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The last post dealt with the link between highly processed food and increased risk of cancer. Now an interesting article written by Dr. Lisa Mosconi (Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College/New York -Presbyterian Hospital) refers to that study when discussing research about lifestyles (and especially diet) and later Alzheimer's disease.

It'll be interesting to see how this research plays out - is her approach stressing diet (and avoiding ultra-processed food and trans fats) and lifestyle correct or not? Much of what she says definitely makes sense and is supported by research, such as the negative health effects of chronic inflammation, and how eating actual, real foods has beneficial health effects. On the other hand, vitamin, mineral, and fish oil supplements generally don't show those health benefits (as she discusses here).

Currently there are a number of theories about causes of Alzheimer's disease (including the role of microbes), as well as a number of drug treatments that so far have gone nowhere. If Dr. Mosconi's research interests you, then read the interview she did in 2017. [In the interview she talks about the importance of exercise, intellectual stimulation, social networks, and the benefits of eating real foods rather than supplements. She recommends: drink water, eat fish, eat vegetables and fruit, eat glucose rich foods, and don't eat highly processed and fast foods.]  From Quartz:

The road to Alzheimer’s disease is lined with processed foods

Dementia haunts the United States. There’s no one without a personal story about how dementia has touched someone they care for. But beyond personal stories, the broader narrative is staggering: By 2050, we are on track to have almost 15 million Alzheimer’s patients in the US alone. ... It’s an epidemic that’s already underway—but we don’t recognize it as such. The popular conception of Alzheimer’s is as an inevitable outcome of aging, bad genes, or both.  ...continue reading "Ultra-Processed Foods and Alzheimer’s?"

 Artificial trans fats in foods are bad for health in so many ways: linked to increased risk of coronary heart disease, atherosclerosis, inflammation, and risk of early death. And even though the FDA is finally phasing out partially hydrogenated oils (because they have high levels of artificial trans fats) within the next 3 years, trans fats will still be found in foods (processed foods). How can this be? Well, trans fats are still allowed to be in foods that are labeled as 0 trans fats if it is less than .5 grams trans fats per serving (a loophole allows them to round downward to zero ). And according to research by Environmental Working Group (EWG), trans fats are being used by the food industry in undisclosed ways in amounts low enough to exploit the trans fat loophole. Besides partially hydrogenated oils, they are found in other types of refined oils, monoglycerides, diglycerides and other emulsifiers, and even in flavors and colors. So when you see ZERO trans fats on the label, it doesn't actually mean that it is zero trans fats. The problem is that over the course of a day, eating a number of foods and servings that have under .5 grams of trans fats adds up to levels that research now says has negative health effects!

Artificial trans fats are found in a lot of processed foods. A EWG analysis found that harmful artificial trans fatty acids lurk in more than 27 percent of more than 84,000 processed foods common in American supermarkets.  Another 10 percent contain ingredients likely to contain trans fat. Foods most likely to have hidden trans fats are: breakfast bars, granola and trail mix bars, pretzels, peanut butter, crackers, breads, kids fruit snacks, kids cereal, graham crackers, whipped topping, non-dairy creamers, pudding mixes, cupcakes, and ice cream cones.

So what can you do? Read ingredient lists on labels and try to avoid foods with the above mentioned ingredients: partially hydrogenated oils, emulsifiers, monoglycerides, diglycerides and other emulsifiers, artificial flavors, artificial flavors, and colors. Try to cut back or avoid foods that have ingredients that are not real foods - tough to do, but it can be done.

And the amazing part, saturated fats (such as butter) are NOT linked to early death and heart disease, but trans fat in foods is. Latest research, from Science Daily:

Trans fats, but not saturated fats like butter, linked to greater risk of early death and heart disease

A study led by researchers at McMaster University has found that that trans fats are associated with greater risk of death and coronary heart disease, but saturated fats are not associated with an increased risk of death, heart disease, stroke, or Type 2 diabetes. The findings were published today by the British Medical Journal (BMJ)...."For years everyone has been advised to cut out fats. Trans fats have no health benefits and pose a significant risk for heart disease, but the case for saturated fat is less clear," said de Souza.

Saturated fats come mainly from animal products, such as butter, cows' milk, meat, salmon and egg yolks, and some plant products such as chocolate and palm oils. Trans unsaturated fats (trans fats) are mainly produced industrially from plant oils (a process known as hydrogenation) for use in margarine, snack foods and packaged baked goods.

Contrary to prevailing dietary advice, a recent evidence review found no excess cardiovascular risk associated with intake of saturated fat. In contrast, research suggests that industrial trans fats may increase the risk of coronary heart disease.

To help clarify these controversies, de Souza and colleagues analysed the results of 50 observational studies assessing the association between saturated and/or trans fats and health outcomes in adults....The team found no clear association between higher intake of saturated fats and death for any reason, coronary heart disease (CHD), cardiovascular disease (CVD), ischemic stroke or type 2 diabetes. However, consumption of industrial trans fats was associated with a 34 per cent increase in death for any reason, a 28 per cent increased risk of CHD mortality, and a 21 per cent increase in the risk of CHD.

Inconsistencies in the studies analysed meant that the researchers could not confirm an association between trans fats and type 2 diabetes. And, they found no clear association between trans fats and ischemic stroke. The researchers stress that their results are based on observational studies, so no definitive conclusions can be drawn about cause and effect.

