Men who die from cancer have lower cholesterol levels

This study was published in the American Journal of Epidemiology 1980 Sep;112(3):388-94

 

Study title and authors:

Total serum cholesterol and cancer mortality in a middle-aged male population.

Cambien F, Ducimetiere P, Richard J.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/7424886

This study investigated the relationship between cholesterol levels and death from cancer. The study included 7,603 men, aged 43-52 years, who were followed for an average of 6.6 years.

The study found:
(a) Those who died from cancer had lower cholesterol levels than those who survived.
(b) Cholesterol levels increased steadily with survival time.

Clearing Up The Confusion Surrounding Saturated Fat

In 2010, Siri-Tarino and colleagues published a meta-analysis of prospective cohort studies evaluating the association between dietary saturated fat and cardiovascular disease in the American Journal of Clinical Nutrition.1 Based on the results of this meta-analysis, these researchers concluded that there was insufficient evidence from prospective cohort studies to conclude that dietary saturated fat increases the risk of coronary heart disease. However, a number of prominent diet-heart researchers identified many serious flaws and omissions in this meta-analysis that cast doubt on the validity of these researchers conclusions.2 3 4 5 6

More recently, Chowdhury and colleagues published a separate meta-analysis in the Annals of Internal Medicine, and reached similar conclusions to that of Siri-Tarino and colleagues regarding the association between saturated fat and coronary heart disease.7 Unfortunately, this meta-analysis also failed to sufficiently address a number of important limitations that it shares with the meta-analysis by Siri-Tarino and colleagues. Furthermore, in this meta-analysis, although positively, but not significantly associated in the random-effects model, both dietary and total circulating concentrations of saturated fat were associated with a small, but statistically significant increased risk of coronary heart disease in the fixed effects model (RR=1.04 [95% CI, 1.01, 1.07] and RR=1.13 [95% CI, 1.03-1.25], respectively). These significant findings were however ignored in the conclusions of this study. Nevertheless, the media and proponents of popular Low-Carb and Paleo diets have repeatedly cited these meta-analyses as evidence to support a diet rich in saturated fat. 

Saturated Fat and Coronary Heart Disease Mortality

In the editorial to the Siri-Tarino meta-analysis, Jeremiah Stamler noted that saturated fat intake was more strongly associated with fatal than non-fatal incidence of coronary heart disease. Stamler calculated that based on the 11 studies included in the meta-analysis which provided estimates specifically for fatal cases, saturated fat was associated with a 32% increased risk of death from coronary heart disease, when weighted by person-years of exposure.2 Siri-Tarino and colleagues noted this concern in a follow-up paper, but instead downplayed these findings by asserting that in their own analysis of only 7 studies, saturated fat intake was associated with only a borderline significant 18% increased risk of death from coronary heart disease, when using the random effects model (RR=1.18 [95% CI 0.99-1.42]).8 Similarly, in the more recent meta-analysis, Chowdhury and colleagues found that in their sub-analysis of only 9 studies, saturated fat intake was associated with a borderline significant 7% increased risk of death from coronary heart disease (RR=1.07 [95% CI, 1.00-1.13]).7

It can be deduced by the estimates and the sample size of these sub-analyses by both Siri-Tarino and Chowdhury, that only the studies that provided estimates specifically only for fatal cases were included. Therefore these sub-analyses excluded studies that provided estimates for fatal cases in additional to that of total incidence of coronary heart disease. In total, 14 prospective cohort studies provided estimates for death from coronary heart disease, of which 3 were not included in the original meta-analysis by Siri-Tarino and colleagues.1 9 10 11 12 13 14 15 16 17 18 19 20 21 22

The exclusion of several studies in these analyses warrants a reanalysis of the studies evaluating the association between saturated fat and the risk of death from coronary heart disease. I therefore performed a meta-analysis including all 14 studies for which estimates were available specifically for death from coronary heart disease. Similar to the methods of Siri-Tarino and colleagues, I chose to compare extreme quantiles of saturated fat intake where possible. However, for the studies which estimates were provided as either a 1% increase of energy, or as a 1-unit increase, the estimates were transformed to represent roughly a 5% increase in energy from saturated fat, as this was similar to the difference for high vs low quantiles of intake in the other studies included in this meta-analysis. In order to ensure that the methods used for the statistical analysis were consistent with that used by Siri-Tarino and colleagues, I performed the meta-analysis in Review Manager (from The Cochrane Collaboration), and pooled the estimates using the random effects model for both within-study and between-study variation. Similarly, risk ratios and 95% confidence intervals were log transformed to derive the corresponding standard error for beta-coefficients by using Greenland’s formula.23 Otherwise, the exact P-value was used where available to derive the corresponding standard error.

In a meta-analysis including 14 studies, dietary saturated fat intake was associated with a statistically highly significant 24% increased risk of death from coronary heart disease (Fig. 1). Similarly, for the 11 studies included in the Siri-Tarino meta-analysis, saturated fat was associated with a statistically highly significant 26% increased risk of death from coronary heart disease (RR=1.26 [95% CI, 1.14-1.40]). 

FIGURE 1. Risk ratios and 95% CIs for fully adjusted random-effects models examining associations between saturated fat intake in relation to coronary heart disease mortality. ¹Studies that included adjustments for serum or LDL cholesterol. SAT, saturated fat intake.

