Media coverage of a study published in the medical journal BMJ last month left the impression that eating saturated fat is not harmful to one’s health. These news stories left out an important point. Low–saturated-fat diets, in which those fats are replaced with even less healthful food (refined carbohydrates, for example), may not be any healthier than diets higher in saturated fats. Experts generally agree that the overall quality of a person’s diet matters more than any one particular food or food group. That said, the type of fat you eat is important, so choose foods with healthy unsaturated fat (fish, nuts, and most plant oils), limit foods high in saturated fat (butter, whole milk, cheese, coconut and palm oil, and red meats), and avoid foods with trans fat altogether.
The PREDIMED study showed that the Mediterranean diet can statistically lower a person’s risk for cardiovascular disease, including heart attacks, strokes, and death from heart-related causes. The data also suggest that a Mediterranean diet is associated with a reduced chance of getting breast cancer. This small analysis has some limitations, but provides another reason to consider this already healthful way of eating.
Like millions of Americans, I plan to fire up the grill today for a Fourth of July cookout. But I’ll be adding an extra step to my routine: checking the grate for bristles that may have fallen off my cleaning brush. An article in this week’s Morbidity and Mortality Weekly Report describes six people injured by consuming grill-cleaning bristles hidden in grilled meat. Three had abdominal pain from wire bristles poking through the small intestine or colon. Three others had bristles stuck in the neck. All of the wire bristles were safely removed with open surgery or laparoscopy (“keyhole” surgery). The same team had published a report of six other cases earlier this year in the American Journal of Roentgenology. Twelve cases from one medical center over a three-year period does not an epidemic make. But it’s enough to suggest that ingesting wire bristles happens wherever home grilling is going on. Keep your grill bristle free by using a brush that’s in good shape. After you use a brush to clean your grill rack, use a towel or wadded up bunch of paper towels to wipe it down.
Protein is essential to good health. The very origin of the word — from the Greek protos, meaning “first” — reflects protein’s top-shelf status in human nutrition. You need it to put meat on your bones and to make hair, blood, connective tissue, antibodies, enzymes, and more. It’s common for athletes and bodybuilders to wolf down extra protein to bulk up. But the message the rest of us often get is that we’re eating too much protein. The conclusion from a “Protein Summit” held in Washington, D.C., is that Americans may eat too little protein, not too much. The potential benefits of higher protein intake include preserving muscle strength despite aging and maintaining a lean, fat-burning physique. Based on the totality of the research presented at the summit, getting 15% to 25% of total daily calories from protein is a good target, although it could be above or below this range depending on your age, sex, and activity level. Healthful sources of protein — like fish, poultry, nuts, beans, and whole grains — are best when adding protein to the diet.
Partially hydrogenated oils, once a workhorse of the food industry, have gotten an official heave-ho from the U.S. food supply. In a long-awaited decision, the FDA ruled yesterday that partially hydrogenated oils, which are the main source of harmful trans fats, are no longer “generally recognized as safe.” That means any food company wanting to use partially hydrogenated oils must get the FDA’s approval to do so. Companies have until 2018 to stop using partially hydrogenated oils or to petition the FDA for approval. The move is a good one for individual and public health. Trans fats have been a favorite of the food industry because they increase the shelf life of liquid oils and make margarine easier to spread. But trans fats are bad for arteries. Removing them from the U.S. food supply would prevent between 72,000 and 228,000 heart attacks each year.
If you’re a chocoholic, the news out of England is tantalizing: middle-aged and older adults who eat up to 3.5 ounces of chocolate a day (that’s more than two standard Hershey bars) seem to have lower rates of heart disease than those who spurn chocolate. At least that was the conclusion of a study that followed the health of nearly 21,000 resident of Norfolk, England, for 11 years. Most of the previous studies on the chocolate-heart connection found that only dark chocolate offered any cardiovascular protection. In the Norfolk study, any type of chocolate, including milk chocolate, seemed to have the same beneficial effect. I routinely write my patients a prescription for exercise, and sometimes for eating more vegetables and fruits. I won’t be writing any prescriptions for chocolate in the foreseeable future. But I won’t be telling them not to eat chocolate—in moderation of course.
Can a Mediterranean-type diet with extra servings of nuts and extra-virgin olive oil help protect memory and thinking skills with age? A study in this week’s JAMA Internal Medicine suggests that it might. The findings come from a small substudy done as part of the PREDIMED trial, which showed that a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced heart attacks, strokes, and other cardiovascular problems among people at high risk for them. Although the results of the new PREDIMED study are promising, its small size and the fact that it wasn’t designed to look at connections between diet and brain health mean the results need to be taken with a grain of salt. That said, since there’s no downside to following a Mediterranean diet, an added bonus beyond great taste could be protecting memory and thinking skills.
Calorie counts adorn the exterior of cans and bottles of sodas, juices, sports drinks, and many other beverages. Should alcoholic beverages and drinks also come with calorie counts? Yes, argues Dr. Fiona Sim, chair of the United Kingdom’s Royal Society for Public Health, in an editorial in The BMJ. She explores well-supported links between alcohol drinking and obesity. Beginning in December 2015, alcohol-related calorie counts will be available in the United States to some people who dine out. The Food and Drug Administration is requiring restaurant chains with 20 or more outlets to provide calorie information for food and some alcoholic drinks. The calorie counts may come as a wake-up call for drinkers who are accustomed to thinking of an average drink as containing 100 to 150 calories. That figure may be true for the standard 1.5-ounce shot of distilled spirits, 12-ounce bottle of beer, or 5-ounce glass of wine, but the “generous pour” at many bars and restaurants often doubles the amount. Moreover, concoctions containing syrups, liqueurs, juices, cream, and other ingredients can send the calories soaring.
Switching from a “Western” diet with lots of fat and meat to a fiber-rich diet for just two weeks makes conditions in the large intestine less favorable to the development of colon cancer. The opposite switch may promote the formation of cancer. That’s the conclusion from a small but elegant study done in urban Pittsburgh and rural KwaZulu-Natal, South Africa. In the study, 20 volunteers from each area switched diets. For two weeks, the Americans ate a traditional high-fiber African diet rich in fruits, vegetables, nuts, and beans, while the Africans ate a Western diet with more fat, protein, and meat. In just two weeks, significant changes occurred in the lining of the colon and in its chemical and bacterial make-up in both groups, but in different directions. Those following the African diet showed improvements in colon health likely to protect against colon cancer, while those following the Western diet showed changes that could lead to colon cancer.
This week’s inaugural April Fool’s Day edition of JAMA Internal Medicine carried a report entitled “Association Between Apple Consumption and Physician Visits: Appealing the Conventional Wisdom That an Apple a Day Keeps the Doctor Away.” Based on actual national nutrition data collected from nearly 8,400 men and women it concludes, “Evidence does not support that an apple a day keeps the doctor away; however, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications.” Apples may have failed this critical scientific test, but they are still an excellent choice as a snack, pick-me-up, or dessert.