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1. Ultra-processed foods and diabetes
2. Vitamin K: the Unsung Hero of Heart Health
3. Why Most People Need a Multivitamin
4. High Cholesterol? A Way to Lower Cholesterol That Isn't a Drug
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Ultra-processed foods and diabetes
Srour and team carried out a population-based prospective cohort study in which they included 104,707 adult participants who had participated in the French NutriNet-Santé study. Of these participants, 21,800 were men, and 82,907 were women.
The NutriNet-Santé study spanned a decade, running from 2009 to 2019. The researchers collected data on the dietary intake of the participants using repeated 24 hour dietary records that asked them about their consumption of about 3,500 different foods.
Using the NOVA classification system, the researchers classified the 3,500 food items according to their degree of processing. There were four categories: unprocessed/minimally processed foods, culinary ingredients, processed foods, and ultra-processed foods.
The researchers used multivariable Cox proportional hazard models, which they adjusted for the known risk factors for type 2 diabetes, such as sociodemographic background, lifestyle, and medical history.
Ultra-processed foods may raise risk
Srour and colleagues found a consistent association between the absolute amount of ultra-processed food consumption, which they measured in grams per day, and the risk of type 2 diabetes.
“In this large observational prospective study, a higher proportion of [ultra-processed foods] in the diet was associated with a higher risk of [type 2 diabetes],” conclude the authors. Srour and colleagues add:
“Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting [ultra-processed food] consumption.”
The researchers say that ultra-processed foods are a modifiable risk factor for type 2 diabetes.
They also point to countries such as France and Brazil, whose public health authorities have already started encouraging the population to eat minimally processed foods and avoid ultra-processed ones as a precautionary measure.
What might explain the link?
The researchers did not single out one type of food or ingredient but instead looked at the cumulative effect of ultra-processed foods on type 2 diabetes risk.
The authors recommend caution in interpreting the associations that they found. Most of the additives in ultra-processed foods “are likely to be neutral for long-term health, and some may even be beneficial,” they write, giving antioxidants as an example.
However, there are other compounds that recent studies in mice and in vitro have suggested may be harmful.
For instance, “carrageenan, a thickening and stabilizing agent, […] might contribute to the development of diabetes by impairing glucose tolerance, increasing insulin resistance, and inhibiting insulin signaling,” write the authors.
Nonetheless, they caution that more research in humans is necessary before drawing conclusions about the harms of such compounds.
Chemicals such as phthalates and bisphenol A (BPA), which are often present in plastic packaging, may contaminate many ultra-processed foods.
BPA and phthalates may disrupt endocrine function, and the authors note that some recent meta-analyses have shown that high concentrations of these compounds are associated with a higher risk of type 2 diabetes.
Furthermore, research has associated metabolites that form as a result of high-temperature cooking — such as acrylamide and acrolein metabolites — with insulin resistance.
“Finally, industrial partial oil hydrogenation may lead to the creation of trans unsaturated fatty acids in products containing hydrogenated oils,” mention the authors. “Although still debated, trans fats were linked to increased risks of heart disease and [type 2 diabetes],” they note.
Nevertheless, Srour and team conclude:
“Additional research is needed to understand the biological mechanisms underlying the present observations.”
International study links ultra-processed foods with IBD risk
A spike in inflammatory bowel disease (IBD) prevalence worldwide parallels an uptick in Western dietary patterns.
Clinicians have long conjectured that ultra-processed foods may compromise gastrointestinal (GI) tract health, but they lacked the evidence to confirm this link.
A recent multinational study provides good evidence that regularly consuming highly processed foods and beverages is associated with inflammation and IBD.
IBD is more prevalent in affluent countries than in those with lower median incomes. However, cases are risingTrusted Source in developing nations where ultra-processed foods are increasingly available and popular.
For years, gastroenterologists have suspected that ultra-processed foods may contribute to inflammation and IBD. However, few clinical studies have evaluated this hypothesis on a large scale.
A recent multinational prospective cohort study explored the relationship between the consumption of ultra-processed food and the risk of developing IBD.
Neeraj Narula, M.D., an assistant professor of medicine at McMaster University in Hamilton, Canada, led the study. The results appear in the British Medical Journal.
What is IBD?
IBD is a group of diseases that cause chronic inflammation in the GI tract. Crohn’s disease and ulcerative colitis are in this category.
