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.

Health Tips From The Professor Colon Cancer Prevention and Anti-Inflammatory Diets

Posted June 26, 2018 by Dr. Steve Chaney

How Can You Reduce Colon Cancer Risk?

Author: Dr. Stephen Chaney

 

colon cancer prevention colorectalColorectal cancer is third most common form of cancer in the United States. The American Cancer Society estimates that there will be 140,000 new cases and 50,000 deaths from colorectal cancer in 2018. The death rate has been decreasing due to more aggressive screening, but it is still much too high.

Thus, there is considerable interest in discovering colon cancer prevention we can control. Several studies have suggested that inflammatory diets may be one preventable cause of colon cancer. There are many reasons for suspecting that inflammation may increase colon cancer risk. For example, we know:

  • Inflammation plays an important mechanistic role in cancer development.
  • Obesity causes a chronic state of low-grade inflammation, and obesity increases colon cancer risk.
  • Inflammatory bowel disease increases the risk of colon cancer.
  • Anti-inflammatory medications such as aspirin decrease colon cancer risk.

However, it has been difficult to prove that inflammatory diets increase colon cancer risk. In part, that is because we can’t measure inflammation directly. We must rely on inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor (TNF). Unfortunately, these markers correlate with different inflammatory processes in the body and seldom increase or decrease in unison.

The authors of the current study (FK Tabung et al, JAMA Oncology, 4: 366-373, 2018 ) used a dietary scoring system based on all three inflammatory markers to examine the correlation between an inflammatory diet and colon cancer risk.

How Was The Study Done?

colon cancer prevention inflammationThis study made use of data collected from 46,804 men enrolled in the Health Professionals Follow-up Study (conducted between 1986 and 2012) and 74,246 women enrolled in the Nurses’ Health Study (conducted between 1984 and 2012). Lifestyle, medical, and other health-related information were collected every 2 years. A comprehensive dietary questionnaire was administered every 4 years. During the 26-year follow-up period 2699 cases of colon cancer were diagnosed.

The inflammatory potential of the diet was estimated using an index called the empirical dietary inflammation pattern (EDIP) score that the authors had developed in a previous study (FK Tabung et al, Journal of Nutrition, 146: 1560-1570, 2016 ). This index was based on the effects of individual foods on all three markers of inflammation (CRP, IL-6, and TNF). Inflammatory foods had positive EDIP scores (they increased levels of one or more of the inflammatory markers). Anti-inflammatory foods had negative EDIP scores (they decreased levels of one or more inflammatory markers).

Most of the EDIP scores were consistent with previous studies on the inflammatory potential of various foods. For example:

  • Red meats, processed meats, refined grains, sugar-sweetened beverages, and diet beverages all scored as highly inflammatory.
  • One serving of beer or wine, coffee, dark yellow vegetables, and leafy green vegetables all scored as highly anti-inflammatory.

 

Colon Cancer Prevention By Avoiding Inflammatory Diets

colon cancer prevention fireThe subjects enrolled in the study were divided into five groups based on their inflammatory diet (EDIP) scores. When the investigators compared subjects who had the most inflammatory diet with subjects who had the least inflammatory diet:

  • The risk of colon cancer was increased by 44% in men and 22% in women.
  • People who refrain from alcohol consumption received even greater benefit from anti-inflammatory diets. For teetotalers an anti-inflammatory diet decreased colon cancer risk by 62% in men and 33% in women.

The authors concluded: “Findings from this large prospective [that is scientific jargon meaning the study was carried out over a period of many years] study support a role for the inflammatory potential of diet in colorectal cancer development, suggesting inflammation as a potential mechanism linking dietary patterns and colorectal cancer development.”

 

How To Prevent Colon Cancer Or At Lest Reduce The Risk?

 

colon cancer prevention american cancer societyOf course, holistic approaches are always best. Reducing colon cancer risk involves much more than simply consuming an anti-inflammatory diet. To put this study in perspective, let’s look at what the American Cancer Society recommendations about modifiable lifestyle factors that increase your risk of colon cancer. So, consider these when you think about colon cancer prevention.  I call this the 10,000-foot view because they only list the biggest contributors to colon cancer – the ones for which there is the most scientific evidence (I have put their exact comments in quotes):

#1: Being overweight or obese. “If you are overweight or obese your risk of developing and dying from colorectal cancer is higher”.

#2: Physical inactivity. “If you are not physically active, you have a greater chance of developing colon cancer.”

#3: Certain types of diets.

  • “A diet that’s high in red meats (such as beef, pork, lamb, or liver) and processed meats (like bacon, sausage, hot dogs and some luncheon meats) raises your colorectal cancer risk.” My comment: The evidence is stronger for red meats and processed meats than for any other foods. Processed meats are listed as likely carcinogens and red meats are listed as probable carcinogens by the International Agency For Research On Cancer (IARC), an agency of the WHO.
  • “Cooking meats at very high temperatures (frying, broiling, or grilling) creates chemicals that may raise your cancer risk.”

#4: Smoking. “People who have smoked for a long time are more likely than non-smokers to develop and die from colorectal cancer.”

