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I don't really notice whether working out improves my thought process. (14%)
No. Exercise doesn't affect my thinking or response time. (4%)
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Last day to register for "Battle The Bird" in Battle The Bird challenge update
Posted by ajordan1 Nov 19, 2009
Headlines in major news publications and TV news stations drew attention yesterday with various headlines stating something like "Vitamins cause cancer." It's always interesting how the small number of studies on the use of vitamins and minerals that show a possible association with health concerns draw much more media attention than the large number of studies showing their benefit.
Folic Acid, Vitamin B12 and Cancer
The study that generated the "Vitamins Cause Cancer" headlines was published November 18 in the Journal of the American Medical Association. The study was completed in Norway. Performing the research study in Norway was interesting in that the country does not have a standardized policy for folic acid fortification like the United States does, so people have less exposure to higher levels of folic acid. The researchers concluded that folic acid plus vitamin B12 was associated with increased cancer outcomes and all-cause (any reason for) mortality in patients with ischemic heart disease in Norway. The main cancer that occurred during the study was lung cancer. The published review included data from two different research studies, the Norwegian Vitamin Trial (NORVIT) and the Western Norway B Vitamin Intervention Trial (WENBIT). The structure of the study and the results have been questioned by some experts in the world of vitamin and mineral research.
Daniel Fabricant, PhD, is the Vice President of Scientific and Regulatory Affairs for the Natural Products Association (NPA). He pointed out that participants in both studies were also being treated with beta-blockers and statins, and some were also being treated with ACE inhibitors and diuretics. The studies did not adjust for these. Without adjusting for these additional therapies, it cannot be determined how the results came to be.
Andrew Shao, PhD, Vice President, Scientific and Regulatory Affairs for the Council for Responsible Nutrition (CRN), Washington, D.C. was quoted as saying the results from this study:
"are inconsistent with the larger body of data and that this effect has not been observed previously. In fact, as the authors themselves point out, 'Epidemiological studies have demonstrated no associations between intakes of folate or folic acid and lung cancer risk. Consumers, as well as researchers and healthcare professionals, must not lose sight of the safe, well-established benefits of folic acid supplementation and fortification for women of childbearing age to prevent neural tube defects, as well as other potential benefits of folic acid supplementation, such as for cardiovascular health and cognitive function in the general population."
Another unique aspect of the study was the very high prevalence of smoking in the Norwegian population compared with the averages in the United States. In fact, 40% of the participants were current smokers. Of all of the lung cancers diagnosed, 70% were current and 24% were former smokers. While this single study in a a very specific subset of the population may have raised some red flags, it should not stop people from ensuring they take in optimal levels of these vitamins.
An additional article, also published in the November 18 issue of JAMA, titled Assessing Cancer Prevention Studies - A Matter of Time, the authors explain that the occurrence of cancer has actually decreased during the time that folic acid fortification has taken place in the United States, which goes against the study findings. They also said:
"Cancer prevention efforts to not start or end with folic acid. Cessation of cigarette smoking and prevention of smoking in youth and adolescents remains the highest priority for cancer prevention. For those who do not smoke, eating a healthy diet and exercising to avoid weight gain or maintain weight loss will translate to lower risk of cancer, diabetes, and other chronic conditions. These are population-wide changes that take time, and the benefits of such lifestyle changes can take years, even decades to realize."
Benefits of Folic Acid and Vitamin B12
There is a significant amount of research on the benefits of folic acid and Vitamin B12 supplementation. Some of the conclusions from other studies on Vitamin B12 and folic acid are listed below:
Taking a daily supplement including both folic acid and vitamin B12 would reduce the risk of coronary heart disease, as well as provide a cost effective means of maintaining health
A daily regime of aspirin or B-Vitamins may help reduce the risk of dementia and cognitive impairment
The use of vitamin B12, B6 and folate supplements aids in recovery after heart surgery
Folate, vitamin B6 and vitamin B12 help to improve cognitive functions such as memory, processing speed and verbal abilities
Vitamin B12 has been proven to be a pain reliever, and is safe and well-tolerated
This is a very small sample of the conclusions of other studies on folic acid and vitamin B12 which doesn't begin to describe all of the potential benefits of optimal folic acid and vitamin B12 intake. The evidence overall suggests a strong need for the use of folic acid and vitamin B12, consumed through food and supplements. Even though the headlines make for an attention-grabbing story, be sure to get all of the facts surrounding the use of vitamin and mineral supplements before you consider giving up on an an important component of a sound nutrition program. They don't replace the need for nutrition from food, but are an important part of ensuring your take in optimal levels of these essential micronutrients.
In health,
References:
Tice JA, Ross E, Coxson PG, Rosenberg I, Weinstein MC, Hunik MG, Goldman PA, Williams L, Goldman L. Cost-effectiveness of vitamin therapy to lower plasma levels for the prevention of coronary heart disease: effect of grain fortification and beyond. JAMA. 286(8):936-43, 2001 Aug 22-29
Clarke R, Harrison G, Richards S. Effects of vitamins and aspirin on markers of platelet activation, oxidative stress and homocysteine in people at high risk of dementia. Journal of Internal Medicine. 254(1):67-75, 2003 Jul.
Schnyder G, Roffi M, Pin R, Flammer Y, Lange H, Eberli FR, Meier B, Turi ZG, Hess OM. Vitamin B12 aids Heart Surgery Recovery. New Eng Jour Med. 345(22)1593-600, 2001 Nov 29
Bryan J, Calvaresi E, Hughes D. Vitamin B12 Helps to Improve Memory. Jour of Nutr. 132(6)1345-56, 2002 Jun.
