nicely...

"It is true that high t-C is a risk factor for coronary heart disease, but mainly in young and middle-aged men. If high t-C or LDL-C were the most important cause of cardiovascular disease, it should be a risk factor in both sexes, in all populations, and in all age groups. But in many populations, including women, Canadian and Russian men, Maoris, patients with diabetes, and patients with the nephrotic syndrome; the association between t-C and mortality is absent or inverse; or increasing t-C is associated with low coronary and total mortality. Most strikingly, in most cohort studies of old people, high LDL-C or t-C does not predict coronary heart disease or all-cause mortality; in several of these studies the association between t-C and mortality was inverse, or high t-C was associated with longevity. These associations have mostly been considered as a minor aberration from the LDL-receptor hypothesis, although by far the highest mortality and the greatest part of all cardiovascular disease are seen in old people."

 In case youre having trouble with the terminology, t-C just means total cholesterol, LDL-C means LDL cholesterol.  A couple of key points here...  if cholesterol is the cause of heart disease, then shouldnt it be a risk factor for everybody, regardless of age, sex, or ethnicity?  It should.  But its not.  While cholesterol levels can be somewhat predictive of ones risk of heart disease, cholesterol doesnt cause the problem.  The second bolded quote is very key as well.  Studies done in older adults, like these ones showing that those with high cholesterol have less risk of cardiovascular disease, should not be taken as an aberration.  By far the highest risk group is adults over 60, so if the conventional wisdom doesnt hold true for them, it doesnt hold true at all.  These studies should indicate that our current thinking about cholesterol is highly flawed.  Cholesterol simply cannot be the cause of heart disease when it is so notoriously unreliable as a predictor of heart disease in the most at-risk populations.  Its that simple.

The risks associated with hypertension, high blood pressure (BP) as its commonly called, may be different for very old compared to younger adults. Paula Span, who writes the New Old Age Blog at the New York Times discussed this in her post:

For the Very Old, a Surprise in Blood Pressure Readings, New York Times, 8 August 2012

Span writes:

"I was startled to learn that in the very elderly - those over 85, say - high blood pressure may indicate better health while lower numbers could mean trouble ahead."

Span had been reading a study and an accompanying editorial published in the Archives of Internal Medicine last year:

Rethinking the Association of High Blood Pressure With Mortality in Elderly Adults, JAMA Internal Medicine, August 2012
Comment on “Rethinking the Association of High Blood Pressure With Mortality in Elderly Adults," Goodwin JS, JAMA Internal Medicine, August 2012

In his editorial, Goodwin offered some background:

"In 1988, Matilla et al reported that, among the very old, elevated systolic and diastolic blood pressure (BP) were associated with longer survival. The differences were not subtle. The 5-year survival of those with systolic BPs greater than 200 mm Hg were almost twice as high as those with levels of 120 to 140 mm Hg. Over the ensuing 25 years, a substantial number of population-based studies have reported the same findings: in those older than 85 years (or older than 80 years in some studies), high BP is an excellent prognostic sign.

Perhaps the most rigorous assessment came from the Framingham Study, which reported that the strong positive association of BP with cardiovascular mortality was reversed between the ages of 75 and 85. Importantly, no population-based study has found the opposite, that high BP is a marker for bad outcomes in octogenarians. Conversely, “normal” BP is bad. Perhaps the worst sign is falling BP."

Why does high BP appear to be a good sign in an older population? Goodwin explains that the old are a mixture of frail and more robust individuals.  High BP does not connote the same level of health in both groups.  Referring to Diehr et al. he said:

"[The very old] showed a steady decrease in BP in the 3 years before death. ... High BP is only a good sign in very old age because many of those with “normal” BP have it for bad reasons."

When is it advantageous to treat high blood pressure in an older person? Goodwin says:

"Many robust, very old individuals have hypertension. Antihypertensive treatment in those individuals is beneficial. Frail older individuals are less likely to have hypertension, and treating those who do may produce bad outcomes."

How do you measure robustness? One good test is walking speed.

In the study at the top of this post, those with hypertension who could walk a 20-foot corridor at an average pace of 1.8 mph or better had about the same risk of dying as younger adults. Those with high BP who walked slower did not have an increased risk. And those with high BP who couldnt complete the walk had a 60% lower risk of death:

"Higher systolic BP was associated with an increased risk of mortality only among elderly adults who had a medium to fast walking pace. In contrast, among slower-walking older adults, there was not an association between elevated systolic or diastolic BP and mortality. Strikingly, we found elevated systolic and diastolic BP was strongly and independently associated with a lower mortality risk in participants who did not complete the walk test."

