Wednesday, September 18, 2013

The China Study

Someone asked us about the China Study, so I wanted to address her question....

The China Study was a 20 year research study completed by Dr. Campbell from Cornell University in partnership with Oxford University and China.  The China Study was an epidemiologic survey of diet and health conducted in 65 villages throughout China.  It has been touted as “the most comprehensive study of nutrition ever conducted" by some.  The findings were published in a book, "The China Study", authored by Dr. Campbell, who asserts that we could prevent or cure most disease (heart disease, cancer, diabetes, autoimmune diseases, bone, kidney, eye and other diseases) by eating a whole foods plant-based diet, reducing our protein intake, and avoiding meat and dairy products entirely.  The book was then used as the basis for the documentary "Forks over Knives".

A quote from Dr. Campbell from an interview after the book was released:
"The idea is that we should be consuming whole foods... We should not be relying on the idea that nutrient supplementation is the way to get nutrition, because it’s not. I’m talking about whole, plant-based foods. The effect it produces is broad for treatment and prevention of a wide variety of ailments, from cancer to heart disease to diabetes"
I have to admit, I haven't read the book personally, so I don't know specifics regarding research methods, statistics, etc.  But in doing some research, it looks like his book as drawn a lot of applause, and also a lot of criticism. The main thing that people take issue with from his research was cutting out dairy and meat completely.  In my lack of awareness about the book and research, I did some digging...  I found the experts.

The American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) publishes many recommendations regarding nutrition and cancer prevention.   If you haven't looked at AICR's website yet, you should!  They also have a website specifically addressing foods that fight cancer, which lists foods and how they impact your health.  However, it is important to remember that no single food or food component can protect you against cancer alone, however strong evidence does show that a diet consisting of a variety of plant foods such as vegetables, fruits, whole grains and beans helps lower risk for many cancers.

Their most recent report, published a few days ago, asserts that 3 out of 5 cases of endometrial cancer could be prevented through healthy nutrition, physical activity, and maintaining a healthy weight, avoiding sugar-sweetened foods and beverages.  “Many women are not aware of the strong link between obesity and cancer, which is particularly strong for endometrial cancer,” she said, “however, it is good news that many cases could be prevented every year by maintaining a healthy weight and being physically active" (Elisa Bandera, MD, PhD, AICR Panel member).

AICR's top 10 recommendations to prevent cancer are:
  1. Be as lean as possible without becoming underweight.
  2. Be physically active for at least 30 minutes every day.
  3. Avoid sugary drinks (diet and regular sodas). Limit consumption of energy-dense foods.
  4. Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
  5. Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
  6. If consumed at all, limit alcoholic drinks to 1 per day for women (2 for men).
  7. Limit consumption of salty foods and foods processed with salt.
  8. Don't use supplements to protect against cancer.
  9. * It is best for mothers to breastfeed exclusively for up to 6 months and then add other liquids and foods.
  10. * After treatment, cancer survivors should follow the recommendations for cancer prevention. 
And of course, do not smoke or use tobacco products!  (They don't even include it in the list because it is just a given).

The AICR does address the China Study and Dr. Campbell's research directly, stating that diet is only a piece of the puzzle.  They agree with Dr. Campbell that the link between excess body fat and cancer is convincing, and that the obesity epidemic now raging through our society "will result in millions of cancers in the future unless something this changed".  

The AICR goes on to recommend getting 1/3 of your daily food intake from healthy protein sources.  Remember, protein does NOT necessary equal meat.  Protein can be found in beans, rice, grains, nuts, legumes, fish, poultry, eggs, and low-fat dairy.  They also recommend limiting red meats, processed meats (like some sandwich meats, hotdogs, and smoked/cured meats) to no more than 2 times per week. 

What's the bottom line?  We need protein to survive - to build muscle, regenerate tissues, to heal, to function.  But in the American culture we tend to be rather protein-obsessed (how many people have seen ads for protein shakes? or tried them?)  Get your protein from a wide variety of BOTH plant-based and animal-based sources.

Again, if you haven't checked out the American Institute on Cancer Research website yet, I would highly recommend it!

Tuesday, September 17, 2013

Nutrition overview - Food as Medicine

We spend a lot of our time thinking about what we are eating, what "should" we be eating, and how our nutrition is affecting our health.  The next few blog entries we will touch on some of the major topics in nutrition.  Notice I use the word nutrition to describe what food you put into your body to fuel your life - I don't like the word "diet" because it tends to imply something that you "go on to", or something you do for a short period of time.  Nutrition is foundational to our health. 

Americans are bombarded with information every single day about "healthy eating" - from our parents, spouses or significant others, coworkers, books, magazines, TV shows, commercials, and the list goes on and on...  However, as a nation, we have the highest rates of obesity, and obesity-related disease, of all the developed countries.  This summer of 2013, the American Medical Association (AMA) finally recognized obesity as a disease - hopefully to bring more attention to the health consequences of obesity, including type 2 diabetes and heart disease, and to get better insurance reimbursement for the providers who are working with their patients to help them get to a healthy weight.
The rates of obesity (defined as BMI above 30) have sky-rocketed in the last 20 years.

