Vaccines: Let Nature Do Its Thing or No?

Parents must continually make decisions for the well-being of their kids and themselves. Similarly, older Americans are often on fixed incomes and must plan their dollars and medical decisions carefully. Whether or not to vaccinate has, remarkably, become something that millennial parents weigh right along with what to feed their kids and what daycare to choose. The annual flu season brings with it a new opportunity for us to decide – to get the flu shot or not? Are we better off – resistance-wise – letting nature take its course?

Saavy adults know that the body builds its own ‘natural’ immunity once it has endured and healed from a viral infection such as the flu. In fact, this natural immunity following a viral infection can potentially last decades. As Dr. Alicia Fry of the CDC explains in a recent New York Times article, “people who were infected back in the 1930s still have immunity to those [flu] viruses.” In stark contrast, Wang et al. (2011) showed that patients who received the H1N1 Flu vaccine in 2009 showed significantly decreased antibody resistance just 6 months later, while those who were actually infected with (and suffered through) the flu virus still had antibodies to protect them from a repeat infection. In short, letting nature “run its course” results in a body that is more protected and resistant to a future flu infection. Sweet, you’re done with those pesky flu vaccines!

But, wait, you ask, this means I have to actually get sick with the flu, right? Right! To reap these antibody rewards, you have to be willing – and able – to endure days of chills, fever, nausea, time off work and school, and a whole host of pains. If you are an older adult, this also means you might not live through it all, or, if you do, you might need a hospital stay to get through it. If you are a student, you will miss school and potentially infect others and spread your flu joy. If you are a parent, you will necessarily lose time at work taking care of your kids, lose sleep, and, best of all, deal with a cranky, suffering child for a few days while they and you recover.

So, as you roll the flu dice, know that to beat the flu vaccine’s effectiveness, you have to be willing to get and suffer through all of the costs of actually having the flu. For those of us with demanding lives and kids and jobs, the vaccine takes the guessing out of it and saves lost time, money, and Kleenex. For most of us, the vaccine is the way to go and the risk of not getting vaccinated – and getting sick – does not pay off.

Mccarthy, K. (2016, Oct 28). Does the Flu Provide Better Immunity Than a Flu Shot?. The New York Times. Retrieved from  http://well.blogs.nytimes.com/2016/10/28/does-the-flu-provide-better-immunity-than-a-flushot/rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=stream&module=stream_unit&version=latest&contentPlacement=73&pgtype=sectionfront

Wang M, Yuan J, Li T, Liu Y, Wu J, Di B, et al. (2011) Antibody Dynamics of 2009 Influenza A (H1N1) Virus in Infected Patients and Vaccinated People in China. PLoS ONE 6(2): e16809. doi:10.1371/journal.pone.0016809

Freshman 15?

Being sent off to college for the first time comes with a lot of expected and unexpected changes. Generous meal plans, yay! Binge drinking, woohoo! Condo-style dorm rooms, I’ll take one! More stress, ummm, do I have to?? With all of these changes, welcome or unwelcome, one of the first horizons to expand in college is the waistline.

Unfortunately, if rapid weight gain in the fun years of early adulthood isn’t bad enough, it is also correlated with obesity later in life. In short, these are formative years in more ways than we think. But does providence predestine us for the plumping from the “freshman 15”? According to a recent study, the answer is no.

First, we don’t all gain 15. In fact, the average weight gain upon entry to college is only seven pounds. Seven! Good news, right? Well, not exactly. Seven pounds of weight gain in one calendar year is still SEVEN times what would be considered a healthy weight gain. And remember that whole “correlated with obesity later in life” thing? Yeah. So, before we start celebrating that 15 pounds of gain isn’t the destination, we need to remember that seven is still way too much.

So, with all that in mind, the advice for new coeds is the same for anyone going through a major life transition. Keep to a plan, don’t eat whatever, whenever. Keep your stress in check, maybe even reduce it with a great new yoga class at the college rec center. Don’t slack on sleep. Sleep is the key to restoring your body, keeping cravings at bay, and broadening your horizons where you want them broadest: in your brain.

