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New research finding health benefits to humans from a four day low calorie diet - the Fasting Mimic Diet (FMD). Cutting calories to 34 to 54% of normal for a few days is obviously much easier to do than actual fastiing, so these results look very promising. In summary: the researchers found that in a small human trial, three cycles of this diet given to 19 subjects once a month for five days decreased risk factors and biomarkers for aging, diabetes, cardiovascular disease and cancer (and with no major adverse side effects). Three earlier posts on various types of minifasting health benefits: Minifasting May Benefit Health, Health Benefits of Feast and Famine DietFasting and the Immune System. From Science Daily:

Diet that mimics fasting appears to slow aging

Want to lose abdominal fat, get smarter and live longer? New research led by USC's Valter Longo shows that periodically adopting a diet that mimics the effects of fasting may yield a wide range of health benefits. In a new study, Longo and his colleagues show that cycles of a four-day low-calorie diet that mimics fasting (FMD cut visceral belly fat and elevated the number of progenitor and stem cells in several organs of old mice -- including the brain, where it boosted neural regeneration and improved learning and memory.

The mouse tests were part of a three-tiered study on periodic fasting's effects -- testing yeast, mice and humans...Mice, which have relatively short life spans, provided details about fasting's lifelong effects. Yeast, which are simpler organisms, allowed Longo to uncover the biological mechanisms that fasting triggers at a cellular level. And a pilot study in humans found evidence that the mouse and yeast studies were applicable to humans.

In a pilot human trial, three cycles of a similar diet given to 19 subjects once a month for five days decreased risk factors and biomarkers for aging, diabetes, cardiovascular disease and cancer with no major adverse side effects, according to Longo.

The diet slashed the individual's caloric intake down to 34 to 54 percent of normal, with a specific composition of proteins, carbohydrates, fats and micronutrients. It decreased amounts of the hormone IGF-I, which is required during development to grow, but it is a promoter of aging and has been linked to cancer susceptibility. It also increased the amount of the hormone IGFBP-, and reduced biomarkers/risk factors linked to diabetes and cardiovascular disease, including glucose, trunk fat and C-reactive protein without negatively affecting muscle and bone mass.

Longo has previously shown how fasting can help starve out cancer cells while protecting immune and other cells from chemotherapy toxicity. 'It's about reprogramming the body so it enters a slower aging mode, but also rejuvenating it through stem cell-based regeneration,' Longo said. 'It's not a typical diet because it isn't something you need to stay on.'

For 25 days a month, study participants went back to their regular eating habits -- good or bad -- once they finished the treatment. They were not asked to change their diet and still saw positive changes. Longo believes that for most normal people, the FMD can be done every three to six months, depending on the abdominal circumference and health status. For obese subjects or those with elevated disease risk factors, the FMD could be recommended by the physician as often as once every two weeks. His group is testing its effect in a randomized clinical trial, which will be completed soon, with more than 70 subjects.

Despite its positive effects, Longo cautioned against water-only fasting and warned even about attempting the fasting mimicking diet without first consulting a doctor and seeking their supervision throughout the process....Longo also cautioned that diabetic subjects should not undergo either fasting or fasting mimicking diets while receiving insulin, metformin or similar drugs. He also said that subjects with body mass index less than 18 should not undergo the FMD diet.

Elderly people (average age was 77 years) who have been married a long time (average length of marriage was 44 years, but one couple was married 76 years!) give advice on marriage and love. The gerontologist  Karl Pillemer details the finding of the Cornell Marriage Advice Project in his book, "30 Lessons for Loving: Advice from the Wisest Americans on Love, Relationships, and Marriage."  From Science Daily:

Love, factually: Gerontologist finds the formula to a happy marriage

A gerontologist has uncovered common advice for couples walking down the aisle or decades into marriage. To capture the voice of lived experience, the study included a random national survey of nearly 400 Americans age 65 and older, asking how to find a compatible partner and other advice on love and relationships. In subsequent in-person interviews with more than 300 long-wedded individuals -- those in unions of 30, 40, 50, or more years -- the study captured more insights for overcoming common marriage troubles. The team of researchers interviewed divorced individuals, too, asking how others might avoid marital breakups.