It is well established that saturated fat raises serum and LDL cholesterol, and that these blood lipids increase the risk of coronary heart disease.24 25 26 27 However, in this meta-analysis, almost 40% of the weight was derived from studies that controlled for either serum or LDL cholesterol. Therefore, the inclusion of these studies would be expected to have bias these findings towards null.2 In a sub-analysis excluding the 6 studies that controlled for either serum or LDL cholesterol, saturated fat was associated with a statistically significant 30% increased risk of death from coronary heart disease (Fig. 2). Interestingly, in a sub-analysis including only the 6 studies which controlled for either serum or LDL cholesterol, saturated fat was associated with a statistically significant 18% increased risk of death from coronary heart disease (RR=1.18 [95% CI, 1.01-1.37]). This suggests that the adverse effects of saturated fat may extend beyond on simple measures of blood lipids.

FIGURE 2. Risk ratios and 95% CIs for fully adjusted random-effects models examining associations between saturated fat intake in relation to coronary heart disease mortality. SAT, saturated fat intake.

As coronary heart disease is the leading cause of death in the world, naturally these findings should be a cause for concern.28 Nevertheless, both the Siri-Tarino and Chowdhury meta-analyses are widely cited by proponents of Low-Carb and Paleo diets as providing compelling evidence in favor of a diet rich in saturated fat. It is important to note, however, that in the studies included in this meta-analysis, the difference for high vs low intake of saturated fat only ranged between about 5% and 10% of energy. This suggests that individuals following popular variants of these diets which often emphasize far higher intakes of saturated fat than recommended levels may be at a much greater risk of death.

It is important to note that the influence that saturated fat has on the risk of disease is not primarily determined by intake per se, but by which foods saturated fat is substituted for. As the intake of dietary fiber was universally low among subjects in these studies, this suggests that subjects consuming diets lower in saturated fat were substituting saturated fat primarily with lean animal foods and heavily processed foods.29 As dietary fiber was associated with a decreased risk of death from coronary heart disease in a number of these studies, this suggests that compared to fiber-rich foods, foods rich in saturated fat may be associated with an even stronger risk of coronary heart disease death.29

Although in this meta-analysis, the Israeli Ischemic Heart Disease Study appeared the least favorable of the hypothesis that saturated fat increases the risk of death from coronary heart disease, it should be noted that not only were the estimates controlled for serum cholesterol, in this study, saturated fat as a percentage of fat was actually associated with a statistically significant increased risk of death from coronary heart disease. In addition, subjects who were classified as being most adherent to religious Orthodoxy, which is typically accompanied by fasting periods in which the consumption of meat and other foods rich in saturated animal fat are prohibited, experienced a significantly lower death rate of coronary heart disease.11 This observation is supported by several other studies which found that Orthodox fasting is associated with improved cardiovascular risk factors, including blood lipids.30

The findings from this meta-analysis are in agreement with the demonstrated unequivocal causal relationship between diets rich in cholesterol and saturated fat, and the development of atherosclerosis in nonhuman primates, among dozens of other animal species. It had also been demonstrated that such diets cause heart attacks, and even cardiovascular related deaths in nonhuman primates at a rate similar to that of high-risk populations living in developed nations.31

The findings from this meta-analysis are also in agreement with numerous longitudinal ecological studies. For example, intake of saturated fat explained about 88% of the variance in death from coronary heart disease between the 16 cohorts in the 25-year follow-up of the Seven Countries Study.32 Similar estimates were also found for foods rich in saturated fat, including butter, meat, and animal foods combined.33 Similarly, in 1989, Epstein examined the changes in death from coronary heart disease in 27 countries during the previous 10 to 25 years, and noted that:

In almost all of the countries with major falls or rises in CHD mortality, there are, respectively, corresponding decreases or increases in animal fat consumption...

Epstein also noted that a number of other risk factors, such as smoking could not explain these findings, as the prevalence of smoking among women either remained largely unchanged or increased in most nations during this period, yet similar declines in death were often observed in both men and women.34 Epstein's findings are further supported by a number of studies that have incorporated the IMPACT CHD mortality model, which has been shown to adequately explain which risk factors and treatments that have contributed most significantly to the changes of rates of coronary heart disease mortality throughout most parts of the world.35

Dietary Patterns and Coronary Heart Disease Mortality

Dietary patterns characterized by high or low intakes of saturated fat may provide indirect evidence of the effect saturated fat has on the risk of death from coronary heart disease. For example, a recent meta-analysis of prospective cohort studies by Noto and colleagues found that both low-carbohydrate, and low-carbohydrate, high-protein diets, which highly correlated with saturated fat intake were associated with a statistically significant increased risk of death from all causes combined.36 Conversely, the findings for death from cardiovascular disease, although positive, were not statistically significant. However, several of the studies controlled for saturated intake, and sub-analyses in several of the studies found that the excess risk of death was greater when either saturated fat intake was above the median, or when the diets were classified as being animal based.37 38 Similarly, a sub-analysis in one of the studies found that the association with death was stronger after excluding nonadequate dietary reporters.39

These sub-analyses would likely allow for a clearer interpretation of the effects of a carbohydrate restricted diet rich in saturated fat. Unfortunately, estimates based on these sub-analyses were not provided in the meta-analysis by Noto and colleagues. Therefore, I performed a meta-analysis based on the studies included in the meta-analysis by Noto and colleagues, while using the estimates for the sub-analyses described above where possible.37 38 39 40 41 For the statistical analysis I used the same methods described by Noto and colleagues.36

In this meta-analysis, a high low-carbohydrate score was associated with a statistically significant 15% increased risk of death from cardiovascular disease, for which only 2 of 4 cohorts did not control for saturated fat intake (Fig. 3). On the other hand, a high low-carbohydrate, high-protein score was associated with a statistically significant 100% increased risk of death from cardiovascular disease, for which 3 of 4 studies did not control for saturated fat intake (Fig. 4). 