Rosenbloom C. (2016, Sep 6). You don’t have to gain the ‘freshman 15’ — or even the freshman seven. The Washington Post. Retrieved from https://www.washingtonpost.com/lifestyle/wellness/you-dont-have-to-gain-the-freshman-15–or-even-the-freshman-seven/2016/09/01/ec20bf72-6ebf-11e6-8533-6b0b0ded0253_story.html

Vadeboncoeur, C., Townsend, N., & Foster, C. (2015). A meta-analysis of weight gain in first year university students: is freshman 15 a myth? BMC Obesity, 2, 22. http://doi.org/10.1186/s40608-015-0051-7

Sweet Dreams Aren’t Made of This

According to recent reports, using Facebook makes you live longer (Hobbs et al, 2016), but, if you’re doing all that social networking before bed on your smartphone, a separate, unrelated research team shows how you may be compromising your sleep quality. No good deed goes unpunished, as the saying goes.

Indeed, most Americans are glued to their smartphones and check them all day, right up until their last yawn. A team of researchers from UC-San Francisco, led by Dr. Gregory Marcus, directly measured the screentimes of smartphone users by monitoring use in a background app installed on each user’s phone. They weren’t interested in overall screentime, but, instead, focused on how much time users spent staring into their blue-lighted screen just before falling asleep.

Apparently, those blue lights in our screens aren’t good for our brains’ melatonin production – something we need to fall asleep and, more importantly, STAY asleep through the night. You actually want your body to produce its own melatonin in high quantity right before you go to bed. However, by looking into those blue lights illuminating our facebook pages as our heads are atop our pillows, we are actually suppressing melatonin. Look into your screen, suppress melatonin, and sleep worse.

What’s less clear from this article and from the source research, is to what extent people are looking into their screens in bed BECAUSE they can’t sleep. This could be a classic chicken/egg question. What comes first: we use our screens and then can’t sleep? Or, we can’t sleep so we use our screens? This study only measured the relationship between screentime at bedtime and quality of sleep, and it cannot tell us definitively which causes which.

So, the bottom line is this: While you are giggling at the latest cat videos in bed, know that chances are good that you may end up counting more sheep and losing sleep. For that reason, it is probably a good idea to go to sleep the old-fashioned way: In the dark.

Christensen M.A., Bettencourt L., Kaye L., Moturu S.T., Nguyen K.T., Olgin J.E., et al. (2016) Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep. PLoS ONE 11(11): e0165331. doi:10.1371/journal.pone.0165331

Oaklander, M. (2016, Nov 10). If You Do This Before Bed, Your Sleep Will Seriously Suffer. Time. Retrieved from http://time.com/4565122/smartphone-screen-time-sleep/

Hobbs W.R., Nicholas M.B., Christakis A.,  Fowler J.H. (2016) Online social integration is associated with reduced mortality risk. PNAS 2016 : 1605554113v1-201605554.

JUST DO IT (…in the morning)

Health professionals devote a lot of journal space and public outreach efforts to the topic of exercise. With both obesity rates, metabolic disorders, and sedentary lifestyles on the rise in industrialized nations, the urgency to intervene is clear. So, the public health message is clear: Move more, eat less. Simple enough, right?

Well, sort of. Yes, moving more is definitely a good thing. Increased cognitive function, increased cardiovascular fitness, and improvements to mood are just a few of the major benefits of a lifestyle that includes exercise. As Americans track their movement more and add exercise into their daily routines, do morning exercisers get more from it than evening exercisers? Does it matter if you do it early or late in your busy day?

A recent Newsweek article explores this question. Bass et al. (2016) showed that our bodies may have adapted to better synthesize the impact of exercise when it occurs early in our day’s activities. According to the original study published in Cell Metabolism, strenuous exercise works best for the body’s circadian rhythm when it occurs in the morning.

