Health Journal Online

Category: Nutrition

  • Are Doctors Knowledgeable About Nutrition? 

    Are Doctors Knowledgeable About Nutrition? 

    Do you know more about basic nutrition than most doctors?

    “A poor diet now outranks smoking as the leading cause of death globally and in the United States, according to the latest data.” The top killer of Americans is the American diet, as you can see below and at 0:23 in my video How Much Do Doctors Actually Know About Nutrition?.

    If diet is humanity’s number one killer, then, obviously, nutrition is the number one subject taught in medical school, right? Sadly, “medical students around the world [are] poorly trained in nutrition.” It isn’t that medical students aren’t interested in learning about it. In fact, “interest in nutrition was ‘uniformly high’ among medical students,” but medical schools just aren’t teaching it. “Without a solid foundation of clinical nutrition knowledge and skills, physicians worldwide are generally not equipped to even begin to have an informed nutrition conversation with their patients….”

    How bad is it? One study, “Assessing the clinical nutrition knowledge of medical doctors,” found the majority of participants got 70 percent of the questions wrong—and they were multiple choice questions, so they should have gotten about a fifth of them right just by chance. “Wrong answers in the…knowledge test were not limited to difficult or demanding questions” either. For example, less than half of the doctors were able to guess how many calories are in fat, carbohydrates, and protein; only one in ten knew the recommended protein intake; and only about one in three knew what a healthy body mass index (BMI) was. We’re talking about really basic nutrition knowledge.

    Even worse, not only did the majority of medical doctors get a failing grade, but 30 percent of those who failed had “a high self-perception of their CN [clinical nutrition] expertise.” They weren’t only clueless about nutrition; they were clueless that they were clueless about nutrition, a particularly bad combination given that doctors are “trusted and influential sources” of healthy eating advice. “For those consumers who get information from their personal healthcare professional, 78% indicate making a change in their eating habits as a result of those conversations.” So, if the doctor got everything they know from some article in a magazine while waiting in the grocery store checkout aisle, that’s what the patients will be following.

    Of doctors surveyed, “only 25% correctly identified the American Heart Association recommended number of fruit and vegetable servings per day, and fewer still (20%) were aware of the recommended daily added sugar limit for adults.” So how are they going to counsel their patients? And get ready for this: Of the doctors who perceived themselves as having high nutrition knowledge, 93 percent couldn’t answer those two basic multiple-choice questions, as seen here and at 2:39 in my video.

    “Physicians with no genuine expertise in, say, neurosurgery [brain surgery] are neither likely to broadcast detailed opinions on that topic nor to have their ‘expert’ opinions solicited by the media. Most topical domains in medicine enjoy such respect: we defer expert opinion and commentary to actual experts. Not so nutrition, where the common knowledge that physicians are generally ill-trained in this area is conjoined to routine invitations to physicians for their expert opinions on the matter. All too many are willing to provide theirs, absent any basis for actual expertise…” Or worse, they’re “often made on the basis of native bias and personal preference, at times directly tethered to personal gain—such as diet book sales—and so arises yet another ethical challenge.” That’s one of the reasons all the proceeds I receive from my books are donated directly to charity. I don’t want even the appearance of any conflicts of interest.

    “In a culture that routinely fails to distinguish expertise from mere opinion or personal anecdote, we physicians should be doing all we can to establish relevant barriers to entry for expert opinion in this [diet and nutrition], as in all other matters of genuine medical significance.” I mean, we aren’t talking celebrity gossip. Lives are at stake. “Entire industries are devoted to marketing messages that may conspire directly against well-informed medical advice in this area.”

    “Medical education must be brought up to date. For physicians to be ill-trained in the very area most impactful on the rate of premature death at the population level is an absurd anachronism….The mission of medicine is to protect, defend, and advance the human condition. That mission cannot be fulfilled if the diet is neglected.”

    A possible starting place? “Physicians and health care organizations can collectively begin to emphasize their seriousness about nutrition in health care by practicing what they (theoretically) preach. Is it appropriate to serve pizza and soft drinks at a resident conference while bemoaning the high prevalence of obesity and encouraging patients to eat healthier? A similarly poor example exists in medical conferences, including national meetings, where some morning sessions are accompanied by foods such as donuts and sausage.”



    Source link

  • Fiber or Low FODMAP for SIBO? 

    Fiber or Low FODMAP for SIBO? 

    It may not be the number of bacteria growing in our small intestine, but the type of bacteria, which can be corrected with diet.

    When researchers tested more than a thousand patients suffering for longer than six months from symptoms typical with irritable bowel syndrome (IBS), such as excess gas, bloating, diarrhea, and abdominal pain, but who do not appear to have anything more serious going on, like inflammatory bowel disease, a significant percentage were found to be suffering from lactose intolerance—intolerance to the milk sugar lactose. In infancy, we have an enzyme called lactase in our small intestine that digests milk sugar, but, understandably, most of us lose it after weaning. “Although genetic mutation has led to persistence of lactase in adults, about 75% of the world’s population malabsorbs lactose after age 30” and have lactose intolerance. However, a third of the patients were diagnosed with small intestinal bacterial overgrowth (SIBO).

    “The evidence for SIBO and IBS is shrouded in controversy, predominantly because of the fact that the [breath] tests used in clinical practice to diagnose SIBO are not valid,” as I’ve explored before. As well, the implications of having more versus fewer bacteria growing in the small intestine are unclear since the number doesn’t seem to correlate with the symptoms. It turns out it isn’t the number of bugs growing in the small intestine, but the type of bugs. So, it’s “small intestinal microbial dysbiosis”—not overgrowth in general, but the wrong kind of growth—that appears to underlie symptoms associated with functional gastrointestinal disorders, like IBS.

    How can we prevent this from happening? The symptoms appear to be correlated with a significant drop in the number of Prevotella. Remember them? Prevotella are healthy fiber feeders, “suggestive of a higher fiber intake in healthy individuals,” while the bugs found more in symptomatic patients ate sugar, which “may reflect a higher dietary intake of simple sugars.” However, correlation doesn’t mean causation. To prove cause and effect, we have to put it to the test, which is exactly what researchers did.

    “Switching a group of healthy individuals who habitually ate a high­-fibre diet (>11g per 1,000 calories) to a low­-fibre diet (was the type of bacteria growing, as you can see below, and at 3:12 in my video Fiber vs. Low FODMAP for SIBO Symptoms.

    No wonder their guts got leaky. Levels of short-chain fatty acids plummeted. Those are the magical by-products our good gut bugs make from fiber, which “play an important role in epithelial [intestinal] barrier integrity,” meaning they keep our gut from getting leaky.

    So, while we don’t have sound data to suggest that something like a low FODMAP diet has any benefit for patients with SIBO symptoms, there have been more than a dozen randomized controlled trials that have put fiber to the test. Overall, researchers found there was a significant improvement in symptoms among those randomized to increase their fiber intake. That may help explain why “high-fiber, plant-based diets can prevent many diseases common in industrialized societies.” Such diets have this effect “on the composition and metabolic activity of the colonic microbiota.” Our good gut bugs take plant residues like fiber and produce “health-promoting and cancer-suppressing metabolites” like short-chain fatty acids, which have profound anti-inflammatory properties. “All the evidence points to a physiological need for ~50 g fiber per day, which is the amount contained in the traditional African diet and associated with the prevention of westernized diseases.” That is approximately twice the typical recommendation and three times more than what most people get on a daily basis. Perhaps it should be no surprise that we need so much. Even though we split from chimpanzees millions of years ago, “there is still broad congruency” in the composition of our respective microbiomes to this day. While they’re still eating their 98 to 99 percent plant-based diets to feed their friendly flora with fiber, we’ve largely removed fiber-rich foods from our food supply. 



