Welcome to Weekly Health Update

  “A critical weekly review of important new research findings for health-conscious readers” 

NUTS, DIET & OBESITY

In last week’s column, I reviewed recent research suggesting a role for walnuts in reducing elevated cholesterol levels.  Based upon some of the comments that I received from readers regarding this “walnut column,” I will present some additional favorable new health research findings on nuts in this week’s column.

Hard-shelled nuts tend to be rich in inflammation-fighting omega-3 fatty acids (luckily, the majority of the fat content in hard-shelled nuts is in the form of heart-healthy unsaturated fats), and in plant sterols.  As I discussed last week, these compounds help to lower the level of LDL (the “bad cholesterol”) in the blood.

The Mediterranean Diet, which is rich in fish, whole grains, nuts, fresh fruits, and fresh vegetables (and low in red meat and highly processed foods), has repeatedly been shown to decrease the risk of the top two causes of premature death throughout the world (cardiovascular disease and cancer).  However, some health experts have expressed concerned about the relatively high fat content of nuts, and the possibility that daily nut consumption might lead to an increased risk of obesity.  Fortunately, a newly published prospective public health study suggests that the moderate intake of nuts, in combination with the Mediterranean Diet, is actually associated with a decreased risk of obesity.

The current issue of the journal Nutrition, Metabolism & Cardiovascular Diseases includes the findings of the Mediterranean “PREDIMED” prospective public health study, which enrolled 847 older men and women, with an average age of 67 years.  The diets and activity levels of these patient volunteers were carefully evaluated in this study, and all of these elderly volunteers underwent clinical examinations to determine their waist circumference, and their body mass index, or BMI (a measure of body fat content that is adjusted for both height and weight).

After correcting for other dietary and lifestyle factors associated with obesity in these patient volunteers, the data from this study revealed that increased nut intake was associated with both a decreased BMI and decreased waist circumference.  For every serving of 30 grams of nuts consumed, waist circumference decreased by 2.1 centimeters (approximately 1 inch), and BMI was reduced by 0.78 (kilograms per meter-squared) in these patient volunteers.  Increased vegetable intake was also associated with a decreased waist circumference, as well.  (Not surprisingly, meat intake was significantly associated with an increase in both BMI and waist circumference.)  Moreover, these findings were observed in both male and female study participants.

Walnuts, almonds, hazelnuts, pecans, pistachios, pecans, macadamia nuts, and peanuts (which are, technically, not nuts, but which have a nutritional profile similar to hard-shelled nuts) are all rich in omega-3 fatty acids and other heart-healthy nutrients.  Because these nuts do contain a significant number of “healthy fat” calories, however, nuts should be consumed in moderation, as with all fat-containing foods.  Currently, most experts recommend that 30 to 45 grams (1 to 1.6 ounces) of nuts be added to our daily diet to maximize the health benefits of these delicious nutritional treats!

To learn more about nuts and the Mediterranean Diet as part of a comprehensive, evidence-based cancer prevention lifestyle, look for the publication of my new book, in the spring of this year:

“A Cancer Prevention Guide for the Human Race”

http://www.redcross.org/

http://www.imcworldwide.org/haiti

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

For a different perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

I and the staff of Weekly Health Update would like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. 

Welcome to Weekly Health Update

  “A critical weekly review of important new research findings for health-conscious readers” 

WALNUTS, CHOLESTEROL, LDL & TRIGLYCERIDES

Walnuts are rich in anti-inflammatory nutrients, including omega-3 fatty acids and ellagic acid.   Previous research has shown that the regular consumption of walnuts appears to improve cardiovascular function following high-fat meals.  In diabetics, who face an increased risk of cardiovascular disease, walnuts also appear to improve cardiovascular function.

A newly published prospective, randomized clinical research trial, which appears in the European Journal of Clinical Nutrition, evaluated the effects of a walnut-supplemented diet on 87 adults with normal-to-high cholesterol levels in their blood.  This study used a “crossover” approach, in which all of the patient volunteers received walnut supplements for 6 months, and were then switched to a walnut-free diet for another 6 months.  During this 12-month study, blood tests were performed at the beginning of the study, and then at 4, 6, 10 and 12 months into the study.  Because of the crossover design of this study, the researchers were able to directly compare the effects of walnut supplementation on body weight, total cholesterol, LDL cholesterol (the “bad cholesterol”), HDL cholesterol (the “good cholesterol”), and fatty acids (triglycerides).  (Together, these compounds are referred to as “lipids.”)