FIGURE 3. Risk ratios and 95% CIs for fully adjusted random-effects models examining associations between low-carbohydrate diets in relation to cardiovascular disease mortality. ¹Studies that included adjustments for saturated fat intake.

FIGURE 4. Risk ratios and 95% CIs for fully adjusted random-effects models examining associations between low-carbohydrate, high-protein diets in relation to cardiovascular disease mortality. ¹Studies that included adjustments for saturated fat intake. LCHP, low-carbohydrate, high-protein diet.

As coronary heart disease is the number one cause of cardiovascular death in the nations where these studies were carried out, this provides indirect evidence that diets rich in saturated fat, at least in the context of a carbohydrate restricted diet, increases the risk of coronary heart disease. Furthermore, the difference in intake of saturated fat between the low and high low-carbohydrate scores was generally smaller than the difference of intake between popular low-carbohydrate diets and recommended levels, suggesting that individuals who follow more extreme variants of these diets may be at an even greater risk of death. As reviewed previously, these findings may be explained, in part, by a number of adverse effects that carbohydrate restricted diets have been shown to exert on cardiovascular risk factors. For example, recent meta-analyses of randomized controlled trials have found that compared to diets rich in nutrient poor, low-fiber carbohydrates, carbohydrate restricted diets raise LDL cholesterol and impair flow-mediated dilatation.42

Findings from prospective cohort studies comparing vegetarians characterized by consuming moderately low saturated fat diets and health conscious omnivores may provide further indirect evidence of the adverse effects of saturated fat. I showed previously in a meta-analysis of 7 prospective cohort studies that compared to vegetarians, health conscious omnivores experienced a statistically highly significant 32% increased risk of death from coronary heart disease (Fig. 5).43 44 45 46 47

FIGURE 5. Risk ratios and 95% CIs for fully adjusted random-effects models examining associations between omnivorous diets in relation to coronary heart disease mortality.

It is important to note that the omnivores in these studies had a relatively low intake of meat, suggesting that individuals following popular meat based diets may be at a greater risk of death. This suggestion is supported by a recent meta-analysis of prospective cohort studies which found that an increment of 1 mg/day of heme iron, found only in animal tissue is associated with a 27% increased risk of coronary heart disease.48 As reviewed previously, in these studies, the degree of reduction in risk of death from coronary heart disease observed in vegetarians in these studies was generally in proportion to the expected reduced risk based on the differences in levels of total and non-HDL cholesterol. This suggests that these results may, in part, be explained by differences in intake of saturated fat.

The findings of a pooled-analysis of 11 prospective cohort studies by Jakobsen and colleagues suggested that replacing saturated fat with polyunsaturated fat, but not monounsaturated fat or carbohydrate, was associated with a significantly decreased risk of death from coronary heart disease.49 However, the researchers pointed out that these findings should be interpreted with caution, as the main dietary source of monounsaturated fat in these cohorts was animal fat, whereas the quality of carbohydrate was not considered. In this pooled-analysis, dietary fiber intake was controlled for, essentially removing a primary benefit of replacing foods rich in saturated fat with carbohydrate. In a different pooled-analysis including virtually the same studies, an increment of 10 g/day of dietary fiber was associated with a 27% decreased risk of death from coronary heart disease.23 This suggests that replacing saturated fat with the equivalent energy from fiber-rich carbohydrate would likely be associated with a significantly reduced risk of death from coronary heart disease. This suggestion is supported by a different meta-analysis which found that an increment of about 2 servings a day of whole grains was associated with a 22% decreased risk of death from cardiovascular disease.50 Interestingly, even Siri-Tarino and colleagues concluded in a more recent paper that saturated fat should be replaced with polyunsaturated fat and whole grains in order to reduce the risk of cardiovascular disease.7

Saturated Fat is a Major Problem

The findings reviewed here support the hypothesis that saturated fat increases the risk of coronary heart disease mortality. Furthermore, as reviewed previously, evidence also suggests that the hazardous effects of diets rich in saturated fat are also applicable to diets rich in organic, grass-fed animal foods. However, saturated fat is only one of a number of problems as far as chronic diseases are concerned. The effect that a particular food has on the risk of coronary heart disease cannot be fully explained by saturated fat content alone, but rather by multiple nutrients that likely operate together in a complex manner to modify the risk of disease. Therefore, it may be more appropriate to focus attention on recommending healthy dietary patterns that are naturally low in saturated fat, while rich in dietary fiber and other beneficial nutrients; primarily, minimally processed, plant-based diets. Such a focus may be more effective to help lower the intake of saturated fat, while simultaneously improving overall dietary quality compared to the more contemporary reductionist approach of focusing on modifying single nutrients.

In forthcoming parts of this review, I will examine both the effects of dietary and total circulating concentrations of saturated fat on the risk of total incidence of coronary heart disease. In addition, I will examine a number of other important limitations of the studies included in these meta-analysis that may have bias these findings towards null.2 3 4 5 6


Study acronyms: ATBC, Alpha-Tocopherol Beta Carotene Study; BLSA, Baltimore Longitudinal Study of Aging; EPIC-Greece, European Prospective Investigation into Cancer Greece; EUROASPIRE, European Action on Secondary and Primary Prevention through intervention to reduce events; FHS, Framingham Heart Study; HLS, Health and Lifestyle Survey; HPFS, Health Professionals' Follow-Up Study; IBDH, Ireland-Boston Diet Heart Study; IIHD, Israeli Ischemic Heart Disease Study; JACC, Japan Collaborative Cohort Study; LRC, Lipid Research Clinics; MALMO, Malmo Diet and Cancer Study; NHS, Nurses' Health Study; SHS, Strong Heart Study; SWLHC, Swedish Women’s Lifestyle and Health Cohort; ULSAM; Uppsala Longitudinal Study of Adult Men; VIP, Västerbotten Intervention Program; WES, Western Electric Study.


