CLEVELAND, Ohio–  A dietary compound abundant in red meat and used as a supplement in energy drinks, energy pills and some weight-loss treatments has been found to promote hardening of the arteries, according to a study released Sunday by a research group at the Cleveland Clinic.

The finding may help explain why some people, even when they get their cholesterol under control, still suffer ill effects from a diet high in meats such as beef, venison, lamb, duck and pork.

The research group, led by Dr. Stanley Hazen, section head of preventive cardiology and rehabilitation, has been investigating the link between heart disease and foods, the bacteria in the intestine that digest them, and the substances these bacteria create in the digestion process.

In 2011, the group connected the dietary nutrient lecithin, found naturally in animal products, to heart disease through a byproduct of its metabolism in the gut called TMAO. In those studies TMAO, or trimethylamine N-oxide, proved to be a 10-fold stronger predictor of heart disease than cholesterol, a relationship that has held up in more recent work.

Now Hazens group has found a similar relationship between TMAO and carnitine, a substance that is found in abundance in red meat and is needed in the body for the production of energy. When carnitine is digested, it drives up TMAO, and TMAO leads to increased plaque buildup in the arteries.

Read the entire article via Compound in red meat, energy drinks linked to heart disease in Cleveland Clinic research | cleveland.com.

Top 10 Nutrition Facts That Everyone Agrees on.

Healthy food is Booming! There are numerous trademarks and health claims that giant food producers use to tell us that their products are super healthy. I understand that claiming to be fitting in a healthy diet is good for sales, so let me give you an insight in the tricks they use to make packaged food looking healthier.

Trick number one:
If you want to add a lot of sugar to your product, add different types. In this way these ingredients won’t be on top of the ingredient declaration, making place for more healthy appearing ingredients. Producers of cereal bars are using this trick very often. They appear to be healthy, but are actually high on calories by sugars and saturated fats. Just making something more complicated than it is works.

Trick number two:
When you produce a product which has a lot of sugar, just mention that it’s low on fats. In this way the attention is put on another health fact. A big lolly pop company tried this once, but fortunately did not get away with it.

Trick number three:
I you are able to replace the sugar for fruit concentrate you can tell the consumer that you did not added any sugar! But you did, in the form of concentrated fruit. Believe me there is nothing healthy about fruit concentrate.

Trick number four:
High fiber content in a product is positive for the healthy image. But fibers are not yummy, so add inulin. This is a fiber powder that keeps your product tasty, but you can write on your packaging that it has a lot of fibers. However It does not work the same as fibers in wholegrain and vegetable. products.

Trick number five:
Make a white bread made of refined flour and add caramel as a brown colorant to make it look like it is healthy cause it’s very brown. Yes, we are that stupid..

Trick number six:
A lot of paste or concentrate of vegetables in your product means bingo. You can calculate these overheated concentrated “was a vegetable once” ingredients back to its original water content. Now your packaging can say: 250 grams of vegetable inside! Even if the product itself only weighs 150 grams. Get it?

Trick number seven:
A pile of evidence tells us that milk is not an essential product everyone should eat. In fact, a lot of scientists say milk is not good for anyone, except the milk of your mother the first year of your life. But there is a big industry around milk products, thus there is a big political lobby around it too. As long as we believe it is healthy they can stay in business. How about that?

Trick number eight:
Switch from regular to biological or ecological ingredients. We consumers actually think the product is healthier. Or make it fair trade or bio dynamic. For us it is all the same; it takes our guilt away.

Trick number nine:
Investing a lot of money in governmental organizations who are seen as an authority helps. They can tell all the consumers your product fits in a healthy diet. Bribing famous persons who are seen as an authority helps as well. Unless they are fat, this makes them less convincing.

Trick number ten:
Add some kind of bacteria nobody has ever heard of to your product and show a lot of fit bellies in the commercial. Even better, make up a name for a new lab created bacteria, so no one else can use it. I’ll bet we believe we get a flat belly and a more regular stool as well.

via Dennis Favier: 10 tricks for making packaged food look healthy.

New York Times, February 25, 2013

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study has found.

The findings, published on The New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.