As has been observed in previous clinical studies of shorter duration, this study found that a 6-month period of walnut supplementation resulted in significant reductions in total cholesterol and triglyceride levels.  LDL levels were also reduced, although this finding just barely failed to reach statistical significance.  Importantly, these favorable changes in blood lipid levels were found to be more pronounced in patients with elevated total cholesterol and LDL cholesterol levels.  (I should note that significant reductions in LDL blood levels have been observed in response to adding walnuts to the diet of patients with elevated LDL levels, in other studies.)

While statins, and other lipid-lowering drugs, have revolutionized the management of elevated cholesterol and triglycerides, and have been shown to significantly reduce the risk of cardiovascular disease (and death due to cardiovascular disease), not all patients with hyperlipidemia can tolerate these drugs.  Moreover, as with all medications, these lipid-lowering drugs are not equally effective in all patients, and many patients with hyperlipidemia will continue to have elevated LDL cholesterol and/or triglyceride levels despite taking lipid-lowering drugs.

Studies such as this one suggest that the addition of walnuts to one’s diet may be a useful adjunct in lowering elevated LDL cholesterol and triglyceride levels.  (As always, I encourage everyone to check with their doctor before making any significant alterations in their diet, especially if you have one or more chronic illnesses.)

http://www.redcross.org/

http://www.imcworldwide.org/haiti

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

For a different perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

I and the staff of Weekly Health Update would like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. 

Welcome to Weekly Health Update

  “A critical weekly review of important new research findings for health-conscious readers” 

TESTOSTERONE SUPPLEMENTS IN FRAIL ELDERLY MEN

As we age, we tend to lose both muscle mass and bone density.  These adverse effects of aging often lead to an increased risk of generalized weakness, early fatigue, imbalance and falls, bone fractures, long-term disability, and hospitalization or other forms of chronic institutionalization.  In turn, these complications of frailty in the elderly are significantly associated with an increased risk of death.

While an elixir of eternal youth has not yet been discovered (despite many claims to the contrary over the centuries), some of the causes of aging-related frailty can be treated.  Sex hormone replacement therapy in the elderly has been a major focus of clinical intervention, in both men and women, in an effort to reverse many of the debilitating effects of aging, including declines in muscle mass, bone density, and sexual function.  However, the true risks and benefits of sex hormone replacement therapy have not always been well understood.  Indeed, within the past decade, old assumptions about the safety of hormone replacement therapy have been called into question by high-level prospective, randomized, placebo-controlled, blinded clinical research trials, including the recent and disturbing (but not altogether surprising) findings that long-term combination hormone replacement therapy in postmenopausal women is associated with a significant increase in the risk of both breast cancer and cardiovascular disease.

Although aging men do not experience an abrupt and total loss of testicular function, unlike the complete loss of ovarian function that occurs in women following menopause, testicular function does dramatically and progressively decline with advancing age.  Significant decreases in the levels of testosterone (and other “androgens”) in the blood often leads to decreased muscle mass and bone density which, in turn, can result in reduced strength and balance, and an increased risk of falls and serious injuries. 

Testosterone replacement therapy has been shown to be effective in improving muscle mass and bone density (and sexual function) in older men with very low testosterone levels (hypogonadism).  However, the role of testosterone replacement therapy in men with borderline-low circulating levels of androgen hormones has been much less clear.   As with sex hormone replacement therapy in postmenopausal women, there are known side effects associated with male sex hormone replacement therapy.  These include enlargement of the prostate gland (benign prostatic hypertrophy, or BPH), liver disease (especially with oral testosterone supplements), fluid retention, decreased fertility, breast enlargement and pain (gynecomastia), and a potential increase in the risk of prostate cancer, among others.

