Vitamin D Takes A Hit

Faithful readers of this blog (May 18 and August 29) have read my railings against Vitamin D for some time now. It never made sense to me that so many Americans were deemed to be Vitamin D deficient nor did it make much sense that as people got heavier that their blood test for Vitamin D would report lower levels although they wouldn't develop any deficiency symptoms. I even raised the question if it was possible that fat stored Vitamin D (fat soluble) is available to the body when needed.  While this question remains unanswered, the question of what defines a Vitamin D deficiency just got a new answer and I think it makes sense.

The Institute of Medicine (IOM) just revised the guidelines for what defines a Vitamin D deficiency.

First, a little about the IOM.  The Institute of Medicine (IOM) is an independent, nonprofit organization that

works outside of government to provide unbiased and authoritative advice to decision makers and the public. 

Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as the National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM.

Under the new IOM guidelines, you are considered to have adequate Vitamin D levels if your level is above 20 ng/mL. The previous level was 30 ng/mL. In one fell swoop, the IOM has essentially removed almost all Americans from the category of being Vitamin D deficient. 

You will no doubt hear push-back from those quarters that make money peddling Vitamin D and related advice, but you should essentially ignore them. The IOM is trustworthy.

So if you didn't have enough reasons yet to push aside your multivitamins and Vitamin D supplements, perhaps this one will do the trick for you.

For the umpteenth time, eat whole foods including a wide variety of vegetables, fruits, beans, nuts, seeds, whole grains and Wild Salmon and you will consume all the vitamins, minerals, antioxidants and all the other health promoting nutrients you need for a healthy mind and body. Get 15-30 minutes of sun each day (earlier or later in the day and avoid reddening) and Vitamin D is also well covered. (You also get it from Wild Salmon.)

The key to a healthy life is to eat healthy every day.

Vitamin D Takes A Couple Of More Hits

Two new studies challenge the sweeping hysteria about the need to supplement with Vitamin D.

In one retrospective study looking at Medicare records, researchers could find no link between Vitamin D deficiency and macular degeneration. Based on this study, if you are self-prescribing Vitamin D to treat your macular degeneration, I would strongly consider stopping.

The second study involved men with prostate cancer who are on hormone depleting therapy. This therapy can lead to osteoporosis so it was always thought wise for these men to supplement with Vitamin D and calcium. This study shows that not only doesn't adding these two supplements help, but they may actually be increasing the severity of the cancer. That's on top of the calcium's effects on adding to the risk of calcification of the arteries and heart attacks.

So based on this information you would say that it is probably best to avoid Vitamin D supplements. But wait, there's more. In April 2012, a study showed that high dose Vitamin D supplementation in patients with low risk prostate cancer seemed to help the patients do better with lower Gleason scores, one of the biomarkers for prostate cancer. But wait again.  In this study, involving 52 patients, led by D.T. Marshall of the Medical University of South Carolina and colleagues, 55% did better, 11% had no change, and 34% did worse.

My read on such a study is to basically ignore it because the number of participants was too low, a good percentage got worse and we know little else about their diets, etc.

So what's the answer on Vitamin D? I say sun. It's the only natural way to increase your Vitamin D levels. Of course, don't burn yourself, but 15-30 minutes a day strategically spread out should avoid any such problems in most people. However, that may not be YOU, so if you can't spend even that amount of time in the sun, your next best choice is wild salmon. If you can't or refuse to eat wild salmon, then fortified foods are your next best choice before supplements.

Yesterday, I reviewed 300 study headlines on supplements, particularly about their antioxidant effects, on pubmed.com, and read about 40 abstracts of some of the studies. This effort fortifies my belief that supplements just aren't cracked up to be what their manufacturers and marketers want YOU to believe.

But I also confirmed something else. The studies showed consistently that even with fruits and vegetables, once your body has the vitamins, minerals, and nutrients it needs, giving it more does nothing. It's like filling a canister. Once it's filled, any more added is just spillover. The principle here is that more of a good thing is not better when it comes to your nutritional state. That's the biggest problem I think posed by most supplement products. They operate mostly on the principle of get more to play it safe. More vitamins, more minerals, more antioxidants. YOU don't need more that YOU need and as recent studies suggest, more may not be safe for YOU.