    Source link

  • The Validity of SIBO Tests 

    The Validity of SIBO Tests 

    Even if we could accurately diagnose small intestinal bacterial overgrowth (SIBO), if there is no difference in symptoms between those testing positive and those testing negative, what’s the point?

    Gastrointestinal symptoms like abdominal pain and bloating account for millions of doctor visits every year. One of the conditions that may be considered for such a “nonspecific presentation” of symptoms is SIBO, a concept that “has gained popularity on the internet in addition to certain clinical and research circles.” SIBO is “broadly defined as excessive bacteria in the small intestine” and typically treated with antibiotics, but “dispensing antibiotics to patients with the nonspecific, common symptoms associated with SIBO is not without risks,” such as the fostering of antibiotic resistance, the emergence of side effects, and the elimination of our good bacteria that could set us up for an invasion of bad bugs like C. diff—all for a condition that may not even be real.

    Even alternative medicine journals admit that SIBO is being overdiagnosed, creating “confusion and fear.” SIBO testing “is overused and overly relied upon. Diagnoses are often handed out quickly and without adequate substantiation. Patients can be indoctrinated into thinking SIBO is a chronic condition that can not be cleared and will require lifelong management. This is simply not true for most and is an example of the damage done by overzealousness.” “The ‘monster’ that we now perceive SIBO to be may be no more than a phantom.”

    The traditional method for a diagnosis was a small bowel aspiration, an invasive test where a long tube is snaked down the throat to take a sample and count the bugs down there, as you can see at 2:10 in my video Are Small Intestinal Bacterial Overgrowth (SIBO) Tests Valid?.

    This method has been almost entirely replaced with breath tests. Normally, a sugar called glucose is almost entirely absorbed in the small intestine, so it never makes it down to the colon. So, the presence of bacterial fermentation of that sugar suggests there are bacteria in the small intestine. Fermentation can be detected because the bacteria produce specific gases that get absorbed in our bloodstream before being exhaled from our lungs, which can then be detected with a breathalyzer-type machine.

    Previously, the sugar lactulose was used, but “lactulose breath tests do not reliably detect the overgrowth of bacteria,” so researchers switched to glucose. However, when glucose was finally put to the test, it didn’t work. The bacterial load in the small intestine was similar for those testing positive or negative, so that wasn’t a useful test either. It turns out that glucose can make it down to the colon after all.

    Researchers labeled the glucose dose with a tracer and found that nearly half of the positive results from glucose breath tests were false positives because individuals were just fermenting it down in their colon, where our bacteria are supposed to be. So, “patients who are incorrectly labeled with SIBO may be prescribed multiple courses of antibiotics” for a condition they don’t even have.

    Why do experts continue to recommend breath testing? Could it be because the “experts” were at a conference supported by a breath testing company, and most had personally received funds from SIBO testing or antibiotic companies?

    Even if we could properly diagnose SIBO, does it matter? For those with digestive symptoms, there is a massive range of positivity for SIBO from approximately 4 percent to 84 percent. Researchers “found there to be no difference in overall symptom scores between those testing positive against those testing negative for SIBO…” So, a positive test result could mean anything. Who cares if some people have bacteria growing in their small intestines if it doesn’t correlate with symptoms?

    Now, antibiotics can make people with irritable bowel-type symptoms who have been diagnosed with SIBO feel better. Does that prove SIBO was the cause? No, because antibiotics can make just as many people feel better who are negative for SIBO. Currently, the antibiotic rifaximin is most often used for SIBO, but it is “not currently FDA-approved for use in this indication, and its cost can be prohibitive.” (The FDA is the U.S. Food and Drug Administration.) In fact, no drug has been approved for SIBO in the United States or Europe, so even with good insurance, it may cost as much as $50 a day in out-of-pocket expenses, and the course is typically two weeks.

    What’s more, while antibiotics may help in the short term, they may make matters worse in the long term. Those “who are given a course of antibiotics are more than three times as likely to report more bowel symptoms 4 months later than controls.” So, what can we do for these kinds of symptoms? That’s exactly what I’m going to turn to next.



    Source link

  • Preventing Hair Loss and Promoting Hair Growth

    Preventing Hair Loss and Promoting Hair Growth

    In every grade school class photo, I seem to have a mess of tousled hair on my head. No matter how much my mom tried to tame my hair, it was a little unruly. (I sported the windblown look without even trying.) Later came my metalhead phase, with headbangable hair down to the middle of my back. Sadly, though, like many of the men in my family, it started to thin, then disappear. Studies show that by age 50, approximately half of men and women will experience hair loss. Why do some lose their hair and others don’t? How can we preserve the looks of our locks?

     

    What Causes Hair Loss?

    As I discuss in my video Supplements for Hair Growth, we don’t lose our hair by washing or brushing it too much––two of the many myths out there. The majority of hair loss with age is genetic for both women and men. Based on twin studies, the heritability of baldness in men is 79%, meaning about 80% of the differences in hair loss between men is genetically determined, but that leaves some wiggle room.

    Look at identical twins, for instance: Identical twin sisters with the same DNA had different amounts of hair loss, thanks to increased stress, increased smoking, having more children, or having a history of high blood pressure or cancer.

    Indeed, smoking can contribute to the development of both male and female pattern baldness because the genotoxic compounds in cigarettes may damage the DNA in our hair follicles and cause microvascular poisoning in their base.

    Other toxic agents associated with hair loss include mercury; it seems to concentrate about 250-fold in growing scalp hair. William Shakespeare may have started losing his hair due to mercury poisoning from syphilis treatment. Thankfully, doctors don’t give their patients mercury anymore. These days, as the Centers for Disease Control and Prevention point out, mercury mainly enters the body through seafood consumption.

    Consider this: A woman went to her physician, concerned about her hair loss. Blood tests indicated elevated mercury levels, which makes sense as her diet was high in tuna. When she stopped eating tuna, her mercury levels fell and her hair started to grow back within two months. After seven months on a fish-free diet, her hair completely regrew. Doctors should consider screening for mercury toxicity when they see hair loss.

     

    How to Prevent Hair Loss

    In addition to not smoking, managing our stress, and avoiding seafood, is there anything else we can do to prevent hair loss?

    We can make sure we don’t have scurvy, severe vitamin C deficiency. We’ve known for centuries that scurvy can cause hair loss, but once we have enough vitamin C so our gums aren’t bleeding, there are no data correlating vitamin C levels and hair loss. So, make sure you have a certain baseline sufficiency.

     

    Foods for Our Hair

    What about foods for hair loss? What role might diet play in the treatment of hair loss?

    As I discuss in my video Food for Hair Growth, population studies have found that male pattern baldness is associated with poor sleeping habits and the consumption of meat and junk food, whereas protective associations were found for the consumption of raw vegetables, fresh herbs, and soy milk. Drinking soy beverages on a weekly basis was associated with 62% lower odds of moderate to severe hair loss, raising the possibility that there may be compounds in plants that may be protective.

