Maximum Wellness: Recent Episodes
Mackie Shilstone
Mackie Shilstone has been the sports performance, fitness, and wellness consultant of choice to thousands of top athletes – such as Serena Williams, Peyton Manning, Ozzie Smith, Roy Jones Jr, and Bernard Hopkins – to name a few. Mackie’s helped them all.Now you can look to Mackie—a name you can trust—and his weekly Maximum Wellness podcast to sort through the mountains of daily health misinformation to provide you accurate summaries of the most important wellness findings… news that can put you the right path to health ownership.
Understanding a person’s metabolism – the process in which the body converts food consumed into fuel to expend during all of its functions – is a key component to any successful weight/fat loss program. Resting metabolic rate (RMR) represents roughly 65% of all the calories a person expends during a day - keeping the heart beating, temperature control, breathing, and circulation activities.
Some people have a fast metabolism – one that effectively processes and converts the food you eat into energy, versus a slow metabolism that stores more of the energy from daily food intake.
RMR, also referred to as basal metabolic rate (BMR) - is the total amount of calories that a human body requires to maintain itself.
Other metabolic components include the thermal effect of eating – the energy cost of chewing, digesting, and absorbing nutrients, which increases the RMR by 5 to 15%; physical activity expenditure – daily exercise - that adds another 15 to 30% to RMR; and non-exercise activity thermogenesis (NEAT), that represents walking, sitting down, getting up, and any restless-type activity.
During my thirty years of multiple hospital-affiliated sports performance, fitness, and wellness programs, we measured a person’s RMR using a metabolic cart, which was also used to determine their ventilatory threshold and maximum endurance capacity – all factored into a client’s macro-nutrient intake and exercise guidelines to reduce excess weight and body fat, while preserving or increasing lean muscle.
There are equations that have been used to compare against the RMR measurements.
Harris-Benedict (HB):
- Men: (13.75 x W) + (5 x H) – (6.76 x A) + 66
- Women: (9.56 x W) + (1.85 x H) – (4.68 x A) + 655
- Weight (W) is in kilograms
- Take your weight in pounds / 2.2 = weight in kilograms
- Height (H) is in centimeters
- Take your height in inches x 2.54 = height in centimeters
- A = age
The main issue with the HB calculation is that it does not take into consideration your increase or decrease in lean body mass (muscle).
A more accurate formula is the Cunningham equation:
- RMR = 500 + (22 x LBM in kilograms).
This formula requires obtaining a body composition from a DXA scan or the use of body composition devices, like bio-impedance, and skin calipers (less accurate with obese individuals). You divide your LMB in pounds by 2.2 to get kilograms.
If you would like to learn more about metabolic rate, check out maxwellnutrition.com. You can also find information on other RMR formulas at
https://www.lizino.net/facts-about-resting-metabolic-rate/
The Journal of the American College of Cardiology reported on the results of a modeling study in August 2022 that concluded, “the association of CRF (cardiorespiratory fitness) and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness.”
The study – "Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex" – further concluded that, “being unfit carried a greater risk than any of the cardiac risk factors examined.”
The study group included a diverse group – age, gender, and race – of 750,302 U.S. veterans aged 30 to 95, who were followed for a median of 10.2 years. Age and gender-specific CFR categories were created based on peak MET (metabolic equivalent) achieved on a standardized treadmill test – one MET equal to 3.5 ml/kg/min.
According to the study investigators, “the lowest mortality risk was observed at approximately 14.0 METs for men and women, with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher compared with extremely fit individuals.”
In a related editorial, my friend, Cardiologist, Carl (Chip) J. Lavie, MD, whom I worked closely with during my tenure as Director of Health and Fitness for the Ochsner Heart and Vascular Institute, commented, “indeed, "improving CRF should be considered a target in CVD prevention, similar to improving lipids, blood sugar, blood pressure, and weight.”
If you would like to read the abstract from this study, here’s the link.
https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.05.031
For more detailed information on similar studies, go to maxwellnutrition.com.
Sarcopenia is the aging loss of lean muscle, resulting from a loss of strength – dynapenia – and a related anabolic resistance – the inability to regenerate lean muscle at the same rate, as a younger individual. This degenerative process can begin without interventions, such as increased protein intake and resistance training, in the fourth decade and accelerate after the age of sixty.
New research – Dietary Protein Intake Is Positively Associated with Appendicular Lean Mass (ALM) and Handgrip Strength Among Middle-Aged US Adults - published in the December issue of the Journal of Nutrition, comments that, “protein intake predicts skeletal muscle mass and strength among older adults, but knowledge of similar associations among middle-aged adults is lacking.”
In order to determine the effect of protein intake on lean mass maintenance in middle-aged adults, researchers from Purdue University in Indiana, assessed appendicular lean mass, adjusted for BMI (body mass index), and handgrip strength data from 1209 men and women from 2011 to 2014 aged 40 to 59 years of age. ALM is the sum of lean tissue in the arms and legs.
Daily protein intake per kilogram of body weight was determined by two- 24-hour recalls. The participants protein intake was broken into three categories: less than the recommended daily allotment of 0.8 grams per kilogram (2.2 pounds) of body weight; moderate protein intake of between 0.8 to 1.2 g/kg/; and high at greater than 1.2 g/kg.
The ALM - the sum of lean tissue in the arms and legs - was assessed by DXA Scans and handgrip strength. The investigators used the National Institutes of Health criteria for the ALM to define the categories of “low lean mass and “weakness.”
The results reflected, “among middle-aged adults, 15.6% of men and 13.4% of women had low lean mass and 3.5% of men and 2.3% of women exhibited weakness.”
It was further determined that, compared with the moderate protein group, the high protein group had a higher handgrip strength and the low protein group had lower grip strength among men and women.
The researchers concluded that higher protein intakes were associated with greater ALM and handgrip strength relative to BMI. The take-away is that a protein intake above the recommended daily intake of 0.8 g/kg/day, may need to be increased after the age of 40.
Dementia, which globally effected over 50 million people in 2019, is characterized by a progressive and unrelenting deterioration of mental capacity – compromising everyday activities.
Dementia is a symptom of underlying brain degeneration caused by vascular disease or traumatic brain injury, such as from accidents or contact sports like American football, brain tumors, and the list goes on.
Dementia is classified into two distinct areas: Alzheimer disease and vascular dementia. Since a stroke doubles the risk of developing dementia, it’s estimated that more than a third of the dementia cases could be prevented by reducing the risk to a stroke.
According to research – Consumption of Coffee and Tea and the Risk of developing Stroke, Dementia, and Post-Stroke Dementia: A Cohort Study, which appeared in December 2021, in the open access, peer-reviewed journal Plos Medicine, “epidemiological and clinical studies have shown the benefits of coffee and tea separately in preventing dementia. However, little is known about the association between the combination of coffee and tea and the risk of dementia.”
Chinese researchers sought to investigate the associations of coffee and tea separately and in combination with the risk of developing stroke, dementia, and poststroke dementia, based on data from a large population-based cohort – the UK, a population-based cohort study that recruited more than 500,000 participants (39 to 74 years old), who attended 1 of the 22 assessment centers across the UK between 2006 and 2010.
365, 682 participants reported their coffee and tea consumption. The researchers determined that, “coffee intake of 2 to 3 cups/day or tea intake of 3 to 5 cups/day, or their combination intake of 4 to 6 cups/day were linked with the lowest hazard ratio (HR) of incident stroke and dementia.”
It was also determined that consuming 2 to 3 cups of coffee with 2 to 3 cups of tea daily were associated with a 32% lower risk of stroke and a 28% lower risk of dementia – with the intake of coffee alone or in combination with tea being associated with lower risk of poststroke dementia.
The Chinese investigators concluded that, “our findings support an association between moderate coffee and tea consumption and risk of stroke and dementia. However, whether the provision of such information can improve stroke and dementia outcomes remains to be determined.”
In August of 1985, I designed and implemented the performance nutrition and conditioning plan that transformed the former undisputed World Light Heavyweight Champion Michael Spinks from his light heavyweight weigh-in weight of 175 pounds to 200 pounds.
On September 21st, Spinks won a 15-round historic victory over the reining, undisputed World Heavyweight Champion Larry Holmes. Previously, no light heavyweight boxer had ever successfully moved up and beaten the world heavyweight champion. Both Spinks and I made history on that night.
Losing scale weight, while preserving or increasing fat free mass (FFM), can be quite challenging, as any bodybuilder can attest to.
Researchers from the University of Alicante in Spain and California State University in Northridge, California published research – Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review – in the September 2021 issue of the journal Nutrients.
The researchers used a literature review to develop an evidence-based overview of dietary-nutritional strategies for the loss of fat mass (FM) and maintenance of FFM in resistance-trained athletes.
The first area of concern is caloric intake, which for resistance athletes, “should be set based on a target BW (body weight) loss of 0.5–1.0%/week, in order to maximize retention of FFM.” The researchers point out that athletes with an initial lower percentage of body fat should take a more conservative approach to caloric restriction (CR).
As for protein intake, 2.2–3.0 grams/kilogram of body weight per day (g/kg BW/day) should be distributed throughout the day in three–six meals and ensuring in each of them an adequate amount of protein (0.40–0.55 g/kg BW/intake), note the investigators.
Relative to integrating protein intake around resistance training, “an intake 2-3 hours before training and another 2-3 hours post-training is preferable.”
Carbohydrate consumptions needs to be adapted to the athlete’s activity level, in order to support the energy demands of the training (2–5 g/kg BW/day). “Individuals, who wish to engage in more severe CHO restriction (e.g., ketogenic conditions),” comment the researchers, “may increase the risk of FFM loss, despite a similar capacity to preserve strength.”
The fat macro-nutrient intake should ensure a minimum of greater than or equal to 0.5 grams per kilogram of BW per day.
From a micronutrient standpoint, the researchers point out that there is a need to overcome any potential deficiencies in vitamin B1, B3, B6, vitamin D, and the minerals magnesium, calcium, zinc, and iron.
A good starting point is to use a multivitamin/mineral formula containing, note the researchers, 10 or more vitamins and minerals at recommended daily intake levels in healthy people.
Creatine - produced naturally in the body from the amino acids glycine, methionine and arginine - is used in the phosphocreatine energy system in explosive activities lasting 0–10 seconds.
The researchers comment that, “athletes may benefit from creatine supplementation indirectly, since it has been observed that creatine supplementation in combination with strength training could increase the training-induced proliferation of satellite cells and myonuclei in skeletal muscle, resulting in increased muscle fiber growth.”
For more information about developing a creatine muscle gain protocol in conjunction with your physician, I refer you to my book, Lean & Hard, the body you’ve always wanted in 24 workouts (John Wiley & Sons).
Read the rest at maxwellnutrition.com ...
Researchers from multiple departments of Boston University report in October 2021 in JAMA Network Open that a higher midlife estimated cardiorespiratory fitness level was associated with a lower burden of subclinical atherosclerosis and vascular stiffness, along with a lower risk of hypertension, diabetes, chronic kidney disease, cardiovascular disease, and mortality.
Vascular stiffness refers to left ventricular afterload and the resulting coronary perfusion – leading to cardiovascular disease (CVD). It’s measured by pulse wave velocity (PWV), which can slow with aging – leading to systolic (top blood pressure number) hypertension.
Prior research has shown that a higher CRF level lowers the risk to CVD and all-cause mortality by itself and/or in conjunction with other CVD risk-reduction measures, such as with the Mediterranean eating strategy and weight control.
The American Heart Association recommends that primary care physicians assess CRF in their clinical practices.
As referenced in the Boston University research – Association of Estimated Cardiorespiratory Fitness in Midlife with Cardiometabolic Outcomes and Mortality – “CRF is measured via cardiopulmonary exercise testing; however, this method requires in-person assessment with specialized equipment and trained personnel, rendering it expensive and less accessible.”
Luckily, non-exercise estimated CRF (eCRF) algorithms have been developed using readily available clinical information, such as age, sex, waist circumference, resting heart rate, and physical activity.
In my former hospital-affiliated sports performance, fitness, and wellness programs, we used 12-lead EKG cardiopulmonary VO2 max testing – with a cardiologist interpretation of the data to determine the appropriate heart rate training intensity zones for both athlete and non-athlete.
As for the eCRF, I have successfully used the Polar algorithms and heart rate monitoring devices (polar.com) to provide guidance to members of the US Army Special Operations Command.
Cardiovascular disease (CVD) is still the leading cause of death worldwide. The good news is that modifying CVD risk factors, such as an unhealthy diet, physical inactivity, not smoking, and limiting alcohol intake, can reduce the risk to complications, an early demise, or unnecessary risk to Covid-19 and its pervasive variants.
A recent study – "Using an Erythrocyte Fatty Acid Fingerprint to Predict Risk of All-Cause Mortality: The Framingham Offspring Cohort "– appearing in the June 2021 online issue of the American Journal of Clinical Nutrition (AJCN), sought to compare a combination of RBC (red blood count) FA (fatty acid) levels in predicting all-cause mortality.
Those biomarkers included the FA’s measured in blood plasma and RBC membranes, specifically looking at the omega-3’s EPA, and DHA - which are most notably associated with reduced risk to CVD. Those referenced FA’s are found in fish oil and walnuts, among other dietary sources.
The study also references a 2018 report, which included 2500 participants in the Framingham Offspring Cohort, who were followed for a median of 7.3 years (i.e., between ages ∼66 and 73 y) – with a baseline RBC EPA + DHA content [the omega-3 index]. A higher omega-3 index was significantly and inversely associated with risk for death from all causes.
Those, “individuals in the highest quintile were 33% less likely to succumb during the follow-up years compared with those in the lowest quintile,” comments the AJCN.
There have been similar associations seen in the Women's Health Initiative Memory Study, the Heart and Soul Study, and the Ludwigshafen Risk and Cardiovascular Health Study. However, these prior investigations evaluated only one FA metric, as an exposure variable.
The Framingham Offspring Cohort participants (2240 eligible), who had RBC fatty acid measurements and relevant baseline clinical covariates, were without prevalent cardiovascular disease. The participants were evaluated during eleven years of follow-up looking specifically at the association with eight standard risk factors (age, sex, total cholesterol, HDL cholesterol, hypertension treatment, systolic blood pressure, smoking status, and prevalent diabetes) and 28 FA metrics with all-cause mortality.
The bottom line is that a physician can now assess the patient’s FA levels - along with their medical history and other appropriate lab values - to prescribe or recommend the appropriate intake level of supplementary omega-3’s – prescription or over the counter preparations.
New research – "Mild Cognitive Impairment and Dementia Reported by Former Professional Football Players over 50 Years of Age, An NFL-Long Study", which appeared in the March 2022 issue of Medicine & Science in Sports & Exercise, reports on the increased risk that former NFL players over the age of 50 have for mild cognitive impairment (MCI)
A diverse group of researchers from the Department of Exercise and Sports Science and Center for the Study of Retired Athletes, University of North Carolina and the Department of Neurosurgery/Neurology, Medical College of Wisconsin, among others, concluded that, “Self-reported MCI prevalence and dementia prevalence were higher in former NFL players than national estimates and were associated with numerous personal factors, including mood-related disorders and a high number of self-reported concussions.”
The estimates of MCI risk in Americans is 24 to 32%. While not completely understood, the risk seems to be related to be age, race, social, educational, health status (osteoarthritis and cardiovascular disease) and mood (depression).
The investigators comment that, “Traumatic brain injury (TBI) may also increase risk for developing MCI and dementia-related disorders. With respect to sport-related TBI, the prevalence of MCI may be higher in former National Football League (NFL) players with three or more self-reported concussions compared with those with fewer, but not necessarily for Alzheimer’s disease (AD).”
The overall incidence of AD in former NFL players is higher than for the average American man – with the greatest disparity tied to males under 70 years old.
Based on the need to clarify a retired NFL players risk to MCI, after the age of 50, the investigators contacted 15,025 former NFL players of all ages. Former players were eligible for the study, if they had at least one full season and were 50 years or older. They were asked to complete an online questionnaire or paper hard copy.
The justification by the researchers for a 50-year old cutoff age was that, “It represents the lower-bound age in which neurodegenerative diseases with typical earlier onset first occur (e.g., early onset/autosomal AD, behavioral variant of frontotemporal dementia).”
The questionnaire used was expanded from a prior questionnaire in an ongoing study – Neurologic Function Across the Lifespan: A Prospective, Longitudinal, and Translational Study for Former National Football League Players (NFL-Long).
The questionnaire examined the general health of former NFL players, while also acquiring information regarding the former player’s personal demographics; football playing history; medical history; concussion history; musculoskeletal injury history; self-reported psychological, physical, and cognitive functioning; health-related quality of life; and current substance use-and health-related behaviors.
It was determined that, “In this subset of former NFL players, history of 10 or more sport-related concussions, lifetime diagnoses of depression and/or anxiety, and greater recent pain intensity were each associated with higher prevalence of MCI and dementia.”
In addition, “Sleep apnea was also associated with a greater prevalence of MCI. Older age and self-identifying as non-White were associated with a greater prevalence of dementia.”
As to the implications, “This study, concluded the researchers, “suggests that there may be preventative and therapeutic targets that might mitigate the onset of MCI or dementia-related disorders.”
If you would like to read this study and /or order nutritional products made and sourced in the US – carrying the Good Manufacturing Practices (GMP) designation, and meeting purity standards, go to maxwellnutrition.com.
CDC.gov says that each year millions of people over 65 years of age fall – with one out of five causing serious injury, such as broken bones, or head injury, while three million older individuals are treated in emergency rooms for fall injuries. Over 800,000 older patients are hospitalized due to fall injury – most often head and hip trauma.
Researchers from the faculty of Kinesiology, University of Regina and College of Kinesiology, University of Saskatchewan in Canada report that interventions, “which improve radius and tibial bone geometry and muscle density (MuD) in the surrounding areas may be clinically important for decreasing the risk of falls and fractures in older adults.”
The Canadians writing – Efficacy of Creatine Supplementation and Resistance Training on Area and Density of Bone and Muscle in Older Adults – which appeared in the November 2021 issue of Medicine & Science in Sports & Exercise, reference that, “creatine (Cr) supplementation (methylguanidine-acetic acid) during supervised whole-body resistance training (1 yr) decreased the rate of areal bone mineral density (aBMD) loss in the femoral neck and increased femoral shaft subperiosteal width compared with placebo in postmenopausal women.”
There is a lack of research looking into the effect of oral creatine monohydrate supplementation with or without resistance training (RT) on cortical and trabecular bone structure properties in older individuals. It’s known that resistance training supports bone structure and remodeling, irrespective of concurrent creatine supplementation.
Therefore, the Canadians chose to investigate the efficacy of Cr supplementation relative to sex differences under supervised, whole-body RT on properties of bone and muscle in older adults.
Seventy participants – 39 men and 31 women with an average age of 58 years - were randomized to supplement with Cr at 0.1 grams per kilogram/day, or placebo (Pl) during three days per week of whole-body resistance training for one year.
Bone geometry (radius and tibia) and muscle area and density (forearm and lower leg) were assessed using peripheral quantitative computed tomography.
The primary exercises placed specific strain on regions of the forearm (i.e., radius) and lower leg (i.e., tibia), which included dumbbell wrist pronation and supination, lever machine elbow flexion and ankle plantarflexion and plate-loaded tibia dorsiflexion. Secondary exercises included the hack squat, hip (abduction, adduction, flexion, and extension), leg curl, leg extension, low-back extension, chest press, lat-pull.
The Canadians determined that, “older adults who supplemented with Cr experienced a significant increase in lower-leg MuD compared with those on placebo, which may be important because low MuD is an independent risk factor for falls and disability in older adults.”
It was concluded that, “1 yr of Cr supplementation (0.1 g·kg−1·d−1) and supervised resistance training increased total bone area in the tibia and lower leg MuD in older adults.”
If you would like to read this study and order creatine monohydrate made in the US, under good manufacturing practices (GMP) and third-party tested, go to maxwellnutrition.com.
In light of the ongoing, world-wide death rate attributed to Covid-19, combining a healthy lifestyle with recognized medical interventions – vaccines and medications – is critical to address the current and future pandemics.
Healthy interventions include physical activity, following an anti-inflammatory eating plan – emphasizing fruits, vegetables, omega-3 fish (Mediterranean diet) - minimizing the effects of Covid-associated stress (diminished social interaction), and developing healthy sleep patterns.
These interventions can go a long way to support people with obesity, hypertension, diabetes, and pulmonary dysfunction, who are at higher risk of Covid severity.
Researchers from Spain, reporting in the December online issue of the peer-reviewed journal Nutrients, highlight the role how holistic lifestyles interventions have proven to attenuate the effects of Covid-19 in the “exposome” – life-course exposures starting from the prenatal period onward.
Roughly one-quarter of the world’s population is considered inactive – not achieving 150 minutes of weekly, moderate activity, or 75 minutes of vigorous activity. Social distancing and lockdowns have only acerbated inactivity out of necessity.
The Spanish researchers comment that, “regular PA (physical activity) is associated with a 31% and 37% risk reduction of community-acquired infectious diseases and subsequent mortality, respectively, compared to inactive controls.”
According to their investigation, The Exposome and Immune Health in Times of the COVID-19 Pandemic, “even just four weeks of either moderate-or high- intensity interval exercise can lead to a remarkable improvement in natural killer (NK) cell number and function (i.e., ‘killing capacity’).”
The researchers further site evidence that, “elderly women who were physically active had a better immune response after vaccination than those who were less active.”
From a body weight management perspective, the worldwide prevalence of obesity has almost tripled since 1975, with 39% and 13% of adults now considered to have overweight and obesity, respectively.
There is meta-analytical evidence, “that individuals with obesity are not only at greater risk of COVID-19 infection, but also of having a worse prognosis (higher risk of severe disease and mortality) than their normal-weight peers,” note the Spanish researchers.
The researchers conclude that, “body weight management should be a key public health concern in the prevention/management of the current COVID-19 pandemic.”
Research have proven that when overweight individuals switch from a 14-hour eating window to ten to an eleven-hour eating duration over 16 weeks, they reduce their energy intake by 20% and demonstrated a reduction in body weight.
Simply stated, “due to its antioxidant, anti-inflammatory and immunomodulatory benefits, and its protective effect against predictors of morbidity and mortality in patients with COVID-19, such as CVD (cardiovascular disease), the Mediterranean diet could be a promising and relatively easy-to-apply method to attenuate the severity of SARS-CoV-2 and eventual future viral pandemics.”
While micronutrients, such as Vitamins A, C, B complex, and the minerals zinc and selenium deserve immune support recognition relative to Covid-19, Vitamin D may stand alone for its ability to provide adaptive and innate immune support.
In fact, “there is evidence suggesting that vitamin D supplementation can have a positive effect on COVID-19 symptoms and severity. Compared with a lower dose (1000 IU), daily oral supplementation with 5000 IU of vitamin D3 for two weeks reduced the time to recovery of symptoms such as cough and gustatory sensory loss among mild-to-moderate COVID-19 patients with sub-optimal vitamin D status.”
Sleep disturbances have emerged, as a consequence of the Covid-19 pandemic – due in p
The advent of wearable devices that track daily step count has provided not only population-based weight loss guidelines, but also recommendations for cardiovascular improvement.
Prior physical activity national guidelines recommended at least 150 minutes per week of moderate-to-vigorous-intensity exercise – which did not quantify stepping intensity with mortality risk.
Until now, most research has been targeted to an older demographic versus a younger, racially diverse population. Researchers, from a diverse group of investigators, chose to estimate the association of steps per day with premature age in Black and White men and women ages 41 to 65.
The prospective cohort study- Steps per Day and All-Cause Mortality in Middle-Aged Adults in the Coronary Artery Risk Development in Young Adults, which appeared in the online edition of JAMA Network Open in September 2021, was part of the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Participants, age 38 to 50 years, wore an accelerometer on the hip for seven consecutive days during all waking hours from 2005 to 2006. Participants were followed for 10.8 years. Data was analyzed in 2020 and 2021 – with an objective to establish mortality status.
Step volume was categorized as: less than 7,000 steps/day as low, 7,000 to less than 10,000 as moderate, and greater than 10,000 daily steps as high.
Participants, or designed family members, were contacted twice yearly to determine vital status. Requests were made, where applicable, for death certificates, hospital records for death, and autopsy reports.
When the data was compiled, the investigators determined that, “in this cohort study of Black and White middle-aged women and men, higher daily steps were associated with a lower risk of all-cause mortality. Adults taking at least 7000 steps/d, compared with those taking fewer than 7000 steps/d, had approximately 50% to 70% lower risk of mortality. Taking more than 10,000 steps/d was not associated with further reduction in mortality risk.”
It was concluded that, “taking at least 7000 steps/d during middle adulthood was associated with a lower risk of mortality. There was no association of step intensity with mortality. Improving physical activity levels in the least active segment of the population by encouraging increasing steps/d may be associated with lower mortality risk.”
Photo by Jeremy Bishop on Unsplash
Human beings possess an internal time management mechanism (circadian central clock) that coordinates dark and light activities, while managing such activities as, skeletal muscle preservation, liver health, and fat tissue (peripheral clock), that occur during fasting (especially night-time), activity, and the recovery-repair process that occurs during sleep.
As we age or when we succumb to certain conditions and disease processes, like insulin resistance and type 2 diabetes, homeostasis (balance) in our clock mechanisms can be negatively affected, without intervention.
Such interventions can involve exercise – the timing of which may normalize or stabilize a dysfunctional human clock mechanism. This anomaly is especially true for night shift workers, even those without metabolic challenges.
According to "Exercise Training Elicits Superior Metabolic Effects, When Performed in the Afternoon Compared to Morning in Metabolically Compromised Humans," which appeared in December of 2020 in Physiological Reports, “exercise training is the first-line strategy to counteract skeletal muscle insulin resistance and ameliorate elevated plasma glucose levels.”
The study authors, from the Netherlands, comment that, “the recent insights into the role of the circadian clock in the etiology of T2DM (type 2 diabetes) have raised the suggestion that the timing of exercise may affect the training-mediated effects on glucose homeostasis.”
The researcher report that, “consecutive bouts of high-intensity interval exercise during two weeks, acutely induce more beneficial 24-hour glycemic profiles in T2DM subjects, when performed in the afternoon, as compared to a morning training regime.”
To investigate whether the timing of exercise affected long-term metabolic health training adaptations in metabolically compromised individuals, the investigators analyzed data from a study assessing the effect of exercise training on a large range of metabolic health outcomes.
The study group, which included thirty-two adult males (58 ± 7 years), with a body mass index greater than 26 (overweight) at risk for or diagnosed with type 2 diabetes, performed twelve weeks of supervised exercise.
Twelve volunteers exercised in the morning from 8.00–10.00 a.m., while twenty individuals exercised in the afternoon from 3.00–6.00 p.m.
The exercise sessions consisted of twice weekly stationary cycling for 30 minutes at 70% of a pre-determined workload, and one day of resistance exercise, using three sets of ten repetitions at 60% of maximum voluntary contractions in large muscle groups (leg extension, leg press, chest press, lat. pulldown, triceps and biceps curls).
Pre-participation laboratory and physiological assessment, with appropriate exclusion criteria was performed – leading to the conclusion that, “compared to participants who trained in the morning, participants who trained in the afternoon experienced superior beneficial effects of exercise training on insulin-stimulated peripheral glucose disposal, insulin-mediated suppression of adipose tissue lipolysis, fasting plasma glucose levels, exercise performance, and fat mass.”
In addition, “exercise training in the afternoon also tended to elicit superior effects on basal hepatic glucose output.”
The researchers concluded that, “the timing of an exercise training session is a crucial environmental cue, when aiming to improve glucose homeostasis in metabolically compromised subjects, and elucidates that performing afternoon exercise training might be more optimal than exercising at morning hours.”
It’s estimated in the U.S. that five million young athletes compete on high school swim teams – with an additional 336,000 competing on club teams. The National Collegiate Athletic Association (NCAA), says between 2015-2016, 22,000 college swimmers were participating in competitive leagues. Master level swimmers, who may reenter to compete in the sport at an older age, number about 65,000.
According to Swim-Training Volume and Shoulder Pain Across the Life Span of the Competitive Swimmer: A Systemic Review, which appeared in the January 2020 issue of the Journal of Athletic Training, “injuries in competitive swimming primarily arise from repetitive strain and microtrauma. This is not surprising, when one considers the amount of swimming to which the athletes are exposed.”
The investigators from the Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium, and the Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, note that, “because of these demanding and time-consuming training programs, competitive swimming has essentially developed into a year-round intensive sport, with athletes at young ages focusing solely on swimming.”
It’s also pointed out that in 10 to15-year swimming careers swimmers often practice 5 to 7 days per week and sometimes twice daily, which led to overtraining, and increased the risk of soft tissue injury, pain, and dissatisfaction. Shoulder pain is particularly frequent - with prevalence rates reported as high as 91%, is a major cause of missed practice.
These researchers sought to determine, if there was a correlation between a specified amount of swim training and shoulder pain in competitive swimmers, by examining relevant studies within PubMed, Web of Science, and Medline.
It was determined that 12 studies met the qualified criteria, as grouped by age: young (less than 15 years old), adolescent (15-17 years), adult (18-22), and masters (23-77).
Based on the data of this first of a kind analysis, the researchers concluded that, “evidence suggests that swim-training volume was associated with shoulder pain in adolescent competitive swimmers.”
As for recommendations, it was stated that, “year-round monitoring of the athlete's swim training is encouraged to maintain a well-balanced program. Developing athletes should be aware of and avoid a sudden and large increase in swimming volume.
It was also pointed out that additional research is necessary to determine cutoff values, in order to make data-based decisions regarding the influence of swim training.”
From my own experience helping both high school and collegiate swimmers, especially female athletes, there is a consistent anterior (front) shoulder dominance resulting from the volume of overhead, forward strokes - with inadequate posterior shoulder stabilization exercise during the dry land training.
In other words, if your throw, hit, or swim forward, you need to train in reverse to rebalance the shoulder to reduce the risk to unnecessary shoulder injury.
Be sure to check out maxwellnutrition.com – a science-driven, wellness content & nutritional supplement platform – where you will be able to see important, timely nutrition research and order, with direct shipping, the highest bio-available nutrition supplements, made in the United States.
In 2018, the World Health Organization said the prevalence of a cancer diagnosis reached 18.1 million people – with 9.6 million cancer deaths. Positive lifestyle – such as exercise and diet – reduce the risk to certain forms of cancer.
Adherence to a Mediterranean-style eating strategy – higher intake of fruit, vegetables, and whole grains, limited lean meat, fish, and olive oil - reduces the risk to colon and breast cancer.
Research is still searching for the optimum plan once an individual is diagnosed with cancer. According to "The Facts About Food After Cancer Diagnosis: A Systematic Review of Prospective Cohort Studies," which appeared in the August 2020 issue of the online, peer reviewed journal Nutrients, “to prevent malnutrition, energy and protein requirements for cancer patients are largely widespread by international guidelines, but little is known about the food choices and dietary regimen a cancer patient should benefit from.”
The Italian study researchers point out that, “many ‘cancer diets’ are often restrictive, avoiding a whole nutrient class (i.e., meat or dairy products) in the misleading belief that certain foods “feed the tumor.”
The Italians sought to determine any possible associations between diet patterns, after a cancer patient’s diagnosis, that is affected by a solid tumor, relative to outcomes – mortality, cancer progression, and recurrence.
Those study criteria included a meta-analyses (similar studies) that used an adult population over 18 years of age diagnosed with breast, gastrointestinal, gynecological, lung, and urological cancers; post-diagnosis dietary patterns – such as consumption of fruit, vegetables, diary, meat, fish, and cereals; prospective or retrospective cohort studies; over-all survival, all-cause mortality, cancer-specific mortality, death from a non-cancer cause, cancer progression, disease-free survival, cancer recurrence, and recurrence-free survival.
The study authors determined that, “the overall results of this systematic review highlight that none of the food categories should be eliminated by cancer patients. Especially, there is no clear association between consumption of meat or animal products and cancer progression/recurrence or CSM (cancer specific survival), after a cancer diagnosis.”
However, the Italians also emphasized there was, “a significant positive association between detrimental dietary patterns, such as Western-type Diet (characterized by processed meats, sugar-sweetened soft drinks, and refined grains) and cancer progression.”
Note the investigators, “on the contrary, high consumption of fiber, such as whole grain cereals, green and cruciferous vegetables, seem to be protective against cancer progression and mortality.”
In conclusion, “detrimental dietary patterns, such as the Western Diet and the high consumption of some food categories (saturated/trans fats, high-fat dairy products) could worsen prognostic outcomes in breast, colorectal and prostate cancer patients. Nevertheless, animal proteins, such as fish, poultry, low-fat dairy products and meat, should not be excluded from cancer patient’s diet.”
More research is needed relative to a cancer post-diagnostic diet, as it applies to the most common forms of cancer – lung, stomach, gynecological, bladder, and pancreatic cancer.
For more information, go to maxwellnutrition.com.
With the surge of the Delta Covid-19 variant, the world has a new pathogen enemy among us—the hidden terrorist that spares no one, especially those unvaccinated. What began in Wuhan, China in December of 2019 and declared in March of 2020 a pandemic, Covid-19, the disease spawned by the SARS-CoV-2 virus, has transformed life as we know it. It’s here to stay in some form or another.
The effects of lockdowns, the use of protective masks, social distancing, and more has had a direct impact on an individual’s nutrition status and movement pattern.
A person’s susceptibility to Covid-19 has as much to do with their nutrition status, as it does to any comorbidities on board, such as obesity, hypertension, pulmonary dysfunction, diabetes, and cardiovascular disease.
Researchers, from Spain, Columbia, and Greece, used a narrative review, “with the aim of collecting published literature and articles regarding dietary patterns, body composition, nutritional deficiencies, vitamin interventions, and physical activity in the COVID-19 pandemic.”
The study—Nutrition in the Actual Covid-19 Pandemic. A Narrative Review—which appeared in the June online issue of Nutrients, found that the COVID-19 lockdown promoted unhealthy dietary changes and increases in body weight of the population, showing obesity and low physical activity levels, as increased risk factors of COVID-19 affection and physiopathology.”
What’s more, “hospitalized COVID-19 patients presented malnutrition and deficiencies in vitamin C, D, B12 selenium, iron, omega-3, and medium and long-chain fatty acids, highlighting the potential health effect of vitamin C and D interventions.”
The search methods, from February 1st, 2020, through April 13th, 2021, included PubMed, Embase, SciELO, Science Direct Scopus, and Web of Science, employing MeSH-compliant keywords including, COVID-19, Coronavirus 2019, SARS-CoV-2, 2019-nCoV, Nutrition, Diet, Dietary Patterns, Body Compositions, Vitamins, Nutritional, Immunology, Physical Condition, and Physical activity.
Here’s the summary of the findings, as noted in the narrative review of the data base:
The COVID-19 lockdown promoted unhealthy dietary changes (inactivity, daily intake, snacks, alcohol), increasing body mass and fat, and showing obesity-overweight people poor diet habits.
Obesity is a risk factor for COVID-19.
A healthy balanced diet is an integral part of personal risk management.
Vitamins C and D improve health-related outcomes in COVID-patients.
Sufficient vitamin intake and an active lifestyle are strongly recommended as a preventive measure to the general population.
There is a large prevalence of malnutrition among hospitalized patients with COVID-19.
Nutritional support and rehabilitation exercise are needed to avoid muscle atrophy and sarcopenia in COVID-19 hospitalized patients. They should be considered as an integral part of the therapeutic approach.
Deficient states of vitamin C, D, B12 selenium, iron, ω-3, and medium and long-chain fatty acids increase the probability of hospitalization and mortality from COVID-19.
The gut microbiome profile is altered due to COVID-19, being involved in the magnitude of COVID-19 severity via modulating host immune responses.
A healthy gut microbiome serves as a preventive and protective factor, appropriate nutrition and probiotics are good strategies for its enhancement.
Active lifestyle and physical activity allow a lower risk, and mortality rate in COVID-19 patients, due to its positive effect on metabolic health and inflammation.
The reviewers were quick to point out that more research of this evolving disease and its variants is needed relative to the impact of nutrition and other lifestyle modifications consistent with risk stratification.