“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “And the really important thing — the coolest thing — is that they used very meaningful endpoints. They did not look at risk factors like cholesterol or hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”

Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.

And some experts had been skeptical that the effect of diet could be detected, if it existed at all, because so many people are already taking powerful drugs to reduce heart disease risk, while other experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have a lot of calories.

Heart disease experts said the study was a triumph because it showed that a diet was powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, or had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.

Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality borne out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.

“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”

The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there.

In the end, they decided to randomly assign subjects at high risk of heart disease to three groups. One would be given a low-fat diet and counseled on how to follow it. The other two groups would be counseled to follow a Mediterranean diet. At first the Mediterranean dieters got more intense support. They met regularly with dietitians while members of the low-fat group just got an initial visit to train them in how to adhere to the diet, followed by a leaflet each year on the diet. Then the researchers decided to add more intensive counseling for them, too, but they still had difficulty staying with the diet.

One group assigned to a Mediterranean diet was given extra-virgin olive oil each week and was instructed to use at least 4 four tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least seven glasses of wine a week with meals.

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

Read the rest of the article via Mediterranean Diet Can Cut Heart Disease, Study Finds – NYTimes.com.

February 23, 2013

In January, when the Journal of the American Medical Association (JAMA) published a meta-analysis of 100 studies that probed the relationship between body mass index and mortality — studies that found slightly overweight people have lower all-cause mortality than normal weight and underweight people — media around the globe trumpeted the news.

Many suggested that scientists had failed to understand something crucial about health, and questioned whether carrying extra weight might be healthier than being slim.

“When I read the article I was somewhat taken aback. I wondered if I should send a ‘never mind’ note to all the people I’d taught about the risks of excess fat,” said Jeffrey S. Flier, dean of the Faculty of Medicine, at Harvard Medical School (HMS) and an authority on the biology of obesity and diabetes.

He wasn’t alone. Many others were perplexed by the findings gathered by Centers for Disease Control (CDC) epidemiologist Katharine Flegal, which contradict a preponderance of research indicating that there is a direct correlation between the risk of mortality and being overweight once factors such as lower weight from cigarette smoking, chronic disease, and wasting from frailty in the elderly are taken into account.

To clear up the confusion, Flier worked with Julio Frenk, dean of the Harvard School of Public Health (HSPH), to convene a panel of experts at HSPH on Feb. 20 to discuss the findings with the HMS and HSPH communities. Flegal, a senior scientist at the CDC’s National Center for Health Statistics, was invited to the event, but did not attend.

Information in context
“We live in an era of near-ubiquitous access to information,” Frenk said, “but the University has an important role to play in providing context and analysis to help people judge the value of information they are consuming, especially when there are equivocal or controversial findings.”

The panelists evaluated Flegal’s findings and pointed out a number of methodological errors in the study that they said resulted in the artificial appearance of a protective benefit in being overweight or mildly obese.
“When something sounds too good to be true, it’s usually not true,” said Frank Hu, HSPH professor of nutrition and epidemiology and HMS professor of medicine.

Methodological errors
The selection criteria that Flegal used for her meta-analysis ruled out high-quality studies of 6 million people (more than twice as many as were represented in her analysis), said Hu. These studies, in aggregate, show that the highest survival rates are in normal weight people, not the overweight, Hu said.

The studies that Flegal did use included many samples of people who were chronically ill, current smokers and elderly, according to Hu. These factors are associated with weight loss and increased mortality.

In other words, people are not dying because they are slim, he said. They are slim because they are dying—of cancer or old age, for example. By doing a meta-analysis of studies that did not properly control for this bias, Flegal amplified the error in the original studies.

There is also no known biological basis for any protective effect from being overweight, the panelists said, citing studies that show a clear connection between being overweight and conditions such as hypertension and insulin resistance, which are risk factors for coronary heart disease, stroke and several cancers.
“Even as you get near the upper reaches of the normal weight range, you begin to see increases in chronic diseases,” said JoAnn Manson, chief of the Division of Preventive Medicine, Brigham and Women’s Hospital, HMS Michael and Lee Bell Professor of Women’s Health, and HSPH professor of epidemiology. “It’s a clear gradient of increase. There is no evidence here of any global protective factor for being overweight.”