Please post any comments in the Discussion Thread.

In the Swing of things: Perfect Health Diet and an Activity Challenge

Gnomes make me happy 

Since going all in with the Perfect Health Diet, I've set up a few guidelines that are keeping me feeling good:

• Refined Sugar is out (except small amounts of dark chocolate).
• Fruit is OK and I'm not limiting it at all (I wind up having 2-4 pieces a day). Knowing that this is always a sweet option makes me feel less panicy and restricted. 
• Starch comes mostly from things that contain resistant starch -- cooked cooled potatoes/rice, green bananas but also from sweet potatoes. I am limiting processed starches like rice noodles, etc. to roughly 1 x per week.
• Non-starchy veggies fill half my plate at every meal with the other half split between meat and starch. I have to purposely focus on this and it has led me to eating much less meat overall since my appetite has gone down.
• Mindful activity is a part of each day. I printed out a full year calendar and hung it on the fridge. Every day that I do at least 20 minutes of purposeful activity, I put and X over the date. I'm over 3 weeks in and haven't broken the chain. Yay! Sometimes I do more (like an hour yoga class), but keeping the goal manageable has been key to attaining consistency, which is what I was after. 
• Almond milk is a daily addition to my morning smoothie, in which I get to dump all my food-based supplements like collagen, probiotics, prebiotics, green bananas for RS, fiber, and even liver powder sometimes! Since the store-bought variety comes with additives and stabilizers, I decided to try my hand at making my own. I used this method (I just use the almonds, water, and vanilla) and bought this nut milk bag to strain it. Making homemade almond milk is way easier than I imagined and turns out delicious. It smells amazing whirring in my Vitamix - fresh almonds and vanilla - yum! 
• Almond meal is a lucky side benefit of making homemade almond milk. Who knew? When you strain the milk, you're left with very finely ground almond meal, which you can use to bake cookies. The milk recipe I linked to suggests drying it out in the oven, sending it through the blender again, etc. I am way too lazy. I just save it in the fridge and then make some cookies when I get enough of it. Since it's still damp, not at all like my beloved blanched almond flour, it's a whole different animal. I found I had to turn the oven temp down and bake them longer than usual, but they come out moist, chewy, and more like oatmeal cookies. I love the idea of using one raw ingredient to get so many yummy things! Talk about being thrifty. My Grampy would be proud. 

I am off to go try my hand at baking my low sugar (fruit sweetened) chocolate chip cookies. I'm going to refine the recipe a bit then come back and post an official version with pictures. Stay tuned!

Corrections to the New Review Paper on Dietary Fat and Cardiovascular Risk

The meta-analysis by Chowdhury et al. raised quite a furor from certain segments of researchers and the popular media.  I find this reaction interesting.  I usually write about obesity, which is a topic of great interest to people, but my post about the review paper received more than twice my usual traffic.  People whose findings or opinions are questioned by the paper are aggressively denouncing it in the media, even calling for retraction (1).  This resembles what happens every time a high-profile review paper is published that doesn't support the conventional stance on fatty acids and health (e.g., Siri-Tarino et al. [2], which despite much gnashing of teeth is still standing*).  I'm not sure why this issue in particular arouses such excitement, but I find it amusing and disturbing at the same time.  This kind of reaction would be totally out of place in most other fields of science, where aggressive public media outbursts by researchers are usually frowned upon.

As it turns out, the critics have a point this time.  Significant errors were uncovered in the original version of the meta-analysis, which have been corrected in the current version (3).  These include the following two errors, one of which alters the conclusion somewhat:

• The outcome of one observational study on omega-3 fatty acids was reported as slightly negative, when it was actually strongly positive.  This changes the conclusion of the meta-analysis, making it somewhat more favorable to omega-3 consumption for cardiovascular protection.
• The authors left out two studies on omega-6 fatty acids.  These didn't change the overall conclusions on omega-6.

Read more »

Mobile (cell) phones associated with a 70% increased risk of malignant brain tumours

This study was published in the International Journal of Oncology 2013 Dec;43(6):1833-45

 

Study title and authors:

Case-control study of the association between malignant brain tumours diagnosed between 2007 and 2009 and mobile and cordless phone use.

Hardell L, Carlberg M, Söderqvist F, Mild KH.

Department of Oncology, University Hospital, SE-701 85 Örebro, Sweden.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/24064953

Hardell notes that when mobile (cell) and cordless phones are used they emit radiofrequency electromagnetic fields (RF-EMFs) and the brain is the main target organ for the handheld phone. The International Agency for Research on Cancer (IARC) classified in May, 2011 RF-EMF as a group 2B, i.e. a 'possible' human carcinogen.

The aim of this study was to further explore the relationship between especially long-term use of wireless (mobile and cordless) phones and the development of malignant brain tumours. The study included 593 patients, aged 18-75 years, with a malignant brain tumour and 1,386 controls.

The study found:
(a) Use of a wireless phones (mobile or cordless) was associated with a 70% increased risk of malignant brain tumours.
(b) Use of a wireless phones (mobile or cordless) for more than 25 years was associated with a 200% increased risk of malignant brain tumours.

Hardell concluded: "This study confirmed previous results of an association between mobile and cordless phone use and malignant brain tumours. These findings provide support for the hypothesis that RF-EMFs play a role both in the initiation and promotion stages of carcinogenesis".

