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Colon Cancer Prevention: How genes interact with nutrition and lifestyle

Colon Cancer Prevention: How genes interact with nutrition and lifestyle

Source: The American Journal of Clinical Nutrition (April 2021)

Lifestyle Medicine Update (June 7, 2021)

A study published in the April 2021 issue of the American Journal of Clinical Nutrition illustrates perfectly what I have been citing and teaching over the past 35-40 years. When the human genome project was first undertaken scientists and doctors were quite certain that once sequenced it would reveal which specific gene mutations were the direct cause of specific age-related degenerative diseases like Alzheimer’s disease and certain types of cancer. Much to their surprise it showed the opposite. There is no one gene mutation that causes age-related Alzheimer’s disease, but rather a collection of gene variants that interact in a way that creates an increased risk. These gene interactions are very complex, and no one knows yet exactly how they influence each other. To complicate matters further, not everyone with these gene variants develops Alzheimer’s disease. Rather, a person’s diet, activity level, and other lifestyle factors are shown to reduce the risk of Alzheimer’s disease even in people that have a collection of these high-risk gene variants. And the same appears to be true for most cases of colon cancer, as illustrated by the study I’m citing today.

In this study of almost 350,000 participants in the UK Biobank Study, researchers observed that in individuals who had high genetic risk scores for colon cancer, based on the multiple number of gene variants linked to increased risk of colon cancer, those who had high Healthy Lifestyle Scores had a 40% reduced risk of developing colon cancer compared to those, who had the same genetic variants for the disease, but whose Lifestyle Scores were much less healthy.  In other words, in most cases, genes don’t act alone and predetermine that you are going to develop colon cancer, and many other degenerative diseases. Rather, it is the interaction between our genes and our lifestyle patterns that trigger or prevent the onset of many of these degenerative conditions. In the UK Biobank Study, in high genetic risk cases for colon cancer, individuals who were more active, had better body shape measurements with less body fat, who avoided processed meat and red meat intake, who ate more vegetables and fruit, drank no or little alcohol and who did not smoke, showed a 40% reduced risk of developing colon cancer compared to those who had less healthy lifestyle patterns and body shape measurements. Put another way, individuals who had more unhealthy lifestyle practices had a 40% greater risk of developing colon cancer, genetic risk factors being equal.

The point here is that in most cases our genes are not our destiny. Your wellness game plan matters, not only to your longevity, but also to your healthy life expectancy – the number of years you hope to have a highly functioning body and mind. So be mindful of your diet and lifestyle patterns – they really do matter in the long run. I included the reference for this research paper in the text below.

Reference:

Jungyoon Choi, Guochong Jia, Wanqing Wen, Xiao-Ou Shu, Wei Zheng. Healthy lifestyles, genetic modifiers, and colorectal cancer risk: a prospective cohort study in the UK Biobank. The American Journal of Clinical Nutrition, 2021; 113 (4):

https://academic.oup.com/ajcn/article-abstract/113/4/810/6155851?redirectedFrom=fulltext

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Omega-3 Fat Supplementation (DHA) Decreases Risk of Early Preterm Births

Omega-3 Fat Supplementation (DHA) Decreases Risk of Early Preterm Births

Source: EClinicalMedicine May 2021 (a clinical journal of The Lancet)

Lifestyle Medicine Update (May 26, 2021)

A study published in EClinicalMedicine in May 2021 showed that supplementing pregnant women with a dose of 1,000 mg per day of the omega-3 fat known as DHA (docosahexaenoic acid) cut their risk of having an early preterm birth by 50%. Early preterm birth, defined as birth before 34 weeks gestation, is a serious public health issue because these births result in the highest risk of infant mortality, and child disability. This study was a double-blind, randomized, multi-center trial, involving 1100 pregnant women, which yielded eye-opening results with major implications for new DHA intake guidelines for pregnant women. The researchers stated that, overall, women who received 1,000 mg of DHA supplementation during their pregnancy had fewer early preterm births. However, participants with low DHA levels at enrollment had half the rate of early preterm birth (2.0% compared to 4.1%) when they were given a supplement of 1000 mg compared with those given a DHA supplement containing only 200 mg during the last half of pregnancy. This is an important finding because many prenatal vitamins contain only 200 mg of DHA, and this is clearly inadequate for a large percentage of women who don’t routinely ingest sufficient DHA in the years leading up to their pregnancy or during pregnancy. In women who began the study with high DHA levels because they were already routinely taking higher doses of DHA, there was no further benefit to adding an additional 1,000 mg of DHA.

What’s critically important here is that studies show that many North American women consume very little DHA from food. Studies such as this one, suggest that women who are planning to get pregnant and women who become pregnant should increase their intake of DHA through supplementation to reduce the risk of early preterm birth and also to enhance brain development of the fetus in utero, as other studies have shown. In the words of co-author Dr. Carl P. Weiner MD, “This study is a potential game-changer for obstetricians and their patients.” Carl P. Weiner, M.D. is a professor of obstetrics and gynecology and professor of integrative and molecular physiology at the University of Kansas School of Medicine, and a professor of pharmaceutical sciences at the University of Kansas School of Pharmacy. He goes on to state, “the dramatic decrease in early preterm birth with DHA supplementation will improve short- and long-term outcomes for children, families, and society in a cost-effective fashion.” Dr. Carlson, another co-author of the study, notes that this information should be widely shared with women who are pregnant and those planning to become pregnant. “Women should be consulting with their doctor and getting their DHA levels tested to ensure they are taking the proper dose to prevent preterm birth,” she stated. Funding for the study was provided by the National Institute of Child Health and Human Development (NICHD) U.S.A. The study is one more example where the use of targeted nutritional supplementation can improve outcomes for serious and common health concerns.