Pillemer uncovered common advice for couples walking down the aisle or decades into marriage. The top five lessons from the elders..:

Learn to communicate: "For a good marriage, the elders overwhelmingly tell us to 'talk, talk, talk.' They believe most marital problems can be solved through open communication, and conversely many whose marriages dissolved blamed lack of communication."

Get to know your partner very well before marrying: "Many of the elders I surveyed married very young; despite that fact, they recommend the opposite.

Treat marriage as an unbreakable, lifelong commitment

Learn to work as a team: ...Concretely, this viewpoint involves seeing problems as collective to the couple, rather than the domain of one partner. Any difficulty, illness, or setback experienced by one member of the couple is the other partner's responsibility."

Chose a partner who is very similar to you: "Marriage is difficult at times for everyone, the elders assert, but it's much easier with someone who shares your interests, background and orientation. The most critical need for similarity is in core values regarding potentially contentious issues like child-rearing, how money should be spent and religion."

This latest study finding health benefits of eating nuts was a review of 36 observational studies, involving a total of 30,000 people. Nut consumption was associated with a lower risk of cancer in general, and a decreased risk of some types of cancer (colorectal, endometrial, pancreatic), but not with type 2 diabetes. So go ahead - eat a small handful of nuts for your health at least several times a week.From Medpage Today:

A Nutty Way to Prevent Cancer?

Nut consumption was associated with a decreased risk of some types of cancer but not with type 2 diabetes in a large review.When patients eating the most nuts were compared with those eating the least, those in the first group had a lower risk of colorectal cancer in three studies (RR 0.76, 95% CI 0.61-0.96; I2=51.3%), of endometrial cancer in two studies (RR 0.58, 95% CI 0.43-0.79; I2=0%), and pancreatic cancer in one study (RR 0.68, 95% CI 0.48-0.96; I2 not available). Those results were reported in the meta-analysis of 36 observational studies, with a total population of more than 30,000 patients.

Nut consumption was also associated with a lower risk of cancer in general (RR 0.85, 95% CI 0.76-0.95;I2=66.5%), according to the authors. But it was not associated with other types of cancer or with type 2 diabetes (RR 0.98, 95% CI 0.84-1.14; I2=74.2%), found the researchers, who were led by Lang Wu, a PhD candidate at the Mayo Clinic. They published their results on June 16 in Nutrition Reviews.

"Overall, nut intake was associated with a decreased risk of cancer," wrote Wu and colleagues. "Given the scarcity of currently available data, however, evidence from additional studies is required to more precisely determine the relationship between nut consumption and risk of individual cancer types." Evidence for the association between nuts and cancer has been mixed, according to the authors. Follow-up time in the studies ranged from 4.6 years to 30 years, found the review.

The amount of nuts eaten ranged from none for some of the patients to eating nuts more than seven times a week....No associations were found between nut consumption and acute myeloid leukemia, breast cancer, gastric cancer, glioma, hepatocellular carcinoma, leukemia, lymphoma, ovarian cancer, prostate cancer, or stomach cancer.

Image result for dark chocolate My kind of study! Eating up to 100 grams of chocolate every day is linked to lowered heart disease and stroke risk. Not just dark chocolate, but milk chocolate also. Note that 100 grams of chocolate is equal to about 3.5 ounces chocolate.From Science Daily:

Chocolate for your heart

Eating up to 100 g of chocolate every day is linked to lowered heart disease and stroke risk. The calculations showed that compared with those who ate no chocolate higher intake was linked to an 11% lower risk of cardiovascular disease and a 25% lower risk of associated death.

They base their findings on almost 21,000 adults taking part in the EPIC-Norfolk study, which is tracking the impact of diet on the long term health of 25,000 men and women in Norfolk, England, using food frequency and lifestyle questionnaires.... were monitored for an average of almost 12 years, during which time 3013 (14%) people experienced either an episode of fatal or non-fatal coronary heart disease or stroke. Around one in five (20%) participants said they did not eat any chocolate, but among the others, daily consumption averaged 7 g, with some eating up to 100 g.

Higher levels of consumption were associated with younger age and lower weight (BMI), waist: hip ratio, systolic blood pressure, inflammatory proteins, diabetes and more regular physical activity --all of which add up to a favourable cardiovascular disease risk profile.Eating more chocolate was also associated with higher energy intake and a diet containing more fat and carbs and less protein and alcohol.