The lead author of the study, Dr. Michelle Odden, said:

"The paradigm in medicine is, high blood pressure is bad, treating it is good. We’re saying, maybe we need to look more closely at the guidelines and tailor them more to older adults."

________

According to the White House, the health insurance exchange glitches are a symptom of high demand from a grateful citizenry eager to embrace Obamacare. While articles like this and this suggest that sloppy and amateurish programming is really behind the website crashes, the Disease Management Care Blog is concerned that early high demand - if it exists - could be an early sign of a coming insurance death spiral.

"Death spirals" occur when persons with high levels of risk disproportionately enter an insured population.  When that happens, premiums have to rise to match the increased expenses. That, in turn, causes persons with lower risk to drop their insurance, leading to an even higher proportion of high risk individuals, who drive prices even higher.

The DMCB intuitively doubts that the early high demand described by the White House is the result of healthy latte-sipping millenials and young invincibles having nothing better to do with their web-surfing time.  Rather, the persons most likely to be in a rush to get into the web site are persons who really need insurance.  Those would be the ones facing huge health care bills.
 
Another indication is the relative lack of the standard individual anecdote or "ledes" in media reports that hook the reader into paying attention.  Used by politicians and journalists alike, ledes put a "human face" on a narrative by bridging the personal and the policy.   

Supporters of exchanges would probably like to see something ledes along the lines of...

For years, 25 year old Ivanna Ceeadoc could only lurk outside the local health clinic and watch helplessly as her friends from the coffee shop down the street got free health communications from the nurse practitioners within.  But after using the health insurance exchange....

or

Until he signed up in the health insurance exchange, part-time jazz drummer and retail specialist Hank Erinfersumburgers never had to see a health care provider. Previously unaware of a bleak future of fast food and tight clothes, Hanks zero dollar co-pay now lets him see a dietician and have enough money left over for a lunch......

Young Ivanna and Hank havent made an appearance in the national health insurance exchange narrative because they probably arent part of the story.  More likely, its persons in their 50s and early 60s who have been hold they need a joint replacement, an angioplasty or back surgery....

 Ima Medeesazter was looking at a stack of medical bills a mile high.  Her surgeons plans included weeks in a hospital costing her hundreds of thousands of dollars. Ima put things off, but now that she used the exchange, she can look forward to getting to know her ICU nurses really well.......

Even more worrisome: this astonishing statement by HHS Administrator Kathleen Sebelius that she "doesnt know" how many have enrolled in health insurance since the October 1 opening date.  If the experts running the shop are unaware the Insurance 101 principle of knowing who and why persons are signing up for health insurance, they have no idea about the spiral threat.

Image from Wikipedia

If youre a regular reader of this blog, you may know that I love to talk about cholesterol.  You know about my many blog posts on the falsity of the lipid hypothesis, the idea that high cholesterol causes heart disease.  Its been by far the most covered topic on my blog (1, 2, 3, 4, 5, 6, 7, 8, 9, 10).  Its always been a major topic of interest to me, because I feel so strongly that people are being misled when it comes to cholesterol.  Its my view that high cholesterol (recognized by most doctors as higher than 200 mg/dl) is completely overrated as a risk factor for heart disease, and that cholesterol-lowering drugs are unnecessary/useless/potentially harmful for 95% of the population.  Everyone is always so damn worried about their cholesterol, and they dont need to be.  So Im "that guy".  Im the guy who scoffs at doctors when they prescribe statin drugs for women with cholesterol levels of 210.  Im the guy who shakes his head when an otherwise healthy person returns from the doctors office upset about having high cholesterol.  And Im DEFINITELY the guy who laughs when you start eating egg white omelets every morning to fix it.  Thats just hilarious in so many ways.
Second test
My diet had not changed that significantly from the first to the second test, in which my total and LDL dropped dramatically.  I began to increase my carb intake a little, and I cut back on the conventional fatty meat for sure.  I ate more full-fat dairy and eggs, as well as some rice and potatoes.  The macronutrient ratios likely didnt differ much from that of the first test:  55% fat, 25% protein, 20% carbs.

