Each human body has a unique array of microorganisms, collectively called the “microbiota”. There may be 1000 different species and over 100-fold more genes that are in the human genome.  Studies have demonstrated a symbiotic relationship between the human host and the bacterial microbiota of the gut.  The education and maturation of the intestinal immune system is the result of millions of years of co-evolution with host and their microbiota and dietary intake.

The microbiota serves as a metabolic “organ’ that actively participates in host metabolism.  These bacteria are involved in regulating inflammation, energy, and immunity, playing a role in the development of metabolic and immunological diseases. In addition, the microbiota can improve nutritional status by aiding in digestion, extracting nutrients, and synthesizing vitamins and certain amino acids.

Nutrition plays a prominent role in promoting a healthy gut microbiome. Plant-based eating patterns – one that is high in unrefined carbohydrates and low in fat while providing adequate amounts of protein – support a microbiota that is robust in health-promoting species while preventing overgrowth of pathogenic bacteria.

 

Cardiovascular disease encompasses a broad spectrum including stroke, coronary artery disease, heart failure, and cardiac arrest.  The majority of cardiovascular-related disease is not restricted to the heart, but rather is of the vascular system. This ultimately leads to the development of clinical cardiovascular disease.

Several dietary patterns, foods, bioactive food components, nutraceuticals, and dietary supplements are purported to have protective cardiovascular effects. The dash pattern and Mediterranean pattern are examples. They also improve body weight and composition, blood pressure, blood sugar and insulin resistance, blood lipids and chronic inflammation.

The take-home message is to be proactive and implement lifestyle strategies, diet, nutrition strategies and physical activity, to reduce cardiovascular risk.

 

Excess body weight may be as dangerous as smoking when it comes to cancer.   Recently published reviews report that excess body fatness raises the risk of at least 14 kinds of cancer:

  • Brain/Meningioma
  • Breast
  • Blood/Multiple Myeloma
  • Colon and Rectum
  • Esophagus
  • Gallbladder
  • Kidney/Renal Cell
  • Liver
  • Ovaries
  • Pancreas
  • Prostate
  • Stomach/Gastric Cardia
  • Thyroid
  • Uterus

Maintaining a healthy weight at every age, or reducing weight when necessary, is clearly an important cancer prevention goal. Body fat doesn’t just sit there. Excess fat can influence levels and metabolism of hormones like insulin and estradiol, and it has effects on inflammation and immune function.  Overall, fat tissue activity creates an environment that encourages cell growth and discourages cell death – a perfect environment for cancer. Of course, you can do all the right things and still get cancer, but there is a great deal of evidence showing that eating well, being active and reducing weight can decrease risk.

Nancy Mazarin, MS, RDN, CDN

 

You may have heard that omega-3 fatty acids are good for your health, but did you know that they can actually help you lower your risk of death? According to a study that was recently featured in the Journal of Clinical Lipidology, women between the ages of 65 and 80 who have the highest omega-3 blood levels are 20% less likely to die—from any cause—than those whose blood levels are in the lowest quartile.

 

While this is not the only time that scientists have studied the correlation—and confirmed the link—between longer life expectancies and higher omega-3 blood levels, it is the largest. The data analyzed was taken from a sample of over 6,500 women beginning in 1996 with outcomes being tracked until 2014.

 

Throughout the study, scientists estimated that an intake of 1g of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) per day could increase omega-3 status from the lowest quartile to the highest. 1g a day of omega-3 fatty acids, which is well below the level deemed to be safe by the FDA, could equal:

  • Two and a half to three salmon fillets in a week
  • 1-3 soft gel supplements daily
  • 1 teaspoon of liquid omega-3 supplements daily

There are many other foods rich with omega-3 fatty acids that you could introduce to your diet as well.

 

How does adding that 1g to your diet lower your risk of death? Omega-3 fatty acids help your body to:

  • Boost immunities
  • Maintain cardiovascular health
  • Stabilize blood sugar levels
  • Lower inflammation
  • Treat digestive disorders
  • Reduce cancer risks and reoccurrence

In addition to the above, DHA and EPA fatty acids can also improve mental health by preventing depression and helping with focus and learning.

 

As a Registered Dietician, Certified Nutritional Specialist, and Certified Dietitian Nutritionist in the state of New York, Nancy Mazarin loves helping people get healthy on their terms. Offering medical nutrition therapy and weight management, she provides specialized programs that focus on your individual needs and health goals. These programs focus on a number of things, including education, behavior modification, and meal planning.

