Health Tips From The Professor Are High Fat Dairy Foods Good For You?

Posted November 13, 2018 by Dr. Steve Chaney

Can You Have Your Cream And Eat It Too?

Author: Dr. Stephen Chaney

 

are high fat dairy foods good for youDairy foods can play an important role in helping us get enough calcium in our diet and may provide some other benefits (discussed below). However, many dairy foods contain a lot of saturated fat. Thus, we have been told to select low-fat dairy foods. So, what should we make of the recent headlines and blogs telling us that high-fat dairy foods are good for us?

Are high fat dairy foods good for us?

To answer that question, I picked a recent article (F. Imamura et al, PLOS Medicine, doi: 10.1371/journal.pmed.1002670 ) claiming that dairy fats lower the risk of type 2 diabetes and did an in-depth analysis of the data behind the headlines.

Fat Chemistry 101

 

Before I get started, let me cover what I call “Fat Chemistry 101”. Sorry, professors never fully retire.

are high fat dairy foods good for you professorFat Nomenclature: Let me briefly describe some of the nomenclature that chemists and biochemists use when they describe fats. Fats, or triglycerides, are generally defined as three fatty acids attached to a molecule of glycerol. The chemical nomenclature for fatty acids consists of a “C” followed by the number of carbons in that fatty acid. That, in turn, is followed by a colon (:) and the number of doubles bonds (0 for a saturated fatty acid, 1 for a monounsaturated fatty acid, and 2 or more for a polyunsaturated fatty acid). Let me give some examples, specifically the examples I will refer to in this article.

Saturated fatty acids:

  • C15:0 (pentadecanoic acid)
  • C16:0 (palmitic acid)
  • C17:0 (heptadecanoic acid)
  • C18:0 (stearic acid)

Monounsaturated fatty acids:

C16:0, and C18:0 are referred to as even-chain fatty acids (They have an even number of carbon atoms). C15:0 and C17:0 are referred to as odd-chain fatty acids (They have an odd number of carbon atoms).

C16:0 (palmitic acid) is the most abundant saturated fatty acid in meats and dairy food. C18:0 (stearic acid) is the second most abundant saturated fatty acid in these foods. The odd-chain fatty acids C15:0 and C17:0 are primarily found in dairy fat although small amounts can also be found in meat and fish.

All saturated fats raise LDL cholesterol. However, the effect is not equally strong for all saturated fats. The effect on LDL cholesterol is strongest for palmitic acid (C16:0). It is weaker for stearic acid, possibly because stearic acid (C18:0) can be metabolized to oleic acid (C18:1), which has no effect on LDL cholesterol.

Foods Are A Complex Mixture Of Fats: We generally think of saturated fats coming from meat and dairy, monounsaturated fats coming from olive oil and avocados, and polyunsaturated fats as coming from vegetable oils, seeds, and nuts. However, that is an oversimplification. Meats also contain monounsaturated and polyunsaturated fats. Olive oil contains some saturated and polyunsaturated fats. Vegetable oils also contain monounsaturated and saturated fats.

Why do I even mention this? It is important because we tend to label a food “good” or “bad” based on its most abundant fat. Perhaps we would be better served if we considered all the major fats in that food before deciding whether it is good or bad for us.

How Was The Study Designed?

are high fat dairy foods good for you studiesWith that background in mind, let us turn our attention to the current study. The authors wished to test the hypothesis that high-fat dairy foods might decrease the risk of type 2 diabetes. The results of previous studies had been mixed, but the authors hypothesized that might have been due to the limitations of using dietary recalls to assess intake of high-fat dairy foods. Specifically, they theorized that dietary recalls tend to underestimate the less apparent sources of dairy fats such as creams, sauces, cheeses, and butter used as part of meal preparation or in prepared foods.

They postulated that blood and tissue concentrations of the odd-chain fatty acids (C15:0 and C17:0) would be a much better biomarker of dairy fat consumption than dietary recalls. They performed a meta-analysis of all studies that measured blood or tissue levels of odd-chain fatty acids and looked at type 2 diabetes as an outcome.

Their meta-analysis included 16 studies from 12 countries with a total of 63,682 participants (age range: 49 to 76 years). The participants were slightly overweight, but none of them had type 2 diabetes at the beginning of the studies. The participants were followed for an average of 9 years. By the end of the studies 15,180 (24%) had developed type 2 diabetes.

 

Are High Fat Dairy Foods Good For You?

 

are high fat dairy foods good for you milk cheeseWhen the authors compared the highest versus the lowest levels of odd-chain fatty acids in the subjects, the results of the study were as follows:

  • The highest level of C15:0 fatty acids was associated with a 20% lower incidence of type 2 diabetes.
  • The highest level of C17:0 fatty acids was associated with a 35% lower incidence of type 2 diabetes. This is consistent with several previous studies that have suggested C17:0 fatty acids are a better predictor of type 2 diabetes than C15:0 fatty acids.
  • When these data were combined the overall effect was a 29% lower incidence of type 2 diabetes.

The authors concluded: “These novel findings support the need for additional clinical and molecular research to elucidate the potential effects of [odd-chain] fatty acids on glucose-insulin metabolism and the potential role of selected [high-fat] dairy products for the prevention of type 2 diabetes.”

What Does This Study Mean For You?

are high fat dairy foods good for you what does it meanOn the surface, this looks like a very strong study. It is, after all, a meta-analysis with over 68,000 subjects. It also used biomarkers for dairy fat consumption rather than relying on less accurate dietary recalls. Finally, it is consistent with several earlier studies suggesting that high-fat dairy foods decrease the risk of type 2 diabetes and heart disease. What could go wrong?

The answer is “Plenty.”

  • Studies looking at the effect of high-fat dairy foods on the risk of heart disease and type 2 diabetes have been inconsistent. Some have shown benefit, but others have come up empty. Despite the inconsistent results, the idea that high-fat dairy foods might be good for us has gotten a lot of media attention. I suspect that is because this is the kind of news we really want to be true. After all, wouldn’t it be great news if we could eat all the cheese, cream, and butter we wanted?
  • Some studies have concluded that high-fat and low-fat dairy products were equally effective at decreasing the risk of heart disease and type-2 diabetes. If these studies are correct, they would suggest something else in dairy foods is protective, not the kind of fat.
  • The odd-chain saturated fatty acids are very minor constituents of dairy fat. Together, they represent 1.3% of the fatty acids in dairy fat. In contrast, even-chain saturated fatty acids make up 68% of the fatty acids in dairy fat. Palmitic acid (C16:0) makes up 30% or 23 times the concentration of odd-chain fatty acids. Stearic acid (C18:0) makes up 12% or 9 times the concentration of odd-chain fatty acids.
  • This study, and most previous studies, have just looked at the association between odd-chain fatty acids and type 2 diabetes. They do not prove cause and effect.
  • No mechanism has been proposed that would account for the proposed beneficial effects of odd-chain saturated fatty acids, especially in the presence of much higher concentrations of even-chain saturated fatty acids.
  • A study published last year (BJ Jenkins et al, Scientific Reports, 7:44845, doi: 10.1038/srep44845 ) reported that blood levels of C15:0 were dependent on intake of dairy foods, but that blood levels of C17:0 were independent of dairy intake. These authors presented evidence showing C17:0 in the human body resulted from metabolism of C18:0 (stearic acid) in our diet rather than coming from dairy fats.