And among the 16,000 people whose inflammatory protein (CRP) level had been measured, those eating the most chocolate seemed to have an 18% lower risk than those who ate the least.The highest chocolate intake was similarly associated with a 23% lower risk of stroke, even after taking account of other potential risk factors.

Of nine relevant studies included in the systematic review, five studies each assessed coronary heart disease and stroke outcome, and they found a significantly lower risk of both conditions associated with regular chocolate consumption. And it was linked to a 25% lower risk of any episode of cardiovascular disease and a 45% lower risk of associated death.

This is an observational study so no definitive conclusions about cause and effect can be drawn. ...Nevertheless, they add: "Cumulative evidence suggests that higher chocolate intake is associated with a lower risk of future cardiovascular events."And they point out that as milk chocolate, which is considered to be less 'healthy' than dark chocolate, was more frequently eaten by the EPIC-Norfolk participants, the beneficial health effects may extend to this type of chocolate too. 

Could this be true? Eating fermented foods linked to fewer social anxiety symptoms? Fifteen years ago before the world of bacteria could be explored with state of the art genetic tests, this would have sounded too woo-woo. And now we say - could be. Next the researchers will test an experimental version of this study to see if they find causation. Right now all we can say they are linked or that we see an association.

But note that exercise also reduced social anxiety (this was also a finding in other studies). From Science Daily:

Decreased social anxiety among young adults who eat fermented foods

A possible connection between fermented foods, which contain probiotics, and social anxiety symptoms, is the focus of recent study...The researchers found that young adults who eat more fermented foods have fewer social anxiety symptoms, with the effect being greatest among those at genetic risk for social anxiety disorder as measured by neuroticism. "It is likely that the probiotics in the fermented foods are favorably changing the environment in the gut, and changes in the gut in turn influence social anxiety," said Hilimire. "I think that it is absolutely fascinating that the microorganisms in your gut can influence your mind."

The researchers designed a questionnaire that was included in a mass testing tool administered in the university's Introduction to Psychology courses during the fall 2014 semester; about 700 students participated. The questionnaire asked students about the fermented foods over the previous 30 days; it also asked about exercise frequency and the average consumption of fruits and vegetables so that the researchers could control for healthy habits outside of fermented food intake, said Hilimire.

"The main finding was that individuals who had consumed more fermented foods had reduced social anxiety but that was qualified by an interaction by neuroticism. What that means is that that relationship was strongest amongst people that were high in neuroticism," Hilimire said.The secondary finding was that more exercise was related to reduced social anxiety

"However, if we rely on the animal models that have come before us and the human experimental work that has come before us in other anxiety and depression studies, it does seem that there is a causative mechanism," said Hilimire. "Assuming similar findings in the experimental follow-up, what it would suggest is that you could augment more traditional therapies (like medications, psychotherapy or a combination of the two) with fermented foods -- dietary changes -- and exercise, as well."

This latest study confirms the benefits of eating peanuts and nuts. The Netherlands Cohort Study has studied 120, 000 Dutch men and women since 1986, and they found that eating approximately 1/2 handful of peanut or nuts per day is linked to a lower risk of mortality. However, this beneficial effect did not apply to peanut butter, and they theorize that it may be due to the added ingredients in it (salt and vegetable oils that are trans fats) that negate the beneficial effects of nuts. And perhaps eating an all natural peanut butter would have the same beneficial effects as plain nuts.

Note: Since 2013 even the United States FDA has said that partially hydrogenated oils (they are artificially made through an industrial process and contain trans fats) are no longer "generally recognized as safe" because they are linked to heart disease. So in general avoid all products with "partially hydrogenated" in the ingredients. From Science Daily:

Nuts and peanuts -- but not peanut butter -- linked to lower mortality rates, study finds

A paper published in the International Journal of Epidemiology confirms a link between peanut and nut intake and lower mortality rates, but finds no protective effect for peanut butter. Men and women who eat at least 10 grams of nuts or peanuts per day have a lower risk of dying from several major causes of death than people who don't consume nuts or peanuts.

