What if your doctor failed to talk to you about the most important threat to your health?

The Hill  10/18/19

What if your doctor failed to talk to you about the most important threat to your health? Wouldn’t you worry about the quality of your health care? Poor quality diet is a leading cause of death in the United States, but it is unlikely that your doctor has the knowledge to even begin a meaningful conversation about your nutrition or to make an appropriate dietary referral.  

Most doctors lack the knowledge necessary to offer nutrition advice to patients; indeed, fewer than 14 percent of physicians report feeling equipped to advise on diet or the connection between food and health. This is unsurprising given that, for example, 90 percent of cardiologists in a recent survey reported receiving minimal or no instruction on nutrition during medical training. 

Yet it is also concerning. Obesity, type-2 diabetes, heart disease, cancer, and stroke, which are leading causes of death in the United States, all are closely linked to diet and nutrition. 

Nearly 40 percent of adults and 18 percent of children are obese, and these numbers are increasing; almost 10 percent of Americans suffer from diabetes, compared with less than 1 percent just 50 years ago. Even more concerning, more than one-third of Americans have pre-diabetes. 

A focus on treatment rather than prevention has led to medical education that ignores the central role that food plays in health. The average U.S. medical school devotes less than 1 percent of total lecture hours to nutrition. Accreditation requirements for medical residencies and fellowships do not include nutrition. 

The standardized exams that medical students must pass to become board certified lack questions that test the ability to advise patients on diet. And to date, no state requires continuing medical education in nutrition or diet-related disease as part of the ongoing education for physicians to maintain licensure. 

This dangerous gap in their education means that doctors do not learn the basic guidance in the U.S. Dietary Guidelines for Americans, or stay apprised of the latest nutrition science. Accordingly, they fail to recognize, and are unable to convey to patients, the importance of diet to health. This means fewer referrals to nutritionists, even when diet plays a vital role in their patient’s health.

The lack of nutrition education during medical training is also a costly mistake. Health-care spending has skyrocketed — Medicare benefit payments exceeded $730 billion in 2018 and account for nearly 15 percent of all federal spending.

For years it has been a supposed mystery, but it is finally being acknowledged that a primary cause of cancer in the world today is diet

Walking Times   October 30, 2017

For years it has been a supposed mystery, but it is finally being acknowledged that a primary cause of cancer in the world today is diet. Studies are now showing that obesity plays an enormous role in one’s chances of getting cancer, and the main cause of obesity is the type of foods people eat. It is in large part a lifestyle disease, and the most important relevant lifestyle choice is food.

“Overall, we estimated that 40.8% of incident cancer cases were attributable to exposure to the 24 factors included in the analysis (Table 2). Tobacco smoking was responsible for the greatest cancer burden, accounting for an estimated 15.7% of all incident cancer cases (2485 cases), followed by physical inactivity and excess body weight, which were responsible for an estimated 7.2% and 4.3% of incident cancer cases, respectively. All other exposures of interest were estimated to be responsible for less than 4.0% of incident cancer cases each.” [Source]

More specifically, researchers are pointing out the connection between the body’s insulin response to food and cancer metabolism. In short, there is a paradigm shift taking place and we are admitting that food can either feed or starve cancer cells. Here, in a piece for The Los Angeles Times, writer Sam Apple explains this connection:

“… researchers have made progress in understanding the diet-cancer connection. The advances have emerged in the somewhat esoteric field of cancer metabolism, which investigates how cancer cells turn the nutrients we consume into fuel and building blocks for new cancer cells.

Largely ignored in the last decades of the 20th century, cancer metabolism has undergone a revival as researchers have come to appreciate that some of the most well-known cancer-causing genes, long feared for their role in allowing cancer cells to proliferate without restraint, have another, arguably even more fundamental role: allowing cancer cells to “eat” without restraint. This research may yield a blockbuster cancer treatment, but in the meantime it can provide us with something just as crucial — knowledge about how to prevent the disease in the first place.” [Source]

Does this mean that these new revelations about cancer and the foods which cause it will trigger a widespread shift in the consumption habits of ordinary people? Will people switch to real food and abandon fake food?

Could it also mean that major food companies will face some degree of liability for producing addictive foods which are extremely high in sugars, artificial sweeteners, refined carbohydrates and other ingredients which trigger the body’s insulin response?

Ashwagandha improves memory

APRIL 26, 2017 by MAE CHAN

Ashwagandha is an herb from India used for centuries as a body tonic for general health of the body and mind. Adults supplemented with ashwagandha root extract had improved memory test scores, researchers in India found.