I have included the reference for this study in the text below.

 

Reference:

Susan E Carlson, Byron J Gajewski, Christina J Valentine, Elizabeth H Kerling, Carl P Weiner, Michael Cackovic, Catalin S Buhimschi, Lynette K Rogers, Scott A Sands, Alexandra R Brown, Dinesh Pal Mudaranthakam, Sarah A Crawford, Emily A DeFranco. Higher dose docosahexaenoic acid supplementation during pregnancy and early preterm birth: A randomised, double-blind, adaptive-design superiority trialEClinicalMedicine, 2021 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00185-1/fulltext

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Stress-Fighting Adaptogen Herbs: Scientific update and practical use in mental and physical health

Stress-Fighting Adaptogen Herbs: Scientific update and practical use in mental and physical health

Source: Various peer-reviewed scientific journals (see references)

Lifestyle Medicine Update (May 13, 2021)

I want to update you today on adaptogen herbs that have been shown to mitigate the negative effects of stress on the body and the brain. My favorite adaptogen herbs are Ashwagandha, Rhodiola, and Schisandra. When we are faced with chronic stress, which is a common feature in our modern world, our adrenal glands are prompted to pump out more cortisol (the stress hormone) than is often desirable for optimal health. Chronically high levels of cortisol can produce many negative effects on the body and the brain, such as:

  • Increasing inflammation and worsening inflammatory diseases like arthritis and autoimmune conditions.
  • Decreasing immunity -increasing risk of infections and even cancer
  • Raising blood sugar levels – triggering or exacerbating diabetes
  • Damaging brain cells in a way that negatively impacts our memory, learning ability, and sleep cycles.
  • And changing brain chemistry in ways that can trigger or worsen mental health problems, such as depression, burnout syndrome, and anxiety.

In 2017, the Georgia State Honors College Undergraduate Research Journal published a review of recent human studies where adaptogen herbs, like Ashwagandha, Schisandra and Rhodiola were used in the treatment of patients who were diagnosed with:

  • Stress/Burnout
  • Anxiety
  • Stress-Induced Fatigue
  • Mental Fatigue from shift work and exhausting work schedules
  • And weight-gain patients where excessive life stress was a factor.

Each of the studies showed that supplementation with adaptogen herbs was effective at not only improving these symptoms along with patient vitality and resilience, but supplementation with these herbs also lowered blood levels of cortisol (the stress hormone) in these patients. Other studies published in the Journal of Neuropsychiatric Disease Treatment (2017) and the Indian Journal of Psychological Medicine (2012) have shown similar results. Human clinical trials have also shown that, when used in conjunction with anti-depressant or anti-anxiety drugs, patients using adaptogen herbs often responded better to their treatment than do the group not given the adaptogen herbs. An excellent review in the Journal Pharmaceuticals (2010) highlighted the studies showing that adaptogen herb supplementation has also reduced major side effects of drugs used to treat schizophrenia and depression, they’ve improved recovery for patients recovering from influenza and pneumonia, and enhanced recovery from depression and improved physical performance in those who work or train hard physically. Unfortunately, as helpful as they can be, some adaptogen herbs can be dangerous to use in the view of some experts (including me), such as ginseng and licorice extract. These two adaptogen herbs can interact badly with many types of medications causing untoward and even life-threatening side effects. They can also produce adverse effects on blood pressure and the heart, cause skin rashes and impair the normal detoxification of coffee, alcohol, and acetaminophen. On the other hand, the use of Ashwagandha, Schisandra, and Rhodiola has shown a high level of safety and efficacy in human studies, which means that most people can use them without the risk of serious side effects. Based on available human studies and experimental and experiential evidence, here are some examples where a supplement combination of safe adaptogen herbs can be considered as an ancillary measure to help combat the effects of stress, enhance recovery, and/or improve health conditions:

  • General Unexplained Fatigue
  • Over Training Syndrome
  • Recovering from Infectious Disease
  • Weakened Immunity (Chemo, Radiation, Infection, Diabetes, etc.)
  • Mental Health: Prevention and Adjunct in Depression, Anxiety, Stress-Burnout where stress is a factor.
  • Declining Libido and Sexual Performance
  • Menopausal Symptoms not responding to standard and other natural interventions.
  • Signs and symptoms of underactive thyroid in presence of normal thyroid blood tests (high cortisol can block the effects of thyroid hormone)
  • Sleep Disturbances
  • Decreased Concentration and Learning Ability in Stressful situations – also consider prior to exams and other mental stressors on the horizon.
  • Decreased Physical Endurance – also consider prior to physical work stress.
  • Early-Stage Memory Loss (along with other nutrients that support memory)
  • Stress-related hair loss (along with a high potency multiple vitamin and mineral supplement)
  • Adjunct to a Weight Management Program, where stress is a factor.
  • In Some Neurodegenerative Diseases (Parkinson’s dis/Alzheimer’s dis)
  • Autoimmune Conditions affecting the Joints (i.e., RA)

 

If any of this sounds like it applies to you then my personal preference is a supplement containing a combination of Ashwagandha, Schisandra, and Rhodiola.I have included the references for these stress-fighting adaptogens in the text below.