The reduction in mortality was strongest for respiratory disease, neurodegenerative disease, and diabetes, followed by cancer and cardiovascular diseases. The effects are equal in men and women. Peanuts show at least as strong reductions in mortality as tree nuts, but peanut butter is not associated with lower mortality, researchers from Maastricht University found. This study was carried out within the Netherlands Cohort Study, which has been running since 1986 among over 120,000 Dutch 55-69 year old men and women. 

The associations between nuts and peanut intake and cardiovascular death confirm earlier results from American and Asian studies that were often focused on cardiovascular diseases. However, in this new study, it was found that mortality due to cancer, diabetes, respiratory, and neurodegenerative diseases was also lowered among users of peanuts and nuts. Project leader and epidemiologist Professor Piet van den Brandt commented: "It was remarkable that substantially lower mortality was already observed at consumption levels of 15 grams of nuts or peanuts on average per day (half a handful). A higher intake was not associated with further reduction in mortality risk. This was also supported by a meta-analysis of previously published studies together with the Netherlands Cohort Study, in which cancer and respiratory mortality showed this same dose-response pattern."

Peanuts and tree nuts both contain various compounds such as monounsaturated and polyunsaturated fatty acids, various vitamins, fiber, antioxidants, and other bioactive compounds, that possibly contribute to the lower death rates. In contrast to peanuts, no association was found between peanut butter intake and mortality risk. However, besides peanuts, peanut butter contains also added components like salt and vegetable oils. In the past, it has been shown that peanut butter contains trans fatty acids and therefore the composition of peanut butter is different from peanuts. The adverse health effects of salt and trans fatty acids could inhibit the protective effects of peanuts.

Two studies showing detrimental effects on children from pyrethroids in 2 weeks! The June 3 post was about research linking household pyrethroid exposure to ADHD in children and young teens. The second study found that low level childhood exposures to pyrethroid insecticides was linked to lower scores on an IQ test (Wechsler Intelligence Scale for Children - verbal comprehension and working memory) in 6 year old children. The researchers viewed this as evidence that pyrethroid insecticides may "negatively affect neurocognitive development".

Bottom line: even though pyrethroid pesticides are considered safer than many other pesticides, they still can have undesirable effects on humans, especially developing children. To be safe, use least toxic pest control that uses non-toxic, safe "alternative" or "natural" methods rather than just "spraying a chemical". Another possibility is looking for "organic pest control" or"least-toxic Integrated Pest Management" (IPM) that looks to deal with pest problems with non-toxic methods (which may include sealing holes, heat, caulking, trapping, using sticky traps, and even vacuuming up insects). From Science Daily:

Impact of insecticides on the cognitive development of 6-year-old children

Researchers have provided new evidence of neurotoxicity in humans from pyrethroid insecticides, which are found in a wide variety of products and uses. An increase in the urinary levels of two pyrethroid metabolites (3-PBA and cis-DBCA) in children is associated with a significant decrease in their cognitive performances , particularly verbal comprehension and working memory. This study was carried out on nearly 300 mother and child pairs from the PELAGIE cohort (Brittany).

Pyrethroids constitute a family of insecticides widely used in a variety of sectors: agriculture (various crops), veterinary (antiparasitics) and domestic (lice shampoo, mosquito products). Their mode of action involves blocking neurotransmission in insects, leading to paralysis. Because of their efficacy and relative safety for humans and mammals, they have replaced older compounds (organochlorides, organophosphates, carbamate) considered more toxic.

Exposure of children to pyrethroids is common. It is different to adult exposure, due to the closer proximity of children to ground-level dust (which stores pollutants), more frequent hand-to-mouth contact, lice shampoos, etc. In children, pyrethroids are mainly absorbed via the digestive system, but are also absorbed through the skin. They are rapidly metabolised in the liver, and mainly eliminated in the urine as metabolites within 48 hours.

Pregnancy is also an important period of life for the future health of the child. For this reason, the researchers studied the PELAGIE mother-child cohort established between 2002 and 2006, which monitors 3,500 mother-child pairs. This cohort simultaneously considers exposure to pyrethroid insecticides during fetal life and childhood. A total of 287 women, randomly selected from the PELAGIE cohort and contacted successfully on their child's sixth birthday, agreed to participate in this study.