Read more at MaxWellNutrition.com
Covid-19—the infectious disease initiated by SARS-CoV-2—that primarily attacks respiratory (breathing) function—has not only spread rapidly over the prior year, but also has spawned more contagious variations, such as the current Delta variant.
The human immune system—innate and adaptive—activates the body’s response to the Covid-19 antigen. Individuals with comorbidities, like obesity, hypertension, pulmonary dysfunction, diabetes, and cardiovascular disease, are at increased risk to adverse complications.
Supporting the body’s challenge to the invading antigen is an individual’s dietary behavior that influences nutritional status.
With respect to Covid-19 and the association of dietary behaviors, researchers from the Department of Preventive Medicine, Research and Information Services, and the Department of Medicine, Feinberg School of Medicine, Northwestern University in Chicago, chose to use data from the UK Biobank (UKB) to examine the dietary behaviors measured in 2006-2010 and Covid-19 infections in 2020.
The American researchers linked the UKB geo-data to UK Covid-19 surveillance data to account for Covid-19 exposure.
The UKB is an international health resource of over 500,000 participants aged 37–73 years at 22 centers across England, Wales, and Scotland.
The UKB participants, who underwent physical measurements, assessments about health and risk factors (including lifestyle and dietary behaviors), and blood sampling at baseline (2006–2010), agreed to follow-up on their health status. Country-wide surveillance data was used to identify UKB participants exposed to COVID-19.
Based on the data analysis, it was determined that, “consuming more coffee, vegetables, and being breast fed, as well as, consuming less processed meat intake were independently associated with lower odds of COVID-19 positivity. These associations were attenuated (reduced), when accounting for the UK’s COVID-19 case rate (i.e., exposure).”
The data analysis reflected that, “habitual consumption of 1 or more cups of coffee per day was associated with about a 10% decrease in risk of COVID-19, compared to less than 1 cup/day,” while, “consumption of at least 0.67 servings/d of vegetables (cooked or raw, excluding potatoes) was associated with a lower risk of COVID-19 infection.”
The UKB American investigators found that processed meat consumption (refers to any meat that has been transformed through salting, curing, fermenting, smoking, or other process to enhance flavor or improve preservation) of as little as 0.43 servings/day was associated with a higher risk of COVID-19.
However, comment the Americans, “red meat consumption presented no risk, suggesting meat per se does not underlie the association we observed with processed meats.”
Finally, it was found that, “a long-term favorable association between being breastfed as a baby and COVID-19 infection in UKB contribute to the growing evidence in support of nutrition early in life for optimal immunity for life.”
The study analysis concluded, “our results support the hypothesis that nutritional factors may influence distinct aspects of the immune system, hence susceptibility to COVID-19.”
To read this study, you can find it under the “open access research” on maxwellnutrition.com.
In 2007, my book, Lean & Hard – the body you’ve always wanted in 24 workouts, was published by John Wiley & Sons. L&H offered a comprehensive six week, four workouts per week diet, nutritional supplement schedule, resistive exercise, and sprint-interval program, all designed to increase lean muscle mass.
The L&H book was based on a research study of my concepts that followed a cross section of athletes and non-athletes over six weeks, when I was an Associate Professor in the LSU School of Public Health and Preventive Medicine.
One of the nutritional supplements tested in the applied research study and utilized in the book was creatine, an organic acid that is created internally from the action of the amino acids arginine, glycine, and methionine, which are constructed in the liver and regulated through kidney function.
Creatine predominantly resides in skeletal muscle—mostly as phosphocreatine—with roughly two percent degrading to creatinine, a metabolic by-product, which is why too much creatine may skew a creatinine clearance test assessing kidney function.
Creatine use by athletes has been widely studied for its side effect of weight gain, which was initially thought to be fluid gain, but after years of research, has now been determined to be lean muscle development—when used correctly.
I came to the conclusion, after seeing the results of the LSU applied study and my continued research on creatine, that someday creatine monohydrate would offer additional benefits to an ageing population—specifically to address sarcopenia—the age-related loss in muscle strength (dynapenia), muscle mass, muscle quality, and physical performance (frailty issues).
That day has now arrived.
New research, “Current Evidence and Possible Future Applications of Creatine Supplementation for Older Adults,” appearing in the March 2021 online, peer-reviewed journal Nutrients, comments that, “sarcopenia typically occurs in 8–13% of adults ≥60 years of age, and, is associated with other age-related health conditions, such as osteoporosis, osteosarcopenia (muscle related bone loss), sarcopenic obesity, physical frailty, and cachexia (muscle loss due to disease).”
Muscle mass decreases by 0.45% in men and by 0.37% in women. However, these decrements climb to 0.9% for men and to 0.7% for women starting in their seventh decade.
The age-related decrease in muscle strength—a strong predictor of poor health outcomes, such as mobility disability, falls, fractures, and mortality in older adults—occurs more rapidly (2–5 times fold faster) than the reduction in lean (muscle) mass.
The Canadian and Australian study authors performed a narrative review evaluating the current research involving creatine (CR), with and without resistive training (RT), on properties of muscle and bone in older adults, “in order to provide a rationale and justification for future research involving CR in older adults with osteosarcopenia, sarcopenic obesity, physical frailty, or cachexia.”
Here’s what was determined.
As it pertains to addressing sarcopenia, “CR (≥3 grams/day) and RT (≥7 weeks; primarily whole-body routines) can improve some measures of muscle accretion, strength, and physical performance in older adults. Independent of RT, a CR loading phase and/or high relative daily dosage of creatine (≥0.3 g/kg/day) may be required to produce some muscle benefits in older adults.”
Relative to creatine usage with osteoporosis—the age-related loss of bone mineral density – “collectively, the vast majority of studies show no greater effect from CR, with and without RT, on properties of bone in older adults.”
To read the rest, go to maxwellnutrition.com
Prior research has established that the consumption of green tea or coffee has been said to reduce the all-cause mortality in the general public. However, as to the similar effects in those with health challenges, such as diabetes, research is either controversial or devoid – until now.
Japanese researchers publishing the “Additive Effects of Green Tea and Coffee on All-Cause Mortality in Patients with Type-2 Diabetes Mellitus: the Fukuoka Diabetes Registry”, which appeared in October 2020 in the open-access online BMJ (British Medical Journal) Diabetes Research & Care, determined that, “higher consumption of green tea and coffee was associated with reduced all-cause mortality: their combined effect appeared to be additive in patients with type-2 diabetes.”
The Japanese researchers from the Departments of Medicine and Clinical Sciences, Graduate School of Medical Sciences and the Division of Internal Medicine, Fukuoka, Japan, comment that green tea derives benefits from fresh leaves of Camellia sinensis - containing various chemicals, such as phenolic compounds, theanine, and caffeine, which possess antioxidant, anti-inflammatory, or anti-bacterial properties.
Coffee, note the Japanese, contains phenolic compounds and caffeine that offer antioxidant, anti-inflammatory, and ant-mutagenic benefits – especially, to type-2 diabetics, those with abnormal lipid profiles, and malignancy.
To reach this conclusion, the investigators, after appropriate exclusion criteria, used data from 4923 study participants enrolled between April 2008 and October 2010, in the Fukuoka Diabetes Registry, “a multicenter prospective study designed to investigate the effects of modern treatments and lifestyle on the prognoses of patients with diabetes mellitus.”
Using a self-administered questionnaire, the participants provided information regarding their diagnosed diabetes duration, smoking habits, alcohol intake, leisure-time physical activity, sleep duration, depressive symptoms, and history of coronary heart disease, stroke, and cancer. Their smoking habits and alcohol intake were classified as either current or not.
Body weight, height and body mass index were ascertained – along with blood pressure. Medical charts were reviewed for all medications, including insulin, oral hypoglycemic agent, antihypertensive drugs, antiplatelet drugs, and statins.
The Japanese used self-reported answers to dietary questions to categorize the participants into the following four groups by beverage: green tea - none, ≤1 cup/day, 2–3 cups /day, ≥4 cups/day, and coffee - none, <1 cup/day, 1 cup/day, ≥2 cups/day.
There were no questions about the consumption of decaffeinated or caffeinated drinks because decaffeinated beverages are uncommon in Japan.
From a laboratory perspective, blood and spot urine samples were obtained to establish the levels of Hemoglobin A1c (HbA1c), serum low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, creatinine, urinary creatinine, and albumin – along with the glomerular filtration rate (GFR) and calculations of the urinary albumin-creatinine ratio levels.
The Japanese investigators said, “results suggest that consuming green tea and coffee may have beneficial effects on the longevity of Japanese people with type 2 diabetes.”
How this data translates to all of us outside Japan, will require further research. Until then, keep my green tea and black coffee consumption – in moderation – flowing.
For more information, go to maxwellnutrition.com.
When the Covid-19 management strategy unfolded over 2020—which included assessment, treatment, prevention, and immunization—return to normal safety protocols became a complex, yet vital part, of preventing further devastation to human life and the world’s economy.
As time and the control of the coronavirus disease unfolded, the major North American professional sports leagues were among the first to implement a return-to-play (RTP) scenario—with the appropriate prevention measures in place—like no fans, player and staff bubbles, daily Covid-19 testing, sequestering players that tested positive, and much more.
As a result of the unknown incidence of “cardiac sequelae” (consequences of a particular condition)—resulting from Covid-19 infection, a conservative RTP cardiac testing program mirroring the American College of Cardiology recommendations, was implemented for all athletes, who tested positive for Covid-19.
In new research—"Prevalence of Inflammatory Heart Disease Among Professional Athletes with Prior COVID-19 Infection Who Received Systemic Return-to-Play Cardiac Screening”—which appeared in March of 2021 in the online issue of JAMA Cardiology (Journal of the American College of Cardiology), a diverse group of medical experts sought to, “to assess the prevalence of detectable inflammatory heart disease in professional athletes with prior COVID-19 infection, using current RTP screening recommendations.”
This descriptive study, a cross-sectional evaluation of cardiac testing, performed between May to October 2020, followed the Strobe (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
It included 789 professional athletes from Major League Soccer, Major League Baseball, National Hockey League, National Football League, and the men’s and women’s National Basketball Association—with an average age of 25—composed of 777 men, of which 460 athletes had prior symptomatic COVID-19 illness, and 329 were asymptomatic or paucisymptomatic (minimally symptomatic).
A summary of the study group’s cardiac health status was as follows: “Thirty athletes were sent for additional cardiac testing, as a result of abnormalities on the initial cardiac screening tests that raised concern for potential COVID-19– associated cardiac injury. Cardiac magnetic resonance (CMR) imaging was performed in 27 of these 30 athletes. Downstream testing confirmed diagnoses of inflammatory heart disease in 5 of 27 athletes: 3 athletes with CMR-confirmed myocarditis (inflammation of the heart muscle) and 2 athletes with CMR-confirmed pericarditis (swelling of the thin, saclike tissue surrounding the heart). The remaining 25 of 30 athletes (83.3%) who underwent additional testing, did not ultimately have findings to suggest acute cardiac injury and returned to play.”
RTP cardiac screening for professional athletes testing positive for COVID-19, noted the investigators, “demonstrated that 0.6% (5 of 789 athletes) had imaging findings, “suggestive of inflammatory heart disease, that resulted in restriction from play in alignment with American Heart Association/ACC guidelines.”
The researchers concluded that, “while long-term follow-up is ongoing, few cases of inflammatory heart disease have been detected, and a safe return to professional sports activity has thus far been achieved.”
That’s great to know for the athletes, their families, and sports fans everywhere. If you would like to read the study, go to maxwellnutrition.com.
Having been exposed to the medical, metabolic, and physiological gender-based factors associated with weight gain, weight loss, body composition changes, and the psychological aspects in a diverse cross-section of male and female participants in my prior hospital-affiliated wellness and weight management programs over the last thirty years, I can attest to the fact that what you eat, when you eat—along with age and health profile, account for many of the complex issues associate with weight control.
Biologically speaking (circadian rhythm), late night eating certainly has its drawbacks on metabolic rate, cardiometabolic health, hormone secretion (melatonin production), and fat oxidation versus storage.
Prior research and common sense have demonstrated that eating chocolate late at night has been associated with long-term weight gain, especially in postmenopausal women (average age of 51), who are vulnerable to weight gain. It appears now that chocolate and the timing of its consumption may have earned a bad rap.
Research—"Timing of Chocolate Intake Affects Hunger, Substrate Oxidation, and Microbiota: a Randomized Controlled Trail”—reported in the July online issue of the FASEB journal (the journal of the Federation of American Societies for Experimental Biology), suggests that, “chocolate, in the morning or in the evening/night, in a narrow window of time (1 hour), results in differential effects on hunger and appetite, substrate oxidation, fasting glucose, microbiota composition and function, and sleep and temperature rhythms.”
“The intake of a rather high amount of chocolate (100 grams),” comment the researchers from Brigham and Woman’s Hospital in Boston, “concentrated in a narrow (1 hour) timing window in the morning could help to burn body fat and to decrease glucose levels in postmenopausal women.”
This determination involved 19 postmenopausal females, who completed a nine week, randomized, controlled, cross-over trial of “ad libitum food” intake —with either 100 grams of chocolate (~33% of their daily energy intake) in the morning, defined as within one hour after waking time, or at evening/night —within one hour before bedtime, compared to no chocolate intake. The duration of each intervention was two weeks, which included a transition period.
The study participants underwent the following tests and measurements:
Body weight (baseline and three additional timed dates), height, body fat, dietary food intake record, visual analog scale before and after each meal (hunger & appetite assessment), body temperature, activity, sleep duration, number of awakenings, nap frequency and duration, metabolic rate assessment, salivary cortisol determinations, fasting glucose, and analysis of their gut microbiota (short-chain fatty acids from fecal samples).
The study found that the 19 postmenopausal participants did not gain body weight with the chocolate intake. In fact, comment the investigators, “while the volunteers had an increase of energy intake due to chocolate’s extra calories (extra 542 kcal), as compared to the non-chocolate condition, they spontaneously reduced their ad libitum energy intake by 16%, when eating chocolate in the morning.”
This situation occurred even though the females consumed milk chocolate that has been shown to have less of an effect in decreasing appetite than dark chocolate.
Further stated, “results show that when eating chocolate, females were less hungry and had less desire for sweets than with no chocolate, especially when taking chocolate during the evening/night. Moreover, daily cortisol levels were lower when eating chocolate in the morning than at evening/night.”
Read the rest at MaxWellNutrition.com.
As the saying goes, the key to longevity is to age gracefully. That includes our skin, the largest organ of the body. Skin aging is defined by its components: natural, heat, and photoaging—critical factors that cause skin aging damage.
According to Boosting the Photoaged Skin: The Potential Role of Dietary Components, which appeared in the May 2021 online issue of the journal Nutrients, “skin photoaging is caused by long-term exposure to ultraviolet (UV), and manifests as rough, dry, and sagging skin, deeper skin wrinkles, excessive skin pigmentation, or angiotelectasis, even leading to various benign or malignant tumors, such as solar keratosis, squamous cell carcinoma, and malignant melanoma.”
Addressing skin damage may involve methods, such as the use of sunglasses, window films, and clothing—along with topical treatment of active ingredients, and medical cosmetology.
From a prevention standpoint, what you eat may prove to be the best skin defense. The Nutrients study authors from Korea and China, comment that, “phytochemicals, functional proteins and peptides, functional sugars, functional oils, probiotics, vitamins, and minerals are well-known to improve the photoaging-associated morphological abnormalities and functional decline.”
The Korean and Chinese literature reviewers sought to, among other objectives, “provide insight into the preventive and therapeutic potential of various food-derived active ingredients in skin photoaging and their underlying mechanisms.”
The oral administration of phytochemicals has been shown to have beneficial effects at reducing the risks associated with skin aging, while boosting photoaged skin. Carotenoids, such as astaxanthin and lycopene, are two such examples.
Astaxanthin, note the reviewers, “has diverse functions in skin biology, including photoprotective, antioxidant, and anti-inflammatory effects. Oral administration of astaxanthin is protective against UV-induced skin deterioration and is helpful to maintain healthy skin.”
Lycopene, found in tomatoes and tomato-based products, “is recognized as a potent antioxidant. Lycopene has been found to be efficient in skin photoaging.”
The polyphenols dihydromyricetin, a flavonoid, and ellagic acid, a polyphenol dilactone, both found in fruits and vegetables, are used for anti-photoaging treatment.
Resveratrol - a naturally occurring polyphenolic phytoalexin found in grapes, red wine, peanuts, mulberries, and fruits, “in a placebo-controlled, double-blind clinical study, caused facial skin moisturization and elasticity to be enhanced, “while facial skin roughness and depth of wrinkles were reduced, in subjects, who were orally supplied with a resveratrol–procyanidin blend.”
Green tea catechin is a natural iron chelator and antioxidant. In a study using oral supplementation with green tea polyphenols containing catechin, epicatechin, epigallocatechin gallate, epicatechin gallate, epigallocatechin, and glucuronidase/sulfatase, the blend, “protects against the UV-induced sunburn response, immunosuppression, and photoaging of the skin.”
The Korean and Chinese researchers site a 12-week, double-blind, placebo-controlled study employing supplementation with green tea polyphenols that, “significantly reduced the UV-induced erythema in facial skin, improved skin elasticity, roughness, density, and water homeostasis, and increased the blood flow and oxygen delivery to the skin.”
Read the rest on maxwellnutrition.com.
It’s no secret that being overweight or obese may predispose those individuals to associated diseases – particularly type 2 diabetes, metabolic syndrome, and cardiovascular disease.
It’s uncommon to find individuals, who follow plant-based diets in that cohort – due to the high-fiber, low-fat content of vegan-style eating strategies – in conjunction with the increased thermal effect of these diet plans, which accounts for approximately 10% of the total energy expenditure.
Another feature of the vegan-type diets is its reduction of both muscle and liver fat, while increasing mitochondrial (energy burning) and postprandial (after eating) metabolisms. Just how successful have these diet strategies been for overweight adults, is food for thought for researchers.
In November of 2020, JAMA Network Open reported the results of an original investigation – Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults, which concluded that, “a low-fat plant-based dietary intervention reduces bodyweight by reducing energy intake and increasing postprandial metabolism. The changes are associated with reductions in hepatocellular (liver) and intramyocellular (muscle) fat and increased insulin sensitivity.”
The study authors, from Physicians Committee for Responsible Medicine (Washington, DC), Yale School of Medicine (New Haven, Conn.), CNR Institute of Neuroscience (Padua, Italy), Institute of Endocrinology (Prague, Czech Republic), University of Utah (Salt Lake City), and George Washington University School of Medicine & Health Sciences (Washington, DC), recruited 244 participants between January 2017 and February 2019 in Washington, DC., to participate in a 16 week- randomized clinical trial
Enrollment included adults between 25 and 75 years old – with a body mass index between 28 (overweight) and 40 (obese).
Those participants in the intervention group followed a vegan diet composed of approximately 75% of the energy from carbohydrates, 15% protein, and 10% fat – which took the form of vegetables, grains, legumes, and fruits. The eating plan was devoid of animal products or added fats.
The control diet group was asked to make no changes to their standard diet, while both groups limited alcohol consumption to 1 drink for women and 2 for men. Both groups were asked to maintain their current exercise level and medication, unless changed by their personal physician.
At baseline and at study conclusion, 3-day dietary intake assessments were analyzed, appropriate laboratory assessments were completed, after an overnight fast – along with height, weight, body composition and visceral fat determinations assessed.
The researchers found, “the dietary intervention reduced body weight, apparently owing to its tendency to reduce energy intake and increase postprandial energy expenditure. The intervention also improved glycemic control and reduced insulin concentrations, owing in part to reduced lipid accumulation in liver and muscle cells and thus reduced insulin resistance in these organs.”
It appears that this research also validated prior research. “The present finding that the increase in thermic effect of food was associated with decreased fat mass and increased insulin sensitivity confirm the findings of previous research,” which led the researchers to state that, “this intervention may be an effective treatment for overweight adults.”
For more information, go to maxwellnutrition.com.
According to "Food Timing, Circadian Rhythm and Chrononutrition: A Systematic review of Time-Restricted Eating’s Effects on Human Health," which appeared in the December 2020 issue of the online, peer-reviewed journal Nutrients, “a recent systematic review and meta-analysis of 19 studies showed that TRE leads to weight loss and a reduction in fat mass with a preservation of fat-free mass and also has beneficials effects on cardiometabolic parameters, such as blood pressure, fasting glucose concentration, and cholesterol profiles.”
Read the rest on MaxWellNutrition.com
Prior research, which appeared in the British Journal of Sports Medicine in 2016, corroborates that physical activity has a protective effect against an individual’s overall cancer mortality risk, specifically, as it applies to colorectal and breast cancer.
Current research, “Effect of Time of Day of Recreational and Household Physical Activity on Prostate and Breast Cancer Risk (MCC-Spain Study),” which appeared in the September 2020 issue of the International Journal of Cancer, said, “a recent meta‐analysis on breast cancer reported an approximate 20% reduction in risk associated with physical exercise for both premenopausal and postmenopausal women.”
Additionally, “evidence for recreational physical activity and prostate cancer is less consistent, although long‐term occupational physical activity seems to reduce prostate cancer risk.”
Factors, such as circadian rhythm disruption from dietary patterns, work hours, environmental cues (light exposure) and melatonin production, can affect cancer risk. The circadian rhythm is knocked off balance, when external factors—like light exposure during sleep—may interfere with the normal nighttime production of melatonin.
Mayoclinic.orgsays that melatonin, which declines with age, is a hormone producted and released in the brain - increasing when it's dark and decreasing when it's light.
The study authors, from various university and government departments in Spain, report that, “in 2007, the International Agency for Research on Cancer classified shift work, which includes circadian disruption as probably carcinogenic to humans.” Further stating that, “exposure to artificial light at night and particularly exposure to blue light spectrum light has been associated with higher breast and prostate cancer risk.”
In 2018 in the same study population, researchers report in the International Cancer Journal that a study examining circadian timings and chronotype (a human attribute that correlates with diurnal preferences for activities in morning or evening), concluded that morning exercisers had the highest protection, when following diurnal patterns of diet compared to those having late supper (last evening meal).
Using a refined cohort of 5365 participants—breast cases: 1438 female controls: 1593; prostate cases: 1004, male controls: 1330)—in the MCC-Spain population that included five cancer types and 10,106 subjects (51.8% males), data was collected between September 2008 to December 2013 in 23 hospitals, and the rosters of primary health care centers (controls) in 12 Spanish provinces.
The 5365 participants, who initially responded to circadian timing questionnaires, had a computerized questionnaire administered by experienced personnel in face-to-face interviews—with subsequent information taken, as to residential history, personal and family medical history, sociodemographic factors, occupational and lifestyle history, height, weight, along with securing biological samples.
The participants were told, “we are going to ask you about any physical activity done outside working hours, including walking, any exercise, and going to the gym. We are interested in any physical activity you did continuously and for at least six months throughout your life.”
Then, the participants were asked, “what activity do you do, or did you use to do?”
Appropriate medical information was obtained, so as to identify multiple facets of breast and prostate cancer status in those respective participants.
The Spanish study authors “observed that the overall protective effect of recreational and household physical activity for cancer may vary depending on the time of the day of the activity.”
Read the rest on MaxWellNutrition.com
The May 2021 Issue of the online, peer reviewed journal Nutrients provided an excellent narrative review of the ketogenic diet from researchers in the Department of Biology, Western Kentucky University.
Ketogenic diets, which traditionally have emphasized keeping total carbohydrate intake to less than 50 grams per day, have increased in usage from its inception in the 1930’s to treat epilepsy. Restricting carbohydrate consumption, emphasizing moderate protein intake and increasing caloric consumption from fat, causes the body to draw more from fat for energy than from glucose metabolism.
According to the Nutrients research – The Potential Health Benefits of the Ketogenic Diet: A Narrative review – “recent studies utilizing Low-carbohydrate, High-fat (LCHF) diets, such as the ketogenic diet, show promise in helping patients lose weight, reverse the signs of metabolic syndrome, reduce, or eliminate insulin requirements for type II diabetics, reduce inflammation, improve epigenetic profiles, alter the microbiome, improve lipid profiles, supplement cancer treatments, and potentially increase longevity and brain function.”
That’s important, since WebMD estimates that 27 million people are Type 2 diabetic – 86 million pre-diabetics. In addition, the Centers of Disease Control and Prevention (CDC) says almost 40% of adults and around 20% of American children are obese.
The Western Kentucky reviewers segment the ketogenic diet (KD) into two classifications versus the standard American diet. The therapeutical keto diet’s caloric distribution is 5% carbohydrate, 5% protein, and 90% fat, while the standard keto variation is 5% carbohydrate, 20% protein, and 75% fat. The standard American diet is 55% carbohydrate, 15% protein, and 30% fat.
The researchers point out that “ketosis is normally achieved through either fasting or carbohydrate restriction. It is important to clarify that a low-carb diet typically refers to a diet with an intake of 50 to 150 g of carbohydrate per day. However, although this is a lower amount of carbohydrates than the standard American diet, it is not low enough to enter nutritional ketosis. Only when a patient restricts carbohydrates to less than 50 g/day will the body be incapable of fueling the body by glucose and will switch to burning fat.”
The areas of focus by the Kentucky investigators centered on the effects of the keto diet (KD) on the microbiome (intestinal bacteria), epigenome (changes “on top” of the genome, which modify our gene expression), diabetes, weight loss, cardiovascular disease, and cancer.
The microbiome is composed of trillions of microscopic organisms housed in the intestinal tract – supporting 70% of our immune function. While there is limited long-term data on the effects of the keto diet, “based on various studies, many predict that the diet will positively affect the microbiome by increasing the Bacteroidetes and Bifidobacteria species associated with improved health and decreasing microbial species known to increase health risks,” comment the reviewers.
As for the epigenome, our heritable markers, it’s suggested that by changing our environment to a more favorable status, we can affect our genetic predisposition to heritable disease risk. According to the reviewers, “the benefits of the ketogenic diet might also go beyond treating existing disease, and instead help prevent chronic and degenerative disease.”
Read the rest at maxwellnutrition.com
"Why Do Men Accumulate Abdominal Visceral Fat?" That’s the topic of research published in 2019 in Frontiers of Physiology. “The accumulation of abdominal visceral fat in men, which is a strong independent predictor of mortality, is mainly due to the higher dietary fat uptake by their abdominal visceral fat,” according to the researchers from Ketchum University in Fullerton, California and Washington University in St. Louis.
Premenopausal women accumulate fat below the belt – gynoid or pear shape - while men accumulate fat in the visceral abdominal area – android or apple shape. Post-menopausal females are at greater risk to developing an apple shape that gives them a comparable risk to a man for type 2 diabetes and cardiovascular disease.
It’s important to understand the physiology of body fat accumulation over time. Body fat comes in various classifications – brown, beige, which are capable of thermogenesis (heat producing), and the predominant white, non-thermogenic fat.
White fat comes in different forms – subcutaneous (under the skin), visceral (that surrounds internal organs), and ectopic (located within the internal organs).
As the visceral, high risk fat builds up, the “belly” enlarges, which also includes the subcutaneous fat. While the waist measurement can be a good indicator of the subcutaneous fat, it’s a poor indicator of the deeper visceral fat.
Visceral fat encompasses both intraperitoneal and retroperitoneal fat, which surround the pancreas, duodenum, kidneys, and the ascending and descending colon.
Unlike the subcutaneous fat, it’s the retroperitoneal and intraperitoneal fat, which increases the risk to metabolic syndrome – a cluster of events that predispose the individual to type 2 diabetes, cardiovascular disease and cancer risk.
It appears that a man’s abdominal, visceral fat accumulates from excess consumption of dietary fat. The researchers comment that, “dietary fat is digested and absorbed by the small intestine. The absorbed dietary fat is secreted by the enterocytes in two major forms: chylomicrons and VLDLs (very low-density lipoproteins).”
Studies indicate that chylomicron transport significantly increases more dietary fat storage in men than in women. Those chylomicrons, note the researchers, “preferentially promote the accumulation of the abdominal, visceral fat.”
The researchers recommended, “spreading out the amount of dietary fat intake into several smaller meals, which should reduce the likelihood of abdominal, visceral fat accumulation by reducing both the size and number of chylomicrons.” Exercise is also another avenue to control visceral fat accumulation.
“Based on our proposed mechanisms,” comment the university researchers, “exercising and eating a diet low in fat—or at least spreading the fat intake into several smaller meals—should help in slowing down the development of abdominal, visceral fat.”
In 2006, my book, The Fat Burning Bible (John Wiley & Sons) was released. The book provides a strategic plan to address the accumulation of excess body fat with age. Since male and female physiologies are as different as night and day, the book can be a guide to a gender specific plan of attack to reduce total and high-risk visceral fat.
For more information, go to maxwellnutrition.com.
Runrepeat.com, the world’s largest online, athletic shoe review company, as noted on its site, surveyed 3961 current runners to understand how many of those runners began their first steps to fitness during the Covid-19 pandemic. It appears that 28.76 % of the current runners were motivated to strap on their running shoes and head out during the pandemic.
This result compares to doing outdoor activities, as the top trend in 2020 and in 2021—consisting of running, hiking, walking, cycling, and any other form of outdoor workouts, exercises, or training. Exercising outdoors, notes the website, “was voted the best way to stay fit in 2021 by 59.1% of active adults, increasing 14.6% from the start of 2020.”
It was also determined that 19.82% of the novice runners were less likely to participate races in-person over the following 12 months—an assumed pandemic-related fear of crowds.
“Motives for running are changing—physical health is the primary motivation for 72% of new-pandemic runners, up 18.03% from runners who began running before the pandemic,” according to the website.
The survey noted the following data points: 34.27% less likely to run for competition or achievement, 31.44% less likely to run for social interaction, 14.81% less likely to run for mental or emotional health, 3.00% less likely to run for their confidence or self-esteem.
The study investigators concluded that, “there has been a significant boom in running during the pandemic. The situation and circumstances that these people have taken up running are drastically different than their pre-pandemic counterparts.”
Another trend that has grown in popularity is exercising at home – spawned by the pandemic world-wide lockdowns. Notes the survey, “a lot of people made the decision to start investing in at-home gym equipment or make use of the fitness equipment they already had”—with the percentage of active adults seeing at-home fitness equipment, as the best way to stay fit increased by 49.6%, making it the fastest growing trend of 2021. In the US, this trend has grown explosively by 218.3%.
The pandemic took a hit on sports participation – with the percentage of active adults relying on sports to stay fit decreasing by 25.2% over the year, noting only 6.0% still seeing it as their best option for 2021. Female sports participation saw a decrease in this trend—down 53.0%—which was more than double that for men, who were down by 23.8%.
Another characteristic change, resulting from the pandemic, was the positive impact of online fitness content, courses, classes, and subscriptions. “The trend of online fitness exploded in America, with 134.7% more active American adults switching to this new trend to reach their fitness goals, as the pandemic continues into 2021,” noted the survey.
To find the latest wellness research and products made in the USA, go to maxwellnutrition.com.
To access the survey, go to https://runrepeat.com/new-pandemic-runners
According to the Journal of Sport and Health Science, hamstring strains are one of the most common sports injuries. The journal reports that, “a review of the medical database of the National Football League (NFL) between 1987 and 2000 indicated that 10% of all injuries in American college football players likely to play in the NFL were hamstring strain injuries.” It’s also been reported that “12% of all injuries in NFL training camps were hamstring strain injuries—making it the second most commonly seen injury.”
One of the main causes of hamstring injury is fatigue—both systemic and muscular. Research, which appears in the December 2019 issue of the Journal of Strength & Conditioning Research reported that, “47% of hamstring injuries were sustained during the final 15 minutes of the first and second halves of match play in soccer.”
The take-away message is that excess fatigue—with deficits in hamstring strength-endurance - places the athlete at greater risk to sustain a hamstring strain, or tear—taking significantly longer to recover.
The December 2019 issue of the Journal of Athletic Training comments that, “lateral ankle sprains (LAS’s) are common musculoskeletal injuries among the general population.” As a sports-related injury, “approximately 11,000 ankle sprains occur per year in US collegiate athletes, and ankle-ligament sprains were most frequent in men’s basketball players,” notes the research.
Yet, many people do not perceive the LAS, as being a substantial injury – with 73% of those sustaining a LAS reporting reinjury. Up to 40% of these so called “copers” – with reoccurring LAS - will develop chronic ankle instability (CAI).
The researchers comment that individuals with CAI describe feelings of instability or episodic ‘giving way’ and physical or subjective dysfunction lasting more than 1 year, after the initial LAS.
The gluteal muscles, notes the journal, play an important role in global movement of the hip, as well as, pelvic stabilization during closed chain exercises.
The take-away message is that it’s important to develop hip abduction (away from midline) strength to reduced LAS and CAI.
The shoulder, specifically the posterior rotator cuff, is one of the most injured sites that overhead, throwing athletes experience in their throwing careers—at any level of play. Understanding scapular function and its dynamic role in rotator cuff function is critical to prevent needless, non-contact injury.
The serratus anterior (SA) and trapezius play important roles in moving and stabilizing the scapula during upper extremity motion, according to research— "Serratus Anterior and Upper Trapezius Electromyographic Analysis of the Push-Up Plus Exercise: A Systematic Review and Meta-Analysis"—which appeared in the November 2019 issue of the Journal of Athletic Training.
The serratus anterior—a muscle that originates on the surface of the 1st to 8th ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula—acts to pull the scapula forward around the thorax. “Serratus anterior weakness is often present in overhead athletes and can result in shoulder dysfunction due to altered scapular kinematics, such as winging and tipping,” notes the research.
The trapezius—a diamond-shaped, flat, triangular muscle located on each side of the upper back—functions as a shoulder stabilizer with the serratus anterior and the rhomboids. The trapezius moves the scapula and supports the arm.
In overhead throwing athletes, there typically is an intramuscular imbalance between the SA and upper trapezius (UT). It appears that push-up plus exercise strengthens the SA, while minimally activating the UT.
Read the rest on MaxWellNutrition.com
In the coming months, new research will be presented in the journal Medicine & Science in Sports & Exercise that will corroborate one of the benefits of acute exercise (single session) - its ability to lower the post meal (postprandial) plasma triglyceride (blood fat) response to a high fat meal, as well as, increase fat utilization (oxidation).
To do so, the acute exercise session must be able to overcome what’s termed as “exercise resistance.” That’s not to be confused with “anabolic resistance,” or the inability of a senior individual to repair, as quickly and effectively as, their younger counterpart, without intervention.
It appears from upcoming research that the exercise duration must account for at least 5,000 steps or the metabolic equivalent. From previous step-count research, we’ve learned that obese individuals – a body mass index of 30 or greater – tend to take between 4600 to 6,000 total daily steps, irrespectively of intensity.
Since the research paper is sequestered until publication, I’m not able provide any further details until its release date. However, I can go back to October 2020 to research – Hourly 4-s Sprints Prevent Impairment of Postprandial Fat Metabolism from Inactivity – which appeared in the same publication.
Researchers from the Human Performance Laboratory at the University of Texas at Austin concluded that, “that hourly very short bouts (4 seconds) of maximal intensity cycle sprints interrupting prolonged sitting can significantly lower the next day’s postprandial plasma triglyceride response and increase fat oxidation, after a high-fat meal in healthy young adults.”
Given that these improvements, comment the researchers, “were elicited from only 160 seconds of non-fatiguing exercise per day, it raises the question, as to what is the least amount of exercise that can acutely improve fat metabolism and other aspects of health.”
The Texas researchers point to prior research that stated that in order to overcome the negative effects – like reducing the rise in post-meal triglycerides (risk to cardiovascular disease) of prolonged sitting, an individual had to exercise for 60 to 75 minutes per day at a moderate intensity.
Using eight healthy, untrained and recreationally active subjects – four men and four women – the researchers looked, “to determine if very brief (4-s) cycling performed at maximal intensity in blocks of five repetitions per hour is effective in counteracting the effects of prolonged sitting on postprandial lipid (fat) metabolism.”
The participants sat for 8 hours. Then, their postprandial metabolism was measured the next day (SIT), which was compared - with an exercise trial of five repeat-cycle sprints (inertial load ergometer) - lasting only 4 seconds each - performed every hour for 8 hours (SPRINTS). Taken in context, each hour, 20 seconds of sprint exercise was performed totaling 160 seconds of SPRINTS for the entire 8-hour day.