    A randomized, double-blind, placebo-controlled study of compounds in hot peppers and soy found significantly higher promotion of hair growth, and the doses used were reasonable: 6 milligrams of capsaicin a day and 75 milligrams of isoflavones. How does that translate into actual food? We can get 6 milligrams of capsaicin in just a quarter of a fresh jalapeño pepper a day and 75 milligrams of isoflavones eating just three-quarter cup of tempeh or soybeans.

    Researchers also investigated pumpkin seeds and hair loss. For a few months, 76 men with male pattern baldness received 400 milligrams of pumpkin seed oil a day hidden in capsules (the equivalent of eating about two and a half pumpkin seeds a day) or took placebo capsules. After 24 weeks of treatment, self-rated improvement and satisfaction scores in the pumpkin group were higher, and they objectively had more hair—a 40% increase in hair counts, compared to only 10% in the placebo group. In the pumpkin group, 95% remained either unchanged or improved, whereas in the control group, more than 90% remained unchanged or worsened. Given such a pronounced effect, there was concern about sexual side effects, but researchers looked before and after at an index of erectile dysfunction and found no evidence of adverse effects.

    graph showing effects positive effects of pumpkin seed oil consumption on hair growth

     

    The Best Vitamin for Hair Growth?

    The most common ingredient in top-selling hair loss products is vitamin B7, also known as biotin. Biotin deficiency causes hair loss, but there are no evidence-based data that supplementing biotin promotes hair growth. And severe biotin deficiency in healthy individuals eating a normal diet has never been reported. However, if you eat raw egg whites, you can acquire a biotin deficiency, since there are compounds that attach to biotin and prevent it from being absorbed. Other than rare deficiency syndromes, though, it’s a myth that biotin supplements increase hair growth.

    Can we just adopt the attitude that it can’t hurt, so we might as well see if it helps? No, because there is a lack of regulatory oversight of the supplement industry and, in the case of biotin, interference with lab tests. Many dietary supplements promoted for hair health contain biotin levels up to 650 times the recommended daily intake of biotin. And excess biotin in the blood can play haywire on a bunch of different blood tests, including thyroid function, other hormone tests (including pregnancy), and the test performed to determine if you’ve had a heart attack––so it could potentially even be life or death.

     

    Do Hair Growth Pills Really Work?

    What about drugs? We only have good evidence for efficacy for the two drugs approved by the U.S. Food and Drug Administration: finasteride, sold as Propecia, and minoxidil, sold as Rogaine. It’s considered a myth that all the patented hair-loss supplements on the market will increase hair growth. And they may actually be more expensive, with over-the-counter supplement regimens costing up to more than $1,000 a year, whereas the drugs may cost only $100 to $300 a year. As I discuss in my video Pills for Hair Growth, the drugs can help, but they can also cause side effects. Propecia can diminish libido, cause sexual disfunction, and have been associated with impotence, testicular pain, and breast enlargement, while the topical Minoxidil can cause itching, for example.

    How do they work (if they work at all)? Androgens are the principal drivers of hair growth in both men and women. Testosterone is the primary androgen circulating in the blood, and it can be converted to dihydrotestosterone, which is even more powerful, by an enzyme called 5-alpha reductase. That’s the enzyme that is blocked by Propecia, so it inhibits the souping up of testosterone. This is why pre-menopausal women are not supposed to take it, since it could feminize male fetuses, whereas for men, it has sexual side effects like erectile dysfunction, which can affect men for years even after stopping the medication and may even be permanent. Indeed, up to 20% of people reporting persistent sexual dysfunction for six or more years after stopping the drug, suggesting the possibility that it may never go away.

     

    Pass on the Pills and Reach for a Fork

    Given the side effects of the current drug options, I encourage you to incorporate hair-friendly foods in your daily routine.



    Source link

  • PCOS | Dietitian Connection

    PCOS | Dietitian Connection


    PCOS is one of the most common hormonal conditions affecting women, yet it often goes undiagnosed or misunderstood. So, what does the evidence really say, and how can dietitians best support clients living with PCOS?

    In this episode of the Dietitian Connection Podcast, Dr Stephanie Pirotta – dietitian, researcher and founder of Womanly Nutrition and Dietetics – unpacks the latest research and shares practical strategies you can apply in clinic.

    Hosted by Brooke Delfino

    Biography

    Dr Stephanie Pirotta is an APD and adjunct research fellow at Monash University, Melbourne, Australia. Her work focuses on women’s health lifestyle management, with particular interest in PCOS, infertility and chronic pelvic pain. Alongside her research, Steph works clinically as the founder and lead dietitian at Womanly Nutrition and Dietetics where she translates the latest nutrition research into clinical practice for people with PCOS, chronic pelvic pain, infertility, pregnancy and postpartum, perimenopause and eating disorders. 

     

    In this episode, we discuss:

    • The challenges of diagnosing PCOS
    • Myths and misconceptions to address with clients
    • PCOS, fertility and reproductive outcomes
    • Dietary and lifestyle strategies that make a difference
    • The role of weight-inclusive care

    Additional resources

    • Connect with Stephanie at Womanly Nutrition and Dietetics or on Instagram @womanly_nd

    • Click here to catch up on our 2025 Women’s Health Symposium ‘From PCOS to peri – Women’s health across the life stages’

    • Click here to learn more about how to support Jean Hailes Women’s Health Week (1-5 Sept, 2025)

    • Click here to learn about Nutrition Therapy for Pregnancy by the Early Life Nutrition Alliance.

    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.


    Source link
  • Do Fruits and Vegetables Boost Our Mood? 

    Do Fruits and Vegetables Boost Our Mood? 

    A randomized controlled trial investigates diet and psychological well-being.

    “Psychological health can be broadly conceptualized as comprising 2 key components: mental health (i.e., the presence of absence of mental health disorders such as depression) and psychological well-being (i.e., a positive psychological state, which is more than the absence of a mental health disorder,” and that is the focus of an “emerging field of positive psychology [that] focuses on the positive facts of life, including happiness, life satisfaction, personal strengths, and flourishing.” This may translate to physical “benefits of enhanced well-being, including improvements in blood pressure, immune competence, longevity, career success, and satisfaction with personal relationships.”

    What is “The Contribution of Food Consumption to Well-Being,” the title of an article in Annals of Nutrition & Metabolism? Studies have “linked the consumption of fruits and vegetables with enhanced well-being.” A systematic review of research found evidence that fruit and vegetable intake “was associated with increased psychological well-being.” Only an association?

    There is “a famous criticism in this area of research—namely, that deep-down personality or family upbringing might lead people simultaneously to eat in a healthy way and also to have better mental well-being, so that diet is then merely correlated with, but incorrectly gives the appearance of helping to cause, the level of well-being.” However, recent research circumvented this problem by examining if “changes in diet are correlated with changes in mental well-being”—in effect, studying the “Evolution of Well-Being and Happiness After Increases in Consumption of Fruit and Vegetables.” As you can see below and at 1:37 in my video Fruits and Vegetables Put to the Test for Boosting Mood, as individuals began eating more fruits and veggies, there was a straight-line increase in their change in life satisfaction over time.

