Keith Roach, To Your Health 5:43 p.m. ET March 21, 2017

Dear Dr. Roach: There was some controversy recently in a medical journal about the risk of sugar intake for heart disease. What is your take?

M.P.

Dear M.P.: There was a recent article in the Annals of Internal Medicine that evaluated recommended limits on added sugar in food. The guidelines came from the World Health Organization, Public Health England and the U.S. Department of Health and Human Services. Although their guidelines were different, all recommended limiting added sugar intake.

The paper, which was funded by a trade group, concluded that the guidelines were based on low-quality evidence and do not meet criteria for trustworthy recommendations. Thats the controversy.

I did an extensive search of recent articles on the health effects of high-sugar diets. I found two fairly well-done trials that show a modest increase in risk of chronic diseases (diabetes, heart disease, breast cancer and gallbladder disease) in people who have higher-glycemic-index diets.

I also reviewed a companion piece in the Annals, which found evidence that studies supported by manufacturers of sugar-sweetened beverages were much more likely to find that sugar is NOT a good cause of chronic disease than studies that were independently funded.

This suggests that the sugar industry may be trying, as did the tobacco industry, to discredit work on diet. I must unfortunately conclude that the Annals review paper has a potential for conflicts of interest.

Nearly all authorities agree that excess dietary sugar is a significant risk factor, not only for the development of diabetes, but also for other serious medical conditions. I continue to recommend against excess sugar intake. However, I cant say exactly how much is safe, so I think using a guideline, such as the U.S. Health and Human Services recommendation to limit to less than 10 percent of daily calories, is rational.

Dear Dr. Roach: It seems a lot of people have high total cholesterol and take drugs for it.

But what do you think of an elderly person having a total cholesterol of 138 without taking any drugs? It seems to me this is an unhealthy situation, and somehow this person needs to do something to increase his cholesterol. How would a person do this? The stats are triglycerides 99, HDL 45 and LDL 74.

R.I.

Dear R.I.: Unfortunately, I cant answer the question, because a low cholesterol level can be either a healthy or an unhealthy finding, depending on the circumstance.

For a healthy, active elderly person of normal weight, the numbers you told me about would represent a low risk of heart disease. However, low cholesterol levels, particularly in the elderly, often go along with poor nutritional status and chronic disease. It wouldnt surprise if you told me the person you are referring to has a serious chronic illness (of almost any type).

If the person does have chronic illness, the cholesterol is a marker for a problem, not a problem in itself. Therefore, the treatment isnt increasing the cholesterol (especially with unhealthy foods); rather, the treatment should be directed at the underlying disease. If a disease is unknown but suspected, then a careful history and physical exam, with a judicious laboratory evaluation, is warranted.

Email questions to ToYourGoodHealth@med.cornell.edu.

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Doc: Authorities agree too much sugar intake is risky - The Detroit News

A long-awaited study has found that limiting caloric intake not only preserves health but also increases longevity. The paper, which was published in Nature Communications, involved decades of study of rhesus monkeys, is said to resolve the debate over whether caloric restriction (CR) extends lifespan. 1, 2,3

The main message from this studyis that the amount you eat influences how you age, said Rozalyn Anderson, study author and associate professor, Department of Medicine, University of Wisconsin-Madison. The work shows that in primates, reducing calorie intake in adulthood and later in life confers benefits in terms of both health and survival.1, 4

The latest findingsrepresent the collaboration between two competing research teamsone at the University of Wisconsin-Madison (UW) and the other at the National Institute on Aging (NIA)that worked together in an effort to explain their differing observations on the impact of CR on longevity. 1, 2, 3

Both teams had initially set out to study the effects of caloric restriction--defined as a diet comprised of about 30% fewer calories but providing the same nutrients as a standard dieton rhesus monkeys, who as they age are vulnerable to many of the same diseases as humans. 1, 2, 3

In 2009, the UW research team reported significant extension of life and reductions in cardiovascular disease, cancer and insulin resistance in the monkeys whose diets were calorically restricted. But in 2012, while the NIA group also found better health among its CR monkeys, the researchers observed no significant improvement in survival. 1, 2, 3

