Welcome to another segment of food, nutrition, and obesity in the news. As I mentioned on our inaugural episode last month, these topics are so topical and often misrepresented. So once a month, I'll be coming to you on Health Bite, offering you the food and nutrition news that is out on the street, and hopefully give you some practical, actionable health bites to take home with you.
FIRST NEWS STORY: THE GOOD IN THE 10,000 STEPS PER DAY CONCEPT, AND THE STUDY ABOUT THE RELATIONSHIP BETWEEN STEP COUNT AND DEMENTIA
And the first news story I want to cover is getting in your steps.
So, we all know about the 10,000 steps per day concept, and funny enough, this number came about in a sort of bogus way. But counting your steps is a popular and easy approach to getting in your activity. And there have been studies that have looked at people's step counts and have shown that that target of about 10,000 steps per day can do a lot of good. For example, 6,000-8,000 steps per day have been shown to increase the lifespan and reduce mortality. More steps may also lower the risk of cardiovascular related and cancer-related deaths, as well as reduce the incidence of diabetes, particularly when we take more intensive steps or engage in more intensive activity.
Regardless, the studies show that any movement is good movement, and so any strategy like 10,000 steps is welcome – as far as I'm concerned – to help us get our activity and movement quotient for the day.
But a great study came out this month that looks at the relationship between step count and dementia.
Now, dementia – and Alzheimer's disease, in particular, which is the most common type of dementia – has become a super hot topic of conversation lately, and it's not without cause. In 2020, it was estimated that 5.8 million Americans age 65 and older had Alzheimer's disease, and this number is projected to nearly triple, to 14 million by 2060, which quite frankly, is a frightening number. But as you know, my approach is not about fear, but it is about empowerment. So, how can we provide you an actionable bite?
Well, the study that came out this month goes a long way.
So, this study came out of the U.K. and it looked at over 78,000 people and analyzed data and followed these participants for about seven years. They looked at their step counts and also their risk of going on to develop dementia, and their findings were really encouraging.
The study showed that individuals who walked as little as 3,826 steps per day – so let's just call it 3,800 steps – they had a 25% reduction in going on to develop dementia over the course of seven years when they were followed. They found that the optimal dose, meaning the value at which the maximum risk reduction occurred, was 9,826 – so let's call it 9,800 steps per day – which reduced the risk of these individuals going on to develop dementia by 50%. So, looks like shooting for that kind of 9,800 to 10,000 steps per day right around the number that we're used to counting, if done consistently, can reduce the incidence of dementia by 50%, which is really extraordinary and tremendous.
They show that this occurs even at lower cadences, when people weren't going as fast, but greater benefits were to be gained if individuals had a higher cadence or quicker pace.
So the take home message here is if you're not doing this already, if you're not getting in your activity or your steps, I really recommend that you get an accelerometer, a Fitbit, an Apple Watch. You can even turn on a pedometer on your phone; most phones come with one installed. And try and shoot for that 10,000 steps per day. If you do, you will reduce your risk of important diseases, including dementia. Not to mention, as I've mentioned in prior podcasts, the benefits to our mood and emotional well-being.
So, get your steps in.
SECOND NEWS STORY: THE RECENT RELEASE OF THE INJECTABLES FOR WEIGHT LOSS, AND HOW SEMAGLUTIDE HELPS LOWERS PEOPLE’S RISK OF DEVELOPING TYPE 2 DIABETES
The second news story also piggybacks on something we talked about last week, which is the recent release of the injectables for weight loss.
So again, to review, there's a new class of medications called GLP and GIP analogs that have been approved for the treatment of diabetes, and in some cases, also for the treatment of obesity.
Again, to recap, these GLP and GIP are normal hormones that we release in the body when we consume nutrients. So when you eat food, the food travels from your mouth to your stomach to your gut, and then your intestines will release these hormones, which have two functions: number one, they send a signal to the pancreas and says to the pancreas, “Hey, we got food down here. Go ahead and send over some insulin so that I can manage my blood sugar.” These hormones will also send a signal to the brain saying, “Hey, we got food down here. You can go ahead and shut off that hunger signal.”
So the medication also – or the hormone, I should say, in normal physiology – also will curb appetite; will enhance fullness or satiety. And so now, we have medications that are analogs or kind of copycats of these hormones that are doing the same thing in the body – enhancing the production of insulin in response to nutrient intake, as well as enhancing sensation of satiety. And these medications, I have been using them in the office for the last several months; have really been a game changer for a lot of my patients in terms of helping stem the tide of excess weight.