Book Review: Your Personal Paleo Code

Chris Kresser has been a major figure in the ancestral health community for some time now.  It's funny to recall that I was actually one of his first readers, back in the early days of his blog when it was called The Healthy Skeptic and the audience was small.  Chris's readership rapidly eclipsed mine, and now he's in high demand for his ability to convey ideas clearly and offer practical solutions to important health concerns.

He recently published a book titled Your Personal Paleo Code, which also happens to be a New York Times bestseller.  The primary goal of the book is to help you develop a diet and lifestyle that support health and well-being by starting from a generally healthy template and personalizing it to your needs.  Let's have a look.

Introduction

Kresser opens with the poignant story of his own health problems, which began with an infectious illness in Indonesia and several courses of antibiotic therapy.  After years of struggling with the resulting symptoms, trying a variety of diets, and finally accepting his condition, he was unexpectedly able to recover his health by adopting a personalized Paleo-like diet that included bone broth and fermented foods.

Why Paleo?

Read more »

Animal protein intake is associated with higher-level functional capacity in elderly adults

This study was published in the Journal of the American Geriatric Society 2014 Mar;62(3):426-34

 

Study title and authors:

Animal protein intake is associated with higher-level functional capacity in elderly adults: the ohasama study.

Imai E, Tsubota-Utsugi M, Kikuya M, Satoh M, Inoue R, Hosaka M, Metoki H, Fukushima N, Kurimoto A, Hirose T, Asayama K, Imai Y, Ohkubo T.

Section of the Dietary Reference Intakes, Department of Nutritional Epidemiology, National Institute of Health and Nutrition, Tokyo, Japan.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/24576149

The objective of the study was to determine the association between protein intake and risk of higher-level functional decline in older adults. The study lasted for seven years and included 1,007 participants, average age 67.4 years, who were free of functional decline at the start of the study.

The study found:
(a) Men who consumed the most animal protein had a 59% reduced risk of higher-level functional decline compared to men who consumed the least animal protein.
(b) Women who consumed the most animal protein had a 24% reduced risk of higher-level functional decline compared to women who consumed the least animal protein.
(c) No consistent association was observed between plant protein intake and future higher-level functional decline in either sex.

Higher animal protein intake is associated with lower risk of decline in higher-level functional capacity in elderly adults.

Evidence from 72 studies shows that saturated fat does not cause heart disease

This study was published in the Annals of Internal Medicine 2014;160(6):398-406-406

Study title and authors:
Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis                                                                    

Rajiv Chowdhury, MD, PhD; Samantha Warnakula, MPhil; Setor Kunutsor, MD, MSt; Francesca Crowe, PhD; Heather A. Ward, PhD; Laura Johnson, PhD; Oscar H. Franco, MD, PhD; Adam S. Butterworth, PhD; Nita G. Forouhi, MRCP, PhD; Simon G. Thompson, FMedSci; Kay-Tee Khaw, FMedSci; Dariush Mozaffarian, MD, DrPH; John Danesh, FRCP; and Emanuele Di Angelantonio, MD, PhD

This study can be accessed at: http://annals.org/article.aspx?articleid=1846638

This review led by Dr Rajiv Chowdhury from the University of Cambridge, notes that current "official" dietary guidelines advocate that high consumption of polyunsaturated fatty acids and low consumption of total saturated fats are recommended to prevent heart disease.

The purpose of this review was to summarise evidence about associations between different fats and coronary heart disease. The review included 72 studies from 18 countries with a total of 659,298 participants.

 

The study found:

(a) Current evidence does not support guidelines which restrict the consumption of saturated fats in order to prevent heart disease.

(b) There is insufficient support for guidelines which advocate the high consumption of polyunsaturated fats (such as omega 3 and omega 6) to reduce the risk of coronary disease.

 

Dr Chowdhury states: "These are interesting results that potentially stimulate new lines of scientific inquiry and encourage careful reappraisal of our current nutritional guidelines".

For more detailed appraisals of the above study please see:
http://www.drbriffa.com/2014/03/21/yet-another-major-review-finds-no-reason-at-all-to-limit-saturated-fat-in-the-diet/

and also:
http://drmalcolmkendrick.org/2014/03/19/although-now-dead-the-cholesterolosaurus-will-march-on/

Am I training with your Shaolin Warrior DVDs correctly?

I made my DVDs to share my more than thirty years knowledge of Shaolin. My life has been transformed by my practice and I hope that my DVDs can transform my student's life.

Of course learning from a DVD has its drawbacks. For example, if you are doing something incorrectly then there is no one there to tell you and correct you. So it's a good idea to keep checking your movements and your forms and even to video them so you can see how they compare to mine or my students who train with me.

How do I know if I'm training correctly?

I can see if students are training just by looking at them. Everyone who trains in Shaolin looks younger than their years, are more grounded, their reactions are quick. Even within a few weeks of dedicated practice, students transform. I've seen this with students who train with my DVDs and come for a check up as well as students who train one2one.  So check yourself, do I look younger? Do I feel more grounded and confident? If the answer is no, then you need to find where you're going wrong.

How hard should I push myself with your kung fu DVDs?

I recommend you start training with my 3 Shaolin Workout DVDs, then progress to Bootcamp and then Circuit Training. If you're training to be a martial artist then you need to train 6 days a week. You can alternate these DVDs , as you advance do less workout and more Bootcamp and Circuit Training. Take a day to slow down and check your form and your stances. There should be no pain when you train. You will ache the next day, if you don't then you're not pushing yourself enough.

Your stances should get deeper, you should become more flexible and your stamina should be as good as a boxer in training. Check your stamina, time yourself. Do my running exercises on youtube, and keep pushing yourself safely. A martial artist is in tune with their body so as you train, your bodies wisdom will take over.

