Retro Post!

This is a copy of a news story I wrote in March of 2007 when I was still an employee of Wake Forest University Baptist Medical Center. I tried NOT to edit it too much :) You can see that some of the issues have remained in the press and that maybe, my writing skills have improved since this was written!


News Notes

Special Edition

The information in today’s newsletter is derived directly from a conference I attended earlier this week. This was part of the research series brought to us by the Women’s Health Center of Excellence. I did attend sessions on weight loss surgery, diabetes, fad diets and most importantly life style factors and disease. In fact, the reason I took the day off from work was to hear the man, the physician and doctor of public health whom I esteem above all others, speak on the prevention of the chronic diseases that are affected by life style and diet. He is Walter Willett, Harvard professor and researcher. This is my best representation of what I heard during his lecture. He also has a new book for the public titled Eat, Drink and Weigh Less. I highly recommend any and all of his publications.

There were pearls here and there in his lecture. But I will begin with the bottom line. Based on careful analysis of two large, rigorous and scientifically valid prospective cohort studies,[ one the Nurses Health Study, the other the Physician’s Health Study] ….it is believed that the following life style choices are protective against heart disease and diabetes… Moreover, as much as 80 to 90 % of the cases of these diseases could have been prevented…. [ NOTE: Dr. Willett did not provide a presentation out line and I am fallible. There could be error here, by misunderstanding or even a typo… check the facts ok!]

Okay, the LIST of things to DO!!!!!

To prevent heart disease
1) be a nonsmoker
2) keep the BMI (body mass index) below 25 and lower is better (to 20) but he is choosing a number that more persons might be able to attain. [realism…]
3) exercise more than ½ hour a day every day. He suggested brisk walking though he said running is better. Again he said he is being realistic for the majority.
4) choose what you eat! Low to no trans fats, high ratio of polyunsaturated/saturated fats, low glycemic load foods, high CEREAL fibers, high fish intake (3x/week), consume the recommended daily allowance of folate
5) alcohol (any kind not just wine, it’s the ethanol stupid – little joke there, but yes, it is the ethanol that appears protective as long as the folate intake is not lacking. Very important that you hear that part, FOLATE + ½ glass per day of alcohol o prevent heart disease

For diabetes Dr. Willett said it was the same but not the fish and folate recommendations.

He said that prevention for colon cancer also adds that one should not have more than two servings of red meat a week (serving is 3 oz which is NEVER the size a restaurant provides!). Alcohol and Folate rule does apply and I think the alcohol recommendation was slightly higher. Screening for this cancer is strongly recommended in the literature.

Dr. Willett does not recommend dairy products or calcium overmuch. He noted some bad outcomes with too much calcium, regardless of fat content in the dairy products. He notes that we are the only country that consumes so much dairy. Some use none. He noted research that does NOT show that calcium protects against fracture. A new to me "factoid". Height is a risk factor for fractures… long bones.. Also the hormones in milk accelerate growth in our kids leading not only to early puberty, but breast cancer and fracture risks because of the growth…

He promotes Vitamin D… I hinted at that a few weeks ago and now I am going to make changes because of it……. All he recommended in regards to supplements is Vit D 1000 IU a day and the RDA for Folate…. He suggested a multivitamin with 1000 D, but I haven’t seen one (yet) [actually I went shopping between the above and the below, I did not see any multivitamins with more than 400 IU of D but the D tablets came themselves in 400 and a 1000. Be careful you don’t over do it if you are taking multiples, i.e. your calcium might have D and your Multivitamin, so don’t add 1000 of D if they both already have some]

Dr. Willett reviewed research that helped us track down why some countries had more rates of certain disease than others. He spoke about the mistakes made with fat free diets and the error of the original food guide pyramid. He addressed the butter v margarine and Trans Fat issue.

He believes that the biggest issue and the one that has had the most impact on this increase in obesity, heart disease, diabetes and some cancers is the failure to differentiate between the types of fats and the types of carbohydrates in our diets. He supports the positive aspect of fats in olive, canola, and soy bean oils. He encourages consumption of food with poly unsaturated fatty acids or PUFA and of foods with Omega 3 and 6. These fats are correlated in the rigorous research with decrease in heart disease where as trans fats those in processed, and until recently, fried foods as well as saturated fats in red meats, etc are related to increase in heart disease.

Though both are health promoting Omega 3 is better than 6 in this regard: A real pearl for me: Omega 3 fatty acids, often found in fish are the only ones that in research have been shown to control or prevent heart arrhythmia, ( irregular heart beat ) and though they do not stop heart attacks from occurring, they decrease DEATH from the heart attack.. My father’s death certificate states arrhythmia and acute MI… so hmmmm. Food for thought isn’t it.

Oh yes, on that same note. He said that dietary changes such as he proposes are good at ANY age and with any heart disease history. He states that the Mediterranean type diet, low in sat fat, higher in fish and veggies and monounsaturated oils will increase life expectancy. His best quote I thought, “the hydrogenation of oils that leads to the TFAs is done to increase the shelf life of products, but it decreases OUR shelf lives!”

Do you all remember a couple years back I brought up a type of inflammation in the blood that might indicate heart attack risk. The CRP or c reactive protein? WELL he mentioned it and said that trans fat could double it! Oh dear, I notice I am on page three. Better wrap this up. Gosh it’s hard to not repeat everything he said. I suppose the most important thing would be the pyramid that I mentioned earlier. It was a lovely slide.

Shoot. I didn’t get to the carbohydrate issue. Basically it’s the same as I’ve already written. He said that white potatoes should not be in the vegetable category.. He said that white flours, rice, pasta, bread etc are high glycemic foods and he did give credence to the issue that these foods should be avoided or limited. This is especially so if one has an increased BMI. In other words, lean all day active people, like the Chinese of a generation ago, they can eat white rice and not get diabetes!

In July of 2009 I did include Dr. Willett's food pyramid in a post. You can see it here.