Ashwagandha has been used as an herbal remedy for hundreds of years to help the body deal with stress. It has also been used traditionally for pain relief and to treat skin diseases, diabetes, gastrointestinal disease, rheumatoid arthritis, epilepsy and many other conditions naturally.

Ashwagandha also known commonly as Indian ginseng, poison gooseberry,or winter cherry is a plant that flourishes in India and North America. The roots of the ashwagandha plant have been employed for millennia by Ayurvedic healers. Ashwagandha has many beneficial elements, including flavonoids and members of the withanolide class. Numerous modern studies have found that ashwagandha shows great promise for being effective in reducing inflammation, decreasing stress, increasing mental activity, invigorating the body, and as an antioxidant. It is even known to relieve arthritis better than medication.

Some lesser known benefits were been published in the Journal of The International Society of Sports Nutrition including improvements in muscle strength, size, and recovery.

Dietary supplements that address cognitive function are increasingly in the limelight thanks to a growing aging population, as well as the gaming, tech, and fitness culture that's making nootropics in vogue .

Ashwagandha root has been a part of the medicinal traditions of Ayurveda as a memory aid, wrote researchers of a new study published in the Journal of Dietary Supplements. In this current study, the researchers conducted what they claimed to be the first trial that looked at "the clinical impact of ashwagandha on the cognitive deficits seen in mild cognitive impairment."
Participants: Selecting patients of mild cognitive impairment

The study was conducted over eight weeks using a random-assignment, parallel-group, double-blind, placebo-controlled design. Clinical visits all took place at one center, with participants being selected from different outpatient clinics in the city of Pune, India, who sought treatment for mild cognitive impairment.

To be included in the study, participants had to be aged 35 or older, have subjective sumptoms of memory impairment, a previous diagnosis of early dementia or a score a certain amount in a mini-mental state examination, and the ability and willingness to provide informed consent.

Excluded from the study are participants with severe memory impairment, known neuropsychiatric conditions, persistent endocrine disorders, and chronic medical conditions such as uncontrolled hypertension or diabetes mellitus.

Throughout the study period, other than ashwagandha root extract for the supplement group, the use of nootropic agents or anticholinesterase drugs were prohibited.       Read More

 

Parents who restrict their children to a vegan diet could face a jail term if a controversial bill is passed by the Italian parliament.

10 August 2016 From the section Europe

Such parents, the draft bill claims, are imposing a diet "devoid of essential elements for [children's] healthy and balanced growth".

It has been proposed by Elvira Savino of the centre-right Forza Italia party.

It follows a number of high-profile Italian cases where malnourished children have been taken into care.

In four cases over the last 18 months, malnourished children were hospitalised in Italy after being fed a vegan diet.

However, dieticians such as the American Dietetic Association say vegan diets are suitable for children but advise that care needs to be taken to ensure children are receiving the full range of required nutrients - in particular vitamin B12.

Doctors speculated in some cases that the guardians of the hospitalised children may not have understood how to supplement a vegan diet to make it safe for children.

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What is veganism?

A vegan diet eliminates anything which originates from animals:

• No meat, fish, animal fats or gelatine
• No dairy products such as cow's milk, cheese, butter, yogurt, goat's or sheep's milk
• No eggs, nor foods containing eggs, such as most Quorn products
• No honey

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Ms Savino's proposed bill will be discussed by parliamentary committees before going to the chamber for debate - probably later this year, reports Reuters news agency.

Meanwhile, three rival bills are on the table - all aiming to make vegan and vegetarian options more commonplace in Italian canteens.

'Reckless and dangerous'

In the preamble of Ms Savino's bill (in Italian), she highlights the spreading belief in Italy of "substantial health benefits" provided by a vegetarian or vegan diet.

"There is no objection if the person making this choice is an informed adult. The problem arises when children are involved... The vegetarian or vegan diet is, in fact, deficient in zinc, iron, vitamin D, vitamin B12 and omega-3".

Her draft bill aims to "stigmatise the reckless and dangerous eating behaviour imposed by parents" who pursue a vegan diet, "to the detriment of minors".

Offenders would face up to a year in jail - rising to a maximum of four years where the child suffers illness or permanent injury and six years in the case of death.

While some nutrition experts have challenged the validity of the bill, other commentators have cautioned that its imprecise wording means it could be used to penalise a far greater range of parents than vegans or vegetarians - for instance, the parents of obese children.

Some say better public health education rather than punitive measures would be more effective at improving children's nutrition.       BBC

Reducing consumption of added sugar improves health in children

By Juliana Bunim, UC San Francisco Tuesday, October 27, 2015

Credit: iStock

Reducing consumption of added sugar, even without reducing calories or losing weight, has the power to reverse a cluster of chronic metabolic diseases, including high cholesterol and blood pressure, in children in as little as 10 days, according to a study by researchers at UC San Francisco and Touro University California.