    “Increased fruit and vegetable consumption was predictive of increased happiness, life satisfaction, and well-being. They were up to 0.24 life-satisfaction points (for an increase of 8 portions a day), which is equal in size to the psychological gain of going from unemployment to employment.” (My Daily Dozen recommendation is for at least nine servings of fruits and veggies a day.)

    That study was done in Australia. It was repeated in the United Kingdom, and researchers found the same results, though Brits may need to bump up their daily minimum consumption of fruits and vegetables to more like 10 or 11 servings a day.

    As researchers asked in the title of their paper, “Does eating fruit and vegetables also reduce the longitudinal risk of depression and anxiety?” Improved well-being is nice, but “governments and medical authorities are often interested in the determinants of major mental ill-health conditions, such as depression and high levels of anxiety, and not solely in a more typical citizen’s level of well-being”—for instance, not just life satisfaction. And, indeed, using the same dataset but instead looking for mental illness, researchers found that “eating fruit and vegetables may help to protect against future risk of clinical depression and anxiety,” as well.

    A systematic review and meta-analysis of dozens of studies found “an inverse linear association between fruit or vegetable intake and risk of depression, such that every 100-gram increased intake of fruit was associated with a 3% reduced risk of depression,” about half an apple. Yet, “less than 10% of most Western populations consume adequate levels of whole fruits and dietary fiber, with typical intake being about half of the recommended levels.” Maybe the problem is we’re just telling people about the long-term benefits of fruit intake for chronic disease prevention, rather than the near-immediate improvements in well-being. Maybe we should be advertising the “happiness’ gains.” Perhaps, but we first need to make sure they’re real.

    We’ve been talking about associations. Yes, “a healthy diet may reduce the risk of future depression or anxiety, but being diagnosed with depression or anxiety today could also lead to lower fruit and vegetable intake in the future.” Now, in these studies, we can indeed show that the increase in fruit and vegetable consumption came first, and not the other way around, but as the great enlightenment philosopher David Hume pointed out, just because the rooster crows before the dawn doesn’t mean the rooster caused the sun to rise.

    To prove cause and effect, we need to put it to the test with an interventional study. Unfortunately, to date, many studies have compared fruit to chocolate and chips, for instance. Indeed, study participants randomized to eat fruit showed significant improvements in anxiety, depression, fatigue, and emotional distress, which is amazing, but that was compared to chocolate and potato chips, as you can see below and at 4:26 in my video. Apples, clementines, and bananas making people feel better than assorted potato chips and chunky chocolate wafers is not exactly a revelation.

    This is the kind of study I’ve been waiting for: a randomized controlled trial in which young adults were randomized to one of three groups—a diet-as-usual group, a group encouraged to eat more fruits and vegetables, or a third group given two servings of fruits and vegetables a day to eat in addition to their regular diet. Those in the third group “showed improvements to their psychological well-being with increases in vitality, flourishing, and motivation” within just two weeks. However, simply educating people to eat their fruits and vegetables may not be enough to reap the full rewards, so perhaps greater emphasis needs to be placed on providing people with fresh produce—for example, offering free fruit for people when they shop. I know that would certainly make me happy!



    Source link

  • Taking Advantage of Sensory-Specific Satiety 

    Taking Advantage of Sensory-Specific Satiety 

    How can we use sensory-specific satiety to our advantage?

    When we eat the same foods over and over, we become habituated to them and end up liking them less. That’s why the “10th bite of chocolate, for example, is desired less than the first bite.” We have a built-in biological drive to keep changing up our foods so we’ll be more likely to hit all our nutritional requirements. The drive is so powerful that even “imagined consumption reduces actual consumption.” When study participants imagined again and again that they were eating cheese and were then given actual cheese, they ate less of it than those who repeatedly imagined eating that food fewer times, imagined eating a different food (such as candy), or did not imagine eating the food at all.

    Ironically, habituation may be one of the reasons fad “mono diets,” like the cabbage soup diet, the oatmeal diet, or meal replacement shakes, can actually result in better adherence and lower hunger ratings compared to less restrictive diets.

    In the landmark study “A Satiety Index of Common Foods,” in which dozens of foods were put to the test, boiled potatoes were found to be the most satiating food. Two hundred and forty calories of boiled potatoes were found to be more satisfying in terms of quelling hunger than the same number of calories of any other food tested. In fact, no other food even came close, as you can see below and at 1:14 in my video Exploiting Sensory-Specific Satiety for Weight Loss.

    No doubt the low calorie density of potatoes plays a role. In order to consume 240 calories, nearly one pound of potatoes must be eaten, compared to just a few cookies, and even more apples, grapes, and oranges must be consumed. Each fruit was about 40 percent less satiating than potatoes, though, as shown here and at 1:45 in my video. So, an all-potato diet would probably take the gold—the Yukon gold—for the most bland, monotonous, and satiating diet.

    A mono diet, where only one food is eaten, is the poster child for unsustainability—and thank goodness for that. Over time, they can lead to serious nutrient deficiencies, such as blindness from vitamin A deficiency in the case of white potatoes.

    The satiating power of potatoes can still be brought to bear, though. Boiled potatoes beat out rice and pasta in terms of a satiating side dish, cutting as many as about 200 calories of intake off a meal. Compared to boiled and mashed potatoes, fried french fries or even baked fries do not appear to have the same satiating impact.

    To exploit habituation for weight loss while maintaining nutrient abundance, we could limit the variety of unhealthy foods we eat while expanding the variety of healthy foods. In that way, we can simultaneously take advantage of the appetite-suppressing effects of monotony while diversifying our fruit and vegetable portfolio. Studies have shown that a greater variety of calorie-dense foods, like sweets and snacks, is associated with excess body fat, but a greater variety of vegetables appears protective. When presented with a greater variety of fruit, offered a greater variety of vegetables, or given a greater variety of vegetable seasonings, people may consume a greater quantity, crowding out less healthy options.

    The first 20 years of the official Dietary Guidelines for Americans recommended generally eating “a variety of foods.” In the new millennium, they started getting more precise, specifying a diversity of healthier foods, as seen below and at 3:30 in my video. 

    A pair of Harvard and New York University dietitians concluded in their paper “Dietary Variety: An Overlooked Strategy for Obesity and Chronic Disease Control”: “Choose and prepare a greater variety of plant-based foods,” recognizing that a greater variety of less healthy options could be counterproductive.

    So, how can we respond to industry attempts to lure us into temptation by turning our natural biological drives against us? Should we never eat really delicious food? No, but it may help to recognize the effects hyperpalatable foods can have on hijacking our appetites and undermining our body’s better judgment. We can also use some of those same primitive impulses to our advantage by minimizing our choices of the bad and diversifying our choices of the good. In How Not to Diet, I call this “Meatball Monotony and Veggie Variety.” Try picking out a new fruit or vegetable every time you shop.

    In my own family’s home, we always have a wide array of healthy snacks on hand to entice the finickiest of tastes. The contrasting collage of colors and shapes in fruit baskets and vegetable platters beat out boring bowls of a single fruit because they make you want to mix it up and try a little of each. And with different healthy dipping sauces, the possibilities are endless.



    Source link

  • Dietary Diversity and Overeating 

    Dietary Diversity and Overeating 

    Big Food uses our hard-wired drive for dietary diversity against us.