Flegal responded in an email to the criticisms by saying that she stands by her findings, which she noted had withstood review by the CDC, the National Institutes of Health and the editors and four of five reviewers at JAMA. She said that her team looked at 7,000 articles already in the medical literature.
“We explicitly included studies that were prospective studies of adults that looked at all-cause mortality with BMI measured or reported at baseline and that used the standard international categories of BMI … used by the World Health Organization and the U.S. government,” Flegal said.

Credibility of science
Panelists, however, expressed concern that much of the popular journalism and commentary about Flegal’s research could undermine the credibility of science, citing articles that show studies wavering between alternating conclusions, and opinion pieces suggesting that researchers have some conspiratorial interest in making people feel bad about their weight or lifestyle choices.

Translating the nuances of these and other critically important findings to the public, practitioners and policy makers is part of the core mission of a university, Frenk said.

“The role of the university is not to shy away from controversy but to embrace it. Protecting the credibility of science becomes very important,” Frenk said.
Steven Heymsfield, the George A. Bray Jr. Endowed Super Chair in Nutrition and executive director of the Pennington Biomedical Research Center, who co-authored a JAMA editorial that accompanied Flegal’s findings, noted that BMI alone could not provide a definitive assessment of the health of any given individual.

He said, “Misleading data on BMI and mortality conveys an erroneous message to the public and practitioners that being overweight does not have major consequences.”

Walter Willett, the Fredrick John Stare Professor of Epidemiology and Nutrition and chair of the Department of Nutrition at HSPH, and HMS professor of medicine, said it is important for people to have correct information about the relationship between health and body weight.

“If you don’t have the right goal you are very unlikely to end up in the right place,” Willet said.

The panel was presented by the HSPH Department of Nutrition. This article first appeared on the Harvard Medical School news website on Feb. 22.
Weight and mortality | Harvard Gazette.

February 25, 2013 Harvard School of Public Health

Boston, MA – A new poll released today shows a large gap between parents’ perceptions of their children’s weight and expert definitions. According to their parents, 15% of children are a little or very overweight, while national data suggest more than twice as many, or 32% of all children, are overweight or obese. The poll was conducted by NPR, the Robert Wood Johnson Foundation (RWJF), and Harvard School of Public Health (HSPH).

In addition, only 20% of children in households that participated in this poll had a parent who was concerned that his or her child will be overweight as an adult. However, it is estimated that 69% of adults are overweight, including 36% who are obese and an additional 6% who have “extreme obesity.” Together, these results indicate that parents may underestimate their children’s current risk for being overweight or obese, and how that risk could continue to impact them as adults.

View complete survey

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“We know that nearly one in three kids in America is overweight or obese, and that’s a national emergency,” said Risa Lavizzo-Mourey, RWJF president and CEO. “Better nutrition and more physical activity can help turn this epidemic around, and parents have a unique role to play. Knowing the risks of obesity and dealing with the issue proactively can improve kids’ health now and prevent serious problems down the road.”

The poll assesses a nationally representative sample of children ages 2 to 17 through the eyes of their parents or caregivers who know what the youths ate, drank, and did the day before the poll.

“People often have a hard time making the connection between national problems and their own families,” said Gillian SteelFisher, assistant director of the Harvard Opinion Research Program (HORP) and research scientist in the HSPH Department of Health Policy and Management. “Tackling these blind spots can be a difficult, even if necessary, element of public education.”

Despite its importance, many face challenges in helping children maintain or achieve a healthy weight

Although nearly all parents agree it’s important for their children to eat and exercise in a way that helps them maintain or achieve a healthy weight, many parents find it difficult to do. More than four in 10 children (44%) have parents who say it is difficult to make sure their kids eat this way, and roughly a third of children (36%) have parents who say it is difficult to make sure their kids exercise this way.

Between 3 p.m. and bedtime, children consume foods and drinks that can lead to unhealthy weight gain, according to parents. When examining what children ate in the afternoon, during family dinners, and after dinner during the school week, the poll found that more than half of children (60%) ate or drank something that can lead to unhealthy weight gain, as perceived by their parents.