References:

2017 Review: Georgia State Honors College Undergraduate Research Journal: Human Clinical Studies on Mental Health https://scholarworks.gsu.edu/cgi/viewcontent.cgi?article=1057&context=discovery

Kasper S and Dienel A. Multicenter, open-label, exploratory clinical trial with Rhodiola Rosea extract in patients suffering from burnout symptoms.  Neuropsychiatr Dis Treat. 2017. 13:889-898. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370380/

Chandrasekhar K, Kapoor J, Anishetty S. A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults, Indian Journal of Psychological Medicine. 2012. July-Sept.34(3):255-262 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/

Panossian A and Wikman G. Effects of adaptogens on the central nervous system and the molecular mechanisms associated with their stress-protective activity. Pharmaceuticals 2010; 3(1):188-224 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991026/

Dangerous Effects of Ginseng and Licorice Root:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291795/

https://www.medicalnewstoday.com/articles/262982

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452531/#:~:text=Siegel%20%5B16%5D%20described%20the%20unfavorable,and%20hypotension%20(%E2%88%BC10%25).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498851/

https://www.sciencedirect.com/science/article/abs/pii/S0928098717304335?via%3Dihub

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498851/

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Low Iodine Intake from Plant-based Diets Increasing Risk of Neurological Defects in Children

Low Iodine Intake from Plant-based Diets Increasing Risk of Neurological Defects in Children

Source: Multiple Peer-reviewed Studies (see references below)

Lifestyle Medicine Update (May 5, 2021)

So, let’s talk about iodine. It’s not considered to be a really sexy topic and it hardly gets mentioned in the nutrition and wellness news of the day. But the fact is that recent dietary trends have resulted in a growing number of people who are becoming more and more iodine deficient. More specifically, many young people are now adopting the dietary practices of avoiding consumption of all dairy and animal products, including fish and using sea salt and other salt substitutes in place of common table salt, in an effort to consume all things natural. One of the unintended consequences is that an increasing number of young women now find themselves at increased risk of having children born with impaired neurological conditions, due to poor iodine intake. A small study in South Australia recently showed this finding, but a 2017 U.S. study found that nearly 2 billion people worldwide were iodine deficient, resulting in 50 million experiencing clinical side effects.

Of importance to young women is the fact that just mild to moderate iodine deficiency has been shown to affect language development, memory, and mental processing speeds in their offspring. In fact, the need for increased iodine intake occurs during pregnancy, but studies show that most women do not ingest the amount of iodine that is desirable leading up to becoming pregnant, nor do they consume the increased amount required during pregnancy and lactation, which is 220 and 290 mcg per day, respectively. As was stated at the 1990 World Summit for Children, “Iodine deficiency remains the single greatest cause of preventable brain damage and mental retardation worldwide. “Eliminating iodine deficiency was recognized as one of the most achievable of the goals that the 1990 World Summit for Children set for the year 2000. Unfortunately, the year 2000 has long come and gone and many women who live in modern countries, who have ample access to foods rich or fortified with iodine, are now avoiding these foods.

Dietary strategies such as using plant-based beverages (oat milk, soy milk, etc.) in place of dairy products, avoiding all dairy products, avoiding all meaty foods, including fish, and using Himalayan sea salt and other salt alternatives that are not fortified with iodine, as well as avoiding bread products, have lead to an increased number of young women becoming mild to moderately iodine-deficient, which does not present with any physical symptoms, but does lay the foundation for brain development problems in their children should these women become pregnant. I’m the first person to tell you that a more plant-based diet is desirable for many reasons, including reducing the risk of cardiovascular disease and many types of cancer. It’s also better for the environment, and the ecosystem, not to mention the animals themselves. But, it has to be done intelligently, not guided only by philosophical principles. An iodine food fortification program exists in many developed countries for a reason, which is to help avoid the consequences of widespread iodine deficiency and insufficiency, which commonly occurs in populations where iodine-rich and iodine fortified foods are not available.

The daily requirement for iodine for most adults is 150 mcg per day. As little as ¼ teaspoon of iodized salt contains 76 mcg of iodine. As well, many flours and bread doughs are enriched with iodine often providing 180-185 mcg in one slice of bread. Boling pasta with a bit of iodized salt provides 36 mcg of iodine in a 1 cup serving of pasta. Many non-fat yogurts contain up to 116 mcg of iodine in 8 oz. 1 cup of non-fat milk contains 85 mcg of iodine. Some seaweeds contain up to 230 mcg of iodine, whereas other ones contain very little – so you can’t depend only on seaweed as your source of iodine. Most fruits and vegetables and legumes contain very little or no iodine at all and 1 cup of soy milk has 7 mcg (not very much). Of course, fruits, vegetables, and legumes, including soy products are healthy food choices, but they don’t provide iodine in an appreciable amount. You’ll have to find that elsewhere. Some fish, like cod, have as much as 158 mcg of iodine in 3 oz, whereas 3 oz of shrimp only has about 13 mcg, so it varies from fish to fish and from seafood to seafood. For example, 3 oz of tuna has 17 mcg of iodine.

In our society, individuals who tend to ingest less than the desired amount of iodine include:

  • People who avoid iodized salt
  • Pregnant and breast-feeding women (because they have increased need)
  • Vegans and people who eat few or no dairy products, seafood, or eggs.

In addition to increasing the risk of neurological deficits in offspring, mild to moderate iodine deficiency has also been linked to increased risk for thyroid cancer as well as breast and stomach cancer, in a number of studies. Iodine deficiency can also cause fibrocystic breast disease, which can be reversed in many cases via medically supervised iodine supplementation. As a rule, iodine supplementation is not something that is required for most people, as the dosage of safe levels of iodine supplementation is still being debated.  We do know that iodine supplementation can be harmful if too high a dosage is ingested. For most of us, paying attention to food sources of iodine is a prudent strategy to employ. We are fortunate enough to live in a part of the world where iodine fortification and iodine-rich foods are available. We should ensure that we keep iodine intake on our radar and get enough iodine each day to meet our daily requirements, while still being cognizant of the other health-promoting and environmentally and animal-friendly dietary practices we may be seeking to follow.

I have included the references for this information in the text below.