In other words, the odd-chain fatty acid (C15:0) that comes from dairy foods is the one that has only a weak association with the risk of developing type 2 diabetes. The odd-chain fatty acid with a strong association with diabetes risk is synthesized in our bodies from stearic acid (C18:0), a fatty acid that is also found at high levels in meat.

So, are high fat dairy foods good for you?  More studies are needed.

 

The Bottom Line

 

A recent study has reported that high-fat dairy products may reduce the risk of type 2 diabetes. This is consistent with a few other studies that have suggested high-fat dairy products may reduce the risk of diabetes and heart disease.

The idea that high-fat dairy foods might be good for us has gotten a lot of media attention. I suspect that is because this is the kind of news we really want to be true. After all, wouldn’t it be great news if we could eat all the cheese, cream, and butter we wanted?

However, the clinical results have been inconsistent. Some have shown benefit, but others have come up empty. Most of the studies also had significant limitations. I have discussed the limitations of the current study in the article above.

We can remain hopeful that high-fat dairy foods will eventually be shown to be good for us, but until we have stronger evidence for the proposed benefits of dairy fats, my recommendation is to consume high-fat dairy products sparingly.

 

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor Is Our Microbiome Affected By Exercise?

Posted November 6, 2018 by Dr. Steve Chaney

Microbiome Mysteries

Author: Dr. Stephen Chaney

is our microbiome affected by exerciseIn a recent post,  What is Your Microbiome and Why is it Important,  of “Health Tips From The Professor” I outlined how our microbiome, especially the bacteria that reside in our intestine, influences our health. That influence can be either good or bad depending on which species of bacteria populate our gut. I also discussed how the species of bacteria that populate our gut are influenced by what we eat and, in turn, influence how the foods we eat are metabolized.

I shared that there is an association between obesity and the species of bacteria that inhabit our gut. At present, this is a “chicken and egg” conundrum. We don’t know whether obesity influences the species of bacteria that inhabit our gut, or whether certain species of gut bacteria cause us to become obese.

Previous studies have shown that there is also an association between exercise and the species of bacteria that inhabit our gut. In particular, exercise is associated with an increase in bacteria that metabolize fiber in our diets to short chain fatty acids such as butyrate. That is potentially important because butyrate is a primary food source for intestinal mucosal cells (the cells that line the intestine). Butyrate helps those cells maintain the integrity of the gut barrier (which helps prevent things like leaky gut syndrome). It also has an anti-inflammatory effect on the immune cells that reside in the gut.

However, associations don’t prove cause and effect. We don’t know whether the differences in gut bacteria were caused by differences in diet or leanness in populations who exercised regularly and those who did not. This is what the present study (JM Allen et al, Medicine & Science In Sports & Exercise, 50: 747-757, 2018 ) was designed to clarify.  Is our microbiome affected by exercise?

 

How Was The Study Designed?

is our microbiome affected by exercise studyThis study was performed at the University of Illinois. Thirty-two previously sedentary subjects (average age = 28) were recruited for the study. Twenty of them were women and 12 were men. Prior to starting the study, the participants filled out a 7-day dietary record. They were asked to follow the same diet throughout the 12-week study. In addition, a dietitian designed a 3-day food menu based on their 7-day recall for the participants to follow prior to each fecal collection to determine species of gut bacteria.

The study included a two-week baseline when their baseline gut bacteria population was measured, and participants were tested for fitness. This was followed by a 6-week exercise intervention consisting of three supervised 30 to 60-minute moderate to vigorous exercise sessions per week. The exercise was adapted to the participant’s initial fitness level, and both the intensity and duration of exercise increased over the 6-week exercise intervention. Following the exercise intervention, all participants were instructed to maintain their diet and refrain from exercise for another 6 weeks. This was referred to as the “washout period.”

VO2max (a measure of fitness) was determined at baseline and at the end of the exercise intervention. Stool samples for determination of gut bacteria and concentrations of short-chain fatty acids were taken at baseline, at the end of the exercise intervention, and again after the washout period.

In short, this study divided participants into lean and obese categories and held diet constant. The only variable was the exercise component.

 

Is Our Microbiome Affected By Exercise?

is our microbiome affected by exercise fitnessThe results of the study were as follows:

  • Fitness, as assessed by VO2max, increased for all the participants, and the increase in fitness was comparable for both lean and obese subjects.
  • Exercise induced a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
  • Exercise increased fecal concentrations of butyrate and other short-chain fatty acids in the lean subjects, but not in obese subjects.
  • The exercise-induced changes in gut bacteria and short-chain fatty acid production were largely reversed once exercise training ceased.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent of diet, and contingent on the sustainment of exercise.” [Note: To be clear, the exercise-induced changes in both gut bacteria and short-chain fatty acid production were independent of diet and contingent on the sustainment of exercise. However, only the production of short-chain fatty acids was dependent on obesity status.]

 

What Does This Study Mean For You?

is our microbiome affected by exercise gut bacteriaThere are two important take home lessons from this study.

  • With respect to our gut bacteria, I have consistently told you that microbiome research is an emerging science. This is a small study, so you should regard it as the beginning of our understanding of the effect of exercise on our microbiome rather than conclusive by itself. It is consistent with previous studies showing an association between exercise and a potentially beneficial shift in the population of gut bacteria.

The strength of the study is that it shows that exercise-induced changes in beneficial gut bacteria are probably independent of diet. However, it is the first study to look at the interaction between obesity, exercise and gut bacteria, so I would interpret those results with caution until they have been replicated in subsequent studies.

  • With respect to exercise, this may be yet another reason to add regular physical activity to your healthy lifestyle program. We already know that exercise is important for cardiovascular health. We also know that exercise increases lean muscle mass which increases metabolic rate and helps prevent obesity. There is also excellent evidence that exercise improves mood and helps prevent cognitive decline as we age.

Exercise is also associated with decreased risk of colon cancer and irritable bowel disease. This effect of exercise has not received much attention because the mechanism of this effect is unclear. This study shows that exercise increases the fecal concentrations of butyrate and other short-chain fatty acids. Perhaps, this provides the mechanism for the interaction between exercise and intestinal health.

 

The Bottom Line

A recent study has reported that:

  • Exercise induces a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
  • Exercise causes an increase in the number of gut bacteria that produce butyrate and other short-chain fatty acids that are beneficial for gut health.
  • These effects are independent of diet, but do not appear to be independent of obesity because they were seen in lean subjects but not in obese subjects.
  • The exercise-induced changes in gut bacteria and short-chain fatty acid production are largely reversed once exercise training ceases.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent on diet, and contingent on the sustainment of exercise.”

For more details and my interpretation of the data, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor Are Vitamin D Supplements Worthless?

Posted October 30, 2018 by Dr. Steve Chaney

Are We Asking The Right Question?

Author: Dr. Stephen Chaney

 

are vitamin d supplements worthlessWe have been told that vitamin D is a miraculous “must have” vitamin. We have been told it’s not just important for healthy bones. It’s also important for a strong immune system, heart health, protection from cancer, and many other health benefits. We have been told that we should get our 25-hydroxy vitamin D levels tested and supplement with extra vitamin D if they are low.

