**Closure of my websites askdrray.com and nethealthbook.com**

These websites will be taken down on **April 30, 2025** and no further updates will be provided.
I hope you enjoyed the content of these websites. You can continue to read Dr. Schilling’s blogs which I publish daily on Quora

My home page there is: ** https://www.quora.com/profile/Ray-Schilling**

Click on this: Under my image there is a heading “Profile”. Right underneath this you find a search box entitled “search content”. Type in any term you are interested in. You will get several answers I have written (I have written more than 15,000 answers).

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Thank you for your trust in the past. Ray Schilling, MD
**Closure of my websites askdrray.com and nethealthbook.com**

These websites will be taken down on **April 30, 2025** and no further updates will be provided.
I hope you enjoyed the content of these websites. You can continue to read Dr. Schilling’s blogs which I publish daily on Quora

My home page there is: ** https://www.quora.com/profile/Ray-Schilling**

Click on this: Under my image there is a heading “Profile”. Right underneath this you find a search box entitled “search content”. Type in any term you are interested in. You will get several answers I have written (I have written more than 15,000 answers).

On Quora you can also write comments that I will answer.

Thank you for your trust in the past. Ray Schilling, MD
Apr
21
2018

3 Cups Of Coffee Stop Clogged Arteries

There is a new coffee study that says 3 cups of coffee stop clogged arteries. The study appeared in the Journal of the American Heart Association on March 24, 2018. It was part of the cross sectional Brazilian Longitudinal Study of Adult Health. This study took place from August 2008 to December 2010. It followed 15,105 civil servants, aged 35 to 74 years. They were living in 6 Brazilian cities (Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitoria). The final study sample comprised 4426 individuals who underwent CAC measurements.

CAC score

CAC stands for “coronary artery calcium”. Other tests in the past have shown that CAC is a very sensitive test that quantitates the calcification status of coronary arteries. The CAC score is also known as Agatston score. It also predicts how likely it is that a person with a high CAC count will develop a heart attack down the road. A score of 100 or less is considered to be a low risk for developing a heart attack later in life. If the score is between 100 and 400, it is a moderate risk. A score of more than 400 ranks as a high risk to develop a heart attack.

Study design

Upon entering the study the participants had an extensive entrance exam and interview. Part of this was a nutritional and lifestyle questionnaire. This told the examiners whether the patients were smokers or not. Their age ranged between 35 and 74 years. Participants took a CAC test. 4426 individuals who underwent CAC measurements became part of the study. The participants’ blood pressure and body weight were additional measurements.

Results of the study

There was a negative correlation between the amount of coffee consumed on a daily basis and the CAC score. Specifically, the following observation emerged regarding daily coffee consumption and the risk of a higher than 100 CAC score.

  • Less than 1 cup per day: odds ratio 0.85
  • 1 to 3 cups per day: odds ratio 0.73
  • More than 3 cups per day: odds ratio 0.33

These results show clearly that there is an inverse relationship between coffee consumption and risk of developing coronary artery hardening. Those who consume 3 or more cups of coffee have a lower coronary artery disease risk.

The risk to develop coronary artery calcification in coffee drinkers (3 or more cups) is 67% lower. The comparison group are non-coffee drinkers.

Discussion of the results

The research paper from Brazil compares their results with many other research facilities and concludes that others had very similar conclusions. For instance, a 2014 publication pointed out that consuming more than 5 cups of coffee per day had no association with heart disease and did not cause any increased mortality.

The 2015–2020 Dietary Guidelines for Americans recommends consuming 3 to 5 cups of coffee per day, which reduces the risk of getting diabetes type 2 or cardiovascular disease.

Korean study using CAC scores

One other relevant Korean study that involved 25,138 participants is also of note. The participants consumed 3 to 5 cups of coffee per day. They also underwent CAC tests. The coffee drinkers had a 41% lesser prevalence of CAC score in comparison to non-coffee consuming controls. The authors of the present study said that the Korean study was comparable to their own findings.

Comparison of study to previous literature

Mortality data and coffee consumption

In a large Harvard study that I discussed on Nov. 18, 2017 the end point was mortality data. There too, was a dose response curve. With 3 to 5 cups of decaffeinated or regular coffee there was a reduction of death rates by 15%. Less coffee consumption produced less reduction of mortality.