The real take away from all three studies quoted above is that Vitamin D supplementation may not be the panacea that many proclaim it is on a daily basis. Tread cautiously, my friends, when it comes to taking supplements and heed the Latin phrase, Caveat Lector, "Let the reader beware." That includes reading my blog with a bit of caution as well. Nothing written here should be construed as medical advice. The only medical advice you should heed is from a doctor that knows your medical history personally and discusses treatment with YOU directly.

The Only Thing I Know For Sure Is That We Need To Keep Learning

About 30 years ago, I read an article about agriculture that had a profound impact on my thinking. The article was about soil erosion and basically stated that what had long been considered an incontrovertible truth about how to avoid soil erosion turned out to be the exact opposite. The idea that something held as an absolute truth could prove to be absolutely wrong has given me pause to think about such 'truths' to this day.

Thirty years later, a new study about exercise emerges that reminds me of what we consider absolute truths may not be so. For as long as I can remember, exercise has been associated with increasing your metabolism. It's been widely believed that exercise contributes to weight loss by burning calories and increasing your metabolism, which is believed to keep revving and burning calories even during the cool down phase.  While certain people argued that exercise was not an effective way to lose weight because they were unsuccessful losing weight despite much exercise, it was still a tenet of the weight loss movement. For example, Weight Watchers allows you to add extra "points" based on the amount of exercise you do.

The new study, which is a wonderful study, titled Hunter-Gatherer Energetics and Human Obesity, (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0040503) studied the Hadza tribe of hunter-gatherers in Tanzania. Strapping members of the tribe with a GPS device and having them swallow so-called doubly labeled water, a liquid in which the normal hydrogen and oxygen molecules have been replaced with versions containing tracers, researchers were able to quantify their levels of physical activity, energy expenditures and metabolic rates. What they discovered is groundbreaking!

The study showed that contrary to popular belief, exercise slows down one's metabolic rate so that calories burned are actually far less than expected.  What's amazing is that this is intuitive and yet for so long everyone believed otherwise. Think about it for a moment. If your body doesn't eat for several hours, we think (I'm now officially afraid to say anything for certain any more; well, maybe some things) your metabolic rate slows down as your body tries to conserve energy, as it doesn't know when energy will be replenished. Applying that same principle to exercise, when the body senses a loss of energy consumed by increased activity, it makes sense that it will slow down its burn rate to conserve energy.

This doesn't mean that you aren't burning calories and you can't lose weight by exercising. It simply means that you burn less than you think, which means don't think you can eat a lot more because you had a good exercise session.

By now you couch potatoes are turning to your spouses or friends and smugly telling them you were right all along about exercise. Well not so fast.  Exercise is still critical to good heart and brain health. Exercise keeps the heart functioning well and exercise has been shown to be as effective as anti-depressants in treating many cases of mild to moderate depression. But that's not all. Two new studies published online in the Archives of Internal Medicine support the tremendous impact of exercise on lowering the risk of death among diabetic patients, and that weight training may reduce the risk for the disease even without aerobic activity.

Quoting medpagetoday.com, "In a large prospective trial, moderately active patients with diabetes had a lower risk of total mortality compared with those who were completely inactive...according to Diewertje Sluik, MSc, of the German Institute of Human Nutrition in Potsdam, and colleagues. And in a separate prospective study, men who did weight training only at least 150 minutes per week had a 34% lower risk of developing diabetes to begin with ...according to Frank Hu, MD, PhD, of the Harvard School of Public Health in Boston, and colleagues."

I also previously wrote about a study that shows that exercise can return the inflexible blood vessels of pre-diabetics to normal as well.

So while exercise is not the great weight loss panacea it was once thought to be, it is still a critical component of a healthy lifestyle. Keep exercising, but more importantly, if you want to stay slim or lose weight avoid the four whites--white sugar, white flour, white pasta, and white rice. If you watched 60 Minutes this past Sunday, you now know that some scientists view sugar as toxic and cancer causing. Just another good reason to choose whole foods like fruits, vegetables, nuts, beans, and whole grains. And of course, don't forget my favorite, Wild Salmon.  Bon appetite!