About 3 million people in the United States live with IBD.
Some studies point to genetic risk factors for the condition, but mounting evidence links dietary patterns to its development.
Ashkan Farhadi, M.D., MS, FACP, a gastroenterologist and author, describes IBD as “a disease of wealthy nations.”
As societies progress economically, he says, they forgo traditional ways of growing, preparing, and preserving foods in favor of grabbing conveniently packaged products.
In a recent interview with Medical News Today, he hailed the current study as the first cohort work pinpointing processed foods as the culprit driving IBD development.
Before this, Dr. Farhadi noted, “there was no actual research demonstrating what happens [to gut health] as a nation becomes better off economically.”
Dr. Farhadi also commended the researchers for having included ultra-processed drinks, unlike most other research.
What is ultra-processed food?
The NOVA food classification system defines four categories of foods: unprocessed and minimally processed foods, processed ingredients, processed foods, and ultra-processed foods.
Ultra-processed foods include most mass-produced foods and beverages. These items contain food additives, such as emulsifiers, preservatives, added sweeteners and flavorings, trans fats, and colorings.
Prof. Tim Spector, an author and epidemiologist at the King’s College London in the United Kingdom and co-founder of the ZOE personalized nutrition program, shared his insights on ultra-processed foods with MNT.
Prof. Spector asserted that adults in the U.S. eat more highly processed foods than those living in any other country in the world. He stated that ultra-processed foods make up more than 60% of the caloric intake there.
Measuring food consumption and IBD risk
Narula and his team assessed the medical data of more than 116,000 adults aged 35–70 years. The participants came from 21 low, middle, and high income nations across North America, South America, Europe, Africa, Middle East, South Asia, Southeast Asia, and China.
The participants completed a food frequency questionnaire at least every 3 years from 2003 to 2016.
They reported their consumption of “all types of packaged and formulated foods and beverages that contain food additives, artificial flavorings, colors, or other chemical ingredients.”
The study’s primary outcome was diagnoses of IBD following completion of the baseline questionnaire.
Participants in North America, South America, and Europe reported higher consumption of ultra-processed food than those in the other regions. The occurrence of IBD was greater in these three areas, as well.
Processing might be the problem
Earlier research suggests that certain foods increase the risk of developing IBD.
For instance, the popular low FODMAP diet encourages people with IBD to avoid foods with high levels of specific sugars.
Narula’s team did conclude that higher consumption of ultra-processed foods and drinks increases the likelihood of developing IBD.
The study, however, could not confirm a causal link between ultra-processed foods and IBD development.
Although high consumption of ultra-processed foods was associated with a higher incidence of IBD, consumption of the same foods in unprocessed form did not carry the same risks. Therefore, the researchers conclude that the risk of IBD is associated with the processing of the foods.
Limiting factors
The study authors mentioned several limitations that could have affected their findings.
Firstly, they acknowledge that food questionnaires may not assess absolute intake. However, they note that these can capture relative — high vs. low — intake of the food categories in question.
Also, the researchers are uncertain whether their findings, which came from participants aged at least 35 years, can apply to children or young adults who develop IBD.
The age range of the study’s participants may have limited the ability to determine risk factors for Crohn’s disease, too.
Although the study does not account for dietary modifications over time, the reported dietary patterns seemed to remain stable.
However, the observational nature of the study may have left some residual bias due to unmeasured variables, such as antibiotic use during childhood and unknown confounders.
Hope for healthier food choices
Narula and his team hope that further research will clarify just how ultra-processed foods might trigger IBD.
According to Spector, “most clinicians and gastroenterologists believe the quality of the diet is really important for health.”
He feels that the consumption of “low quality” food disturbs the gut microbes, weakens the immune system, and causes the inflammatory overreactions behind many common diseases.
The professor hopes that the current study and his own work in personalized nutrition, which he is carrying out as part of the ZOE project, will encourage a more mindful, proactive approach to food choices. He also wants physicians to advise patients on how to assess the quality of food. He said:
“[We’re] trying to educate people to what’s in the food, [to] start thinking about food a different way […] — not just as calories, fats, or proteins, but actually, what are all these chemicals doing to your body?”
Vitamin K: the Unsung Hero of Heart Health
Hey, It's Dr. Martin here…
You have over 60,000 miles of blood vessels in your body…more than enough to circle the globe.