Stroke data and coffee consumption

In another review on March 4, 2013 I reviewed a 10-yer study that looked at the effect of 1 to 2 cups of coffee per day in 32,600 women. There was a 25-32% reduction of strokes compared to non-coffee or tea consuming controls. I also reviewed a Finnish study that consisted of 29,133 smokers (smoking 5 cigarettes a day) aged 50 to 69 who were stroke free when entering the study. It ended in 1993 and the study had lasted for at least 5 years. Drinking two cups of black tea or 8 cups of coffee reduced the stroke risk by 21 to 23%.

Stroke mortality and coffee consumption

In the Annals of Internal Medicine (June 17, 2008) researchers have found that coffee consumption can be beneficial to reduce stroke mortality. A study using the data from 41,736 male and 86,214 female subjects is quite informative. Researchers followed these people over 18 years in the male group and over 24 years in the female group. The risk of all-cause mortality decreased significantly with increasing coffee consumption in the male as well as in the female group. Men had a relative risk reduction of 20% in comparison to those with the lowest level of coffee consumption. Women with intermediate to high consumption of coffee had a relative risk reduction of 10% to 30 % when compared to the group that drank less than 1 cup of coffee per day. The end point here was risk of death from stroke.

3 Cups Of Coffee Stop Clogged Arteries

3 Cups Of Coffee Stop Clogged Arteries

Conclusion

Coffee has a number of anti-oxidant bioflavonoids that help increase survival. The main study reviewed measured the effects of coffee consumption by calcium scores of the coronary arteries. This is a specific way to look at the relative risk to come down with a heart attack in the future. Other ways to measure the beneficial effect of coffee are mortality as the end point, stroke or stroke mortality. I have reviewed some studies that used all of these end points. It is interesting to observe that consumption of 3 to 5 cups of coffee has such a beneficial effect. It does not matter whether it is regular or decaffeinated coffee. Both have the identical effect. This has been shown by a recent Harvard study.

Coffee and tea make you live longer

Coffee keeps the arteries open for longer, if we consume 3 to 5 cups of coffee per day. This allows our brain to think longer and allows our heart to beat for many more years. It is time to stop the research and to apply what was found: 3 to 5 cups of coffee per day. If tea is what you prefer, you are in luck. Everything I said about coffee also applies for green and black tea. There is one word of caution. Using copious amounts of sugar in your coffee or tea will most likely cancel some or all of the benefits. Cream and sugar-laced Frappuccino or Chai Lattes are calorie bombs and not conducive to good health. I use stevia instead of sugar to sweeten my coffee.

Jul
06
2013

The Inconvenient Truth About Convenience Foods

When your grandmother grew up there was very little convenience food, maybe ketchup and yes, there was processed cheese and coke. There were also bread and butter.

Now we go through a large grocery store and the center of the whole store is occupied by convenience food, row after row.

What is convenience food? It is pre-cooked or processed food that sits on a shelf waiting to be bought and consumed. You may be able to just eat it the way it is (power bars, fruit yoghurt snacks, ice cream, breakfast cereals etc.) or you just have to microwave it for a minute or two (ready made meals, pizzas). Even, if you make a fresh salad, you top it with a salad dressing that has been processed and may contain chemicals that are not necessarily healthy for you.

This blog is meant to make you think and get educated as a consumer. As a physician I am guided by what is healthy for you, but at the same time food needs to be interesting and taste good and be affordable.

As fat, carbohydrates and protein are the main food groups that we eat, I will deal with each of these categories first followed by vitamins and minerals, which we also need.

Fats and oils

Many convenience foods are full of saturated fatty acids, which contribute to the overall calorie count of the package and are one of the main reasons why we gain weight and deposit fat into our arteries in preparation for a heart attack or stroke down the road. As you may know the worst form of fat is hydrogenated fat, also known as “trans fat”.

It contains free radicals from the hydrogenation process, which damage your cells and interfere with normal body metabolism. Read labels and avoid any foods that have a long shelf life as this is due to hydrogenated fats and chemicals known as food preservatives.

This food group also contains sausages and other processed meat; I wrote a separate blog about this recently.