A Hodgepodge of New Studies

Making Sense of Two Recent Testosterone Studies:

I am always trying to make sense of the studies I come across. In the past couple of days, I came across two studies involving testosterone, the male hormone. One study showed that overweight men who suffered from hypogonadism (a medical term which describes a diminished functional activity of the gonads, the testes in males) who received testosterone lost weight; the other study showed that men who suffered from hypogonadism who lost weight increased their testosterone to a level where they no longer had hypogonadism (incidence of hypogonadism went from 20% to 11%, about a 50% improvement).

After reading the two studies, I had to ponder for a while how they related to each other and then it came to me. Although I claim no absolute certainty in these conclusions, it seems that for certain overweight men, increasing testosterone, either endogenously (from within) or exogenously (from outside) helps them lose weight. Given the choice, it would seem better to naturally increase a hormone as opposed to getting it from some other derived source. The best way to do so if you are overweight is to change your diet to the a mostly plant-based diet, increase your exercise to moderately-intense 150 minutes per week, and get at least 7 hours of sleep a night.

Are Vitamin D Blood Tests Always Accurate?

Apparently not. A recent study showed that 40% of the time, blood-labs misdiagnose Vitamin D deficiency by reporting lower than actual levels. This may not be true for all labs or all types of equipment used. The equipment/tests that seemed to be the worst offenders were the Architect and Centaur-2 tests. The liquid chromatography/mass spectrometry (LC/MS) test is the gold standard and can generally be relied upon. So the next time you have a test, ask what equipment they are using and consider going to another lab with LC/MS equipment for greater peace of mind.


Is There A Link Between Vitamin B6 and Heart Disease?

A new study shows a link between low Vitamin B6 levels and increased risk for heart disease. The study does not show causality, which means it isn't clear if the low Vitamin6 causes the heart disease or the heart disease causes the low Vitamin B6. It is possible that the inflammation often seen in heart disease may decrease blood levels of the vitamin. Nevertheless, it is important to maintain adequate levels of all vitamins, including B6, so I include the reference table below for your edification.

This table is not meant to be a recommended diet; rather, it is meant to give you a representative sample of sources of Vitamin B6 in regularly available foods.  A healthy diet is one that contains fruits, vegetables, nuts, legumes (beans), whole grains, and fat from fatty fish like Wild Salmon and Wild Cod. It can also include some olive oil, limited red wine, and very occasional chicken or meat. This is often referred to as the Mediterranean Diet and it still seems to pack the most bang for the buck.
Food	Milligrams (mg) per serving	Percent DV*
Chickpeas, canned, 1 cup	1.1	55
Tuna, yellowfin, fresh, cooked, 3 ounces	0.9	45
Salmon, sockeye, cooked, 3 ounces	0.6	30
Chicken breast, roasted, 3 ounces	0.5	25
Breakfast cereals, fortified with 25% of the DV for vitamin B6	0.5	25
Potatoes, boiled, 1 cup	0.4	20
Turkey, meat only, roasted, 3 ounces	0.4	20
Banana, 1 medium	0.4	20
Marinara (spaghetti) sauce, ready to serve, 1 cup	0.4	20
Ground beef, patty, 85% lean, broiled, 3 ounces
Waffles, plain, ready to heat, toasted, 1 waffle	0.3	15
Bulgur, cooked, 1 cup	0.2	10
Cottage cheese, 1% low-fat, 1 cup	0.2	10
Squash, winter, baked, ½ cup	0.2	10
Rice, white, long-grain, enriched, cooked, 1 cup	0.1	5
Nuts, mixed, dry-roasted, 1 ounce	0.1	5
Raisins, seedless, ½ cup	0.1	5
Onions, chopped, ½ cup	0.1	5
Spinach, frozen, chopped, boiled, ½ cup	0.1	5
Tofu, raw, firm, prepared with calcium sulfate, ½ cup	0.1	5
Watermelon, raw, 1 cup	0.1	5

*DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers compare the nutrient contents of products within the context of a total diet. The DV for vitamin B6 is 2 mg for adults and children age 4 and older. However, the FDA does not require food labels to list vitamin B6 content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.

I'm Sorry To Be A Party Pooper, But...

Many people love chocolate for obvious reasons. When they hear it's good for them, that's just frosting on the cake (pun intended). Over the next day or so, you are going to see and hear a tsunami of headlines, yet again, about the heart benefits of eating dark chocolate. The headlines will blare how dark chocolate prevents cardiovascular events.