Two psychologists visited them at home. One assessed the child's neurocognitive performances using the WISC scale (verbal comprehension index, VCI, and working memory index, WMI). The other psychologist characterised the family environment and stimuli that might have had a role on the child's intellectual development, collected a urine sample from the child, and collected dust samplesExposure to pyrethroid insecticides was estimated by measuring levels of five metabolites (3-PBA, 4-F-3-PBA, cis-DCCA, trans-DCCA and cis-DBCA) in urine from the mother (collected between the 6th and 19th weeks of pregnancy) and from the child (collected on his/her 6th birthday).

Results show that an increase in children's urinary levels of two metabolites (3 PBA and cis-DBCA) was associated with a significant decrease in cognitive performances, whereas no association was observed for the other three metabolites (4-F-3-PBA, cis-DCCA and trans-DCCA). With respect to metabolite concentrations during pregnancy, there was no demonstrable association with neurocognitive scores.

Study after study finds health benefits from exercise of all sorts, but what about those people who are so fit that they run marathons longer than normal marathons of 26.2 miles?

This study looked at those who participate in extreme events include ultramarathons, which tend to be 30 to 50 miles long, but can be more than 100 miles long or even last 24 hours. One study published in 2014 found that "compared with the general population, ultramarathon runners appear healthier and report fewer missed work or school days due to illness or injury...have a higher prevalence of asthma and allergies than the general population" and they may get some "exercise-related injuries such as stress fractures involving the foot."

But this newly published study found that the effects of extreme exercise (because it causes changes in the gut wall and allows bacteria to leak into the bloodstream) can be very serious if you haven't trained properly and over a long period of time.

From Medical Xpress: Extreme exercise linked to blood poisoning

Researchers have discovered that extreme exercise can cause intestinal bacteria to leak into the bloodstream, leading to blood poisoning. Experts at Monash University monitored people participating in a range of extreme endurance events, including 24-hour ultra-marathons and multi-stage ultra-marathons, run on consecutive days.

"Blood samples taken before and after the events, compared with a control group, proved that exercise over a prolonged period of time causes the gut wall to change, allowing the naturally present bacteria, known as endotoxins, in the gut to leak into the bloodstream. This then triggers a systemic inflammatory response from the body's immune cells, similar to a serious infection episode. Significantly the study found that individuals who are fit, healthy and follow a steady training program to build up to extreme endurance events, develop immune mechanisms to counteract this, without any side effects.

However individuals who take part in extreme endurance events, especially in the heat and with little training, put their bodies under enormous strain above the body's protective capacity. With elevated levels of endotoxins in the blood, the immune system's response can be far greater than the body's protective counter-action. In extreme cases, it leads to sepsis induced systemic inflammatory response syndrome, which can be fatal if it is not diagnosed and treated promptly.

The study, led by Dr Ricardo Costa, from the Department of Nutrition and Dietetics, is the first to identify a link between extreme endurance exercise and the stress it may place on gut integrity. "Nearly all of the participants in our study had blood markers identical to patients admitted to hospital with sepsis. That's because the bacterial endotoxins that leach into the blood as a result of extreme exercise, triggers the body's immune cells into action."

Dr Costa said anything over four hours of exercise and repetitive days of endurance exercise is considered extreme...."It's crucial that anyone who signs up to an event, gets a health check first and builds a slow and steady training program, rather than jumping straight into a marathon, for example, with only a month's training," he said.

The research team found that people who were fitter and trained over a longer period of time leading into the ultra-marathon event had higher levels of Interleukin 10 – an anti-inflammatory agent, which allowed them to dampen down the negative health impacting immune response.

A wonderful commentary by Dr. Mandrola about recent research of almost 500,000 UK citizens. Researchers found that just asking the patient several basic questions was a better predictor of 5 year mortality than all sorts of blood tests, measurements, and analyses. The best basic questions were: Is your health excellent, good, average, or poor? Is your walking pace slow, average, or brisk? Along with smoking, those two basic questions were the best predictors of staying alive in the next 5 years. These excerpts are from Medscape:

Health Is Not Complicated—Just Ask the Patient

It turns out predicting health is not so complicated. Nor is it digital at all. For persons of middle age (40 to 70 years), self-reported overall health and walking speed were the best predictors of death in the next 5 years, according to a study published this week in the Lancet.[1]

In an analysis of nearly 500,000 UK citizens followed for 5 years, these two simple questions outperformed 655 measurements of demographics, health, and lifestyle. Is your health excellent, good, average, or poor? Is your walking pace slow, average, or brisk? Along with smoking, those two basic questions, inquiries that hardly require a digital device, were the best predictors of staying alive in the next 5 years.