Now, the latest headlines are saying all of that is wrong. They are telling us vitamin D supplements do not improve bone density or protect against falls and bone fractures. They are telling us to forget all the other claimed benefits of vitamin D. Those claims have been disproved. Forget about the 25-hydroxy vitamin D tests. They are a waste of money.

What is the truth? Why is it so confusing? Are vitamin D supplements worthless?  Let me guide you through the claims and counterclaims so you can discover the truth for yourself.

How Did Vitamin D Become So Popular?

are vitamin d supplements worthless popularLet’s start with a brief history of vitamin D. It all started with the industrial revolution in Northern Europe. Suddenly, children and adults in the large cities were spending the bulk of their waking hours in dark factories rather than outdoors on the farm. They were already living in northern latitudes where sunlight was weak during the winter months. To make matters worse pollution from the factories was creating a haze that blocked the sunlight.

That lead directly to the discovery that sunlight was crucial to our body’s ability to synthesize vitamin D and that vitamin D was essential for building strong bones. The solution to the public health crisis of rickets and osteomalacia was to fortify dairy products with vitamin D. The almost universal adaptation of vitamin D fortification virtually eliminated rickets and osteomalacia except in association with certain rare diseases. The two important lessons learned from this experience were:

  • Vitamin D is essential for healthy bone formation.
  • Vitamin D supplementation improves bone health for individuals who are deficient in vitamin D

As we discuss the latest findings, we need to keep in mind that these fundamental principles have not changed.

In the late 20th century our understanding of vitamin D took another leap with the discovery that vitamin D receptors were not restricted to bone cells. Almost every cell in our body contained vitamin D receptors. That lead to studies showing that people with low vitamin D intakes were more likely to experience heart disease, cancer, some autoimmune diseases, and infectious diseases such as flu than people with high vitamin D intakes.

The final leap in our understanding of vitamin D took place when the medical profession started routinely testing blood levels of 25-hydroxy vitamin D. That is when we discovered that some people who appeared to have adequate intake of vitamin D and/or adequate exposure to sunlight had low blood levels of 25-hydroxy vitamin D. Furthermore, follow-up studies showed that low 25-hydroxyvitamin D levels correlated with an increased risk of heart disease, cancer, and infectious disease. The important lessons learned from these experiments were:

  • Vitamin D deficiency is associated with increased risk of multiple diseases.
  • 25-hydroxy vitamin D tests are the best way to measure vitamin D deficiency.

Once again, these fundamental principles have not changed.

What Did The Study Show?

are vitamin d supplements worthless studyThe study (MJ Bolland et al, Lancet Diabetes Endocrinology 2018) behind the headlines was a meta-analysis of 81 randomized, placebo-controlled studies with a total of 53,537 subjects that looked at the effect of vitamin D supplementation in elderly populations on bone mineral density, bone fractures, and falls.

The meta-analysis only included studies in which vitamin D intake was the sole variable. In many cases the subjects were not taking a calcium supplement. If they were taking a calcium supplement, both the vitamin D group and placebo group were taking the same amount of calcium.

 

The results were unequivocal. In this study vitamin D supplementation had no effect on bone mineral density, bone fractures, or falls in elderly populations. The authors concluded “There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health.”

 

Is this conclusion justified? Let’s put the findings of this study into a broader perspective.

 

Are We Asking The Right Questions?

are vitamin d supplements worthless holistic approachBefore throwing out our vitamin D supplements let’s ask whether this study is asking the right question. I have covered this topic in detail in my new book “Slaying The Supplement Myths” (https://slayingthesupplementmyths.com) with respect to similar studies that had called into question the value of calcium supplements for bone health. Let me cover the highlights here.

In my book I created the graphic on the right to put the question of who benefits from supplementation into perspective. For the purposes of this discussion, I will just focus on poor diet (or, in the case of vitamin D, poor exposure to sunlight). As I discussed above, science shows that people who are not getting enough vitamin D from diet and sunlight benefit from vitamin D supplementation. Unfortunately, vitamin D enthusiasts and some supplement companies have muddied the waters by going beyond what good science shows and suggesting or implying that everyone will benefit from vitamin D supplementation.

This is part of the problem. Once you have created a paradigm that everyone will benefit from vitamin D supplementation, that paradigm is easy to disprove. If someone already has adequate, or nearly adequate, levels of 25-hydroxy vitamin D, would we expect additional vitamin D to make a difference? Of course not, but that is exactly the question the most recent study was asking.

In discussing the limitations of their study, the authors said: “It is possible that trials of populations with low baseline 25-hydroxy vitamin D might produce different results because only 4 trials, involving 831 participants (1.6% of all participants), reported mean baseline 25-hydroxy vitamin D levels lower than 25 nmol/L (the level indicating vitamin D deficiency).

In other words, the study did not measure the effect of vitamin D supplementation for people who were vitamin D deficient. The only take-home lesson from this study is that people with adequate, or near adequate, vitamin D status do not benefit from vitamin D supplementation. That is a “no-brainer.”

 

Vitamin D And A Bone Healthy Lifestyle

are vitamin d supplements worthless garbage in outThe other glaring deficiency of this study is that it was only measuring the effect of vitamin D on bone health. They purposely excluded any other factor that might influence bone health. That was a fatal flaw because healthy bone requires a holistic approach, not individual nutrients. In my book Slaying the Supplement Myths  I refer to this as a “bone healthy lifestyle.”

The most important feature of a “bone healthy lifestyle” is this:

  • Calcium, vitamin D, and resistance (weight bearing) exercise are all essential for healthy bones.
  • However, none of them is sufficient by itself. You need all three. You need a holistic approach if you wish to build strong bones.

Simply put, that means unless you include adequate calcium and exercise there is no reason to expect vitamin D supplementation to help build strong bones. Unfortunately, none of the studies included in the recent meta-analysis took a holistic approach to bone health. Some included calcium, but many didn’t. Resistance exercise was never considered. The studies were doomed to failure.

When you include flawed studies in your meta-analysis, you have what computer programmers call “Garbage in. Garbage out.” A meta-analysis can never be stronger than the individual studies it includes.

Other features of a “bone healthy lifestyle” include:

  • We need more than calcium and vitamin D for strong bones. We need magnesium, zinc, copper, manganese, vitamin C and vitamin K. If we are deficient in any of these, calcium will not be utilized as efficiently.
  • The foods we eat are also important. Our bones serve as a buffer system to keep our bodies slightly alkaline. Every time we eat acid-forming foods a little bit of bone is dissolved to neutralize the acid. For optimal bone health we need to minimize acid-forming foods and eat more alkaline-forming foods. That means we need to avoid sodas, sweets and refined grains. We also need to minimize meats, eggs, and dairy. Instead, we should focus on fruits, vegetables, peas, beans, lentils, seeds, and nuts.
  • Beware of drugs. The list of common medications that dissolve bones is a long one. Some of the worst offenders are anti-inflammatory steroids such as cortisone and prednisone, drugs to treat depression, drugs to treat acid reflux, and excess thyroid hormone. I am not suggesting that you should avoid properly prescribed medications. I would suggest you ask your doctor or pharmacist whether the drugs you are taking adversely affect bone density. If they do, you should pay a lot more attention to the other aspects of a “bone healthy lifestyle.”