This breaking news will be the result of a modeling study that predicts that patients with metabolic syndrome who eat dark chocolate every day could have 85 fewer events per a population of 10,000 over 10 years. The study, conducted by Chris Reid, PhD, of Monash University in Melbourne, Australia and colleagues was supported by a grant from a pharmaceutical company.  (For more about metabolic syndrome, please read end of blog).

The researchers used a Markov model to assess health effects and associated costs of daily consumption of plain dark chocolate compared with no chocolate in a population with metabolic syndrome but without diabetes or cardiovascular disease.

That's my first problem with the study.

It wasn't a gold standard randomized double blind controlled study. It wasn't even a good observational study. It was a mathematical calculation, and at that it only showed a benefit of .85 (yes, point eighty five) fewer heart related events per 100 people, and of the heart events, they are predicting .15 fewer events leading to death. That means for every 1000 people who eat the chocolate, there would be 1.5 fewer deaths.

Okay, you say, I get to eat chocolate and maybe I'll be the one guy or gal out of a thousand that benefits from it. So here's my real problem with the study. As a modeling study, it also made assumptions about the type of chocolate that was consumed. The researchers wrote, ""Evidence to date suggests that the chocolate would need to be dark and of at least 60% to 70% cocoa, or formulated to be enriched with polyphenols." There is no reference to the sugar content of the chocolate.

True, dark chocolate in high concentrations (usually over 75% cacao) contains polyphenols, which are healthful antioxidants. However, the sweetness in the dark (or sometimes called bittersweet) chocolate always comes from added sugar of one sort or another. This sugar is usually not healthy and is also fattening.

I know from personal experience that when I added for the purported health benefit (and the taste) one small piece (1/8 of a bar) of dark chocolate a night with 75% cacao (the higher the cacao the more sugar needed to make it enjoyable), my weight started to slightly increase from that one solo change. I stopped the practice.

If you think that this was a study that should make you go out and buy some dark chocolate, here is what the researchers said about their own study.

Reid and colleagues noted that the study was "limited by its reliance on the Framingham algorithm, which may underestimate risk in a high-risk population, and by assumptions about the risk of death following a cardiovascular event." Furthermore, "the study was also limited by the assumption that the benefits of dark chocolate, which have only been observed in short-term trials, extend to 10 years."

By the way, there are many non-processed rich sources of polyphenols in fruits and vegetables such as blueberries, black berries, strawberries, red grapes, eggplant, etc., so you don't need to eat chocolate to get your daily dose.

In conclusion, dark chocolate is better than regular chocolate. The higher the percentage of cacao, the more healthy polyphenols it contains, but watch out for the increase in carbohydrates. Nibble on no more than 1/8 of a bar at any given time. Most importantly, if you want to eat it, do it for the taste, because the heart benefits are still inconclusive.

More on Metabolic syndrome

From PubMed

Insulin resistance syndrome; Syndrome X

Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke and type 2 diabetes .

Causes, incidence, and risk factors

Metabolic syndrome is becoming more and more common in the United States. Some estimate it as affecting 25% of the U.S. population. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity.

The two most important risk factors for metabolic syndrome are:

• Extra weight around the middle and upper parts of the body (central obesity). The body may be described as "apple-shaped."
• Insulin resistance, in which the body cannot use insulin effectively. Insulin is needed to help control the amount of sugar in the body. As a result, blood sugar and fat levels rise.

Other risk factors include:

• Aging
• Genes that make you more likely to develop this condition
• Hormone changes
• Lack of exercise

People who have metabolic syndrome often have two other problems that can either cause the condition or make it worse:

• Excess blood clotting
• Low levels of inflammation throughout the body

Symptoms

• Extra weight around your waist (central or abdominal obesity)

Signs and tests

According to the American Heart Association and the National Heart, Lung, and Blood Institute, metabolic syndrome is present if you have three or more of the following signs:

• Blood pressure equal to or higher than 130/85 mmHg
• Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
• Large waist circumference (length around the waist):
  
  • Men - 40 inches or more
  • Women - 35 inches or more
• Low HDL cholesterol:
  
  • Men - under 40 mg/dL
  • Women - under 50 mg/dL
• Triglycerides equal to or higher than 150 mg/dL

Tests that may be done to diagnose metabolic syndrome include:

• Blood pressure measurement
• Fasting glucose test
• HDL cholesterol level
• LDL cholesterol level
• Total cholesterol level
• Triglyceride level

Treatment

The goal of treatment is to reduce your risk of heart disease and diabetes. Your doctor will recommend lifestyle changes or medicines to help reduce your blood pressure, LDL cholesterol, and blood sugar.
Recommendations include:

• Lose weight. The goal is to lose between 7% and 10% of your current weight. You will probably need to eat 500 - 1,000 fewer calories per day.
• Get 30 minutes of moderate intensity exercise, such as walking, 5 - 7 days per week.
• Lower your cholesterol using weight loss, exercise, and cholesterol lowering medicines, if needed.
• Lower your blood pressure using weight loss, exercise, and medicine, if needed.

Some people may need to take daily low-dose aspirin.
People who smoke should quit.

Expectations (prognosis)

People with metabolic syndrome have an increased long-term risk for developing cardiovascular disease and type 2 diabetes.

Complications

• Atherosclerosis
• Diabetes
• Heart attack
• Kidney disease
• Nonalcoholic fatty liver disease
• Peripheral artery disease
• Stroke
  

Calcium Pills Raise Concerns -- Again!

If you've heard me say it once, you probably have heard me say it many times -- taking dietary supplements in the absence of known deficiency is a mistake. One of the more controversial supplements I've rallied against has been calcium. Most women are told by their doctors, particularly as they get older, to take calcium supplements, usually about 1,000 mg.

When I give lectures, I often ask of the audience whose doctor adjusted their calcium recommendation based on the calcium the individual consumes through his or her food. The answer is almost always that none of their doctors made any such adjustment. I've always considered this problematic because why supplement at all if you are getting sufficient calcium in your diet, and why not adjust when you are getting calcium from other sources.

My real concerns about calcium began to grow almost two years ago when studies began to emerge challenging the wisdom of taking this supplement.  Specifically, these studies linked calcium supplementation with increased heart attack risks. Some studies suggested the mechanism for this, calcium supplements, were contributing to calcification, or hardening, of the heart.

So a new study that just came out should be of no surprise to my patients.

The large European study showed that people taking calcium supplements had nearly double the risk of heart attack as individuals not taking any dietary supplements. Among 23,980 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg) study, the hazard ratio for heart attack in those using calcium supplements, compared with nonusers of supplements, was increased according to Sabine Rohrmann, MD, of the University of Zurich in Switzerland, and colleagues.

"This study suggests that increasing dietary calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise MI risk, should be taken with caution," the researchers concluded. In an accompanying editorial, two New Zealand physicians went further and suggested that use of calcium supplements should be actively discouraged.
 
This was an imperfect study as it was an observational study that relies on self-reporting. Nevertheless, once again, the red flag rises over taking calcium pills, or any dietary supplement for that matter. The evidence continues to mount that at best they confer no benefit, and at worst, they are harmful.

Eat a Mediterranean diet consisting of fruits, vegetables, beans, nuts, and some whole grains, add in some wild fish and save yourself some money from not buying unnecessary pills.

When More Choices Are Bad...

When comparing over-indulgent Americans to the more svelte (perhaps not for long) Europeans, it is often said that we "live to eat" while they "eat to live." This may explain why we have among the highest rates of obesity in the world, but it doesn't necessarily explain why our appetites have evolved so differently.

A new study out of Italy may shed some light on this phenomenon. Quoting from Medscape, "Scientists from three academic labs in Italy found that levels of ghrelin, [...a hormone that stimulates appetite] rose substantially in eight healthy volunteers -- who had already eaten a full meal -- when they were allowed to eat as much as they wanted of their favorite food. No such increase was seen when, under the same conditions, the same volunteers were told to eat foods they didn't like but that had the same calorie content." In layman's terms, our brains respond positively to foods we like to eat and therefore we are able to keep eating such food even when we are not hungry.

Another popular belief is that Europeans are more sophisticated eaters than Americans and relish their food more than we do. Indirectly, this Italian study would appear to support that contention. When it comes to food, most Americans are not very discriminating. Exposed to many foods from many different cultures, we seem to like the variety, and so we develop a wide range of tastes. The panoply of food choices available to us at any given time stimulates our appetite as we seek to determine what we will choose next. The Italian study therefore demonstrates why we may over-eat. The more foods we like, the more foods we eat. The more we eat, the heavier we get.