In trying to help their children maintain or achieve a healthy weight overall, parents face problems in the community. For 43% of children, parents say the amount of advertising of foods that can lead to unhealthy weight gain presents a problem for them in trying to help their child achieve or maintain a healthy weight. For roughly a third of children, parents report that they face the following problems: many such foods are offered at lunch at school (33%); the costs of exercise equipment, gym memberships, or team fees is too high (33%); there aren’t good sidewalks near home, so the family drives instead of walking (31%); and there are few places that do not serve these foods where the child can spend time with friends (31%).

“These problems parents face are issues that community leaders can address with policy changes,” saidRobert Blendon, professor of health policy and political analysis at HSPH.

Family dinners may include challenges that contribute to obesity and overweight

Even among those who ate together at home, many were distracted by TV, cell phones, laptops, or iPods.While 70% of children live in households where the family ate dinner together at home on a given night, 24% had the TV on during dinner, or someone used a cell phone, a laptop, or an iPod during dinner. This means only 46% of children live in households where the family ate together without these distractions.Research suggests that meals without distractions, particularly TV, are associated with lower obesity rates.

Common family events may contribute to childhood obesity and overweight

Many children have parents who say foods and drinks that can lead to unhealthy weight play an important role in family events. Nearly all children (96%) attended family events in the past year where foods with high fat or sugar content, like chips, fried foods, fast foods, or sweets were served. Among those children, approximately half live in households where the parent feels that “family celebrations are a time to take a break from being concerned about eating in a way that can lead to unhealthy weight gain” (48%). Sizable shares of these children live in households where these foods are felt to be “an important part of family traditions” (39%) and where “it doesn’t feel like a celebration” without them (32%).

Read more via: Harvard School of Public Health » HSPH News » Poll finds big gap between parents and experts: Parents less likely to recognize children as overweight or obese.

“What I found, over four years of research and reporting, was a conscious effort — taking place in labs and marketing meetings and grocery-store aisles — to get people hooked on foods that are convenient and inexpensive. I talked to more than 300 people in or formerly employed by the processed-food industry, from scientists to marketers to C.E.O.’s. Some were willing whistle-blowers, while others spoke reluctantly when presented with some of the thousands of pages of secret memos that I obtained from inside the food industry’s operations. What follows is a series of small case studies of a handful of characters whose work then, and perspective now, sheds light on how the foods are created and sold to people who, while not powerless, are extremely vulnerable to the intensity of these companies’ industrial formulations and selling campaigns.”

Read the rest of this amazing article via:

The Extraordinary Science of Addictive Junk Food – NYTimes.com.

Harvard School of Public Health, February 7, 2013

Pizza and cheese are the biggest food sources of saturated fat in the U.S. diet, and other dairy products and meat products are also are also major contributors. Keep in mind that all foods contain a mix of fats. Even “healthy” foods like chicken, fish, nuts, and oils do contribute some saturated fat to the diet, though they are much lower in saturated fat than beef, cheese, and ice cream. And it would be a mistake to cut back on nuts, oils, and fish to minimize saturated fat.

As a general rule, it’s a good idea to keep your intake of saturated fats as low as possible. We can’t eliminate saturated fat from our diets completely, because foods that are good sources of healthy fats—olive oil, peanuts, salmon—also contain a little bit of saturated fat. Since red meat and full-fat dairy products are among the main sources of saturated fat in our diets, keeping these foods low is the best way to reduce intake of saturated fat. And when you cut back on red meat and dairy products, replace them with foods that contain healthy fats—fatty fish like salmon, nuts and seeds, plant oils, avocadoes—not with foods that are high in refined carbohydrates. Here is a table showing the top food sources of saturated fat in the American diet.

Source: National Cancer Institute. Risk Factor Monitoring and Methods: Table 1. Top Food Sources of Saturated Fata among U.S. Population, 2005–2006. NHANES.

Harvard School of Public Health » The Nutrition Source » Top Food Sources of Saturated Fat in the U.S..

January 10, 2013, Liz Szabo, USA Today

Americans live sicker and die younger than people in other wealthy countries — and the gap is getting worse over time, a new report shows.