Third test
I would say my diet has changed more from the second to the third test than from the first to the second.  I now eat significantly more gluten-free grains like rice and corn, as well as potatoes.  I still eat around 4 eggs each day and drink whole milk regularly.  But of course, meat, vegetables, and fruits are still a major part of my diet.  Oh, and grass-fed butter.  What would I ever do without you.  I would estimate my diet at about 40% fat, 25% protein, 35% carbs. 

Nutrition researchers from Northwestern Medicine in Chicago report that a diet naturally high in fiber provides critical protection from heart disease in a study of adults aged 20 to 59 years. Results presented to the American Heart Association`s Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention Scientific Sessions draws the direct correlation between fiber consumption and heart disease risk.

Can what we eat affect how well we breath while were asleep? By the looks of this study, yes:

Associations Of Dietary Intake And Physical Activity With Sleep Disordered Breathing In The Apnea Positive Pressure Long-term Efficacy Study (APPLES), Journal of Clinical Sleep Medicine, 2008

Its one of the first examinations of diet in people with sleep disordered breathing (SDB), including sleep apnea. It found:

"The results indicated that even after adjusting for BMI, age, and daytime sleepiness, subjects with very severe and extremely severe SDB (RDI ≥ 50*) consumed a diet that was higher in cholesterol, protein, total fat, and total saturated fatty acids. These findings were most evident among women."

* RDI is Respiratory Disturbance Index. Individuals with an RDI ≥ 10 events/hour were considered to have obstructive sleep apnea.

Although obesity is a risk factor for sleep apnea, this study found that - apart from being overweight - a high-fat, high-protein diet led to disordered nighttime breathing. Cholesterol and protein, nutrients typically found in foods of animal origin, were especially strong indicators. Trans fats, total fat, and saturated fat followed.

Below is a chart from the study. It shows that people with apnea tended to eat fewer carbohydrates than recommended, and more total fat and saturated fat. (Goals were based on the 2005 USDA Dietary Guidelines.) Although it shows protein consumed near goal, its misleading and in actuality "high when considered in absolute terms, partly as a consequence of high overall caloric intake."


Click to enlarge.

Correcting sleep apnea is desirable since its linked to high blood pressure, heart disease, and stroke.

If youre experiencing sleep apnea, take note if cutting back on meat, cheese and other dairy products improves your nighttime breathing.

Related post: Sleep Apnea: Common Among People With Diabetes
________

Whether you hope to lose weight or just stay healthy, what you eat is a crucial factor. The right nutrients can not only trim your waistline, but also provide energy, improve your mood, and stave off disease. Now a Tel Aviv University researcher has found that its not just what you eat — but when.

Metabolism is impacted by the bodys circadian rhythm — the biological process that the body follows over a 24 hour cycle. So the time of day we eat can have a big impact on the way our bodies process food, says Prof. Daniela Jakubowicz of TAUs Sackler Faculty of Medicine and the Diabetes Unit at Wolfson Medical Center. In a recent study, she discovered that those who eat their largest daily meal at breakfast are far more likely to lose weight and waist line circumference than those who eat a large dinner.

And the benefits went far beyond pounds and inches. Participants who ate a larger breakfast — which included a dessert item such as a piece of chocolate cake or a cookie — also had significantly lower levels of insulin, glucose, and triglycerides throughout the day, translating into a lower risk of cardiovascular disease, diabetes, hypertension, and high cholesterol. These results, published recently in the journal Obesity, indicate that proper meal timing can make an important contribution towards managing obesity and promoting an overall healthy lifestyle.

The study was done in collaboration with Dr. Julio Wainstein of TAU and the Wolfson Medical Center and Dr. Maayan Barnea and Prof. Oren Froy at the Hebrew University of Jerusalem.

A dramatic difference

To determine the impact of meal timing on weight loss and health, Prof. Jakubowicz and her fellow researchers conducted a study in which 93 obese women were randomly assigned to one of two isocaloric groups. Each consumed a moderate-carbohydrate, moderate-fat diet totalling 1,400 calories daily for a period of 12 weeks. The first group consumed 700 calories at breakfast, 500 at lunch, and 200 at dinner. The second group ate a 200 calorie breakfast, 500 calorie lunch, and 700 calorie dinner. The 700 calorie breakfast and dinner included the same foods.