Prior to the testing, resting metabolic rate studies were performed to asses caloric intake to maintain a stable body weight - with an additional 20% of calories was added to account for exercise. The morning of each trial, the participants took a high-fat/glucose tolerance test (HFGTT) – followed by sitting for six hours – with a fasted blood sample taken.
The tests extended at 2, 4, and 6 hours, after the ingestion of a high-fat and glucose shake. Fat oxidation rates were determined at baseline, 2, 4, and six hours from expired gases postprandially (after a meal).
The investigation determined that hourly 4-second “all-out” sprints - performed five times per hour on the stationary cycle - while sitting for 8-hours reduced the next day’s postprandial plasma triglyceride incremental by 31%, compared with sitting for 8 continuous hours. .
Read the rest at maxwellnutrition.com.
In a systematic review of literature published before March 15th, 2021 - regarding an association between Vitamin D deficiency and the risk of Covid-19 in an aged population, French researchers report that, “vitamin D deficiency appears to expose these subjects to a greater risk of adverse outcomes. Because of its simplicity of administration, and the rarity of side effects, including vitamin D in preventive strategies for certain viral diseases, it appears to be an attractive option.”
This study – "Relation Between Vitamin D and Covid-19 in Aged People: A Systematic Review" – which appeared in the April 2021 issue of the online, peer reviewed journal Nutrients, used 707 studies identified to assess adverse outcomes and the benefits of Vitamin D supplementation for people 60 years and older with Covid-19 exposure. Studies included data from aged patients on vitamin D use and Covid-19, while basic science articles, editorials, and correspondence was excluded from the analysis.
Since its inception in December of 2019, Sars-CoV-2, Covid-19, has become a worldwide pandemic. Most infections cause mild-to-moderate signs, while severe forms – acute respiratory distress secondary to lung damage - of the disease can lead to death, especially in aged people or those with comorbidities, such as obesity, hypertension, pulmonary issues, and heart disease.
It’s also known that respiratory complications beyond seven days were caused by a dysregulation of the immune system – referenced as a cytokine storm. Vitamin D has proven to support an immune response through activation of the innate immunity, which reduces the overactivity of the adaptive immune system.
According to the researchers, “there was a high prevalence of low vitamin D levels, even in countries with abundant sunshine, particularly in aged people. Observational studies suggest an association between low serum vitamin D level and susceptibility to acute respiratory tract infection.”
Further, comment the French researchers, “concerning the relationship between vitamin D level and outcomes in COVID-19, patients with vitamin D deficiency have worse clinical outcomes than non-deficient patients in terms of mortality.”
Also noting that, “aged people are at greater risk of severe forms of COVID-19 infection and at risk of vitamin D deficiency, prompting some authors to suggest that vitamin D supplementation may improve the prognosis of aged people infected by SARS-CoV- 2.”
The good news is that you can check your vitamin D status with a blood test. Depending on the laboratory reference range, a vitamin D blood value of less than 20 ng/mL is considered deficient, while a reference range of between 20-30 ng/mL is considered insufficient.
Your primary care physician can provide you with appropriate supplement guidelines, which might include a prescription vitamin D, if deficient.
For more information, go to maxwellnutrition.com.
Prediabetes, which affects over 86 million adults in the United States, is established by achieving a fasting blood sugar in the range of 100-125 mg/dl and / or an impaired glucose tolerance test.
The good news is that prediabetes can be, in many cases, returned to a normal blood sugar status, with appropriate, positive lifestyle changes, that involve a combination of dietary restriction and exercise.
There is also evidence that type 2 diabetes may be reversed with more invasive strategies – such as bariatric surgery - in a select, overweight/viscerally fat population.
According to research – a “Single Bout of Premeal Resistance Exercise Improves Postprandial Glucose Metabolism in Obese Men with Prediabetes” – which appeared in the April 2021 issue of Medicine & Science in Sports & Exercise, the (2002) Diabetes Prevention Program Research Study demonstrated that lifestyle interventions, which targeted a 7% weight loss with 150 minutes per week of moderate-intensity endurance exercise, “reduced the incidence of T2D by 58% and was significantly more effective than treatment with metformin alone in individuals with prediabetes.”
Yet there is insufficient research to establish the effects of resistance exercise (RE) on glucose metabolism in prediabetics. Some evidence has demonstrated that, in older, overweight subjects with prediabetes, twelve weeks of RE improved glucose tolerance, but not insulin sensitivity, during an oral glucose tolerance test.
The Medicine & Science researchers, from Washington University School of Medicine in St. Louis and the Department of Orthopedics, Duke University in North Carolina, chose to establish the effects of a single bout of RE on post-meal (postprandial) glucose metabolism, after a mixed meal in obese, sedentary men with prediabetes.
Ten sedentary, prediabetic, obese men enrolled in the randomized, cross-over study. After an overnight fast, the participants were guided to complete a single session of RE – seven exercises, 3 sets of 10-12 repetitions at eighty percent of their predetermined maximum strength (1-rep max), or an equivalent rest period.
After the RE, the subjects consumed a mixed test meal, while simultaneously having an intravenous glucose infusion, to establish their basal and post-meal rate of glucose appearance and disappearance from their plasma, insulin insensitivity, and an insulinogenic index to measure beta cell function in the pancreas.
“Skeletal muscle biopsies were obtained 90 min post-meal to evaluate pyruvate-supported and maximal mitochondrial respiration. Whole-body carbohydrate oxidation was assessed using indirect calorimetry,” according to the researchers.
The researchers concluded that, “a single bout of RE moderately reduced the glycemic response to a mixed meal, significantly improved insulin sensitivity, and reduced the glucose-normalized insulin response in obese, middle-age men with prediabetes.”
It was also noted that, “there were limited effects on postprandial glucose clearance, insulinogenic index, whole-body carbohydrate oxidation, or skeletal muscle pyruvate-supported respiration.”
As with any such research, with a small group of subjects, additional research is needed to determine how RE brings about positive changes after a meal, which typically in the US, is high in fat and sugar.
Before you embark on changes to your exercise or diet, especially if you are a male, who is sedentary and obese, with known or undiagnosed prediabetes or type 1 or 2 diabetes, check with your primary care physician.
For more information, go to maxwellnutrition.com.
In the February 2020 online issue of the Journal of Urology, a study – "The Association Between Popular Diets and Serum Testosterone Among Men in the United States" – concluded that, “men adhering to low fat diets had lower serum testosterone levels, even when controlling for comorbidities, age, body mass index, and activity levels.”
It was further noted that, “as differences in serum testosterone between the diets were modest, the avoidance of fat restrictive diets should be weighed against the potential benefits on an individual basis.”
This conclusion reached by the Illinois medical researchers came, as a result of a review of the NHANES (National Health and Nutrition Examination Survey) from 2000, 2003, 2011, and 2012 - involving 3128 men, age 18 to 80, who completed a 2-day dietary history and testosterone testing. Inclusion criteria included following the American Heart Association low fat and Mediterranean diet.
The AHA low fat diet limits the daily saturated fat intake to less than 7 percent of calories, trans fat to less than 1 percent of total calories, and sodium to 1500 mg a day. It encourages balancing the food intake over three meals, which are consumed at regular intervals
The Mediterranean diet is composed of extra virgin olive oil, seafood, legumes, like lentils or chickpeas, nuts and seeds, leafy greens, a moderate amount of red wine, and herbs and spices, such as oregano.
“Multivariable analysis controlling for age, body mass index, activity level, diabetes, comorbidities and prostate cancer showed that men with a nonrestrictive diet had higher serum testosterone than those adhering to a low-fat diet,” noted the study.
It’s important to point out that a proposition of the men in the study group were at an age, where serum testosterone may have been declining. Urologyhealth.org says that, “overall about 2.1% (about 2 men in every 100) may have TD (testosterone deficiency). As few as 1% of younger men may have TD, while, as many as, 50% of men over 80 years old may have TD.”
The symptoms of TD include low sex drive, fatigue, reduced lean muscle mass, irritability, erectile dysfunction, and depression. Should you suspect that low T is a factor in your lifestyle, then check with personal physician for guidance.
For more information, go to maxwellnutrition.com
In today’s world of high sports participation and recreation, much less the effects of normal human aging, and irrespective of the contact and non-contact trauma that the physical games we play can yield, pain, injury, and skeletal diseases are common occurrences.
Anterior cruciate ligament (ACL) sprains and tears, many of the non-contact type, are at epidemic proportions in female athletes participating in sports like basketball, soccer, and volleyball.
Research points to the increased female ACL injury risk being associated with the anatomical design of the female hip, poor landing technique during jumping activities, reduced muscle stiffness, and faulty recruitment of the hamstring musculature during deceleration, to name a few.
The female athlete is at four times the risk to an ACL injury versus their male counterpart – with, as much as, a 24% increased risk to ACL injury in the uninjured knee, upon return to sport.
According to research – "The Influence of Specific Bioactive Collagen Peptides on Knee Joint Discomfort in Young, Physically Active Adults: A Randomized Controlled Trial"– which appeared in the February 2021 issue of the online journal Nutrients, “collagen type I and II are the most important structural and functional components of the extracellular matrix of tendons, ligaments and cartilage.”
The researchers from Germany and Austria cite research that says, “an increased risk of anterior cruciate ligament rupture or shoulder dislocation is also attributed to an impaired architecture of the connective tissue. Although most complaints are related to sport, non-athletes may also sustain recurrent overuse injuries.”
Once tissue or a joint is damaged, inflammation, a normal reaction to trauma, is initiated, which can be associated with pain. “Regardless of whether muscles, tendons or cartilage tissue are affected, the cause is a disproportion between load and load tolerance of the tissue,” as noted in the Nutrient’s paper.
Excessive training, inadequate recovery periods, and constant competitive stresses on the muscles and joints can be extrinsic factors that potentially increase the incidence of stress-induced injuries in every age group.
Intrinsic factors – like reduced flexibility of a muscle group, loss of range of motion in a joint, and anatomical differences, such as a leg-length discrepancy, can place the active individual to increased injury risk.
The researchers reference the outcomes of preclinical studies, which indicate that consumable collagen peptides have a particularly high absorption rate - the result of their low molecular weight and the high proportion of proline and hydroxyproline, that permits, “a high resistance to intestinal digestion and higher transport efficiency.”
It’s also proven that collagen-derived peptides accumulate in the cartilage tissue, where they can stimulate extracellular matrix molecules, and, therefore, counteract progressive tissue degeneration.
The European investigators note prior research that, “imply that the intake of 5 g of specific collagen peptides for 12 weeks is sufficient to significantly reduce pain intensity during physical activity. Based on the survey of the participants, it can be assumed that medical treatment options, such as drugs or physiotherapy could be reduced by the pain-relieving effect of collagen peptides.”
The investigators chose to confirm the efficacy of the same collagen peptides in a comparable study population.
Read the rest on maxwellnutrition.com.
Cardiovascular exercise (CV), and other such classifications of fitness endeavors, has extensive research to support the American College of Sports Medicine’s broad definition as “exercise medicine.”
Current, established activity guidelines include recommending a minimum of 150 minutes of moderate-intensity exercise, or 75 minutes of high-intensity weekly exercise to maintain or improve cardiorespiratory fitness and health, while reducing the risk to non-communicable diseases – type 2 diabetes, cancer, osteoporosis, stroke, and more.
The nomenclature of CV exercise has specific variations, such as endurance exercise, in the form of moderate-intensity, continuous training (MICT), and high-intensity interval exercise (HIIE) - referenced as high-intensity interval training (HIIT), and sprint interval training (SIT).
HIIT involves alternating intervals at greater than 80% of maximum endurance capacity (VO2 Max) or 85% of your maximal heart rate (220-age), typically 1 to 4 minutes in duration – with lower intensity, active or passive recovery, while SIT uses short – full go – intervals, typically less than 30 seconds, with short, passive recovery.
Writing in the March 2021 issue of Medicine & Science in Sports & Exercise – Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: a Meta-Analysis - researchers from the Sports Medicine Department, Clinical Epidemiology and Applied Biometrics Department, and the Psychosomatic Medicine and Psychotherapy Department, University Hospital of Tubingen in Germany, used a meta-analysis (many similar studies) to investigate the clinical benefits distinguishing each exercise modality (HIIE and MICT) in health and disease.
The data search began in January of 2018 and culminated in July of 2020.
The seven key clinical endpoints of the literature analysis included: “physical fitness (VO2 max), endothelial function (flow-mediated dilation [FMD]), body composition (body mass index [BMI], body mass, and body fat), blood pressure (systolic and diastolic blood pressure), blood lipids (HDL, LDL, triglycerides, and total cholesterol), inflammation (C-reactive protein [CRP]), and insulin and glucose metabolism (fasting glucose, fasting insulin, glycated hemoglobin [HbA1c], and insulin resistance (HOMA-IR).”
After a comprehensive analysis of the data, the researchers said, “overall, HIIE showed to be more effective in improving cardiovascular health and cardio- respiratory fitness, whereas MICT was superior in improving long-term glucose metabolism.”
From an aging perspective, the data analysis determined that relative to endothelial function, which protects tissues from toxic substances, regulates the blood clotting mechanism, controls the transition of fluid and certain substances between the blood and tissues, and inflammatory control in tissues - it was determined that the HIIE had higher effects than did the MICT – the result of the “interval-like” exercise training programs inducing a, “higher shear stress, and promoting an increased nitric oxide release.”
The Germans recommended that, “in the process of personalized training counseling, health-enhancing effects of exercise training may be improved by considering the individual risk profiles.”
And, that risk stratification needs to start with your personal physician. For more information on this topic and more, go to maxwellnutrition.com.
Since the advent and spread of the SARS-CoV-2 acute respiratory syndrome in 2019, classified as Coronary Virus Disease-19 (Covid-19) in February 2020, then transcending to pandemic status in Match 2020 by the World Health Organization, scientists have been searching for efficacious medical treatments and environmental guidelines to halt the spread, treat the symptoms, and reduce the risk to contraction.
As of this writing, there is no cure. However, with three vaccines in the inoculation phase, it appears that the spread and death rate worldwide is going down, as more people receive the vaccinees – pending the Covid-19 disease variant impact. The bottom line is to strengthen the human immune system’s – innate and adaptive - ability to recognize, then destabilize the Covid-19 disease in its tracks.
One non-medical area of research is related to nutraceuticals – nutrients – that may complement prescription medications to address the Covid-19 symptoms, or to support a preventive approach.
According to research – Effect of Oral L-Glutamine Supplementation on Covid-19 Treatment, which appeared in the July 2020, open science journal Clinical Nutrition Experimental – researchers from Biruni University Faculty of Medicine in Afghanistan – conclude that, “adding enteral L-Glutamine to the normal nutrition in the early period of Covid-19 infection, may lead to a shortened hospital stay and lead to less need for ICU.”
Glutamine, a conditionally essential amino acid, is the most abundant amino acid, containing 60% of the total free amino acids in the body – with the main synthesis sources circulating in plasma being skeletal muscle, adipose tissue, and lungs. Glutamine is found in dairy foods, such as yogurt, cottage cheese, and all forms of whey protein powder – blend, isolate, and hydrolysate.
Glutamine performs most of the transport of nitrogen from the skeletal muscle to the visceral (abdominal) tissues, and, is used as a glucose-efficient primary fuel for many rapidly dividing cells, including enterocytes, colonocytes, lymphocytes, and fibroblasts, comment the researchers.
As for a direct immune modulation effect, glutamine is a precursor to the powerful, endogenous liver antioxidant glutathione. “It is one of the most researched amino acids on multiple aspects of medical nutritional care, including conditions, such as gastrointestinal diseases, oncology, burn injury, HIV/AIDS, and chronic wound management,” as noted in the Biruni research.
To reach their conclusions, the Afghan investigators screened 381 Covid-19 patients – sixty meeting the inclusion criteria - those who had lower respiratory tract involvement in computed thorax tomography (thorax CT), and positive real-time reverse-transcriptase-polymerase-chain reaction (RT-PCR) test in oro-nasopharyngeal swab.
The study demographics included, “thirty Covid-19 patients (12 female, 58.2 ± 8.4) using L-Glutamine and 30 Covid-19 patients (14 female, 58.8 ± 7.4) with similar age, gender, and clinical status,” as a control group.
In addition to appropriate laboratory analysis, C-reactive protein (inflammatory marker), complete blood count, kidney and liver function, among others, the nutritional status of all patients, body mass index, any weight loss in the last three months, was also recorded.
Read the rest at MaxWellNutrition.com.
Building muscle, nine essential amino acids (EAA) at a time, is the driving force behind muscle protein synthesis (MPS) – overcoming the normal effects of muscle protein breakdown (MPB) - resulting from a host of situations like, exercise training, rehabilitation sessions, surgery, trauma, and the advanced age-related loss of muscle (sarcopenia), with the associated loss of strength (dynapenia).
A net balance between MPS and MPB – where synthesis is higher than breakdown – equates to an anabolic (building response) versus the reverse – catabolism (breakdown).
Using resistance training as an example, once the session is complete, the body begins the process of releasing intracellular (muscle cells) EAA to support MPS. In essence, your body robs from Peter to pay Peter to the extent of the cellular muscle damage caused by the intensity and the volume of the session.
Body builders know that recovery from intense, frequent training – six muscle training sessions per week, sometimes with daily split routines (AM & PM), starts with a post-absorptive meal or EAA supplementation within 2 hours after session completion.
According to, Essential Amino Acids and Protein Synthesis: Insights into Maximizing the Muscle and Whole-Body Response to Feeding, which appeared in the December 2020 issue of the online, peer-reviewed journal Nutrients, “intracellular amino acid recycling is not 100% efficient.” MPB can exceed MPS in the post-absorptive state, resulting in a net loss of muscle protein.
In order to replace the lost muscle protein, “exogenous (consumed) EAA are required to increase circulating concentrations to induce a stimulation in MPS, while simultaneously reducing MPB.”
The study authors, from Arkansas, Korea, and Tennessee, point out that dietary EAA represent, “the primary stimuli for an increase in MPS and subsequent expansion of the skeletal muscle protein pool,” while also serving, as a resource for the “splanchnic” (organs in the abdominal cavity) and tissue during periods of stress (like trauma) or inadequate EAA dietary consumption.
Lean body mass – muscle – contributes a significant amount of the body’s protein. Yet, note the researchers, “other tissues may account for more than half of the total protein turnover in the body,” – with skeletal muscle accounting for an estimated 25-50% of whole-body protein turnover.
The Nutrient authors investigated how changes in peripheral EAA, after ingesting various protein and free amino acid formats, altered muscle and whole-body protein synthesis.
The male participants - healthy, young, and older – refrained from physical activity for 72 hours. Then, after an overnight fast, an isotope infusion was utilized to determine mixed MPS and whole-body protein synthesis.
It was determined that a greater amount of the peripheral EAA concentration was tied to not only MPS, but also to WBPS (whole-body protein synthesis). The EAA concentration included EAA and BCAA (branch chain acids), specifically leucine, which has been demonstrated to serve, according to the researchers, as a “trigger” to facilitate MPS by mTOR (mammalian target of rapamycin complex) signaling.
To read the rest and for more information, go to maxwellnutrition.com.
Based on epidemiology data, as to the higher incidence of risk to complications related to Covid-19 exposure in African Americans, science has been exploring a number of possible reasons.
New research – “Does the High Prevalence of Vitamin D deficiency in African Americans Contribute to Health Disparities” – which appeared in the online, peer-reviewed journal Nutrients in February of 2021 – says there is a higher prevalence of Vitamin D deficiency in many African Americans – the result of people of African descent having brown-black melanin skin pigment, versus Angelo-Celtics, who have a yellow-to-reddish melanin.
That means African Americans are particularly at risk for vitamin D deficiency (less than 20 ng/mL in the blood) at high latitudes, where vitamin D synthesis depends on exposure to solar UVB radiation. At high latitudes, the UVB radiation dose is lower – causing a lower Vitamin D production, which starts in the skin.
The researchers from the University of California, Berkley, Sunlight, Nutrition and Health Research Center in San Francisco, Harvard T.H. Chan School of Public Health, and Brigham and Women’s Hospital – both in Boston, comment that, “vitamin D deficiency can be corrected rapidly and inexpensively.”
Vitamin D, a seco-hormone, which is a critical component of skeletal integrity, also regulates the activity of many thousand protein-encoding human genes.
Vitamin D’s conversion from 25(OH)D2 to 1,25(OH)D3 is a multi-step process in the body. The process begins, when “vitamin D3 is synthesized in human skin by the UVB-dependent conversion of 7-dehydrocholesterol to vitamin D3. Vitamin D3 is then converted to 25(OH)D3, a precursor of the crucial vitamin D steroid hormone, 1,25-dihydroxyvitamin D3, or calcitriol, in a reaction requiring magnesium.”
Evidence points to the fact that higher serum 25(OH)D levels can reduce the risk or severity of acute respiratory tract infections, possibly including COVID-19 – with Vitamin D’s positive impact on innate and acquired immunity.
The researchers cite evidence, which says the, “incidence and mortality of COVID have been far higher in African Americans than in European Americans; after adjustment for age, African Americans are 4.5 times more likely to die from COVID-19 than European Americans.
As for Vitamin D’s effect on reducing Covid-19 patients from advancing into intensive care units, “in a non-randomized intervention study conducted in Spain among hospitalized patients hospitalized for COVID-19, high doses of vitamin D (as 25(OH) D3) were administered in combination with standard care; only 1/50 required admission to the intensive care unit compared to 13/26 comparable control patients.”
Vitamin D is mainly found in fish and fortified foods, such as milk, and sun exposure (if possible), which is why vitamin D supplementation, based on laboratory studies, is required to meet Institute of Medicine’s (IOM) level of at least 20ng/mL.
However, “levels between 20 and 30 ng/mL have also been associated with lower risks of colorectal cancer, total mortality, dementia, multiple sclerosis, and bone mineral density.”
Yet, according to the Nutrient’s investigators, “three-quarters of African Americans not already taking supplements have levels that do not ensure adequacy even by the IOM definition (20 ng/mL), and 96% have levels below 30 ng/mL. Notably, for African Americans living in Boston, 4000 IU/day was required to achieve serum levels of 30 ng/mL.”
Read the rest at MaxWellNutrition.com
Stress is no stranger to human existence. It’s a normal part of living and functioning in a gravitational state on this planet. But, as Buddha said, “be moderate in all things.” Too much of anything, on a chronic basis, can eventually be deleterious to one’s health.
Hungarian-born Hans Selye MD, Ph.D, the “so-called” father of stress research, developed and implemented his famous concept, “General Adaptive Syndrome (GAS),” a response of the body based on the demands placed on it. The body’s three stage response – alarm, resistance, exhaustion – manifest, as follows, notes Medicalnewstoday.com.
“At the alarm reaction stage, a distress signal is sent to a part of the brain called the hypothalamus. The hypothalamus enables the release of hormones called glucocorticoids. Glucocorticoids trigger the release of adrenaline and cortisol, which is a stress hormone. The adrenaline gives a person a boost of energy” – at cost of raising the heart rate, blood pressure, and blood sugar.
The control mechanism is the autonomic nervous system (ANS) – sympathetic nervous system (SNS) - fight or flight system - and the parasympathetic nervous (PNS) - relaxation or recovery response – all affecting heart rate variability (HRV), what happens between heart beats (R-R interval), resulting from an elevation in the hormone cortisol.
During the resistance stage, which is controlled by the PNS, “the body tries to counteract the physiological changes that happened during the alarm reaction stage,” notes the website.
If the stress gets under control, then the heart rate and blood pressure begin to return to normal. However, if the stressor remains, the body will stay in a state of alert, and stress hormones continue to be produced.
Should the stressor or situation become protracted, then the body goes into the final stage of GAS – exhaustion – depleting its energy resources by continually trying – eventually failing to recover from the initial alarm reaction stage.
Symptoms may manifest in the form of fatigue, depression, anxiety, and a feeling of the inability to cope. That’s when long-term stress may trigger the start of cardiovascular disease, type 2 diabetes, colitis, and other such stress-inflammatory conditions.
According to research – Magnesium Status and Stress: The Vicious Circle Concept Revisited – which appeared in the January 2021 issue of the online, peer-reviewed journal Nutrients, “magnesium is a naturally occurring calcium channel blocker, is involved in the maintenance of electrolyte balance (e.g., regulation of sodium–potassium ATPase activity), and plays a key role in membrane excitability.”
Magnesium, the second most abundant intracellular essential mineral, is a cofactor in hundreds of enzyme processes – specifically protein and nucleic acid synthesis, regulation of metabolic pathways, neuronal transmission, neuromuscular function, and normalization of cardiac rhythm.
The adult human body contains roughly from 21 to 28 grams of magnesium – with 50–60% being stored in the bones, while the remainder is distributed in soft tissues such as muscles.
The study authors, from various medical facilities and universities in France, comment that, “magnesium is also an essential component of the extracellular fluid (ECF) and the cerebrospinal fluid (CSF) in the central nervous system,” with, “only 1% of the total magnesium is extracellular and 0.3% of this circulates in serum in three different forms: Free (unbound; 60%), which represents the biologically active form; albumin-bound (30%); or in a complex with other ions (10%).”
Read the rest on MaxWellNutrition.com.
An individual, who is overweight or obese, with a dysfunctional lipid pattern, especially triglycerides, a blood fat elevated from excessive consumption of simple carbohydrates and saturated fats (fast food), may be at greater risk to postprandial (after a meal) hypertriglyceridemia (elevated triglycerides).
According to "Clinical Relevance of Non-Fasting and Postprandial Hypertriglyceridemia and Remnant Cholesterol," which appeared in 2011 on PubMed.gov, “non-fasting triglycerides are measured at any time within up to 8 hours, after any normal meal, while postprandial triglycerides are measured at a fixed time point within up to 8 hours of a standardized fat tolerance test.”
“In the general population, 38% of men have non-fasting/postprandial triglycerides > 2mmol/L (>176 mg/dL), while 45% of men have non-fasting/postprandial triglyceride levels of 1-2 mmol/L (89-176 mg/dL); corresponding fractions in women are 20% and 47%,” notes the study authors from the Human Performance Laboratory, Department of Kinesiology and Health Education, University of Texas at Austin.
The implications are, “non-fasting triglycerides ≥5 mmol/L vs. <1 mmol/L marked a 17 and 5-old increased risk of myocardial infarction, a 5 and 3-fold increased risk of ischemic stroke, and a 4 and 2-fold increased risk of early death in women and men in the general population.”
The good news is that research has demonstrated that a single exercise bout that involves taking 7,000 to 8,000 steps the day prior to postprandial triglyceride evaluation resulted in reduced and improved postprandial hyperlipidemia.
New research, Daily Step Count and Postprandial Fat Metabolism, which appeared in Medicine & Science in Sports & Exercise, in February of 2021, commented that, “in participants, who were sitting for >14 hours a day and taking only 1650 steps per day, a 1-hour bout of running at 67% maximal oxygen consumption (VO2max) failed to improve postprandial hypertriglyceridemia the next morning.”
It seems, notes the research, “that physical inactivity (i.e., high sitting and severely reduced step count) rendered the participants resistant to the normal acute improvements in indices of cardiometabolic health that are normally derived from a 1-hour bout of running” - a phenomenon labeled “exercise resistance” -becoming, “resistant to the normal acute improvements in indices of cardiometabolic health that are normally derived from a 1-h bout of running.”
The takeaway message is that despite one hour of running at what would be considered a moderate pace – something many people would not tolerate – the prolonged running bout failed to kick start the metabolism, when sitting too long and taking few, total daily steps.
It could be concluded that the extended running bout may have fatigued the runner, such that they sat longer and took fewer steps the rest of the day. That begs the question of what is the minimum step count to assist dietary restrictions to lower the post-meal elevated blood fat levels – understanding that a high saturated fat meal may keep the triglycerides elevated for up to 10 hours?
Many heart attacks come in the early morning hours (2 to 3AM), following an evening high fat meal.
For more information and to read the rest, go to maxwellnutrition.com.
Research has documented that within the first 6 to 8 hours post exercise, competition, or training – the window of recovery – the combined intake of protein (PRO) and carbohydrate (CHO) per hour – based on body weight (kilograms), is the appropriate mode to accelerate glycogen repletion in the liver, muscles, and circulatory system.
The reasoning is the sum of the parts – carbohydrate and protein ingestion – may be greater than either component in isolation. However, research is somewhat inconsistent.
The physiological effect is caused by the insulinogenic effects, when a fast -digesting whey protein isolate – high in the essential, branch chain, anabolic amino acid leucine – is selected, as the post-recovery protein of choice.
It’s also reported that the optimum refeeding of carbohydrate over the 6 to 8-hour recovery window is 1.2 grams per kilogram (2.2 pounds) of body mass, while the optimum protein refeeding is roughly 0.3 grams per kilogram.
Yet, some research says that after a carbohydrate refeeding of greater than 0.8 g/kg/hour a saturation effect takes hold – with more being less, potentially negating the effects, if protein is added to the mix.
In a study – Co-Ingestion of Carbohydrate and Protein on Muscle Glycogen Synthesis After Exercise: A Meta-Analysis – which was reported in the February 2021issue of Medicine & Science in Sports & Exercise, researchers from the Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine in Massachusetts, and the Oak Ridge Institute of Science and Education, in Tennessee, the primary objective was, “to aggregate results from multiple studies to characterize the effects of CHO-PRO on glycogen synthesis, during recovery from exercise compared with CHO alone.”
The meta-analysis (numerous similar studies), which included research from PubMed and the Cochrane Library database, took place in July of 2019 – with a second search in March of 2020. “The population, intervention, control, and outcome for this meta-analysis were healthy, trained or untrained men or women, CHO-PRO, CHO only, and glycogen synthesis, respectively,” commented the investigators.
Read the rest on maxwellnutrition.com
1944 research determined that Greenland Eskimos, who despite a diet high in fat, had a lower incidence of coronary heart disease (CHD) – specifically due to the type of fat found in their diet, which was high in fish (seal & whale), despite a low in consumption of fruits and vegetables.
It was determined that the coronary heart disease risk reduction in the Eskimos was due, in part, to a high intake of omega-3 polyunsaturated fatty acids in their fish selections, that confer benefits of a reduction in high-risk triglycerides (TG), anti-inflammatory and anti—arrhythmic effects, vasodilation, reduced blood pressure, improved arterial and endothelial function, favorable autonomic tone, and reduced platelet aggregation.
According to “An Update on Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Health”, which appeared in the January 2021 online, peer-reviewed journal Nutrients, “TG levels are a historically well-studied, independent risk factor for CHD. Ω-3 (omega-3) or fish oil diet supplementation is evidenced to lower TG levels in a dose-dependent fashion, whereby 3–4 g/day of eicosapentaenoic acid (EPA), or a combined EPA and docosahexaenoic acid (DHA) reduces blood levels by 20–50% in those with high TG’s.”
I had the distinct pleasure to work with and learn from one of the study authors, Carl J. Lavie, MD, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinic School, The University of Queensland School of Medicine in New Orleans, during my prior tenure, as the Director of Health and Fitness for Lavie’s institute.
To this date, Lavie still provides interpretation of cardiovascular testing for my diverse client population.
In their review of the omega-3 history and research, Lavie and his study colleagues note prior controversies over the purported omega-3 benefits taken from popular media, “which wrongly suggested that Ω-3 ingestion, including that from fish, increased prostate cancer risk, with many commentaries thereafter advising against the use of supplemental fish oil.”
On the contrary, the study investigators comment that, “habitual high intake of fish and seafood in men, who have prostate cancer, however, has been linked to significantly improved survival. Accordingly, Japanese men, who consume approximately 8 times more fish than their American counterparts, have a rate of prostate cancer mortality many-fold lower.”
It was further noted by the investigators that in 2018, three large trials added to the omega-3 controversy.
The ASCEND trial determined that there was no reduction in cardiovascular disease (CVD) risk, when 1 gram per day of EPA plus DHA was used for primary prevention in patients with diabetes. “There was no significantly lowered incidence of serious vascular events in 15,480 patients after mean 7.4 years of follow up.”
However, comment the study authors, “there was a statistically significant 18% relative risk reduction in vascular death, defined as death from CHD, stroke or other vascular causes, which seems to be a meaningful endpoint that was not emphasized in this paper.”
In the VITAL trial, which administered 2000 IU/day vitamin D3 and 1 gram/day Ω-3 (EPA + DHA) for primary prevention of CVD and cancer in 25,871 patients, there was no difference between the intervention and placebo groups at a median of 5.3 years.
Read the rest on maxwellnutrition.com.
It’s estimated that the annual cost of recreational or sports-related injury and rehabilitation is roughly nine billion for young adults seventeen to forty-four years of age. In many cases, such as in an injury to the anterior cruciate ligament (ACL), with associated surrounding ligament damage – meniscus and medial collateral ligament - early osteoarthritis is in the future.
When I was affiliated with the St. Louis Blues Hockey Organization, as their Performance Conditioning & Nutrition consultant, from 1989 to 1999, hockey research reported that you could anticipate an injury for every 1000 man-hours on the ice.
With a 3-hour practice limitation, when you place 50 players (during training camp) on the ice, you’ve burned up 150 man-hours in one practice session. Thirty percent of the injuries were non-contact, fatigue related.
A primary focus of injury management, treatment, and if applicable, pre/post-surgical, is the management of inflammation, which is a normal, important aspect of the body’s repair process – until it gets out of control or protracted.
Modes of treatment, such as cryotherapy, anti-inflammatory prescriptions, and even nutritional interventions, like omega-3 supplementations, may be contraindicated in the initial therapy intervention.
To read the rest or more information on this topic and wellness research, go to maxwellnutrition.com.
Common sense tells you that the longer the duration of exercise, the larger the energy expenditure – more calories burned. The intensity of the exercise – either as a percentage of maximum endurance capacity (VO2 Max) or maximum heart rate (220-age) – determines the type and percent of energy expended – carbohydrate (muscle and liver glycogen) and adipose fat (fatty acids and glycerol).
When exercise is stopped, a process called enhanced or excess post-exercise oxygen consumption is activated - once again, determined by the exercise duration and intensity. As more fatty acids (FA) are expended post-exercise, as reflected in a lower respiratory exchange rate (RER), the FA expensed can go on for hours in untrained and endurance-trained people.
According to "The Importance of Fatty Acids as Nutrients During Post-Exercise Recovery," which appeared in the March 2020, online issue of the journal Nutrients, “the peak in circulating FA concentration in the immediate recovery (first hour post-exercise) period following submaximal exercise has been suggested to be due to a delayed spill-over effect from the increased adipose tissue lipolysis (fatty acid breakdown) induced during exercise.”
As time progresses in the early recovery period, “the whole-body lipolytic rate, determined from the plasma glycerol rate of appearance, increases by up to 400% above resting values during exercise of 1 to 4 h at 40%–65% of VO2peak” – which roughly translates to 55 to 75% of max heart rate.
It’s known that elevated circulating insulin levels can inhibit adipose tissue lipolysis (fatty acid breakdown). It’s also recognized that, “plasma insulin concentrations are decreased during exercise and remain lower in early recovery compared with pre-exercise or resting conditions until glucose or meal ingestion.”
Thus, “a lower plasma insulin concentration can also contribute to an increased adipose tissue lipolytic rate in early recovery,” note the study authors from Denmark.
The Danish researchers comment that, “coinciding with the low RER values in early recovery, oxidation of plasma-derived FAs is increased in the first 3 hours and represents the major part of the FAs oxidized during the early recovery period.”
In my prior hospital-affiliated weight management programs, we monitored our participant’s RQ (respiratory quotient) - representing the spread of energy utilization at rest – and the RER during maximum Pulmonary VO2 testing to determine the optimum fat burning heart rate training zone.
The study authors conclude by saying, “whole-body FA oxidation is increased for several hours following aerobic exercise, even with carbohydrate-rich meal intake during recovery from exercise.”
I’ve previously commented that a person is as young as they are metabolically active. It’s been my experience to see some post-menopausal (average age of 51) women and obese men - with a high RQ coming into my weight management program - signifying that, over time (Rome was not built in a day), they had become proficient at storing fat.