“This study definitively shows that sugar is metabolically harmful not because of its calories or its effects on weight; rather sugar is metabolically harmful because it’s sugar,” said lead author Robert Lustig, M.D., MSL, pediatric endocrinologist at UCSF Benioff Children’s Hospital San Francisco. “This internally controlled intervention study is a solid indication that sugar contributes to metabolic syndrome, and is the strongest evidence to date that the negative effects of sugar are not because of calories or obesity.”
Jean-Marc Schwarz, Ph.D., of the College of Osteopathic Medicine at Touro University California and senior author of the paper, added, “I have never seen results as striking or significant in our human studies; after only nine days of fructose restriction, the results are dramatic and consistent from subject to subject. These findings support the idea that it is essential for parents to evaluate sugar intake and to be mindful of the health effects of what their children are consuming.”
The paper will appear online today (Oct. 27) and in the February 2016 issue of the Journal Obesity.

Restricting sugar intake

Metabolic syndrome is a cluster of conditions — increased blood pressure, high blood glucose level, excess body fat around the waist, and abnormal cholesterol levels — that occur together and increase risk of heart disease, stroke and diabetes. Other diseases associated with metabolic syndrome, such as non-alcoholic fatty liver disease and type 2 diabetes, now occur in children — disorders previously unknown in the pediatric population.
Participants were identified through the Weight Assessment for Teen and Child Health Clinic (WATCH) at UCSF Benioff Children’s Hospital San Francisco, an interdisciplinary obesity clinic dedicated to targeting metabolic dysfunction rather than weight loss. Recruitment was limited to Latino and African-American youth because of their higher risk for certain conditions associated with metabolic syndrome, such as high blood pressure and type 2 diabetes.
In the study, 43 children between the ages of 9 and 18 who were obese and had at least one other chronic metabolic disorder, such as hypertension, high triglyceride levels or a marker of fatty liver, were given nine days of food, including all snacks and beverages, that restricted sugar but substituted starch to maintain the same fat, protein, carbohydrate, and calorie levels as their previously reported home diets. Baseline fasting blood levels, blood pressure, and glucose tolerance were assessed before the new menu plan was adopted. The study menu restricted added sugar (while allowing fruit), but substituted it by adding other carbohydrates such as bagels, cereal and pasta so that the children still consumed the same number of calories from carbohydrate as before, but total dietary sugar was reduced from 28 to 10 percent, and fructose from 12 to 4 percent of total calories, respectively. The food choices were designed to be “kid food” – turkey hot dogs, potato chips, and pizza all purchased at local supermarkets, instead of high sugar cereals, pastries, and sweetened yogurt.
Children were given a scale and told to weigh themselves everyday, with the goal of weight stability, not weight loss. When weight loss did occur (a decrease of an average of 1 percent over the 10-day period but without change in body fat), they were given more of the low-sugar foods.
“When we took the sugar out, the kids started responding to their satiety cues,” said Schwarz. “They told us it felt like so much more food, even though they were consuming the same number of calories as before, just with significantly less sugar. Some said we were overwhelming them with food.”

Reducing harmful metabolic effects of obesity

After just nine days on the sugar-restricted diet, virtually every aspect of the participants’ metabolic health improved, without change in weight. Diastolic blood pressure decreased by 5mm, triglycerides by 33 points, LDL-cholesterol (known as the “bad” cholesterol) by 10 points, and liver function tests improved. Fasting blood glucose went down by 5 points, and insulin levels were cut by one-third.
“All of the surrogate measures of metabolic health got better, just by substituting starch for sugar in their processed food — all without changing calories or weight or exercise,” said Lustig. “This study demonstrates that ‘a calorie is not a calorie.’ Where those calories come from determines where in the body they go. Sugar calories are the worst, because they turn to fat in the liver, driving insulin resistance, and driving risk for diabetes, heart, and liver disease. This has enormous implications for the food industry, chronic disease, and health care costs.”
Other authors of the study include Susan Noworolski, Ph.D., Viva Tai, RD, MPH, Michael Wen, MS and Ayca Erkin-Cakmak, M.D., MPH of UCSF, Alejandro Gugliucci, M.D., Ph.D. of Touro University and Kathleen Mulligan, Ph.D., of UCSF and Touro University.
Funding was provided by the National Institutes of Health (NIH), UCSF Clinical Translational Science Institute (CTSI) and Touro University. None of the authors report any conflicts of interest.

University of California