References:

Poor iodine levels in women pose risks to fetal intellectual development in pregnancy https://www.sciencedaily.com/releases/2021/04/210422093858.htm

Jane S. Whitbread, Karen J. Murphy, Peter M. Clifton, Jennifer B. Keogh. Iodine Excretion and Intake in Women of Reproductive Age in South Australia Eating Plant-Based and Omnivore Diets: A Pilot Study. International Journal of Environmental Research and Public Health, 2021; 18 (7): 3547 https://www.mdpi.com/1660-4601/18/7/3547

Iodine: National Institutes of Health https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/

Iodine and Thyroid Cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490680/

Iodine and Stomach and Breast Cancer and Fibrocystic Breast Disease: https://www.naturalmedicinejournal.com/journal/2014-06/iodine-and-cancer

Health Consequences of Iodine Deficiency Including Mental Developmental Problems in Children https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074887/

Eat Smart, Live Well, Look Great!

Dr. James Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Diet and Botanical Agents for Premenstrual Syndrome – PMS

Diet and Botanical Agents for Premenstrual Syndrome – PMS

Source: Multiple Peer-reviewed Research Papers (see References)

Lifestyle Medicine Update (April 28, 2021)

In the previous Lifestyle Medicine Update, I explained the research showing how and why certain vitamin and mineral supplements are shown to help reduce or eliminate the constellation of symptoms associated with premenstrual syndrome or PMS. But it’s not just vitamins and minerals that can be helpful. Certain dietary strategies, and the use of certain plant-based nutrients or botanicals, have also been shown to help many women who suffer from this condition. From a dietary standpoint, evidence suggests that reducing refined sugars, caffeine, and alcohol can help to prevent some of the inflammatory aspects of PMS, such as breast pain. But most strikingly, PMS appears to be largely caused by an imbalance between estrogen and progesterone in the final 7-10 days of the menstrual cycle leading up to the onset of menstruation. Normally progesterone is the dominant hormone in this part of the menstrual cycle, but when estrogen levels remain high (or more dominant), this is when PMS symptoms are likely to occur. Studies show that strategies to lower circulating estrogen or mitigate its impact on target tissue like breast and endometrial cells often help to reduce PMS symptoms.

As such, studies have shown that when women lower their intake of high-fat meat and dairy products, as well as deep-fried foods and breaded meats, and use lower-fat alternatives, and/or embrace a more plant-based diet, they begin to excrete more excess estrogen through the fecal route. Adding more dietary fiber, especially wheat bran, has also been shown to increase fecal excretion of excess estrogen. Together, these strategies have been shown to lower circulating levels of estrogen by up 50%, and in doing so, have helped many women reduce PMS symptoms. Exercising regularly also helps the body detoxify more estrogen in the liver and excrete it via the fecal route. Women who exercise regularly are shown to have a lower incidence of PMS. As well, supplementation with the botanical agent Black cohosh as well as Soy extract (standardized to isoflavone content), have been used successfully to reduce or eliminate many PMS problems, including often disabling menstrual cramps.

Black cohosh contains triterpene glycosides and soy extract contains isoflavones. These natural compounds essentially compete with the body’s more potent estrogens for binding to tissue sites. In turn, this reduces the overstimulation effect of estrogen on these tissues, reducing PMS symptoms in many cases. Thus, Black cohosh and Soy Isoflavone tone down the overstimulation effects of estrogen, helping to tame PMS problems. The dosage of Black cohosh shown to be effective is:

80 mg, twice daily (std to 2.5% triterpene glycosides)

For Soy extract, the effective dosage is:

125 mg, twice daily (std to 20% isoflavone content).

Some supplement companies combine Black cohosh and Soy extract into a single supplement product to make things more convenient and to capitalize on the synergistic effects these natural agents have on addressing underlying PMS issues. Some of these products contain other synergistic ingredients, such as Gamma-oryzanol, an extract from rice bran oil that has female hormone-balancing properties as well.

Other strategies to help detoxify excess estrogen, as well as estrogens from the environment known as xenoestrogens, is to regularly consume cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower, Bok choy, turnips), as they contain the indole-3-carbinol, which speeds up liver detoxification of estrogen and xenoestrogens. Ingesting soy products and a heaping tablespoon of ground flaxseed each day can also help to improve estrogen balance within the body.  In PMS cases where abdominal issues are a problem, such as bloating, constipation, diarrhea, taking a probiotic and/or prebiotic supplement may also be helpful, according to published data. Probiotics are combinations of living-friendly gut bacteria, which are sold in many pharmacies and health food stores. Prebiotics, like FOS (Fructo-oligosaccharide) and Inulin, are the type of soluble fiber that is the main food consumed by the gut-friendly bacteria.

 

Ingesting FOS and Inulin helps foster the replication of our gut-friendly bacteria, which usually then crowds out the problematic unfriendly gut bacteria, improving the gut microflora environment. Chiropractic care has also been shown to help reduce menstrual cramps and low back pain associated with PMS, as shown in various published studies. Combining this with acupuncture may be even more effective, according to some studies.

In summary, the holistic approach to the management of PMS entails the following:

Reduce the intake of refined sugars, caffeine, and alcohol.

Follow a lower fat, more plant-based diet that includes wheat bran and 1 tablespoon of ground flaxseed daily.

Consume cruciferous vegetables regularly and consider the inclusion of soy products in the diet as well.

Take a high potency multiple vitamin and mineral supplement, enriched with high doses of antioxidants (like vitamin E), a B-50 complex, 500 mg of calcium, and 200 mg of magnesium.

Take an essential fatty acid supplement containing a combination of fish, flaxseed, and borage seed oil, as an example.

Take a botanical supplement containing the right dosage and standardized grade of Black cohosh and Soy extract, as outlined previously in this update.