    How did we evolve to solve the daunting task of selecting a diet that supplies all the essential nutrients? Dietary diversity. By eating a variety of foods, we increase our chances of hitting all the bases. If we only ate for pleasure, we might just stick with our favorite food to the exclusion of all others, but we have an innate tendency to switch things up.

    Researchers found that study participants ended up eating more calories when provided with three different yogurt flavors than just one, even if that one is the chosen favorite. So, variation can trump sensation. They don’t call it the spice of life for nothing.

    It appears to be something we’re born with. Studies on newly weaned infants dating back nearly a century show that babies naturally choose a variety of foods even over their preferred food. This tendency seems to be driven by a phenomenon known as sensory-specific satiety.

    Researchers found that, “within 2 minutes after eating the test meal, the pleasantness of the taste, smell, texture, and appearance of the eaten food decreased significantly more than for the uneaten foods.” Think about how the first bite of chocolate tastes better than the last bite. Our body tires of the same sensations and seeks out novelty by rekindling our appetite every time we’re presented with new foods. This helps explain the “dessert effect,” where we can be stuffed to the gills but gain a second wind when dessert arrives. What was adaptive for our ancient ancestors to maintain nutritional adequacy may be maladaptive in the age of obesity.

    When study participants ate a “varied four-course meal,” they consumed 60 percent more calories than those given the same food for each course. It’s not only that we get bored; our body has a different physiological reaction.

    As you can see below and at 2:13 in my video How Variation Can Trump Sensation and Lead to Overeating, researchers gave people a squirt of lemon juice, and their salivary glands responded with a squirt of saliva. But when they were given lemon juice ten times in a row, they salivated less and less each time. When they got the same amount of lime juice, though, their salivation jumped right back up. We’re hard-wired to respond differently to new foods. 
    Whether foods are on the same plate, are at the same meal, or are even eaten on subsequent days, the greater the variety, the more we tend to eat. When kids had the same mac and cheese dinner five days in a row, they ended up eating hundreds fewer calories by the fifth day, compared to kids who got a variety of different meals, as you can see below and at 2:35 in my video.

    Even just switching the shape of food can lead to overeating. When kids had a second bowl of mac and cheese, they ate significantly more when the noodles were changed from elbow macaroni to spirals. People allegedly eat up to 77 percent more M&Ms if they’re presented with ten different colors instead of seven, even though all the colors taste the same. “Thus, it is clear that the greater the differences between foods, the greater the enhancement of intake,” the greater the effect. Alternating between sweet and savory foods can have a particularly appetite-stimulating effect. Do you see how, in this way, adding a diet soda, for instance, to a fast-food meal can lead to overconsumption?

    The staggering array of modern food choices may be one of the factors conspiring to undermine our appetite control. There are now tens of thousands of different foods being sold.

    The so-called supermarket diet is one of the most successful ways to make rats fat. Researchers tried high-calorie food pellets, but the rats just ate less to compensate. So, they “therefore used a more extreme diet…[and] fed rats an assortment of palatable foods purchased at a nearby supermarket,” including such fare as cookies, candy, bacon, and cheese, and the animals ballooned. The human equivalent to maximize experimental weight gain has been dubbed the cafeteria diet.

    It’s kind of the opposite of the original food dispensing device I’ve talked about before. Instead of all-you-can-eat bland liquid, researchers offered free all-you-can-eat access to elaborate vending machines stocked with 40 trays with a dizzying array of foods, like pastries and French fries. Participants found it impossible to maintain energy balance, consistently consuming more than 120 percent of their calorie requirements.

    Our understanding of sensory-specific satiety can be used to help people gain weight, but how can we use it to our advantage? For example, would limiting the variety of unhealthy snacks help people lose weight? Two randomized controlled trials made the attempt and failed to show significantly more weight loss in the reduced variety diet, but they also failed to get people to make much of a dent in their diets. Just cutting down on one or two snack types seems insufficient to make much of a difference, as seen below and at 4:44 in my video. A more drastic change may be needed, which we’ll cover next.



    Source link

  • Inspiring action on the many faces of malnutrition

    Inspiring action on the many faces of malnutrition


    Malnutrition Week ANZ is almost here, with the theme “The many faces of malnutrition”. This campaign reminds us that malnutrition can affect anyone, at any age, in any setting. In this episode, Nadia Obeid, Senior Dietitian at Northern Health, shares how her team turned Malnutrition Week into an organisation-wide movement. From embedding screening into practice to engaging families, nurses, pharmacy and even the CEO, Northern Health’s approach shows what’s possible when collaboration and leadership come together.

    Hosted by Bec Sparrowhawk

    Biography

    Nadia Obeid is a clinical dietitian at Northern Health in Victoria. She has over 15 years’ experience specialising in malnutrition and renal nutrition care. She has led numerous quality and research activities focusing on improving malnutrition screening and management practices across her organisation, including annual malnutrition prevalence studies and malnutrition coding analysis studies. She is passionate about collaborating with other disciplines in quality improvement work and developing staff learning and training resources to improve malnutrition screening, diagnosis and management in her organisation.

     

    In this episode, we discuss:

    • The most impactful awareness activities across Northern Health throughout the years

    • Practical ways to improve consistency of malnutrition screening

    • How audits and research have influenced real change in the organisation

    • Top tips for organisations wanting to take part in Malnutrition Week ANZ this year

    Additional resources

    • Click here to learn about Malnutrition Week ANZ and to access a variety of free resources

    • Can connect with Nadia on any of the Northern Health Malnutrition Week initiatives at [email protected]

    The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.


    Source link
  • Biological age tests: Should you get one?

    Biological age tests: Should you get one?

    If you’ve heard of billionaire Bryan Johnson, you’ve likely encountered the phrase “bio age testing.”

    Johnson, the subject of the Netflix documentary Don’t Die, says he’s on a quest to achieve the lowest possible “biological age” (also known as bio age).

    He reportedly spends millions each year on anti-aging treatments—dozens of daily supplements, weekly acid peels for his skin, injections to boost collagen production, hyperbaric oxygen therapy, and plasma infusions extracted from his 17-year-old son’s body.

    To determine what’s working, Johnson has undergone numerous tests to assess his bio age. Johnson says these tests show his age is now 5.1 years younger than when he embarked on his anti-aging quest.

    Apparently, he’s aging in reverse.

    Granted, not everyone’s buying it. A New York Times exposé, for example, claims Johnson’s biological age, in reality, has increased by 10 years.1

    Still, Johnson’s “don’t die” crusade is gaining traction.

    Bio age tests are a frequent topic on popular podcasts by Peter Attia, Joe Rogan, and Andrew Huberman. Google “bio age testing” and you’ll see dozens of ads for mail-order blood or urine testing kits that claim to reveal your biological age, pace of aging, and more. With prices tumbling into affordability, it’s natural to wonder…

    Should you or your client sign up for bio age testing?

    If so, which test is best? Just as importantly, what should you do with the information?

    In this story, you’ll learn:

    What is your bio age?

    Your biological age (bio age) refers to how your cells function. It’s not necessarily the same as your chronological age, which refers to the number of candles on your birthday cake.

