1 June 2017

WHAT’S NEW?

GLUTEN FREE AND HEART HEALTH
In April, ConscienHealth’s Ted Kyle reported on research that found that people who ate less gluten had a slightly higher risk of developing type 2 diabetes. Now a new study from Harvard finds that avoiding gluten won't lower your risk of heart disease. In fact, the researchers conclude from their findings that going gluten-free if you don’t have celiac disease could pose health concerns because “the avoidance of gluten may result in reduced consumption of beneficial whole grains, which may affect cardiovascular risk. The promotion of gluten-free diets among people without celiac disease should not be encouraged.”

As Ted Kyle says, “a gluten-free diet is a no-brainer for someone with celiac disease or confirmed non-celiac gluten sensitivity (gluten intolerance). But gluten-free fad diets have reached far beyond folks with actual gluten sensitivity or celiac disease. Some people falsely believe it will help them lose weight or magically give them better health. This new data is a useful reminder that food fads can have a downside and becoming fixated on demonizing a particular food or nutrient can lead to surprises down the road.”

Study: Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study 

Contact: A T Chan ACHAN@mgh.harvard.edu

YOUR BRAIN REALLY DOES WANT YOU TO EAT MORE VEGGIES
Prof. Felice Jacka is a psychiatric epidemiologist with a strong interest in the prevention of mental disorders. Her research relates to the possible influence of diet on common mental disorders, depression and anxiety. In The Conversation, she reports on a trial to examine whether diet improves depression. This edited extract is published with permission.

As well as our physical health, the quality of our diet matters for our mental and brain health. Observational studies across countries, cultures and age groups show that better-quality diets – those high in vegetables, fruits, other plant foods (such as nuts and legumes), as well as good-quality proteins (such as fish and lean meat) – are consistently associated with reduced depression. Unhealthy dietary patterns – higher in processed meat, refined grains, sweets and snack foods – are associated with increased depression and often anxiety.

vegetables

Our recent trial was the first intervention study to examine the common question of whether diet will improve depression. We recruited adults with major depressive disorder and randomly assigned them to receive either social support (which is known to be helpful for people with depression), or support from a clinical dietitian, over a three-month period.

The dietary group received information and assistance to improve the quality of their current diets. The focus was on increasing the consumption of vegetables, fruits, wholegrains, legumes, fish, lean red meats, olive oil and nuts, while reducing their consumption of unhealthy “extra” foods, such as sweets, refined cereals, fried food, fast food, processed meats and sugary drinks.

The results of the study showed that participants in the dietary intervention group had a much greater reduction in their depressive symptoms over the three months, compared to those in the social support group. At the end of the trial, 32% of those in the dietary support group, compared to 8% of those in the social support group, met criteria for remission of major depression. These results were not explained by changes in physical activity or body weight, but were closely related to the extent of dietary change. Those who adhered more closely to the dietary program experienced the greatest benefit to their depression symptoms. While this study now needs to be replicated, it provides preliminary evidence that dietary improvement may be a useful strategy for treating depression.

Depression is a whole-body disorder. It’s important to understand researchers now believe depression is not just a brain disorder, but rather a whole-body disorder, with chronic inflammation being an important risk factor. This inflammation is the result of many environmental stressors common in our lives: poor diet, lack of exercise, smoking, overweight and obesity, lack of sleep, lack of vitamin D, as well as stress.

Many of these factors influence gut microbiota (the bacteria and other microorganisms that live in your bowel, also referred to as your “microbiome”), which in turn influence the immune system and – we believe – mood and behaviour. In fact, gut microbiota affect more than the immune system. New evidence in this field suggests they are important to almost every aspect of health including our metabolism and body weight, and brain function and health. Each of these factors is relevant to depression risk, reinforcing the idea of depression as a whole-body disorder. If we do not consume enough nutrient-dense foods such as fruits, vegetables, fish and lean meats, this can lead to insufficiencies in nutrients, antioxidants and fibre. This has a detrimental impact on our immune system, gut microbiota and other aspects of physical and mental health.

Gut microbiota are particularly reliant on an adequate intake of dietary fibre, while the health of the gut may be compromised by added sugars, fats, emulsifiers and some artificial sugars found in processed foods. A diet high in added fats and refined sugars also has a potent negative impact on brain proteins that we know are important in depression: proteins called neurotrophins. These protect the brain against oxidative stress and promote the growth of new brain cells in our hippocampus (a part of the brain critical for learning and memory, and important to mental health). In older adults, we have shown that diet quality is related to the size of the hippocampus.

Now we know diet is important to mental and brain health as well as physical health, we need to make healthy eating the easiest, cheapest and most socially acceptable option for people, no matter where they live.

The Conversation: https://theconversation.com/food-as-medicine-your-brain-really-does-want-you-to-eat-more-veggies-74685
Study: A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial)
Contact: f.jacka@deakin.edu.au

ALTERNATE DAY FASTING HYPE SHOULD BE FADING FAST
As a spiritual practice, fasting has deep roots in many religions, but when spiritual practices try to make the leap into health practices, look out. For a prime example, it now looks like the hype about the alternate day miracle fast should be fading fast reports ConscienHealth’s Ted Kyle. A new randomized, controlled study published in JAMA Internal Medicine finds no benefit for alternate day fasting compared to daily caloric restriction.

Researchers randomized 100 people with obesity to an alternate day fast, a standard reduced-calorie diet, or a control group making no change in dietary habits. They followed the participants for six months of weight loss, and six months of weight maintenance. At the end of 12 months, both of the treatment groups had lost about five percent of their starting weight – virtually identical outcomes. And the control group of course had no change in weight. Likewise, the researchers found no difference in markers of heart or metabolic health. For two treatment groups, blood pressure, heart rate, cholesterol, insulin resistance, cholesterol, and a number of other measures were the same at the end of 12 months.

Hopefully, this will put a capstone on years of hype about the health benefits of fasting. We’ve seen claims that it will “reboot your body” and “slow aging.” Health reporters have hyped animal studies to suggest that it will prevent cancer, improve brain function, and cure diabetes. Enough. Fasting is a fine spiritual practice. It’s not a bad way to lose weight. But don’t count on it for miraculous health benefits. – Thanks to Ted Kyle of ConscienHealth for this report

Study: Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults. A Randomized Clinical Trial