 

Are Vitamin D Supplements Worthless?

are vitamin d supplements worthless bone healthNow we can come back to the question “Are vitamin D supplements worthless?” as the recent headlines have suggested. If you phrase the question as “Does everyone benefit from vitamin D supplementation?” or “Is vitamin D supplementation alone sufficient to build strong bones?” the answer is a clear no.

However, those are the wrong questions. If you ask: “Does vitamin D supplementation benefit people who are vitamin D-deficient?” the answer is a clear yes. If you ask: “Does a holistic approach that includes resistance exercise, adequate calcium, and adequate vitamin D improve bone health?” the answer is likely to be yes as well.

What about the headlines claiming that vitamin D is also worthless for strengthening the immune system and reducing the risk of heart disease, cancer, and auto-immune diseases?  The studies on which these claims are based suffer from the same flaws. They are asking the same wrong questions.

My recommendations:

  • Have your blood levels of 25-hydroxy vitamin D tested on a regular basis. I have them tested each year when I get my physical.
  • If your blood levels of 25-hydroxy vitamin D are below 25 nmol/L (which the NIH considers deficient), you are likely to benefit from vitamin D supplementation. If they are above 50 nmol/L (which the NIH considers sufficient), vitamin D supplementation is unlikely to provide additional benefit. However, that level of vitamin D doesn’t guarantee that you will have strong bones. You also need sufficient calcium and resistance exercise.
  • If your blood levels are in the insufficient range (between 25 nmol/L and 50 nmol/L), the situation is more complicated. If you are close to 50 nmol/L, you may benefit slightly from adding a vitamin D supplement, but the benefit will be too small to show up in a clinical study such as the one that resulted in the recent headlines. My advice is to look at your diet and medication use. If they put you at risk for low bone density, my recommendation would be to add a vitamin D supplement – along with adequate calcium and resistance exercise, of course. If you are closer to 25 nmol/L, you will likely benefit from a vitamin D supplement along with adequate calcium and exercise.
  • Don’t think of vitamin D supplementation as a “magic bullet” that will solve all your ills. Instead, think of it as just one component of a holistic approach to a bone healthy lifestyle.

 

The Bottom Line

 

A recent meta-analysis concluded that vitamin D supplementation did not improve bone mineral density, reduce bone fractures, or reduce falls in the elderly. While this conclusion was definitive, the study was asking the wrong questions.

  • We know that vitamin D improves bone health for people who are vitamin D-deficient. However, only 1.6% of the people in this study were vitamin D-deficient at the beginning of the study. That means the study was really asking: “If people have adequate, or near adequate, vitamin D status, does vitamin D supplementation provide any additional benefit?”  The answer to that question is a “no-brainer.”  There is no reason to expect that additional vitamin D would provide benefit.
  • We know that while vitamin D is essential for building strong bones, it is not sufficient by itself. Strong bones require a holistic approach that includes resistance exercise, adequate calcium, and adequate vitamin D. However, this study only looked at the effect of vitamin D on bone health. Calcium and exercise were excluded from consideration. That means the study was really asking: “Is vitamin D a “magic bullet” that can build strong bones by itself?” Again, there is no reason to expect vitamin D to provide much benefit under those conditions.

My recommendations:

  • Have your blood levels of 25-hydroxy vitamin D tested on a regular basis. I have them tested each year when I get my physical.
  • If your blood levels of 25-hydroxy vitamin D are low, you are likely to benefit from vitamin D supplementation. If they are already optimal, vitamin D supplementation is unlikely to provide additional benefit.
  • Don’t think of vitamin D supplementation as a “magic bullet” that will keep your bones strong by itself. Instead, think of it as just one component of a holistic “bone healthy lifestyle.”

 

For more details and to see my detailed recommendations, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Turmeric Forskolin – Opinions – Price

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Italy – works – opinions – reviews – forum – who tried Turmeric Forskolin Body Garcinia Blast is Italy a powerful weight loss formula using powerful ingredients blended with advanced formula technology that came from a Garcinia Cambogia fruit crust. Reviews The extract of this fruit is known as Hydroelectricity Acid is an incredible ability to hinder one who has tried Turmeric Forskolin enzyme necessary to develop the fats from the carbohydrates that opinions you eat. This acid helps the body Italy to reverse sugar in energy, forum rather than accumulate fat in the body. Works Body Garcia Blast Review Nobody wanted extra weight gain, reviews Turmeric Forskolin men and women, never wanted to have fat bowl, especially those health conscious. But as we age, our metabolism slows down or weak opinions and that affects factor that we gain extra fats and store fatter forums. The more truth that one has tried Turmeric Forskolin eats every day, so we will always gain more weight.

 

Turmeric Forskolin – comments – ingredients – herbal medicine – how to use – composition

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While we did not have access to the exact Turmeric Forskolin data from that study, if those are the results, where we buy in effect, they are possible using BodyBlast, so it’s going to be the most popular Amazon  to hit the market in the Middle Ages. Price There is not a complete list of available ingredients for Body Blast Garcinia, for safety. But they assure us that the product is 100% Natural, and with a 60% HCA rating, a significant part of the pill must be dedicated to Garcinia Cambogia pharmacies. That said, we suspect that the formula is the use of at least one type of natural stimulating Turmeric Forskolin. It could be Green Coffee, or it could be something like Ginseng, or even of natural caffeine origin. Price But if we want to believe that significant claims are made about its metabolic effects, then it’s probably Green Tea related pharmacies. One ingredient that we can talk about for a long time is the Garcinia Cambogia present in the formula.where we buy The nature of the extraction method is still unknown to us, but it Amazon Aliexpress thinks that I’m definitely going to something. How else could they get 60% of HCA rating? These are some serious numbers. How else could they get 60% of HCA rating? These are some serious numbers. How else could they get 60% of HCA rating? These are some serious numbers.

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The procedure for the purchase of Privy Frams Keto products on the website implies the execution of an order, the customer is contacted price, then the product is sent to the person opinions and the payment is made in cash Privy Frams Keto on delivery after confirmation and the affirmation of the product.

 

The order was made through the opinions filling out an order form, providing the contact price number, name and location. Here are the rules to check if your Privy Frams Keto in which the purchase is original:

 

Italy – it works – opinions – reviews – forum – who tried it Privy Frams Keto

Italy – it works – opinions – reviews – forum – who tried it Privy Frams KetoIt comes with its original Italy box and with the unique identifier In the box, there are images of all natural ingredients that are opinions used in the manufacture of the product. In the back working part, there is a label with a 32-character verification code and a link to the one who tried it on Privy Frams Keto webpage. Follow the link and enter the code in the appropriate field reviews and click on “clock / follow”.

 

All original bracelets forums are these labels. Missing labels or codes can not be found on the website are fake! Look at opinions out! The inscription “smart technology Privy Frams Keto reviews”, in the original bracket starts with a splat.This slimming product is very effective and Italy work with the help of natural ingredients that provide a style of those who have tried Privy Frams Keto healthy life and a diet balanced, so it works to support the normal functioning of the digestive system. Privy Frams Keto works by stimulating body organs that activates the metabolism forum, which allows you to convert excess weight to energy. This will ensure that unregulated metabolism rate, which systematically balances the normal functioning of the digestive system.