    For example, let’s say Chang, a 50-year-old man, works at a desk, spends his free time in front of the TV, lives in the most polluted city in the world, eats a candy bar for lunch, and smokes. On the other hand, Jabari, a different 50-year-old man, hits the gym several times a week, lives in the mountains, doesn’t smoke, relishes his five servings of veggies a day, meditates, and spends most evenings in his garden.

    Genetics aside, you’d be wise to wager that Jabari’s bio age is younger than Chang’s.

    How do these tests measure bio age?

    Bio age testing kits measure one or more biological markers of aging, also known as biomarkers.

    For example, some tests focus on the size of your telomeres, the protective caps at the ends of chromosomes. Others measure DNA methylation, a physiological process that chemically alters DNA.

    Once a company isolates and measures these markers from your blood or urine, it plugs the bio data into a formula that calculates your bio age.

    However, if you see a doctor with any regularity, you’re likely already tracking some biomarkers of aging. For example, biomarkers such as blood pressure, cholesterol levels, and blood glucose can help predict your risk of future cardiovascular disease, a leading cause of premature death.

    What’s the point of biomarker testing?

    Biomarker testing can help you monitor your wellness proactively rather than waiting for disease symptoms to appear.

    For some, it also serves as a motivator. If you learn you have the bones of someone 20 years older, this may give you the nudge you need to start strength training consistently.

    In addition, biomarkers provide objective data, allowing you to track and evaluate various health-related actions quantitatively. By monitoring your blood pressure, you might learn that consistent exercise helps, but your late-afternoon energy drink does the opposite.

    5 FREE biomarker tests

    You don’t have to be a billionaire (or even a millionaire) to track biomarkers of aging.

    In this section, we’ll cover several massively underappreciated, scientifically validated tests you can use to gain insight into your bio age—for FREE.

    Before scientists developed high-tech blood-based bio age tests, researchers used these free tests to calculate the pace of aging in the people they studied.

    FREE biomarker test #1: Get off the floor

    People who are fitter and stronger tend to live longer.2

    That’s because muscles do more than just move us around. They also secrete anti-inflammatory substances, help to regulate blood sugar, slow cellular aging, protect the lining of the arteries, and more. All this helps reduce the risk of age-related diseases, such as type 2 diabetes, high blood pressure, and heart disease, a phenomenon we explore in our article, The New Science of Muscle.

    Related to strength, your ability to balance is also key. If you’re middle-aged or older and can’t stand on one foot for at least 10 seconds, your risk of dying in the next seven years is double that of someone who can stand for longer, according to a study of 1,700 people.3

    The Sitting-Rising Test (SRT) is one way to assess both strength and balance at the same time.

    People with low scores on this test have a higher risk of dying from cardiovascular disease, according to a 12-year study of 4,200 adults between the ages of 46 and 75.4

    ▶ How to measure it

    Lower yourself to the floor with your legs in a crisscross position. Then, with your legs in the same position, stand back up. As you stand, notice if you must use a part of your body—hand, shin, knee—as leverage.

    To score yourself, start with 10 points. Then, for each body part you used to stand, deduct a point. Subtract a half point if you became unsteady or lost your balance.

    Keep in mind that this (and other tests) serve as a proxy for your fitness. A low score indicates that your balance and coordination, muscle strength and power, and mobility may all require some attention.

    FREE biomarker test #2: Squeeze a ball

    Like the SRT test, your grip strength provides insight into your overall fitness. If the muscles in your hands are weak, the muscles throughout your body are more likely to be weak, too.

    Poor grip strength can also predict future muscle weakness. In one study, people with a weak grip were more likely to walk slowly and be unable to rise from a chair, complete rigorous housework, or climb a flight of steps 25 years later.5

    Low grip strength has also been associated with:6

    • Low bone mineral density
    • Increased risk of falls
    • Poor nutritional status
    • Depression
    • Poor sleep, cognitive function, and/or quality of life
    • Increased risk of heart disease, cancer, and premature mortality

    According to one study, grip strength was a better indicator of longevity (or lack thereof) than blood pressure.7

    ▶ How to measure it

    Grab a standard tennis ball, and squeeze as hard as you can, for as long as you can.

    If you can manage 15 to 30 seconds before your grip fatigues, you’re doing fine. Ninety seconds puts you well above average—anything over 90 ranks you solidly in the upper-third percentile.

    If you’re below 15, keep in mind that this test is also just one indicator of your overall strength. (And squeezing balls to improve grip strength without training the rest of your body is unlikely to make significant improvements in your overall health and fitness.)

    A hand-held dynamometer—available for use at most occupational therapists’ and some gyms—can also test grip strength. (If you’re willing to shell out some cash, you can buy your own for somewhere between $100 and $500.)

    FREE biomarker test #3: Stand on one foot

    An ability to balance on one foot for an extended period can help reduce your risk of falls, one of the leading causes of injury-related death among older adults.

    In addition, many different bodily systems—the eyes, inner ear, skeletal muscles, and brain—must work together to help you stay upright.

    Conditions like diabetes, heart disease, and cancer can all affect balance. As a result, an inability to stand on one foot can serve as a warning sign for eroding health and fitness.8

    ▶ How to measure it

    Stand near a wall or chair for safety. Keep your eyes open and hands on your hips. Then, lift your dominant leg and start timing yourself. Once you put your foot down, stop the clock. Repeat the test with your non-dominant leg.

    Once you have your times, compare them to the following averages, from a study out of Duke University, to see how you did compared to your age-matched peers.9

    Age Seconds on one leg (males) Seconds on one leg (females)
    30-39 59 56
    40-49 56 55
    50-59 42 48
    60-69 40 38
    70-79 27 25
    80+ 13 11

    FREE biomarker test #4: How you feel

    Sometimes you know why you’re tired, such as the morning after binge-watching the last few episodes of a thriller. Once you catch up on your sleep, the weariness lifts.

    That’s not the same thing as fatigue, which describes persistent exhaustion that worsens over time and interferes with life. In addition to feeling physically tired, someone who’s fatigued feels mentally dull and emotionally exhausted.

    Think of fatigue as an early sign that something’s off, especially if you don’t know the cause.

    Let’s say you’ve already ruled out the usual suspects like too much caffeine, dehydration, too much alcohol, medication side effects, chronic stress, or too much or too little exercise. What’s left is likely a sleep disorder or a developing health problem such as anemia, obesity, depression, cancer, or diabetes, to name a few.

    If you’re 60 or older, fatiguability—or how worn out you feel after an activity—can also predict longevity.

    According to research out of the University of Pittsburgh Medical Center, the higher someone scores in fatiguability, the higher their risk of death in the future.10 Other research has linked high fatiguability with declines in gait speed, walking ability, and other tests of fitness.11

    ▶ How to measure it

    To measure fatigability, use a tool called the Pittsburgh Fatigability Scale. Using a 0 (no fatigue) to 5 (extreme fatigue) scale, rate how fatigued you think you would feel after completing the following activities:

    Activity Duration Score (0 to 5)
    Leisurely walking 30 minutes
    Brisk or fast walking 1 hour
    Light household activity 1 hour
    Heavy gardening or yard work 1 hour
    Watching television 2 hours
    Sitting quietly 1 hour
    Moderate-to-high intensity strength training 30 minutes
    Participating in a social activity 1 hour
    Hosting a social event for 60 minutes 1 hour
    High intensity activity 30 minutes
    Add all scores:

    If you score less than 15, you’re doing well. Scores between 15 and 24 are a warning sign. Anything 25 and above is regarded as severe, and worth mentioning to your healthcare professional.12

    FREE biomarker test #5: Body composition

    Despite popular belief, both too little and too much body fat can influence health for the worse, as we explore in our infographic, Is body fat good or bad for you?