It usually took 6 weeks of combined aerobic exercise in a target heart rate zone – based on testing – of 50 to 70 percent of maximum heart rate – along with circuit training (ten exercises) – to get back to a baseline to begin to expense excess body fat and inches.
The solution is to keep moving – with a modicum of dietary controls – to keep the system metabolically active well into old age.
For more information, please go to maxwellnutrition.com
Anyone following college and professional sports has witnessed the lengths that colleges and professional organizations are talking to keep their respective players and fans safe from the ravages of COVID-19, while attending sporting events, albeit with limited seating capacity.
Sporting events have been cancelled or postponed due to a team experiencing multiple player COVID exposures. Arenas have been mandated, at times, to have no fans in attendance, due to the corresponding local population, exceeding a 5% population COVID-19 exposure rate.
According to research - The Benefits of Vitamin D Supplementation for Athletes: Better Performance and Reduced Risk of COVID-19 - which appeared in December 2020, in the online, peer-reviewed journal Nutrients, "a hypothesis now under scientific consideration is that taking vitamin supplements to raise serum 25-hydroxyvitamin D [25(OH)D] concentrations could quickly reduce the risk and/or severity of COVID-19.
The research investigators from Sunlight, Nutrition, and Health Research Center in San Francisco, Vitamin D Wiki in Washington State, and the Departments of Human Nutrition, Foods, and Exercise and Center for Transformative Research on Health Behaviors at Virginia Tech University, comment that, "clinical trials have confirmed that vitamin D supplementation reduces risk of acute respiratory tract infections, and approximately 30 observational studies have shown that incidence, severity, and death from COVID-19 are inversely correlated with serum 25(OH)D concentrations (how vitamin D is measured in the blood)."
These investigators, in a narrative review of the data and literature to date, chose to evaluate, "the use of vitamin D supplementation to raise serum 25-hydroxyvitamin D [25(OH)D] concentrations to optimal values, which may be at least 40 ng/mL for sports. The benefits of vitamin D for athletic performance and general well-being are similarly reviewed."
In terms of the Vitamin D lab values - mean 25(OH)D concentrations of less than 15 ng/mL were generally associated with an increased severity and risk of death for COVID-19 patients. A mean 25(OH)D concentration of less severe, hospitalized COVID-19 patients were determined to be in a range between 17 to 30 ng/mL.
The researchers note that, "the 10 observational studies suggest that 25(OH)D concentrations <30 ng/mL are associated with increased risk of COVID-19 infection, but that the risk with respect to higher concentrations cannot be ruled out. Thus, it would be prudent to assume that higher values, such as between 40 and 60 ng/mL, might be the more appropriate range."
As to one mechanism, which Vitamin D may reduce the risks to COVID-19, it helps to mount a defense against the virus, while simultaneously supporting the control of COVID-19's cytokine storm by activating, "the anti-inflammatory cytokine IL-10, and downregulating pro-inflammatory cytokines such as IL-6."
Pertaining to the effects of COVID-19 relative to athletes, it has the ability to inflict short-term and permanent damage to many organs, like the lungs, respiration mechanism, and the cardiovascular system.
"Athletes who recover from COVID-19 may have lingering damage or other health concerns, such as chronic fatigue, which could be considered a fifth stage of the disease," according to the researchers.
To read the rest and for more information, go to maxwellnutrition.com.
Exercise and caloric restriction are a proven combination to reduce scale weight. The real key, however, is to reduce excess body fat - subcutaneous (under the skin), visceral (around vital organs), and ectopic (within the organs).
From an exercise perspective, it's all about frequency, intensity, and time - the "fit principle." Of the three variables, the appropriate intensity to optimize fat max - maximal fat burning - requires testing or the use of heart rate percentages that estimate fat max.
When exercising, the primary energy sources are derived from a percentage of fat and carbohydrate - depending on the intensity of exercise. The higher intensity the less fat is used and vice versa. The fat max zone can be determined via a VO2 Max test correlated to a percentage of maximum heart rate.
The V stands for volume, and the O2 is the chemical formula for oxygen we breathe. Your VO2 at the stage of maximal exertion is called your maximal oxygen consumption (VO2 max). The test is usually performed in a laboratory by a trained medical professional.
The VO2 Max test measures milliliters of oxygen per kilogram of body weight (1 kilogram = 2.2 pounds) used per minute. By measuring VO2 max relative to body weight, we are able to determine endurance and stamina levels. Then, we can relate this to a heart rate at any point during the test.
For max heart rate (HRmax) determination, the age-predicted HRmax formula used by the American College of Sports Medicine (ACSM) is 220-age.
According to research - "Fat Oxidation Rate As a Function of Plasma Lipid and Hormone Response in Endurance Athletes" - which appeared in the January 2020 issue of theJournal of Strength and Conditioning Research, "the regulation of adipose (fat) tissue lipolysis (breakdown) and the release of FFAs (free fatty acids) from adipose tissue to the muscle is an important route of control for fat oxidation (burning)."
Researchers from Spain sought to investigate, "the relationship among fat oxidation rate, plasma lipids (total cholesterol, triglycerides, HDL good cholesterol, and LDL bad cholesterol), and hormone concentrations (adrenaline, noradrenaline, catecholamine, insulin) in well-trained athletes."
The Spanish investigators recruited twenty-six trained triathletes, who completed a graded stationary cycle test to exhaustion - increasing the intensity every 10 minutes. Fat oxidation rates were determined using the indirect calorimetry method.
Each individual's maximal fat oxidation (MFO) rate - the intensity at which MFO occurred (fat max), and the intensity at which fat oxidation became minimal (fat min) were determined. Blood samples for lipid and hormone analysis were collected at the end of each stage of the graded exercise test.
It was determined that the fat oxidation rate became significant at 60% of VO2 max or 75% of HRmax, while maximizing at 70% of VO2 max or roughly 80% HRmax. As an individual reaches their VO2 max, they approach their HRmax.
From a lipid and hormone perspective, the researchers determined that, "low-density lipoprotein (LDL) and triglycerides (TG) decreased and showed lowest levels at 60%VO2max and reaching significant increases after 80%VO2max. High-density lipoprotein (HDL) reached significant increase at 60%VO2max. Adrenaline and noradrenaline increased until the end of the incremental exercise, and significant differences were from 50%VO2max."
The take-away message is that fat burns in the flame of oxygen at roughly 70-80% HRmax. From my experience, I have found the lower end of the range starts at 55% of HRmax.
Subtract your age from 220. Then take 55 and 80% for your lower and upper fat max training zone - ideally staying closer 70%, as the higher number.
To read the rest, and for more information and research-based nutritional products made in the USA, visit maxwellnutrition.com.
With COVID-19 surging after the Christmas and New Year’s holiday season, and the two vaccines, to date, relatively slow in the initial inoculation phase, any potential, safe, preventive therapy, as an adjunct to current modes of treatment, is a blessing.
Researchers from the United Kingdom, United States, and New Zealand report in the December 2020 issue of the online, peer reviewed journal Nutrients, that, “vitamin C’s antioxidant, anti-inflammatory, and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19.”
The research, Vitamin C – An Adjunct Therapy for Respiratory Infection, Sepsis, and COVID-19, states that, “the evidence to date indicates that oral vitamin C (2–8 g/day) may reduce the incidence and duration of respiratory infections, and intravenous vitamin C (6–24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections.”
Vitamin C, a water-soluble nutrient, is derived by humans only from the diet or supplementary intake – owing to a gene mutation prior to the human evolutionary period, unlike certain other species.
The researchers point out that in the European Union, the average vitamin C requirement is 90 mg/day for men and 80 mg/day for women, while the Swiss Society of Nutrition recommends that, “everyone supplement with 200 mg to fill the gap for the general population, and especially, for adults age 65 and older.”
The Linus Pauling Institute, here in the US, recommends 400 mg of vitamin C per day for adults 50 years and older.
“Pharmacokinetic studies in healthy volunteers,” comment the researchers, “support a 200 mg daily dose to produce a plasma level of circa 70 to 90 μmol/L. Complete plasma saturation occurs between 1 g daily and 3 g every four hours, being the highest tolerated oral dose, giving a predicted peak plasma concentration of circa 220 μmol/L.”
Read the rest on mackieshilstone.com.
Research is well documented on the benefits of moderate-to-vigorous intensity physical activities – meaning engaging in exercise that causes your breathing to be at or below a breathless state.
Former Oregon track coach and co-founder of Nike – Bill Bowerman - referred to moderate physical activity (MPA), as being below a breathless state, in which you are able to carry on an activity, like running, while simultaneously talking out loud – “the Talk Test.”
Bowerman’s innovative approach, defining the anaerobic or ventilatory threshold, was validated years later.
The 2018 Physical Activity Guidelines for Americans suggests that adults should accumulate at least 150 to 300 minutes per week of (MPA), 75 to 150 minutes per week of vigorous intensity physical activity (VPA), or an equivalent combination of physical activity of both intensities.
The VPA, as it pertains to best use of time – as intensity goes up, the duration comes down - has proven quite effective in sports to simulate the work-to-rest ratios that the game imparts to the competitor.
Yet, according JAMA (Journal of the American Medical Association) Internal Medicine research – Association of Physical Activity Intensity with Mortality, which appeared online in November of 2020, “it remains uncertain whether, for the same amount of total MVPA, VPA may actually offer additional health benefits compared with MPA.”
Researchers from China, Chile, Spain, and Brazil used 403,681 adults from the National Health Interview Survey from 1997 to 2013, who provided data on self-reported physical activity - linked to the National Death Index records through December 31, 2015.
Statistical analysis was performed from May 15, 2018, to August 15, 2020. Participants were excluded, if they lacked physical activity data, had disabilities that might affect daily activity, or incapable of performing moderate or vigorous physical activity.
It was speculated by the researchers that, “for the same amount of total physical activity, a higher proportion of VPA is associated with lower mortality.”
When the data was compiled and analyzed, the researchers determined that, “for the same amount of total physical activity, participants with a greater proportion of VPA to MPA had a lower all-cause mortality.”
“For instance,” noted the investigators, “among participants doing any MVPA, more than 50 to 75% of VPA to total physical activity was associated with 17% lower all-cause mortality, even after adjusting for total amount of MVPA.”
However, it was also noted that, “we did not find a consistent inverse association of proportion of VPA with CVD (cardiovascular disease) and cancer mortality.”
The bottom line: Participants performing 150 to 299 minutes per week of MPA and those individuals reporting 150 minutes per week or more of VPA had the lowest all-cause mortality risk.
From a heart rate intensity perspective, it’s been demonstrated that exercising in the range of 72 to 87% of maximum heart rate can improve cardiorespiratory fitness. Maximum heart rate is found by subtracting your age from 220. Then, take 72 and 87% of that number to have a projected heart rate training zone.
The caveat is that it’s best to speak with your personal physician, as to the best duration, mode, and intensity of exercise – based on your personal health profile.
Medscape.com reported in March 2020 that researchers from the Department of Epidemiology, School of Public Health, Southern Medical University in China, determined that, “habitual fish oil supplementation was associated with a 13% lower risk for all-cause mortality, a 16% lower risk for CVD (cardiovascular disease) mortality, and a 7% lower risk for CVD events in the general population.
The study, "Associations of Habitual Fish Oil Supplementation Population-based Cohort Study, "which appeared in the British Medical Journal, used a total of 427,678 men and women aged between 40 and 69, who had no CVD or cancer at baseline were enrolled between 2006 and 2010 and followed up to the end of 2018.
The inverse associations of fish oil use with CVD events, commented the researchers, “seemed to be somewhat stronger in participants with hypertension than in those without hypertension, which was consistent with a meta-regression analysis showing a more favorable effect of fish oil on blood pressure in those with hypertension.”
It was noted that the beneficial effect of fish oil on CVD may have to do with the lowering of blood pressure, plasma triglycerides, and heart rate – all of which exert a protective effect against CVD development. Also, several prior studies have shown that Omega-3 fatty acids in fish oil improve flow mediated arterial dilation – a measure of endothelial function.
Lastly, prior research has determined that Omega-3 fatty acids have shown to possess “antiarrhythmic (irregular heartbeat) properties and can reduce thrombosis (blood clot).”
All of which led to the following conclusion: “These findings indicate that habitual use of fish oils is associated with a marginal benefit for CVD events in the general population, supporting their use for the prevention of mortality from all causes and CVD.
You are now able to determine your Omega-3 index though a blood test, which gives you a range from low to high – along with an Omega-6/ Omega-3 ratio – with Omega-6 being proinflammatory and Omega-3, anti-inflammatory.
I reference in my book, Stop Renting Your Health: Own It, on page 112, a prior study in the New England Journal of Medicine, which reported that people with a total omega-3 level of 6.9% were 90% less likely to die of sudden cardiac death than those people with a total omega-3 level of 3.6%. Be sure to check with your doctor, before you supplement with omega-3’s, since you want to make sure that that they fit into your respective health profile
You can download a free copy of my book on mackieshilstone.com.
Happy New Year.
According to researchers from the Vitamin D, Skin, and Bone Laboratory, Section Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University School of Medicine, and the Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, “although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40–60 ng/mL (100–150 nmol/L) to achieve the optimal overall health benefits of vitamin D.”
I opened with this definitive statement on what blood level of the tested form of Vitamin D—25(OH)D–is necessary to achieve, since the Boston co-study author, Michael F. Holick, in my opinion, is one of the world's leading experts on this topic.
Immunologic Effects of Vitamin D on Human Health and Disease—the study–which appeared in the December issue of Medicine & Science in Sports & Exercise, qualifies current recommendations of Vitamin D deficiency—a blood level of less than 20 ng/mL—and insufficiency—between 20 to 30 ng/mL–with a specific blood range–“preferably 40-60 ng/mL”—for the, “optimal overall health benefits of Vitamin D.”
The researchers comment that vitamin D, which regulates calcium and phosphate metabolism, is critical in maintaining skeletal integrity, while also functioning as an immunomodulatory hormone—a seco-hormone.
Holick and his fellow co-author, Nipith Charoenngam, note that there is a vitamin D link with the incidence and severity of many disorders, such as psoriasis, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, and infectious diseases—specifically, “experimental studies have shown that vitamin D has significant biologic activities on the innate and adaptive immune systems.”
Holick and his Thailand associate executed a review examining the biologic effects of vitamin D on the immune system and its association with several types of immune-related diseases and conditions, in addition to the impact that Vitamin D has relative to prevention and treatment of immune-related diseases.
Vitamin D gains access to the human system via sunlight exposure, diet, and supplements. The active forms include vitamin D2—ergosterol—obtained in the diet from yeast, sun dried and irradiated mushrooms, and plants, while the active form—D3—is manufactured internally from dietary sources, such as cod liver oil and oily fish.
Once in the system, the liver converts both D2&3 to 25(OH)D, then the kidneys complete the task by transforming the 25(OH)D to its active form—1,25(OH)2D.
In order to meet the recommended vitamin D intake, the Endocrine Society Guidelines state that adults, who are at risk for vitamin D deficiency, should strive for 1500-2000 iu's (international units) per day—with an upper limit of 10,000iu's.
The review concluded that, among other variables, “most of the evidence, to date, suggests that maintenance of a healthy vitamin D status is important for modulating the body's immune function. Low serum levels of 25(OH)D are associated with multiple immune-related diseases, including autoimmune disorders and infectious diseases.”
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Anyone who's been involved in athletics at any level—professional, college, recreational, or those older individual with the reoccurring aches and pains of general living—appreciates the benefits of over-the-counter non-steroidal anti-inflammatories (NSAID's), or the prescription version, as first-line pharmaceutical drugs to treat pain and localized inflammation—under physician guidance.
These medications inhibit cyclooxygenase enzymes, which are responsible for the discomfort associated with overuse issues.
Like a financial statement, which lists both assets and liabilities, NSAID's have their own negative aspects, when overused. Those complications, with chronic or overuse, may include cardiovascular (CV) outcomes, hypertension, coronary heart disease, atrial fibrillation, and congestive heart failure, especially with high-risk people.
As it pertains to a higher risk population—like American-style football (ASF) athletes of larger sizes, such as the offensive and defensive linemen, retired ASF players, and those ASF players with numerous orthopedic injuries in their medical history, all who later in life may have a higher incidence of hypertension and cardiovascular disease—NSAID use may be contraindicated.
According to Nonsteroidal Ant-Inflammatory Drugs and Cardiovascular Risk in American Football, which appeared in the December 2020 issue of Medicine & Science in Sports & Exercise, “ASF participation is associated with the development of early hypertension and acquired pathologic CV phenotypes—all associated with significant weight gain. Epidemiologic data also suggest increased CV mortality among retired professional ASF athletes, who had the largest playing time body mass index (BMI).
There are still uncertainties, as it pertains to habitual NSAID use and increased CV risk in AFS.
Researchers from Emory University, Georgia Institute of Technology, Woodward Academy in Atlanta, and the Cardiovascular Performance Program at Massachusetts General Hospital in Boston, “sought to characterize NSAID use patterns and the association with cardiovascular risk in a diverse cohort of high school and collegiate ASF athletes.”
The testing group of young athletes included a total of 226 ASF players, 60 endurance athletes, and 63 nonathletic controls, who were studied pre and postseason. Echocardiography, vascular applanation tonometry, and clinical data assessment were obtained. Qualitative NSAID use throughout the season was recorded at postseason.
It was determined that, “within a large cohort of combined HS and collegiate ASF athletes, habitual NSAID use was more common among those with established CV risk factors, and importantly, increased weight across the ASF season was associated with an increased frequency of NSAID use.”
The researchers also said, “second, and just as concerning within this diverse ASF cohort, sport-related ASF NSAID use more commonly began early, in middle school, before full physical maturation.”
It was concluded that, “our data suggest that increased weight, a critical pathologic factor linking early ASF-associated CV risk with adverse long-term outcomes, is also associated with increased NSAID use during competitive ASF training.”
“Taken together, commented the researchers, “we believe that our findings provide compelling rationale that habitual NSAID use may adversely affect CV risk among competitive ASF athletes and should therefore be considered in the CV risk stratification of high-risk ASF athletes.”
As with any medication—prescription or over-the-counter—it's best to be used under the guidance of your personal physician, in order to avoid potential contraindications or complications.
According to research—"Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity"—which was published in the November issue of the online, peer reviewed journal Nutrients, “the world had recorded 40,628,492 cases and 1,122,733 deaths from COVID-19 by 19 October 2020.”
The study researchers, from Cape Coral, Florida, San Francisco, California, and the Medical University of South Carolina, report that COVID-19 began in the winter in the northern hemisphere—with both cases and deaths being lowest in the summer. That was especially true in Europe. Rates began increasing again in July, August, or September in various European countries.
This data caused the researchers to comment, “it (COVID-19) is thus generally inversely correlated with solar UVB doses and vitamin D production.”
Prior research has concluded that Vitamin D, “is a powerful epigenetic regulator, influencing more than 2500 genes and impacting dozens of our most serious health challenges, including cancer, diabetes mellitus, acute respiratory tract infections, and autoimmune diseases, such as multiple sclerosis.”
It's thought that the impact of COVID-19's damage control corresponds with a “cytokine storm”—causing an uncontrolled and excessive innate immune system release of pro-inflammatory signaling molecules called cytokines, which can damage tissue.
The researchers comment that, as of their study submission date, of, “the Clinical Trials registry maintained by the U.S. government, only four will investigate prevention, and three of those are enrolling health care workers, a group that is highly exposed to COVID-19.”
In their investigation of the relationship between Vitamin D status and COVID-19 susceptibility and impact, the researchers cite, among other European data, a U.S. observational study, the largest observational study to date from Quest Diagnostics–with data for 191,779 patients–having a mean age of 50 years, who were tested for SARS-CoV-2 between March 9th and June 19th, with 25(OH)D tests in the preceding 12 months at Quest.
25(OH)D—(25-hydroxy-Vitamin D) is the standard laboratory test to assess Vitamin D status.
The study, note the authors, “reported the following rates of SARS-CoV-2 positivity vs. 25(OH)D concentration: 39,120 patients <20 ng/mL; 27,870 patients 30–34 ng/mL; 12,321 patients >55 ng/mL (nanograms per milliliter).”
Labtestsonline.org says, “the Endocrine Society defines vitamin D deficiency as a 25-hydroxyvitamin D blood level below 20 ng/mL (50 nmol/liter) and vitamin D insufficiency as a level between 21–29 ng/mL (52.5–72.5 nmol/liter).”
Emerging evidence has demonstrated that, “higher serum 25(OH)D concentrations are associated with the reduced risk and severity of COVID-1”—with “the strongest evidence to date (coming) from 14 observational studies that report inverse correlations between serum 25(OH)D concentrations and SARS-CoV-2 positivity and/or COVID-19 incidence, severity and/or death.”
Also in the November Nutrients issue was research—Vitamin D Supplementation Associated to Better Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Quasi-Experimental Study—which had as its objective to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after the diagnosis of COVID-19 was effective in improving survival among hospitalized frail elderly COVID-19 patients.
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Mayoclinic.org says that type 2 diabetes – also referred to as adult onset diabetes – is a chronic condition that affects the way your body metabolizes glucose (blood sugar) – resulting in your body either resisting the effects of the hormone insulin that regulates the movement of sugar into your cells, or doesn't produce enough insulin to maintain normal glucose levels.
Mayo comments that, “type 2 diabetes develops, when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as being overweight and inactive, seem to be contributing factors.”
Research has demonstrated that exercise improves glycemic control in people with type 2 diabetes, alone, or the result of weight loss, improved insulin sensitivity, and modifications in cardiovascular risk factors like elevated blood pressure and triglycerides – a blood fat associated with an excess of simple carbohydrates in the diet.
The American Diabetes Association recommends that people with type 2 diabetes attain a minimum of 150 minutes per week of aerobic exercise and at least two weekly resistance exercise sessions, while minimizing sedentary time.
A study – Significant Dose-Response Between Exercise Adherence and Hemoglobin A1c Change – which appears in the September 2020 issue of Medicine & Science in Sports & Exercise, examining the physical activity level in individuals with type 2 diabetes over the age of 65 years in the United States, “found that only 25% met the American Diabetes Association 2007 guideline recommendations for total physical activity.”
A separate study of physical activity levels in the United States reported that, “41.1% of individuals with type 2 diabetes met the aerobic exercise recommendations compared with only 12.4% for resistance training.”
Canadian authors of this Medicine & Science study chose to examine, “whether a dose–response relationship existed between the level of adherence to prescribed exercise over a 6-month exercise intervention and glycemic control (specifically, change in hemoglobin A1c [HbA1c]) in patients with type 2 diabetes.” And, “if this association was affected by any of the following factors: modality of exercise, age, sex, or glycemic control before participating in exercise training.”
A HbA1c test, according to Medlineplus.gov, “measures the amount of glucose attached to hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body. An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months.”
The Canadian researchers used data from the Diabetes Aerobic and Resistance Exercise (DARE) trial, “a single-center, randomized controlled trial designed to evaluate in type 2 diabetes the effect of aerobic, resistance, and combined aerobic and resistance exercise training compared with no exercise training on glycemic control over 26 wk.”
The aerobic exercise participants utilized a gradual intensity-based progression – with a duration to 45 min at 75% of maximum heart rate per session, while the resistance participants worked up to three sets of eight repetitions of seven exercises at an intensity of eight maximal repetitions. The combined exercise training group completed both the aerobic and resistance training components.
The control group were encouraged to maintain their usual pretrial level of physical activity from baseline to the end of the intervention period.
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In November 2020, Harvard researchers reported in JAMA Network Open that, “vitamin D3 may reduce the risk of developing advanced cancer among adults without a diagnosis of cancer at baseline; this protective effect is apparent for those, who have normal but not elevated body mass index.”
The research – Effect of Vitamin D3 Supplements on Development of Advanced Cancer – A Secondary Analysis of the VITAL Randomized Clinical Trial – included men aged 50 and older and women aged 55 and up, who were free of cancer and cardiovascular disease at the start of the study.
The Harvard researchers cite prior research, which concluded that, “vitamin D may decrease tumor invasiveness and propensity to metastasize, leading to reduced cancer mortality. Higher serum 25-hydroxyvitamin D (25[OH]D) levels at diagnosis have been linked to longer survival in cancer patients.”
The VITAL study examined the benefits and risks of vitamin D3 - cholecalciferol -at a dosage of 2000 international units (IU’s) per day, and marine omega-3 fatty acids – 1 gram daily - for primary prevention of cancer and cardiovascular disease, among the 25,871 study participants, who were recruited throughout the US and balanced by sex. An objective was to include at least 5000 Black participants.
To be included in the study group, participants had no history of cancer (except nonmelanoma skin cancer) or cardiovascular disease at study entry. Excluded from the study, were those individuals with kidney failure or dialysis, cirrhosis, history of hypercalcemia, or other serious conditions that would preclude participation.
Additionally, all participants were required to limit vitamin D intake to no greater than 800 IU’s per day from all supplemental sources - including multivitamins, while forgoing the use of any out-of-study fish oil supplements.
Those people, who met the study criteria, completed a 3-month placebo run-in phase. Randomized usage of vitamin D3, omega-3 fatty acids, both active agents, or both placebos, took place from November 2011 to March 2014 – with study medication ending on December 31, 2017 – yielding a median intervention period of 5.3 years.
Prior to the start of the trial, blood samples – 25(OH)D - were collected during the run-in period for willing participants, which netted 16, 956 of the 25, 871 randomized participants.
At 6 months, 1 year after randomization, then annually thereafter, participants received follow-up questionnaires to collect information on adherence to randomized treatments, use of non-study vitamin D and fish oil supplements, development of major illnesses, cancer recurrence, updates on risk factors, and potential side effects of the study agents.
At conclusion, the researchers said, “in this more detailed secondary analysis of VITAL, vitamin D3 reduced the risk of developing advanced (metastatic or fatal) cancer among adults without a diagnosis of cancer at baseline. However, this protective effect was apparent only for those with normal BMI.”
We did not see differences in effect by race or baseline vitamin D levels” commented the researchers.
The Harvard researchers also said that, “additional randomized trials focusing on cancer patients should be considered, as well as, investigations of differential benefit by BMI.”
Further, it was stated that, “even if vitamin D effects were modest, vitamin D supplementation at the studied levels are much less toxic and lower cost than many current cancer therapies.”
The bottom line: get your body mass index – your weight relative to your height -under control. Then talk to your physician about getting a vitamin D blood test to determine the appropriate amount of an over-the-counter vitamin D3 supplement or the prescription form, if you have a deficient (less than 20 ng/dl) or insufficient level - especially if you have cancer in your family history or genetics.
In 2005, with the publication of my book, The Fat Burning Bible (John Wiley & sons), I called for at least 300 minutes of weekly exercise to reduce excess scale weight and body fat. That’s in spite of current recommendations, which states that exercise programs should exceed 225 weekly minutes to induce clinically significant weight loss.
Now, my recommendation has found merit with research –"Exercise for Weight Loss: Further Evaluating Energy Compensation with Exercise" – which appeared in the November 2020 issue of Medicine & Science in Sports & Exercise.
The University of Kentucky study authors suggest that it will take in excess of 300 minute per week of exercise to overcome the approximate 1000 calories per week compensatory response that accompanies exercise.
“The lack of weight loss success with exercise is due to compensatory responses counteracting the negative energy balance created by exercise to maintain homeostasis, thereby alleviating the energy deficit required for weight loss.”
Maintaining energy balance, note the researchers, “can be viewed, as an evolutionarily conserved mechanism in place to retain bodily energy stores and reproductive function, a useful survival strategy in times of famine.”
Several reasons for the post-exercise compensation effect include an increased food intake stimulated by a need to have calories in to exceed calories expended, and hormone regulators – acylated ghrelin, peptide YY, insulin, leptin (after eating or fasting) – that regulate hunger.
Of specific note, are ghrelin – the hunger hormone produced by cells of the gastrointestinal tract - specifically the stomach, which increases food intake (stomach growl) and leptin – a hormone secreted by fat cells and enterocytes in the small intestine that regulate energy balance and inhibits hunger.
It appears that obese individuals can experience leptin resistance – a situation that makes them non-responsive to the fullness effect or satiety after food consumption.
To back up their exercise duration recommendations, the study authors employed a three-arm, randomized, controlled trial among sedentary adults between the ages of 18 to 40 – with a body mass index of 25 (overweight) to 35 (obese) to assess how individuals compensate for energy expended during a 12-wk aerobic exercise intervention – explaining the potential mechanisms and the role exercise dose plays in the compensatory response.
The 44 final study participants (32 women) were assessed, after a medical history, physical, and diet and exercise history, along with other relevant tests - as to their rate of exercise energy expenditure, which was calculated from a graded exercise test averaged across five heart rate (HR) zones – zone 1, 50-59% of heart rate reserve (HRR), zone 2, 60-69%, zone 3, 70-79%, zone 4, 80-89% and zone 5, 90% or greater. The heart rate zones were calculated – based on the Karvonen formula, (220-age) – resting heart rate (RHR) x a high and low zone percent + resting heart rate.
The energy compensation effect was calculated, as the difference between expected weight loss (based on exercise energy expenditure) and changes in fat and fat-free mass (DXA Scan).
Resting energy expenditure (REE) was assessed via indirect calorimetry, while concentrations of acylated ghrelin, leptin, insulin, and glucagon-like peptide 1 (GLP-1) were assessed fasting and postprandial (six timepoints over 2 hours.)
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In January of 2020, research determined that individuals who follow the Mediterranean diet, intermittent fasting, or the Paleo diet will lose weight fairly quickly, “and reap profound health benefits – particularly ones pertaining to cellular vascular health.”
It appears that of the three food intake patterns, the Mediterranean diet proved to be the most sustainable. Researchers at the University of Otago in New Zealand
note that the best diet is, “one that includes healthy foods and suits the individual.”
New Zealand investigators followed 250 participants over twelve months, who either chose intermittent fasting (54%), Mediterranean diet (27%), or the Paleo diet (18%) to lose weight.
It was determined that participants, who fasted, lost a little more than eight and a half pounds on average. Participants, who followed the Mediterranean diet, lost a little more than six and half pounds on average, while the median amount lost for those participants, who adhered to the Paleo diet, was just under four pounds.
Of the three weight loss modes, the Paleo diet was the only diet that did not confer, “sizeable reductions in blood pressure and blood sugar levels.”
The Mediterranean diet participants incorporated fruits, vegetables, whole grain bread and cereal, legumes, nuts, seeds, and olive oil – with reduced amounts of fish, chicken, eggs, and dairy. Red meat was limited to once a week or less.
Paleo followers excluded dairy, grains, and legumes. However, the version of the diet employed in the study permitted one daily serving of legumes and one daily serving of grain-based foods. Other than those two modifications, participants were advised to consume plenty of fruits and vegetables, animal proteins, nuts, coconut products, and extra-virgin olive oil.
As for intermittent fasting group, the female followers consumed no more than 500 calories on two selected days per week, while men were permitted to limit their calorie intake to 600 calories, alongside the same time period, as the female participants.
At the study conclusion, “fifty-seven percent of participants kept on with the Mediterranean diet after 12 months, 54% continued to fast, and 35% remained on the Paleo diet.”
Once again, the research demonstrates the powerful health-promoting benefits associated with the Mediterranean diet, especially the pescatarian or pesco-Mediterranean variation, with fish – salmon, anchovies, sardines and trout - as the principle meat source.
In September of 2020, JAMA Network Open reported on a pooled cohort study – Association Between Sleep Duration and Cognitive Decline – which demonstrated an, “inverted U-shaped association between sleep duration and global cognitive decline (that) was found, indicating that cognitive function should be monitored in individuals with insufficient (less than or equal to 4 hours per night) or excessive (greater than or equal to 10 hours per night) sleep duration.”
It’s estimated that 12% of the global population is 60 years of age or older – with an estimated increase to one-fifth of the population by 2050.
Dementia, a common feature of old age, affect 50 million people world-wide, according to the World Health Organization – with roughly 14 percent of Americans 71 years and older at risk. Sixteen percent of women older than 71 suffer from dementia compared to 11 percent of men.
Mayoclinic.org notes that, “dementia describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several different diseases may cause dementia.”
The website further states that, “though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn't mean you have dementia. Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms may be reversible.”
The JAMA pooled study data - which included results from the English Longitudinal Study of Ageing (2008-2017) and the China Health and Retirement Longitudinal Study (2011-2015) - used a randomly enrolled group of 28,756 people over 50 years of age living in England and individuals over 45, residing in China.
The sleep data was determined from self-reported sleep duration – based on face-to-face interviews, while cognitive function assessed three aspects of memory, executive function, and orientation.
The Chinese study investigators, “found that extreme sleep duration at baseline, including 4 hours or less or 10 hours or more per night, was statistically, significantly associated with faster cognitive decline during 100,000 person-years of follow-up.”
The Chinese researchers recommend that, “future mechanism studies and intervention studies examining the association between sleep duration and cognitive decline are needed.”
You might talk to your physician about the benefits of the essential omega-3 fatty DHA to improve cognitive function – along with either ginkgo biloba or phosphatidyl serine – to see if they fit your health profile.
In August 2020, Psychology Today reported on a placebo-controlled study – Improved Metabolic Function and Cognitive Performance in Middle-Aged Adults Following a Single Dose of Blueberries– which appeared in the European Journal of Nutrition. And, is said to be the first examination of the cognitive effects of blueberry consumption in healthy individuals aged forty to sixty-five.
Psychologytoday.com commented that, “previous research has shown that berries in general, and blueberries in particular, can enhance cognitive performance in healthy children, young adults, and older adults.”
Thirty-five participants, who completed the double-blinded, balanced crossover study, were cognitively screen at 2, 4, 6, and 8 hours post consumption of a beverage that contained 25 grams of freeze dried blueberry powder (WBB), equivalent to one cup of fresh blueberries, mixed in water with frozen lemonade concentrate, and unsweetened Kool-aid, or a matched placebo for taste and coloring.
The cognitive assessments included two tasks measuring executive abilities and one test of episodic memory. An Auditory Verbal Learning Task was used to measure learning, recall, and recognition memory.
The cued Go/No-Go task examined the response inhibition and reaction time, while the Modified Attention Network Task assessed the susceptibility to response interference (tendency to become distracted).
Study results determined that participants, who consumed WBB, saw that their, “cognitive performance was improved in comparison to (a) placebo on delayed recognition memory and aspects of executive function. Importantly, these benefits were found on more demanding elements of the tasks, where some form of additional cognitive effort was required.”
The website said, “taken together, these findings suggest that blueberries can enhance several aspects of cognitive performance in healthy middle-aged adults, especially in cognitively demanding situations.”
As always check with your physician as to your personal health profile relative to any medication contraindications that might be associated with a 25-gram intake of blueberry powder.
Researchers from the Department of Internal Medicine, University of Heidelberg, Germany, report in the September issue of the online, peer-reviewed journal Nutrients, an association between vitamin D deficiency and the severity/mortality of COVID-19 – which, they say, highlighs the need for interventional studies on vitamin D supplementation in SARS-CoV-2 infected individuals.
The study - "Vitamin D Deficiency and Outcome of COVID-19" – said the clinical features of this SARS coronavirus can vary from those people, who present with no symptoms, to those people with upper respiratory tract symptoms, and patients with severe lung injury – yielding inflammation, multiorgan failure, and a fatal outcome.
At present, there is no causal treatment for COVID-19, according to the study. Age, male gender, and underlying comorbidities, such as obesity, type 2 diabetes, cardiovascular and lung disease, have been associated with a severe COVID outcome.
The patient population of this investigational study included 185, “consecutive symptomatic SARS-CoV-2-positive patients admitted to the Medical University Hospital Heidelberg, who were enrolled onto a prospective, non-interventional register. Included in the analysis were patients diagnosed and treated between 18 March and 18 June 2020, who had consented to study participation and had serum samples available for analysis.”
The Germans point to a controversial association of a low vitamin D status with increased susceptibility to infectious disease. They reference the fact that the active form of vitamin D3, also known as calcitriol, is a “pluripotent” (capable of differentiating into one of many cell types) hormone, and an important modulator of both innate and adaptive immunity.