“Oxygen and the internal clock are doing a dance together inside muscle cells to produce energy, and the time of day determines how well that dance is synchronized,” according to the research team. In short, our bodies are programmed to do their best cellular work at the beginning of the day. So, given the cellular-level impact of exercise, you might want pull yourself out of bed early rather than waiting until after work. Grab your coffee and just do it.

Cara, E. (2016, October 29). Is There an Optimal Time of Day to Exercise. Newsweek, Retrieved  from http://www.newsweek.com/optimal-time-day-exercise-514302

Peek, C.B., & Levine, C. B. (2016, October 20). Circadian Clock Interaction with H1F1a Mediates Oxygenic Metabolism and Anaerobic Glycolysis in Skeletal Muscle. Cell Metabolism. doi: http://dx.doi.org/10.1016/j.cmet.2016.09.010

Sugary beverages are a hot topic as of late. From proposed soda taxes to outright removal of soda in some organizations, it is clear that there is a movement to reduce the consumption of these calorically-rich, nutritionally-empty drinks. With more than 24,000 employees, The University of California-San Francisco is perhaps the largest institution to take action systematically thus far. Sugary drinks were removed from every outlet on campus, including fast-food chains and replaced with diet beverages and fruit juices with no added sugar.

Being a public institution that also conducts health research, UCSF researchers not only wanted to reduce consumption, but also set out to study whether any impact on metabolic systems would also be measurable as a result of this policy change. One researcher also cited the moral implications of profiting off of something that is known contribute to adverse health effects. Researchers are studying 214 employees and looking at the impact on weight loss, liver health, insulin resistance, and telomeres. Although the study is still in progress a survey of over 2,500 employees found that soda consumption among employees dropped by a quarter, a significant overall decrease.

The article mentions the beverage industry fighting back with the argument that restrictions and taxes hurt the poor. My question, then, is: What is the definition of “hurt”? If allowing “the poor” – and, in most cases, the least educated in terms of nutrition and health outcomes – easy access to sugary beverages by keeping the prices low, then who is really doing the hurting of this population in need? It is a moral and a money question that is not easily answered.

Early results from the UCSF study show that participants have lost weight, and, despite early resistance to the policy change, they are now glad their employer has removed the sugary sodas. Once long term results have been reported, it will be especially interesting to see whether UCSF employees maintained lower sugar consumption or whether they replaced soda with other high-sugar foods while at work. If they maintain lower sugar intake, UCSF will become an example for schools and employers throughout the country that not only improves the waistline, but the bottom line.

O’connor, A. (2016). Putting Sugary Soda Out of Reach. Retrieved November 06, 2016, from

When it comes to your health, there may be more to consider than just what you are eating –   calories, fat content, types of fat, carbohydrates, protein, vitamins, minerals, and… well, you get the picture. A new study published in the journal Nutrition warns that the temperature at which we cook is as just as important as what we are cooking and how we are cooking it.

Researchers warn that when foods are cooked to high temperatures, they release chemicals linked to an increased risk of heart disease.  According to the article, South Asian populations are at four times greater risk of heart disease, citing the propensity of cooking in hot oils at high temperatures. This implies, however, that they type of oil itself is not a factor – or, at least, not as much of a factor as the temperature of the oil may be.

To break it down further, researchers studied the difference between Chinese and Indian populations’ food preparation methods and how they related to health outcomes. Indian food is typically cooked for longer times and at higher temperatures, thus changing healthy oils and making them unhealthy. In addition, reheating oil is a typical practice in Indian culture, a practice which can bring a separate set of health risks.

Although the argument presented in the article seems valid enough, the research is still nonetheless hypothetical, not empirical. As both the article and the original study state, it has not been tested in a broader, more generalizable population. Although this information seems noteworthy, it all “boils down” to what we already know: Deep fried foods are simply not healthy.