    Too much fat raises the risk for: Too little muscle raises risk for:
    Heart disease Heart disease
    High blood pressure High blood pressure
    Cancer Cancer
    Fatty liver disease Stroke
    Insulin resistance Insulin resistance
    Type 2 diabetes Faster cellular aging
    Inflammation Inflammation
    Joint distress Depression and anxiety
    Sleep apnea Falls and loss of balance

    Your muscle mass also plays a role, which is why someone’s body composition matters more than their weight.

    The gold standard methods that estimate body composition—underwater weighing, air displacement (Bod Pod), and dual-energy X-ray absorptiometry (DEXA)—certainly aren’t free.

    However, a recent study determined that a good old-fashioned (and cheap) tape measure can provide a comparably accurate estimate of body composition.13

    ▶ How to measure it

    To use a tape measure to keep track of your body fat percentage, measure:

    • The widest part of your neck
    • The narrowest part of your waist (For some people, this will be at the navel. For others, it might be slightly above the navel)
    • The widest part of your hips

    Ensure the tape is snug but not so tight that it cuts into the skin. Once you have your measurements, plug those numbers—along with your age, sex, height, and weight—into our FREE Body Fat Calculator, which will take it from there.

    Doctor-approved biomarker tests

    Depending on where you live in the world, the following tests may not be free. However, as part of routine preventative care, your insurance might cover them.

    Doctor-approved test #1: Blood panel

    If your primary care doctor recommends yearly blood work, it’s for good reason.

    By keeping tabs on several blood markers, you can see if your health is trending toward type 2 diabetes or heart disease, both leading causes of premature mortality.

    Many blood markers can also be influenced relatively quickly (within 6 to 12 weeks) through lifestyle changes, supplement protocols, or medications. This makes them practical tools for monitoring whether various lifestyle or medical modifications are working.

    ▶ How to measure it

    If you’re not already doing so, consider having the following blood markers tested annually. Then, talk to your health care professional about what your numbers mean. They might use the following numbers, along with your blood pressure, to calculate a cardiovascular disease risk score.

    Blood marker Optimal range
    Total cholesterol
    LDL
    HDL > 60 mg/dL
    Triglycerides
    Alipoprotein B (Apo B)
    Lipoprotein (a)
    C-reactive protein
    Fasting glucose
    Hemoglobin A1C

    *Milligrams per deciliter of blood
    **Milligrams per liter

    Doctor-approved test #2: Bone density

    When researchers study healthy super-agers aged 90 and older, strong bones are one of their defining features.14

    That may be because, like muscles, bones are live organs that secrete substances that may be beneficial to overall health and longevity.15

    For example, bones secrete osteocalcin, a hormone that plays a role in bone remodeling. When osteocalcin circulates in the body, it’s thought to play a role in everything from helping muscles to produce ATP to regulating brain neurotransmitters.

    Because of these varied roles, it’s thought that, as bones wear away, osteocalcin levels drop, contributing to many age-related health problems, including diabetes, low muscle mass, and cognitive issues.16 17 (At least, that’s the theory. Most of this research has been done on mice.)

    Osteocalcin aside, loss of bone density can, of course, lead to fractures, which can increase your risk of death for up to 10 years after a break.18

    It’s especially important to keep tabs on bone health if you’re in any of these high-risk categories:

    • You’re female and went through menopause before age 45.
    • You’ve been sedentary most of your adult life.
    • You take medications such as diuretics or stomach-acid blockers, which are linked with an increased risk of osteoporosis.
    • You have a history of nicotine use or excessive alcohol consumption.
    • You have a medical condition, such as diabetes or thyroid disease, that raises your risk.
    • You have a family history of osteoporosis.

    ▶ How to measure it

    Dual-energy X-ray absorptiometry (DEXA) scans are a type of X-ray that measures the amount of bone mineral content packed into a square centimeter of bone.

    Insurance often won’t cover these scans for people younger than 65 unless there’s a documented risk of developing osteoporosis. Out of pocket, the average cost is about $300.

    When you receive your DEXA results, you’ll see a T-score that represents how your bone density compares to the average bone density of a young adult with peak bone mass. A T-score of +1.0 to -1.0 means you have normal bone mineral density for someone your age. Anything below -1.0 means you might have osteopenia (low bone mineral density) or osteoporosis (porous bones that are prone to fracture).

    Commercial bio age tests

    If you have some money to burn, you can learn an awful lot about your body.

    Here, you’ll find a quick run-down on some of the more high-tech tests you can get and what they can tell you.

    However, before we get into the details, we want to point out a few caveats:

    ▶ Biological age can vary over time, and by organ. Someone may go through a period of accelerated aging—saying, during a period of intense stress—then their rate of aging may slow as they focus more on recovery. Additionally, organs can age at different rates. For example, someone with heart disease may have a relatively older heart than their kidneys. (Not all tests measure individual organ age, but it’s becoming more common.)

    ▶ Commercial tests won’t always accurately reflect the changes you’re making. Until more research supports the reliability of these tests, evaluate your behaviors over isolated test results. If you’re eating more fruits and veggies, exercising more consistently, managing stress, and otherwise slaying the healthy lifestyle department, don’t sweat your results. Focus on doing the things we know improve health.

    ▶ If a company pairs your test results with a hard sell for a proprietary and expensive supplement protocol, be wary. It’s better to share and discuss your results with a trusted health professional than take health advice from a profit-seeking stranger over the internet.

    Commercial test #1: DNA methylation

    DNA methylation is a biological process that chemically alters DNA. Because the rate of methylation accelerates with aging, it can be used to estimate someone’s biological age and life expectancy, finds research.19 20 21

    The Horvath Clock and DunedinPACE both measure specific biomarkers that can be used to better understand someone’s methylation rate. Scientists developed these tests to help other scientists study how various lifestyle factors, environmental exposures, and medicines affect aging. They didn’t develop the tests as a way for the average person to pinpoint their biological age. (Which hasn’t stopped companies from selling DNA methylation testing kits to the public.) They cost about $300.

    If you decide to get one of these tests, keep in mind your results won’t give you a complete picture of your health and longevity. Aging typically occurs at varying rates throughout the body. Your liver might age faster than your heart or brain, for example. So if you measure DNA methylation in your blood, that’s all you know about. Put another way, a DNA methylation test isn’t a substitute for your annual wellness checkup or blood work.

    Commercial test #2: Telomere analysis

    Telomeres—the protective caps on the ends of chromosomes—wear away with age. The length of a telomere can predict how many times a specific cell can divide before dying.

    Abnormally short telomeres are associated with several genetic diseases. For this reason, when physicians suspect someone might have inherited a genetic disease, they’ll order a specific type of telomere test—the flow-FISH test—to measure the telomere length in all the cells in a blood sample.22 23

    It’s more debatable whether telomere tests can predict aging in healthy people.