Read The 3 Keys To A Powerful Qigong Practice to check on your Qigong practice

The 3 Keys To A Powerful Qigong Practice

Most people's bodies are too Yang. One of the main purposes of our Qigong practice is to re-balance our body and stop it burning itself out.  This is why we believe that Qigong doesn't just increase the quality of our life but through slowing down the causes of illness, it potentially increases our life span.

1) Keep it Simple

The beauty of Qigong is in its simplicity. At the Shaolin Temple, we don't learn complex Qi theory, we don't focus on one area of our body such as the Dan Tian. We just focus on breath and movement together. The Qigong that we learn at the temple is the same Qigong I teach in my DVDs. These precious teachings are passed down from the founder of Zen, Bodhidharma. He was a great master and didn't gain anything from teaching these treasures. This gives us trust that what our teachers and ancestors have passed down to us is authentic.

2) Practice Consistently

We've been given the key but the only way to open the door is through consistent practice. Minimum, half an hour, five days a week. And always include the Qigong Instant Health Massage with the bamboo brush (or for more advanced students the metal brush.)

3) Do the Qigong Instant Health Massage / or

The Instant Health massage increases the benefit of our Qigong. I'm sure, that, given the choice, most of us would choose to have a massage once a week but the cost is what stops us. With the Instant Health Massage we can have a massage for free every day of the week.

4)  or (for more advanced students) Bone Marrow Cleansing Massage

If you've been using the bamboo brush for a few years and you're not feeling as much benefit then it may be time for you to progress to doing the Instant Health Massage with the Metal Massage Brush. The metal massage brush is about the price of six massages but it will give you a lifetime of massages. Many people mistakenly believe that the metal brush is only used for body conditioning but at the Shaolin Temple we use it for bone marrow cleansing.

Start off by warming up with the bamboo brush then move on to the metal  brush. This heavier brush creates vibrations in the bones and helps to cleanse them so even though you are still doing the Instant Health massage it is having a much more powerful effect. This is where the name "Bone Marrow Cleansing" comes from.  

As we age, not only do our bones and muscles shrink unless we exercise to prevent them but also the blood cells produced by our bone marrow slow down. This is because the marrow becomes dirty. Through using the metal brush we cleanse the marrow and stop this reversal.

WARNING: The metal brush is heavy and is only for professionals and advanced students so only use it if you feel you are ready. The bamboo brush is safe to use even if used incorrectly but the metal brush is not. If used incorrectly it can damage the body. For most people the bamboo brush is all they need for their practice. 

For more information visitshifuyanlei.com

Why Your Shaolin Practice Benefits Others

When I was a boy studying at the Shaolin Temple, my master told me that my Shaolin Practice was not just for myself alone but for the benefit of other people. I asked him, "How could my practice benefit other people ?" He replied, "Shaolin training strengthens the heart, mind and body so that a person has more command over the actions of their body, speech and mind, and therefore it helps that person live a good life. Shaolin Practice gives the inherent goodness which is inside all of us, some breathing space."

I was about fourteen years old at the time and didn't fully understand what my master meant but I've thought about it a lot since then.

Our training is about finding the natural healthy state which lives inside all of us, and nurturing that state so it can grow into good health. We are taught that if we can just be, really be in our true natural state then all of our health and good qualities are naturally there. We don't need to force or make ourselves into something.

Through our Shaolin Qigong practice, our mind, which is usually in a whirlwind of agitation, glides naturally into the present moment, slowing down and coming to rest. This is our first taste of calmness. As we become more familiar with it, we stay in this experience longer.  Research on meditation shows that this experience increases our feelings of happiness and decreases our feelings of anxiety. Yes, we still have plenty to worry about but what help can worrying do? The worries no longer get hold of us. Our peace then permeates into our work ,family and friends and we function better in our life.

And what about Shaolin Kung Fu, how can our practice benefit others? Well, think for a moment about what happens to your body if you don't train.

Acceleration of ageing

Lack of stamina, strength and flexibility

Lack of connection between the body and the mind

Increase of potential illness such as heart disease, diabetes and high blood pressure

Increase of falls in later life.

Less energy in day to day life

Of course, not all illnesses are preventable but for the ones that are, we need to do everything we can.

This is why Shaolin is a lifestyle choice. I know it's not easy. Some days we lack the motivation to train. I've been doing it now for nearly thirty years, and I still have days when I struggle. But this struggle is part of our path. Without struggle we can't become strong. 

Shifu Yan Lei teaches Shaolin Qigong and Kung Fu on his DVDs

Mint Chip Super Food Ice Cream

In honor of St. Patrick's Day, I decided to churn up some creamy green goodness. I'm trying to avoid refined sugar so I used a combo of medjool dates and stevia to sweeten it. I added some avocado and spinach for the green as well as collagen, probiotics, and some green banana for the resistant starch. That's a lot of nutrition packed into a tasty frozen treat!

Mint Chip Super Food Ice Cream

1 14.5 oz can full fat coconut milk 

2 Medjool dates (take out the pit first!)

1 very small avocado (half of a medium or large one)
1/4 cup frozen spinach*
1/2 frozen green banana*
1/2 contents of one probiotic capsule
1 Tbs collagen
1 tsp powdered stevia
1/2 tsp peppermint extract
1/4 tsp real salt
1/2 cup enjoy life chips

Blend all ingredients (except chocolate chips) -- I used my Vitamix. I blended it for quite some time because I wanted to make sure that everything was completely incorporated. Refrigerate for at least 30 minutes before churning it in an ice cream maker until it reaches the consistency of soft serve. Empty into a quart sized Tupperware container and mix in chocolate chips. Dish out a nice scoop into a chilled bowl and enjoy! Stick the rest in the freezer and get your super foods in each day for the rest of the week.