Are you ready to make some adjustments to your diet that could help you to improve your overall health? Contact Nancy today via email (nmeatrite@mazarinrd.com) to learn more about what individualized plan can help you to get the long-term health results you’re looking for.

 

Heart disease is a woman’s disease:  1 in 4 will die in the U.S. from heart disease this year that is half a million deaths each year – yet the perception that heart disease is primarily a man’s disease persist. The reality is that coronary heart disease (CHD) is the #1 killer of both men and women in this country.  Coronary heart disease occurs when plaque builds upon the inner walls of coronary arteries, preventing the flow of oxygen-rich blood to the heart.  This buildup of plaque is called atherosclerosis and it can trigger a heart attack.

While the basic process of coronary heart disease is the same for men and women, the disease, its symptoms and outcomes differ between the sexes:

Women with diabetes have twice the risk of CHD compared with men.

Heart attacks among women with diabetes are more deadly.

Women tend to develop CHD 10 years later than men.

When women have symptoms, they tend to differ from those of men:  they are more likely to have pain in the neck, jaw, throat, abdomen or back rather than in the chest.

Women may experience lightheadedness, an upset stomach and sweating when having a heart attack.

While it is important to pay attentions to the signs of a heart attack it is equally important to take preventive measures.  Research has found that diet, a healthy weight and exercise reduce risk.  Put your emphasis on health promotion and disease prevention.

 

We have the answers to these questions, kept in the shadows impressively well by the peddlers of pepperoni and bacon.

  • The range of saturated fat intake examined is pretty narrow. In the first meta-analysis, the top and bottom of the range often differed by only a few percentage points, and even the bottom of the range was above current recommendations. The later meta-analysis compared the top third of the population to the bottom third and, again, the difference was small.
  • To the extent saturated fat intake has gone down over time in the U.S. – and it hasn’t gone down much – it has mostly been replaced by sugar and refined carbohydrates.

A generally neglected consideration is that overall diet quality was comparably bad at the “extremes” of the rather narrow saturated fat range observed. That’s about what we would expect if the main alternatives to saturated fat from burgers, pizza and ice cream were refined carbohydrate and sugar from soda cookies, fries and donuts.

The available evidence suggests that is exactly what happens. Data from both the U.S. Department of Agriculture and the Centers for Disease Control and Prevention shows that animal fat intake in the U.S. has stayed fairly constant over recent decades, while sugar intake, refined carbohydrate intake and total calories have gone up.

The crucial question that neither meta-analysis answered is this: How does variation in saturated fat intake affect rates of heart disease when the alternatives to saturated fat calories are assessed? A 2015 paper provides the answer. In roughly 125,000 people over nearly 30 years, heart disease rates went from bad to even worse if trans-fat replaced saturated fat, stayed the same when sugar and refined carbohydrates replaced saturated fat and declined significantly when saturated fat calories were replaced with either calories from whole grains or calories from unsaturated fats coming from nuts, seeds, olive oil, avocado, fish and seafood. A more recent study of comparable size and methods appended this: Rates of heart disease go up when more of total dietary fat is saturated, and go down as more of total dietary fat is unsaturated.

Shockingly at odds with those making a case for saturated fat, what all of these data seem to indicate is just what both science and sense suggested all along: A diet made poor by an excess of saturated fat from the usual sources –  beef, processed meats, fast food and processed dairy – is almost exactly as bad for health outcomes as a diet made poor by an excess of sugar and refined carbohydrate from the usual sources. There is more than one way to eat badly – and we seem dedicated to exploring them all.

It is certainly true that saturated fat is not, and never was, the one and only thing wrong with our diets. It’s also true that not all saturated fats are created equal. But those are not the propositions that are being peddled. The misguided premise is that we must choose the one, true dietary scapegoat from either saturated fat or sugar.

The fundamentals of a genuinely healthful diet are clear, supported by vast and diverse evidence and a matter of global consensus. They translate into dietary patterns of wholesome foods in any of various sensible combinations that are inevitably low in added sugar, refined carbohydrate and saturated fat alike. Applied routinely, they could add years to lives, and life to years – and benefit the planet too.

 

For decades the American public has been warned that eating saturated fat, the type found in meat and processed foods, can lead to heart disease.  Now there is a booming cottage industry peddling the argument that saturated fat is good for us. Unfortunately, for those who wish to believe this, the argument is invalid.