    Just as importantly, the telomere test marketed to the public, known as the qPCR telomere test, isn’t used in research or medicine. These $100 tests are fine if you’re merely curious—just don’t base health and fitness decisions on your results.

    Commercial test #3: VO2 Max

    For years, only elite athletes cared about VO2 max, which describes the maximum amount of oxygen that your body can use during exercise.

    More recently, however, some experts have suggested that VO2 max can serve as a measure for athletes and non-athletes alike to track the rate at which their bodies are aging.

    People with high VO2 max tend not only to be more physically fit but also less likely to develop heart disease, diabetes, cancer, or stroke.24 25 26 27

    In an observational study that followed the health outcomes of 5,107 Danish men over 46 years, men with above-average V02 max during middle age lived an average of five years longer than men with below-average V02 max. Each unit increase in VO2 max was associated with a 45-day increase in longevity. The researchers suggested VO2 max may more accurately predict all-cause mortality than high cholesterol, obesity, high blood pressure, and insulin resistance.28

    You might think of V02 max as a canary and your aging body as a coal mine.

    As you age, your chest wall becomes more rigid, the muscles that surround the lungs weaker, and the oxygen-carrying blood vessels calcified and less elastic. The heart also squeezes with less force, max heart rate drops, muscle mass and strength decline, the mitochondria in cells and muscles lose their effectiveness, among other differences.

    In addition to raising your risk for many different diseases, these changes can also affect VO2 max, which tends to decline 10 percent per decade starting around age 30.29 30

    In the past, the only way to reliably measure VO2 max was in a fitness lab.

    You would wear a metabolic mask and a heart monitor while you ran or cycled to exhaustion. The mask collected your expired carbon dioxide and monitored how much oxygen you sucked into your lungs. This lab-based testing is still the most accurate way to measure V02 max as well as other key fitness metrics such as:

    • Max heart rate, or the highest number of times your heart can beat per minute during exercise
    • Ventilatory threshold 1, or the point during exercise when the body switches from mainly using fat for fuel to using a combination of fat and glucose or glycogen (stored glucose) for fuel.
    • Ventilatory threshold 2, or the point where your body moves away from aerobic metabolism (which uses oxygen) to anaerobic metabolism (which doesn’t use oxygen).
    • Tidal volume is the amount of air inhaled or exhaled during each breath

    Depending on where you live, you might be able to get your VO2 max tested for around $150.

    However, if you don’t have access to a VO2 max clinic, three somewhat less accurate options exist.

    ▶ The 1-mile walk test

    Wear a heart rate monitor as you walk one mile on a flat surface, such as a treadmill or running track. As soon as you complete the mile, record your heart rate and walk time. Then, plug it into the following formula to calculate your VO2 max:

    132.853 — (0.0769 × Weight) — (0.3877 × Age) + (6.315 × Sex) — (3.2649 × Time) — (0.1565 × Heart rate)

    If that feels like too much math, you can also use a free online tool.

    ▶ The smartwatch test

    Many smartwatches will estimate your VO2 Max for you based on information the watch gathers from your workouts, sex, and age. Compared to in-office testing, smart watches can over- or underestimate V02 max, especially in people who are very out of shape or extremely fit.31

    Because of this, you don’t necessarily want to use your smart watch measurement to determine your current state of health. However, it can help you to see trends. For example, does your VO2 estimate drop after a few weeks of skipping your usual spin class? If so, that’s good information to have.

    ▶ The PR test

    Fitness performance correlates with longevity. If you’re getting faster at running a certain distance or can go a longer distance than before, you’re getting fitter and increasing your chances of living a long, healthy life.

    One way to test this: the 12-minute run test, also known as the Cooper test. (This is a validated way to estimate VO2 max—and shows about a 90 percent correlation with lab-based measurements.)

    Here’s how it works:

    Run as fast as you can on a flat surface, such as a treadmill set at a 1 percent incline or running track, for 12 minutes. After 12 minutes, record your distance. Then, plug it into one of the following formulas to calculate your VO2 max.

    Distance in Miles Distance in Kilometers
    VO2 Max = (35.97 x distance in miles) – 11.29 (22.351 x distance in kilometers) – 11.288

    In lieu of doing math, you can also use a free online calculator.

    How to change your biological age

    Try to think of the information you gather about your body as just that—information.

    It’s not a moral judgment of who you are as a person.

    Just as importantly, it’s not a permanent situation.

    • If you’re weaker than other people your age, you can grow stronger.
    • If your cholesterol or blood glucose levels are high, you can take steps to lower them.
    • If your body is aging faster than your birthdays, consider exploring key lifestyle changes that may help turn the situation around.

    You have options. However, most people make two big mistakes when it comes to longevity-related lifestyle changes.

    Mistake #1: Ignoring evergreen, big-impact strategies

    It’s the simple, boring, “I’ve heard this a million times before” health practices that, when done consistently, add up to a long, healthy life.

    We’re talking about things like…

    • Eating more minimally processed foods and fewer ultra-processed foods
    • Consuming more brightly colored fruits and veggies
    • Moving your body regularly
    • Getting enough rest and sleep
    • Enjoying community, time in nature, and other activities that make life meaningful
    • Keeping alcohol intake moderate
    • Not using tobacco
    • Wearing sunscreen
    • Flossing

    And that’s just a partial list.

    According to thousands of studies, people who practice these and other high-impact strategies not only live longer, but also live better. They’re stronger, happier, and less likely to spend their later years disabled or in pain.

    (If you’d like to see where you stand when it comes to big impact health and longevity strategies, check out our FREE Longevity Assessment.)

    However, when it comes to health, fitness, and longevity, many people pursue options with minimal impact (at best). They reach for the latest, trendy supplement rather than taking steps to quit smoking, as just one example.

    Here’s the thing: Big rock strategies require changes in behavior. If daily physical activity were as easy as popping a pill, walkers and cyclists would clog up the streets in your neighborhood.

    (It’s precisely this reason why so many people need the support of a certified health coach who has undergone training in the science of behavior change.)

    Mistake #2: Not turning data into action

    The data gathered from biomarker aging tests can give you a sense of control.

    However…

    Data, in isolation, doesn’t lead to a longer life.

    Gathering data without changing your behavior is like checking your reflection in the mirror, seeing spinach wedged between your incisors, and leaving it there.

    You need to remove the spinach for the mirror check to be worthwhile.

    Biomarker testing is the same.

    If you don’t use your bio data to inform behavior change, you’re wasting your money and time.

    Consider your biomarker data as a baseline or starting point.

    Then, use it to assess whether various lifestyle changes or medical interventions are moving you closer to your goal of living a longer, healthier life.

    References

    Click here to view the information sources referenced in this article.

    If you’re a health and fitness pro…


    When your clients are stressed and exhausted, everything else becomes a
    struggle    : going to the gym, choosing healthy foods, and managing cravings.


    But with the right tools, you can help your clients overcome
    obstacles like chronic stress and poor sleep—leading them toward the
    lasting health transformations they’ve always wanted.


    PN’s Level 1 Sleep, Stress Management, and Recovery (SSR) Coaching
    Certification
    will give you these tools. And it’ll give you confidence and credibility as a
    specialized coach who can
    solve the biggest problems blocking any clients’ progress.     (You can
    join the SSR Early Access List for our biggest discount + exclusive perks.)

    Source link