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June 2008

Mediterranean diet reduces diabetes
Popcorn raises whole grain intake
Body mass index and cancer
Eggs increase mortality risks
Fruits, veggies, and head/neck cancers
Milk no help for weight loss
Omega-3 oils reduce eye disease

Mediterranean diet reduces diabetes

Researchers evaluated subjects for their level of adherence to the Mediterranean diet and correlated that to their risk of diabetes. They assessed 13,380 subjects for an average of 4.4 years using a validated diet questionnaire. (Martínez-González MA, et al., Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ. 2008 May 29. [Epub ahead of print])

Those subjects who ate the most closely to the Mediterranean diet had an 83 percent lower risk of developing type 2 diabetes than those who were following it the least closely. This was after adjustment for sex, age, education level, total calorie intake, physical activity, body mass index, smoking, family history of diabetes, and elevated blood pressure, showing that the diet benefits everyone.

Moderate adherence to the diet led to a 59 percent reduction in risk compared to those with the lowest score. The Mediterranean diet is rich in fruits, vegetables, grains, beans, fish, and olive oil, and low in animal products. Adherence was measured on a nine point scale. For every two point increase in score, the risk of diabetes dropped by 35 percent, and they showed a clear linear trend to a reduction in risk with increasing scores on their scale.

Popcorn raises whole grain intake

A recent evaluation of the National Nutrition Health and Nutrition Examination Survey conducted from 1999 to 2002 showed that people who ate popcorn more frequently consumed more whole grains and dietary fiber than those who did not. (Grandjean AC, et al., Popcorn consumption and dietary and physiological parameters of US children and adults: analysis of the National Health and Nutrition Examination Survey (NHANES) 1999-2002 dietary survey data. J Am Diet Assoc. 2008 May;108(5):853-6.)

Overall, popcorn consumers ate three times as much whole grain and 22 percent more fiber than non-consumers. They also ate less meat than non-consumers. The study sample included 15,506 subjects. Dietary whole grains and reduced meat consumption have previously been associated with lower risk of heart disease, diabetes, and other diseases, and improved health markers, these benefits were not found in this study.

Part of the reason for this last finding might be that much of the popcorn consumed in this country is doctored with fats (butter and hydrogenated oils), salt, artificial additives (flavors and preservatives), or sweeteners (caramel). One additive to microwave popcorn, diacetyl, an artificial butter flavor, causes lung disease in the workers involved in manufacturing the product, and it is possible that breathing the fumes during the popping might cause some exposure to the chemical.

All of these alterations might obliterate the potential health benefits of this whole grain. I suggest air popping untreated popcorn (hot air poppers are readily available), and if you like some flavoring, spray on some olive oil or flaxseed oil.

Body mass index and cancer

Being overweight is associated with many health risks. New information shows that a high body mass index (BMI) increases the risk for esophageal and stomach cancer. In a study of approximately 500,000 people, those with a BMI over 35 had a 2.5 times higher risk of gastric cancer and a 2.25 times higher risk of esophageal cancer than people with a BMI between 18 and 25. (Abnet CC, et al., A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma. Eur J Cancer. 2008 Feb;44(3):465-71.)

Even among people with the normal BMI of 18 to 25, the researchers found an increasing risk of these cancers with higher BMI levels. This suggests that if you want to be at the lowest risk of developing these cancers it is not enough to be normal weight, you want to be near the lower end of the normal weight range.

Eggs increase mortality risks

In the Physicians’ Health Study of 21,327 male physicians followed for an average of 20 years, egg consumption was associated with an increased mortality, especially in diabetics. The subjects ranged from 40 to 86 years old. Consuming more than six eggs per week was associated with increased mortality from all causes. (Djoussé L, Gaziano JM, Egg consumption in relation to cardiovascular disease and mortality: the Physicians' Health Study. Am J Clin Nutr. 2008 Apr;87(4):964-9.)

Although consuming less than seven eggs per week was not associated with increased risk of mortality, those subjects who ate seven or more eggs per week had a 23 percent increased risk of mortality. This is in spite of a lack of a finding of increased cardiovascular deaths. The risk for diabetics for all-cause mortality was doubled in the group with the highest egg consumption compared to those with the lowest.

This finding might have something to do with the poor quality of commercial eggs, coming from hens living in cramped henhouses, dosed with antibiotic and hormone treatments, eating non-organic foods, and having no exposure to sunlight and fresh air. It is not clear that organic eggs will not produce similar mortality risks because we just do not have evidence from enough people eating this way to draw statistically valid conclusions.

Fruits, veggies, and head/neck cancers

People consuming large amounts of vegetables, fruits, and beans have a lower incidence of head and neck cancers compared to people consuming little of these foods. Head and neck cancers include throat (pharynx and larynx) and oral cancer, and they are the sixth most common cause of cancer mortality in the world.

In a study of 490,802 participants in the NIH-AARP Diet and Health Study, those with the highest legume intake had a 20 percent reduced risk compared to those with the lowest intake. High intake of apples, pears, peaches, plums, and strawberries led to a 40 percent reduction in risk, while peppers, tomatoes, and carrots led to an 18 to 27 percent lower risk of developing these cancers. In this study, other botanical groups were unrelated to these cancers. (Freedman ND, et al., Fruit and vegetable intake and head and neck cancer risk in a large United States prospective cohort study. Int J Cancer. 2008 May 15;122(10):2330-6.)

Independent of the subgroups within fruits, vegetables, and beans, overall the benefits were seen most with vegetables, with a 35 percent risk reduction. In this study, which agrees with other research, the benefits were seen even in heavy smokers and heavy drinkers, both of which habits contribute to these cancers.

Milk no help for weight loss

Although it is common to see advertisements promoting milk consumption as a way to help with weight loss, these claims are not backed up by science. Of 49 published studies on the subject, the vast majority showed either no change in weight with milk consumption (41 of the studies, or weight gain (2 of the studies) One study showed a lower rate of weight gain compared to controls. Only 5 of the 49 studies showed some weight loss. (Lanou AJ, Barnard ND, Dairy and weight loss hypothesis: an evaluation of the clinical trials. Nutr Rev. 2008 May;66(5):272-9.

While numerous celebrities are seen promoting milk for a variety of supposed health benefits, most of those claims are not adequately substantiated. If you choose to include dairy products in your diet, you would be wise to choose non-fat, organic yogurt. Soymilk is a good substitute for dairy products (although not to replace mother’s milk for infants).

Omega-3 oils reduce eye disease

A new review of studies shows that consumption of omega-3 oils can lower the incidence of macular degeneration. This meta-analysis by Australian researchers reviewed data in nine studies on 88,974 subjects consuming varying levels of foods rich in omega-3 oils and fish. (Chong EW, et al., Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol. 2008 Jun; 126(6):826-33.)

They found that those who consumed high amounts of omega-3 rich foods had a 24 to 38 percent lower rate of developing macular degeneration. Eating fish twice a week led to a 24 percent reduction in the condition compared to people who ate lower amounts. High levels of all sources of omega-3 oils led to the most benefits.

Omega-3 oils are found not only in fish, but also in flaxseeds (and flaxseed oil), walnuts, tofu, and hempseed (and hempseed oil). Flaxseed is the richest source. The omega-3 oil found in vegetable sources is alpha-linolenic acid, and some people have difficulty converting this to the EPA and DHA that they need. This is especially true for older people or those who have various health problems who may need fish or fish oil supplements to supply their needs.

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From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.

Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.