The conflicting findings cast doubt on the benefits of CR on longevity and appeared to go against nearly a century of laboratory research showing that CR significantly extends lifespan, albeit in non-primates. Beginning in the 1930s, for example, researchers found that laboratory rats and mice live up to 40% longer when fed a diet that has at least 30% fewer calories than they would normally consume. Substantial research over the last two decades has also demonstrated the benefits of CR in short-lived organisms such as yeast, nematodes and fruit flies.1, 2, 3, 5

But, after sifting through all the information from the two study sites including data from nearly 200 monkeys, the authors concluded that CR is indeed associated with longer survival. The observed discrepancies, they said, stemmed from a variety of factors including: diet composition (the NIA monkeys ate naturally-sourced foods while the UW group ate relatively more processed foods with higher sugar content); the age of the monkeys when the restricted diets were introduced (eating less confers benefits in adult primates but not in younger animalswhich, by the way, is unlike in rodents, where the earlier the animals begin CR the longer the resulting lifespan); and genetics. 1, 2, 3

Of course, the research begs the question of what all this means for humans. The study authors say their findings suggest that CR mechanisms are likely translatable to human health. The profound similarities between humans and rhesus monkey in the rate of aging, the types of diseases of aging that occur, and how they manifest clinically makes it extremely likely that the mechanisms of CR in monkeys will be translatable to human health and aging too. Anderson said. 1, 4

It appears that researchers who have looked at CR in humans agree. There are numerous examples from well-studied human cohorts that there is a likely benefit for reduced-calorie diets to promote healthy aging and lifespan extension in humans, said Leanne Redman, Ph.D, associate professor and investigator in the CALERIE study at the PenningtonBiomedical Research Center at Louisiana State University in Baton Rouge. As humans strive for the fountain of youth in today's obesogenic environment, looking to dietary and nutritional approaches for improved health across the lifespan is the most obvious choice. 6, 7

Indeed, one theory is that CR evolved as a protective response to enable animalsand humansto survive periods of food shortage. But this evolutionary advantage might seem to backfire in todays environment of overabundant and chronic accessibility to food combined with a trend of reduced physical activity. 6

Others see in the latest research the value of diet composition. The more wholesome and less-refined diet consumed by the NIA monkeyswhich contained substantially less sucrose, more favorable lipid and protein sources and higher fiber relative to the Wisconsin dietappears to have benefits independent of the level of CR, said Susan B. Racette, Ph.D., professor at Washington University School of Medicine in St. Louis. This finding is encouraging for human application, given the challenges of adhering to a calorically-restricted diet long-term. 8, 9

Last updated on 03/21/2017

Black Tea Improves Glucose Levels, May Help Prevent Diabetes

Excerpt from:
Caloric Restriction: Key to Better Health, Longer Life? - EndocrineWeb

I'm used to the shaming look I get from my peers when I crack open a can of sugar-free Red Bull. The questions and judgement never end. "That stuff'll kill you," someone said to me the other day, shaking his head. "So many chemicals!" was what I heard last week.

Truth be told, Red Bull (at least the sugar-free kind) isn't all that terrible for you. Besides having only 10 calories and no sugar, it has only 80 milligrammes of caffeine, about a third of the amount in a tall Starbucks drip coffee. As far as its other ingredients namely B vitamins and taurine go, scientific studies have found both to be safe.

But my favourite source of caffeine isn't the only harmless food or drink that gets a bad rap. Here are some of the rest, along with the science behind their safety.

Gluten

The myth: As more and more of your friends go gluten-free, you may wonder: Is there something to this latest diet craze? Is gluten intolerance a thing? Is it getting more common?

Why it's bogus: Only about 1% of people worldwide have celiac disease, the rare genetic disorder that makes people intolerant to gluten, according to the Celiac Disease Foundation. For most of the rest of us, this doughy, chewy ingredient is simply how it tastes: delicious!

Eggs

The myth: The massive amounts of cholesterol in eggs will translate to a massive amount of cholesterol in your veins.

Why it's bogus: Even though eggs are high in cholesterol (a single egg packs roughly 185 mg), eating them likely won't translate into higher blood cholesterol for you. The first studies that suggested that were done with rabbits, as my colleague Kevin Loria reported. So go ahead, pop a perfectly poached egg on that avocado toast. You know you want to.

Caffeine

The myth: Caffeine stunts your growth and messes with your health.

Why it's bogus: According to the Mayo Clinic, the average adult can safely consume up to 400 mg of caffeine daily. Most standard cups of coffee contain between 90 and 120 mg. So if you're limiting yourself to under four cups of joe a day, you should be relatively in the clear. Still, some java packs more of a punch than others. A 12-ounce "tall" cup of Starbucks drip coffee, for example, has about 260 mg of caffeine putting you well over the daily dose after two cups.

Carbonated water

The myth: Fizzy water is all the rage these days, showing up in grocery-store aisles in flavours like coconut or watermelon. But many people worry the bubbles cause kidney stones, leach calcium from your bones, and even strip the enamel from your teeth.

Why it's bogus: The bubbly stuff is just as good for you as plain water, Jennifer McDaniel, a registered dietitian and certified specialist in sports dietetics, told my colleague Dina Spector.

"Carbonated or sparkling water is made by dissolving carbon dioxide in water, creating carbonic acid," Spector wrote. "This process just adds bubbles it does not add sugar, calories, or caffeine. Tonic water, club soda, and mineral water are all types of carbonated water, but these have added sodium, vitamins, or sweeteners, so it's important to read the label."

Fatty foods

The myth: Fatty foods like avocados and olive oil will make you fat.

Why it's bogus: Although it makes intuitive sense, this myth is not borne by scientific research. A recent look at the studies behind the dietary guidelines that suggested we cut back on fat found that there wasn't evidence to support those rules in the first place. In the book "Eat Fat, Get Thin," Mark Hyman, director of the Cleveland Clinic's Center for Functional Medicine, talks about how he incorporated healthy fats from foods like fish and nuts in his diet to lose weight.

Cheese

The myth: Some news outlets have reported that cheese "is like crack" because it's "as addictive as drugs."

Why it's bogus: We tracked down the study that appears to lie at the root of these claims, and it found no such thing. Several University of Michigan researchers asked people to report which foods on a list they had the hardest time cutting out or eating moderately. Cheese ranked toward the middle. Nevertheless, since pizza, a cheesy food, ranked high on both lists, people speculated that cheese was the culprit, going as far to suggest something about the way one of its proteins breaks down in the body is addictive. There's little to no evidence to back this up.

Artificial sweeteners

The myth: Artificial sweeteners like Splenda and Equal have been found to cause cancer.

Why it's bogus: The Food and Drug Administration has evaluated hundreds of studies on sucralose (Splenda), aspartame (Equal), saccharin (Sweet'N Low) and more. So far, it has deemed all of them safe.

That said, some preliminary research suggests artificial sweeteners may not satisfy your craving for sweets and therefore may not be effective at curbing your overall sugar intake.

GMOs

The myth: Genetically modified organisms cause cancer and wreak havoc on the environment.

Why it's bogus: GMO crops, which have been around since the 1980s, have been studied at length, and a recent report from the National Academies of Sciences, Engineering, and Medicine found that they aren't posing any greater risk to the environment than regular crops. It also found no evidence that they "are less safe to eat than conventional food," my colleague Lydia Ramsey reported.

Salt

The myth: Salt causes heart problems and weight gain.

Why it's bogus: The science about whether eating salt in moderation has a net negative or positive effect on our health is somewhat unclear. However, a 2011 meta-analysis of seven studies involving more than 6,000 people published in the American Journal of Hypertension found no strong evidence that reducing salt decreased people's risk of heart attack, stroke, or death even in those who had high blood pressure.

"If the US does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily," Melinda Wenner Moyer wrote in Scientific American.

All carbs

The myth: Carbohydrates including rice, bread, cereal, and potatoes contribute to weight gain.

Why it's bogus: While it's a good idea to limit your intake of processed carbs like white bread, white rice, and white pasta, not all carbs are bad for you. Some are healthy and a great source of energy. Take potatoes, for example.

"White potatoes are actually very good for you," Christian Henderson, a registered dietitian, told Health. Potatoes pack potassium and vitamin C, and they have almost 4 grammes of fibre just cook them with the skins on.

Fish

The myth: Fish is high in mercury and will make you sick.