If you eat cheese, reduce your saturated fat intake by buying cheese with only 18% fat (such as Cantenaar cheese, Jarlsberg light, skim milk mozzarella and goat cheese). Avoid the rich 45% type cheeses. The best oil in your kitchen would be an organic cold pressed olive oil. It figures prominently in Mediterranean cooking.

The Inconvenient Truth About Convenience Foods

The Inconvenient Truth About Convenience Foods

Sugar, starch and other carbohydrates

A large portion of snacks from the mid section of the grocery store contains all forms of sugar: high fructose corn syrup, sugar, honey, agave syrup, maple syrup etc.  You may think that a harmless fruit juice would be healthy until you see from the ingredient list on the label that it contains 5 to 6 teaspoons of sugar per cup (250 ml) of juice.

Unfortunately our body is not equipped to process all the sugar that the food industry wants us to consume and we develop insulin resistance; the liver converts the excess sugars into fat and deposits it into our arteries and as fat deposits between our guts (visceral fat) and as subcutaneous fat in the thighs, around the hips and the waist. It is no secret that a lot of obesity is related to overconsumption of sugar containing convenience foods (snacks and sugar-laden drinks).

Often low calorie alternatives contain aspartame or sucralose (Splenda). Aspartame is an excitotoxin damaging your brain cells and sucralose was developed in the 1950’s as an insecticide. We do not want to replace disease-promoting sugar with toxins as sweeteners. Safe alternatives for sugar are xylitol, mannitol, and stevia.

What is sometimes overlooked is the fact that your body digests bread, starchy foods such as potatoes, and pasta, rice and flour products like pizza or cookies within 30 minutes into sugar that is as harmful to your pancreas as plain sugar or high fructose corn syrup. The body reacts with the same overproduction of insulin converting the excess sugar into fat and depositing it in your body as described above. Much of the obesity wave we see in the past 3 decades is due to baked goods like bagels, bread, pasta and pizza. It is much better to enjoy your stevia-sweetened coffee without any bakery pieces to go along with it.

Protein in meats, dairy products and sausages

You would think that a healthy cut of meat from the grocery store would be a good source of protein for you. You probably did not think that it could be contaminated with a superbug when you bought it. This is especially true for ground meats like hamburger meat. If you bought a portion of organic meat you can be more certain that you are buying a qualitatively superior product. I discussed this whole issue of superbugs in meat and meat products in this blog recently.

We need to be aware of the agroindustry, the feedlots and what they fed the animals. I only buy organic meat and organic dairy products as my source of protein. I avoid sausages altogether because of the food additives that they contain, which are cancer causing.

The problem with prepared meats like chicken nuggets and others is that they contain breading and food preservatives and they have been deep fried, which makes these items an unhealthy choice.

What are some of the problems with dairy products? Despite the allegations that bovine growth hormone would be harmless to your health, your body thinks otherwise. Your body has hormone receptors that are very specific and bovine growth hormone can block them so your own human growth hormone from the pituitary gland cannot function properly. This is why I would recommend only organic milk products. You may have heard that in many European countries bovine growth hormone is banned for that reason.

Next the fat content of dairy products needs to be monitored: go for low-fat milk, cheese and yoghurt. While we are talking about yoghurt, stay away from fruit yoghurts that have all kinds of sugar and food additives mixed in. Add fruit of your choice and stevia, if you need a sweet taste.

Vitamins and minerals

The more foods are processed, the less natural vitamins and minerals stay behind. Particularly vitamin C and the B complex group are affected, but also magnesium, which is an important co-factor to enzymatic reactions within our cells. Often processed foods contain too much salt with sodium displacing potassium from the cells resulting in a lack of energy and high blood pressure.

Your best prevention is to stick to as little processed food as possible and to eat organic. If you eat enough organic greens and vegetables, there is an ample supply of vitamins and minerals. Prepare your own soups as canned products are high in sodium; another unwanted additive is often sodium glutamate (MSG), which comes under many disguised names. It belongs to the group of excitotoxins like aspartame and is not welcomed by your brain cells.

Public Awareness

Lately there has been more of public interest and awareness to the detrimental effects of convenience foods. Alarming reports about the increase in the obesity rates, the rise in diabetes type 2 even in children have been in the media for some time. The publications are not only North American, but also European, as can bee seen in this link.

New legislation is being introduced in many states of the US regarding school snacks and vending machines in schools.

Not all food news is bad. Recently it was reported that fish oil could protect against the effects of junk food. Omega-3-fatty acids contained in fish oil are helping to rebalance the ratio between omega 3 and omega 6-fatty acids in food, which often is disbalanced towards an overabundance of omega-6 fatty aids in processed foods. Rebalancing the omega3/omega6 ratio in food helps to normalize the metabolism of the brain and prevents hardening of arteries.

What you can do to get healthy food

It starts when you buy food. Read labels and look for calories, sugar, fat and sodium content. You may be surprised how many stores carry organic foods now. The price may not be that much more. There is a useful app for your cell phone, Buycott, that you may want to download. This way you can scan items in the store and find out what ingredients are contained in a particular food item and which company produces it.

With meats it is particularly important to buy organic (because of superbugs and also because of the aspect that feed lot animals often receive antibiotics and hormones). Stick to organics also with vegetables and greens (xenoestrogens in non-organic greens that block hormone receptors). Milk products also need to be organic because of the bovine growth hormone facts mentioned above.

When you eat out, things become more difficult unless you find an organic food restaurant. You can always prepare your own salad for lunch with organic greens and a lean protein food, which you keep refrigerated until you are ready to consume it. On weekends a portable picnic in a park can be a great way to relax and socialize, especially in summer.

More information about nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

Last edited Nov. 6, 2014

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Jul
01
2008

High-protein, Low-refined carb diet useful in controlling diabetes

Diabetes type 2 is often associated with obesity (body mass index higher than 30.0 kg per meter squared). At the 16th European Congress on Obesity in Geneva Dr. Neil Mann presented a study of 99 patients. Half were put on a high protein diet, the other half on a high carbohydrate low glycemic index diet and followed for one year with periodic blood tests and examinations by their family doctors. The study population’s age ranged from 30 to 75 years and their body mass index varied from 27 to 40. The hemoglobin A1C level that is a measure of severity of the diabetic condition ranged from 6.5% to 10%.

The high-protein diet was structured so that 30% of calories came from protein, 40% came from carbohydrates and 30% came from fat. With the high-carbohydrate low glycemic index diet 15% of the calories came from protein, 55% from low glycemic index carbs and 30% from fat. In both groups the total calorie intake per day was restricted to 1500 calories and the carbohydrates were given as low glycemic index carbohydrates (less processed). In both groups the diabetes was better controlled with hemoglobin A1C, triglyceride levels and cholesterol levels normalizing. Both groups also showed an equal amount of weight loss that stayed down as long the patients adhered to the diet. However, the high-protein group was able to reduce diabetes pills (metformin) and insulin achieving the same results as the high-carbohydrate low glycemic index group that could not reduce their medications. The conventional approach is to use a low-fat, high-carbohydrate diet along with medication. However, this diet tends to lead to higher triglyceride levels, higher blood sugar levels and a reduction in the good cholesterol (HDL).

High-protein, Low-refined carb diet useful in controlling diabetes

High-protein, Low-refined carb diet useful in controlling diabetes

Dr. Mann who is a professor and head of the department of nutrition and food science at RMIT University, Melbourne, explained the people get confused when they hear the term high-protein diet as they think of the Atkins diet where the protein component was much higher. The diet that was investigated here is a more natural diet consisting of slightly higher protein and less processed carbohydrates. By containing more fat than in the conventional diabetic diet the patient is not getting hungry and finds it easy to stick to the diet, which leads to weight loss and improvement of the metabolism. Many patients can normalize their blood values and often even get off their diabetic medication (under careful supervision by their treating physician). The physician will address the three components of diabetic control (energy balance, glycemic control, and vascular complications) by recommending to the patient this high-protein/low-carb diet. This likely will replace the conventional approach of using a low-fat, high-carbohydrate diet.

More information about a Mediterranean type diet in firefighter’s, which is very similar to this study: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

Reference: 16th European Congress on Obesity, Geneva June 23, 2008

Last edited November 4, 2014