Well, a study came out this week that looked at one of these drugs – semaglutide – weekly, and compared it to placebo for individuals who were at risk for developing diabetes, and looked at their risk going forward in taking this medication as compared to those who were on placebo or did not. And they found that for individuals who were using this weekly injection for about 16 months, the calculated risk of developing Type 2 diabetes over the subsequent ten years went from almost 20% to 7%, compared to the individuals who were on placebo who had a drop from 18% to 16%.
So, the take home message here is that here is a medication that can actually help with prevention. So many of our drugs that are geared towards diabetes are really treatment and after the fact, trying to treat a disease or a complication that has come on in large part by excess weight, because we know that we have twin epidemics in this country of obesity and diabetes and the two go hand-in-hand. But in this study, we have a medication that potentially can help stem the tide of developing diabetes. We know that once people go on to develop diabetes, it is very hard to put those individuals in remission, so this is a major wohoo for prevention.
THIRD NEWS STORY: DO PLASTICS MAKE YOU GAIN WEIGHT? WHAT ARE THESE OBESOGENS, AND HOW DO THESE AFFECT THE HORMONAL SYSTEMS IN OUR BODIES?
In other interesting news – do plastics make you gain weight?
A little bit of background here, because the information is not new, even though the news headline was, but this headline refers to the topic of obesogens. Now, obesogens are chemicals that are found in the environment that act as endocrine or metabolism disruptors. So essentially, these are chemicals that are found in a lot of our normal household items – in plastics, in woods, in commercially prepared items, and the chemicals that are contained within these plastics have been shown to interrupt our normal hormonal systems in our bodies, and in doing so, can increase the likelihood for metabolic diseases, including obesity.
Researchers have already found thousands of these obesogens; an example is BPA. BPA is a chemical that is pretty well known to us. It's used widely in plastic and plastisizing agents, so it can be found in paint, it can be found in cosmetics, it can be found even in medicines and certain coatings that are used in medicines, unfortunately. Other potential sites are parabens. They're used as preservatives in food and paper products, and it can also be found in chemicals like pesticides and herbicides.
And we know from scientific data that BPA can increase the risk of obesity and expose individuals in a dose-dependent way. So many years ago, there was a study that looked at the number of canned food items that a child had consumed over their lifetime, and showed that the number of canned foods was directly proportional to their risk of going on to developing obesity.
So again, these chemicals can interrupt our normal hormonal systems that affect our metabolism and can increase the risk of developing obesity, as well as other endocrinology diseases and problems.
So again, the take home here is not to freak people out or leave them with inactionable information, because the truth of the matter is until our government and our policies begin to regulate these things and these chemicals, we're going to be exposed.
But there are steps that we can take, and one of those, again, is being mindful of our food consumption. So, when we can try and get our food from whole foods, less processed, less packaged foods. Remember that you do not have to be perfect in order to be effective. Just merely reducing the consumption of these foods by incorporating more plants, more fresh fruits and vegetables, more lean proteins, more legumes and grains that you may cook on your own can help reduce the overall load of processed foods, which reduces our exposure to these chemicals that can increase the susceptibility for certain diseases. So, a big nod towards less processed and more whole food consumption.
FOURTH NEWS STORY: THE EFFECTS OF ULTRA-PROCESSED FOODS ON ONE’S LIKELIHOOD TO HAVE COLON CANCER, AND THE POTENTIAL REASONS ON WHY THIS HAPPENS
And on the subject of processed food, another study that was published in the last few weeks analyzed the effect of ultra-processed foods and colon cancer.
So, a little bit of background here; colon cancer is the second most common cancer in the United States, the third most common cancer-related death in the United States. About 4% of men will develop colon cancer, and 4.3% of women in the United States will develop colon cancer over their life span.
Now, while there are genetic factors and factors that are out of our control, the good news is that there are factors that are in our control. Colon cancer tends to be one of those cancers that's very much lifestyle driven. So, lifestyle factors including our diet, including our activity level, and including our degree of excess weight tends to be contributory. So, people who are consuming a higher nutrient-full diet are less likely to develop cancer; colon cancer, specifically. Individuals who are more active and less sedentary also helps prevent the risk of colon cancer.