Why it's bogus: While mercury can build up in larger, older predator fish like marlin and shark, it's not generally a problem in smaller fish. The FDA maintains a helpful list of guidelines for mercury in seafood salmon, trout, oysters, herring, sardines, and Atlantic and Pacific mackerel are all considered "good" or "best" choices, according to the FDA.

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11 things people think are terrible for your diet that actually aren't - The Independent

For decades there has been a steady stream of anti-soy publicity and I am often send Internet articles from readers and my patients warning about the dangers of soy. In my experience however, soy is a virtual super food.

I personally have consumed soy products daily for more than 25 years and regularly recommend this humble bean to my patients. As a vegetarian, I emphasise the importance of dietary protein and am always seeking ways to supplement my protein intake. Soy is a great protein source as it is a complete protein containing all the essential amino acids.

The anti-soy lobby has actually encouraging intensive scientific research into the benefits or dangers of eating soy foods, so the issue can be dealt with using facts instead of anecdotes.

Overwhelmingly, medical and nutritional research has shown that soy offers protection against the killer diseases - heart disease, cancer and osteoporosis while helping to ease the symptoms of the menopause. It also is an economical and complete source of high quality protein that can safely replace animal protein in the diet.

The major accusations against soy are that it may cause cancer and may disturb thyroid function.

Much of the worry about soy has to do with naturally occurring compounds called phytoestrogens, the most abundant of which is the isoflavone, genistein. As their name suggests, phytoestrogens have chemical structures similar to that of the hormone oestrogen. This enables them to fit into the bodys oestrogen receptor sites, much as a key fits into a lock. Instead of causing breast cancer, this ability to bind to oestrogen receptors allows phytoestrogens to block the effects of the much stronger oestrogen produced in the body or come from toxic chemicals like insecticides. The weak soy phytoestrogens are actually oestrogen blockers and this is one way by which soy protects women against breast cancer.

Most research as well as the experience of Asian populations, where soy has been a dietary staple for thousands of years, confirms the protective role of soy. A report published back in 2001 in the journal Cancer, Epidemiology, Biomarkers, and Prevention provides compelling evidence of the anti-cancer effects of soy foods. This study found that an increase in soy intake by adolescent girls reduced theirlater risk of breast cancer. Women with the highest consumption of soy had only half the risk of those with the lowest intake. Other studies have also shown a reduced risk of prostate and colon cancers with increasing soy consumption.

Another charge against soy is that it contains anti-thyroid agents that can disturb the function of the thyroid gland. This is largely theoretical. Certain compounds in soy can affect thyroid tissue in test tube studies, but this does not appear to be the case in live human beings.

Population studies show no increased prevalence of thyroid disease in countries with a high intake of soy, and the clinical research has been inconclusive. That debate aside, most researchers agree that consuming soy at optimal healthy levels (about 25 to 40 grams per day) is most unlikely to impair thyroid function. After using soy with hundreds of patients, I have detected no disturbance of thyroid function that I could blame on soy.

However, if you have an under-active thyroid, a bit of caution may be in order. Keep your soy intake within the above range and have your thyroid function monitored periodically. Also, be aware that taking thyroid medication at the same time as any food (soy or otherwise) may decrease the drugs absorption. Take it on an empty stomach.

Have some soy in your daily diet. Soy is now available in many, many forms: soymilk, shakes, soy cheese, soy nuts, soups, drinks, protein bars, tofu and tempeh. There are also textured vegetable protein products like veggie mince and soy burgers. My favourite way to have high quality soy each day is with a soy protein shake. This is a delicious nutritious drink that can conveniently replace a meal.

With the tremendous increase in commercially processed soy products there are justifiable concerns about their quality. Not all soy products are equal. I use mainly non-GMO soy products from the most reputable sources. Avoid foods containing hydrogenated or partially hydrogenates soybean oil. Select high quality soy products as many so-called soy products have low levels of the substances that provide the health benefits of soy. Look for the term soy protein isolate and check the protein content on labels as a guide in assessing soy products.

You may email Dr, Vendryes at tonyvendryes@gmail.com or listen to An Ounce of Prevention on POWER106FM on Fridays at 9 p.m. Visit http://www.tonyvendryes.com for details on his books and articles.