A newly published research study, in the Journal of Clinical Endocrinology & Metabolism, evaluated 274 men who were 65 years of age or older, and who were determined, by validated clinical criteria, to be either “intermediate-frail” or “frail.”  All of these men were also confirmed to have “borderline-low” levels of testosterone in their blood. 

In this randomized, prospective, placebo-controlled, double-blind study (which is the “gold standard” method of performing clinical research), these older men were randomly assigned to receive either transdermal testosterone therapy (50 mg per day) or a placebo gel that appeared identical to the testosterone gel.  These treatments were continued for 6 months.  The researchers then assessed both groups of men in terms of their muscle strength, muscle mass, body fat, overall level of physical function, and self-reported quality-of-life.

At the end of 6 months, the men who had been secretly randomized to the testosterone gel group were found to have experienced significant improvements in both muscle mass and muscle strength, as well as a decrease in total body fat.  Overall physical function in the “intermediate-frail” and “frail” older men also significantly improved.  Finally, and not surprisingly, self-reported physical health and sexual health satisfaction scores were substantially improved among the men who, unknown to them at the time, had received the testosterone gel.

Thus, the findings of this prospective, randomized, controlled clinical research trial certainly suggest a potential role for transdermal testosterone supplementation in frail older men with borderline-low testosterone levels.  At the same time, continued follow-up of the men in this study who elected to continue receiving testosterone supplementation is indicated, as the rather short duration of this study (6 months) is not long enough to identify the long-term benefits and risks of androgen replacement therapy.

If you are an older man who is experiencing significant frailty and disability due to progressive muscle mass and bone density loss, and you have borderline-low or low testosterone levels, then you might wish to discuss the potential benefits of a monitored testosterone supplementation regimen with your physician, or with an Endocrinologist who specialize in male endocrinology (Andrology).

On a related topic, please also see my recent column on the use of Vitamin D to decrease the risk of falls and fractures in the elderly:

http://doctorwascher.com/Archives/10-11-09.htm 

In view of the extreme devastation and human misery brought about in Haiti and Chile by the recent earthquakes, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti

For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

Welcome to Weekly Health Update

VITAMIN D, CARDIOVASCULAR DISEASE & DEATH

There is mounting evidence that Vitamin D plays a much more complex role in maintaining health beyond its primary function in regulating calcium absorption.  Increasingly, research data suggests that this hormone-like vitamin may also play important roles in the prevention of cardiovascular disease and cancer, as well.  (A comprehensive update on Vitamin D’s cancer prevention properties will appear in my forthcoming book, “A Cancer Prevention Guide for the Human Race.”)

The vast majority of published research studies in disease prevention have relied upon low-level research methods, including surveys of patient volunteers and retrospective medical chart reviews.  More recently, however, high-quality prospective, randomized cardiovascular disease prevention and cancer prevention clinical research trials have been performed.  These high-level studies have the potential to significantly improve lifestyle-based approaches to preventing the diseases that, together, cause the majority of all premature deaths.   

A newly published prospective clinical research study, from the Chianti region of Italy, enrolled more than 1,000 adults, aged 65 years and older.  All patient volunteers were tested for the level of Vitamin D in their blood when they joined this study, and all of these older adults were then carefully followed for an average of nearly 7 years.  During the course of this study, 228 study participants died.  The researchers then compared the levels of Vitamin D in the blood of the participants who died during the study with those of the volunteers who survived.  (This study is published in the current issue of the European Journal of Clinical Nutrition.)

The findings of this prospective clinical study were striking.  The patient volunteers with the lowest levels of Vitamin D in their blood were more than 2 times as likely to die, from any cause, when compared with the patients who had the highest levels of Vitamin D in their blood.  The patients with the lowest Vitamin D levels were also nearly 3 times as likely to die from heart attacks, and other complications related to cardiovascular disease, when compared to the patients with high levels of Vitamin D in their blood.  These dramatic findings held up even after the researchers made statistical adjustments for differences in the age, gender, education level, exercise habits, and other health-related factors among these two groups of study participants. 

