Light Exercise Boosts Spirits

by Dr Alex Jimenez | Diets, Fitness

Dozens of studies have found that exercising can lift your spirits by boosting levels of serotonin — the “feel good” hormone — but a study from the University of Connecticut shows the exercise doesn’t have to leave you sweating and panting for breath. If you spend hours at your desk at work or sit at home watching television, just getting up and moving around can reduce depression and make you feel better about yourself.

“We hope this research helps people realize the important public health message that simply going from doing no physical activity to performing some physical activity can improve their subjective well-being,” says study lead author Gregory Panza.

“What is even more promising for the physically inactive person is that they do not need to exercise vigorously to see these improvements,” Panza continues. “Instead, our results indicate you will get the best ‘bang for your buck’ with light or moderate-intensity physical activity.”

Light physical activity is the equivalent of taking a leisurely walk around the mall with no noticeable increase in breathing, heart rate, or sweating, said Linda Pescatello, senior author of the study that was published in the Journal of Health Psychology.

Moderate intensity activity is equivalent to walking a 15-20-minute mile with an increase in breathing, heart rate, and sweating, yet still being able to carry on a conversation. Vigorous activity is equivalent to a very brisk walk or jogging a 13-minute mile with a very noticeable increase in breathing, heart rate, and sweating to the point of being unable to maintain a conversation.

The study tracked the movements of 419 middle-aged adults for four days and then asked them to fill out questionnaires including exercise habits, depression, pain levels, and feelings of well-being.  

Researchers found that those who were most sedentary were the least happy. Overall, physical activity improved their sense of well-being. But different levels of physical activity helped some people more than others.

People who were sedentary and engaged in light or moderate physical exercise showed the greatest improvement in their sense of well-being.

“The ‘more is better’ mindset may not be true when it comes to physical activity intensity and subjective well-being,” says Panza. “In fact, an ‘anything is better’ attitude may be more appropriate if your goal is a higher level of subjective well-being.”

Most previous studies found that although exercise increased serotonin levels, the most effective exercises were aerobic, like running, swimming and biking.

There are other simple ways that are clinically proven to increase serotonin levels including massage and getting enough sunlight.

DASH Diet Lowers Risk of Gout

by Dr Alex Jimenez | Diets, Fitness

Warding off the joint pain of gout may be as easy as eating right, a new study suggests.

Gout, a joint disease that causes extreme pain and swelling, is caused by excess uric acid in the blood. It’s the most common form of inflammatory arthritis, and its incidence has risen among Americans over recent decades, Harvard researchers noted.

But the DASH (Dietary Approaches to Stop Hypertension) diet — which is high in fruits and vegetables, and low in salt, sugar and red meat — can lower levels of uric acid in the blood.

The American Heart Association has long supported the DASH regimen as a way to help avoid heart disease.

“Conversely, the [unhealthy] Western diet is associated with a higher risk of gout,” said Dr. Hyon Choi, of Harvard Medical School in Boston, and colleagues. The “Western” diet describes the fatty, salty, sugar-laden fare of many Americans.

One nutritionist wasn’t surprised by the new findings, pointing out that the DASH diet is low in compounds called purines, which break down to form uric acid.

“I can see how the DASH diet may benefit someone with gout,” said Jen Brennan, clinical nutrition manager at Lenox Hill Hospital in New York City. “The DASH diet avoids excessive consumption of red and organ meats known to have high purine levels.”

Brennan added that the DASH diet “also encourages high intake of fruits and vegetables. We want to encourage fluids and vitamin C for these patients to help rid the body of uric acid, and fruits/vegetables can support this.”

In their study, the Harvard researchers analyzed data from more than 44,000 men, aged 40 to 75, who had no prior history of gout. The men provided information about their eating habits every four years between 1986 and 2012.

Over the study period, more than 1,700 of the men developed gout.

During 26 years of follow-up, those who followed the DASH diet — high in fruits, vegetables, legumes, nuts, low-fat dairy products and whole grains, and low in salt, sugary drinks and red and processed meats — were less likely to develop gout than those who ate a typical Western diet, the findings showed.