The serum level of total 25-hydroxyvitamin D (25(OH)D) is commonly used to assess individual vitamin D status. The German researchers defined vitamin D deficiency, as serum total 25-hydroxyvitamin D level < 12 ng/mL (nanograms per milliliter of blood).
The study patients were screened and diagnosed for the SARS-CoV-2 infection based on recognized diagnostic procedures and standards. The patient’s vitamin D status was assessed at the time of first presentation - using accredited laboratory methods.
As noted in the study, “the decision for inpatient versus outpatient admission was based on the level of spontaneous oxygen saturation (SpO2 ≤ 93%), comorbidities, and the overall performance status.’
With regard to established COVID-19 severity classifications, “all inpatients had severe disease, oxygen saturation ≤ 93% at rest, or critical disease – stated as respiratory failure, requiring mechanical ventilation, septic shock, or other organ dysfunction, or failure that requires intensive care.”
From an outpatient standpoint, symptomatic disease presented with fever, cough, sore throat, myalgia, and/or fatigue. Outpatients, as noted, were visited in their home quarantine on a regular basis and their clinical conditions were regularly evaluated.
In all cases, appropriate treatment modalities and care was administered.
The researchers reported that, “the present study demonstrates an association between VitD deficiency and severity of COVID-19. VitD-deficient patients had a higher hospitalization rate, and required more (intensive) oxygen therapy and IMV (invasive mechanical ventilation).”
“In our patients, when adjusted for age, gender, and comorbidities, VitD deficiency was associated with a 6-fold higher hazard of severe course of disease and a ~15-fold higher risk of death,” commented the Germans.
The Germans stated, “prospective, randomized controlled studies on VitD supplementation in SARS-CoV-2 infected individuals are highly warranted.”
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Between the fourth and fifth decade of life, a human can experience the potential effects of sarcopenia – the aging loss of muscle, and its associated dynapenia – the deterioration of strength and power.
It estimated, according to a study - Nutritional Supplements to Support Resistance Exercise in Countering the Sarcopenia of Aging - which appeared in the August 2020 issue of the online journal Nutrients, that from 2.5 to 30 % of older adults are categorized, as having low muscle mass.
Additionally, “the progression of sarcopenia is closely associated with (the) enhanced risk of falls and fractures, metabolic dysfunction, cardiac and respiratory disease development, early mortality, and overall quality of life. Thus, age-related skeletal muscle deterioration warrants significant trepidation,” commented the nutrient authors from the Exercise Metabolism Research group, Department of Kinesiology, McMasters University, Hamilton, Ontario, Canada.
As any body builders knows, lean muscle development is a balance between muscle protein synthesis (MPS) - also called anabolism and muscle protein breakdown (MPB) – known as catabolism, while attempting to stay in what’s called positive nitrogen balance from diet - specifically protein intake, resistive exercise (RE), and nutritional supplement support.
The Canadian researchers sought to provide an up-to-date discussion surrounding the interaction between RE and various nutritional strategies, as a means to augment MPS, promote muscle protein accumulation, and mitigate the progression of sarcopenia.
It’s known that RE reduces the risk to type 2 diabetes, cardiovascular disease, and cancer, but RE also is the primary means to counter the age-associated effects of sarcopenia and dynapenia.
The Canadians note that, “at the molecular level, a bout of RE stimulates MPS via activation of the mechanistic target of rapamycin (mTORC-1) signaling pathway,” which increases protein synthesis and lean muscle development.
With age, there is a loss of type II muscle fibers - creating the dynapenia effect. It’s reported that the vastus lateralis (thigh muscle) accounts for approximately 30% of quadriceps muscle mass – yielding an estimates 20,000 individual muscle fibers to be lost from each quadricep muscle per year, beyond the age of 30 years (assuming a linear decline). If ignored, by failing to perform RE, then said fiber loss will have marked consequences for muscular strength, power, and the maintenance of muscular functional capacity.
The Canadians report on current research, which states that, “work-matched studies in younger and older adults have demonstrated that low-load RT (i.e., 30–50% 1-repetition maximum) may be just as effective as high-load RT to increase muscle mass and strength, when performed to volitional fatigue,” - practically translated, an exertion of a high degree of effort.
From a protein feeding standpoint, the recommended daily dietary allowance (RDA) of 0.8 grams of protein per kilogram to maintain nitrogen balance has been unchanged for decades – warranting further scrutiny, as it pertains to older adults, who have increased protein requirements.
The Canadians site the PROT-AGE study group and the European Society for Clinical Nutrition and Metabolism, which have, “suggested that older adults should consume between 1.0–1.5 g/kg/day of protein” – commenting that current protein recommendations are yet to be revised.
As to the allocation of the effective protein dosage per meal or from a supplementary standpoint, research has demonstrated that, “feeding-induced MPS is saturated following ingestion of ~0.24 g protein/kg/meal and 0.4 g protein/kg/meal in younger and older adults, respectively.”
It was also stated that, a protein intake pattern that is more evenly distributed throughout the day may help confer significant musculoskeletal benefits.
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Prior research has inferred that performing aerobic exercise (AE) concurrently with resistance training (RE) – specifically, if the RE was preceded by the AE – was contraindicated. The assumption was that the AE might limit the muscle building (myogenic) and protein break down (proteolytic) processes.
From the standpoint of developing strength, size, and speed enhancement – the mainstays of explosive sports like football – resistance exercise is a prerequisite to attaining these goals. Regular AE enhances the metabolic and morphologic processes that permit muscles to have greater resistance to fatigue, while increasing endurance and mitochondrial capacity.
It would make sense that RE and AE would be a match made in Heaven. However, research has reported that when AE was performed before RE – even with a time separation during the same day of concurrent training – there was a molecular interference in the mTOR (mammalian target of rapamycin) signaling pathway, which correlates with protein synthesis (muscle building).
Researchers in Sweden writing – "Aerobic Exercise Alters Skeletal Muscle Molecular Responses to Resistance Exercise" – which appears in the December 2019 issue of Medicine & Science in Sports & Exercise, chose to, “explore the effects of aerobic exercise on the acute molecular response supposed to control exercise-specific muscle adaptations to resistance exercise.”
The Swedes subjected one leg to aerobic and resistance exercise, which allowed for restored muscle function between bouts, while the other leg was exposed to resistance exercise only. It was hypothesized, “that aerobic exercise would interfere with the molecular response induced by subsequent resistance exercise.”
Nine healthy, physically active college student volunteered to perform a 45-min one-legged aerobic exercise (session) in the morning and four sets of RE for each leg 6 hours later. Hence, legs randomly chosen in a counter-balanced manner were subjected to either AE + RE or RE only.
Muscle biopsies were obtained pre and post RE sessions, which assessed muscle glycogen content, mTOR, and myostatin, which inhibits muscle hypertrophy (enlargement) - along with knee extensor (quadriceps) power.
The study concluded that, “in contrast to the posted hypothesis, it seems that concurrent AE + RE may enhance skeletal muscle anabolic environment,” which means that, “aerobic exercise can precede RE on the same day without compromising in vivo muscle power.”
The researchers point out that scheduling RE 6 hours after AE did not compromise the mTOR-related proteins. They do qualify their conclusion by commenting that, “it remains to be shown if cumulative exercise training, using the current paradigm, modifies chronic skeletal muscle adaptations, (i.e., muscle size and strength and power-related performance), compared with resistance training.”
Innate immunity – barriers set up in the eyes, mucus membranes, and the epithelium or lining of the gastrointestinal tract – function, as the first line of defense from an invading pathogen – with phagocytes, neutrophils, dendritic and natural killer cells that neutralize the foreign invader, setting the stage for the next phase of the immune response – the adaptive immune system.
The adaptive phase is characterized by responses from T and B cells, who remember the battle, in case of future challenges by the same organisms.
Micronutrients are critical to both innate and adaptive responses. According to Inadequacy of Immune Health Nutrients: Intakes in US Adults, the 2005 – 2006 NHANES (National Health and Nutrition Examination Surveys) – which appeared in the August issue of the online, peer-reviewed journal Nutrients – “vitamin D is known to trigger the production of antimicrobial peptides, and folate, vitamin B6 and B12 are all required for white blood cell production. Additionally, vitamins A, C, D, E, and zinc, iron, and selenium are all involved in the innate and/or adaptive immune response.”
The 2015-2020 U.S. Dietary Guidelines has determined that vitamins, A, C, D, and E, are under consumed across all populations. The Nutrient study authors from Science & Technology, Pharmavite LLC in West Hills, California, report that, “previous NHANES reports showed that for vitamins A, C, D, and E, a high percentage of the population fell below the estimated average requirement (EAR), a nutrient intake value that is estimated to meet the requirement of half the healthy individuals to avoid symptoms of a clinical or subclinical deficiency.”
The mineral zinc tends to be under consumed or supplemented by older individuals - a deficiency being associated with inadequate sleep cycles that can affect the immune response.
The World Health Organization, comment the California researchers, has classified the deficiency of vitamin A, as a public health issue, especially in children and pregnant women, in over 50% of all countries.
They add that, “vitamin C inadequacy is common in many countries, specifically with at-risk populations, and almost 1 billion people around the world have low vitamin D levels, regardless of ethnicity or age. Only 1/5 of the global population are at the optimal vitamin E status levels. In developing countries, zinc deficiency is a health concern.”
Research demonstrates that micronutrient insufficiencies/deficiencies and inadequate intake can impair immune function and weaken immune response, which may increase the risk of infections and other immune-associated diseases and conditions.
The researchers chose to analyze a large cross-sectional U.S. population database on dietary intake – looking to identify the current prevalence of nutrient inadequacies of key micronutrients critical for immune function. Then, review the function of these shortfall nutrients important for the immune system, and discuss strategies for filling dietary nutrient gaps.
Using the NHANES, a bi-yearly cross-sectional study of the US population conducted by Centers for Disease Prevention and Control (CDC), data was extracted from the 2005–2016 – based from two reliable 24 h dietary recall interviews of 26,282 adults aged 19–99 years.
It was determined that, “45% of the U.S. population had a prevalence of inadequacy for vitamin A, 46% for vitamin C, 95% for vitamin D, 84% for vitamin E, and 15% for zinc.”
This determination caused the researchers to conclude that, “given the long-term presence and widening of nutrient gaps in the U.S.—specifically in critical nutrients that support immune health—public health measures should adopt guidelines to ensure an adequate intake of these micronutrients” – with further on gong research recommended.
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Researchers from the Department of Medicine and Center for Health and the Social Sciences, University of Chicago, reported in the September 3rd. 2020 online edition of JAMA (Journal of the American Medical Association) Network Open that, “in this single-center, retrospective, cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.”
Vitamin D deficiency affects roughly half of the US population—with higher deficiency rates in people of darker skin or reduced sun exposure, which included people residing at higher latitudes. According to the Illinois researchers, “vitamin D treatment has been found to decrease other viral respiratory infections, especially in persons with vitamin D deficiency.”
The study—"The Association of Vitamin D Status and Other Clinical Characteristics with Covid-19 Test Results"–included data taken from 4314 patients, who were tested from March 3 to April 10, 2020. Patients were considered vitamin D deficient, if their most recent serum D level within one year before their first Covid-19 tests, was less than 20 ng/mL (25-hydroxycholecalciferol) or their 1,25 vitamin D status was less than 18 pg/mL.
“Vitamin D3 dosing was defined, based on most recent daily dose recorded over the past year, excluding the 14 days before testing: none, 1 to 1000 IU or a multivitamin, 2000 IU, or greater than or equal to 3000 IU. Indicators for treatment with vitamin D2 and calcitriol were also included,” commented the study authors.
Based on assessments, the patient were assigned to 1 of 4 categories, which reflected their likelihood of being vitamin D deficient at the time of COVID-19 testing: “likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased).”
The researchers said, “our results raise the consideration of whether treatment for vitamin D deficiency is associated with reductions in the risk of COVID-19, since vitamin D deficiency may be increased by many factors that could be associated with COVID-19 risk, including age, obesity, diabetes, and chronic illness.”
That conclusion led to the comment that, “the low costs of vitamin D and its general safety, at least at doses of up to 4000 IU per day, support arguments for population-level supplementation, perhaps for targeting groups at high risk for vitamin D deficiency and/or COVID-19.”
Before you decide to supplement with vitamin D beyond what is found in a multi-vitamin/mineral formulation, it's best to check with your personal physician, who can order a vitamin D lab test, to ascertain your status—yielding appropriate intake guidelines.
It’s no secret that moderate intensity, continuous training (MICT) – usually in the range of a rate of perceived exertion (RPE) of 11 to 13 on the Borg scale of 6 to 20 – has demonstrated significant improvement in cardiorespiratory fitness – for both healthy individuals and patients with coronary artery disease (CAD).
While high-intensity interval training (HIIT) is known to improve cardiorespiratory fitness (CRF), as measured by the maximum volume of oxygen consumption (VO2Max), in a healthy population, its feasibility, safety, and long-term effects for improving CRF in patients with CAD is unclear.
Researchers from the Australia and the United Kingdom – reporting in the online September 2020 issue of JAMA (Journal of the American Medical Association) Cardiology - chose to compare HIIT with MICT for feasibility, safety, adherence, and efficacy of improving VO2 peak in patients with CAD.
From May of 2016 to December of 2018, ninety-three CAD patients, age 18 to 80, enrolled in 4-weeks of supervised training in a private hospital cardiac rehabilitation program – continuing over 12 months with home-based training.
The HIIT group performed 4 x 4-minute high intensity intervals at an RPE of 15 to 18 with 3-minute active recovery intervals at an RPE of 11 to 13. The MICT group performed 40 minutes of moderate-intensity exercise at an RPE of 11 to 13.
Both groups were asked to complete three sessions per week – two supervised and one home-based over four weeks – followed by home-based training (three weekly sessions) for the remaining eleven months.
The pre and post program testing included VO2 peak at baseline and four weeks – with further testing at 3, 6, and 12 months. Safety was ascertained throughout the study period, as was, “adherence to the exercise protocol, (which) was assessed as 70% attendance or higher at the recommended number of exercise sessions, when training at the prescribed exercise intensity during the exercise sessions.”
The study demonstrated, “that HIIT is superior to MICT for improving cardiorespiratory fitness during a 4-week hospital-based CR (cardiac rehab) program in patients with CAD; but offers similar improvements to MICT at 12 months.”
In short, the HIIT protocol was safe, feasible, and successfully implemented in a home-based environment with similar adherence to MICT over 12 months.
Before you attempt to set up your own home-based HIIT program, first check with your physician.
From COVID-19's inception in China in December of 2019 to the present time, those individuals with comorbidities, such as obesity, hypertension, diabetes, cardiovascular disease, and pulmonary dysfunction were at greater risk to become severely ill.
As the virus spread around the world, it became apparent that a much higher number of people, who were overweight and obese, were being admitted to the hospital—with advancing illness, or critically ill at the time of admission.
The statistics from Italy, the United Kingdom, France, and the United States verified that there was an association with COVID-19 severity with obese patients. However, it was only partially due to obesity's inherent comorbidity risks.
According to "COVID-19 and Obesity," which appeared in the August 2020 issue of Practical Diabetes, “an analysis of more than 20,000 hospitalized patients in the UK identified obesity, as a major independent risk factor for COVID?19 severity and mortality.”
In addition, “two recent studies of Chinese COVID-19 patients also identified obesity, as an independent risk factor–concluding that patients with obesity are three times more likely to develop severe symptoms compared with normal0weight patients, and each unit increase in body mass index was associated with a 13% increase in the risk of severe COVID-19.”
The journal article points to the fact that research from the 2009 influenza A H1N1 pandemic demonstrated that obese individuals had twice the mortality rate of people with normal weight. And, “the mounting evidence (shows) that obesity increases the risk of respiratory diseases and respiratory tract infections, including obesity hypoventilation syndrome, asthma, pulmonary embolism, influenza, and community acquired pneumonia.”
The excess visceral adipose tissue (VAT) in the abdominal cavity, that has an immunomodulatory effect, has been determined to be an important factor in the link between obesity and respiratory infection, despite not being fully understood.
“Through the secretion of adipokines, such as adiponectin and leptin, adipose tissue modulates innate and adaptive immune responses. When VAT becomes dysfunctional in obesity, secretion of adiponectin is reduced and leptin increased–resulting in immune dysregulation,” comment the journal authors from the United Kingdom.
The UK authors also point to a link between low Vitamin D status and obesity. “The reason for the strong association between obesity and vitamin D deficiency is unclear, but the leading theory is that dysfunctional adipose tissue in obesity sequesters vitamin D and impairs its release, so it is no longer bio-available.”
Vitamin D has an essential role in immune function. “People with obesity,” note the British authors, “need to produce or consume more vitamin D than people of normal weight, in order to maintain adequate circulating levels of the vitamin.”
The investigators conclude by saying that, “there is mounting evidence that obesity is a major risk factor for severe illness and mortality from COVID-19. Research is urgently needed to elucidate the mechanisms by which obesity contributes to the severity of COVID-19 illness, in order to identify potential targets for treatment.”
Abnormal blood lipids—such as alterations in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein-cholesterol (HDL-C)—are major risk factors for cardiovascular disease (CVD).
Known collectively as dyslipidemia, these abnormal lipid fractions have a prevalence of 38.6% among individuals aged 40 and above—with alterations of one out of five US children and adolescents aged 8 to17 years—according to research—Ubiquinol (CO Enzyme Q10) Ameliorates Endothelial Dysfunction in
Subjects with Mild-to-Moderate Dyslipidemia: A Randomized Clinical Trial, which appeared in the August 2020 issue of the journal Nutrients.
The endothelium is the largest organ in the body—composed of a layer of cells that lies between the wall of blood vessels and the bloodstream. It is a living shield that keeps the arteries clear of build-up and blockage, so that essential oxygen and nutrients can get to the vital organs of the body.
In addition, endothelial cells are involved in many aspects of vascular structure—acting as a barrier between the vessel lumen and surrounding tissue, while controlling the passage of materials and the transit of white blood cells into and out of the bloodstream.
The authors of the Nutrients study from South Africa and Italy state that, "The impairment of endothelial function (EF) predates the morphological changes of atherosclerosis and can mechanistically contribute to atherosclerosis-related diseases."
Endothelial function can be assessed by flow mediated dilation (FMD), which, "assumes that endothelial dysfunction (ED) is a systemic process involving the coronary arteries, as well as, the peripheral circulation."
Using ultrasound technology, FMD estimates, "the dilation of a large peripheral conduit artery, typically the brachial artery, in response to the increased blood flow resulting from the removal of a transient ischemic stimulus." FMD has proved effective in evaluating the impact of several interventions on ED.
The researchers point out that coenzyme Q10 (CoQ10)—especially in its reduced form known as ubiquinol—"has improved endothelium-dependent vasodilation, as measured by FMD, in patients with type 2 diabetes, or coronary artery disease (CAD). However, the evidence of its effect on ED in subjects without clinical manifestations of atherosclerosis-related disease is limited."
Mayoclinic.org states that CoQ10, "is an antioxidant that your body produces naturally. Your cells use CoQ10 for growth and maintenance. Levels of CoQ10 in your body decrease as you age. CoQ10 levels have also been found to be lower in people with certain conditions, such as heart disease."
CoQ10 is found in meat, fish and whole grains. The amount of CoQ10 found in these dietary sources, according to Mayo, isn't enough to significantly increase CoQ10 levels in your body.
The Nutrient study authors sought to determine whether an 8-week ubiquinol supplementation period enhanced endothelium-dependent vasodilation in adults with moderate, untreated dyslipidemia and without evidence of CVD.
The researchers recruited fifty-one subjects with low-density lipoprotein (LDL) cholesterol levels of 130-200 mg/dL, who were not taking statins or other lipid lowering treatments—with moderate (2.5%–6.0%) endothelial dysfunction, as measured by flow-mediated dilation (FMD) of the brachial artery, and no clinical signs of cardiovascular disease.
During the study period, the participants were randomized to receive either ubiquinol (200 or 100 mg/day) or a placebo. The primary objective was to determine the effect of the ubiquinol supplementation on FMD by the end of the study period.
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The European Journal of Preventive Cardiology reported in August of 2020 on Journals.sagepub.com that, “the consumption of chocolate at least once a week is associated with a reduction in the risk of CAD (coronary artery disease).”
According to CDC.gov, CAD, a blockage of the arteries that supply blood to the heart, is the most common type of heart disease – killing 365,914 people in 2017. It’s estimated that 18.2 million adults age 20 and older have CAD – with roughly 2 in 10 deaths from CAD occurring in adults less than 65 years old.
Using a systematic review and meta-analysis (many similar studies), researchers from the VA Medical Center, Icahn School of Medicine, the Mayo and Cleveland Clinics, and the Baylor College of Medicine, extracted information from a database - 1966 to January 2020 - of prospective or cross-sectional studies – with chocolate consumption relative to CAD, acute myocardial infarct, and acute coronary syndrome.
The investigators identified six prospective studies with a median follow-up of 8.78 years – which included 336,289 individuals with 21,777 diseases – “composed of 14,043 cases of CAD, 4,667 myocardial infarctions, 2735 cerebrovascular accidents and 332 cases of heart failure. Study subjects included 266,264 individuals from the United States, 68,809 from Sweden and 1216 from Australia.”
Prior research demonstrated that chocolate consumption was associated with a decrease risk of CAD. The current meta-analysis found that chocolate consumption of more than one time per week or 3.5 times per month was associated with a reduced risk of CAD.
The researchers point out that, “chocolate consumption may offer cardioprotective effects due to several nutrients.” For instance, it was noted that, “flavanols (e.g. epicatechin, catechin and procyanidins) have been shown to reduce myocardial infarct size in one animal study, to reduce platelet aggregation and improve endothelial function in several randomized controlled trials of healthy individuals, or people with CAD.’
In addition, chocolate components, including methylxanthines, have been shown to have beneficial effects on cardiovascular function, while polyphenols have been shown to facilitate nitric oxide synthesis, and stearic acid has also been shown to reduce mean platelet volume.
The researchers point out that, “fats, milk, or sugar in chocolate, total energy intake, body mass index, and types of chocolate products (milk, dark, or white) could confound any potential association observed” – meaning that there could be unfavorable effects of the extra calories associated with commercial chocolate versus the beneficial effects tied to consumption of dark chocolate - with a much lower sugar and saturated fat content.
Be moderate in all things, to quote Buddha.
According to the World Health Organization, the worldwide estimate of influenza-related, severe illness is 3 to 5 million cases, which require hospitalizations—with roughly 290,000 to 650,000 deaths annually. Acute respiratory illnesses approximated 2.8 million deaths worldwide in 2016.
Severe, lower respiratory tract infections, such as the SARS-CoV-2 infection leading to COVID-19 disease, were the most common cause of sepsis-related deaths globally from 1990-2017.
Mayoclinic.org says, “sepsis is a potentially life-threatening condition caused by the body's response to an infection. The body normally releases chemicals into the bloodstream to fight an infection. Sepsis occurs when the body's response to these chemicals is out of balance, triggering changes that can damage multiple organ systems.”
Our body's defense mechanisms include the fast, non-antigen (virus) specific innate and the latent, slower antigen-specific (memory of past infection) adaptive immune response. The innate system reacts rapidly to search and destroy “non-self” threats—specifically though an inflammatory response, which is followed by damage repair from the attack.
The adaptive attack comes in the form of T and B lymphocytes, which secrete antibodies that are specific to the infecting pathogen—causing an immunological memory recall for future responses to the same pathogen.
There are specific nutritional strategies, which support optimal immune function. According to Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect Against Viral Infections, which appeared in the journal Nutrients in 2020, “several vitamins, including vitamins A, B6, B12, C, D, E, and folate; and trace elements, including zinc, iron, selenium, magnesium, and copper, play important and complementary roles in supporting both the innate and adaptive immune systems.”
Other nutrients, such as omega-3 fatty acids, also support an effective immune system–specifically by helping to resolve the inflammatory response.
The study authors from the University of Southampton (United Kingdom), Oregon State University, University of Otago (New Zealand), and the University Medical Center (Netherlands), comment that, “vitamin C affects several aspects of immunity, including supporting epithelial barrier function, growth and function of both innate and adaptive immune cells, white blood cell migration to sites of infection, phagocytosis and microbial killing, and antibody production,”
Vitamin D metabolites, note the researchers, “appear to regulate production of specific antimicrobial proteins that directly kill pathogens, and thus are likely to help reduce infection including in the lungs.”
In order to resolve the inflammatory immune response, the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are sent to the site, “enzymatically converted to specialized pro-resolving mediators (SPMs) known as resolvins, protectins, and maresins. These molecules, along with others, function together to orchestrate the resolution of inflammation and to support healing, including in the respiratory tract.”
As for recommended supplementation, the study authors cite a recent meta-analysis on upper and lower respiratory infections. “Based on this evidence, a daily intake of at least 200 mg/day for healthy individuals is recommended,” for vitamin C. This (level) is above the US RDA of 75 and 90 mg/day for female and male adults, respectively.”
As for Vitamin D supplemental intake, “a daily intake of 2000 IU (50 ?g) is recommended.” However, this amount is also above the US RDA of 400–800 IU (depending on age).
For Omega-3 fatty acids, “an intake of 250 mg EPA + DHA per day is recommended–consistent with global, regional, and national expert recommendations,” according to the study.
Human body water functions include aiding the digestion process, circulation of nutrients and substances across cell membranes, influencing our metabolic rate, and balance of electrolytes, which are controlled much in part through the central nervous system – all of which are under the auspices of the brain.
The percentage of water in the human body ranges from 50 to 75% - depending on age and gender – with an average adult having 57 to 60 percent. Mayoclinic.org comments that men need about 15.5 cups (3.7 liters) of daily fluid, while women require 11.5 cups (2.7 liters). Recommendations also are inclusive of plain water, other beverages, and water content of food – yielding total water intake (TWI).
According to Distinguishing Low and High Water Consumers – A Paradigm of Disease Risk – which appeared in the March 2020 issue of the online peer-review journal Nutrients, “changes of body water volume and osmolality are monitored by the brain, while renal water and electrolyte excretion/retention is regulated by neuroendocrine responses.”
The authors of the study, from the Universities of Connecticut and Hartford, and the Riverside Behavioral Health Center in Hampton, Virginia, state that among other control mechanisms, the primary regulatory components of fluid-electrolyte homeostasis (balance) are thirst and the pituitary release of arginine vasopressin into the circulation
The Connecticut researchers propose a novel theory that there is an increased disease risk in those, who are LOW (habitually low volume) drinkers (1 liter per day) versus High drinkers (>2 liters), which they say causes, “chronic release of fluid-electrolyte and stress hormones.
Most people don’t hit the severe dehydration level (>5% weight loss), but some do sustain mild hydration (1-2%) at some point on a weekly basis. From a sports perspective, a drop of 2.5% body weight in a short time period, such as boxers or wrestlers making weight before a fight, can impair their performance.
Twenty-five to thirty-three percent of all adults in the United States and Europe consume less than 1.5 liters of water per day (i.e., total water intake (TWI) = plain water + beverages + food moisture), according to the Connecticut investigators. This consumption level is considerably less than the adequate intakes for water recommended by the European Food Safety Authority and the U.S. National Academy of Medicine, which is 2.5 to 3.7 liters per day for men and 2.0 to 2.7 for women.
As to nutritional recommendations for LOW water consumers with higher vasopressin values, who may have an increased risk of chronic diseases and potentially lifespan, the researchers offered five goals: select solid foods with a high water content; take action to increase consumption of water and beverages; reduce daily dietary osmolar load by moderating specific foods; self-assess hydration status; and avoid overdrinking.
Foods with higher water content include soups, fruits, vegetables and other water-rich foods that can increase TWI more than 1 liter per day – which encourages a shift of nutrient intake toward a healthful plant-based diet - reducing cardiovascular disease risk.
However, you should be aware of the salt content.
The researchers also offered six simple lifestyle changes that will help to increase the daily intake of water and beverages by LOW and the elderly.
Select fluid flavors, colors and temperatures that are pleasurable, while considering energy and sugar contents. Place a water bottle next to your computer or wear a refillable bottle on your belt. Refill the bottle each time you empty it. Develop a habit of drinking a glass of water, when you wake, before each meal, after you visit the bathroom, or when you are waiting for someone or an event.
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According to research – Early Morning Food Intake as a Risk Factor for Metabolic Dysregulation – which appeared in the March 2020 issue of the online journal Nutrients, “individuals who begin work in the early morning hours [i.e., between 04:00 and 07:00] make up the largest population of shift workers in the United States.”
It’s also known that overweight and obesity is prevalent among shift workers, which may have to do with elevated fasting insulin resistance – causing the storage of increase visceral (around the abdominal organs) and ectopic (within organ) fat. “It is possible that food intake during the biological night may be a mechanism that contributes to negative metabolic outcomes in this population,” note the Colorado authors of the Nutrient research paper.
Increased food intake during the “biological night” - determined by high levels of the hormone melatonin - are the result of altered behavioral sleep and wakefulness schedules – resulting in inadequate sleep and increased food intake, specifically higher carbohydrate intake.
The researchers comment that, “recent studies suggest that the circadian timing of food intake may have a larger impact on body composition than the local clock time of food intake. If sustained, the imbalance resulting from this behavioral pattern, may lead to weight gain over time.”
Mayoclinic.org says melatonin plays a role in sleep. “The production and release of melatonin in the brain is connected to time of day, increasing when it's dark and decreasing when it's light. Melatonin production declines with age,” acknowledges the website.
The Colorado investigators chose to determine the impact of food intake during a simulated early morning shiftwork protocol and its affects on sleep, endogenous (internal) melatonin levels, and metabolic outcomes. The crossover designed study population included twenty-two non-obese, healthy adults.
The participants, who were healthy as assessed by physical, psychological, and sleep disorder screenings and physical exam, blood chemistries, 12-lead clinical electrocardiogram, and urine toxicology, had not participated in shiftwork within six months or traveled across more than one time zone, within three weeks prior to study.
Each participant’s energy content of their diet was established through resting energy expenditure (REE) testing at the medical screening - adding an activity factor that reflected the habitual low level of physical activity. The timing of sleep and food intake were scheduled relative to each participant’s normal sleep time to maintain relative consistency.
The participants were scheduled to an 8-hour sleep opportunity at their habitual time. In the early morning shiftwork condition, participants were scheduled to a 6.5-hour sleep opportunity from one hour prior to habitual bedtime, until 2.5 hours prior to habitual wake time.
The current research demonstrated that, “early morning caloric intake after one night of insufficient sleep, when melatonin levels are high, leads to a small increase in glucose levels, when compared to the same meal, after sleeping and awaking at habitual times.”
That led to the recommendation of a need, “for future analysis exploring, whether delaying breakfast time, after an early morning awakening may be a potential therapeutic target for improving metabolic health in the largest population of shift workers, and perhaps in modern society for people with high morning melatonin levels for hours after awakening.”
In the Covid-19 world, research shows that being older – over 65 – with hypertension – high blood pressure – increases the risk to complications associated with this SARS-2 virus. In addition to older age, another associated-risk to hypertension has to do with arterial stiffness (AS) – which represents a decrease in the compliance of large, central arteries.
According to research – Cardiorespiratory Fitness and Muscular Strength on Arterial Stiffness in Older Adults – which appears in the August 2020 issue of Medicine & Science in Sports & Exercise, “arterial stiffness is an emerging strong and independent predictor of cardiovascular disease.”
In addition, “arterial stiffness also strengthens CVD (cardiovascular disease) risk prediction, when added to traditional risk factors, such as blood pressure, and may provide unique predictive insight that is undetected by traditional risk factors.”
The study authors, from the Department of Kinesiology at Iowa State University, comment that higher levels of fitness – cardiorespiratory (CRF) and maximum strength (MS) - are associated with lower AS in older adults. Aerobic and resistance exercise have been shown to improve traditional CVD risk factors – along with numerous other conditions related to advanced vascular aging, such as AS.
“Higher levels of CRF, which is often used to represent recent aerobic exercise participation, are consistently associated with reduced AS in populations generally predisposed to high AS, including older adults,” note the Iowa researchers.
Yet, most of the research on the benefits of AS and MS have been performed on a younger study population. As such, the Iowa investigators sought to investigate the independent and combined associations of CRF and MS with AS in older adults -using data from the Physical Activity and Aging Study (PAAS) - an ongoing prospective, observational cohort study of older adults (497 men and women) at least 65 years of age.
It was speculated that higher CRF would be associated with lower AS, independent of MS, while MS would be associated with lower AS, independent of CRF- with the combined association of CRF and MS being stronger than either CRF or MS alone.
After appropriate exclusion criteria, 405 of the PAAS older adults - with a mean age between 66 to 78 – were assessed over two visits with a medical history questionnaire, pulse wave velocity, mean arterial pressure, height, weight, body mass index, blood lipid panel, cardiorespiratory fitness – 400-meter walking test, and strength – hand grip strength.
It was determined that both CRF and MS were independently associated with reduced odds of having high AS in older adults. Additionally, “a joint analysis revealed that the relative contribution of CRF and MS appears to be similar, when directly comparing the “fit and weak” group with the “unfit and strong” group.”
The research demonstrated that the “fit and strong” group showed the lowest incidence of having high AS - suggesting a possible additive benefit of being both fit and strong on AS. As noted, further research is necessary to gain a better understanding of how CRF and MS can reduce risk to age-associated health complications.
In the Covid-19 world, those individuals, especially older males, with comorbidities, like hypertension and diabetes, are at increased risk to complications, if this SARS 2 disease is contracted.
The journal Cell Metabolism reported in June of 2018 that early time restricted feeding (eTRE)–between 8 am and 2 pm–increases insulin sensitivity and lowers blood pressure–even in the absence of weight loss, in prediabetic men.
Intermittent fasting (IF), which alternates periods of eating and fasting, has been speculated to improve cardiometabolic health more than conventional dieting. Yet, most of the IF evidence, to date, in humans has suggested that the benefits accrue mostly from weight loss.
The study authors, from the Pennington Biomedical Research Center in Baton Rouge, Columbia State University, the American Diabetes Association, and the University of Alabama, state that there was a, “need to determine whether the benefits of interventions, such as IF, are mediated only through weight loss or through mechanisms that are independent of weight loss.”
These investigators used a “proof-of-concept trial”—using a form of IF called time-restricted feeding (TRF)—to determine whether IF had benefits independent of weight loss.
TRF, note the Pennington team, “is a type of IF that extends the daily fasting period between dinner and breakfast the following morning, and, unlike most forms of IF, it can be practiced either with or without reducing calorie intake and losing weight.”
TRF is limiting daily food intake to a window of ten hours or less—with fasting the remaining 14 hours, over a 24-hour period. The typical American eats over a 12-hour window (8am to 8 pm on average).
The researcher's study period spanned five weeks, in which a group of prediabetic men adopted an (eTRF) schedule—over a six-hour period–versus a second control group of male prediabetics, who adhered to a twelve-hour eating window.
The participants consumed only food provided by study staff, were fed enough food to maintain their weight, and ate all meals, while being monitored by study staff.
From a metabolic, medical standpoint, glucose tolerance, postprandial (after a meal) insulin, and insulin sensitivity, as measured using a 3-hr oral glucose tolerance test (OGTT) were assessed, while the secondary endpoints were cardiovascular risk factors and markers of inflammation and oxidative stress.
It was determined that, “5 weeks of (eTRF) improved insulin levels, insulin sensitivity, beta cell responsiveness, blood pressure, and oxidative stress levels in men with prediabetes—even though food intake was matched to the control arm and no weight loss occurred.”
Before you embark on such an eating schedule, be sure to check with your primary care physician to see how such a plan might impact your health profile.
Immune modulation—having an aggressive immune (defense) system, available to meet invading pathogens and destroy foreign cells—came into vogue, when Covoid-19 first surfaced, as a recognized disease. Prior to the SARS-2 infection, immune modulator agents—such as various types of immunotherapy—were referenced relative to cancer treatments.
One related factor to both cancer and Covid-19 is the unique role that cytokines—proteins made by white blood cells—play in the human body's normal immune response. Covid-19 causes a “cytokine storm,”—a situation where, “viral replication triggers an abnormally strong release of cytokines and other immune-related stimuli, resulting in hyper-inflammation.”