There is a concept called habituation that explains this phenomenon from another angle. Habituation means that we become accustomed to our foods. The less types of foods we eat, the less of that food we need to be satiated. In light of the Italian studies, this makes sense. The more foods we like, the more foods we eat. The fewer types of food we regularly consume, the less of it we hunger for.

On a personal level, this has worked for me. At 50, I was diagnosed with calcification around the heart, a sign of impending disaster. I was overweight, popped pills every day for reflux and irritable bowel syndrome, was on a statin for cholesterol near 300, and couldn't run 50 feet without limping the rest of the day.  I was your typical middle-aged American male. When I began to pursue MDPrevent in 2010, I was exposed to the science that changed my life. I learned that changing one's lifestyle, particularly how you eat, can change your life trajectory.

I now religiously eat the same breakfast and lunch every day. Breakfast is comprised of sliced bananas, blueberries, Bob's Red Mill Muesli, an organic cereal like Ezekiel Almond or Nature's Path Flax, and a glass of Blue Diamond Vanilla Unsweetened Almond Milk. I eat in a small bowl and I am NEVER hungry before lunch. For lunch, I eat hummus on Arnold's Whole Wheat Thins (has preservatives) or Ezekiel bread (no preservatives - found in freezer section), topped with spinach and sometimes olives, and over the next or so hour afterwards, I snack on sliced apples, a small bag of carrots, and a bag of mixed nuts. Again, I am NEVER hungry before dinner and I am not even famished by dinner time. For dinner, I try to eat wild fish like salmon or cod, with quinoa and mixed vegetables and for dessert, I enjoy sliced melon.

This food routine has allowed me to shed 20+ pounds, eliminate my reflux, my irritable bowel syndrome, stop my statin and still reduce my cholesterol to less than 150, move out of the pre-diabetic range, and also practically eliminate my hip osteoarthritis, which allows me to run for longer distances than I have in 20 years.

I am not saying that one has to eat exactly what I eat, but the facts remain that the less variety of foods I eat, the less I crave.

So if you want to stay healthy, get healthy, and keep the grim reaper waiting, consider narrowing down your food choices to a select group of healthier foods because the less foods you choose from, the less of those foods you will need to be satiated, and therefore, the less of those foods you will eat. Become a more discriminating eater and you will most likely also become a healthier one as well.

My Wife Is Smarter Than Me

I grew up on dietary supplements. As I've written before, my mother was a devout reader of Prevention Magazine in the 1960s and my supplementation experience began with cod liver oil some 50+ years ago and continued over many years with strong recommendations to take Vitamin C, beta-carotene, the B complex vitamins, etc. It was only within the past year or so that I realized my folly.

My wife, Yael, on the other hand, has always disdained supplement pills. We never really discussed her aversion to such pills and I just assumed she didn't like pills in general as she always tries to avoid medication whenever possible (another check-mark on her smart list).

Today, we got into a discussion about dietary supplements and she reminded me of her decision to abstain from them over all the years that I was popping them.  I finally asked her specifically for her reasoning. Her answer was so eloquent and pure that I had to write about it.

She explained that part of her childhood took place on a farm where she would pick eggs off the floor and fruits and vegetables from trees and fields.  It simply never made sense to her that somehow our health was dependent on taking little capsules that had been chemically synthesized and produced in some plant or laboratory as opposed to eating nature's own produce. She is so right and obviously much smarter than me because she realized the insanity years before I did.

Yet, it is reported that by some estimates, 80% of Americans now take some form of dietary supplementation. This is unfortunately the case despite a slew of recent studies beginning to form quite a unavoidable pile that have revealed that these pills instead of making us healthier may in fact be making us sicker.

A new patient of mine yesterday handed me Tuft University's Health and Nutrition Letter and asked my opinion if it was worth reading. She was on a dozen dietary supplements and admitted confusion on what she should take and had sought out such publications for affirmation of her choices. By the way, she was on many of the usual suspects with doubling and tripling of dosages across her various pills. Some dosages were 30 times the recommended daily allowance (RDA). I put her on a two week vacation from all her dietary supplements other than Aspirin to see if it would help with some of he medical issues.