The Western diet is high in items such as red and processed meats, French fries, refined grains, sweets and desserts.

The study wasn’t designed to prove a cause-and-effect relationship. However, the findings suggest that the DASH diet may provide “an attractive preventive dietary approach for the risk of gout,” the researchers concluded.

Choi’s team noted that many people who have high uric acid levels also have elevated blood pressure, or “hypertension” — another reason to switch to the healthier DASH diet.

According to the study’s lead author, Sharan Rai, of Massachusetts General Hospital, “The diet may also be a good option for patients with gout who have not reached a stage requiring [uric acid]-lowering drugs, or those who prefer to avoid taking drugs.” Rai is with Mass General’s division of rheumatology, allergy and immunology.

“And since the vast majority of patients with gout also have hypertension, following the DASH diet has the potential of ‘killing two birds with one stone,’ addressing both conditions together,” Rai said in a hospital news release.

However, more studies are needed to track the diet’s effectiveness in curbing gout flare-ups, the researchers said.

Dana Angelo White is a registered dietitian at Quinnipiac University in Hamden, Conn. She called the new study “another win for the DASH diet, a sensible plan that emphasizes whole foods and a healthy balance of all major food groups. I’m pleased to see a study that highlights the benefits beyond cardiovascular health. If more people ate this way, we would continue to see decreases in all kinds of chronic illness.”

The study was published online May 9 in the BMJ.

Only 5 Percent of Salt Gets Added at the Table

by Dr Alex Jimenez | Diets, Fitness

Tossing out the salt shaker may not be enough for your heart health. Most of the salt that Americans consume comes from processed foods and restaurant meals, a new study finds.

In a sampling of 450 U.S. adults, only 10 percent of salt, or sodium, in their diet came from food prepared at home. About half of that was added at the table.

Instead, restaurant meals and store-bought foods — including crackers, breads and soups — accounted for 71 percent of salt intake, the study found.

“Care must be taken when food shopping and eating out to steer clear of higher-sodium foods,” said lead researcher Lisa Harnack.

For prevent harmful high blood pressure, Americans are advised to limit salt intake to 2,300 milligrams (mg) daily, said Harnack, a professor at the University of Minnesota School of Public Health. That’s the equivalent of one teaspoon.

But, more than eight out of 10 Americans exceed this limit “by a mile,” she said.

Food diaries from study participants showed that about 3,500 mg of sodium was consumed a day on average.

The report was published online May 8 in the journal Circulation.

Kathryn Foti, an epidemiologist who wasn’t involved in the study, pointed out that high blood pressure is a leading cause of heart disease and stroke in the United States.

“Reducing salt reduces blood pressure and can help prevent cardiovascular disease,” said Foti, of the Johns Hopkins Bloomberg School of Public Health in Baltimore.

“The most effective way to reduce salt is to reduce the content in commercially processed and prepared foods,” added Foti, co-author of an accompanying journal editorial.

She said gradual, voluntary reductions across the food supply could have a large public health benefit.

“Reducing average sodium intake by as little as 400 mg per day could prevent up to 32,000 heart attacks and 20,000 strokes annually,” she said.

The American Heart Association has launched a sodium-reduction campaign to encourage food companies and restaurants to reduce the salt in their products.

Harnack said food companies and restaurants that have pledged to comply “should be commended.”

But, Foti added, doctors should step up their efforts by educating patients about where their salt actually comes from.

“While it’s OK to encourage patients to go easy on the salt shaker, more importantly, physicians should emphasize product selection,” Foti suggested.

She and Harnack recommended reading the Nutrition Facts panel on packaged foods.

Swap out the high-sodium items with lower-salt options, Foti advised. Salt content in many foods varies widely across brands, she noted.

In restaurants where nutrition information isn’t posted, “consumers can request information about the salt content of menu items or ask how foods are prepared,” Foti added.

“And of course, choosing more fresh foods, such as fruits and vegetables, can help you reduce the salt in your diet,” she said.