I prefer to make my ice cream really rich and creamy as opposed to lighter and less filling. I tend to only eat a tiny bowl of it at a time and really savor it. I find it's much more satisfying than something that I can eat and eat without getting full.

*You can use fresh/not frozen spinach and banana - just chill the mixture longer before churning.  

New Review Paper on Dietary Fat and Heart Disease Risk

A new review paper on dietary fatty acids and heart disease risk was just published by Dr. Rajiv Chowdhury and colleagues in the Annals of Internal Medicine-- one of the top medical journals (1).  The goal of the paper is to comprehensively review the studies evaluating the effect of dietary fatty acids on heart (coronary) disease.  The review covers observational and intervention studies pertaining to saturated, monounsaturated, trans, omega-6 polyunsaturated, and omega-3 polyunsaturated fats.  The paper is notable for its comprehensiveness (inclusion criteria were very lax).

Here is a summary of the results:

• In observational studies that measured diet, only trans fat was related to cardiovascular risk.  Saturated, monounsaturated, and polyunsaturated fats were unrelated to risk.
• In observational studies that measured circulating concentrations of fatty acids, long-chain polyunsaturated fatty acids (DHA, DPA, EPA, AA) were associated with lower risk.  The dairy-fat-derived margaric acid (17:0) was also associated with lower risk.  No other fatty acids were related to risk, including trans fatty acids.
• In controlled trials, supplementation with omega-3 or omega-6 fatty acids did not alter risk.

The authors conclude:

In conclusion, the pattern of findings from this analysis did not yield clearly supportive evidence for current cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of saturated fats.  Nutritional guidelines on fatty acids and cardiovascular guidelines may require reappraisal to reflect the current evidence.

My view

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Statins increase the risk of serious adverse cardiovascular events

This study was published in the Journal of the American Medical Association 2007 Mar 28;297(12):1344-53

 

Study title and authors:

Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial.

Crouse JR 3rd, Raichlen JS, Riley WA, Evans GW, Palmer MK, O'Leary DH, Grobbee DE, Bots ML; METEOR Study Group.

Department of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA. jrcrouse@wfubmc.edu

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17384434

This study investigated the effects of statins in participants with a low risk of heart disease. The two year study was a randomised, double-blind, placebo-controlled trial of 984 individuals, average age 57 years. The participants received either a daily 40-mg dose of rosuvastatin or placebo.

The study found:
(a) Cholesterol levels reduced by 33% in the statin users and remained the same in those on placebo.
(b) Low density lipoprotein (LDL) cholesterol levels reduced by 49% in the statin users and remained the same in those on placebo.
(c) Statin users had a 21% increased risk of death compared to placebo.
(d) Statin users had a 423% increased risk of a serious adverse cardiovascular event compared to placebo.
(e) Statin users had a 4% increased risk of any adverse event compared to placebo.
(f) Statin users had a 5% increased risk of developing cancer compared to placebo.
(g) Statin users had a 5% increased risk of muscle pain compared to placebo.
(h) Statin users had a 121% increased risk of elevated liver enzymes compared to placebo.
(i) Statin users had a 56% increased risk of developing arthritis compared to placebo.



Food Reward Friday

This week's lucky "winner"...  the Taco Bell waffle taco!!

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Healthy World Cafe will be open for lunch Wednesday, March 26!

We've had a great month of announcements, donations and support from the York area community -- thank you! If you missed us in the York Dispatch or the York Daily Record/Sunday News, check out the stories on our big news: We signed a lease at 24 S. George St. in downtown York!

Curious to what you'll find when we open several days a week the summer? Join us this month for lunch, from 11:30 a.m. to 1:30 p.m. Wednesday, March 26, at First Moravian Church, 41 N. Duke St., York, where we'll be serving up delicious, locally sourced eats.

We're working on signature dishes for the cafe, including
a hummus! (Photo courtesy of Flickr user Robert Judge)

Menu:
-- White Chicken Chili
-- Carrot Ginger Soup
-- Greek Picnic Torte
-- Roasted Butternut Squash Hummus with Chapati
-- Garlic Tapenade with Chapati
-- Moroccan Carrot Salad
-- Mediterranean Couscous Salad
-- Premixed Winter Green Salad

-- Cardamom Lime Rice Pudding
-- Signature Dried Fruit and Oatmeal Cookies with Cider Glaze
Of course, our menu is always based on what's available from our farmer friends, so check back for updates.

At Healthy World Cafe, we always feature our "eat what you want, pay how you can" philosophy. The ability to pay should never be a barrier to accessing delicious, unprocessed, healthy food.

Housekeeping items worth noting:
-- PARKING: When coming to the cafe for our Wednesday lunches, please DO NOT park in the private lots surrounding 1st Moravian Church.  You may park on the street (metered), or you may park at First Presbyterian Church at E. Market and N. Queen Sts. in the un-numbered, yellow-lined parking spots, and please include a sign on your dashboard to indicate you are a Healthy World Cafe volunteer. Then, walk one block west down Clarke Ave. to First Moravian (and enter on north side)!

-- TAKE OUT: Take out orders for lunch are available by e-mailing your selections (by 10 a.m. March 26) to healthyworldcafe(at)gmail(dot)com.

-- VOLUNTEERING: In order to better respect our volunteers' time, we split the Wednesday lunch into two volunteer shifts: 9 a.m. to 1 p.m., and noon to 3 p.m. Feel free, of course, to sign up for both shifts, if you wish.