Also, consider a probiotic and/or prebiotic supplement if abdominal issues are a factor.

Have a chiropractor assess your low back function in cases of dysmenorrhea (menstrual cramps) or if PMS triggers low back pain symptoms.

Engage in regularly endurance-based aerobic exercise.

 

All these strategies working together can address many of the underlying factors that cause PMS, improving outcomes for many women who are looking for natural solutions for this common problem.

I hope this was helpful. I have included the references for this information in the text below.

 

References:

Frachiewicz E, et al. Evaluation and management of premenstrual syndrome and premenstrual syndrome dysphoric disorder. J Am Pharm Assoc 2001;41(3):437-447.

Gorbach SL, et al. Diet and the excretion and enterohepatic cycling of estrogens. Prev Med 1987;16:525-531.

Goldin BR, et al. Estrogen patterns and plasma levels in vegetarian and omnivorous women. New Engl J Med 1982;307:1542-1547.

Longcape C, et al. The effect of a low-fat diet on oestrogen metabolism. J Clin Endocrinal Metab 1987; 64:1246-1250.

Woods MN, et al. Low-fat, high fiber diet and serum estrone sulfate in premenopausal women. Am J Clin Nutr 1989;49:1179-1183.

Jones DY. Influence of dietary fat on self-reported menstrual symptoms. Physical Behav 1987;40:483-487.

Aganoff JA, et al. Aerobic exercise, mood states and menstrual cycle symptoms. J Psychosom Res 1994; 38:183-192

Choi PY, et al. Symptom changes across the menstrual cycle in competitive sportswomen, exercisers, and sedentary women. Br J Clin Psychol 1995;34:447-460.

Steege JF, et al. The effects of aerobic exercise on premenstrual symptoms in middle-aged women: a preliminary study. J Psychosom Res 1993;37(2):127-133.

Limon L. Use of alternative medicine in women’s health. Am Pharmaceutical Assoc Annual Meeting. APHA 2000:1-5.

Schildge E. Essay on the treatment of premenstrual and menopausal mood swings and depressive states. Rigelh Biol Umsch 1964;19(2):18-22.

Heck A, et al. Potential Interactions between Alternative Therapies and Warfarin. Am J Health – Syst Pharm 2000;57;13:1221-1227.

McNeil JR. Interactions between herbal and conventional medicines. Can J CME 1999;11(12):97-110.

Dittmar RW, et al. Premenstrual syndrome, treatment with a phytopharmaceutical. Therapiewache Gynakol 1995;5:60-68.

Pteres-Welte C., et al. Menstrual abnormalities and PMS: Vitex agnus-castus. Therapiewache Gynakeol 1994;7:49-52.

Albertzazzi P, et al. The effect of dietary soy supplementation on hot flashes. Obstet Gynecol 1998;91: 6-11.

Cassidy A, et al. Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr 1994;60:333-340.

Patter SM, et al. Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr 1998;68(suppl):137-139.

Dalais FS, et al. Dietary soy supplementation increases vaginal cytology maturation index and bone mineral content in postmenopausal women. Am J Clin Nutr 1998;68(suppl):1519 (abstract).

London RS, et al. Effect of a nutritional supplement on premenstrual syndrome in women with PMS: a double-blind longitudinal study. J Am Cell Nutr 1991;10:494-499.

Stewart A. Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med 1987;32:435-441.

Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndrome. J Reprod Med 1983;28:446-464.

Walsh MJ, Polus BI. A randomized, placebo-controlled clinical trial on the efficacy of chiropractic therapy on premenstrual syndrome. Journal of Manipulative Physiol Ther 1999 Nov-Dec;22(9):582-5

Liebl NA, Butler LM. A chiropractic approach to the treatment of dysmenorrhea. J Manipulative Physiol Ther 1990. Vol.13(2):101-106.

Walsh MJ, Polus BI. The frequency of positive common spinal clinical examination findings in a sample of premenstrual syndrome sufferers. J Manipulative Physiol Ther 1999 May;22(4):216-20.

Deadman P. Acupuncture in the treatment of premenstrual syndrome. Journal of Chinese Medicine May 1, 1995:5-14.

Connelly DM. An acupuncturist looks at women’s health. Meridians Jun 1, 1993;1(2):18-20.

de Vrese M. Health benefits of probiotics and prebiotics in women. Menopause International. 2009; 15(1):35-40

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Vitamins and Minerals in the Management of Premenstrual Syndrome (PMS)

Vitamins and Minerals in the Management of Premenstrual Syndrome (PMS)

Source: Cochrane Database Systematic Review (2018)

Lifestyle Medicine Update No 200 (April 22, 2021)

Premenstrual syndrome or PMS affects about one-third of women ages 25-40 years old and for about 10% of women, the symptoms are very severe. Of course, some of the common symptoms include any combination of intense or debilitating menstrual cramps, abdominal bloating, breast pain, joint swelling, food cravings, mood swings, and even depression. Drugs such as oral contraceptives, anti-depressants, diuretics, and other medications are sometimes prescribed to help treat these symptoms. But these drugs typically treat the symptoms not the cause of the problem. A growing number of published research papers in recent years have shown that the root cause of many PMS cases stems from underlying marginal deficiencies of certain vitamins and minerals and that supplementation to correct these deficiencies often eliminates or minimizes many PMS symptoms. As stated in the 2018 Cochrane Database review on this subject, “deficiencies of certain vitamins and minerals including vitamin B, vitamin D, calcium, and magnesium may play a role in PMS. This hypothesis is based primarily on the high incidence of PMS in populations with low levels of these micronutrients.”

