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.
Looking for ways to ward off colorectal cancer? According to a new study, a pescovegetarian diet — that’s a vegetarian diet that includes fish — was linked to a 43% reduction in the risk of developing colorectal cancer. The study, published in JAMA Internal Medicine, adds more support to the notion that something in red meat, or the way it is cooked, encourages the growth of colorectal cancer. It’s also possible that eating more plant foods provides extra beneficial nutrients such as folate, calcium, and fiber that may protect against colorectal cancer. Fish contain healthful omega-3 fats and vitamin D. Another good strategy for preventing harm from colorectal cancer, the second leading cause of cancer death in the United States? Have colonoscopies as needed.
Nuts have been gaining traction as an all-natural health food. Tree nuts like almonds, pecans, and walnuts are especially prized for their rich cargo of vitamins, minerals, and mono- and polyunsaturated fats. The downside is that tree nuts tend to be pricey. But a study published online this week in JAMA Internal Medicine puts the humble peanut squarely in the same nutritional league as its upscale cousins. This work makes the health benefits of nuts more accessible to lower-income shoppers. An international team of researchers found that in more than 200,000 people from Savannah to Shanghai, those who regularly ate peanuts and other nuts were substantially less likely to have died of any cause — particularly heart disease — over the study period than those who rarely ate nuts. A key take-home message from this study is that eating peanuts appears to be just as potent for preventing heart disease as eating other nuts.
Peanut allergies can cause severe and sometimes deadly allergic reactions. A new study holds out the possibility that peanuts themselves may prevent peanut allergies. An international team asked parents of infants who were prone to a peanut allergy to give their children a peanut-based snack called Bamba or peanut butter three times a week until age five. The parents of another group of peanut allergy-prone infants were asked to make sure their children didn’t eat any peanuts, peanut butter, or other peanut-based products until age five. The results were surprising and dramatic. A peanut allergy developed in 1.9% of children who ate Bamba or peanut butter, compared with 13.7% of those who didn’t eat peanuts. This new work suggests that preventing peanut allergies may be a possibility in the near future.
Getting to a healthy weight and staying there isn’t always easy. Many complicated diets offer solutions. A study published in today’s Annals of Internal Medicine suggests that something as simple as aiming to eat more fiber each day can be just as good as a more complicated diet. In a head-to-head study of a simple diet (eat more fiber) and a complex one (eat more fruits, vegetables, high-fiber foods, fish, and lean protein but also cut back on salt, sugar, fat, and alcohol), participants lost almost the same amounts of weight on either diet. Both diets led to similar improvements in blood pressure the body’s response to insulin. The results of the study don’t prove that a high-fiber diet is necessarily as good (or better) for health than the AHA diet or the highly in-vogue Mediterranean diet. But it does suggest that one simple step can make a difference and that encouraging healthy behaviors may be more effective than discouraging unhealthy ones.
Nearly 2 billion people around the world are anemic, meaning they don’t get enough iron to produce the red blood cells and oxygen-carrying hemoglobin needed to nourish their myriad cells. In developed nations like the United States, though, iron-poor blood is uncommon. The body stores most of its iron in hemoglobin inside red blood cells and in ferritin, a protein that latches onto iron and sequesters it in the liver, spleen, and bone marrow. Most Americans get all the iron they need from food. The body absorbs iron from meat more easily than it absorbs it from plants. Getting enough vitamin C helps the body absorb iron from food. Because the body does not excrete iron rapidly, it can build up over time and possibly cause problems. That’s why it’s a good idea to ask your doctor if you need to take an iron supplement.