Every day, your heart pumps more than 1800 gallons of blood through your blood vessels…well over a million barrels of blood in your lifetime.
Needless to say you need every square inch of your blood vessels to be healthy for you to live.
One problem anywhere in the 60,000 miles of blood vessels, and you're at risk of STROKE, HEART ATTACK, or BLOOD CLOTS.
Now all of your blood vessels have a Teflon-like inner lining called the ENDOTHELIUM.
When the endothelium is healthy, blood is flowing smoothly.
But what happens when the Teflon-like inner lining no longer works?
You end up with Endothelial Dysfunction. When this happens, blood won't flow as well as it should. It also puts you at risk for blood clots and heart attacks!
One of the dangers of endothelial dysfunction is vascular leak.
Vascular leak is common in conditions like cardiovascular disease, arthritis, multiple sclerosis, and sepsis.One of the many reasons I talk about Vitamin D often is that it's critical to endothelial health…
Specifically
Vitamin D helps STABILIZE the endothelium, which helps PREVENT vascular leak.
It's one reason why a person who is chronically low in vitamin D is at a much greater risk of cardiovascular disease.
Getting vitamin D is easy and one of the best things a person can do to protect EVERY system in their body.
Sadly, few don't get anywhere near enough vitamin D., And it's not their fault.
The media, public health, doctors, and "experts" discourage vitamin D.
They scare people enough to avoid the sun…
And they freak out whenever someone takes a vitamin D supplement.
If I had a dollar for every time I've heard, "My doctor says it's dangerous to take more than 1000 IU of vitamin D, "…But here's what really gets me going:
Canada and the U.S. have significant vitamin D deficiency problems.
One study found between 70% and 97% of North Americans are low in vitamin D. That's a public health crisis.
The same study found that if North Americans took only 2000 IU per day…93% would achieve normal blood levels. Yet…few doctors know this…and even if they did… they'd still only recommend 1000 IU per day as the max.
Let me be clear…the vitamin D blood levels that doctors consider normal are considerably different from what most integrative healthcare practitioners consider optimal.
Vitamin K
A study published in the European Heart Journal…
"The effect of Vitamin K2 supplementation on coronary artery disease in a randomized multi-center trial"
Found vitamin K2 significantly reduced the risk of heart attack and all-cause death in high-risk patients.
Vitamin D is critical to heart health…and so is Vitamin K.
You should know that not all vitamin K supplements are the same.
The type of vitamin K matters…big time.
We use a specialized type of vitamin K2 called MK-7.
Not only is MK-7 the most absorbable form of vitamin K — it has other critical functions.
For example, MK-7 is critical for bone health.
Most people don't need more calcium. They need better calcium ABSORPTION.
Vitamin D is like a bouncer — It lets calcium in. Without enough vitamin D, you can't absorb calcium from the gut into your bloodstream.
If you're low in vitamin D, you can eat as much calcium as you want.
It isn't going to help your bones.
But absorbing more calcium isn't the solution.
You DON'T want calcium to STAY in your bloodstream. That's terrible news.
Calcium will HARDEN your blood vessels — causing heart disease and strokes.
This is where vitamin K steps in. If Vitamin D is the bouncer…
Then, Vitamin K is the TRAFFIC COP. It directs calcium from blood vessels to your bones. And this is what makes MK-7 great.
As we head into fall your vitamin D levels start falling (you're not in the sun in shorts and a T-shirt anymore)…
So, make sure you're getting enough vitamin D (and vitamin K).
Talk soon.