They indicate that magnesium and vitamin B6 status is often low in PMS patients. These nutrients are required for brain synthesis of serotonin – the feel-good brain chemical that is low in cases of depression. Vitamin B6 and magnesium are also required to prevent joint swelling, especially in conjunction with omega-3 fats. Other studies have noted a low intake of vitamin D and calcium in PMS patients compared to women who don’t suffer from PMS. Like vitamin B6 and magnesium, vitamin D also supports brain function and calcium is necessary to prevent the kind of abdominal cramping often seen in PMS. Calcium is also a messenger within cells, which supports the synthesis of ovarian hormones necessary to keep hormones in balance throughout the menstrual cycle. Some clinical trials have shown that supplementation with B-vitamins, magnesium, vitamin E, and-or calcium, as well as certain essential fatty acids (omega-3 fats and GLA-rich -oils like Borage Seed Oil) have helped to improve various physical and brain-associated PMS symptoms, including mood swings and food cravings.

This is the reason I often recommend to PMS patients that they take a high potency multiple vitamin and mineral each day that contains a B-50 complex, 200 mg magnesium, 500 mg calcium, 1000 IU vitamin D and everything else from vitamin A to zinc, along with an essential fatty acid supplement containing a combination of Fish, Flaxseed, and Borage Seed Oil). This combination of nutrients can help to correct any underlying marginal deficiencies and it provides key nutrients to support brain chemistry, suppress inflammation and even muscle cramps in some cases. There are also some other important dietary, lifestyle and botanical considerations that are shown to be effective in the management of PMS, which I will review in the next Lifestyle Medicine Update.

I have included the references for this information in the text below.

References:

Cochrane Database Systematic Review: Vitamin or mineral supplements for premenstrual syndrome (2018) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491313/#:~:text=Several%20vitamins%20and%20minerals%20including,the%20underlying%20pathogenesis%20of%20PMS

Berman MK, et al. Vitamin B6 in premenstrual syndrome. J Am Diet Assoc 1990;90:859-861.

Kliejnen J, et al. Vitamin B6 in the treatment of premenstrual syndrome – A Review. Br J Obstet Gynaecol 1990; 97: 847-852.

London RS, et al. Effect of a nutritional supplement on premenstrual syndrome in women with PMS: a double-blind longitudinal study. J Am Cell Nutr 1991;10:494-499.

Stewart A. Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med 1987;32:435-441.

Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndrome. J Reprod Med 1983;28:446-464.

London RS, et al. The effects of Alpha-Tocopherol on premenstrual symptomatology: A double-blind study. II. Endocrine Correlates. J Am Col Nutr 1984;3:351-356.

London RS, et al. Endocrine parameters and alpha-tocopherol therapy of patients with mammary dysplasia. Cancer Res 1981;41:3811-3813.

Thys-Jacobs S, Starkey P, Bernstein D, Tian JCalcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual syndrome Study Group. Am J Obstet Gynecol 1998;179(2):444-52.

Walker AF, De Souza C, Vickers MF, et al. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Women’s Health 1998;7:1157-55.

Facchinetti F, Sances G, Borella P, et al. Magnesium prophylaxis of migraine? Effects on intracellular magnesium. Headache 1991;31:298-301.

Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nutr 2000;19:3-12

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Vitamin D Treatment Guidelines for Covid-19 Patients

Vitamin D Treatment Guidelines for Covid-19 Patients

Source: The Spanish Society of Geriatrics and Gerontology Position Statement (February 8, 2021)

Lifestyle Medicine Update (April 14, 2021)

The link between sub-optimal vitamin D nutritional status and severity and mortality from Covid-19 has become so strongly tied together that on February 8, 2021, a position statement from the Spanish Society of Geriatrics and Gerontologists published their recommendations entitled, “Vitamin D supplementation for the prevention and treatment of Covid-19.” Quoting from their position statement they indicate that Covid-19 produces severe respiratory symptoms such as bilateral pneumonia associated with a rate of morbidity and mortality, especially in patients of advanced age. At this time, there is no known active treatment for this virus. Corticosteroid drugs and biological immunomodulators are being used to treat the inflammatory phase of the disease.

With respect to vitamin D, they state that vitamin D receptors are expressed by most immune cells, including B-lymphocytes, T-lymphocytes, monocytes, macrophages, and dendritic cells and that vitamin D stimulation of these immune cells produces anti-inflammatory effects, which help suppress the cytokine storm that typically causes death to occur in advanced Covid-19 cases. They also reinforce the fact that vitamin D also is required for certain immune cells (dendritic and T-T-reg cells) to fully mature and respond in appropriate ways to help ward off and fight viral and other infections.  They state that, in this context, some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19. They go on to state that some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients. They cite a meta-analysis study showing a lower mortality rate in patients given vitamin D supplementation (10.6%) compared to controls (23.9%). Two retrospective studies included in this meta-analysis showed a decrease in clinical symptoms in patients treated with vitamin D, and a third study demonstrated a lower rate of admission in intensive care units for Covid-19 patients given vitamin D supplements. A fourth study cited in the Meta-analysis showed a significant decrease in serum fibrinogen levels in Covid-19 patients given vitamin D supplements. As a rule, lower fibrinogen blood levels translate into a lower risk for developing abnormal blood clots and blood vessel inflammation. Another study (as I reported on last week) showed that patients with low blood levels of vitamin D, who were administered vitamin D supplements within a month before contracting Covid-19, had less severe symptoms, better recovery, and a lower risk of mortality than patients identified with low vitamin D blood levels who were not recommended to take vitamin D by their doctors, and who subsequently contracted Covid-19 within the next month.