The study involved 450 racially diverse adults, aged 18 to 74, living in Birmingham, Ala.; Minneapolis-St. Paul; or Palo Alto, Calif.

Between December 2013 and December 2014, the participants were asked to record their daily diet for four 24-hour periods. In addition, the study participants provided samples of salt equivalent to the amount they added at home.

Average salt consumption was over 50 percent more than the recommended 2,300 milligrams, the researchers found.

Salt added while cooking comprised only about 6 percent of sodium consumption, and salt added at the table from the salt shaker accounted for just 5 percent, according to the study.

Salt naturally found in foods made up about 14 percent of dietary sodium, while salt in tap water, dietary supplements and antacids made up less than 1 percent, according to the report.

'Bat Salad Case' Spotlights Potential Bagged Lettuce Contamination

by Dr Alex Jimenez | Diets, Fitness

If you’re doing your best to eat lots of fresh fruits and vegetables, the convenience of pre-washed bagged salads may be too hard to resist. The problem is such products can contain contaminants and foreign substances that can make you sick.

That reality was dramatically spotlighted last month when two people ate fresh salad from a bagged lettuce product before discovering the remains of a bat in it. Further complicating things, the unfortunate were treated for rabies as a precaution (although lab tests later showed the bat was not rabid).

Peter Cassell, spokesperson for the Food and Drug Administration (FDA), noted the case was extremely rare and not a reason for a larger public health concern.

“Packaged salads are generally safe to eat right out of the package,” he said. “Most salads are double-washed or triple-washed and dried under managed conditions. Packaged salads are widely sold for consumer’s convenience.”

But he acknowledged such products can contain contaminants, so consumers need to take precautions to be sure they are not consuming anything dangerous or, at least, unappetizing.

“The most common extraneous materials that can be found in produce grown close to the ground include stones, rocks and dirt,” he noted. “One way consumers can identify and remove these materials is to pour the salad out into a bowl and lightly sift it with clean hands or utensils. There is no need to rewash salads that have already been washed before packaging.”

It’s not the first time that consumers have encountered problems with pre-washed salads, veggies, and fruit. Last year, four people died and 33 became ill from listeria in packaged salads.

Listeria found in food processing plants is not uncommon, but it isn’t always toxic. Dole salads, the problem in the case of listeria, closed the offending plant, issued a recall, and followed FDA requirements to sanitize its processing systems.

The salad with the dead bat was in Organic Marketside Spring Mix, produced by Fresh Express. It was only distributed at Walmart stores in the Southeastern United States.

The odds of finding a bat or dangerous pathogen in your salad are quite rare, experts say. According to Cassell, people can generally trust that pre-washed salads are handled correctly and present little to no risk to the consumer.

But health specialists say a handful of safe food-handling practices, especially for produce, are a good idea for consumers to follow. Among them:

• Wash your hands thoroughly before starting to prepare food.
• Sort through bagged or boxed greens and/or vegetables carefully.
• Rinse thoroughly and inspect the contents of bagged greens, even if they are already pre-washed.
• Do not use special “veggie soaps.” They don’t do much and remain on the food that you eat.
• Look for “best used by” dates and buy foods accordingly. If food is really fresh it will be better for you.
• Cut away damaged or bruised areas on fruits and vegetables. Throw it away if it looks rotten.
• Even if you plan to peel the produce, it is a good idea to wash it.
• Scrub things like melons or cucumbers with a clean produce brush.
• Use a paper towel to dry produce because it can help to get rid of bacteria.
• When you purchase and store your produce, bag it and store it separately from other foods like meat, seafood, and poultry.
• Refrigerate any produce that is pre-cut or peeled.
• Additional advice from the FDA:
• Wash hands and surfaces often when preparing food.
• Wash your cutting boards, dishes, counters frequently to avoid cross contamination with bacteria and other microbes.
• If you use cloth dishtowels to wipe counters clean, make sure you wash them in hot water. Consider using paper towels instead of cloth towels.

Most of us face some risk from foods — even fresh foods — that aren’t properly washed or cleaned, or that may have been contaminated by other foods like fresh meat.