Nevertheless, I promised to read Health and Nutrition Letter and report back to her on its value and reliability. After reading it, on first exposure, I give it a thumb's up. I thought it was well written, thoughtful, not attempting to be provocative; rather, I found the information to be factual and reported without apparent bias.

Articles included a report further debunking ginkgo biloba as effective in preventing heart attacks and strokes. It did report that ginkgo may have some mild benefit in preventing peripheral arterial disease (disease of blood vessels in arms and legs that prevents blood flow). Another article reported on yet another study that shows the benefits of a Mediterranean diet. There were articles on the FDA warning Cheerios about their bogus health claims and how Organic produce, contrary to widespread myth-making, has no nutritional benefit over conventionally raised produce. The study did not address the pesticide risks, just the nutritional value.

But my favorite article was titled "The Bad News About Products "Too Good to Be True."" It was a well presented argument against the false advertising perpetuated by a rapidly growing supplement industry. One key aspect of the article was discussion how Congress bowing to pressure from the ever-growing increasingly powerful dietary supplement industry, essentially sought to gut the 1990 Nutritional Labeling and Education Act (NLEA) by passing the Dietary Supplement Health and Education Act in 1994 (DSHEA) and the Food & Drug Admoinstration Modernization Act (FDAMA) in 1997.

While the NLEA "set a standard of "significant scientific agreement" for health related claims on product labels," both the DSHEA and FDAMA, according to a professor named Dr. James Tilloston at Tufts, marked a "return to snake oil. The FDA's hands are tied by unwise policy initiated by pressure groups to allow them to huckster. It's undermined all health claims."

I was recently interviewed by a reporter for The Globe Magazine on the deceptive practices of dietary supplement marketers. The reporter told me something that should give us all pause for thought. She told me that the reason there have been so few articles exposing the chicanery of the industry is because the dietary supplement industry represents a significant source of advertising dollars and no media outlet usually wants to bite the hand that feeds it. Nevertheless, I see this changing as the proverbial cat is out of the bag as the tsunami of recent studies showing harms from many such products simply can't be ignored.

 If this is any solace and it shouldn't be, I was invited to appear on the most popular morning TV show in Australia to discuss the problems with dietary supplements. I guess this growing public health problem is not confined to our borders and has become a world-wide phenomenon.

So warn your family, friends, neighbors, and even strangers: Don't take supplements without the advice of you doctor and even when doctors gives such advice, you should ask them what information they are relying upon as that information may now be outdated.

A word to the wise should be sufficient.

What Staple of Most People's Diet is Unnecessary?

During my lecture on why supplements are usually a waste of money, I list the six essential nutrients that the human body needs to exist.

They include:
1. Vitamins
2. Minerals
3. Essential fatty acids
4. Essential amino acids
5. Oxygen
6. Water

This list is remarkable for two missing items. One is anti-oxidants. They are not considered an essential nutrient. The more amazing exclusion is carbohydrates. Homo sapiens does not need to consume a single carbohydrate to thrive. Wait, you say, don't we need glucose to fuel our metabolism? The answer is yes but glucose is a by product of proteins, from which we also get our essential amino acids. Also, fruits and vegetables, which are a natural source of vitamins and minerals (and antioxidants) are also a source of carbohydarates.

Nevertheless, our diets need not include carbohydrates. From an evolutionary perspective, the superfluousness of carbohydrates may explain the current obesity epidemic.  Early man did not routinely come across simple carbohydrates (like glucose) other than the more complex carbohydrates found in natural foods.  When he did, his brain signaled him to consume as much of it as possible. Even though it was not essential, it did provide for fast and easily used energy.

Today, we are bombarded with easy access to almost unlimited simple carbohydrates, many in the form of unhealthy snacks and deserts. Our minds and bodies continue to crave them even to the point of excess and we are not easily satiated by them when we eat them in even relatively large amounts. That is why there is some science behind the low-carb diets.

However, I am not in the camp that believes that carbohydrates should be replaced by fats in excess of what our bodies need. Studies have shown protein, which can be obtained from vegetable sources and even grains like quinoa, are a viable alternative to carbohydrates and can even contribute to increases in lean body mass.

So the next time you consider consuming a processed carbohydrate perhaps you will remember that it is not essential to your diet and will probably do you no good. Perhaps, you will now consider eating a vegetable instead.