Previous studies have indicated that the risk of developing many types of severe infections is much lower in people who have blood vitamin D levels between 80 and 140 nmol/L (30 -56 ng/ml), as I have reported on in previous updates. Based on the available evidence the Spanish Society of Geriatrics and Gerontologists have established recommendations for vitamin D supplementation for patients testing positive for Covid-19. The vitamin D recommendations are based on the patient’s vitamin D blood level; the lower the patient’s blood level of vitamin D, the more aggressive is the vitamin D supplementation protocol. As an example, for Covid-19 patients presenting with a blood vitamin D level below 25 nmol/L (which is not uncommon), they recommend 7,000 IU of vitamin D daily for the first 8 weeks, followed by 3,500 IU daily for the next 8 weeks. The goal in these cases is to quickly establish more ideal nutritional status of vitamin D, with the intention of improving immune competence and helping to prevent a life-threatening cytokine storm from occurring.

I have included the comprehensive vitamin D supplementation protocol they recommend, based on the patient’s vitamin D blood level, in the text below for those who are interested. I have also included the reference for this position statement in the text below.

Blood Level -25 Hydroxycholecalciferol and Recommended Oral Doses of Cholecalciferol (Regular Vitamin D Supplements):

Blood Level Less than 10 ng/mL = 25 nmol/L   – 8 weeks – 7,000 IU/d; then 3,500 IU/d for 8 weeks

Blood Levels between 11-20 ng/ml (27.5 – 50 nmol/L)    – 2 weeks – 7,000 IU/d; then 3,500 IU/d for 14 weeks

Blood Levels between 21-29 ng/ml (52.5 – 72.5 nmol/L) – 4 weeks – 7,000 IU/d, then 3500 IU/d for 12 weeks

Blood Levels between 30 – 40 ng/ml (75 – 100 nmol/L) – Single Dose – 50,000 IU; Later 3,500 IU/d for 12 weeks

Blood Level between 41-60 ng/ml (102.5 – 150 nmol/L) – 25,000 IU biweekly for 12 weeks

Reference:

Vitamin D supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology https://www.sciencedirect.com/science/article/pii/S0211139X21000044?via%3Dihub

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Vitamin D Supplementation Improves Outcomes for Covid-19 Patients: Study Shows

Vitamin D Supplementation Improves Outcomes for Covid-19 Patients: Study Shows

Source: The Endocrine Society (March 21, 2021)

Lifestyle Medicine Update (April 8, 2021)

In previous Lifestyle Medicine Updates, I cited the research showing that individuals with low vitamin D blood levels are shown to be more prone to serious Covid-19 outcomes and complications, including death, than individuals with more optimal vitamin D blood levels (80-140 nmol/L). Building on these findings, a Spanish hospital study showed that providing Covid-19 patients with vitamin D supplementation upon admission to the hospital resulted in fewer cases escalating to the point where they required treatment in the Intensive Care Unit, as well as many fewer deaths occurring in the vitamin D, supplemented Covid-19 patients, compared to the non-vitamin D supplemented Covid-19 patients.

As I speak to you today, a multi-center trial is underway throughout Spain in various hospitals to confirm the protective effects of vitamin D in this regard. The breaking news at this moment, however, are the findings that were presented at the annual Endocrine Society Annual meeting on March 21, 2021, which reported that patients with low vitamin D levels who were hospitalized for COVID-19 had a lower risk of dying or requiring mechanical ventilation if they received vitamin D supplementation of at least 1,000 units weekly.The researchers studied 124 adult patients with low vitamin D blood levels, which were measured up to 90 days prior to their admission to the hospital for COVID-19. Researchers compared the patients who were supplemented with at least 1,000 units of vitamin D weekly to those who had not received vitamin D supplements in terms of whether they were mechanically ventilated or died after admission to the hospital. They found that patients who were supplemented with at least 1,000 IU of vitamin D weekly were less likely to be mechanically ventilated or to die following hospital admission for Covid-19.

 

They also found that more than half of the patients with low vitamin D levels, who should have been recommended to take vitamin D supplements by their doctor, were not told to do so. As stated by Dr. Chekuri, a coauthor of the study from Albert Einstein College of Medicine in New York, “given how common vitamin D deficiency is in the world and the United States, we believe that this research is highly relevant right now.” Another co-author of the study, Dr. Corinne Levitus commented, “we hope this research will encourage clinicians to discuss adding this supplement (vitamin D) with their patients who have low vitamin D, as this may reduce the odds of people developing severe COVID-19.”

Once again, the overall evidence right now suggests that for optimal immune support it is wise for most individuals to achieve a blood level of vitamin D between 80 – 140 nmol/L (32 – 56 ng/mL). Most people need to supplement with at least 1,000 IU of vitamin D per day to achieve this blood level.

I have included the reference for this study in the text below.

Reference:

https://www.sciencedaily.com/releases/2021/03/210321215452.htm

 

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Pre-Exercise Coffee Consumption and Fat-burning

Pre-Exercise Coffee Consumption and Fat-burning

Source: Journal of the International Society of Sports Medicine (January 2021)

Lifestyle Medicine Update (March 31, 2021)

Studies over the years have suggested that caffeine intake 30 minutes prior to endurance exercise can help increase fat-burning during exercise.  In January 2021, these findings were confirmed in an important study published in the Journal of the International Society of Sports Medicine. Scientists from the Department of Physiology of the University of Granada (UGR) showed that the equivalent of an 8 oz cup or black coffee containing caffeine (about 3 mg/kg, the equivalent of a strong coffee) ingested half an hour before aerobic exercise significantly increases the rate of fat-burning.  They also showed that if the exercise is performed in the afternoon, the effects of the caffeine on fat-burning are greater than if the exercise occurs in the morning.