Sign up to volunteer through our calendar on VolunteerSpot.

New Discoveries and a Shift in Focus

For the past three years, I’ve been focusing pretty fiercely on my attempt to lose weight. I’ve tried to keep a good, body positive perspective but have never lost sight of that end goal. Since my experience with Intuitive Eating prior to discovering Paleo, I’ve been pretty fearful of letting go and losing control. I did not trust myself to make good decisions for my health so I settled on the prize of weight loss to keep me on the straight and narrow. I also harbored a secret fear that no one would ever take me seriously in the Paleo community if I was still fat.

I don’t know if there is something physically, psychologically, or otherwise holding me back from achieving my desired body composition, but any which way, I’m over it. I am over actively trying to change my body. Here’s a little recap of what I’ve been working on lately to take the very best care of myself without the express goal of weight loss:

Dressing Your Truth

I’m in love with this program. I look and feel better than ever and haven’t lost a pound (not that I’ve weighed myself!) I cannot recommend it highly enough for promoting great self-care and expression true to yourself. Life changing.

T-Tapp

I’d heard of this before but never thought it would be for me. It was mentioned in one of the DYT videos and I decided to give it a whirl. I feel more toned, energetic, and have gotten lots of compliments from Cute Man since doing this 2-5 times per week. The basic workout takes less than 20 min. Score.

Perfect Health Diet

Yes, that again. I’m just eating real, normal food while avoiding nasty oils, processed food, added sugar, and wheat products. The biggest difference is that I’m not doing it to try to diet or lose weight. My only goal is to promote overall health and avoid the acid reflux, psoriasis, headaches and other health problems I dealt with pre-Paleo. I’ve also started incorporating resistant starch, which blunts blood sugar spikes and promotes gut health. It just means that I cook my potatoes and rice a day in advance to allow them to cool down after cooking in order to allow the RS to be formed. My appetite is WAY down and my sugar cravings have diminished a lot. I feel almost incapable of overeating. When I’ve had enough, I have to stop right in my tracks with a feeling of not being able to take even one more bite. I can’t eat even half what I used to for dinner. Very interesting. I am not eating any rice noodles or other gluten free processed foods – those seemed to set me off and gave me acid reflux. I started with the RS after listening to this Latest inPaleo Podcast. More info on Free the Animal (warning – he is very unpolitically correct, so if you’re easily offended, please avoid).

The Ultimate Detox: Your Kidneys

The specter of unseen, unspecified toxins eroding our health is worth many millions of dollars in the United States and abroad.  Companies offer "detox" supplements, beverages, and creams that supposedly rid us of supposed toxins, despite a complete lack of evidence that these products do anything at all*.  This comes from an industry that excels at creating boogeymen and offering costly solutions for them.

If your wallet needs to lose weight, then these products are highly effective, otherwise it's probably best to save your money.  Here's why.

The body is equipped with an extremely advanced system for excreting toxins.  The kidneys are part of this system, and their design is genius.  The basic functional unit of the kidney is the nephron, and the average kidney contains about a million of them.  Nephrons have two major parts: a renal corpuscle and a renal tubule. 

A nephron.  In this image, the Bowman's capsule and glomerulus make up the renal corpuscle, and the proximal/distal tubules and the loop of Henle (#1-3) make up the renal tubule.  Note the network of blood vessels (capillaries) that allow the transfer of water and other goodies from the tubule back into the blood.  Image source.

The renal corpuscle is the interface between the blood and the fluid that will eventually become urine.  Blood is filtered by a fine "sieve" of cells that prevents everything larger than a small protein from passing into the renal tubule.  Red blood cells, platelets, and most proteins stay on the blood side, while small proteins such as albumin, minerals, urea, glucose, water, and almost anything that would be considered a toxin** are allowed through into the renal tubule.

The renal tubule is a long tube that re-absorbs everything in this filtered blood that the body wants to keep.  Water, minerals, albumin, glucose, amino acids, and other useful molecules are re-absorbed.  Everything else ends up as urine and is excreted. 

Can you see the genius of this design?  Urine is blood, minus all the good stuff.  Everything that isn't specifically recognized by the body as useful is excreted by default, no matter what it is.  The body doesn't have to recognize each of the thousands of foreign compounds that make their way into our circulation each day.  These substances are all out the door, by default.

Are you impressed by your kidneys yet?  If not, consider this.  Your kidneys filter your entire blood volume roughly 70 times per day.  The reason you don't have to pee a liter a minute is that urine volume is reduced by 99 percent due to water reabsorption in the renal tubules.

This is why most drugs have to be taken on a regular basis, often several times per day.  In concert with the detoxification enzymes of the liver, which tend to make drugs easier for the kidneys to excrete, the kidneys rapidly reduce the circulating concentration of drugs simply by excreting everything they don't recognize as useful.

Can a detox product improve upon 500 million years of kidney evolution***?  I have my doubts.


* Exception: chelation therapy offered by a licensed medical practitioner for actual, diagnosed heavy metal poisoning.  Second exception: strategies that use the word "detox" loosely to refer to removing unhealthy foods from the diet.

** Toxins tend to be very small-- either small organic molecules or minerals such as arsenic.  Larger toxins such as proteins are uncommon in the circulation because proteins are generally not absorbed by the digestive tract.  Toxic proteins have to be injected or otherwise directly introduced into the circulation, e.g. by a snake bite or a bacterial infection.  But if you're bitten by a rattlesnake, I hope your first line of treatment won't be a detox kit from your local supplement store.

*** Kidneys are present in hagfish and lampreys, the most "primitive" living vertebrates.