Trans fats are commonly used in processed foods to improve taste, texture, and shelf life. Artificial trans fats are found in partially hydrogenated oils and in other ingredients, such as refined oils, emulsifiers, flavors and colors. Even those processed foods that say zero trans fats may contain trans fats - due to a loophole in labeling laws (if it has less than .5 grams per serving, then it can be rounded down to zero - thus allowing the incorrect claim of zero trans fats). Eating a variety of processed foods, each containing a little trans fats, easily adds up to eating a significant amount daily.Trans fats in the diet have long been linked to cardiovascular disease, artherosclerosis, obesity, oxidative stress, and inflammation, but now research finds that it is linked to a poorer memory in middle-aged men under the age of 45. From Science Daily:

Dietary trans fat linked to worse memory

Higher consumption of dietary trans fatty acids (dTFA), commonly used in processed foods to improve taste, texture and durability, has been linked to worsened memory function in men 45 years old and younger, according to a study.

Researchers evaluated data from 1,018 men and women who were asked to complete a dietary survey and memory test involving word recall. On average, men aged 45 and younger recalled 86 words; however, for each additional gram of trans fats consumed daily, performance dropped by 0.76 words. This translates to an expected 12 fewer words recalled by young men with dTFA intake levels matching the highest observed in the study, compared to otherwise similar men consuming no trans fats.

After adjusting for age, exercise, education, ethnicity and mood, the link between higher dTFA and poorer memory was maintained in men 45 and younger.The study focused predominantly on men because of a small number of women in this age group. However, including women in the analysis did not change the finding, said Golomb. An association of dTFA to word memory was not observed in older populations. Golomb said this is likely due to dietary effects showing more clearly in younger adults. Insults and injuries to the brain accrue with age and add variability to memory scores that can swamp ability to detect diet effects.

Trans fatty acids have been linked to negative effects on lipid profiles, metabolic function, insulin resistance, inflammation and cardiac and general health. In 2013, the United States Food and Drug Administration issued a preliminary determination that trans fats were no longer generally recognized as safe. According to the Centers for Disease Control, reducing dTFA consumption could prevent 10,000 to 20,000 heart attacks and 3,000 to 7,000 coronary heart disease deaths per year in the U.S.

Finally the FDA is phasing out the use of artificial trans fats in foods (found in partially hydrogenated vegetable oils) within 3 years. It turns out that even though for many years scientists and the medical community pushed foods such as margarine (which have trans fats) as healthier than saturated fats such as butter, they were wrong. Instead the trans fats are linked to cardiovascular problems.

We can thank 100 year old Frank Kummerow for the ban, and for warning about trans fats for six decades! He is still drinking whole milk, eating eggs and butter, but he does avoid "fried foods, margarine, and anything associated with partially-hydrogenated oils". Other foods that are currently viewed as healthy by the medical community are extra virgin olive oil and coconut oil. However, please note that canola oil, currently viewed as a healthy and safe alternative to partially hydrogenated oils, also contains trans fats (due to the manufacturing process) and should be avoided. Also keep in mind that companies are allowed to say they have zero trans fat of they contain less than 0.5 grams per serving (which means the trans fats can add up over the course of a day). From The Washington Post:

The 100-year-old scientist who pushed the FDA to ban artificial trans fat

No one was more pleased by the Food and Drug Administration's decision Tuesday to eliminate artificial trans fats from the U.S. food supply than Fred Kummerow, a 100-year-old University of Illinois professor who has warned about the dangers of the artery-clogging substance for nearly six decades."Science won out," Kummerow, who sued the FDA in 2013 for not acting sooner, said in an interview from his home in Illinois. "It's very important that we don't have this in our diet."

In the 1950s, as a young university researcher, Kummerow convinced a local hospital to let him examine the arteries of people who had died from heart disease. He made a jarring discovery. The tissue contained high levels of artificial trans fat, a substance that had been discovered decades earlier but had become ubiquitous in processed foods throughout the country.

Later, he conducted a study showing that rats developed atherosclerosis after being fed artificial trans fats. When he removed the substance from their diets, the atherosclerosis disappeared from their arteries.

Kummerow first published his research warning about the dangers of artery-clogging trans fats in 1957. More than a decade later, while serving on a subcommittee of the American Heart Association, he detailed the massive amounts of trans fat in the shortening and margarines lining grocery shelves, and helped convince the food industry to lower the content in certain products.

Despite Kummerow's research and warnings over the years, artificial trans fats remained a staple of processed food for decades. Well into the 1980s, many scientists and public health advocates believed that partially hydrogenated oils were preferable to more natural saturated fats. And the food industry was reluctant to do away with artificial trans fats, which were cheaper than their natural counterparts, extended shelf life and gave foods desirable taste and texture.

Frustrated by the lack of action, Kummerow filed a 3,000-word citizen petition with the FDA in 2009, citing the mounting body of evidence against trans fat. The first line read: "I request to ban partially hydrogenated fat from the American diet."

In the 1990s, more and more studies had shown that trans fats were a key culprit in the rising rates of heart disease. The advocacy group Center for Science in the Public Interest also petitioned the FDA in 1994 to require that the substance be listed on nutrition labels -- a move that the agency put into place in 2006. In 2002, the Institute of Medicine found that there was “no safe level of trans fatty acids and people should eat as little of them as possible.” As the dangers of trans fat became clearer, public opinion also shifted, and food companies increasingly removed the substance from products, though it remained in a broad range of foods, from cake frostings to baked goods.

Four years after filing his petition and hearing nothing, Kummerow sued the FDA and the Department of Health and Human Services in 2013, with the help of a California law firm. The suit asked a judge to compel the agency to respond to Kummerow's petition and "to ban partially hydrogenated oils unless a complete administrative review finds new evidence for their safety."

Three months later, the FDA announced its plans to effectively eliminate trans fats by saying that the substance no longer would be assumed safe for use in human foods. Tuesday's action finalizes that initial proposal, and manufacturers will have three years to reformulate products or to petition the agency for an exception.

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.