A total of 15 men (mean age, 32) participated in the research, completing an exercise test four times at seven-day intervals. Subjects ingested 3 mg/kg of caffeine or a placebo at 8 am and 5 pm (each subject completed the tests in all four conditions in random order). The conditions prior to each exercise test were strictly standardized, and fat-burning during exercise was calculated accordingly. The results of the study showed that caffeine ingestion 30 minutes before performing an aerobic exercise test increased maximum fat oxidation (burning) during exercise regardless of the time of day, but higher amounts of fat were burned when exercising in the afternoon compared to exercising in the morning, when all other factors are kept constant, such as hours of fasting prior to exercise.

In summary, the findings of this study suggest that the combination of acute caffeine intake and aerobic exercise performed at moderate intensity in the afternoon provides the optimal scenario for people seeking to increase fat-burning during their workout routine. The take-home message is that an 8 oz cup of black coffee ingested 30 minutes prior to your aerobic work out routine enables your body to burn more body fat during your work out routine, which can help you more easily maintain your ideal weight or help further reduce your body fat during each work out if that is one of your goals. If you happen to favor working out in the afternoon, as I do, then the fat-burning effect is likely to be even greater.

I have included the reference for this information in the text below.

Reference:

Mauricio Ramírez-Maldonado, Lucas Jurado-Fasoli, Juan del Coso, Jonatan R. Ruiz, Francisco J. Amaro-Gahete. Caffeine increases maximal fat oxidation during a graded exercise test: is there a diurnal variation? Journal of the International Society of Sports Nutrition, 2021; 18 (1)  https://jissn.biomedcentral.com/articles/10.1186/s12970-020-00400-6

 

Eat Smart, Live Well, Look Great,

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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Soy Protein vs Animal Protein in Muscle Gains

Soy Protein vs Animal Protein in Muscle Gains

Source: Runners World (March 2021)

Lifestyle Medicine Update (March 17, 2021)

A study reviewed in Runners World Magazine on March 12, 2021, referenced an important study showing that plant protein can be just as effective as animal protein for muscle gains in young, healthy people. It is well established that you need two things to build muscle tissue and lean mass: resistance training and adequate protein intake. Many studies over the years have shown that animal protein (especially whey protein) is superior to vegetable and other protein sources for muscle tissue and lean mass development because it contains a more complete complement of amino acids for muscle protein synthesis, as well as higher amounts of the amino acid leucine, which directly prompts muscles to “turn-on” genetic switches that trigger muscle protein synthesis to occur.

The study they cite involved 38 men, average age of 26, who started a 12-week leg-focused resistance training program. Half of the men in the group were longtime vegans and half were longtime omnivores. The participants followed their usual diet while adding a supplement (soy for the vegans and whey for the omnivores) to ensure they were all getting 1.6 grams of protein per kilogram of bodyweight—the amount recommended by the American College of Sports Medicine to support athletic activity. For someone who weighs 170 lbs. they would require about 124 grams of protein per day to meet this standard. At the end of three months, both groups showed significant increases in leg lean mass and hypertrophy. And both improved the amount of weight they could push on the leg press machine. The researchers concluded that, as long as you are getting the amount of protein you need, the source appears to be less important.

However, purely plant-based athletes tend to need more protein supplementation to get the amount of protein they need. The researchers indicated that the vegan lifters needed about 58 grams a day of supplemental soy protein to get 1.6 grams of protein per kilogram of body weight. By comparison, the omnivore group needed to supplement with only 41 grams of protein per day to achieve the desired intake amount. They also note that this study was done on relatively young men and that further research needs to be done on other populations, such as older adults and women who may have more trouble making and maintaining muscle and may benefit from specific protein sources. Previous studies have shown that whey protein is an effective source of protein for older subjects to use to gain muscle, lean mass, and strength, which in turn improved their functional daily capabilities. In the accompanying text below I have provided a list of plant-based foods and the corresponding amount of protein found in those foods:

  • Seitan — 21 grams per 3 ounces
  • Lentils — 18 grams per cup
  • Edamame — 17 grams per cup
  • Beans — 15 grams per cup
  • Chickpeas — 5 grams per cup
  • Veggie burger — 15 grams per patty
  • Tofu — 12 grams per 4 ounces
  • Spelt — 11 grams per cooked cup
  • Peas —9 grams per cup
  • Hemp seeds — 9 grams per 3 Tbsp
  • Quinoa — 8 grams per cup
  • Nut butter — 8 grams per 2 Tbsp
  • Soy milk — 7 gram per cup
  • Seeds and nuts — 6 to 8 grams per ¼ cup

So, in summary, I would say that if you don’t have a job that is physically demanding it is very wise to have a resistance training program of some kind that you do throughout all of adult life. Otherwise, loss of muscle mass begins in a person’s late twenties, and by middle life and beyond the loss of muscle mass and strength can lead to a significant loss in functional ability required for many simple day-to-day tasks, culminating in later years into a need for a walker, wheelchair and /or scooter; not to mention falls leading to hip fractures and other fractures. The time to address lean mass preservation and even strength gains, is many years before these dreaded and unnecessary outcomes manifest themselves. In addition to resistance training ingesting the required amount of protein, each day is also essential to preserving and gaining muscle and lean mass. If you routinely don’t get enough protein each day from food to achieve at least 1.2 gm of protein per kilogram of body weight, then using a protein powder shake mix is something you should consider. I personally use a whey protein shake that has helped me gain lean mass in conjunction with my training program but based on this study soy protein shakes appear to be a good alternative for at least younger individuals wishing to maintain a pure vegan or vegetarian approach.

I have included the reference for this information in the text below.

Reference:

Runners World March 12, 2021 (Slene Yeager)

https://www.runnersworld.com/news/a35807952/plant-protein-vs-animal-protein-for-muscle-gain-study/

Eat Smart, Live Well, Look Great

Dr. Meschino

Dr. James Meschino

ABOUT THE AUTHOR

Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.