And don't forget that this is screenable. The most recent guidelines have dropped cancer screening recommendations from 50 and then to 45. And again, the most recent guidelines say that individuals ages 40 or greater should be screened for colon cancer. So if you are in that age demographic, please go get your colon cancer screening. It is uncomfortable perhaps to think about, but honestly, you get sedation, you sleep, you won't feel a thing, and it could save your life.
So, back to the study.
The study looked at ultra-processed foods. Ultra-processed foods are basically foods that are going through multiple processes. They are being milled; they are being extruded. Basically, they're being processed in a way in which nutrients are removed. Examples of ultra-processed foods include commercial ready-to-eat cereals, breakfast cereals, processed meats, packaged meats, ready-to-eat or reheatable meals. Ultra-processed meals or foods can also be packaged baked goods and ice cream, for example. These foods also tend to be high in refined sugar, refined starch, as well as high in trans fats. Believe it or not, ultra-processed foods currently contribute to 57% of the daily dietary intake of the United States. So that means that 50% of our calories, by and large, are coming from ultra-processed food. And in this study, individuals who are at the highest level of ultra-processed food consumption had a 29% higher risk of developing colon cancer, as compared to those who had the lowest consumption.
Some potential reasons for this are, again, ultra-processed foods are devoid of those nutrients like fiber, antioxidants that could be protecting or are protecting gut health and digestive health. Also, this type of diet and the consumption of ultra-processed foods are affecting the diversity of our gut bacteria and gut microbiota; the organisms that live symbiotically in our gut. They scratch our backs by providing immunity, protection, health; they even can contribute to a reduced incidence of depression. And we scratch their backs by giving them a place to live for free. So we know that our diet can affect the composition of healthy gut microbiota, and ultra-processed foods, of course, fits into that category of foods that can affect our diversity in the gut. And then finally, a high consumption of these ultra-processed foods is also associated with weight gain, and obesity is a risk factor for colon cancer.
So again, this is about prevention. If you find that you're consuming a diet that is high in processed foods, think about what can you do to reduce your risk? Can you replace some of your packaged snacks or packaged food with whole foods? And a little bit will go a long way.
And I know that convenience is a major factor for a lot of us; time constraints is a major factor for a lot of us. It doesn't require a tremendous amount of time. I joke often with my patients; “I don't expect you to be in the kitchen like Martha Stewart, whipping up a batch of homemade meals.” No offense to Martha Stewart or anyone who does that; If you can, more power to you. But if you are intentional and you plan in advance, maybe you have a meal prep day where you take time to cut up your veggies, marinate some chicken or fish, maybe it's about having some easy, accessible lean meats in the fridge, like hard boiled eggs that are already cooked, having sashimi, maybe, even tuna, which comes out of a can, is not considered an ultra-processed food, so having tuna in the pantry can be another way that you can add protein to your diet. Maybe you make a habit of going to the farmer's market once a week with the family. This is something you can do with your friends, with your family. It's something that is active. It's something that is proactive in terms of your meals and can be a fun activity to engage in. And buying what looks good and is in season and coming home and preparing those meal kits or ziplocs or little glass containers of snacks.
Dairy is another good source of protein. And in fact, this study looked at dairy. Dairy gets vilified often in the news cycle, but there really is nothing wrong with wholesome dairy products. And this study showed that actually consuming more of that, like high protein Greek yogurt, actually did not contribute to risk and was associated with reduced risk.
A QUICK RECAP: YOUR NEWS AND HEALTH BITES THIS SEPTEMBER
So, there you have it; your health bites for the month, for the week, but also your news for the month.
Get your steps in if you're not doing it already. Get yourself an accelerometer, track your steps on your phone, and try and shoot for at least 3,000 to 4,000 steps per day. That, in and of itself, will reduce the risk of dementia by 25%.
Number two, let's go towards more whole foods, less processed foods; less foods that come out of a container or a package. It has been shown that you can reduce your consumption of the chemicals that are found in those plastic containers and may contribute to metabolic disease, including excess weight. And also, when you eat more whole foods, you're eating less processed and ultra-processed food, which can go a long way to reducing your risk of colon cancer, among other things.
I hope that you found this episode to be inspiring and empowering to take home some actionable health bites to yourself and your family. I look forward to seeing you again next week when we'll have another episode of Health Bite here waiting for you.
Have a great week, and in good health. This is Dr. Adrienne, your host, signing off.