Mauro Gl, Martorana U, Ctaldo P, Brancato G, Letzia G. Vitamin B12 for Lower Back Pain. Europ Rev for Med & Pharm Sci. 4(3):53-8, 2000 May-Jun
Neutraceuticals World. Study Links Folic Acid with Cancer Risk. neutraceuticalsworld.com
Ebbing M, Bonna KH, Nygard O, Arnesen E, Ueland PM, Nordrehaug JE, Rasmussen K, Njolstad I, Refsum H, Nilsen D, Tverdal A, Meyer K, Vollset SE. Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12. JAMA. 2009;302(10):2119-2126
Drake B, Colditz G. Assessing Cancer Prevention Studies - A Matter of Time. JAMA 2009;302(19):2152-2153
This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.
Even though people are dining out today less often than in the past, according to a recent Zagat survey, the average person still eats out 3.2 times per week (previous statistics were 3.3 times per week). While it can be easier to cook a healthy meal at home, knowing what all of the ingredients are, it's still quite possible to eat well at a restaurant as long as you do some investigating before going out. Most restaurant websites have the nutrition information for their menus. Waiting until you get there is a recipe for disaster, as you can easily choose with your stomach instead of your brain. We'll look at a common situation many of us face each week.
As we were getting our morning started, my wife got an email from a friend inviting her to lunch at Red Robin, a burger restaurant here in the Twin Cities. Actually, they're all over the country. To make sure she didn't sabotage her nutrition plan, she got on their website and did a little homework prior to going out for lunch.
A Typical Scenario
When invited to go out, many people won't consider what they're going to eat until they get to the restaurant. The smell of the food, the pictures on the menu, the descriptions of the menu options can all lead to diet sabotage. Since my wife was planning to go to Red Robin, we'll use that menu as an example.
Let's say you wait to get to the restaurant to decide what to order. If you wait, it's much more likely you'll go with what your stomach is telling you. Here are some of the menu options, and their associated nutrition information.
- Royal Red Robin Burger with Fries (no soda): The "It's the weekend. I'll eat whatever I want" meal: 1625 calories, 101 g fat, 108 g carb, 66 g protein
- California Chicken Burger: The "It's got chicken on it so it must be good for you" meal: 946 calories, 57 g fat, 49 g carb, 55 g protein
- Caesar's Chicken Wrap: The "Wraps are healthy" meal: 852 calories, 43 g fat, 69 g carbs, 40 g protein
- Fajita Fiesta Pollo Salad: The "I need to eat more salads" meal: 1000 calories, 62 g fat, 59 g carb, 51 g protein
- Onion Rings: The "I barely ever order them so I'll treat myself" side dish: 724 calories, 54 g fat, 62 g carb, 7 g protein
The menu is pretty extensive, and contains a LOT of great tasting items, too many to include in these examples. The point is, it's pretty easy to eat half or more of a day's worth of calories in a single meal. Doing that 3.2 times per week, even with an otherwise healthy diet can quickly halt or even reverse the results of a sound nutrition plan. Now, let's look at this with a little bit of planning. Fortunately, at Red Robin, like many other restaurants, you can customize your menu item of choice. Their website shows you what it does to the nutrition information to exchange or replace ingredients in any of the menu items.
My wife was looking for a salad, which is pretty typical for a lunch meal for her. The Cobb Salad sounded good. The Cobb Salad with Ranch dressing looks like this:
1156 calories, 82 grams of fat, 44 grams of carbs, 8 grams of fiber, 56 grams of protein
Can you eat a salad without dressing? Absolutely! This one has blue cheese and avocado on it too, so there's plenty of extra flavor without the need for dressing. When you drop the dressing, the meal looks like this:
736 calories, 38 grams of fat 42 grams of carbs, 8 grams of fiber, 54 grams of protein (A reduction of 420 calories!)
That's a lot better! What else could be done? Well, she was not going to be super-active today, so the focaccia bread really wasn't necessary. She also doesn't care for black olives or tomatoes, although they could certainly could have been left on if she did. Without the focaccia bread, tomatoes or olives, the salad still had grilled chicken breast, one ounce of blue cheese crumbles, avocado (healthy fat), hard-boiled egg, crumbled bacon and salad mix. The nutrition information now looks like this:
495 calories, 27 grams of fat, 14 grams of carbs, 4 grams of fiber, 49 grams of protein (Another reduction of 241 calories!)
Not bad at all! Plenty of healthy protein, a reasonable number of calories, healthy fat from the avocado and not a ton of excess carbohydrates that would leave her drained of energy later in the afternoon.
Summary
Dining out can be an enjoyable experience and does not need to be one of the reasons for not managing weight. With a little bit of planning, you can enjoy a great meal at your favorite restaurant. A couple of additional reminders for the next time you eat out are:
- Skip the soda. Drink water, unsweetened tea, milk, even a glass of wine, which can all be a lot less calories that soda.
- Ask for extra steamed vegetables or a salad instead of the fries, coleslaw, onion rings, etc.
- Go for grilled chicken or fish, but check on how it is prepared. If you're going for steak, get the filet, as it is much leaner.
- Skip dessert. You REALLY don't need it, and, half an hour after you leave the restaurant, you'll be glad you skipped it. The ten minutes of satisfaction while you eat it won't be worth the extra hour or more you'll need to spend doing intense cardio to burn it off.
The most important part of all of this is to ask your server to prepare it the way you want it. If you wait until the meal comes and you plan to remove the ingredients you don't think you should eat, or plan to leave the focaccia bread on your plate, you'll be battling the will of your stomach. Before the meal is finished, you may find the dressing and bread are no longer on your plate, and it won't be because someone else ate them for you. Plan ahead and enjoy your meal.
In health,
Tom Nikkola
This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.