When researchers compare the Chinese cooking methods of boiling and lightly frying with Indian methods of “fried batter soaked in sugar syrup,” it seems as though they aren’t comparing apples to apples, or, perhaps, samosa to samosa. So, are the health risks related to cooking methods between populations really comparable even if traditional food preparation methods are not? It would be interesting and perhaps more useful to look at food preparation methods within a specific group rather than between groups in order to limit the genetic and environmental variables which may also contribute to heart disease.

Senthilingham, M. (2016, November 5). Too much heat in the kitchen may increase your risk of

heart disease. Retrieved November 6, 2016, from  http://www.cnn.com/2016/11/04/health/high-

temperature-cooking-increases-heart disease-risk/index.html

Kakde, S. (2016, July 25). Urbanized South Asians’ susceptibility to coronary heart disease: The high-heat

food preparation hypothesis. Nutrition. http://dx.doi.org/10.1016/j.nut.2016.07.006

Less Might Be More

More protein, less carbs, no sugar, more carbs, less protein, Mediterranean diet, Atkins diet?! In my thirty-six years I have heard almost every different kind of diet advice imaginable. The one thing that has remained steady is that almost always, what was once “proven” effective is soon replaced by a new magic bullet, sure to make me a size 4 again.

According to a recent article on Time.com, It’s Time to Rethink High-Protein Diets for Weight-loss, new evidence suggests “while the diet (high protein) may help people slim down, it doesn’t necessarily improve other health problems under the hood.” Wait, so should I re-think it or will it help me slim down? Rethink protein for weigh loss – they just said it will help slim down! Like most weight loss articles and advice out there, this one is no exception and may add to the confusion.

So, what is the scientific premise of this article? The author cites a small study out of Washington University School of Medicine in St. Louis. The original study, titled High-Protein Intake during Weight Loss Therapy Eliminates the Weight-Loss-Induced Improvement in Insulin Action in Obese Postmenopausal Women, followed 34 postmenopausal women in three conditions: no diet change, calorie-restricted diet (with DRV of protein), and calorie-restricted with increased protein by 150-250 calories. They found that both intervention groups were able to achieve 10% weight loss. Not to shabby! Refer back to the title of the media article and we can stop reading there (weight loss achieved in both conditions, done and done, size 4 here I come!). But, wait, I’m not post menopausal and – oh yeah – they mentioned insulin action. So, this sample is not exactly representative of larger populations.

The popular media article, like the scientific study, goes on to explain that the women who did not increase protein experienced a 25 – 30% improvement in insulin sensitivity, a key risk factor in developing type-2 diabetes. So, surprisingly, the metabolic benefit came to those who didn’t increase protein in their diets. The scientific article also states that the high-protein condition experienced a 45% reduction in the weight-loss-induced decline in lean muscle mass. So, higher protein diets resulted in more muscle retention. The authors concluded that protein content of a weigh loss diet can have profound effects on metabolic function. These two major findings have positive implications that relate to overall health, but applications by health practitioners may differ depending on concerns around type-2 diabetes.

Despite the fact that this was a small study including a very specific demographic, health practitioners can still find some important take-aways. Based on the results of the study, if obesity complications such as type-2 diabetes are a concern, then adopting a weight-loss diet that includes protein in moderation should be more beneficial for the overall health of an individual. However, if muscle mass retention is a concern – as it might be with postmenopausal women, then a high-protein diet helps retain muscle while also losing fat.

Sifferlon, A. (2016, October 11). It’s Time to Rethink High-Protein Diets for Weight Loss.

Retrieved October 17, 2016, from http://time.com/4526448/high-protein-diet-weight- loss-insulin/

Smith, G.I., & Yoshino, J., et al., (2016). High-Protein Intake during Weight Loss Therapy Eliminates the

Weight-Loss-Induced Improvement in Insulin Action in Obese Postmenopausal Woman. Journal of

 Applied Developmental Psychology, 17(3), 849-861. http://dx.doi.org/10.1016/j.celrep.2016.09.047