Wednesday, May 22, 2019

Live longer, avoid cancer, and lose weight: research shows that making your own food may be your most important decision

Living longer and feeling better is often a matter of which food we eat when we’re hungry – and it looks like we’d be all be better off if we stop choosing commercially-processed food.  This includes those convenient ready-to-eat protein bars, heat-and-eat meals, and food from restaurants or grocery store delis.  Multiple studies show commercially processed food to be associated with increased weight gain [1], a shorter life [2], and more cancer [3].  In one of the most recent studies [1], participants were randomized to either a diet of unprocessed food or a diet of highly-processed food: both diets were matched for calories, sugar, fat, fiber, and other major nutrients.  Those eating the highly processed foods gained weight over the period of the study, while those eating unprocessed foods lost weight; although they were offered the same amount of food, they apparently simply ate less.  There appears to be many reasons why processed foods cause more harm (see pages 59–61 of Good Food, Great Medicine, 4th edition), including chemical alterations during processing, additives, calorie density, and less appetite suppression.  The fact that those eating less processed foods were also more likely to be at lower risk of common diseases is a bonus worth considering!
 
My recommendation:
For optimal health, one of the best decisions we can make for ourselves and our family is to prepare our food from scratch as much as possible.  It takes some extra time, but the rewards are unbeatable.  Get together with family and friends and make home cooking a part of your life.  Bring a lunch to work.  Keep snacks simple and homemade, and put together a repertoire of easy dinners.  Teach children how to help in the kitchen when they’re young and cook when they’re older.  There are lots of meal planning ideas, recipes, and snack suggestions in Good Food, Great Medicine, pages 134–146.  Call our office at 503.291.1777 to sign up for a disease reversal class or schedule an appointment for a one-on-one medical consultation (goodfoodgreatmedicine.com).

Miles Hassell MD

[2]Schnabel, L. et al. JAMA Intern Med 2018; doi:10.1001 (NutriNet-Santé Study)
[3]Fiolet, T. et al. BMJ 2018;360:k322 (NutriNet-Santé Study)

Thursday, February 21, 2019

Good bugs for a better mood

Want a better mood – with less help from drugs?  Try increasing the good bugs in your GI tract!  The mechanism for benefit may be the ability of your gut microbes to produce butyrate, a short chain fatty acid with a wide range of metabolic effects, including strengthening the epithelial defense barrier [1], a layer of cells that line the gut to resist invaders like toxins and bad bugs.  In fact, it is increasingly evident that a healthy gut microbiome is also associated with a multitude of other health benefits such as better weight management, less cancer, diabetes, heart disease, and more.  Now that should help improve your mood!    

My recommendation:
There are many non-drug options for treating depression and anxiety, including targeted diet therapy, fitness, weight management, light exposure, and heat therapy; this study adds powerful support for eating more probiotic foods such as plain kefir and yogurt (meaning unsweetened, with milk and active cultures as the only ingredients) as well as foods like salt-cured sauerkraut and kimchi for a healthier gut microbiome and mood.  Although there is a subgroup that does very well on medications, be aware that the lifestyle prescription on pages 23-24 of Good Food, Great Medicine (4th edition) is arguably more powerful medicine.  For more on how and why to choose probiotic foods, see page 49.    

Miles Hassell MD

Monday, February 18, 2019

Joint steroid injection? Think twice…

There are ongoing concerns that steroid injections for painful knee osteoarthritis [1,2] may have the negative effect of accelerating joint breakdown while having no benefit – including for pain control – compared to placebo injections.  This is in addition to data showing that even short-term steroids (as well as other anti-inflammatory medications) have significant potential for harm to overall health.

My recommendation:
This is an area of legitimate debate; however, given both the uncertainty regarding the benefit and the potential harm, I strongly recommend that patients exhaust all other options before having steroid injections.  The alternative is a plan that includes meticulous attention to diet, weight, blood sugar management, appropriate exercise, and topical or oral pain medications.  There are some nutritional supplements that may help, and targeted physical therapy can make an enormous difference.  Occasionally I use lidocaine injections without steroids and see excellent results.

Keep the most important goals in mind: less pain and improved function in the short term, and avoiding further joint breakdown or joint replacement in the long run.  Make sure you have all options in view.  (See my 5/1/2017 blog post on corticosteroids for more information about short-term oral steroids.)

Miles Hassell MD

[2] McClindon, T. et al. JAMA 2017;317:1967-75