Pause for a moment here and ponder the beauty of that top-line result. Half a million people followed for 5 years; 655 measures of health, including heart rate, blood pressure, and lab tests, and the best predictors were that simple.

In the 5 years of follow-up, 8532 (1.7%) subjects died. Overall, cancer was the most common cause of death (53% in men; 69% in women). The most common cancer-related cause of death was lung cancer in men (n=546) and breast cancer in women (n=489). Cardiovascular disease was the second leading cause of death (26% in men; 33% in women).

 

There were gender differences in predictors of death. Self-reported health was the strongest predictor of death in men (C index 0.74). In women, a previous cancer diagnosis was the strongest predictor (C index 0.73).Self-reported walking pace was a strong predictor of death in both men and women (C index 0.72 and 0.69, respectively.) For example, a man aged 40 to 52 years who reported a slow walking pace was 3.7 times more likely to die than a similarly aged man who reported a steady walking pace. In a large subset of subjects with no reported health conditions, smoking was the best predictor of mortality.

 

The final, and perhaps niftiest, aspect of this study was that researchers developed an 11 to 13 question risk prediction score, which they then put on an interactive website. Anyone can answer these simple questions and get their health-related age relative to the UK population. The researchers call this age the UK Longevity Explorer (UbbLE) age.

I am drawn to these findings because they emphasize something that is increasingly lost on both doctors and patients. True health is not complicated. And the big picture is still useful.Any experienced clinician will testify that patients know when they are well and when they are not. The finding that self-reported health predicts death urges clinicians, generalists and specialists alike, to ask our patients how they feel about their health.

Then there is the matter of self-reported walking pace. How easy it is to be distracted by digital data. We walk into the exam room to see our patient. He is still. We look at him. We poke and listen to his body. We assess his ECG and other measures. Soon we will review his smartphone metrics and DNA data. Yet we tend to forget the obvious: to move is to be healthy. Drs Ganna and Ingelsson teach us that to move briskly may be healthier.

Stop drinking soda every day! Research finds that a daily sugar-sweetened beverage habit may increase the risk for non-alcoholic fatty liver disease (NAFLD). Earlier research has already linked daily sugar-sweetened beverages (typically soda) to type 2 diabetes and cardiovascular disease. And try to avoid high-fructose corn syrup in general (found in many highly processed foods) . From Medical Xpress:

Daily sugar-sweetened beverage habit linked to non-alcoholic fatty liver disease

A daily sugar-sweetened beverage habit may increase the risk for non-alcoholic fatty liver disease (NAFLD), researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HRNCA) at Tufts University report today in the Journal of Hepatology.

The researchers analyzed 2,634 self-reported dietary questionnaires from mostly Caucasian middle-aged men and women enrolled in the National Heart Lunch and Blood Institute (NHLBI) Framingham Heart Study's Offspring and Third Generation cohorts....The participants underwent a computed tomography (CT) scan to measure the amount of fat in the liver and the authors of the current study used a previously defined cut-point to identify NAFLD. They saw a higher prevalence of NAFLD among people who reported drinking more than one sugar-sweetened beverage per day compared to people who said they drank no sugar-sweetened beverages.

The relationships between sugar-sweetened beverages and NAFLD persisted after the authors accounted for age, sex, body mass index (BMI), and dietary and lifestyle factors such as calorie intake, alcohol, and smoking. In contrast, after accounting for these factors the authors found no association between diet cola and NAFLD.

NAFLD is characterized by an accumulation of fat in the liver cells that is unrelated to alcohol consumption. NAFLD is diagnosed by ultrasounds, CT, MRI, or biopsy, and many of the approximately 25% of Americans with the disease don't experience any symptoms. Being obese or overweight increases the risk for NAFLD and people with NAFLD are at greater risk of developing cardiovascular disease and type 2 diabetes.Sugar-sweetened beverages are a major dietary source of fructose, the sugar that is suspected of increasing risk of NAFLD because of how our bodies process it.