#5: Heavy alcohol use. “Colorectal cancer has been linked to moderate to heavy alcohol use. Limiting alcohol use to no more than 2 drinks a day for men and 1 drink a day for women could have many health benefits, including a lower risk of many kinds of cancer. “

#6: Early detection. In case you have not heard, the American Cancer Society just released new guidelines recommending that screening for colon cancer begin at age 45.

If you want to take a closer look at the diet – colon cancer connection, you might be interested in the recommendations of Harvard’s Men’s Health Watch newsletter.

  • In terms of inflammatory foods that increase colon cancer risk, they list red meats, fried foods, sugary beverages, and refined carbohydrates.
  • In terms of anti-inflammatory foods that likely decrease cancer risk, they list tomatoes, olive oil, green leafy vegetables, nuts like almonds and walnuts, fatty fish, and fruits like strawberries, blueberries, cherries, and oranges.

 

What Does This Mean For You?

colon cancer prevention inflammatory dietsIf you are confused about the conflicting information about which foods affect colon cancer risk, start with the American Cancer Society recommendations. Avoid red meats and processed meats as much as possible and don’t cook your meats at high temperatures. I realize this is not popular advice at the time of year when everyone is firing up their grills for summer cookouts, but these recommendations will go a long way towards colon cancer prevention. Don’t shoot the messenger. I’m just conveying information based on the best scientific evidence we have to date.

For best results follow the recommendations of the Harvard Men’s Health Watch newsletter to also avoid fried foods, sugary beverages and refined carbohydrates and add anti-inflammatory foods such as fresh fruits & vegetables, nuts, olive oil, and fatty fish.

With Harvard’s recommendations in mind, let me extend an olive branch to all of you red meat lovers. An ounce or two of red meat in a green salad or a stir fry with lots of fresh, colorful vegetables is much less likely to increase your risk of cancer than a steak or burger with fries. You will find more information on this topic in my book “Slaying The Food Myths.”

 

The Bottom Line:

A major study has just been published looking at the correlation between an inflammatory diet and colon cancer risk. When the investigators compared subjects who had the most inflammatory diet with subjects who had the least inflammatory diet:

  • The risk of colon cancer was increased by 44% in men and 22% in women.
  • People who refrain from alcohol consumption received even greater benefit from anti-inflammatory diets. For teetotalers an anti-inflammatory diet decreased colon cancer risk by 62% in men and 33% in women.

The authors concluded: “Findings from this large study support a role for the inflammatory potential of diet in colorectal cancer development, suggesting inflammation as a potential mechanism linking dietary patterns and colorectal cancer development.”

If you are confused about the conflicting information about which foods are inflammatory and anti-inflammatory, start with the American Cancer Society recommendations. Avoid red meats and processed meats as much as possible and don’t cook your meats at high temperatures. I realize this is not popular advice at the time of year that everyone is firing up their grills for summer cookouts, but these recommendations will go a long way towards colon cancer prevention.

For best results follow the recommendations of the Harvard Men’s Health Watch newsletter to also avoid inflammatory foods such as fried foods, sugary beverages and refined grains and add anti-inflammatory foods such as fresh fruits & vegetables, nuts, olive oil, and fatty fish.

With Harvard’s recommendations in mind, let me extend an olive branch to all of you red meat lovers. An ounce or two of red meats in a green salad or a stir fry with lots of fresh, colorful fruits and vegetables is much less likely to increase your risk of cancer than a steak or burger with fries. You will find more information on this topic in my book “Slaying The Food Myths.”

For more details on the American Cancer Society and Harvard recommendations and colon cancer prevention, 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 The Economic Benefits of Plant-Based Diets

Could Plant-Based Diets Cut Healthcare Costs?

Author: Dr. Stephen Chaney

 

Could saving the healthcare system be one of the economic benefits of plant-based diets?

economic benefits of plant-based diets healthcare system costsI don’t need to tell you that our healthcare system is in crisis. Costs are out of control. The Centers for Medicare and Medicaid Services (CMS) estimates that healthcare costs will account for 25% of the gross domestic product by 2025. They also predict that 47% of that spending will be financed by federal. State, and local governments. That is unsustainable.

Our politicians have no answer. Neither political party has a viable plan to cut costs. Perhaps it is time to take matters into our own hands. What if there were a way to improve our own health and the viability of our healthcare system? A recent study suggests there may be a way to accomplish both goals.

How Was The Study Done?

In a recent study (L. Annemans and J. Schepers, Nutrition, 48: 24-32, 2018 ) scientist at Ghent university in Belgium set out to investigate the effect on public health and healthcare costs if just 10% of the population of Belgium and England switched to a primarily plant-based diet. They started with two diets for which the health benefits have been well established by multiple studies. These diets are:

economic benefits of plant-based diets soy#1: A Soy-Containing Diet: This is defined as a diet in which soy protein foods were consumed in place of animal protein foods more than 5 times per week. The soy foods included in their study were soybeans, tofu, miso, soy protein drinks, and soy yoghurt.