 

Privy Frams Keto – comments – ingredients – herbalist – how to use – composition

should be noted that excess weight can lead to hypertension, diabetes, chronic renal failure, stomach ulcers, Privy Frams Keto  coronary artery disease and vascular atherosclerosis. However, this product slimming remarks that works effectively, ensuring that that has eliminated the symptoms that cause these diseases and how it is used for the total elimination of diseases, making sure that there is no excess of fat in the body.

 

In addition to using high quality ingredients, this product ingredients works by providing phenomenal weight loss results, which means you lose weight more effectively, Privy Frams Ketobecause Privy Frams Keto increases the rate of metabolism. It also works with hunger suppression, which means that as you use it you will have to control your appetite by just taking calories that your body needs. We all want the perfect body of our dreams. These are comments of an inevitable desire: on a daily basic composition, the media show us images of beautiful women and men, with a sculpted and defined body, happy ingredients and satisfied with their physical prowess. Herbalism Our whole society is based on the cult of the perfect body! The sizes of clothing sold in stores are getting smaller, the models and herbalist mannequins that use more and more thin, and the canons of beauty change quickly every day.

 

Side effects – contraindications – hurts – Privy Frams Keto

The hands of those who have never tasted the massacre of diets, dangerous exercise and expensive Supplements, Privy Frams Keto in an attempt to get fit! These are the solutions that require a great deal of time. Side effects and a considerable investment of money. In the end, among other things, the results are not 100% guaranteed, and if you trust wrong solutions, you may experience more or less serious contraindications and discomfort problems. In the pharmacy there are dozens of different products aimed at weight loss, but everyone has an inebriating price and the results hurts are hardly guaranteed. The problem lies in the ingredients, which were not carefully selected side effects and selected by a team of experts only.

 

Privy Frams Keto is the only slimming product tested and guaranteed by the comments of hundreds, if not thousands, of satisfied consumers. Say goodbye to Privy Frams Keto pounds and rediscover the joy of living and moving freely in a body that you like and makes you feel self-confidence. The solution is just a click away! First of all, Privy Frams Keto is available in capsule form. The capsules must hurt to be swallowed with a large amount of water. The work supplements give the body a great demand for energy and the burning of fat. Since the supplement contraindications comes in capsule form, the instructions for use are very simple. It is consumed by ingestion of substance, with a lot of water in the morning and at night for the best results.

 

Privy Frams Keto – where do you buy – pharmacies – price – Amazon 

The component has been recognized as Privy Frams Keto a supplement capsule, in essence, with the aim of eliminating and burning where you buy all the body fat, which helps to lose weight in excess price. The supplement also works as a multivitamin for the immune system. Where to buy Contains the minerals pharmacies and nutrients that promote the body metabolism and Amazon improve the immune system by increasing the efficiency of the production of gastric acid that is used in the combustion Privy Frams Keto of fats.

 

The procedure for using Privy Frams Keto used is simple and easy. Just take a capsule with a glass of water. Drink in the morning and night pharmacies for the best results. To drink an Amazon  bottle of water during the day. Repeat the process for 30 consecutive days, and you will see a greater reduction in the weight price and cleaning of all the fat from your body. You will be able to get the size of the body, and its desires.

Pure Fast Keto – Works – Opinions

Overweight problems? Do you want to get rid of the extra pounds but do not want to make sacrifices at the table or enroll in the gym knowing that you will not go there?

In our new article we want to offer you a product that is right for you and on which we wanted to carry out an in-depth research to find out the motivations of its great success achieved throughout the world. The product name is Pure Fast Keto. It is a syrup that contains totally natural ingredients that  Pure Fast Keto thanks to an innovative and exclusive formula will make you lose weight fast and healthy.

 

In this review you will find all the information on this syrup, how it works, how much it costs and how to order it to receive it at the best price guaranteed.

 

Pure Fast Keto, the natural syrup that will make you lose weight quickly and naturally. Get ready for the costume test!

 

Pure Fast Keto â ????  It works â ????  OpinionsHere is all the information on this fantastic and effective product.

 

Now at 50% off!

 

Pure Fast Keto – opinions – Italy – works – reviews – has tried it

Multi Slim syrup works as a food supplement made with only 100% natural ingredients. According to the opinions of those who have tried it here in Italy, this product is able to help you lose weight and eliminate the accumulations of fat that usually settle in the critical points of the body. According to reviews that you can read online, the Pure Fast Keto syrup is able to:

 

Reduce appetite;

Normalize hormone function;

Accelerate metabolic processes and consequently lose weight;

Eliminate all the toxins and fluids accumulated by the body.

 

This syrup is also a powerful draining agent that in an only four weeks of treatment actively helps the body to dissolve the accumulations of fat, and give vitality without negatively affecting the normal functions of the body.

 

Andrea, 29 years old

 

“I’ve never been thin and filiform. H always had a little ‘bacon but lately, because of a strong period of stress at work I had accumulated a few extra pounds that I could not dispose of .. I did diets, I joined the gym, I did slimming but expensive almost totally useless, wasting time and money. Luckily I managed to recover by buying the Pure Fast Keto syrup. A truly effective product, above all safe and convenient. In about a month I was able to free myself of all the weight I wanted to lose and I feel energetic and in great shape “.

 

Monica, 39 years old

 

” A dear French friend of mine told me about Pure Fast Keto a few months ago. I often hear it through social networks in the photos I posted I saw her lose weight day by day. I waited impatiently for Pure Fast Keto to arrive in Italy and I ordered it, plus half-price as soon as they activated the official website. I received it in a few days and I’ve been taking it for about fourteen days. Result? I have already lost four kilos simply by taking the product diluted in water as instructed. My French friend lost a good thirteen pounds in two months of treatment. I would like to get the same results and this product will allow me without any effort ! “.

 

Annarita, 50 years old

 

“I already knew that menopause would have led me to a series of problems, some of which related to weight gain. I have always maintained my form but in the last semester I had taken about seven kilos without an apparent motivation or more simply my metabolism was slowing down its processes .. As much as I tried to lose them, those kilos just did not want to leave. Yet I had not changed anything of my lifestyle. The natural syrup Pure Fast Keto evidently managed to speed up my metabolism, helping me to eliminate excess pounds. I came back to wear the wardrobe a year ago that actually tells me it’s a little wide. I am fully satisfied with the results “.

 

Pure Fast Keto – opinions – Italy – works – reviews – has tried it

 

Pure Fast Keto – composition – ingredients – herbal medicine – how to use it? Pharmacy

Pure Fast Keto is sold by the official manufacturer and has an absolutely natural composition, which is why it is not available in pharmacies or herbalists.

 

Here is the list of ingredients and how to use it?

 

The Pure Fast Keto oral suspension is very simple to take, the compound, flavored with raspberry, should be taken every day, possibly at breakfast, in the amount of 20 ml of product dissolved in 200 ml of water.

 

 

Here are the exclusive ingredients:

 

Artichoke Extract – A well-known ingredient with a digestive, diuretic and lipid-lowering effect. This extract also has an action potency on liver function.

Apple Pectin – Able to reduce cholesterol levels and to regulate the functioning of the digestive system and the intestine.

Stevie – A natural and low-calorie sweetener that is experiencing enormous success.