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Ounce of Prevention | Should I ever have soy? - Jamaica Gleaner

Kennedy Wolf is a 6-year-old with Down syndrome who has always had trouble gaining and maintaining weight. Kennedys mother, Tammy, says it dates back to her stay in the neonatal intensive care unit at Golisano Childrens Hospital. In her first 72 days, she had gained just three ounces of weight.

Six years later, Kennedy is still facing eating challenges.

Kennedy isnt particularly a picky eater. Rather, she gets tired of chewing and tries to swallow everything she eats before its fully chewed, said Tammy. Shell eat anything. How can we make sure she doesnt choke on it?

Picky eating and building proper eating habits has long been called a normal rite of passage for most toddlers. Structuring a childs eating routine so that they are getting proper nutrients is tough enough for the average baby, but for families that have a child with a developmental disability, it can be much more difficult.

Nearly 75 percent of children diagnosed with a developmental disability have some type of feeding disorder. Most children with Autism Spectrum Disorders, Down syndrome, and other developmental disorders who have problems feeding fear new foods and often have a preference for certain brands. Children who are extremely selective run the risk of having nutrient deficiencies. Selective eating that is not treated can remain a lifelong challenge.

Five years ago, the Feeding Disorders Program - part of the division of Developmental and Behavioral Pediatrics - was started at Golisano Childrens Hospital as a way to help children and families evaluate their childs nutrition, feeding behaviors and chewing/swallowing skills, and help them get on the path to eating in an age-appropriate way. They see children ages 1-10 years old who have feeding problems such as very selective eating, refusing certain foods or liquids, disruptive mealtime behavior, difficulty chewing or swallowing, or fear of choking. They also see children with complex medical conditions. These are all areas the team in the Pediatric Feeding Disorders Program aims to help.

The interdisciplinary nature of our clinic allows for collaboration between our dietitian, speech therapist, social worker, nurses, and doctors, said Kimberly Brown, Ph.D., director of the Pediatric Feeding Disorders Program. We provide a full nutritional analysis for patients and provide an individualized plan for parents to teach their children better eating habits.

The Pediatric Feeding Disorders Program is typically six to eight weeks of weekly or biweekly appointments, where families practice sitting for a meal and go through many of the interactions associated with eating. If a child has a really hard time trying new foods, they may begin by teaching the child to learn to interact with new foods before committing to eating it. Kennedy started attending the Feeding Disorders Clinic about eight months ago. She has worked with Dr. Brown, speech therapist Katherine Maruska, and registered dietitian Brianne Schmidt. Katherine assisted in identifying safe and appropriate textures that Kennedy could eat, monitoring her chewing and swallowing skills while assisting with her self-feeding.

The overall goal was to realize what she could safely eat and how to introduce new foods into her diet, said Tammy.

The team at the Pediatric Feeding Disorders Clinic ran blood work on Kennedy to see what nutrients she was lacking in her current diet. When Tammy and Brianne went over the results, they discovered that Kennedy was lacking Vitamin D and iron, so she is now on supplements for those nutrients.

Every visit, I had a homework assignment to bring in a different food to evaluate and see how Kennedy was maneuvering with her food, Tammy said. The overall nature of the clinic allowed us to see multiple specialists per visit, so the collaborative nature really benefited Kennedy.

And that collaboration is about to get better. When the Pediatric Feeding Disorders Program makes their move to the new space on East River Road, providers from Developmental and Behavioral Pediatrics, Child Neurology, and Psychiatry will be co-located. The clinic will have a fully stocked kitchen, which will allow families to be comfortable in an environment that looks more like their own home.

We want kids engaged in cooking and meal prep, Brown said. The new area will have two rooms directly next to each other, each with observation areas. Our ultimate goal is to make home life be similar to their appointments in our clinic.

Patients will also benefit from having other providers sharing clinic space in addition to their developmental pediatrics team.

The Feeding Disorders Clinic will begin seeing patients in the Neuromedicine and Behavioral Health center in early April.

3/21/2017

Hello and welcome! We're excited to share this blog with our wonderful advocates, supporters and members of the community. Right now UR Medicines Golisano Children's Hospital is in the midst of a capital campaign to finish building our new hospital and enhance seven key programs to improve the health of our region's children. Bookmark this blog to follow our progress!

You can also view past issues of the printed version of our newsletter.