The relevant literature has already been summarized for us in some rather famous, if not infamous, systematic reviews. The very purpose of systematic reviews, and their quantitative counterpart, meta-analysis, is to help establish conclusions based not just on any one study, but the overall weight of evidence. Systematic reviews and meta-analyses about saturated fat and health outcomes are readily available.

There are only two reviews that suggest we consume more saturated fat. The first dates from 2010; the second from 2014. They differ in many details, but they effectively address the same basic issue. What did they find? Rates of heart disease were high, and almost exactly the same, at the high and low ends of the saturated fat intake range. The currently popular argument is that rates of heart disease did not go down when saturated fat intake went down; and therefore, saturated fat must be good for us.

These studies represent poor science. We could use exactly the same data, and just the same “logic,” to argue that rates of heart disease did not go down when saturated fat intake went up; and therefore, saturated fat must be bad for us (still).

The simple fact is that neither of these assertions is valid. If heart disease rates don’t change across the range of saturated fat being examined, all it does is raise additional questions. How much variation is there in saturated fat intake in the first place? If there isn’t much, it’s no surprise that outcomes affected by saturated fat don’t vary much either.  When saturated fat intake goes down, what is replacing it – and what is happening to the overall diet quality?

 

“Calcium supplements could increase risk of heart disease, new study finds” said a Washington Post headline in October. “Calcium supplements could give you a heart attack,” wrote the New York Daily News.

Researchers at Johns Hopkins and other universities analyzed data from the Multi-Ethnic Study of Atherosclerosis Study, which was conducted from 2000 to 2012. The 5,458 study participants came from Baltimore, Chicago, New York City, Los Angeles, Minnesota and North Carolina. At the start of the study, the calcium content of their diets and of their dietary supplements and the amount of calcification in their coronary arteries was recorded. Ten years later, the coronary calcification of the 2,742 remaining participants was again measured.

The results: for those who had some calcification to start with, how much calcium they consumed, whether from food or supplements, didn’t matter. For them, calcium supplements clearly did not increase their risk of heart disease.

Among the participants who had no calcification at the beginning of the study, those who consumed the most calcium from food and supplements – an average of about 2,150 mg – significantly lowered their risk of developing calcification by 27 percent. That means the risk of heart disease was lower, not higher.

Among the participants who began the study with no calcification, those who consumed the least amount of calcium from supplements – an average of 90 mg a day – had the highest risk of developing calcifications. And those who consumed more calcium from supplements than that – an average of 165 mg to 1,125 mg – had no greater risk of developing calcification. Somehow this got translated by the media into “calcium supplements could give you a heart attack”. Bizarre to say the least!

Two weeks after this study appeared, reason prevailed. The American Society for Preventive Cardiology and the National Osteoporosis Foundation assured the public that calcium supplements have no impact on heart attacks, stroke, or other cardiovascular disease. These two organizations based this advice on a new review of 31 studies – four clinical trials and 27 observational studies – by an expert panel which found no increased risk of cardiovascular disease in people who consumed up 2,500 mg of calcium in supplements a day.

As a medical nutrition consultant, I continue to tell my patients is if they don’t get 1,000 to 1200mg of calcium a day from food they should take a supplement, so between their diet and supplements calcium intake is adequate.

Learn more about me, Nancy Mazarin, medical nutritional therapy and weight management at www.mazarinrd.com.

NANCY MAZARIN, MS, RDN, CDN
891 Northern Boulevard
Great Neck, New York 11021
516-466-9087

BIGGEST LOSER – a misleading report
The grim message from the recent New York Times article is that dieting is futile and re-gain is all but pre-ordained. The authors of the original research didn’t interpret their results that we are doomed to battle our biology or remain fat, which is certainly what the New York Times article implies. The researchers stated that in this subgroup we need to explore other approaches

The artificial environment of “The Biggest Loser” – being followed with cameras 24/7, exercising 9 hours daily and watched by millions for seven months – resulted in extreme weight loss: 8 pounds/week for 34 weeks. By comparison, weight loss after bariatric surgery averages 3 pounds/week which is still considered a rapid rate of loss. The goal rate for a healthy and sustainable loss is an average of ¾ pound /week.
When comparisons were made between contestants and gastric by-pass (RYBP) patient’s, they found considerably more muscle mass was sustained by the contestants, yet their RMR was slower. An anomaly occurred that is not customarily seen in the normal dieting population. The findings, in fact, are consistent with current data that show the response to starvation. This is in contrast to data about the RYGB that shows no slowing of the metabolic rate. Also with the RYBP hunger goes away whereas the lower leptin levels in the Biggest Loser Contestants (BLC) probably leads to more hunger or at least less satiation. What must be considered is that extreme, massive weight loss in so short a time may have created an aberrant metabolism. Changes that occurred in these individuals (e.g. hormonal, metabolic), cannot be extrapolated to individuals losing weight at a slower rate.