Forskolin Extract – Plant belonging to the mint family, is considered one of the most powerful fat burning supplements offered by nature.

Pure Fast Keto – side effects – cheating – badly – contraindications – dangerous

Not presenting any chemical component but exclusively natural and biological ingredients, Pure Fast Keto has no side effects or contraindications of any kind. Thousands of consumers have used it without contraindications.

 

Following a series of online surveys on Pure Fast Keto two indicative data have emerged: Pure Fast Keto is not considered a dangerous supplement or it hurts and above all, being proven its effectiveness, it has not been included in the list of those scam products that it is often easy to meet online.

 

Pure Fast Keto – where to buy it? price – amazon – pharmacy –  – ebay – cost

It is first and foremost important to point out that Amazon,  or Ebay or the pharmacy do not represent a channel of purchase of the original product. Online, in fact, offers are often offered that are not such. We therefore want to relieve ourselves from any responsibility for fraud or counterfeiting in which you could run if you do not buy the product from the official website.

 

So, where to buy it?

We suggest to our readers the easiest and safest way, that is Pure Fast Keto official website. Just fill in the form by entering the required data (country, name, surname and telephone number) and confirm the order. Then simply answer the call from Pure Fast Keto customer service that will be at your disposal if you have questions or concerns about the food supplement.

 

It is also important to remember that payment must be made on delivery and in cash directly to the postman. The product will be delivered in a few days directly to the address you have indicated.

For what concerns the cost it is advisable to hurry up to execute the order to take advantage of the promotional discount that reduces the price of half and that will be active for a few days.

Keto Diet – Opinions – Price

Keto Diet is a highly effective and modern weight loss method, where the secret lies in acid. You do not need more torture for hours in the gym and use diet draconian! Just because I met Keto Diet not only managed to find it is down to weight, but also do not meet yo-yo effect! And all this in a simple and completely healthy and safe way. The only thing you have to remember, this is the patch of every day, which is extremely simple.

 

Glue Keto Diet that slims the patches on the shoulder or back and get rid of superfluous fat once and for all! Slices of Keto Diet completely natural composition, efficacy and without side effects! Tests on a group of volunteers have shown that, after 30 days of use, the same average life of about 15 centimeters. Together (6 inches) in the abdominal area, hips and thighs. Complete with the body, it has a great appeal for the cession of hidden complexes and gain the trust! Studies have shown that the regular use of Keto Diet combs already in 6 months can be lost up to 60 pounds!

 

Keto Diet – works – comments – market – Italy

The spectacular effect of Petting Keto Diet is to reduce the formation of new adipose tissue. The experiments show that it included slices of hydroxycitric acid (HCA) is able to positively influence the feeling of satiety and, therefore, decrease the amount of food intake works comments Italy market. HCA also stimulates the formation of compounds that significantly suppress appetite, effectively getting rid of desire for a snack. In addition, the acid helps to increase heat and, as a result, the excess calories are burned. Very importantly, the slices of Keto Diet works they can be used by people at serious risk of atherosclerosis and with high cholesterol. Not only will it help you lose weight, but also reduce blood pressure,

 

Weight loss with the help of slimming patches Keto Diet not in the pharmacy causes nausea and other unpleasant side effects that accompany the other pills treatment. The application is completely safe, which in case of use for weight loss is rare. Apply slimming patch regularly Catch Me, Patch I is getting not just a dream figure, but and much, much more! What to expect after having Catch Me, Me Patch?

The effects are:

The suppression of appetite

limiting the amount of caloric intake

In Overclock the metabolic rate works comments market Italy

Accelerate fat burning

Body cleansing from toxins

Prevention of accumulation of fat in the problem areas of the body

Increase vitality and energy

 

Keto Diet – how to use it? – ingredients – composition – female forum

garcinia cambogia composition The basic component of Combs Catch Me Mi Patch I is acidic, which is mainly produced from the husk of garcinia cambogia plants. It is good substance for them and 100% safe for health as it uses feminine forum composition ingredients. It has a positive effect on the fight against overweight, reduce the amount of stored fat and suppress appetite. Acid contained in the Keto Diet patch not only prevents the conversion of carbohydrates from fatty food onto the road. Appetite, which is m.in., is effectively suppressed. caused by an increase in glycogen production. Scientists agree that over the kilos of acid positively influences the efficiency of the body during exercise,

 

In addition to HCA Slices Keto Diet also contain other substances, which are designed to increase the activity of natural extract from garcinia cambogia fruit. Optimal composition compound provides excellent results that are felt after first use! It happens that, despite the use of the diet (also selected for us by a specialist), we are not able to lose weight, exercise does not bring any results, as we use feminine forum composition ingredients and we are increasingly convinced that nothing is able to help us. Nothing could be further from the truth! First: never give up, you must always fight to the end and secondly: reach for the reliable method – what slacking the Keto Diet!

 

Keto Diet – contraindications – side effects – does it hurt? – opinions

Can you lose weight with the help of slimming patches? Of course yes! Thanks to the innovative system, which catches me, patches, the active ingredients are delivered directly to your body through the skin for 24 hours contraindications side effects hurts opinions. Which active ingredients? Garcinia cambogia extract is a rich source of HCA or acid which helps to burn fat and accelerates the digestive processes. The guarani increases the efficiency of the body and accelerates the breakdown of fats. It also stimulates micro-circulation and firms the skin.The Mucus Vesiculate is of algae, which is a natural source of iodine and perfectly cleanses  Keto Diet the body of toxins and inhibits the deposition of fat in the body. The combination of these three compositions that makes the Keto Diet, are effective and the results do not need to wait long. The substances contained in plants, extracts directly reach the fat layer and effectively support its reduction contraindications side effects hurts opinions, even the most problematic parts of the body. Thanks, transporting ingredients takes place through the skin and evenly throughout the day.

 

Keto Diet – where to buy – price – pharmacy – Amazon – eBay – 

Keto Diet – where to buy – price – pharmacy – Amazon – eBay – Sometimes changing eating habits or regular training is not enough, which is why stricter measures are needed where you buy Amazon pharmacy price . To go to Take Me, Patch Mi side effects of slimming patches I have never registered. What’s more, it hit directly in fat and not in the stomach, where the first shot of supplements. Discontinue use in case of allergic reactions to any of the ingredients. The manufacturer ensures that the slimming patches are 100% safe for our health and contains only natural substances.

Keto Diet price where to buy amazon, pharmacy

Pharmacy the problem areas of the body are trivial day easy to use – what you need to stick to the new lot of the body. And this is the only thing we must keep in mind. The rest happens alone. I confirmed the effectiveness of the catch, Keto Diet is one of the many advantages. Wearing a 24-hour weight loss patch reception gradually releases the active ingredients which, through the skin penetrate into the deeper layers of the skin. From there they are transported directly to the fat deposited in the body. When we get to actively contribute to its reduction where we buy Amazon pharmacy price eBay. Beware of fakes available on various auction sites. The original Mi Capture, Patches are only available on the zone distributor certificate or directly from the manufacturer itself. Unfortunately, most vendors cheat their customers by offering them an inexpensive counterfeit pharmacy instead of the original. Therefore, before placing the order, and make sure that the credibility of the distributor.