Inflammation and oxidative stress are essential to the normal functioning of the human body. Free radical oxidative stress can have a protective effect against invading microorganisms. However, chronically elevated oxidative stress—defined in relation to excessive reactive oxygen and nitrogen species–is seen in longer duration viral diseases like HIV and Epstein-Barr.
According to Strengthening the Immune System and Reducing Inflammation and Oxidative Stress Through Diet and Nutrition: Considerations During the Covid-19 Crisis, which appears in the July 2020 online issue of Nutrients, “an optimal immune response depends on an adequate diet and nutrition in order to keep infection at bay.”
For instance, a low protein intake—below the basic recommended 0.8 grams per kilogram of body weight–has been shown to increase risk to infection. The study authors—from Luxembourg Institute of Health, First Moscow Medical University, and California Polytechnic State University—comment that, “the low pool of available proteins also results in a decreased amount of functional active immunoglobulins and gut-associated lymphoid tissue (GALT), which play a role in gut-mucosal defense against infection.”
Further stating that high quality proteins—such as eggs, fish, lean meat (poultry), and whey proteins–are an essential component of an anti-inflammatory diet, as are plant-derived proteins–like pea isolate protein.
The amino acid glutamine is needed to support genes of the immune system–with glutamine providing energy to, “macrophages, neutrophils, and lymphocytes, (which are) needed for pathogen-identification through the proliferation of immune cells and the repair of tissues.”
Fatty acids (FA) can alter the immune response. Note the researchers, “(essential) omega-3 FAs appear to have the most potent anti-inflammatory capability, though not all omega-3 FAs are anti-inflammatory. Trans-fatty acids derived from processed foods, such as fries and chips, are pro-inflammatory.
The omega-3 FA alpha linolenic acid (ALA) is obtained from various plant sources, while the two other Omega 3's, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are found in fish and seafood sources–salmon, mackerel, and tuna.
The essential omega-6 FAs, such as arachidonic acid–found in certain vegetable oils and processed, baked goods–are primarily pro-inflammatory, and can hamper the omega-3 metabolism, when a ratio of omega-6 to omega-3 exceeds 10:1 versus a healthy ratio of 1:1 to 4:1.
From a gut health perspective, prebiotic (food for healthy GI bacteria) fiber is critical to offset a pro-inflammatory-type diet. As the researchers point out, “while the intake of 25 grams and 38 grams of fiber for women and men, respectively, is recommended, true intake is generally lower (around 15–20 g/d), at least in Westernized countries.”
An advantage of whole-grain intake is to create a more favorable gut microbiome (organisms in GI tract) composition, which lowers both gut and systemic inflammation, and even small increases of only 5 grams of additional fiber per day can be beneficial, comment the researchers.
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Based on research—Calorie Restriction and Aging in Humans—which appeared online in June of 2020 in the Annual Review of Nutrition—“over the past century, the average life span in higher- and lower-income countries has increased by 15 and 30 years, respectively.”
Additionally, “this (outcome) is the result of lessening mortality and morbidity from food shortage, malnutrition, and infectious diseases through improved food supply and quality, as well as, advances in health care.”
Aging, which is associated with a decline in an individual’s physical and physiological capabilities, is part of life—as in death and taxes.
The speed and progression of age can be effected by such variables, as excess food consumption—overweight and obesity, poor fitness—less than 150 minutes of light to moderate weekly exercise, 75 minutes of moderate to vigorous weekly exercise, or a combination of both, or, the extent of an individual’s exposure to disease—all equaling secondary aging, added to or subtracted from (with prevention in place) the normal primary aging process.
According to the Annual Nutrition Reviews researchers from Pennington Biomedical Research Center, Louisiana State University, and Nutrition and Movement Sciences at Maastricht University in the Netherlands, “advanced age is associated with increased mortality and susceptibility to disease. This increase is caused by a progressive decline in physiological function. The slope of this decline over time can be defined as aging,” which, under an optimal scenario, may approach 120 years.
Primary aging, note the researchers, “describes the inevitable age-associated decline in physiological and physical functions due to energy expenditure and oxidative stress.” It appears that individuals with higher metabolic rates have shorter life spans—known as the rate-of-living theory—which the Pennington and Maastricht researchers say is, “still a matter of discussion, and may only apply in species, and not between species.”
It was also noted that average lifespan is reduced to 61 to 83 years—“an acceleration of this process reflects the interaction between innate aging and the extrinsic influences of the environment.”
As aging applies to our functional capacity, I’ve often commented to many of my athlete clients—when my patience (with age) wears thin—discussing my strategic plan—that age is mandatory, but maturity is optional.
They’ve also heard me explain from day one that my objective is to make them perform better than before—with a higher quality of health in the years extending beyond their playing career.
I recognize three ages—chronological age, what we’re given at birth, performance age, how successful we are at achieving our mental and physical objectives on and off the playing field, and health age, resistance to the effects of chronic fatigue and disease.
With the exception of our chronological age, being the constant, the goal from a health age perspective is to work toward a compressed morbidity, pushing illness to the shortest period of time late in life—which is extended toward a higher quality.
The pillars of life extension—slowing the aging process—has to do with lengthening the telomeres—segments of DNA occurring at the ends of the chromosomes in eukaryotic cells (that containing a clearly defined nucleus), according to Britannica.com.
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Non-alcoholic fatty liver disease (NAFLD) is defined in the literature, as an accumulation of liver fat in individuals, who are not consumers of excessive amounts of alcohol—more than 20 grams per day for women and less than 30 for men.
According to research—"Mediterranean Diet and NAFLD: What We know and Questions That Still Need to be Answered"—which appeared in the December 2019 online issue of the journal Nutrients—"NAFLD encompasses different clinical scenarios, from the simple accumulation of fat in the liver (steatosis), to steatohepatitis (NASH), cirrhosis, and its complications."
The research points out that the presence of liver steatosis globally has hit 25% of the population—with 46% here in the United States. Liver steatosis represents a reversible condition caused by an accumulation of triglyceride fat in liver cells.
The Merckmanual.com says that NASH is defined as the presence of fat leading to lipo-toxicity and inflammatory damage to hepatocytes (liver cells).
Since there no approved drug treatment methods to address the global impact of NAFLD and its manifestations, addressing systemic and visceral (fat in midsection) obesity and the associated inflammation is an appropriate place to start.
The Mediterranean Diet (MD)—a plant-based eating plan with a high ratio of mono-unsaturated fatty acids (MUFA), representing 30-40% of the daily caloric intake—is rich in olive oil, nuts, vegetables, whole grains, legumes, fish (high sources of omega-3 fatty acids) and other seafood, while low in meat and dairy products, and moderate alcohol consumption (mainly rede wine)—all anti-inflammatory in nature.
From a dietary pyramid perspective, the MD breaks out as follows: protein (legumes, fish & meat) constitute 25%, vegetables & fruits 50%, grains, rice, and pasta 25%—with 1 glass of red wine and 1-2 servings of olive oil.
The Italian study investigators comment that, "a diet (like the MD) rich in omega-3-fatty acids has been shown to be protective against fatty liver as it prevents hepatic fat accumulation and reduces hepatic steatosis. An additional benefit of the MD on fatty liver disease is related to its low content of refined sugars, fructose, and high content of complex carbohydrates and fibers."
Surprisingly, the researchers note that, "the MD consents to a moderate amount of alcoholic units per day. Although there is a lack of studies with convincing evidence to support the benefits versus harms of ethanol intake, light alcohol intake seems safe in NAFLD non-cirrhotic patients."
A recent retrospective study the Italians cite on the effects of alcohol consumption on survival in NAFLD-patients, "reported that drinking 0.5-1.5 drinks per day decreases the risk of overall mortality by 41%." I personally find that research suspect.
The MD is rich in high-fiber whole grains, which may be beneficial in NAFLD patients, since they have less energy density and induce more satiety (hunger satisfaction) than refined carbohydrates. The whole grains also modulate gut microbiota through its prebiotic (food for the healthy gut bacteria), which may play a role in the pathogenesis of NAFLD and its progression.
The Italians conclude by commenting that, "MD has recently been suggested as the diet of choice for NAFLD treatment, but the evidence behind this recommendation is very low, as most of the studies that have addressed this issue included few patients, differed in the inclusion/exclusion criteria, the methods by which steatosis was measured, and in the measurement of outcomes."
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On June 15,th 2020, NBC News reported that death rates are 12 times higher for coronavirus patients with chronic illnesses compared to healthier individuals, who became infected.” Citing a Center for Disease Control and Prevention report, the top three chronic health issues found with Covid-19 patients were heart disease, diabetes, and lung ailments.
On the same day of the NBC News report, JAMA (Journal of the American Medical Association) Internal Medicine published a study— Association Between Healthy Eating Patterns and Risk of Cardiovascular Disease—which determined that, “in 3 large prospective cohorts, greater adherence to various dietary patterns was associated with lower CVD (cardiovascular disease) risk.”
The healthy dietary patterns were taken from the 2015-2020 Dietary Guidelines for Americans that, “highlight a shift from focusing on individual nutrients or foods to emphasizing healthy eating patterns, as a whole, and recommend multiple healthy dietary patterns to provide dietary choices for all Americans with diverse cultural and personal food traditions or preferences.”
According to Health.gov, “the 2015-2020 Dietary Guidelines provides five overarching Guidelines that encourage healthy eating patterns, recognize that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern, and acknowledge that all segments of our society have a role to play in supporting healthy choices.”
These Guidelines, notes the website, “also embody the idea that a healthy eating pattern is not a rigid prescription, but rather, an adaptable framework in which individuals can enjoy foods that meet their personal, cultural, and traditional preferences and fit within their budget.”
Those healthy dietary guidelines include:
- Follow a healthy eating pattern across the lifespan
- Focus on variety, nutrient density, and amount
- Limit calories from added sugars and saturated fats and reduce sodium intake
- Shift to healthier food and beverage choices
- Support healthy eating patterns for all
The healthy eating patterns include consuming vegetables from all sub-groups—dark green, red and orange, beans and peas, starchy and other; fruits, especially whole fruits; grains, at least half of which are whole grains; fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages; a variety of protein foods, including seafood, lean meats and poultry, eggs, beans and peas, and nuts, seeds, and soy products; and healthy oils like olive and canola, while limiting saturated and trans fats, added sugars, and sodium.
To reach the conclusion that these healthy eating guidelines and food patterns would reduce CVD risk, Harvard University researchers and others, including members from the Tulane University School of Public Health and Tropical Medicine, used data from the Nurses’ Health Study (NHS) from 1984-2016, NHS II from 1991-2017, and Health Professionals Follow-up Study (HPFS) 1986- 2012.
The NHS is a prospective cohort study of 121,700 female registered nurses aged 30 to 55 years that began in 1976. The NHS II was established in 1989 and consists of 116, 671 younger female registered nurses, aged 25 to 42 years. The HPFS is a prospective cohort study of 51,529 male health professionals aged 40 to 75 years that began in 1986.
Among other criteria, dietary information was collected every 2 to 4 years. Participants were asked how often, on average, they consumed a standard portion size of each food in the past year—with a frequency response ranging from never or less than 1 time per month to at least 6 times per day.
In order to assess the frequency of CVD, which was defined as fatal and nonfatal CHD (including nonfatal myocardial infarction), participants were asked to report an incident event on each biennial questionnaire. Then, permissio
The US department of Health and Human Services says the most common way to determine, if a person is overweight or obese is to calculate body mass index (BMI), which is an estimate of body fat, based on comparing a person’s weight to his or her height. However, BMI can be flawed with more lean muscle weight, such as the case with a fit person or athlete.
The Centers for Disease Control and Prevention (CDC) comments that, “BMI does not measure body fat directly, but research has shown that BMI is moderately correlated with more direct measures of body fat obtained from skinfold thickness measurements, bioelectrical impedance, underwater weighing, dual energy x-ray absorptiometry (DXA) and other methods.”
When BMI is added to a person’s potential health comorbidities (high blood pressure, cardiovascular, liver, or kidney disease), there can be a higher risk to complications associated with viral-associated diseases, such as Covid-19. “BMI appears to be strongly correlated with various adverse health outcomes consistent with these more direct measures of body fatness,” notes the CDC.
For adults, a BMI of 18.5 to 24.9 is considered normal weight; 25.0 to 29.9 is considered overweight; 30.0 to 39.9 is considered obese, and 40.0 and higher is considered extremely obese.
The World Health Organization (WHO) states that the number of obese people has tripled worldwide in the last twenty years – reaching the status of a global epidemic – mainly associated with improper dietary habits and a sedentary lifestyle.
According to April 2020 research – Obesity, Bioactive Lipids, and Adipose Tissue in Insulin Resistance – published in the online, peer reviewed journal Nutrients, “obesity is a state of pathological increase in the amount of adipose tissue, which boosts the risk of numerous diseases, such as cardiovascular disease, some types of cancer, and type 2 diabetes.”
The study authors from the Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Poland, stress that “there are a number of causes leading to the development of obesity, including genetic and environmental factors. The contribution of genetic factors to obesity is very important and is thought to be responsible for 40–70% of obesity cases.”
However, note the Polish researchers, “it appears that non-genetic factors, especially environmental factors such as unhealthy eating habits and lack of physical activity, also play a substantial role in generating obesity.”
Let’s add sleep duration and daytime sleepiness to the list of complications that may affect being overweight and obese.
When insulin resistant – a precursor to type 2 diabetes and obesity – insulin stimulates fat storage and inhibits fat breakdown for energy. Under normal conditions, insulin is an anabolic (building) hormone that increases the uptake of amino acids by muscle tissue and enhances protein synthesis (making muscle).
The American Diabetes Association (ADA) defines insulin resistance as, “a condition in which the response of cells to insulin is impaired with respect to carbohydrates, lipids, and proteins, resulting in elevated blood glucose levels.”
The ADA further states that, “insulin has a wide spectrum of effects on metabolic processes in adipocytes (fat cells); therefore, it is considered the most important hormone regulating anti-lipolytic processes, and deterioration of cell sensitivity to this hormone or impairment of the insulin pathway may affect the metabolism of adipose (fat) tissue.”
The central accumulation of fat tissue – known as an android visceral fat - is consistent with a male fat pattern. Female fat accumulation – known as a gynoid fat pattern – is the increase of subcutaneous (under the skin) fat in the hip and thigh regions.
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As we age, especially over 65, our habitual sleep duration changes— emphasizing a potentially shorter duration that has been associated with increased risk to obesity and hypertension— irrespective of sleep apnea (stop breathing) interruptions.
According to Association of Longitudinal Patterns of Habitual Sleep Duration with Risk of Cardiovascular Events and All-Cause Mortality, which appeared on JAMA Network Open in April of 2020, “a laboratory study suggested that a repeating pattern of insufficient sleep may lead to long-term metabolic changes that cannot be effectively mitigated by weekend recovery sleep.”
These findings, comment the Chinese study authors, “highlight the importance of examining the effect of long-term patterns of sleep duration beyond single or mean measures, which fail to consider the effect of change in sleep duration over time.”
Chinese researchers sought to look at the direction of long-term versus single-measure sleep duration’s effect on cardiovascular events (CVE’s) and all-cause mortality - by using the Kailuan study population of 52,599 Chinese adults without atrial fibrillation, myocardial infarction, stroke, or cancer - between 2006 to 2010 - with risk of CVEs and all-cause mortality from January 1, 2010, to December 31, 2017.
Study participants completed a face-to-face questionnaire survey, which highlighted demographic characteristics, medical comorbidity, medical history, medication use, and lifestyle factors - including measures of sleep, clinical examinations, and laboratory tests. Participants were then followed up biennially to update the data— with outcome events recorded annually until death or December 31, 2017, whichever came first.
The study data suggested that, “trajectories in sleep duration were significantly associated with the risk of the first CVE’s and death, even after adjustment for a single measure of baseline sleep duration.” The authors note that conventional evidence supports that, “single measures of sleep duration were associated with adverse health outcomes.”
Relative to the effects of short-term versus long-term sleep duration, “participants with short (less than 6 hours per night) and long (8 to less than 9 hours per night) sleep duration had adverse health outcomes, regardless of their earlier sleep patterns,” which led to the findings that, “trajectories of long-term sleep duration are associated with subsequent risk of CVE’s and death besides one-off measures closer to the time of events.”
The Chinese researchers said that, “the better understanding of the effect and timing of change in sleep duration may help to identify populations with higher risk, who can then be targeted with interventions to promote cardiovascular health and healthy sleep.”
In conclusion, “sleep duration trajectories with lower or unstable patterns were significantly associated with increased risk of subsequent first CVEs and all-cause mortality.” As was noted, much more research is needed to determine the appropriate quality and quantity of sleep, including napping, to add to our menu of healthy living criteria.
With Covid-19 a major player in the health care arena—immune modulation, diagnostic testing, comorbidities (concurrent health issues), social distancing, masks, gloves, and so forth—the controlling factor to a best outcome is to develop a healthy lifestyle.
JAMA (Journal of the American Medical Association) Internal Medicine published in April 2020 an original investigation—Association of Healthy Lifestyle with Years Lived Without Major Chronic Diseases—which sought to estimate the association between a healthy lifestyle and the number of disease-free years.
It was determined that four basic lifestyle characteristics—smoking status, body mass index (weight in kilograms divided by height in meters squared), physical activity level, and alcohol consumption—would be compared to the number of years between 40 to 75, without chronic diseases, such as type-2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease (COPD).
In order to assess the disease impact on healthy years, the study evaluation included 116,043 people from a multicohort European population (Working Populations Consortium), who had a mean age of 43.7 years—with 70,911 women (61.1%) represented in the sample.
"Participants were included in the analyses, if they were free from the 6 chronic diseases at baseline and had information available on sex, age, socioeconomic status, lifestyle factors (weight, height, smoking, physical activity, and alcohol consumption), and follow-up for chronic diseases. Study baseline ranged from August 7, 1991, to May 31, 2006, and data analysis was conducted from May 22, 2018, to January 21, 2020," as noted in the study methods.
A scoring system was established based on recognized standards. Here’s how the parameters were established—directly taken from the JAMA paper.
BMI: < 25 optimal, 25-25.9 intermediate, and > or = to 30 poor; smoking: never optimal, former smoker, intermediate, and current smoker, poor; leisure-time physical activity: meeting world health organization recommendations of > 2,5 hours of moderate weekly activity or > 1.25 hours of vigorous weekly activity was optimal, activity between optimal and poor was intermediate, while no or very little moderate /vigorous leisure-time physical activity was labelled as poor.
As for total, weekly alcohol consumption (1 drink = 10 grams of ethanol), 1 to 14 (women) or 1 to 21 (men) weekly drinks was classified as optimal, no alcohol was intermediate, while > than or = to 15 drinks for women and 22 for men was poor.
The researchers then, "computed an overall healthy lifestyle score by aggregating responses for the 4 individual lifestyle factors: optimal (2 points), intermediate (1 point), or poor (0 points). This scale resulted in a healthy lifestyle score ranging from 0 (lowest healthy score, highest risk) to 8 (highest healthy score, lowest risk)."
It was determined that, "all of the 4 lifestyle profiles that were associated with the highest number of disease-free years included a body-mass index less than 25, and at least 2 of the following factors: never smoking, physical activity, and moderate alcohol consumption. Participants with 1 of these lifestyle profiles reached age 70.3 to 71.4 years disease free, depending on the profile and sex."
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Dyslipidemia, the characteristic change of one or more blood lipid (fat) components – including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (Trig), and high-density lipoprotein cholesterol (HDL-C) – is an established risk factor for cardiovascular disease (CVD).
According to Italian research – Ubiquinol (co-enzyme Q-10) Ameliorates Endothelial Dysfunction in Subjects with Mild-to-Moderate Dyslipidemia: A Randomized Clinical Trail —dyslipidemia, “has a prevalence of 38.6% among individuals aged 40 years and above, and the alteration of TC, HDL-C, or non-HDL-C has been reported in one out of five US children and adolescents aged 8–17 years.”
Stanfordhealthcare.org says, “endothelial dysfunction is a type of non-obstructive coronary artery disease (CAD) in which there are no heart artery blockages, but the large blood vessels on the heart’s surface constrict (narrow) instead of dilating (opening).”
This condition, comments Stanford, “tends to affect more women than men and causes chronic chest pain. Because most clinics do not diagnose or treat endothelial dysfunction, people with this condition may feel frustrated and hopeless.”
The vascular endothelium is critical in maintaining vascular balance – capable of sensing alterations in vessel walls and releasing a variety of autocrine (a substance secreted by a cell on its surface structure) and paracrine (stimulate cell regeneration) substances to protect the cell wall integrity.
COQ-10 and its bioactive form ubiquinol, exert antioxidant protection by preventing the oxidation of LDL-C, while also improving endothelium-dependent vasodilation (opening).
“CoQ10 has improved endothelium-dependent vasodilation, as measured by FMD (flow mediated dilation), in patients with type 2 diabetes, or coronary artery disease,” notes the study authors.
The Italian researchers sought to determine, if an 8-week ubiquinol supplementation period enhances endothelium-dependent vasodilation in adults with moderate, untreated dyslipidemia and without evidence of CVD.
The primary study outcome was to measure the effect of COQ-10 (ubiquinol) on FMD of an artery, when blood flow increases or not in that artery.
A secondary outcome included the assessment FMD and changes in COQ-10 status at weeks 4 and 8 – along with changes in vasodilators nitrite and nitrate levels, and LDL-C oxidation at week 8.
The Italian’s study participants included fifty-one subjects with low-density lipoprotein (LDL) cholesterol levels of 130–200 mg/dL, not taking statins or other lipid lowering treatments, moderate (2.5%–6.0%) endothelial dysfunction, as measured by FMD of the brachial artery, and no clinical signs of cardiovascular disease, who were randomized to receive either ubiquinol (200 or 100 mg/day) or placebo for 8 weeks.
At the study completion, it was determined that, “ubiquinol significantly ameliorated (make more acceptable) dyslipidemia-related endothelial dysfunction. This effect was strongly related to increased nitric oxide bioavailability and was partly mediated by enhanced LDL antioxidant protection.”
The take-away message is clear that COQ-10 is another option, with medical supervision, in the non-pharmaceutical tool kit to help address, along with diet and exercise, the negative health effects of dyslipidemia.
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Based on research into the various paths the Covid-19 disease can track in the human body, it’s apparent that the entire body—from the inflammation in the brain to swelling (redness) in the toes—can be affected.
It’s also recognized that people over the age of 65—especially those with comorbidities, such as hypertension, diabetes, cardiovascular, liver, and kidney disease, are at greater risk to complications, if the disease gains a foothold in the lungs.
With advanced age, there is also an inherent risk, without early lifestyle intervention, to vascular dysfunction—specifically arterial stiffness. In essence, the arteries become stiffer, which involves structural and functional changes—leading to cardiovascular and cerebrovascular disease.
Stiff arteries can lead to buffering changes in large, central arteries and increases in blood pressure, and blood flow pulsatility, comment researchers from the Human Performance Laboratory at Syracuse University in New York, who published "Effects of Whey Protein Supplementation on Aortic Stiffness, Cerebral Blood Flow, and Cognitive Function in Community-Dwelling Older Adults: Findings from the Anchors A-Whey Clinical Trail" in the April issue of the journal Nutrients.
“Arterial stiffness and subsequent increases in central hemodynamic pulsatility,” say the study authors, “are associated with several pathologies of aging including hypertension, left ventricular hypertrophy and heart failure, renal dysfunction, and retinal damage. Moreover, increased arterial stiffness and central hemodynamic pulsatility are independent predictors of cardiovascular and cerebrovascular events and mortality.”
Sciencedurect.com says, “the arterial pulse consists of three components:pressure, vessel diameter, and blood velocity waves. As the pulse wave travels downstream in the vascular tree, the pressure wave moves faster than the blood velocity and diameter pulse. The stiffer the vessel, the faster the pressure wave travels.”
These researchers point out that life extension is an important health goal. Independent living and functioning are of equal importance. That requires interventions—like functional fitness and eating strategies—to improve cognition with age.
“The brain is a high flow target organ that is particularly sensitive to excessive hemodynamic pulsatility, with central hemodynamic pulsatility potentially infiltrating and damaging the delicate cerebral microvasculature”.
According to the Syracuse researchers, numerous studies note relationships between central artery stiffness, pulsatile hemodynamics, cerebrovascular pulsatility, and cognitive function. “Arterial stiffness and cerebral pulsatility also predict cognitive decline with advancing age and incident dementia.”
The Syracuse study involved a 12-week, randomized controlled trial designed to examine the effect of whey protein on large artery stiffness, cerebrovascular responses to cognitive activity and cognitive function in older adults.
Ninety-nine older adults between 61-73 years of age were recruited, of which 45% were female. Participants were randomly assigned to consume 50 grams per day of whey protein isolate (WPI)—25 grams twice daily—or a iso-carbohydrate control.
Prior to the study, there was an initial screening of the participants: a health history questionnaire, visual acuity and color-blindness tests, height, weight, and waist circumference, depressive symptoms and global cognitive function assessment, urinalysis, fasting glucose and lipid levels, physical activity assessment, blood pressure and aortic stiffness assessment, carotid blood flow and stiffness—along with an assessment of cerebral blood flow velocity. These measurements were also completed following the 12-week intervention.
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In January of 2020, "A Review of Micronutrients and the Immune System—Working in Harmony to Reduce the Risk of Infection" was published in the online peer review journal Nutrients. How prophetic that such a review would turn out to be critical three months later, with the worldwide onset of the pandemic—Covid-19.
Researchers from the Linus Pauling Institute, Department of Biochemistry and Biophysics, Oregon State University and Bayer Consumer Care AG in Switzerland, comment in the Review that, “immune support by micronutrients is historically based on vitamin C deficiency and supplementation in scurvy in early times.”
Scurvy, a disease caused by vitamin C deficiency, causes swollen, bleeding gums, opening of previously healed wounds, weakness, feeling tired, with sore arms and legs- along with decreased red blood cells, changes to hair, and bleeding from the skin may also occur.
In 1753, researcher James Lind used three different diet approaches with men suffering from scurvy to determine that citrus fruits—higher in vitamin C- provided a solution to this condition.
In addition to vitamin C, vitamins A, D, E, B6, B12, and folate, along with minerals zinc, iron, copper, selenium, and magnesium also play vital, synergistic roles at every stage of the immune response.
Our immune defense system is composed of elaborate components, which provide physical and biochemical barriers, specialized immune cells, and antibodies that challenge and attack an invading pathogen.
The first line of defense is called the innate immune response—characterized by a challenge by the skin, hair, and mucus membranes to provide a barrier into the body. In other words, limit access points of entry.
From there, it’s the job of biochemical attackers—leukocytes such as neutrophils, natural killer (NK) cells, and macrophages—to identify “non-self” molecules to open fire and destroy the invader, which is marked as an antigen. Cytokines (involved in cell signaling), then repair any damage.
That’s followed by a second wave of attackers, T & B cells, which is the phase of the immune response characterized as adaptive immunity—that remembers the invader and coordinates a joint response.
The researchers from Oregon State and Bayer AG provide an excellent overview, “of the known mechanisms of micronutrients that are fundamental to immune function,” and how inadequate intake might affect risk to infection. Here are few of the impacts of specific immune modulating nutrients.
Vitamin A—important for intestinal immune response, thus supporting the gut barrier; carotenoids (either provitamin A or non-provitamin A) have immunoregulatory actions.
Vitamin D—calcitriol (a form of vitamin D3) regulates antimicrobial proteins responsible for modifying intestinal microbiota to a healthier composition and supporting the gut barrier, as well as, protecting the lungs against infection.
Vitamin C—promotes collagen synthesis and protects cell membranes from damage caused by free radicals, thus supporting integrity of epithelial barriers.
Vitamin E—protects cell membranes from damage caused by free radicals and support the integrity of epithelial barriers.
Vitamins B6, B12, Folate—involved in intestinal immune regulation (e.g., by mediating lymphocyte migration into the intestine) in the case of vitamin B6, while folate is essential for the survival of regulatory T cells in the small intestine. Human gut microbes use vitamin B12, as a cofactor for metabolic pathways, thus supporting the gut barrier. Folate is also important for sufficient antibody response to antigens.
Iron—essential for differentiation and growth of epithelial tissue.
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Recently NBC News reported on the findings of research, "Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area," published April 22nd in the Journal of the American Medical Association’s online Jamanetwork.com.
The study, noted NBC, was that the underlying conditions were common, “with 57% having high blood pressure, 41% were obese, and just over a third had diabetes.”
The report also found that, “fever wasn't a reliable warning sign of infection. Just one-third of patients had elevated temperatures, when they were triaged upon arrival.”
Of note, “other known symptoms of the coronavirus include cough, headache, trouble breathing, severe fatigue, and loss of smell and taste. But those symptoms tend to vary from person to person. And, it's unclear whether certain symptoms might serve as warning signs that a person might end up in the hospital with severe disease.”
Based on reports here in Louisiana, it appears that those same comorbidities - hypertension, obesity, diabetes, and underlying cardiovascular disease - may have a higher risk stratification to advanced complications with the virus.
Much attention, including my recent columns, has focused on ways – like cardiovascular exercise and the Mediterranean eating style - to strengthen the immune system, which is especially challenged, if dealing with other health issues concurrently with virus exposure.
Other immune modifying, non-pharmaceutical options – such as vitamin c, zinc, garlic, olive leaf extract, N-acetyl-cysteine – with physician buy-in – have gained attention nationwide, causing a shortage in the supply chain in some cases.
Let me add for medical consideration a powerful, long-term immune modulating agent – bovine (cow) colostrum, which has flown under the radar screen.
Colostrum, according to Robert Rountree, MD and Carol Coleman’s 2000 edition book, Immunotics (G.P. Putnam and Sons), is, “premilk, a thin, yellowish fluid produced for only the first two days, after giving birth by lactating humans and mammals.”
Rountree, who is an integrative medical specialist, comments that, “it is chock full of potent immune enhancing factors that jump start the infant’s immature immune system.” In fact, Rountree goes further to say, “what colostrum is to infants, it can also be to adults - a sturdy framework on which to build a better immune system.”
This physician also points out that colostrum, which in supplement form can be derived from bioactive peptides or protein fractions extracted from bovine colostrum, is not intended for acute conditions, but primarily, as a long-term immune builder – like in transition toward what some experts say may be a second Covid-19 wave in the fall and winter months.
Of course, the key is to derive colostrum from cows raised without pesticides, antibiotics, or growth hormones. It should also be pointed out that while many allergy-causing proteins from colostrum are attempted to be eliminated, some people with milk allergies could potentially develop symptoms. Bovine colostrum is best consumed on an empty stomach to enhance absorption.
As I say, before you make any changes to your supplementary intake, you must first consult with your physician. Right, now mistakes are not an option.
You can also contact spencer@mackienutrition.com should you desire nutrition product shipped or locally delivered to your door. My 4 locally operated GNC franchise stores are open, regularly sanitized – with appropriate staff and customer safety in place. Check mackieshilstone.com for store locations and hours.
Statistics point to the fact that the elderly population - those over 65 years of age -has tripled from 4 to 13% over the last century – with an expectation that it will grow to 20% by 2025 and 33% by 2050.
With aging, there is an associated decline in cognitive function of 15-20% of those over 65. Alzheimer’s, the main neurodegenerative disease, affects 24 million people worldwide.
According to research - n-3 Polyunsaturated Fatty Acids and Their Derivates Reduce Neuroinflammation During Aging - which appeared in the March issue of the online journal Nutrients, “dietary n-3 polyunsaturated fatty acids (PUFAs) are particularly attractive, as they are present in the brain, possess immunomodulatory properties, and are precursors of lipid derivates named specialized pro-resolving mediators (SPM).”
“SPMs are crucially involved in the resolution of inflammation that is modified during aging, resulting in chronic inflammation,” comment the French study researchers. The advanced age-associated chronic, low grade inflammation is known as inflammaging.
The French reviewers point out that microglial cells - the resident innate immune cells of the CNS - are involved in various physiological and pathophysiological functions - initiating the immune response, when they recognize damage and pathogen-associated molecular patterns.
The French also point out that with aging, there can be an increase in the expression of blood and brain levels of pro-inflammatory cytokines, and a decrease in the expression of anti-inflammatory factors.
Britannica.com says cytokines are, “any of a group of small, short-lived proteins that are released by one cell to regulate the function of another cell, thereby serving as intercellular chemical messengers.”
Cytokines, says the website, “effect changes in cellular behavior that are important in a number of physiological processes, including reproduction, growth and development, and injury repair. However, they are probably best known for the roles they play in the immune system’s defense against disease-causing organisms.”
In their review of neuroinflammation on aging, the French reference that the Omega-3 essential fatty acid docosahexaenoic acid (DHA) represents 12-14% of the total fatty acid content in the brain, and, “has key-regulator functions in inflammation. Eicosapentaenoic acid (EPA), the other EFA, despite its low level in the brain, has great importance, as well.
Fish consumption, such as salmon, sardines, and trout, is the main source of long chain Omega-3 polyunsaturated fatty acids ((n-3LC PUFA). “The absence of n-3 LC PUFA consumption and/or a defect in their metabolism is responsible for increased neuroinflammation, leading to neurological disorders,” the reviewers state.
It was concluded that, “n-3 LC-PUFAs and their bioactive lipid derivates (SPMs) are promising, as they reduce and resolve inflammation.”
In a separate study – Beneficial Effects of Walnuts on Cognition and Brain Health – which appeared in February of 2020 in the Nutrients journal – reviewers from the New York State Institute for Basic Research in Developmental Disabilities state that, “oxidative stress and neuroinflammation have important roles in the aging process, mild cognitive impairment (MCI), Alzheimer’s disease (AD), and other brain disorders.”
Their studies, “demonstrated that walnuts reduce oxidative stress, not only by decreasing free radical levels, but also by boosting antioxidant defense, thus reducing oxidative damage to lipids and proteins.”
My 4 locally operated GNC franchise locations – designated, as others, by the US Homeland Security Department as essential businesses – are open, offering online ordering for grab and go, along with full access to our sanitized stores.
For those who desire product to be shipped, please email spencer@mackienutrition.com with your requests. Check mackies
As the second most abundant micronutrient in the human body behind iron, zinc is critical for multiple cellular biological processes – differentiation (the process where cells become more specialized), apoptosis (targeted cell death), and proliferation (multiplication of similar cells), according to A Guide to Human Zinc Absorption: General Overview and Recent Advances of In Vitro Intestinal Models, which was published in the March 2020 issue of the online journal Nutrients.
In vitro refers to studies performed outside the living body, while in vivo means within the body.
The German reviewers comment that, “the micronutrient (zinc) has to be supplied with food on a daily basis.” And, its balance (homeostasis) is predominately determined by intestinal absorption – its bio-accessibility and bioavailability in the intestine.
Zinc binds to roughly 2800 proteins, which means that zinc is critical to growth and development of an organism – requiring distribution in all compartments of the human body.
The adult human has approximately 2.6 grams of zinc - with 86% is located in bone and skeletal muscle, skin 4.2%, and liver 3.4%. Here’s where the immune modulation effect comes in. Zinc-containing entities also include the thymus gland and mucous membranes.
The thymus is a tiny gland that shrinks with age – supporting immunity through the maturation of T cells, which are part of the body’s defense network, and autoimmunity – protecting the body, when the immune system turns against itself.
Mucous membranes are a strong component of the immune system – which cover the digestive and urogenital tracts, the respiratory canal, the eye conjunctiva, inner ear, and most exocrine glands, which secrete substances on the body’s surfaces, like saliva glands.
The German researchers point out that the small intestine, pancreas, and liver play key roles in zinc’s maintenance in the body.
The National Institutes of Health (NIH) says that the spread of the daily zinc requirement – 2 milligrams to 13mg. – is age specific – with most multivitamin / mineral formulas providing 15mg. The World Health Organization (WHO) reports that one-third of the world’s population are at risk for zinc deficiency.
Zinc food sources includes, oysters, which contain more zinc per serving than any other food. Red meat and poultry provide the majority of zinc in the American diet. Other good food sources include beans, nuts, certain types of seafood (such as crab and lobster), whole grains, fortified breakfast cereals, and dairy products.