By the end of the study, participants in the "big breakfast" group had lost an average of 17.8 pounds each and three inches off their waist line, compared to a 7.3 pound and 1.4 inch loss for participants in the "big dinner" group. According to Prof. Jakubowicz, those in the big breakfast group were found to have significantly lower levels of the hunger-regulating hormone ghrelin, an indication that they were more satiated and had less desire for snacking later in the day than their counterparts in the big dinner group.

The big breakfast group also showed a more significant decrease in insulin, glucose, and triglyceride levels than those in the big dinner group. More important, they did not experience the high spikes in blood glucose levels that typically occur after a meal. Peaks in blood sugar levels are considered even more harmful than sustained high blood glucose levels, leading to high blood pressure and greater strain on the heart.

Eliminating late night snacking

These findings suggest that people should adopt a well thought-out meal schedule, in addition to proper nutrition and exercise, to optimize weight loss and general health. Eating the right foods at the wrong times can not only slow down weight loss, it can also be harmful. In their study, the researchers found that those in the big dinner group actually increased their levels of triglycerides — a type of fat found in the body — despite their weight loss, reports Prof. Jakubowicz.

Prof. Jakubowicz suggests an end to late night snacking. Mindless eating in front of the computer or television, especially in the late evening hours, is a huge contributor to the obesity epidemic, she believes. It increases not only poundage, but the risk of cardiovascular disease — making that midnight sugar rush more costly than it appears.

It is the first time that a scientific study associates high polyphenols intake with a 30% reduction in mortality in older adults. The research, published on Journal of Nutrition, is the first to evaluate the total dietary polyphenol intake by using a nutritional biomarker and not only a food frequency questionnaire. Research is signed by Cristina Andrés Lacueva, Montserrat Rabassa and Mireia Urpí Sardà, from the Department of Nutrition and Bromatology of the UB; Raúl Zamora Ros (ICO-IDIBELL), and experts Antonio Cherubini (Italian National Research Centre on Aging), Stefania Bandinelli (Azienda Sanitaria di Firenze, Italy) and Luigi Ferrucci (National Institute on Ageing, United States).

Polyphenols: diet improves health

Polyphenols are naturally occurring compounds found largely in fruits, vegetables, coffee, tea, nuts, legumes and cereals. More than 8,000 different phenolic compounds have been identified in plants. Polyphenols have antioxidant, antiinflammatory, anticarcinogenic, etc. effects.

The research published on Journal of Nutrition is based on a 12-year follow-up of a population sample composed by 807 men and women aged 65 or over from Greve and Bagno (Tuscany, Italy), within the InCHIANTI study. The group of the UB analysed the effect of polyphenol-rich diets by means of a nutritional biomarker -- the total urinary polyphenol (TUP) concentration -- as a proxy measure of intake. To be exact, UB researchers contributes to first literature erences on TUP application to epidemiological or clinical studies.

New biomarkers for nutritional studies

Professor Cristina Andrés Lacueva, head of the Biomarkers and Nutritional & Food Metabolomics Research Group of the UB and coordinator of the study, explains that "the development and use of nutritional biomarkers enables to make a more precise and, particularly, more objective estimation of intake as it is not only based on participants memory when answering questionnaire. Nutritional biomarkers take into account bioavailabity and individual differences. According to the expert, "this methodology makes a more reliable and accurate evaluation of the association between food intake and mortality or disease risk."

In conclusion, the research proves that overall mortality was reduced by 30% in participants who had rich-polyphenol diets (>650 mg/day) in comparison with the participants who had low-polyphenol intakes (<500 mg/day).

Raúl Zamora Ros, first author of the study, points out that "results corroborate scientific evidence suggesting that people consuming diets rich in fruit and vegetables are at lower risk of several chronic diseases and overall mortality." Moreover, the research stresses the importance of evaluating -- if possible -- food intake by using nutritional biomarkers, not only food frequency questionnaires.

The Biomarkers and Nutritional & Food Metabolomics Research Group, which participates in the project Fun-C-Food (Consolider Ingenion), collaborates actively with several national and international research groups. It focuses its activity on the analysis of new more effective and sensitive nutritional biomarkers based on the bioavailabilty of bioactive compounds in food and their activity, in order to associate the intake of certain foods (consumption markers) with their potential effects on peoples health.