Prime Skin Cream – opinions – price

Prime Skin Cream – opinions – price What is Prime Skin Cream?

As what you will often see on other Prime Skin Cream reviews, Prime Skin Cream is a brand of anti-aging cream that is known to reverse the signs of aging, such as wrinkles, dark circles, fine lines and the like.

In fact, many people who have already tried this anti-aging cream claim that surgery is no longer necessary to get rid of these skin problems. All you have to do is use anti-aging cream on a regular basis, and you are good to go to achieve positive results forward. In addition to eliminating the signs of aging on the skin, Prime Skin Cream also stops these ugly skin problems from happening again.

Italy – works – opinions – reviews – forum – who tried it – Prime Skin Cream

Italy – works – opinions – reviews – forum – who tried it – Prime Skin CreamHow Do You Do Prime Skin Cream Work Prime Skin Cream Italy forum?

 

Prime Skin Cream cream deeply penetrates Prime Skin Cream Italy forums the skin, working the smallest possible skin cells. Once the cream has entered leather, the ingredients in this cream start working immediately. While skin cells are clearly addressed by this beauty cream, collagen production is also improved when Prime Skin Cream is used on a regular basis. It is easy to say that those who have tried it have a positive effect. Collagen production has been activated and strengthened as it can be seen that the skin becomes oily and smooth. Regularly applying this anti-aging cream, skin relaxation is limited by the cream ingredients that are known to work who has tried opinions to have lifting powers.

 

Prime Skin Cream IngredientsAre They Safe and Effective?

Vitamins

Each group of organic compounds, which are known Prime Skin Cream reviews to be very essential for growth, Prime Skin Cream reviews nutrition and body health, including skin.

Immune Booster

Improve the immune system of the skin, making it resistant to different types of skin diseases and problems.

Powerful Antioxidants

Inhibit oxidation and counteract deterioration of stored food products. These powerful antioxidants potentially remove damage to oxidizing agents, making your skin healthier and younger.

Prime Skin Cream – comments – ingredients – herbalist – how to use – composition

Prime Skin Cream – comments – ingredients – herbalist – how to use – composition Peptide Firming Face

Peptides are known to contain two Prime Skin Cream herbal remedies or more amino acids that are linked in a chain. These are known to have a firming face effect on the skin, making it stronger, brighter, younger and healthier Prime Skin Cream herbal remedies with the continuous use of the cream-containing peptide.

What are the Benefits of Prime Skin Cream ingredients how do I use composition?

Reduces fine lines and wrinkles

Eliminates age spots and dark circles

It increases and improves the production of elastin and collagen

It prevents the emergence of free radicals and their harmful effects

It makes the skin hydrated and hydrated

Improves skin structure and tone

Promotes skin elasticity and softness

Prevents roughness and promotes brighter and brighter skin

Reduces crow’s feet and skin blemishes

All natural and very effective formula

What are the Disadvantages of Prime Skin Cream?

 

Prime Skin Cream is not recommended for women under the age of thirty

Availability is limited to the official website of the company. This means that you can not generally buy this product in the markets, beauty stores and stores ingredients as you use composition.

Side effects – contraindications – it hurts – Prime Skin Cream

How long does it take for Prime Skin Cream to show results?

 

This product contains ingredients that penetrates deep into the layers of the skin, working immediately in the process. It enhances the production of collagen and elastin and works at the cellular level to counteract Prime Skin Cream’s side effects hurts or reverse the aging process. Furthermore, it prevents bad effects of environmental factors. With regular use, you can see incredible changes and positive results in short, like a couple of days Prime Skin Cream side effects hurts.

Works on all skin types contraindications Prime Skin Cream?

There are anti-aging creams that work best for others but not for you and vice versa. However, Prime Skin Cream contraindications Prime Skin Cream is clinically proven to work on all skin types.

How to get good positive results?

Good results equate with the application of Prime Skin Cream on your skin. This means that the application of this product should connect with the expert skincare guidelines.

Prime Skin Cream – where you buy – pharmacies – price – Amazon –

Today, a wide range of Prime Skin Cream where you buy anti-aging product prices can be found on the market, and are yet to be discovered again. For this Prime Skin Cream Viper review, all the product has been well discussed, Prime Skin Cream where one buys price from its disadvantages for its many advantages. However, there is no denying the fact that when it comes to beauty products, there are more out there that offer similar effects. For non-Amazon  pharmacies to mention, of course, they also contain natural ingredients that are truly long-lasting as far as the effects are concerned. As for the price, Prime Skin Cream is one of the inexpensive anti-aging creams that, like many similar products out there, can make you look younger, younger and proud,

Prime Skin Cream Review – Final Verdict

As we age the composition, the texture and appearance of our skin changes. The signs of skin aging include wrinkles, fine lines, loss of hydration, uniform and dull tone, tired of the skin. There are countless anti-wrinkle creams on the market that promise to make the skin look and feel younger. Many anti-wrinkle creams promise everything, shortly, of a face lift or providing the much sought after “fountain of youth”. In reality, most are just moisturizers marketed as anti-aging products.

 

Health Tips From The Professor How Long Do the Benefits of Supplements Last?

Posted October 23, 2018 by Dr. Steve Chaney

Can Supplements Set You On A Path Towards A Healthier Life?

Author: Dr. Stephen Chaney

 

benefits of supplements heartA recent study (U Alehagen et al, PLOS One, April 11, 2018, 1-15 ) reported that the heart benefits of supplementation with coenzyme Q10 and selenium persisted for 12 years after supplementation ended. You would have thought a story like that would have made the headlines. Nope. Hardly a mention. Perhaps it did not match the narrative of the media and health professionals that supplements are worthless.

This study broke new ground. Most studies last a year or two and report whether there were any benefits of supplementation. A few studies have been extended a few years beyond the original supplementation period and have reported continued benefits of supplementation. However, in those studies the intervention group was still taking supplements. The intervention period was simply extended.

However, this study was unique in that supplementation was discontinued after 4 years. However, the positive effects of supplementation during that four-year period persisted for another 12 years without additional supplementation.

 

How Was The Study Done?

benefits of supplements monitoring heartIn this study 443 elderly individuals (average age =78) were recruited from a rural village in Sweden. They were given either supplements providing 200 mg/day of coenzyme Q10 and 200 mcg/day of selenium yeast or placebo pills. They were followed for four years. At this point the intervention phase of the trial ended, and the participants were followed for another 12 years without supplementation.

Cardiovascular deaths and all-cause mortality were recorded at 4 years (the end of the original intervention period), 10 years, and 12 years. The Swedish health care system is incredibly efficient. None of the participants were lost to follow-up.

Note on study design: Both coenzyme Q10 and selenium have heart health benefits and they compliment each other. Coenzyme Q10 was included in this study because our bodies lose the ability to make coenzyme Q10 as we age. By the time we reach age 80, we only make around half the coenzyme Q10 we made when we were younger. Selenium was included in the study because most Swedes are selenium deficient.

This study measured selenium levels and confirmed that all participants were selenium deficient at the beginning of the study. Selenium levels increased to near optimal in the supplemented group during the 4-year intervention period. In contrast, the placebo group remained selenium deficient.

 

How Long Do the Benefits of Supplements Last?

benefits of supplementationThe results of the study were truly amazing.

When you compared the group that had received coenzyme Q10 and selenium during the first 4 years of the study with the placebo group:

  • Cardiovascular mortality was 38% less and all-cause mortality was 24% less 12 years later in the supplement group.
  • The decrease in cardiovascular mortality lessened slightly with time (53% lower at 4 years, 46% lower at 10 years, and 38% lower at 12 years.
  • In contrast, the decrease in all-cause mortality remained relatively constant.
  • The effect was greater for women (who have lower coenzyme Q10 levels than men) than it was for men.
  • The decrease in cardiovascular mortality was 57% for women and 22% for men.
  • Cardiovascular mortality was decreased by 40-50% for people at high risk of cardiovascular death because of atherosclerosis, diabetes, high blood pressure, or impaired heart function.

Putting This Study Into Perspective

benefits of supplements wellnessI don’t want to read too much into this study. It has multiple limitations:

  • It is a very small study.
  • It is the first study I am aware of that has followed study participants years after supplementation has ended. More studies like this are clearly needed before any firm conclusions can be drawn.
  • It may be unique to Sweden where selenium deficiency is widespread. Selenium deficiency is much less prevalent in some other countries such as the United States.
  • It is possible that once the study population heard about the results of the initial 4-year study they started self-supplementing with coenzyme Q10 and selenium. However, since the participants did not know whether they were in the supplement or placebo group, that would likely affect both groups equally.

However, it is the implications of the study that fascinate me.

  • The authors of the study speculated that the improvement in endothelial cell function (Endothelial cells line the arteries and play an important role in arterial health) and/or decreased inflammation may have persisted long after supplementation stopped.
  • A more interesting idea is that supplementation (or the effects of supplementation) caused modifications to the DNA that were persistent (something we refer to as epigenetics). Moreover, those DNA modifications may have altered gene expression in a manner that reduced heart disease risk.

Much more work needs to be done before we know whether epigenetic modifications were responsible for the persistent benefit of supplementation in this, or any other, study. However, the ramifications of this idea are substantial. We think of supplementation as something that provides benefit only while we are taking the supplement. What if, under the right conditions, supplementation could send us down an entirely different path to better health? That would be worth major headlines.

 

The Bottom Line

 

A recent study in Sweden looked at the effects of supplementation with coenzyme Q10 and selenium on heart health 12 years after supplementation had ended.

  • The study reported that cardiovascular mortality was 38% less and all-cause mortality was 24% less 12 years later in the group that supplemented during the first 4 years.

The study has multiple limitations and needs to be repeated before drawing any definite conclusions. However, if true, it has interesting implications. What if the benefits of supplementation didn’t stop when you stopped supplementing? What if supplementation sent you down an entirely different path, a path towards better health?

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

Health Tips From The Professor High Protein Diets and Weight Loss

Do High Protein Diets Reduce Fat And Preserve Muscle?

Author: Dr. Stephen Chaney

Healthy Diet food group, proteins, include meat (chicken or turkAre high protein diets your secret to healthy weight loss? There are lots of diets out there – high fat, low fat, Paleolithic, blood type, exotic juices, magic pills and potions. But recently, high protein diets are getting a lot of press. The word is that they preserve muscle mass and preferentially decrease fat mass.

If high protein diets actually did that, it would be huge because:

  • It’s the fat – not the pounds – that causes most of the health problems.
  • Muscle burns more calories than fat, so preserving muscle mass helps keep your metabolic rate high without dangerous herbs or stimulants – and keeping your metabolic rate high helps prevent both the plateau and yo-yo (weight regain) characteristic of so many diets.
  • When you lose fat and retain muscle you are reshaping your body – and that’s why most people are dieting to begin with.

So let’s look more carefully at the recent study that has been generating all the headlines (Pasiakos et al, The FASEB Journal, 27: 3837-3847, 2013).

The Study Design:

This was a randomized control study with 39 young (21), healthy and fit men and women who were only borderline overweight (BMI = 25). These volunteers were put on a 21 day weight loss program in which calories were reduced by 30% and exercise was increased by 10%. They were divided into 3 groups:

  • One group was assigned a diet containing the RDA for protein (about 14% of calories in this study design).
  • The second group’s diet contained 2X the RDA for protein (28% of calories)
  • The third group’s diet contained 3X the RDA for protein (42% of calories)

In the RDA protein group carbohydrate was 56% of calories, and fat was 30% of calories. In the other two groups the carbohydrate and fat content of the diets was decreased proportionally.

Feet_On_ScaleWhat Did The Study Show?

  • Weight loss (7 pounds in 21 days) was the same on all 3 diets.
  • The high protein (28% and 42%) diets caused almost 2X more fat loss (5 pounds versus 2.8 pounds) than the diet supplying the RDA amount of protein.
  • The high protein (28% and 42%) diets caused 2X less muscle loss (2.1 pounds versus 4.2 pounds) than the diet supplying the RDA amount of protein.
  • In case you didn’t notice, there was no difference in overall results between the 28% (2X the RDA) and 42% (3X the RDA) diets.

Pros And Cons Of The Study:

  • The con is fairly obvious. The participants in this study were all young, healthy and were not seriously overweight. If this were the only study of this type one might seriously question whether the results were applicable to middle aged, overweight coach potatoes. However, there have been several other studies with older, more overweight volunteers that have come to the same conclusion – namely that high protein diets preserve muscle mass and enhance fat loss.
  • The value of this study is that it defines for the first time the upper limit for how much protein is required to preserve muscle mass in a weight loss regimen. 28% of calories is sufficient, and there appear to be no benefit from increasing protein further. I would add the caveat that there are studies suggesting that protein requirements for preserving muscle mass may be greater in adults 50 and older.

The Bottom Line:

1)    Forget the high fat diets, low fat diets, pills and potions. High protein diets (~2X the RDA or 28% of calories) do appear to be the safest, most effective way to preserve muscle mass and enhance fat loss in a weight loss regimen.

2)     That’s not a lot of protein, by the way. The average American consumes almost 2X the RDA for protein on a daily basis. However, it is significantly more protein than the average American consumes when they are trying to lose weight. Salads and carrot sticks are great diet foods, but they don’t contain much protein.

3)     Higher protein intake does not appear to offer any additional benefit – at least in young adults.

4)     Not all high protein diets are created equal. What some people call high protein diets are laden with saturated fats or devoid of carbohydrate. The diet in this study, which is what I recommend, had 43% healthy carbohydrates and 30% healthy fats.

5)    These diets were designed to give 7 pounds of weight loss in 21 days – which is what the experts recommend. There are diets out there promising faster weight loss but they severely restrict calories and/or rely heavily on stimulants, they do not preserve muscle mass, and they often are not safe. In addition they are usually temporary.  I do not recommend them.

6)    This level of protein intake is safe for almost everyone. The major exception would be people with kidney disease, who should always check with their doctor before increasing protein intake. The only other caveat is that protein metabolism creates a lot of nitrogenous waste, so you should drink plenty of water to flush that waste out of your system. But, water is always a good idea.

7)     The high protein diets minimized, but did not completely prevent, muscle loss. Other studies suggest that adding the amino acid leucine to a high protein diet can give 100% retention of muscle mass in a weight loss regimen – but that’s another story for another day.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.