Men in the USA have shorter lives than men in 16 developed nations. American women also fall near the bottom of the list, living 5.2 fewer years than Japanese women, who live the longest.

Americans “have a long-standing pattern of poorer health that is strikingly consistent and pervasive” over a person’s lifetime, says the report, from the Institute of Medicine and the National Research Council, independent, non-profit groups that advise the federal government on health.

“The tragedy is not that the United States is losing a contest with other countries,” the report says, “but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.”

Family physician Steven Woolf, who chaired the panel that wrote the report, said authors were “stunned by these findings.”

The report’s most important purpose, Woolf says, is to alert Americans to these problems. “Our sense is that Americans don’t really know about this,” says Woolf, a professor at Virginia Commonwealth University in Richmond. “I don’t think people realize that their children are likely to live shorter lives than children in other countries.”

Most of the difference between male Americans’ longevity and that of their peers is due to deaths before age 50, with many problems rooted in poor childhood health, according to the report, published online Wednesday.

The USA has had the highest infant mortality rate of any developed country for several decades, due partly to a high rate of premature birth. With more than one in five American children living in poverty, the USA also has the highest child poverty rate, the report says.

The USA ranks at or near the bottom in nine key areas of health: low birth weight; injuries and homicides; teen pregnancy and sexually transmitted infections; HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and general disability.

These poor outcomes are especially depressing, because the USA spends twice as much on healthcare — about $9,000 per person — as other industrial countries, says Gerard Anderson of the Johns Hopkins School of Public Health, who was not involved in the report.

Authors examined health by income and race, Woolf says, to ascertain whether Americans’ overall low health scores were mostly due to the poor health among minorities and low-income Americans. Many studies have noted stark disparities in health between whites and blacks, for example.

Yet even wealthy, white Americans fare worse than their equally wealthy counterparts in other countries, Woolf say….

Read the rest of this article via Americans die younger than others in rich nations.

January 9, 2013, Melissa Healy, Los Angeles Times

After all those well-intentioned New Year’s resolutions have yielded to the force of habit, many of the nation’s 79 million obese adults will have a day of reckoning with their primary care physicians.

Lose weight and get active, the doctor will order, or risk developing diabetes. Then the MD will scribble a prescription.

For most patients, the prescribed treatment will not be a pill. It will be a 12-week program aimed at preventing Type 2 diabetes by getting obese adults to shed as little as 10 pounds and exercise for a little more than 20 minutes a day.

That regimen — the Diabetes Prevention Program — may soon become the blockbuster prescription medicine you’ve never heard of. In 2013, it is poised to become the envy of pharmaceutical companies, a new rival to programs such as Weight Watchers, and a target of opportunity for healthcare entrepreneurs.

Led by a trained coach, it is a testament to the power of a mentor and of setting modest goals in spurring healthful behavior. And it may be a crucial first test of the Affordable Care Act’s focus on preventive health.

In nearly 30 clinical trials, scientists have established that the program is far more effective at helping people lose weight and prevent or delay the onset of diabetes than “usual care” — essentially, a doctor telling a patient to slim down and get active, and then sending him on his way. But the program hasn’t been packaged in a form that healthcare providers can simply and cheaply offer to patients, said Dr. Jun Ma of the Palo Alto Medical Foundation Research Institute, who studies diabetes prevention.

The Diabetes Prevention Program is not rocket science. In 12 weekly sessions, a coach teaches obese subjects at high risk of developing diabetes to set goals for losing 5% to 7% of their body weight, limit the fat and calories they consume, track their food intake, get at least 150 minutes of exercise each week, and devise strategies to avoid gaining back lost pounds.

In trials, subjects who attended the tightly scripted sessions and followed the regimen were far more likely than those who were on their own to reach their weight-loss goals in three months — and to keep that weight off for more than a year. By doing so, they drove down their risk of developing Type 2 diabetes by 58%, according to a landmark report published in the New England Journal of Medicine in 2002.

The program, in short, is powerful medicine.

“If you could take it as a pill, it would definitely be commercialized,” said Sean Duffy, a software designer and former Google employee who launched an online version of the program about a month ago…

Read the entire  article via Weight-loss regimen a preferred choice for countering diabetes – latimes.com.