As we age, our bodies become less efficient in converting sunlight into Vitamin D, and multiple research studies have shown that the majority of older adults are deficient in Vitamin D.  A growing number of high-level clinical research studies, such as this Italian study, continue to suggest that Vitamin D deficiency is associated with an increased risk of cardiovascular disease, cancer, osteoporosis, bone fractures, and decreased muscle strength in older men and women.  Therefore, the importance of this vitamin-hormone in maintaining optimal health is becoming increasingly apparent.

For additional Weekly Health Update articles on Vitamin D, please click the following links:

http://doctorwascher.com/Archives/2-3-08

http://doctorwascher.com/Archives/10-11-09.htm

http://doctorwascher.com/Archives/11-8-09.html

http://doctorwascher.com/Archives/9-20-09.htm

http://doctorwascher.com/Archives/8-9-09.htm

http://doctorwascher.com/Archives/12-28-08.htm

http://doctorwascher.com/Archives/10-5-08.htm

http://doctorwascher.com/Archives/6-29-08.htm  

In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti

For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers”

MOZART, MUSIC, BABIES & HEALTH

Wolfgang Amadeus Mozart, born in Salzburg on January 27, 1756, was a prolific and gifted composer, and is credited with over 600 original compositions prior to his death in 1791 at the age of 35.  A child prodigy, Mozart is said to have written his first composition by the age of 5.  Although Mozart composed music in a wide variety of styles, music scholars have noted that Mozart’s compositions tend to reflect a high degree of “periodicity,” involving extensive repetition of major melodic themes, when compared to the other enduring master classical music composers of Mozart’s era.  This aspect of Mozart’s music may be clinically important as, for example, clinical research studies in adults with epilepsy have compared Mozart’s music with that of Beethoven, Wagner, Bach, Chopin, Hayden, and Liszt, among others, and found that Mozart’s music was more effective in reducing seizure activity than that of the other titans of Classical music.  Thus, some experts in brain physiology have concluded that Mozart’s compositions may particularly resonate with the human brain’s circuitry, and may potentially affect brain function in clinically significant ways.

An entire commercial industry has emerged from a phenomenon that is often referred to as the “Mozart Effect.”  Clinical research in the early 1990s with infants suggested that listening to music by Mozart could at least temporarily improve spatial reasoning, or “spatial-temporal intelligence” in babies.  The rather narrowly focused findings of these studies have subsequently been grossly over-generalized, primarily by companies marketing Mozart recordings to hopeful new parents, as evidence that regularly listening to Mozart can enhance the IQ of infants and toddlers. 

Putting aside the debate over the potential impact of Mozart on the IQ of babies and toddlers, other recent research data has suggested that exposure to Mozart’s music might be associated with improved weight gain in underweight babies and children.  A newly published prospective clinical research study, which appears in the current issue of the journal Pediatrics, suggests a mechanism whereby underweight premature infants may be stimulated to gain weight following exposure to the music of Mozart. 

In this prospective, randomized study, 20 hospitalized premature infants receiving liquid nutrition through feeding tubes were randomly assigned to two different groups.  In the experimental group, the pre-term babies were exposed to a 30-minute period of Mozart’s music each day, for two consecutive days.   The control group of infants, however, was not exposed to any music on these two consecutive days.  This study included a crossover design, wherein all of these infants were then “crossed-over” into the opposite group, such that each baby participated in both the experimental group and the control group.  Measurements of these babies’ rate of energy metabolism were then performed during each 30-minute period of Mozart music exposure in the experimental group, and for equal 30-minute periods in the babies that were randomized to the control group.

Interestingly, the metabolic rates of the babies exposed to Mozart’s music decreased by 10 to 13 percent within 10 minutes of starting the Great Composer’s music (compared to the infants in the control group).  This innovative little study’s finding that the rate of energy metabolism in premature infants decreases following exposure to Mozart’s music is interesting, and may explain, at least in part, the findings of previous studies that underweight children gain weight after being exposed to recordings of Mozart’s music. 

Research studies such as this one raise the question of whether or not Mozart’s music, or that of other Classical composers, should be routinely used in hospital nurseries and neonatal intensive care units.  Meanwhile, if your baby or toddler is underweight, but otherwise healthy, a trial of “Mozart therapy” might just be in order.

In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti

For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg