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What I Learned By Actually Reading That Drinking Milk Will Kill You Study

Posted October 30, 2014 by Yoni Freedhoff

So a study was published the other day in The BMJ. In it authors explored their theory that milk consumption might in fact increase your risk of death and of hip fracture. Why? Well they finger D-galactose, one of the breakdown byproducts of the lactose in milk, which in animal models has been shown to be pro-inflammatory and lead to shortened lifespans and neurodegeneration. Extrapolating from the mouse models led the authors to infer that 1-2 glasses of daily milk would provide sufficient D-galactose for human harm. The authors further assert that not only can D-galactose lead to shortened life and neurodegeneration, but also to cardiovascular disease, cancer, and ironically, age-related bone loss. And it’s not all dairy that worried these authors, just milk, as both cheese and yogurt have lower concentrations of lactose and galactose, and cheese and yogurt also may have positive probiotic related health contributions.

To explore their theory the researchers used two Swedish cohorts. The first included 61,433 women, and the second 45,339 men (both after all exclusions), and with them the authors explored the cohorts’ relationships between milk intake (ascertained by way of just two food frequency questionnaires with the women and only one with the men) and mortality and hip fractures over a 20.1 year mean follow-up period. As far as possible confounders go, they considered hormone replacement therapy, menopausal status, and whether or not the women had children, smoking status, body mass index, vitamin D supplementation, alcohol consumption, a healthy dietary pattern, cortisone use, leisure time physical activity, education, and marital status.

Results wise the researchers found that the mean intake of milk was roughly a glass a day for both men and women but that some folks were drinking more than 3 glasses daily, and some less than 1. During the 1,231,818 person years of follow up 15,541 women died as did 10,112 men. Fracture wise there were 4,259 hip fractures among women and 1,166 among men. As far as milk goes, the researchers found those women consuming >3 glasses a day vs. women consuming <1 had a hazard ratio of total mortality of 1.93 (and 1.60 for hip fractures). Comparing male heavy vs. light milk drinkers, the risk found was less pronounced (though still significant according to the researchers) at 1.10 for mortality, but nothing for hip fractures. But bear in mind, those hazard ratio span an average of 20 years of follow-up.

So should you stop drinking milk because it’s going to kill you after it leads you to have a hip fracture? These sorts of studies are brutal. No doubt the researchers do their utmost to try to ensure they control for confounders, but given the food data utilized are often single contact food frequency questionnaires (as was here) which are then extrapolated to represent decades worth of consumption, and that lives in general are complicated, it really is difficult to get too worked up about the results. For instance it’s difficult to put a great deal of stock in this particular study’s FFQ validities as they report the frequent milk drinkers as consuming nearly 40% more calories than the infrequent, and yet the weights of those two groups are within about 3lbs of one another.

So I remain unconvinced that milk is in and of itself markedly toxic, but that said, drinking 3 or more glasses of the stuff a day isn’t something I’d be advising anyone to do simply on the basis of liquid calories not being particularly filling. Given that there are many studies that dance around milk providing ever so slight health benefits as well as many studies that dance around milk providing every so slight health risk, I’m still comfortable with my belief that milk is neither a magic fairy brew nor a devil’s broth and consequently should be consumed in the name of loving it (in the smallest quantities you need to like your life), but not in the name of health, and that eating your dairy, from a health perspective, is likely preferable to drinking it.

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General

If By “American” and “Religious” You Mean “Republican” and “Conservative Christian,” Then Yes…

Posted October 28, 2014 by Eric C. Miller

Last month, RD’s Diane Winston commented on the overhyping of a recent Pew survey suggesting that…

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General

Guess What? Childhood Obesity Won’t be Solved By Healthy Corner Stores Alone.

Posted October 27, 2014 by Yoni Freedhoff

And no, the study wasn’t published in the Journal of Duh, it was published in Obesity and it explored the impact of corner stores stocking healthy foods alongside all the junk on the obesity rates of surrounding schools’ 4th-6th graders over the course of 2 years.

And, shocker, the singular intervention of stocking healthy foods alongside chips, candy, and soda in corner stores didn’t all by itself lead the surrounding 9-11 year olds to lose weight.

Yet that didn’t stop The Obesity Society from tweeting out,

Jumping on pop pub health initiatives w/o science costs time & resources- Study-no benefit for healthy corner stores http://t.co/DAlqXwGMrK

— The Obesity Society (@ObesitySociety) October 23, 2014

I found this tweet incredibly frustrating as by definition complex problems won’t be solved by way of singular interventions, and of all folks The Obesity Society ought to know that.

I’m not suggesting there’s an easy solution, but we need to figure out a better way to consider single sandbags than to design (or publicize) studies that invariably will show them to be incapable on their own of stemming a flood.

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General

What Actually Reading that Fast vs. Slow Weight Loss Study Taught Me

Posted October 16, 2014 by Yoni Freedhoff

I imagine this one will be all over the news today, and superficially I can certainly see why – a new study reportedly proves that if you lose weight fast or slow, 3 years later, regardless of the speed you lost your weight, you’ll have gained back the same amount. This of course flies in the face of the advice that slow and steady wins the weight loss race.

Read the actual paper and the story becomes far less exciting.

In brief, study participants were randomized to either lose weight quickly with an all-liquid meal replacement shake program (Optifast), or to lose weight slowly using that same Optifast shake to replace one to two meals daily. Once a target weight loss of 15% was reached all patients who got there were then instructed to follow Australia’s national dietary guidelines and to see a dietitian once every 3 months for the next 3 years.

Over that same 3 year period, everyone, regardless of whether they lost weight with Optifast quickly, or lost weight with Optifast slowly, regained the same amount of weight when following Australia’s national dietary guidelines – guidelines not even remotely designed for weight management or satiety (15% protein, 30% fat, 55-60% carbs) – while being provided with very little in the way of ongoing support.

Put another way, being prescribed a weight loss program that involves zero changes to lifestyle (aside from drinking shakes in place of meals), and then once weight is lost quickly or slowly, being told to follow a diet not designed in any way shape or form for weight management while receiving infrequent ongoing support, is clearly equally ineffective.

The fact that weight lost comes back when the intervention you undertook to lose the weight is stopped is anything but surprising, and yet that is precisely what was done with both the rapid losers and the slow losers. That there was no difference in their rate of regain speaks more to the authors’ failure of recognizing obesity as a chronic condition, which like any chronic condition, returns once treatment is stopped, than it does to the speed participants lost weight using weight loss interventions that they were explicitly instructed to stop once their weight was lost.

The more weight you’d like to permanently lose, the more of your life you’ll need to permanently change. All this study proves is that temporary changes lead to only temporary results and that what matters to your longterm success isn’t the speed with which you lose your weight, but whether you lose your weight with a lifestyle that you enjoy enough to sustain.

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Children

The Recipe for the Perfect Family Meal

Posted October 14, 2014 by Yoni Freedhoff

Yesterday a fascinating new study published in Pediatrics. Researchers studied the video recordings of 120 families’ meals for over a week to try to tease out what family meal factors were most associated with overweight and obesity in children. Not only were where the meals taking place studied, but also who was there, how long they lasted, and then what sort of interpersonal relationships were seen at the table (both between parents, between parents and kids, and between kids themselves).

Before I get to the results it goes without saying that these results can’t distinguish between cause and effect – meaning that it’s unclear if the relationships described by the study, if adopted, would in fact prevent weight gain (or lead to loss). That said, given how easy and straightforward many are, I thought it would be worthwhile to publish a simple recipe for healthful family meals based on the study’s findings.

The Perfect Family Meal

  1. Takes place in the kitchen
  2. Lasts for 18 minutes or longer
  3. Has at least one (or ideally both) parents present
  4. Is consumed alongside attentive, warm and supportive conversation
  5. Includes a positive discussion of the foods involved (not a discussion in terms of weight or good/bad, but rather such things as where the food came from, what it might be like to grow it, other meals that might be enjoyable from similar/same ingredients, etc.)

and while not found to be significant in the study I’d still add:

       6.  No screens (TV, phones, or other).

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