About 48 million cases of foodborne illness occur each year, with one in six Americans becoming ill from some sort of food contamination. Illness usually starts within days after eating contaminated food, and can include vomiting, diarrhea, abdominal pain, fever, and headache.

Most people recover from food poisoning, according to the FDA. But pregnant women, young children, the elderly, and those with weakened immune systems face a greater risk of complications.

The bottom line: Take a look at that pre-washed salad, toss it with some utensils, and be wary, but be aware that it is probably safe, according to Cassell.

For more information about recalls, or to file a complaint about purchased food, visit the FDA Website.

Eating Pure Oats May be Okay for Celiac Sufferers

by Dr Alex Jimenez | Diets, Fitness

People with celiac disease have to avoid most grains, but oats may be an exception that’s safe, according to a recent research review, so long as the oats are uncontaminated by traces of other grains.

More studies are needed to see whether so-called pure oats available in the real world don’t provoke celiac symptoms. If proven safe, oats could provide celiac sufferers some of the benefits of eating grains that they miss out on following a gluten-free diet, researchers say.

“Oats, compared to other cereals, are a source of good quality proteins, vitamins and minerals and they improve palatability and the texture of gluten-free food,” said study coauthor Dr. Elena F. Verdu.

“For a person diagnosed with celiac disease, adding oats to a gluten-free diet could not only increase food options but also help them follow a better gluten-free diet and have a higher quality of life,” said Verdu, a gastroenterology researcher at the Farncombe Family Digestive Health Research Institute at McMaster University in Hamilton, Canada.

Celiac disease is an autoimmune disorder that affects roughly one of every 100 people in the U.S. For sufferers, consuming even trace amounts of the gluten protein in wheat, barley and rye can trigger an immune response that damages the intestines. Over time, this immune attack can lead to malnutrition, osteoporosis, chronic inflammation and a variety of other problems.

People with celiac disease are also at heightened risk of heart disease and some recent research suggests that might be in part because avoiding gluten causes them to miss out on the heart-protective benefits of eating whole grains.

Oats don’t contain the same celiac-provoking protein found in other grains, the study team writes in the journal Gastroenterology. However, Verdu told Reuters Health, issues have been raised regarding potential adverse reactions to oats by celiac patients, and this has reduced the enthusiasm of adding oats to the gluten-free diet in many cases.

“The first study suggesting that oats may be harmful for patients with celiac disease was published more than 50 years ago. Since then, the addition of oats to a gluten-free diet has remained clouded in controversy,” she said in an email.

For this reason, the review team decided to evaluate the existing evidence. They re-analyzed data from 28 previous studies that included oats in gluten-free diets for people with celiac disease. Eight of the studies were controlled clinical trials; the rest were observational.

The researchers looked at any negative effects on symptoms or blood tests for up to one year of oat consumption.

“In our study, we found no evidence that addition of oats to a gluten-free diet affects symptoms or activates celiac disease. However, it is very important to stress that there were few studies in some of the analyses, the quality of the studies was low and most of them were conducted outside of North America,” Verdu said.

Although the consensus is that pure oats are safe for most patients with celiac disease, contamination with other cereal sources that may contain gluten needs to be avoided, Verdu added.

“The purity of oats will depend on the country of origin and local regulations, and this is why we were surprised to see that most recommendations in North America are still based on studies performed in Europe,” she said.

“Patients who follow a gluten-free diet are sometimes able to consume small quantities of gluten-free oats without adverse reaction,” said Hannah Swartz, a clinical dietitian at Montefiore Medical Center in New York who wasn’t involved in the study.

“Patients who have the most success with including oats in their diet ensure the oats are certified gluten free, and wait one or more years after following a gluten free diet to ensure that gut inflammation has subsided,” she said.

“Patients with celiac disease must first ensure that the oats they are adding are certified gluten free oats. Regular oats used in products that are labeled ‘gluten free’ such as some mainstream cereals are not recommended for patients with celiac disease as there remains the possibility of cross contamination with gluten containing grains during the processing of the oats,” she said.