Why Most People Need a Multivitamin
Older adults taking a multivitamin supplementation may experience memory improvements
Taking a multivitamin improved performance by "the equivalent of 3.1 years of age-related memory change" compared to placebo and could not only help maintain cognitive functioning but potentially enhance it
Separate research found three years of multivitamin supplementation translated to a 60% slowing of cognitive decline; Improvements in global cognition, episodic memory and executive function were noted
Other research revealed daily multivitamins potentially reduced lung cancer by 38% and improved levels of several nutritional biomarkers
While whole, nutrient-dense foods are the best source of nutrition, older adults may be at risk of nutrient deficiencies and some may benefit from multivitamin supplementation
Food is your best source of nutrients, but with soil health declining and many people not eating an ideal diet, multivitamins may help address any gaps. This may be particularly true for adults age 60 and over. A large study on the effects of multivitamins and cognitive function found the supplements have the potential to improve memory.1
It’s the second study using data from the COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web), which was an ancillary study of COSMOS, to link a daily multivitamin to better brain function. Separate research also linked multivitamins to improved cognition.2
"When we start seeing that kind of consistency across well-designed studies, it certainly helps convince me — the ultimate skeptic — that we're on to something real," professor Adam Brickman of Columbia University, who worked on the first study, told Insider. "… I started taking multivitamins the day we ran the analyses and saw the results, and I take 'em every morning."3
Daily Multivitamin Gives Memory a Boost
Scientists from Harvard Medical School and Columbia University demonstrated that older adults taking a multivitamin supplementation may experience memory improvements.4 In this group of 3,562 older adults, including men over the age of 60 and women over 65, participants received either a multivitamin supplement or a placebo.
The participants were evaluated at baseline and each year using a battery of neuropsychological tests over a period of three years. Results showed that participants taking the multivitamin supplement had better immediate recall at the first year point, which was maintained during follow-up. Effects were most pronounced in people with cardiovascular disease.
"There is evidence that people with cardiovascular disease may have lower micronutrient levels that multivitamins may correct, but we don’t really know right now why the effect is stronger in this group," Brickman said.5
The researchers estimated that taking a multivitamin improved performance by "the equivalent of 3.1 years of age-related memory change" compared to placebo6 and could not only help maintain cognitive functioning but potentially enhance it later in life. The team concluded:7
"Vitamin supplementation is relatively inexpensive, accessible, and has a few adverse effects, and thus might be a potentially useful population health intervention … Daily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age."
Multivitamins Offer Cognitive Benefits
A separate study involving 2,262 participants with a mean age of 73 tested whether cocoa extract versus placebo and a multivitamin supplement versus placebo improved cognition.8 In addition to taking the supplement, the participants took tests designed to evaluate memory and other cognitive functions when the study started and annually.
Significant benefits were found from the daily multivitamin, with three years of such supplementation translating to a 60% slowing of cognitive decline, which is equivalent to about 1.8 years.9
Improvements in global cognition, episodic memory and executive function were noted, with the effects again most pronounced in people with cardiovascular disease. According to the study, which was published in the journal Alzheimer’s & Dementia:10
"COSMOS-Mind provides the first evidence from a large-scale, long-term, pragmatic RCT [randomized controlled trial] to suggest that daily use of a safe, readily accessible, and relatively low-cost MVM [multivitamin-mineral] supplement has the potential to improve or protect cognitive function for older women and men.
An additional trial is needed to confirm these findings in a more representative cohort and to explore potential mechanisms for cognitive benefit. This work may ultimately have important public health implications for standard of care to improve or protect cognitive function in older adults."
Multivitamins May Lower Cancer Risk
The larger COSMOS study evaluated whether cocoa extract supplementation with and without a standard multivitamin affected the risk of developing cardiovascular disease and cancer. The larger study enrolled 21,442 participants and found cocoa flavanol supplementation did not show a significant impact in reducing the total number of cardiovascular events.
However, when the data was evaluated further, they found daily multivitamins potentially reduced lung cancer by 38% and "did appear to improve levels of several nutritional biomarkers."11
Previous research also found that daily multivitamin supplementation led to a statistically significant reduction in the incidence of total cancer among men aged 50 years or older.12
Other research found multivitamin use was associated with a 70% decrease in risk of non-cardia gastric cancer among Black participants in the Southern Community Cohort Study who were below the healthy eating index median, meaning they had a lower quality diet.13
B Vitamins May Also Slow Brain Aging
Many multivitamins contain B-complex vitamins, which are important for your brain. Vitamins B6, B9 (folate) and B12 support cognitive function as you age and have been shown to play a major role in the development of dementia. As noted in Nutrition Reviews:14
"Deficiencies of the vitamins folate, B12 and B6 are associated with neurological and psychological dysfunction … In the elderly, cognitive impairment and incident dementia may be related to the high prevalence of inadequate B vitamin status and to elevations of plasma homocysteine.