The NIH notes that, phytates—which are present in whole-grain breads, cereals, legumes, and other foods—bind zinc and inhibit its absorption. Thus, the bioavailability of zinc from grains and plant foods is lower than that from animal foods, although many grain and plant-based foods are still good sources of zinc.
From a dietary supplement standpoint, the NIH says, supplements contain several forms of zinc, including zinc gluconate, sulfate, and acetate. The percentage of elemental zinc varies by form. For example, approximately 23% of zinc sulfate consists of elemental zinc; thus, 220 mg of zinc sulfate contains 50 mg of elemental zinc.
Let me add zinc picolinate and chelate, which is bound to amino acids to improve absorption. Zinc citrate can help to prevent the potential aromatization of testosterone to estrogen in men on testosterone replacement therapy.
Too much zinc, in certain cases, can bind with the mineral copper, and reduce its bioavailability. Ask your physician, as to how much zinc is too much.
Zinc is a key driver of many human body processes, including maintaining a strong immune defense. It’s said in sports that sometimes the best offence is a great defense.
My 5 locally operated GNC franchise locations – designated, as others, by the US Homeland Security Department as essential businesses – are open, offering
With the need now to strengthen our lung function - endurance and stamina - to support immunity against the Covid-19 disease, walking, while practicing social distancing, is an easy access, inexpensive choice in our wellness toolbox. The question arises, as to how daily steps and what intensity level to facilitate this cardiopulmonary objective.
Prior national recommendations have include achieving 10,000 daily steps, which has spawned digital and wrist-worn monitors to track everything from heartrate, movement pattern (GPS), cardio load, strain, and tolerance (short and long-term exercise stress).
Limited evidence exists, as to the ability of this 10K daily step objective relative to its effect on mortality. It’s no secret that higher step counts can reduce risk to premature death, but the evidence to date is with older adults, those with chronic conditions, or with study groups experiencing relatively few deaths, which can skew outcomes.
Original investigation – Association of Daily Step Count and Step Intensity with Mortality Among US Adults – which appeared in March of 2020 on JAMANetwork.com (Journal of the American Medical Association) stated that, “although higher gait speeds and self-reported walking pace have been associated with lower mortality risk, there is conflicting evidence that higher accelerometer-measured step intensity is associated with better health.”
Researchers from the National Cancer Institute, University of Tennessee, Centers for Disease Control and Prevention, and the National Institute on Aging, sought to determine the dose-response relationships between steps per day and step intensity (steps/min) relative to mortality in a cross section of US adults 40 years or older. The objective was to see, if taking more steps and stepping at a higher intensity were associated with lower mortality risk.
From 2003 to 2006, a cohort of 4840 participants from the National Health and Nutrition Examination Survey were asked to wear an accelerometer on their hip for seven days to determine average daily step rate and step intensity. Then, they were followed for a prescribed period of time.
The participants also provided self-reported information on race or ethnicity - using fixed categories, which was collected - along with demographic information (age, sex, education); health behaviors (alcohol intake, smoking); and diagnoses of diabetes, heart disease, heart failure, stroke, cancer, chronic bronchitis, and emphysema. Height and weight were measured, and diet quality was assessed with 24-hour recall-based diet assessments.
All-cause mortality was assessed from the National Death Index and the International Classification of Diseases, 10th Revision (ICD-10) cardiovascular disease and cancer.
It was determined that, “higher step counts were associated with lower all-cause mortality risk among men, women, non-Hispanic white participants, non- Hispanic black participants, and Mexican American participants. In contrast, there was no significant association between higher step intensity and mortality, after adjusting for total steps per day.”
After tracking hundreds of weight-management participants in my prior hospital-affiliated wellness programs, we found that obese individuals (body mass index =/> 30) walked 4600 to 6,000 steps per day, while overweight individuals (BMI 27-29) accumulated 6,000 – 8,000 daily steps. To get the weight off, it required 10,000 to 12,000 daily steps.
We also found that it’s best to not get all your steps in one outing. Rather, break up your steps into multiple 10-15 minutes sessions, which not only helps to stimulate your metabolic rate, but also a great way to break up sedentary time.
Walk up to just below a breathless state and keep going – with emphasis on burning more calories from excess fat. The bottom line is to get out and attempt to increase your daily step count, while practici
With everyone today concerned about maintaining a strong immune system, whey protein, which is one of the primary proteins in dairy products—a byproduct in cheese processing—provides significant amounts of essential amino acids to support muscle structure, wound healing, and immune function.
According to a 2004 monograph—Whey Proteins and Immunity—from the U.S. Diary Export Council in Arlington, Virginia—“whey proteins are unique in their ability to optimize a number of key aspects of immune function, although the exact mechanisms are not yet fully understood, whey proteins appear to modulate immune function by boosting glutathione (GSH) production in various tissues and preserving the muscle glutamine reservoir.”
GSH is the centerpiece of the body’s antioxidant defense system that regulates many aspects of immune function. Muscle glutamine is the essential fuel of the immune system, says the Dairy Export Council.
Our immune system—a complex network of cells, organs and molecules—work together to defend the body against foreign microorganisms, such as bacteria, parasites and viruses. It can recognize millions of foreign invaders that trigger an immune response—antigens. This antigen defense involves the recruitment of the B cells and T cells (lymphocytes)—with the T cells remembering how to conquer past invaders, and therefore form the basis of our vaccines.
With advanced age, this antigen response may be weakened—immunosenescence—especially if the immune system must contend with diseases such as, diabetes, hypertension, and cancer, while simultaneously being exposed to viruses like the flu.
Whey protein, notes the monograph, “is a collective term that encompasses a range of fractions including the major bovine proteins alpha- lactalbumin and beta-lactoglobulin, and minor fractions, such as serum proteins, lactoferrin, immunoglobulins, and tissue growth factors. Individually, these fractions are established immune-enhancing constituents that modulate a range of immune functions.”
Whey protein concentrates (WPC) and isolates (WPI) are fast acting—absorption—providing essential amino acids to organs and tissue, especially after intense exercise or stress, as in wound healing or immuno-challenges. Another form is hydrolyzed (acid digest) WPI, which, “increased intracellular GSH by 64% and protected cells from oxidant-induced cell death.” A high concentration of GSH in cells boosts cellular antioxidant defenses that promote carcinogen detoxification.
Dietary sources of whey protein include cow’s milk (preferably low fat or skim), goat milk, yogurt, Ricotta cheese, other cheeses, cottage cheese, and whey protein powders, to name a few.
There are potential contraindications to whey consumption, according to Mayoclinic.com. Whey protein taken with Albenza, a parasite killing drug, Fosamax to prevent or treat osteoporosis, and certain antibiotics like tetracycline, may affect absorption rates. Best to check with your prescribing physician, as to any medication conflicts.
My 5 locally operated GNC franchise locations—designated, as others, by the US Homeland Security Department as essential businesses—are open, offering online ordering for grab and go, along with full access to our sanitized stores. For those who desire product to be shipped, please email spencer@mackienutrition.com with your requests.
Check mackieshilstone.com for store locations and hours of operation.
The Centers for Disease Control and Prevention (CDC) says that adults between the ages of 18 to 60 require 7 or more hours of sleep per night. Those individuals 61-64 years need 7-9 hours, while those over 65 should get 7-8 hours. In comparison, a toddler should get 11-14 hours per each 24-hour period, and school age kids need 9-12 hours.
Poor sleep quality, notes the CDC, has symptoms ranging from not feeling rested even after getting enough sleep, multiple awakenings during the night, along with sleep disorders associated with snoring or grasping for air associated with sleep apnea, which can affect both thin and overweight people.
To improve sleep quality, the CDC recommends that you go to bed at the same time each night and get up at the same time each morning—including on the weekends. Your bedroom should be quiet, dark, relaxing, and at a comfortable temperature—with electronic devices, such as TVs, computers, and smart phones removed from the bedroom.
In addition, you need to avoid large meals, caffeine, and alcohol before bedtime. Being physically active during the day can also help you fall asleep more easily at night.
Sleep.org states that stress, such as the anxiety we’re experiencing with the effects of the Covid-19 disease, can impact your life in many ways—including negatively affecting the quality of your sleep. “You lie in bed, worrying, and feeling anxious, which makes it almost impossible to relax and quiet your mind enough to fall asleep.”
The brain neurotransmitters secreted during deep REM (rapid eye movement) sleep are the same ones that tell the body to stop the production of stress hormones. When you don’t sleep well, your body keeps pumping out those hormones. Notes the website, “the next day, you feel more stressed, the following night you find it harder to fall asleep, and so on.”
Sleep, as defined in the April 2019 issue of the online journal Nutrients, “is a complex reversible behavioral state, where an individual is perceptually disengaged from and unresponsive to their environment.”
Melatonin, a hormone secreted by the pineal gland, has been demonstrated to have sedative effects—permitting a more deep, restful sleep. “Since endogenous (within the body) melatonin influences core temperature facilitating sleep, increased exogenous (consumed) melatonin could affect changes in core temperature, improving sleep quality,” notes the Nutrients journal.
However, melatonin’s effect on sleep is rate limited by an individual’s own production of this hormone, which tends to wane with older age. A 2012 study in the European Journal of Nutrition said that Tart Cherry juice, which has a higher concentration of melatonin, “increased circulating melatonin levels and improved sleep time and quality in healthy adults.”
The Nutrients journal also commented that vitamin B-12 and the mineral magnesium contribute to melatonin secretion.
Tart Cherry juice is also highly concentrated with antioxidants such as vitamin C, which reduce the oxidative effects associated with increased stress.
Another hormone, serotonin, which is the end product of the amino acid L-tryptophan, has been associated with improved sleep. “The serotonin content in kiwifruit may contribute to improved sleep, while the rich antioxidant content may suppress free radical expression and inflammatory cytokines.”
The best advice is to follow the CDC guidelines for enhanced sleep, eat a balanced diet, and exercise. My 5 locally operated GNC franchise locations—designated, as others, by the US Homeland Security Department as essential businesses—are open, offering online ordering for grab and go, along with full access to our sanitized stores. Check mackieshilstone.com for store locations and hours of operation.
According to the National Center for Complementary and Integrative Health, a division of the National Institutes of Health (NIH), probiotics—found in yogurt, and other fermented foods, such as kefir and buttermilk, dietary supplements, and even beauty products—are live microorganisms that are intended to have health benefits, when consumed or applied to the body.
Most probiotics contain a variety of microorganisms—for instance, Lactobacillus and Bifidobacterium—with certain yeasts like Saccharomyces Boulardi qualifying, as well.
Many of probiotics sources will also have prebiotics—nondigestible food—inulin—to support the healthy probiotic bacteria. When pre and probiotics are combined together, the term becomes synbiotics.
Probiotics create healthy microorganisms in the gastrointestinal tract—where as much as 70% of our immunity is derived from the mucosa-associated lymphoid tissue (MALT) and the gut-associated lymphoid tissue (GALT). Probiotics produce substances—among them butyrate—that influence our immune response.
The community of organisms that lives on and in the human body is called the “microbiome.”
The Human Microbiome Project, which was funded by the NIH from 2007 to 2016, played a key role in this research by mapping the normal bacteria that live in and on the healthy human body.
The NIH says that, “probiotics have shown promise for a variety of health purposes, including prevention of antibiotic-associated diarrhea (including diarrhea caused by Clostridium difficile), prevention of necrotizing enterocolitis and sepsis in premature infants, treatment of infant colic, treatment of periodontal disease, and induction or maintenance of remission in ulcerative colitis.”
It was also pointed out that how much of the probiotic a person would have to take, or who would be most likely to benefit, is under ongoing research.
From the NIH research, it appears that probiotics are a first line defense against harmful bacteria and, “have an extensive history of apparently safe use, particularly in healthy people.” What is still outstanding is whether the same can be said for those people with severe illness and the associated compromised immune systems.
Probiotic supplements are measured by how many CFU’s—colony forming units usually in the billions—are delivered. The NIH says, “the seven core genera of microbial organisms most often used in probiotic products are Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus.”
It’s further noted that, “because probiotics must be consumed alive to have health benefits and they can die during their shelf life, users should look for products labeled with the number of CFU at the end of the product’s shelf life, not at the time of manufacture.”
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On March 13th, the Wall Street Journal published a Special Report, "Navigating the Coronavirus," which provided background information explaining what the coronavirus is, it’s origin, and symptoms. Seven strains, notes the Journal, are known to infect humans—through the respiratory (breathing) tract—specifically the lower respiratory tract. Four of the corona strains cause common colds, while two strains are considered quite severe human infections—causing acute respiratory syndrome (MERS).
The current virus—Severe Acute Respiratory Syndrome (coronavirus 2)—causes the disease COVID-19 (for a 2019 origin). The virus presents initially with a fever, shortness of breath, and potential complications with pneumonia. It may also cause fatigue, sore throat, headache, nausea, vomiting, and diarrhea.
Some individuals have only a mild illness for several days, then deteriorate to pneumonia, while others, who are infected, don’t get ill. Proper hygiene—washing hands regularly, social distancing, and following all of the prevention strategies presented by the Centers for Disease Control is critical. When in doubt, turn to your healthcare provider for guidance.
Building a strong immune system to keep your respiratory tract in top form is something anyone can do to take ownership of their health. Here are four vitamins demonstrated to assist proper lung function.
Vitamin D, a fat-soluble vitamin, status depends on age, sunlight exposure, and consumption of foods like fortified dairy products and salmon. The National Institutes of Health suggests a daily intake in a range of 600 to 800 international units (IU)—age specific. A Vitamin D blood test may significantly alter that range.
The Busselton Healthy Ageing Study, which involved 5,000 subjects, determined that, “low levels of serum 25OH-D (measured in the blood) were independently associated with asthma, bronchitis, wheeze and chest tightness, after three levels of adjustment for potential confounders. Higher Vitamin D levels were associated with higher levels of lung function.”
Vitamin A, a fat-soluble vitamin found in many vegetables like carrots, sweet potatoes, and spinach, “plays a substantial role, especially in the respiratory epithelium and the lung. During moderate vitamin-A-deficiency, the incidence for diseases of the respiratory tract is considerably increased and repeated respiratory infections can be influenced therapeutically by a moderate vitamin-A-supplementation,” according to a 2003 study—Importance of Vitamin A for Lung Function—authored by researchers at the Department of Biological Chemistry and Nutrition at the University of Hohenheim in Germany.
Mayoclinic.org notes the adult Vitamin A recommended daily allowance to be 3,000ius for men and 2300ius for women (not pregnant).
Vitamin C, found in strawberries, oranges, and tomatoes, is best known for its immune modulating effect and collagen support. A 2014 study in the journal Allergy, Asthma & Clinical Immunology said, Vitamin C supports lung function and reduces exercise induced respiratory symptoms significantly.
The Mayo Clinic says the, “(adult) recommended daily amount for Vitamin C is 65 to 90 milligrams (mg) a day, and the upper limit is 2,000 mg.” Increased stress on the body may adjust that requirement accordingly.
Vitamin E, also a fat-soluble vitamin found vegetable oils, avocado, nuts, spinach, and whole grains, reduces inflammation, according to a 2017 study that appeared in the Journal of Allergy and Clinical Immunology. The recommended dietary allowance (RDA) for vitamin E is 15 milligrams (or 22.4 International Units, or IU) for people over age 14, according to the National Institutes of Health (NIH).
You start with a balanced eating plan and support it with a good multi-vitamin / mineral formula. Add a dose of aerobic exercise to the plan. Go to mackieshilstone.co
According to Mayoclinic.org, “gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints - often the joint at the base of the big toe. An attack of gout can occur suddenly, often waking you up in the middle of the night, with the sensation that your big toe is on fire. The affected joint is hot, swollen, and so tender that even the weight of the sheet on it may seem intolerable.”
Research – Combined Supplementation with Glycine and Tryptophan Reduces Purine Induced Serum Uric Acid Elevation by Accelerating Urinary Uric Acid Excretion – which appeared in the November 2019, online journal Nutrients, states that, “the progression of gout is suggested to result from an imbalance between uric acid synthesis and excretion. The most important factor considered to increase the risk of gout is hyperuricemia with persistently high serum uric acid levels. In particular, hyperuricemia has been suggested to be caused primarily by weakened kidney excretion of uric acid.”
Investigators from Japan used a randomized, single-blind, placebo-controlled, crossover clinical trial designed to examine whether combined supplementation with glycine and tryptophan (amino acids) suppressed the elevation in serum uric acid levels - caused by purine (like liver and other organ meats, anchovies, chocolate) ingestion, and accelerated urinary uric acid excretion in subjects with lower urate excretion.
Glycine, a non-essential amino acid, enhances the urinary excretion of uric acid in healthy individuals, in addition to those people with gout in prior studies. Tryptophan’s (an essential amino acid) effect on lowering uric acid levels is somewhat suspect at this point, which was why the Japanese investigators sought to confirm whether or not the combined effect of both amino acids would synergistically lower uric acid.
The study group included healthy Japanese males aged 20–64 years, with lower urinary uric acid excretion, and no prior history of liver, renal, heart, or severe disease, drug or food allergy, or routine use of drug or dietary supplements for hyperuricemia.”
According to the researchers, “all volunteers ingested four test drinks (A; placebo, B; tryptophan, C; glycine, or D; glycine + tryptophan) in the crossover design,” with a small amount of lemon flavor and critic acid added to achieve a standardized taste.
The volunteers maintained their daily eating and drinking schedule – refraining from eating and drinking alcohol, for at minimum, 10 hours before the experiment. After an overnight fast, 200 milliliters were consumed, followed by voiding urine. Blood was collected 1 and 2 hours after the experimental drink was consumed.
The study concluded that, “the combined supplementation with glycine and tryptophan significantly reduced the elevation in serum uric acid levels induced by purine ingestion via the acceleration of uric acid excretion and urate clearance in healthy males with lower urate excretion.”
It was also determined that, “tryptophan alone did not induce serum uric acid elevation or urinary excretion of uric acid, but it might have enhanced the action of glycine by regulating the metabolism of glycine to creatinine.”
Before you consider treating yourself, if applicable, you must first consult with your personal physician for guidance.
The prevalence of non-alcoholic fatty liver disease (NAFLD)—defined as an excessive accumulation of fat in liver tissue, when other causes of secondary hepatic fat accumulation disorders, including significant alcohol consumption, hereditary disorders, and steatogenic medication have been ruled out—is estimated to be 25% world-wide.
According to the Role of Probiotics in Non-Alcoholic Fatty Liver Disease: Does Gut Microbiota Matter, which appears in the November 2019 issue of the online, open access journal Nutrients, “NAFLD has been recognized, as one of the leading causes of chronic liver disease in the world, and its prevalence, along with a global epidemic of metabolic syndrome, obesity, and insulin resistance, has risen sharply across continents.”
Researchers from the Department of Medicine, Division of Gastroenterology and Hepatology at Thomas Jefferson University in Philadelphia, note that, “NAFLD is characterized by a large spectrum of liver disease, from isolated steatosis to steatohepatitis, and can progress to cause hepatic fibrosis formation and cirrhosis. Among the NAFLD spectrum, nonalcoholic steatohepatitis (NASH) is the more severe form and presents with hepatic steatosis, lobular inflammation, and cell injury (i.e., hepatocyte ballooning) on histology.”
It’s known that NAFLD progresses under conditions associated with inflammation, oxidative stress, insulin resistance, abnormal lipid patterns and obesity—which is closely associated with the cluster of symptoms of metabolic syndrome. Unfortunately, the pathophysiology of NAFLD still remains unclear.
The Philadelphia researchers comment that, “no definitive pharmacological treatment has been approved by the Food and Drug Administration or the European Medicines Agency. Lifestyle changes include physical activity, weight loss, and diet modification are currently the main strategies to mitigate the NAFLD epidemic. Therefore, it remains essential, though challenging, to identify new therapeutic strategies for NAFLD.”
One pathway may be through the gut microbiota (GM) and its 1,000 species and 100 trillion bacteria, which colonize in the human intestinal tract, and its relation to the liver—known as the gut-gut microbiota-liver axis. “The composition and abundance of GM,” comment the researchers, “varies due to considerable heterogeneity between individuals and underlying conditions such as age, gender, diet, pregnancy, hormonal changes, travel, infection, and medication such as antibiotics and proton pump inhibitors.”
The human body’s host defense mechanism is influenced by the balance of healthy, diverse GM bacteria. Problems can arise through a process known as dysbiosis—defined as an imbalance between healthy and disease-promoting microorganisms, which is, “manifested through changes of diversity and fluctuation in the relative abundance of certain microorganisms.”
Probiotics are non-pathogenic, live microorganisms that confer health benefits by adjusting the GM composition. Prebiotics are non-digestible carbohydrates, which the GM bacteria ferments to provide food for the good bacteria. Synbiotics refer to the combined pre/probiotics combination.
Research says that, “most human clinical trials conducted to study the therapeutic effect of probiotics/synbiotics in NAFLD patients have been conducted over the past 10 years and are small scale with mixed clinical outcomes. However, the overall outcome indicates that probiotics/synbiotics could be a promising therapeutic strategy for the NAFLD population.”
The Thomas Jefferson researchers state that, “overall, probiotics/synbiotics have a safe profile and are well-tolerated though more safety evaluations need to be completed in the future. Additionally, the sustainability of the probiotic/synbiotic protective effect on NAFLD over the long-term is still not clear.”
An easy, preventive measure is to include plain, low-fat or regular higher protein Greek yog
As we age, especially after 60, our body is exposed to the effects of sarcopenia, the aging loss of muscle, dynapenia, the resulting loss of strength, and anabolic resistance - reduced skeletal muscle repair—especially after intense exercise. Aging is also associated with both glucose and insulin resistance—increasing the risk to type 2 diabetes.
Add to this complication the potential to increase the inflammatory response to a high sugar/fat Western-type diet, then aging increases the associated risk to atherosclerotic disease, which has been called an inflammatory disease of the arteries.
Researchers from Ohio University writing "Impact of Endurance and Resistance Training on Skeletal Muscle Glucose Metabolism in Older Adults," which appeared in the November 2019 issue of the online journal Nutrients—state, “age-associated muscle atrophy begins as early as 25 years of age and accelerates thereafter, so that, by 80 years of age, approximately 40% of the vastus lateralis (muscle in the thigh) has been lost.”
Further, “much of the current literature discussing age-related loss of muscle mass focuses on the adverse effects to muscular strength and power, leading to loss of mobility and the inability to perform daily activities, including climbing stairs and lifting objects,” the Ohio researchers added.
The aging process targets type 2 glycolytic fibers - yielding an impaired glucose metabolism compared to a younger individual. One manner of addressing this short coming is through physical activity.
The researchers cite, “the Harvard Alumni Health Study, (which) suggested that older men (mean age: 66 years) without a major health risk could reduce their risk of dying by becoming a ‘weekend warrior’ (at least 1000 kcal/week), suggesting that even one to two exercise sessions a week can prolong a person’s lifespan. Older adults who have been physically active throughout their lifetime have been found to have superior levels of metabolic health, compared to inactive older adults.”
Specifically, higher intensity exercise, without weight loss, has been reported to improve whole-body insulin sensitivity, which means less storage of body fat—the result of better glycogen storage in muscle.
Also beneficial is resistance training in older individuals. The Ohio investigators note research which, “reported that 16 weeks of resistance training in men between the ages of 50 and 63 increased insulin-stimulated nonoxidative glucose disposal by 40%, likely contributing to the improved whole-body insulin sensitivity (22%), and suggesting resistance training could improve skeletal muscle glycogen metabolism.”
This effect is especially true in older adults, who suffer from type 2 diabetes. For postmenopausal women, the research points to improved mitochondrial (the muscle spark plug) area and density, with 6 months of progressive resistance training.
The researchers comment that collectively, “these findings suggest that older adults may be especially responsive to mitochondrial adaptations with resistance training, including changes that would permit improved insulin-stimulated skeletal muscle glucose oxidation.”
Among other summaries, it was concluded that, “while both types of exercise - endurance and resistance training - generally increase insulin sensitivity in older adults, the metabolic pathways through which this occurs can differ and can be dependent on preexisting conditions including obesity and type 2 diabetes.”
It makes sense to begin a structured exercise program at a young age. However, it’s never too late to take back ownership of your health—move it, push it, pull it, and press it.
In 2020, cancer is predicted to be diagnosed in 15 million people – with 12 million associated deaths. Lifestyle choices – like our diet, percent total and visceral, abdominal body fat, and exercise history (or lack of it), are potentially tied to 35% of all cancer deaths.
According to research - From the Table to the Tumor: The Role of Mediterranean and Western Dietary Patterns in Shifting Microbial-Mediated Signaling to Impact Breast Cancer Risk - which appeared in the November 2019 issue of the online, open access, peer-reviewed journal Nutrients, “diet-associated elevation of cancer risk has been specifically linked to 13 malignancies, and is most closely correlated with prostate, colorectal, gall bladder, pancreatic, endometrial, and breast cancer patient deaths.”
Obesity, notes the research, “is associated with 14% of cancer deaths in males and 20% in females, though dietary intake (i.e., red meat intake), regardless of body weight is heavily correlated with cancer risk and prognosis.”
Researchers from various departments at Wake Forest University School of Medicine, comment that the correlation between dietary intake and cancer risk is well documented. However, an understanding of the causation mechanisms behind this association is unclear.
It’s estimated that more than 12% of US women will be diagnosed with breast cancer during their lifetime. 268,600 new cases were diagnosed in 2019. Breast cancer risk is also associated with health and lifestyle behaviors.
It’s estimated that approximately 30% to 50% of all cancer cases could be prevented by practicing healthy lifestyle habits and minimizing exposure to cancer risk factors.
The Mediterranean (Med) diet is a good place to start on the cancer prevention path. Consuming a dietary pattern that consists largely of vegetables (including beans and legumes), fruits, and whole grains, while reducing exposure to processed red meats, refined sugars, carbohydrates, fat, and excessive alcohol, is the hallmark of the Med diet.
The Wake Forest researchers comment that, “vegetables, fruits, lean protein, and monounsaturated fatty acids contained in olive oil were reported to reduce postprandial glucose variations and pro-inflammatory molecule secretion. The n-3 fatty acids contained in fish, fish oil, and nuts that are also components of the Med have anti-inflammatory effects, and thereby reduce arachidonic-acid-derived eicosanoids.”
On the other hand, the Western - American-type - Diet (WeD) - characterized by containing high amounts of refined starches, sugar, red and processed meats, saturated fats, trans fats, and low amounts of fruit, vegetables, and whole grains – has been associated with an elevated breast cancer risk.
The researchers reference a study from October 2007–July 2008, “that was conducted to investigate the association between the WeD and MeD and mammographic density. Mammographic density was categorized as (1) less than 10%, (2) 10–25%, (3) 25–50%, and (4) greater than 50%. The researchers reported that women, who had higher adherence to the WeD were more likely to have high mammographic density compared to women with low adherence to the WeD.”
This same study determined that, “there was no association between MeD and mammographic density. Elevated mammographic density is associated with increased breast cancer risk,” as noted by the research.
Among other determinations, the researchers emphasized that, “epidemiological data supports the critical impact of dietary pattern on breast cancer risk; WeD consumption elevates breast cancer risk, while consumption of a MeD reduces breast cancer risk.”
According to Life Expectancy and Mortality Rates in the United States, 1959-2017, which appeared on Jamanetworkopen.com in November of 2019, life expectancy has decreased in the US for three consecutive years—having stopped increasing in 2010 and has been decreasing since 2014. That’s irrespective of excessive healthcare spending compared to other high-income countries.
JAMA (Journal of the American Medical Association) commented that the life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER - a comprehensive, on-line public health information system of the Centers for Disease Control and Prevention.
The analysis, said JAMA, "focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined."
It was determined that between 1959 and 2016, US life expectancy increased from 69.9 to 78.9. However, it declined for three consecutive years after 2014. The recent decrease in US life expectancy, notes the website, culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010.
By 2014, midlife mortality was increasing across all racial groups - caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases.
As for the geographic distribution of these midlife all-cause mortality deaths, the largest relative increases occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%).
For certain causes of death—fatal drug overdoses, alcoholic liver disease, and suicide - women experienced larger relative increases in mortality than men, although the absolute mortality rates for these causes were higher in men than women.
It appears that psychological distress, socioeconomic conditions (income inequality, wage stagnation), deficiencies in health care due to barriers to care, tobacco usage, and obesity all may have contributed to this trend.
The conclusion was that, "the implications for public health and the economy are substantial, making it vital to understand the underlying causes."
It makes sense for our political leaders to get the opiod epidemic under control - providing more access to wellness-oriented programs for those individuals, who are at risk to a life cut short prematurely—whatever the reason.
According to research—Beneficial Effects of Leucine Supplementation on Criteria for Sarcopenia: A Systematic Review—which appears in the October 2019 of the online journal Nutrients—"sarcopenia is defined as a progressive loss of muscle mass, strength, and function. From a physiological point view, sarcopenia starts in the fifth decade of life and at a population level, proceeds at a rate of ∼ 0.8% annually."
In fact, notes the research, "the decrease in skeletal muscle strength induced by sarcopenia, known as dynapenia, is even more precipitous, occurring at an annual rate of ∼ 2–3%, and it is estimated that more than 20% of adults aged over 65 years, and over 50% of those aged at least 80 years are sarcopenic."
Certain disease conditions, like liver cirrhosis, can precipitate sarcopenia at an earlier age—with sarcopenic individuals exposed to greater risk to falls, frailty, disability and type 2 diabetes.
Researchers from the University of Valencia in Spain, writing the Nutrients paper, reference that, "within the framework of the Third National Health and Nutrition Examination Survey, (research has) demonstrated that muscle mass is a predictor of longevity, when taking into account the all-cause mortality in North American adults (aged over 55 or 65 years for men and women, respectively)."
They state that, "one of the main ways in which sarcopenia contributes to the disease is that it alters muscular turnover and metabolism. Moreover, older adults exhibit a decreased anabolic response to protein feeding, which is a mechanism underpinning the loss of muscle mass in sarcopenic individuals."
The Spanish researchers performed a systematic review of the literature as it pertained to the effects of oral leucine, an anabolic, branch chain amino acid, alone or in combination with other supplements relative the effect on muscle mass, strength, functional activity in older adults—with emphasis on optimal delivery method, dose, and duration of treatment—among other variables.
What they determined was that over time, the best approach to sarcopenia treatment included physical exercise, specifically resistance training, and nutritional supplementation." Supplementation of the branched-chain amino acid, leucine, or leucine-enriched protein (whey/casein protein) is one of the most common interventions for treating sarcopenia in older individuals."
The researchers also commented that the majority of interventions found that Vitamin D, in conjunction with the nutritional intervention, improvement in muscle mass.
From a dosage perspective, "leucine nutritional interventions were administered alone, in an EAA (essential amino acid) mixture, or in leucine-enriched whey/casein protein at a dose of 1.2–6 g/day, and in nine studies leucine was co-supplemented with 85–800 IU of vitamin D per day."
From a personal perspective and experience, the leucine metabolite, HMB (B-hydroxy-B-methylbutyric acid), as reported in a 2017 Nutrients paper, said, "results indicate that supplying HMB promotes advantageous changes in body composition and stimulates an increase in aerobic and anaerobic capacity in combat sport athletes."
"The consumed HMB dose was equivalent to the most commonly recommended uptake of 3g of HMB a day," as noted in the 2017 research.
Modes of aerobic exercise include cycling, aerobic classes, dancing, calisthenics, jumping rope, swimming, running, and walking. Resistance training comes in a variety of forms, such as using weights, elastic bands, and body weight exercises.
With either mode of exercise, there is a commonality as to each form’s ability to regulate systemic glucose (blood sugar) balance, skeletal muscle transport, and glucose metabolism.
Glucose is stored in the liver and muscles as glycogen. Glycolysis is the process in which one molecule of glucose is broken down to form two molecules of pyruvate, while glucose storage is referred to a glycogen synthesis.
Regulation of glucose balance—homeostasis—is tightly controlled to provide fasted glucose levels at <100 mg/dl, glycated hemoglobin A1c levels at <5.7%, and blood glucose post prandial (after a meal or challenge) at <140 mg/dl.
According to "Regulation of Skeletal Muscle Glucose Transport and Glucose Metabolism by Exercise", which appeared in the October 2019 issue of the online journal Nutrients, "in the fasted state, the liver maintains systemic glucose homeostasis via glycogenolysis (glycogen breakdown) and gluconeogenesis (glucose synthesis)." "In the fed state, glucose released from the digestive system into the bloodstream causes a rise in blood glucose levels that triggers an increase in insulin production and release from the β-cells of the pancreas." Glycogenolysis - the breakdown of glycogen to glucose, which takes place in the cells of the muscles and liver - is initiated by hormonal or neural signals. Gluconeogenesis, on the other hand, is the metabolic process by which organisms produce sugar (glucose) for catabolic breakdown from non-carbohydrate sources—potentially lean muscle - with illness, overtraining, and other such carbohydrate depleting situations.
Research has demonstrated the profound effect aerobic exercise has on its ability to improve systemic glucose control in individuals with type 2 diabetes. The Nutrient journal researchers from East Carolina University, comment that, "type 2 diabetes is a chronic metabolic disease characterized by a dysregulation of systemic glucose homeostasis. It is diagnosed when fasted blood glucose levels are >126 mg/dL, HbA1c levels are >6.5%, and blood glucose levels are >200 mg/dL 2 hrs. following an oral glucose challenge."
While the exact causes of type 2 diabetes remain incompletely understood, note the researchers, "numerous studies have linked impairments in key glucoregulatory functions in the pathogenesis of the disease."
The East Carolina team state that, "studies in both men and women with type 2 diabetes have demonstrated the following beneficial effects: (1) 8 weeks of aerobic walking (30 min/day, 3 days/week) decreased HbA1c levels ~18%; (2) 12 weeks of bicycle training (60 min/day, 3 days/week) decreased fasted blood glucose levels ~14%; (3) 16 weeks of cardiovascular machine-based training (60 min/day, 3 days/week at 60–65% max heart rate) decreased fasted blood glucose levels ~10% and HbA1c levels ~1%.
Resistance training has also demonstrated improvement in glucose in individuals with type 2 diabetes. The researchers provide evidence that, "8 weeks of progressive free weight and weight machine training involving arms and legs (2 days/week, 7 exercises/session, 3 sets of 10 repetitions at 60% 1 repetition max up to 100% of initial 1 repetition max) decreased HbA1c levels ~18%; (2) 16 weeks of weight machine training involving arms and legs (3 days/week, 5 exercises/session, 8 repetitions at 60–80% max, up to 8 repetitions at 70–80% max) reduced HbA1c levels ~13%."
It was concluded that aerobic exercise and resistance training ameliorate hyperglycemia (elevated blood sugar), which has to do in part with the positive training-stimulus associated alterations in skeletal muscl
Curcumin (curcuma longa linn) - a polyphenol compound extracted from the spice turmeric—offers multiple biological activities. Research has pointed to the potential benefits of curcumin, as an associated therapy in oxidative stress diseases, such as neurological disorders.
Curcumin, Hormesis, and the Nervous System, a research paper published in the October 2019, issue of the journal Nutrients, notes that, "there is growing evidence indicating that oxidative stress contributes to the etiology and the progression of neurodegenerative diseases, such as Alzheimer’s Disease (AD), Parkinson’s Disease (PD), Amyotrophic Lateral Sclerosis (ALS) and Multiple Sclerosis."
However, the same research also points out that, "evidence-based medicine has clearly demonstrated the lack of any therapeutic effect of curcumin to contrast the onset or progression of neurodegeneration and related diseases."
With advanced age, the effects of oxidative stress on brain function, known as neuro-inflammaging, has taken center stage in a search for compounds like curcumin that might offer good therapeutic treatment options.
Italian researchers focused on the evidence related to the "hermetic effects" of curcumin relative to neuro-cognitive diseases. Hormesis is, "a term used by toxicologists to refer to a biphasic dose response to an environmental agent characterized by a low dose stimulation or beneficial effect and a high dose inhibitory or toxic effect."
One large issue with the use of curcumin as an adjunct to therapy or a stand-alone compound is its hydrophobic property: being poorly soluble in water. "The poor intestinal absorption, structural instability, limited blood brain barrier penetration, and rapid degradation of curcumin in the body limits the potential, as a therapeutic agent in clinical trials," according to the Italians.