The soy-containing diet was chosen because previous studies have shown it protects against obesity, heart disease, stroke, diabetes, and breast, colon, stomach, lung, and prostate cancer.  (Yes. In spite of the erroneous information you find on the internet, soy foods decrease cancer risk.)

#2: The Mediterranean Diet: This is defined as a diet rich in fruits, vegetables, whole grains, nuts, seeds and large amounts of olive oil. It includes a moderate to high consumption of fish and other seafood and a low intake of meat and dairy products.

economic benefits of plant-based diets mediterranean dietsThe Mediterranean diet was chosen because previous studies have shown it protects against heart disease, stroke, diabetes, and breast cancer. I have documented these health benefits in more detail in my book “Slaying The Food Myths.”

This study did not look at the benefits of other plant-based diets. For example, as discussed in “Slaying The Food Myths,” the Seventh-Day Adventist studies have shown comparable health benefit for a variety of vegetarian diets.

This study looked at the prevalence of each of these diseases in Belgium and England and estimated what the effect would be if the prevalence of these diseases were reduced by the amounts reported in previous studies of soy-based and Mediterranean diets.

The study reported two outcomes: the increase in Quality of Life Years (QALYs) and the decrease in healthcare costs. Increased Quality of Life Years simply means the increase in disease-free years. That is the outcome most important to each of us personally. However, we should be equally interested in the decreased healthcare costs. The dollars our government spends on healthcare don’t grow on trees. They come out of our pockets.

 

Economic Benefits of Plant-Based Diets: Decreasing Healthcare Costs?

 

economic benefits of plant-based dietsWith that buildup, you are probably wondering what the outcome of the study was. The news was good:

If 10% of the population switched to a soy-based diet there would be:

  • An increase of 154 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.9 billion/20 years in Belgium.
  • An increase of 130 Quality of Life Years/1,000 people and a decrease in healthcare costs of $10.7 billion/20 years in England.

If 10% of the population switched to a Mediterranean diet there would be:

  • An increase of 166 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.6 billion/20 years in Belgium.
  • An increase of 116 Quality of Life Years/1,000 people and a decrease in healthcare costs of $7.4 billion/20 years in England.

[Note: In case you were wondering, the authors said the reason why plant-based diets had less of an effect on Quality of Life Years in England than in Belgium is because public health interventions have already significantly decreased the incidence of heart attack and stroke in England. Conversely, the reason healthcare savings are higher in England is because healthcare costs are higher there.]

Finally, if one were to extrapolate the British healthcare savings to the costs of the US healthcare system, one would predict:

  • If 10% of the US population were to switch to a soy-based diet, healthcare savings might amount to $17 billion/20 years.
  • If 10% of the US population were to switch to a Mediterranean diet, healthcare savings might amount to $12 billion/20 years.

The authors concluded: “The result of the present analysis suggests that both a soy-containing diet and the Mediterranean diet could contribute to health promotion because they are predicted to lead to substantial health benefits and societal savings.”

How Accurate Are These Estimates?

The benefits of soy-based and Mediterranean diets on which these estimates are based are very solid. The benefits are based on association studies, but the studies are very well done and are remarkably consistent.

The major weakness of these estimates is the benefits of these diets have been demonstrated in other parts of the world and are being extrapolated to a region of the world where neither of those diets are commonly followed. The authors tried very hard to control for all confounding variables, but the possibility remains that lifestyle differences unique to those geographic regions also contributed to the health benefits of soy-based and Mediterranean diets.

The authors acknowledged that some of the foods that are normally part of soy-based and Mediterranean diets were not as readily available in Belgium and England. They raised the possibility that something like the “New Nordic Diet”, which is also primarily plant-based but incorporates more familiar foods, might be equally effective. The equivalent diet in the US might be the DASH diet.

The economic benefits of plant-based diets may not depend so much on the diet, as long as it is plant-based and those foods are readily available.

 

The Bottom Line:

 

A recent study looked at the effect of a plant-based diet on Quality Of Life Years (disease free years) and healthcare costs in Belgium and England. The study estimated:

If 10% of the population switched to a soy-based diet there would be:

  • An increase of 154 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.9 billion/20 years in Belgium.
  • An increase of 130 Quality of Life Years/1,000 people and a decrease in healthcare costs of $10.7 billion/20 years in England.

If 10% of the population switched to a Mediterranean diet there would be:

  • An increase of 166 Quality of Life Years/1,000 people and a decrease in healthcare costs of $1.6 billion/20 years in Belgium.
  • An increase of 116 Quality of Life Years/1,000 people and a decrease in healthcare costs of $7.4 billion/20 years in England.

If one were to extrapolate the British healthcare savings to the costs of the US healthcare system, one would predict:

  • If 10% of the US population were to switch to a soy-based diet, healthcare savings might amount to $17 billion/20 years.
  • If 10% of the US population were to switch to a Mediterranean diet, healthcare savings might amount to $12 billion/20 years.

The authors concluded: “The result of the present analysis suggests that both a soy-containing diet and the Mediterranean diet could contribute to health promotion because they are predicted to lead to substantial health benefits and societal savings.”

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.