We have forgotten somewhere along the way that our food is our medicine.  Most of the pharmaceuticals and prescription medications that we have today can be traced back to a plant origin.  Just because something is made in nature, does not mean that it is not potent.  We evolved eating food that came from the land - foraging wild fruits, veggies, nuts, roots, fungi, and hunting wild meat.  This diet is not feasible for the vast majority of us in the current day.  However, what does remain is that our bodies evolved to function, grow, and be healthy entirely fueled by foods that we got from our environment (which did not include dietary supplements from our local drug store).

So what's the bottom line??
1) Food is our original medicine, and we should try to get most of our nutrition from foods that are found in their original state.  Try to eat or cook with WHOLE foods - things that you could find in a garden.  Using foods that are close to their original state allows your body to best utilize the food, without additional ingredients or processing.
2) Avoid foods that come pre-packaged and highly-processed.  Just because it says "Lean Cuisine" or "healthy" on the package doesn't mean it is good for you.
Try to eat at least one of each color every day!
3) Try to eat a wide variety of foods, as this will get a wide variety of nutrients and minerals. A good rule of thumb is to eat one of each color every day, i.e. something that is red (like strawberries or an apple), something orange (like yams or golden beets), something yellow (like squash or a bell pepper), something green (like kale, spinach, broccoli, or avocado), and something blue/purple (like blueberries or eggplant). 
4) Supplements should only be used when we are not getting adequate nutrition from our foods.
5) Exercise is necessary in order to maintain our health, prevent disease, and maintain a healthy weight.  Goal: at least 30 minutes, 5 days per week (at a minimum).  Figure out something that works for you and your life.
6) Avoid sweetened beverages, both diet and sugar-containing.  Drink water!
7) Maintaining a healthy weight is not just about "looking good" as our culture defines it, but rather is about preventing diseases that can be caused by excessive weight.

We will talk about many different aspects of nutrition and exercise in future blog posts, and discuss how to get all of the nutrients you need from a healthy, balanced diet.  If there is a specific question you have or want addressed regarding nutrition and exercise, let us know!

In the mean time, some good nutrition resources include the Harvard School of Public Heath, the American Heart Association, the U.S. Dept of Health and Human Services, or the CDC.

Tuesday, September 3, 2013

TDaP Vaccine

As you may have heard, Pertussis (also known as Whooping Cough) is back in our community here in Vermont, including Chittenden county.  Pertussis is an infectious disease, caused by the bacteria Bordetella pertussis.  It is a respiratory infection, that causes inflammation of the tissues in the lungs and airways, impaired ability to clear respiratory secretions, and severe cough with the characteristic "whoop" that can last up to 6-10 weeks, hence the name.  In the 1900's, Pertussis was a major cause of death especially for infants and young children.  However, with the invention of the vaccine and routine administration of vaccines during childhood, Pertussis declined considerably.  Pertussis is particularly dangerous for young children and infants.

The Vermont Health Department tracks Pertussis cases in the state, and they have reported a considerable increase in the number of confirmed cases.

Pertussis is on the rise. Vermont had over a 3-fold increase in the number of Pertussis cases from 2011 to 2012.
Pertussis can be prevented with a vaccine - the TDaP vaccine, which stands for Tetanus, Diphtheria, and Pertussis.  It is recommended that everyone make sure they are up to date on their TDaP vaccine.

Current guidelines for vaccination:
- Infants and Children:  The vaccine DTaP (the formulation for children) series of five shots given at 2, 4, and 6 months of age, 15-18 months, and the fifth shot is given when a child enters school, at 4-6 years of age.

- Preteens and Teens: Vaccine protection for pertussis, tetanus, and diphtheria can decrease with time. Preteens should get a TDaP booster at 11-12 years. Teens and young adults who didn't get a booster of TDaP as a preteen should get one dose when they visit their health care provider.

- For Pregnant Women: Expectant mothers should get one dose of TDaP during each pregnancy, preferably at 27-36 weeks. By getting TDaP during pregnancy, maternal antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. The TDaP vaccine will also protect the mother at time of delivery, making her less likely to transmit pertussis to her infant.  Fathers, childcare providers, or anyone that will be in close contact with the baby should make sure they are up to date on their vaccine, as well.

- For Adults: Adults 19 years and older who didn't get TDaP as a teen should get one dose of TDaP. Adults get TDaP in place of one of their regular tetanus boosters, Td, which is recommended for adults every 10 years.  However, the dose of TDaP should be given no matter when the last Td shot was received. It's a good idea for adults to talk to a health care provider about what's best for their specific situation.  Adults who are in close contact with infants and young children should make sure they are up to date with their vaccine to prevent exposure/risk to the infant.

We carry the TDaP vaccine in our office and administer it routinely!  Please call us if you need to update your vaccine, or if you are unsure.  When in doubt, it is always better to re-vaccinate.  There is no risk to receiving the vaccine twice if you are unsure if you have received the vaccine or not.  As recommended, we provide the vaccine to all pregnant women at 27-36 weeks.  Check out the CDC Pertussis website for more information.