Therefore, note the researchers, "an important aspect for the development of curcumin as a novel "nutraceutical’’ formulation deals with obtaining an increased bioavailability and physiological stability and solubility of this compound in animal models and humans."
Much of the scientific interest has to do with curcumin’s potential to affect the central nervous system and protection from beta amyloid plaque—a prerequisite to neuro-degenerative diseases like Alzheimer’s.
While curcumin is a natural product, it’s not without potential safely concerns, such as a potential toxic effect though its interaction with drug metabolism enzymes.
One such interaction involves the issues associates with curcumin concurrent with tamoxifen, an antagonist to estrogen receptors, which is used as an adjuvant therapy in women with breast cancer."
Furthermore, note the Italian researchers, curcumin has been shown to pose some adverse effects to the liver, under certain circumstances at high doses.
Yet, the researchers conclude that, "with regard to the potential clinical efficacy of curcumin, there are several pre-clinical data in the literature confirming that curcumin possesses neuroprotective and cognitive-enhancing properties that may help delay or prevent neurodegenerative diseases."
The best advice is to take Buddha’s recommendation and, "be moderate in all things." Check with your doctor first.
Obesity, defined as a body mass index greater than 30 or a waist measurement in excess of 40 inches in a woman, and 50 in a man, has been classified as a disease process by numerous scientific circles. According to Effect of Weight Loss via Severe vs Moderate Energy Restriction on Lean Mass and Body Composition Among Postmenopausal Women with Obesity, which appeared in the October 10, 2019, issue of JAMA Network Open, "effective obesity treatments are needed to reduce obesity-related morbidities and costs."
Current research states that, "the most effective dietary obesity treatments are severely energy-restricted diets of less than 800 kcal/day, which often involve replacing all or almost all foods with nutritionally replete meal replacement products (shakes, soups, or bars)."
One issue, especially in women, is the potential for bone loss during severe energy-restricted dieting, according to the study researchers from Australia. In addition, severe energy-restriction may also cause the potential for lean mass loss compared with moderate energy-restriction.
The Australian researchers designed The Type of Energy Manipulation for Promoting Optimum Metabolic Health and Body Composition in Obesity (TEMPO) Diet Trial - a 12-month, single-center, randomized clinical trial - that incorporated, "a total of 101 postmenopausal women, aged 45 to 65 years with body mass index (calculated as weight in kilograms divided by height in meters squared) from 30 to 40, who were at least 5 years after menopause, had fewer than 3 hours of structured physical activity per week."
The intervention included participants, who were randomized to either12-months of moderate (25%-35%) energy restriction with a food-based diet (moderate intervention), or 4 months of severe (65%-75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for an additional 8 months (severe intervention). Both interventions, note the researchers had a prescribed protein intake of 1.0 g/kg of actual body weight per day, and physical activity was encouraged but not supervised.
It was concluded that, "severe energy restriction had no greater adverse effect on relative whole-body lean mass or handgrip strength compared with moderate energy restriction and was associated with 2-fold greater weight and fat loss over 12 months."
However, "there was significantly greater loss of total hip bone mineral density with severe vs moderate energy restriction. Therefore, caution is necessary when implementing severe energy restriction in postmenopausal women, particularly those with osteopenia or osteoporosis."
"Former US football athletes are at increased risk of cardiovascular (CV) morbidity and mortality compared with the general population and other professional athletes." That’s a strong conclusion coming from medical researchers from Emory and Furman Universities writing – Weight Gain, Hypertension, and the Emergence of Maladaptive Cardiovascular Phenotypes Among US Football Players – which appeared in the October 16, 2019, online issue of JAMA (Journal of the American Medical Association) Cardiology.
These researchers cite a previous study comparing longevity of professional baseball versus US football athletes, which found a higher cardiovascular risk among the football players, while cross-sectional studies seem to concur that there is a risk to left ventricular (LV) hypertrophy (enlargement) and hypertension among active professional US football players – specifically the much larger offensive and defensive linemen.
It’s been pointed out that, "the transition from high school to the collegiate US football ranks has been identified as a critical period of CV maladaptation, and weight gain during collegiate US football participation is independently associated with later-life CV morbidity."
As a result of a gap of knowledge, as to the progression of multiple, independent factors related to college football CV risk, the university researchers sought to examine, "the emergence and progression of multiple independent factors associated with CV risk across serial years of collegiate US football participation."
It was hypothesized, "that established determinants of CV risk, including weight gain, hypertension, concentric LV hypertrophy with functional impairment, and arterial stiffening, would develop and progress over the course of a multiyear collegiate US football career."
LV hypertrophy is a thickening of the heart’s left pumping chamber that can be associated with, among other variables, high blood pressure, while arterial stiffness refers to a generalized thickening and stiffening of the arterial wall, also associated with high blood pressure.
From June 2014 and 2017, US football athletes 18 years or older were recruited from National Collegiate Athletic Association Division I programs at Georgia Institute of Technology and Furman University. Exclusion criteria included any athlete with known hypertension requiring pharmacotherapy at enrollment.
Athletes were classified by field position, as either linemen (LM), which included tackle, guard, center, and defensive end positions, or non-linemen (NLM), including quarterbacks, running backs, wide receivers, tight ends, linebackers, cornerbacks, safeties, kickers, and punters.
Assessments were made for age, height, weight, race, current prescription medication usage, systolic and diastolic blood pressure, family history of hypertension and early coronary artery disease, cardiac structure (echocardiography), and arterial function.
It was determined that, "collegiate US football athletes appear to be at risk of developing hypertensive SBP (systolic blood pressure), concentric LV hypertrophy with relative impairments in diastolic function, and arterial stiffening."
Importantly, the researchers comment, "these analyses identified weight gain throughout collegiate US football participation, a factor that has recently been associated with CV morbidity later in life among former professional US football players, as a potential unifying mechanistic factor in the development of this constellation of early life subclinical CV pathology."
A research study - Marine Omega-3 Supplementation and Cardiovascular Disease: An Updated Meta-Analysis (many similar studies) of 13 Randomized Controlled trials Involving 127,477 Participants - appeared September 2019 in Journal of the American Heart Association. It concluded that, “marine omega‐3 supplementation lowers risk for myocardial infarction, CHD (coronary heart disease) death, total CHD, CVD (cardiovascular disease) death, and total CVD.”
Harvard researchers used data from three randomized controlled trials – with and without exclusion of the REDUCDE-IT trial (Reduction of Cardiovascular Events with Eicosapentaenoic Ethyl-Intervention Trial), which observed a protective effect from a highly purified, prescription-type EPA, ethyl ester formula against the occurrence of all fatal or non-fatal cardiovascular events - among established CVD and other risk factors.
According to the study, the clinical perspective and implications are as follows:
Risk reductions were linearly associated with dose of marine omega‐3 supplementation, where greater cardiovascular benefits may be achieved at higher doses of marine omega‐3 supplementation.
Researchers from the Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School report that, “despite consistent findings from observational studies showing inverse associations between higher fish consumption and lower risk of heart disease, recent evidence from randomized controlled trials (RCTs) testing marine omega‐3 supplementation, using a moderate‐dose combination of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) compared with placebo, have had largely null results.”
The American Heart Association (AHA) currently recommends that patients at high risk for CVD (not currently with CVD), utilize Omega-3 supplementation. The AHA also suggests that patients with high triglycerides – a blood fat – under doctor’s supervision - use 2,000-4,000 mg of Omega-3 fish oil daily.
Prior research said, “a dose–response analysis based on 58 placebo‐controlled trials estimated that each 1 g/d increase of marine omega‐3 reduced triglyceride levels by 5.9 mg/dL and such linear association did not plateau even at 7 g/d.”
The researchers also state that, “our results were generally consistent with previous findings that indicated that marine omega‐3 supplementation was not associated with risk of stroke.
The take-away message is that, “daily marine omega‐3 supplementation is effective in lowering risk for coronary and most other cardiovascular end points, including myocardial infarction, coronary heart disease death, total coronary heart disease, cardiovascular disease death, and total cardiovascular disease.”
Be sure to check with your physician first for proper guidance.
Metabolic Syndrome (MetS) - a cluster of conditions, such as increased abdominal obesity, pre-hypertension, dyslipidemia (triglycerides, HDL cholesterol), and pre-diabetes - predisposes that individual, who meets the criteria, to diabetes, cardiovascular disease, and even potentially to certain forms of cancer. It’s now a public health concern world-wide.
According to research – Dietary Patterns and Metabolic Syndrome in Adult Subjects: A Systematic Review and Meta-Analysis – which appears in the September 2019 online journal Nutrients, “the diagnosis of MetS requires three or more of the following criteria: (i) waist circumference >102 cm in men (40 inches) and >88 cm in women (35 inches); (ii) HDL-C <40 mg/dL in men and <50 mg/dL in women; (iii) triglycerides ≥150 mg/dL; (iv) blood pressure ≥130/85 mmHg and (v) fasting glucose ≥110 mg/dL.”
The study authors, from various departments of the University of Perugia in Italy, comment that consumption of specific foods or nutrients is strongly associated to the risk of developing MetS. Therefore, these researchers chose to examine – using a meta-analysis of many similar studies - the association between dietary patterns and the risk to MetS.
A comprehensive literature search, “without restrictions,” though March 31, 2019, using PubMed, Web of Science, and Scopus - all recognized databases. A total of 460 articles were identified that met the pre-exclusion criteria. The researchers commented that, “at the end of the selection process, 40 studies were enclosed for the identification of the different dietary patterns in the systematic review and meta-analysis.”
Two common dietary patterns were identified – healthy and meat/western patterns. The healthy patterns were characterized by the consumption of foods with high content of vitamins, minerals, antioxidants, fiber, MUFA, and n-3 (Omega-3) fatty acids, while the meat/western pattern, characterized by high intake of red and processed meat, eggs, refined grains, and sweets.
The researchers determined that, “the meat/western pattern significantly increased MetS risk of 20% in Asia, 15% in Europe and 33% in America, while the healthy pattern was associated with a lower MetS risk and significantly decreased the risk in both sexes and in Eastern countries, particularly in Asia.”
The Italian researchers concluded, “a protective effect on MetS is attributed to adherence to the healthy pattern, which is characterized by high consumption of fruit, vegetables, whole grains, poultry, fish, nuts, legumes, and low-fat dairy products, whereas the meat/western pattern is positively associated with MetS.”
They further state that, “nutrition is one of the most important modifiable factors affecting health. Public health efforts should aim to adopt healthy dietary patterns and to reduce the burden of MetS, providing guidance for nutritional intervention.”
Let me add a separate comment by quoting the Italians, “other pre-defined representative dietary patterns exist worldwide, such as the Dietary Approaches to Stop Hypertension (DASH) diet, which is characterized by high intake of fruit, vegetables, whole grains and dairy, and the Northern Europe dietary pattern, which is characterized by high intake of fruit, vegetables, legumes, low-fat dairy, fatty fish, oats, barley and almonds.”
The star of the show is the anti-inflammatory Mediterranean eating plan.
Known as Sarcopenia—derived from the ancient Greek words sarx (flesh) and penia (poverty)—the progressive decline in muscle mass and strength (dynapenia) after the age of forty, this condition has caught the attention of researchers and public health experts. So much so, that Sarcopenia has its own ICD-10 reimbursement code.
Sarcopenia is most pronounced in those sedentary individuals, who may also have other comorbidities such as diabetes and heart disease, after the age of sixty.
Consistent with this loss of muscle is the accrual of fat mass—specifically around the mid-section—visceral abdominal fat—while also infiltrating the muscles—intramuscular adipose tissue.
With 87% of falls after the age of sixty-five resulting in fractures, the loss of lean, supporting muscle mass just adds insult to injury.
Writing—Efficacy of Nutritional Interventions as Stand-Alone or Synergistic Treatments with Exercise for the Management of Sarcopenia—in the September 2019 online journal Nutrients, researchers from Italy comment that, “Sarcopenia represents an important sanitary problem, since it affects 20% of people over 70 and 50% of people over 80”
Moreover, the Italians note that, “considering the important function of muscle tissue beyond locomotion (e.g., influence on glucose and protein metabolism and on bone density), it is associated with many adverse clinical outcomes (falls, fractures, functional and cognitive decline, cardiac and respiratory disease, reduced quality of life and independence, hospitalization, and mortality).”
Sarcopenia is now defined as, “a muscle disease, which can be considered probable, if reduced muscle strength is detected” - with the hand grip dynamometer and chair stand test, as the primary measures of muscle strength and the dual-energy X-ray absorptiometry (DXA) and bioelectric impedance used to assess muscle mass.
Sarcopenia can accelerate under a pro-inflammatory state, malnutrition, hormonal changes, higher muscle protein breakdown, loss of motor neurons, mitochondria dysfunction, and insulin resistance—which, “reduces the (body’s) ability to use the available proteins.”
In addition, “insulin resistance in the skeletal muscle results in whole-body metabolic disturbances associated with type 2 diabetes, which are further exacerbated by Sarcopenia. All these alterations are differently responsible for an imbalance between the anabolic (building) and catabolic (breakdown) process at the muscular level.”
The Italian researchers describe several nutritional interventions as follows:
Essential amino acids (EAAs), in particular leucine, are an important anabolic stimulus. The main dietary sources of EEAs are lean meat, dairy products, soybeans, cowpeas, and lentils. The biological pathways on which leucine act are the activation of the mammalian target of rapamycin (mTOR), and the inhibition of the proteasome.
However, supplementation with high doses of EEAs (10–15 g) and leucine (at least 3 g) is necessary to overcome anabolic resistance in older people.
ß-hydroxy ß-methylbutyrate (HMB) is one of the metabolites of leucine, which exerts anabolic and anti-catabolic effects through the activation of the mTOR pathway and the stimulation of the growth hormone/IGF-1 axis.
It is recommended to dose vitamin D in all sarcopenic patients and to prescribe supplements in those who are deficient. Promotion of an adequate sunshine exposure together with the consumption of foods rich in vitamin D (salmon, mackerel, herring, sun-dried mushrooms) should instead be suggested in all older people.
Supplementation with polyunsaturated fatty acids (PUFAs), and in particular with omega-3 fatty acids, improves muscle protein anabolism. PUFAs seem to directly act on mTOR signaling and reduce inflammation.
The researchers importantly comment that, “inactivity is one of the main causes of sarcopenia because it determ
Research has pointed for some time to a strong relationship between a high sodium intake – greater than 5 grams per day – to the increased risk to high blood pressure (BP) and the potential for the associated cardiovascular complications.
The DASH diet (dietary approach to stop hypertension) recommends that those individual with, or at risk to high BP keep their daily sodium intake to less than 1500 milligrams (Mg) – with a general recommendation to less than 2000 Mg.
Researchers from Italy reporting – Sodium Intake and Hypertension – in the September 2019 issue of the journal Nutrients – comment that, “excessive salt intake may induce several adverse effects, causing microvascular endothelial inflammation, anatomic remodeling, and functional abnormalities, even in normotensive subjects”
In addition, “more recent studies have shown that changes in sodium plasma levels do not only exert their effects on small resistance arteries, but also may affect the function and structure of large elastic arteries.”
Adding to the controversy over how much sodium is too much or not enough, the Italian researchers note that, “recent findings further support the calls for caution before applying salt restriction universally. Although more studies have confirmed the benefit of reducing sodium intake in hypertensive subjects with a high salt intake, it is unclear whether the remaining more than 90% of the population will profit from dietary sodium reduction.”
They point out the need to clarify “inappropriate” versus “excessive” salt intake.
As we age, the hypertensive effects of increased sodium intake increases, which is the result of a decrease in the kidney’s ability to concentrate sodium in the urine, which is likely due to a decline in the aging glomerular mass.
Chronic kidney disease can also lead to an impairment of volume excretion and urine sodium-concentrating ability - thus enhancing the salt-sensitivity in its more severe forms.
It appears that individuals from African descent are at an increased risk for hypertension, despite possessing a plasma volume and cardiac index similar to white population.
Waist circumferences greater than 40 inches – moving toward 50 - and metabolic syndrome, a cluster of cardiovascular risk factors, are associated with an increased rate of sodium reabsorption by the kidney, an effect that is at least partially mediated by the hormones insulin and leptin – an adipocytokine produced by fat cells that affect appetite regulation. Excess visceral fat – abdominal obesity – can create leptin resistance, which goes hand in glove with insulin resistance.
Sodium intake worldwide ranges between 3.5–5.5 g per day (corresponding to 9−12 g of salt per day). The World Health Organization has recommended to limit sodium intake to approximately 2.0 g per day (equivalent to approximately 5.0 g salt per day) in the general population – with a concerted effort, note the researchers, to reducing salt intake in the hypertensive population - roughly more than a billion patients globally.
The Italians state that, “a reduction in salt intake can have a favorable effect on the cardiovascular system, inducing a reduction in BP values in hypertensive patients, but also with possible benefits in the vascular function and in the viscoelastic properties of the large arteries.”
Remember, you should always consult your physician before beginning any exercise, diet, or nutritional supplementation program.
Body water represents 76% of a human’s muscle mass. With aging, there is a progressive decline in total body water (TBW) – the result of sarcopenia, the aging loss of muscle, and the associated dynapenia, the aging loss of strength, without the intervention of resistance training and increased protein intake – from 0.8 grams per kilogram (Kg) to 1.2 grams per Kg in a non-athletic population. The result of sarcopenia is the loss of intracellular water (ICW).
In addition, the elderly is at increased to chronic dehydration, which cannot only affect muscle function, but also functional capacity to perform everyday tasks.
Researchers from Barcelona Spain writing – The Role of Water Homeostasis in Muscle Function and Frailty: A Review – in the August 2019 issue of the online, peer review journal Nutrients, comment that, “the role of water in muscular function in the aged population is poorly understood and evidence is both scarce and scattered.”
Suggesting that progressive age-related dehydration may be responsible for muscle function impairment and frailty, the Spanish researchers chose to review cell dehydration mechanisms and the potential consequences for muscle function in the aged population.
The investigators note that water function to act as a medium for all biochemical metabolism, a transport function, temperature control, structural, and mechanical function. In addition, water represents roughly 60% and 55% of body weight in adult males and females, and around 75% in children – with 70-75% in fat free mass and 10% in fat mass.
As lean mass decreases with age, with potential for an increase in fat mass, there is a potential for TBW loss in women and obese individuals.
From a dietary perspective food intake accounts for 20% of total water input – with beverages contributing 70-75%. Daily normal water loss comes from urine output, faecal and respiratory exchange (insensible perspiration).
Water balance (homeostasis) is achieved via the kidneys, where hormones such as anti-diuretic hormone (ADH) controls the thirst and urine output mechanisms, among other body control mechanisms.
The researchers point out that, “the aged population runs a greater risk of dehydration. Prevalence of dehydration in the elderly has been estimated at 20–30% and is associated with greater disability, morbidity and mortality.”
Further, “alterations in the hydro-electrolytic balance may cause decreased muscle strength, gait instability, falls, fractures, respiratory infections, confusion, renal failure and increased medication toxicity and may increase the risk of death.”
Causes of dehydration in the elderly are mainly related to a reduced thirst sensation consistent with a reduced ability to concentrate urine. Compared with younger adults, individuals aged 60–79 years old maximum urine osmolality and solute absorption are 20% and 50% lower, respectively.
The researchers conclude by saying that, “water is an essential nutrient for life as it plays fundamental metabolic, transport, structural and temperature control roles in the body. Ageing is characterized by slow and progressive process of dehydration and hyperosmotic stress, which, apart from being related with inflammation, causes cell shrinkage and damage to intracellular protein structure and function.”
Prior research has demonstrated that resistance training is effective in reducing both visceral (around abdominal organs) and subcutaneous (under the skin) fat mass, which can be significant risk factors to overall health, when in excess. In elderly subjects who are at risk to sarcopenia – the aging loss of lean muscle – resistance exercise is a stimulus to lean muscle development.
Until now, research is sparse, as to how lean muscle development improves cardio-metabolic health in previously healthy, young individuals.
Researchers from Finland and Sweden writing – Resistance Training Induces Antiatherogenic Effects on Metabolomic Pathways – in the September issue of Medicine & Science in Sports & Exercise, chose to, “examine changes in blood metabolome profiles in response to chronic resistance exercise training and associated changes in body composition in healthy young adult men.”
Metabolomics examines small molecules present in biological material – like blood – in a comprehensive manner.
It was hypothesized that, “chronic resistance training has the potential to alter body composition and metabolome profiles in a cardio-metabolically favorable manner.”
Eighty-six recreationally active, healthy thirty-three-year old men without a prior, consistent resistance training background participated in the resistance training (RT) group, while eighteen 31year-old non-training men belonged to non-RT group.
Prior to and after the16-week resistance training intervention program, body composition was assessed by dual-energy X-ray (DXA), along with fasting blood samples, and nuclear magnetic resonance (NMR) to assess quantification of serum metabolites in order to identify metabolic pathways.
Maximum strength was measured at baseline, at 4 and 12-weeks, and post-study. Four-day food diaries were maintained during the second segment of the 12-week resistance period – with verbal and written nutritional recommendations for normal healthy adults.
The resistance training began with 4 weeks of whole-body workouts performed twice-a-week – using 8 to 10 exercises within one workout, two to three sets for every exercise, and 10–15 repetitions in every set. A recovery time of 2 minutes was held constant between sets – with training loads between 50% to 80% of one repetition maximum, which increased throughout the preparatory phase.
It was concluded that, “a short-term (4 to 16 weeks) period of resistance training leading to increased levels of lean mass and reduced overall adiposity (fatness) also leads to antiatherogenic modulation of serum metabolome in healthy young men.” Their cardio-metabolic risk profile improved.
The researchers also comment that, “change in lean mass could be used as a predictor of metabolome profile, especially regarding HDL (good cholesterol) subpopulations. Furthermore, individuals with the poorest baseline body composition and metabolome profile benefit the most from initiating resistance training in terms of positive cardiometabolic health effects.”
Check with your physician before you begin your path to better health using any mode of exercise.
Mayoclinic.org says that Metabolic Syndrome (MetS), “is a cluster of conditions that occur together, increasing your risk of heart disease, stroke, and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.
Mayo further states that, “having just one of these conditions doesn't mean you have metabolic syndrome. But, it does mean you have a greater risk of serious disease. And, if you develop more of these conditions, your risk of complications, such as type 2 diabetes and heart disease, rises even higher.”
Prior research has pointed to the fact that aerobic fitness is low in those individuals, who meet the MetS criteria, which may pose a viable option to reduce many of the MetS criteria.
Researchers from the Exercise Physiology Laboratory at Toledo University of Castilla-La Mancha, Toledo, Spain – writing Effectiveness of Aerobic Exercise Programs for Health Promotion in Metabolic Syndrome – in the September issue of Medicine & Science in Sports & Exercise - tested the effects of 16 weeks of aerobic training with a frequency of three times per week with 125 MetS diagnosed patients – including 42 women and 79 men – with low cardiorespiratory fitness (CRF)
The investigators used either interval training - 4 and 1-minute high-intensity interval training (4HIIT and 1HIIT) or moderate-intensity continuous training (MICT) - and compared it against a non-exercise control group (CONT). The purpose of this study was to determine the therapeutic impact on MetS components and CRF of these three different aerobic exercise programs.
The participants were randomized during the 16-week study period either to four 4- minute HIIT at 90% of their heart rate maximum (HR Max), 50-minutes of MICT at 70% of their HR Max, 1-minute HIIT at 100% of HR Max or a CONT group.
Each participants CRF was measured by a VO2 max test – also known as a cardio-pulmonary stress test – to assess peak oxygen consumption – along with blood and body composition analysis. In addition, sex specific equations were used to calculate MetS risk factors with the treatments.
The researchers said that, “our data suggest that exercise volume is the main factor promoting health in deconditioned people with MetS, whereas exercise type (i.e., intervals vs continuous) and intensity (70% vs 100% HRMAX) are secondary to this particular population.
It was further stated that, “the finding that MICT is enough to improve MetS components and CRF simplifies exercise prescription, while avoiding concerns about the risks of using HIIT in people with a deteriorated cardiovascular system.
In short, not all people, especially those with initial low CRF or obese, tolerate the higher intensity interval training, which makes the MICT a viable, effective alternative to help bring MetS under control.
The U.S. Department of Health and Human Services recommends through their physical activity guidelines that Americans perform muscle-strengthening, resistance-type (body weight, weights, elastic tubing) exercise at least twice weekly, in association with aerobic exercise—moderate-continuous and interval training—to achieve positive health benefits.
The benefits of resistance exercise include bone and muscle development and strength, improved cardiorespiratory health, especially with circuit training; reduced blood pressure (post-exercise hypotension); improved lipid profile (LDL-C), and glucose metabolism.
While the link to reduced cancer incidence with aerobic exercise is valid, similar evidence for resistance training is lacking.
In “Weight Training and Risk of 10 Common Types of Cancer,” appearing in the September issue of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine, researchers from various groups within the National Cancer Institute sought to determine the association of weight training with the incidence of 10 common cancers.
Those cancers included: colon, kidney, bladder, breast, lung, non-Hodgkin lymphoma, pancreas, prostate, rectum, and melanoma.
The investigators used the NIH-AARP Diet and Health Study, which was established in 1995 to 1996. An initial questionnaire regarding demographics, medical history, and dietary behaviors was mailed to AARP members between the ages of 50–71 – residing in six US states and two metropolitan areas.
567,169 questionnaires were returned, which resulted in an 18% response rate. In 2004 to 2005, a follow-up questionnaire was mailed to the remaining participants to update information on lifestyle that included a more comprehensive assessment of physical activity. The follow-up questionnaire was completed by 313,363 participants.
According to the researchers, “our primary exposure was self-reported time spent per week on “weight training or lifting (include free weights and machines),” with 10 possible response options—none, 5 min, 15 min, 30 min, 1 h, 1 h +30 min, 2–3 h, 4–6 h, 7–10 h, and more than 10 h—in the follow-up questionnaire. This information was recoded into “no weight-lifting,” “low weight-lifting” (5 min to 1.5 h), and “high weight- lifting” (2–10+ h).
Based on the data extraction, the researchers said, “of the 10 cancer types examined in this study, weight-lifting was significantly associated with colon cancer only, which differs from aerobic physical activity’s reported benefits for many different cancer types.”
In conclusion, “weight-lifting was associated with lower risk of colon cancer, and possibly kidney cancer. These findings underscore the importance of resistance activity for health, including possibly for prevention of these cancers.”
Remember, you should always consult your physician before beginning any exercise, diet, or nutritional supplementation program.
After 43 years of sports performance management — with over 3,000 pro athletes, such as my eleven years with world champion tennis player Serena Williams, sports teams, and since 2012, volunteer work with special forces, it came as a surprise, when I was contacted in April of 2017, by Hollywood producer, director, and innovator James Cameron.
Cameron wanted me to consider taking on a project consistent with my “so called” reputation of extending careers. Cameron said he wanted to change Hollywood’s mantra of, “throwing female actors away, after the age of forty.” Initially, I wasn’t interested in the project, until he made that comment about discarding human beings based on age.
The project involved transforming Linda Hamilton from her present state — yet to be determined — to be able to perform the physical demands of Sarah Connor — the role Hamilton created in Terminators 1&2 — over 28 years ago.
I was skeptical that Hamilton, 61 when we started, would be able to survive the training long enough to get to the production. That is, until I met her here in New Orleans.
I informed Cameron that I would accept the project, if Hamilton passed extensive medical and physiological evaluations. Hamilton would then have to survive three weeks of training with me to see if she could hold up under the training stress — both physical and mental. She did.
Hamilton’s biggest concern was that the audience would compare her to what she looked like 28 years ago.
The studio budget provided for the creation of a home gym to be built in the annex of Hamilton’s home in New Orleans — used for training and any injury related rehabilitation, should one occur.
The first 12 weeks of work encompassed 6 days per week of 1.5 to 2 hours of circuit training exercises — using a cable weight apparatus with arms — permitting functional human movement patterns, core training using a stability ball, steady state and interval cardio training on an elliptical device, power training with a specially-designed medicine ball — along with specialized pre-habilitation (injury prevention) exercises based on her biomechanical analysis.
Hamilton had two AM/PM additional, scripted, heart rate monitored sessions on the elliptical lasting 45 minutes.
Over the remaining 9 months of the one-year project, our training became more functional to her character’s movement, as the script developed — moving to the Newman School football field to emphasize footwork, short sprints, agilities (cone drills), and combative training.
In Terminator 2 twenty-eight years ago, Hamilton was quite ripped by body building standards, especially in her arms — what I would hear from most women.
The potential for muscle and strength loss — accelerated with age — was a big concern. Understanding the effects of sarcopenia — loss of muscle with age and dynapenia — the associated loss of strength — technology from wound care and my prior experiences, provided a partial solution — the use of an amino acid blend — arginine, HMB, a metabolite of the anabolic amino acid leucine, and glutamine, among other medically approved nutrients.
Research also demonstrated that the standard 0.8 grams per kilogram for protein requirements would not begin to address Hamilton’s needs with the associated intense training. Based on DXA scans every six weeks, the daily protein requirement was determined down to the gram, as with my athletes.
In one of his last communications, when Cameron was provided with pictures of Hamilton just prior to the project completion, he emailed me to say in the words of Arnold Schwarzenegger before T2, “Linda, you look ripped and shredded.”
Depression, according to Psychiatry.org, “is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable.”
Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.
The website says symptoms, which can vary from mild to severe, include:
• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite — weight loss or gain unrelated to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide
Current research – The Association Between Serum Magnesium Levels and Depression in an Adult Primary Care Population – which appears in the July Issue of Nutrients – determined that, “for adults seen in primary care, lower serum magnesium levels are associated with depressive symptoms, supporting the use of supplemental magnesium as therapy. Serum magnesium may help identify the biological mechanism of depressive symptoms and identify patients likely to respond to magnesium supplementation.”
Researchers from various departments at the University of Vermont, Burlington, say that magnesium, the fourth most abundant mineral in the body – affecting over 300 enzymes – “is essential for anaerobic and aerobic energy production, glycolysis, mitochondrial oxidative phosphorylation, as well as, potassium and calcium regulation.”
Low magnesium – hypomagnesemia – is associated with neuromuscular, cardiovascular, neurologic, and electrolyte abnormalities, while being also tied to depressive symptoms in different parts of the world.
The adult RDA for magnesium is 310-420 mg. – depending on age and gender – irrespective of medical issues, such as kidney dysfunction.
The Vermont scientists sought to describe the relationship between serum magnesium and the Patient Health Questionnaire (PHQ) - a measure of depression scores – using cross-sectional analysis of medical records from 3604 adults (mean age 62 years; 42% men) seen in primary care clinics between 2015 and 2018, with at least one completed PHQ were included.
The study found that, “the association between serum magnesium levels and depression was seen even when magnesium was in the normal range. In other words, hypomagnesemia was not a prerequisite for the relationship.”
The bottom line is, “obtaining serum magnesium levels is safe, relatively easy, and inexpensive, and could help individualize treatment.”
People with abnormal kidney function need to check with their physician first before supplementing with magnesium.
The Wall Street Journal recently reported on a story – The Fasting Cure is No Fad – which sites new research showing the profound benefits for weight control, longevity, and fighting disease by eating during limited hours.
With the onset of menopause, many women may experience a variety of symptoms, including a decrease in lean muscle, an increase in fat mass, and a reduction in cardiorespiratory fitness – which may predispose the menopausal woman to insulin resistance and type 2 diabetes. Research says that one such intervention is aerobic exercise – consisting of 30 to 40 minutes of daily moderate-intensity repeated for three to four weeks over a six month duration.
JAMA (Journal of the American Medical Association) Network Open reported in July 2019 that, “normal-weight central obesity in women was associated with excess risk of mortality, similar to that of women with BMI-defined obesity with central obesity.”
2002 research published in PubMed notes that the typical American diet is deficient in fruits and vegetables and contains excessive amounts of meat, refined grain products, and dessert foods. "Such a diet, notes the research, "can have numerous adverse biochemical effects, all of which create a proinflammatory state and predispose the body to degenerative diseases."
Research supports the premise that regardless of age, sex, race, and comorbidities (simultaneous presence of two or more diseases or conditions), there is an inverse relationship between cardiorespiratory fitness (CRF) and mortality.
By the same token, CRF has also been associated with a higher quality of healthy life – owning to reductions in the risk to coronary artery disease, high blood pressure, diabetes, stroke, and cancer.
Research—Association of Lifestyle and Genetic Risk with Incidence of Dementia—published in June of 2019 on JAMAnetwork.com (Journal of the American Medical Association), states that "a favorable lifestyle was associated with a lower dementia risk among participants with high genetic risk.”
Research, which appears in the June 2019 issue of Nutrients – Association of Dietary Omega 3 & 6 Fatty Acid Intake with Hypertension: NHANES 2007-2014 - says, “that dietary n3 (omega 3) and n6 (omega 6) fatty acids intake were inversely associated with the risk of hypertension in US adults.”
Recent studies indicate that for those with cardiovascular health issues, eggs are not the villain they were once thought to be.
Recent clinical trials compared the effects of supervised high-intensity interval endurance training vs. resistance training in reducing two kinds of high-risk cardiac fat, epicardial and pericardial. Results showed that both types of exercise reduced the epicardial fat, while only the resistance training was effective in reducing the pericardial fat. My 40 years of experience back up just how effective that compound approach can be in reducing both total and visceral fat in both our male and female participants.
According to June 2019 research – Association of Exposure to Artificial Light at Night (ALAN) While Sleeping with Risk of Obesity in Women – published on line in JAMA (Journal of the American Medical Association) Internal Medicine, “artificial light at night while sleeping was significantly associated with increased risk of weight gain and obesity, especially in women who had a light or a television on in the room while sleeping. Associations do not appear to be explained by sleep duration and quality or other factors influenced by poor sleep.”
In the August 2019 issue of the Journal of the National Cancer Institute, Justin C. Brown, Director of the Cancer Metabolism Program at LSU’s Pennington Biomedical Research Center and colleagues report that, “for colorectal cancer patients, new research shows a clearer connection than previously known between fat deposits in certain areas of the body and higher rates of death from all causes within seven years of cancer diagnosis.”
Medscape.com recently reported on the results of the Multi-Ethnic Study of Atherosclerosis (MESA) relative to, “high plasma levels of the kinds of fatty acids (omega 3) found in fish oil (EPA/ eicosapentaenoic acid & DHA/ docosahexaenoic) were associated with a lower long-term risk for new heart failure, whether with reduced or preserved ejection fraction, in a community-based cohort of more than 6,000 people.”
According to research – "Increased Protein Requirements in Female Athletes After Variable-Intensity Exercise" – appearing in the November 2018 issue of Medicine & Science in Sports & Exercise – “females are unfortunately underrepresented in sports science research, which is especially true of protein requirement studies that, to date, have been confined to males only. Consequently, there is a need to define protein requirements in female athletes participating in team sports.”
According to research – "Increased Protein Requirements in Female Athletes After Variable-Intensity Exercise" – appearing in the November 2018 issue of Medicine & Science in Sports & Exercise – “females are unfortunately underrepresented in sports science research, which is especially true of protein requirement studies that, to date, have been confined to males only. Consequently, there is a need to define protein requirements in female athletes participating in team sports.”
The Nutrients researchers from the University of Hefei, China, and the State University of New Jersey, comment that, "a number of studies have shown that consumption of both green and black teas is linked to reductions in the risk of CVDs and some forms of cancers, to improved oral health, weight gain control and cognition in the elderly, and to increased antibacterial and antiviral activity and bone density."
Concentrated beetroot juice, "has been shown to acutely improve exercise tolerance in older adults and in patients with peripheral arterial disease." It's also been noted in the research that, "increased NO bioavailability through NO supplementation may promote vessel dilation, increasing blood flow, which might contribute to improved exercise tolerance in older adults."
A study of older women shows that walking is where it's at. While we'd all like to shoot for 10,000 steps a day, even 4,400 daily steps reduced the mortality rate by 41% in the women studied, compared to those who walked less. Lace up those shoes and get going.
In the first episode of Maximum Wellness, Mackie discusses research that shows tomatoes may be a secret weapon in the fight against high blood pressure.