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Pediatric Feeding Disorders Program's Inventive Approach Allows Families to Thrive - University of Rochester Newsroom

Spring greens from the woods can add nutrition and flavor to your diet.

March begins wildcrafting season, when greens from natures salad bowl are tender and tasty, said University of Missouri Extension horticulturist David Trinklein.

Wildcrafting, the gathering of plants from the natural or wild habitat, is a throwback to our early ancestors who were hunters and gatherers. Their winter diets lacked the diversity of fresh produce enjoyed today. Therefore, when spring arrived, they combed the woods for wild edibles to add flavor and nutrition to their meals.

Trinklein cautions new wildcrafters to study plant identities before they begin. The cardinal rule to remember when hunting wild greens is to be certain to know what you are gathering, he said. If in doubt about the identity of a plant, definitely pass it by.

Trinklein recommends the Missouri Department of Conservations book Missouri Wildflowers by Edgar Dennison as a reference to identify plants. He added that beginners benefit from going with seasoned wildcrafters until they learn what plants can be eaten safely.

Avoid roadside hunting, Trinklein said. Roadside plants may contain residue from vehicle exhaust or pesticides from adjoining cropland. Wash all plants at least twice after gathering, changing the water each time. Check for insects and debris. Eat small amounts when trying a new plant, he suggests, to avoid possible allergic reactions.

Prepare wildcrafted greens by putting them in a saucepan with a little water and salt. Cook until tender, but do not overcook. Mix bitter plants with sweeter ones. Add pan drippings, vinegar or lemon juice to taste. Drain water before serving. A common working mans diet in the past included soup beans, fried potatoes, cornbread, raw onions and wild greens.

Trinklein recommends the following common Missouri plants for wildcrafting:

Cutleaf toothwort (also known as crows foot). This low-growing plant is found in woodlands and on wooded slopes. It bears five narrow, deeply lobed leaves that look like the toes on the foot of a crow. The leaves are edible, but cutleaf toothwort is prized for its rhizomes. Their spicy, radish-like flavor livens up salads. Some ferment toothwort to sweeten it; others boil it.

Dandelion. Gardeners hate them; wildcrafters love them. Dandelions are rich in vitamin A and iron. Their flavor peaks during March and April. To gather, cut off the whole crown close to the soil, pluck out the flower stem and sort out any trash or debris.

Lambsquarter. This later-producing green, also known as wild spinach, is high in vitamins and minerals. Its oval- to lance-shaped light green leaves fare well throughout the summer. Pinch off young plants just above the ground and use the entire plant, or harvest just the leaves.

Nettle. Known for its unsocial behavior, stinging nettle is a popular source of springtime fare. It bears egg to oblong-shaped leaves with a heart-like base and toothed, bristly margins. Wear gloves to gather this green. Nettle tastes best in the early spring. It loses its bristly margins when boiled and tastes like spinach.

Shepherds purse. Named because of the shape of its seed pods, it springs to life from a prostrate rosette of deeply cut, lance-shaped leaves. It has long been used to pep up the taste of less savory greens like lambsquarter. Use it raw in tossed salads. Legend has it that old-time raftsmen floated downstream in great flotillas of logs to gather shepherds purse from riverbanks because of its pepper-like taste, Trinklein said.

Watercress. Related to mustard and radish, watercress floats on the surface of ponds, pasture creeks and cold springs. Its bright green leaves taste best April to June. Its pungent taste works well as a salad or meat garnish. Its high ascorbic acid content, along with other vitamins and minerals, made it a favorite with early pioneers to prevent scurvy.

Wild lettuce. This plant grows in lowland pastures and along stream banks. It becomes bitter after early April, so enjoy it in March and early April. Its smooth, deeply lobed, light-green leaves set it apart. When broken, the leaves produce a sticky, milk-like sap. Eat it raw or as wilted lettuce salad.

Winter cress. Called creasies in days gone by, it grows in fields, gardens and waste places. It is a superb potherb picked and enjoyed by generations, Trinklein said. Mature winter cress becomes bitter, so gather early in spring.

Trinklein also reminds wildcrafters that pokeweed is not on the list of recommended plants. Relished as poke salid in the past, its toxic compounds make it unsafe for consumption.

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Wildcrafting offers free spring delicacies for dinner - Marshfield Mail (subscription)