The article implied that the decrease in the metabolic rate is the primary cause of contestants weight gain. The drop in metabolic rate (using the numbers they gave us) is not enough to account for the regain, nor is it the only issue, nor does it seem to happen in everyone to the same extent or even at all. In reference to the contestants’ calorie intake, food consumption was not measured. Hunger, cravings, and disordered eating can quickly return. These effects were unquantified.
The study in Obesity that prompted the article in the Times measured contestants RMR 6 years after the end of the competition. They concluded that calorie restriction along with vigorous exercise in the BLC participants resulted in the preservation of fat-free mass (FFM) and greater metabolic adaption compared to RYGB subjects despite comparable weight loss. Metabolic adaptation was related to the degree of energy imbalance and the changes in circulating leptin
Dr. Hall used a mathematical computer model of human metabolism – currently intended for research conducted by scientists and health professionals – to calculate the diet and exercise changes underlying the observed body weight loss. The computer model simulated the results of diet alone and exercise alone to estimate their relative contributions. These simulations suggest that the participants could sustain their weight loss and avoid weight regain by adopting more moderate lifestyle changes – like 20 minutes of daily vigorous exercise and a 20% calorie restriction – than those demonstrated on the television program.
“Dieters are not at the mercy of their bodies, and this is not a subset of the most successful dieters”, stated Dr. David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston’s Children’s Hospital. They are abnormal dieters who abused their bodies and minds with restrictive programs that are consistent with deprivation. Food problems remained unresolved and accurate education elusive.
In all my years of practice, I have never worked with an individual who could not lose weight and sustain their optimal weight if they were willing to invest the time and effort needed. The National Weight Control Registry reaffirms that obese individuals can lose weight and sustain the weight loss for many years (average loss of 73 lbs. maintained for more than 5 years). Furthermore, individuals who have undergone bariatric surgery often maintain an optimal weight. Is the regain that is often seen a result of a metabolic abnormality that follows a diet or a significant increase in calories that is a backlash to restriction or a return to customary intake and behaviors? If people continued to eat healthy and exercise, they wouldn’t regain 100 to 200 lbs.
There is no situation where an optimal weight is maintained without effort. With weight loss, reduced caloric need, often coupled with a reduced metabolic rate (previously elevated) is to be expected. The body is smaller so requirements are reduced for feeding and moving. We need to understand that as all of us age, in this obesogenic environment, selectivity with respect to what to eat, when to eat and how much to eat is needed. We all live in a very toxic food environment, and maintaining weight loss is not easy.
As stated by Dr. Griffin Rodgers, the NIDDK Director, “This study reinforces the need for a healthy diet and exercise in our daily lives”. The take home message should have been that you cannot abuse your body with extreme dieting without severe repercussions. It’s time to Stop Dieting. Overweight individuals need to learn how to eat in a healthy, enjoyable and sustainable manner with the goal of attaining and maintaining an optimal weight.

The U.S. Department of Health and Human Services just released the dietary guidelines for 2015–2016.  The nation’s “best and brightest nutrition experts”, who pored over the scientific evidence, made the following recommendations:

Healthy eating selections include:

  • A variety of vegetables
  • Whole fruits
  • Grains, at least, half of which are unrefined
  • Fat-free or low-fat dairy
  • A variety of proteins, including seafood, poultry,
    lean meat, eggs, legumes, nuts, seeds and soy products
  • Oils

Healthy eating patterns limit:

  • Saturated fat
  • Trans fats
  • Added Sugars
  • Sodium

Samples of Health eating plans

The Healthy U.S. –Style Eating Pattern, based on lean proteins, whole grains, fruits, and vegetables

The Healthy Mediterranean-Style Eating Pattern focused on seafood, legumes, whole grains, fruits, and vegetables

The Healthy Vegetarian-Style Eating Pattern, which highlights low-fat dairy products, eggs, legumes, whole grains, fruits and vegetables

For more information visit http://health.gov/dietaryguidlines/