Plausible mechanisms include homocysteine neurotoxicity, vasotoxicity and impaired S-adenosylmethionine-dependent methylation reactions vital to central nervous system function. In light of this, it is imperative to find safe ways of improving vitamin B status in the elderly …"
Research published in PLOS One even suggests B vitamins may slow brain aging. It compared brain atrophy in participants taking folic acid (0.8 milligrams (mg) per day), vitamin B12 (0.5 mg per day) and vitamin B6 (20 mg per day) for 24 months with that in patients taking a placebo.15
Those taking B vitamins had a lower rate of brain atrophy per year — 0.76% — than those not taking them, who had an atrophy rate of 1.08%. According to the researchers, "The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins."16
Vitamin B3 is found in grass fed beef, mushrooms and avocados,17 while vitamin B6 is plentiful in grass fed beef, potatoes, bananas and avocados.18 You can find folate, or vitamin B9, spinach, broccoli, avocado and asparagus.19
Vitamin B12-rich foods include grass fed beef liver, wild rainbow trout and wild sockeye salmon. For more serious deficiency you may need weekly shots of vitamin B12 or daily high-dose B12 supplements.
Trace Nutrient Protects Brain Health
Another nutrient to be aware of as you age is nicotinamide riboside (NR), a precursor of nicotinamide adenine dinucleotide (NAD+) and a form of vitamin B3. Found in milk as well as in supplement form, NR may help to boost levels of NAD+, which typically declines in the brain with age, leading to metabolic and cellular dysfunction.20 By raising NAD+ levels, NR may modify neurodegenerative disease in humans, helping to protect brain health.
In a study published in the journal Aging Cell, Martens and colleagues found that NR supplementation increases NAD+ levels and lowers biomarkers of neurodegeneration in plasma extracellular vesicles enriched for neuronal origin (NEVs).21
Among the 22 older adults who took NR at a dosage of 500 mg twice a day for six weeks, NAD+ levels in NEVs increased while kinases involved in insulin resistance and neuroinflammatory pathways decreased.22 The results suggest NR, by increasing NAD+, could help ward off Alzheimer’s disease.
The NAD+ precursor niacinamide is also beneficial, but it’s not widely promoted because it costs much less than other NAD+ precursors, including NR. You can use 1 to 1/2 of 1/64th of a teaspoon of niacinamide powder three times a day (25 mg to 50 mg), but will need special measuring spoons to carefully measure it out. In this case, more is not better as too much can inhibit sirtuins, which are important longevity proteins.
Why Older Adults May Need a Nutritional Boost
Older adults may be perfect candidates for multivitamins as they may be predisposed to deficiencies and inadequacies in micronutrients. Nutrient absorption may decline with age, for instance, while gastrointestinal pH changes, existing diseases, the use of certain medications and inflammation in the gut can all contribute to nutrient deficiencies.23
In addition, older adults may use micronutrients in greater concentrations, making it difficult to maintain adequate levels.24 Changes in eating habits and poor oral health, leading to tooth loss, can further affect older adults’ ability to consume enough nutrients and in a wide enough variety.
Ideally, people of all ages should strive to get their nutrition from whole, nutrient-dense foods. "We're not suggesting that people should get their vitamin and nutrient intake from supplements — the primary source of that should be from whole and healthy foods," Brickman told Insider. "… I think that multivitamins, along with a lot of other things that we could potentially do as we age, might have a modest but meaningful effect on how we age, cognitively."25
He added in a news release, "Supplementation of any kind shouldn’t take the place of more holistic ways of getting the same micronutrients."26 In the event you feel you’re not getting the nutrients you need from diet alone, however, you might want to consider a multivitamin.
They’re among the most popular supplements in the U.S., with an estimated one-third of U.S. adults — and one-quarter of children and adolescents — using them.27 If you decide to add one to your daily routine, look for a manufacturer that has checks and balances in place to ensure a high-quality product.
Since multivitamins contain both water- and fat-soluble vitamins, it’s generally recommended you take half your daily dose in the morning, with breakfast, and the other half with your main meal.
Sources and References
Dr. Mercola
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Alpha lipioc acid comes in two forms. R and S. Alpha lipoic acid is a combination of these two forms. Most supplements have alpha lipoic acid with both forms, not just the R form.
The R form of alpha lipoic acid is the form normally found in the body. Studies indicate the R-alpha lipoic acid form appears to be better absorbed than the combination of R and S alpha lipoic acid.
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