Category Archives: Longevity

What’s the Healthiest Diet?

Steve Parker MD

Not Amby Burfoot

Running guru Amby Burfoot has an article asking, “what is the healthiest diet?”  for the general public. His answer comes from the Journal of Nutrition. Looks like there are four winners. A quote from Mr. Burfoot:

They [the four leading contenders for best diet] differ slightly in the degree to which they favor, or disfavor, certain foods and food types, such as the following:

  • The Healthy Eating Index 2010: Considers low-fat dairy products a plus.
  • The Alternative Healthy Eating Index 2010: Considers nuts/legumes a plus, as well as moderate alcohol consumption. Trans fats, sugary beverages, salt, and red meat get a minus.
  • The Alternate Mediterranean Diet: Considers fish, nuts/legumes, and moderate alcohol a plus; red meat, a minus.
  • The DASH Diet: Considers low-fat dairy and nuts/legumes a plus; sugary beverages, salt, and red meat get a minus.

The four tend to favor whole grains and disparage red meat. I doubt the Journal of Nutrition article even considered the paleo diet because we lack similar extent of clinical data to compete with the others.

Comments are open temporarily.

Steve Parker, M.D.

 

Fish Oil Supplements Are a Waste for Many

Salmon is one the the cold-water fatty fish loaded with omega-3 fatty acids

Salmon is one the the cold-water fatty fish loaded with omega-3 fatty acids

Many of us are eating fish or taking fish oil supplements, hoping that they will prevent heart attacks and the associated premature death. As it turns out, they may do neither.

I’ve been sitting on this research report a few years, waiting until I had time to dig into it. That time never came. The full report is free online (thanks, British Medical Journal!). I scanned the full paper to learn that nearly all the studies in this meta-analysis used fish oil supplements, not the cold-water fatty fish the I recommend my patients eat twice a week.

Here’s the abstract:

Objective: To review systematically the evidence for an effect of long chain and shorter chain omega 3 fatty acids on total mortality, cardiovascular events, and cancer.

Data sources: Electronic databases searched to February 2002; authors contacted and bibliographies of randomised controlled trials (RCTs) checked to locate studies.

Review methods Review of RCTs of omega 3 intake for 3 6 months in adults (with or without risk factors for cardiovascular disease) with data on a relevant outcome. Cohort studies that estimated omega 3 intake and related this to clinical outcome during at least 6 months were also included. Application of inclusion criteria, data extraction, and quality assessments were performed independently in duplicate.

Results: Of 15 159 titles and abstracts assessed, 48 RCTs (36 913 participants) and 41 cohort studies were analysed. The trial results were inconsistent. The pooled estimate showed no strong evidence of reduced risk of total mortality (relative risk 0.87, 95% confidence interval 0.73 to 1.03) or combined cardiovascular events (0.95, 0.82 to 1.12) in participants taking additional omega 3 fats. The few studies at low risk of bias were more consistent, but they showed no effect of omega 3 on total mortality (0.98, 0.70 to 1.36) or cardiovascular events (1.09, 0.87 to 1.37). When data from the subgroup of studies of long chain omega 3 fats were analysed separately, total mortality (0.86, 0.70 to 1.04; 138 events) and cardiovascular events (0.93, 0.79 to 1.11) were not clearly reduced. Neither RCTs nor cohort studies suggested increased risk of cancer with a higher intake of omega 3 (trials: 1.07, 0.88 to 1.30; cohort studies: 1.02, 0.87 to 1.19), but clinically important harm could not be excluded.

Conclusion: Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer.

If you’re taking fish oil supplements on your doctor’s advice, don’t stop without consulting her. The study at hand doesn’t address whether eating cold-water fatty fish twice a week prevents heart attacks and premature death. 

Steve Parker, M.D.

Reference: Hooper, Lee et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ  2006;332:752-760 (1 April), doi:10.1136/bmj.38755.366331.2F (published 24 March 2006).

Fruits and Vegetables May Increase Lifespan, Decrease Cancer and Heart Disease

MedPageToday has some of the details.  A quote:

The largest benefits were seen in people who ate seven or more servings of fruits and vegetables a day compared with those who ate less than one serving, with the higher level of consumption associated with significantly lower all-cause mortality (hazard ratio 0.67; 95% CI 0.58-0.78), lead researcher Oyinlola Oyebode of University College London, and colleagues, reported online in the Journal of Epidemiology and Community Health.

diabetic diet, paleobetic diet, low-carb diet

Prepping for bacon brussels sprouts 

The population under study was English. In addition to lower risk of death, the heavy fruit and vegetable consumers had lower rates of cancer and cardiovascular disease. Click for the actual research report.

If seven servings a day seems like a lot, note that a typical serving is only half a cup. You’ll get those with the Paleobetic Diet.

Steve Parker, M.D.

Is Our Modern Food Supply Killing Us?

paleobetic diet

John Deere combine harvesting wheat

Well, it’s complicated.

Many in the blogosphere wring their hands and pace to-and-fro worrying about GMO food, food preservatives, HFCS, sugar, gluten, artificial chemical additives in our food, arsenic in our water, mercury in our fish, factory-farmed food animals, industrial seed oils, hormones in our milk, antibiotics in our meat, pasteurization of milk, etc.

Consider this: worldwide life expectancy at birth has increased from 52 in 1960 to 70 in 2010. So just how bad can the food supply be?

I wonder how many items in the list above will turn out like dietary cholesterol, saturated fat, and total fat. That is, not a big deal.

You can argue that life expectancy would be even longer if we had better food. I’m sure that’s true to a degree. You can argue that there have been myriad helpful cultural and technological changes, irrespective of the food supply. Very true.

I’m just trying to put things in a perspective. An 18-year improvement in life expectancy over a half century is a big deal. Regardless of how you feel about wheat, Norman Borlaug deserves some credit.

Steve Parker, M.D.

Life Expectancy for Type 1 Diabetics Much Improved

…but we’ve got a long way to go.

When I started my medical career three decades ago, it was rare to see a type 1 diabetic exceed 60 years of age. Thank God that has been changing for the better! A recent Scottish study found life expectancy in type 1 diabetics, compared to the general population, was 11 years shorter for men and 14 years shorter for women. In 1975, the gap was 27 years. One of the investigators was quoted by the article at MedPageToday:

“There is absolutely no doubt that glucose control is important for long-term outcomes in people with type 1 diabetes.”

From the Framingham Heart Study: Compared to those without diabetes, women and men with diabetes at age 50 died 7 or 8 years earlier, on average. This study population was a mix of type 2 and type 2 diabetes, with type 2 predominating, I’m sure.

Steve Parker, M.D.