Junkfood Science Special: Anti-aging diets
For our February look at diets in the news, one deserves a special note.
The RealAge diet and lifestyle has been endorsed by a celebrity with her own television show. Not just any celebrity. Oprah Winfrey. As USA Today reported, within days of the diet doctors appearing on her talk show, their latest book and dvd, YOU: On a Diet, and their earlier book, YOU: The Owner’s Manual, sat in the top three spots on the best seller list of Amazon. Their most recent book remains on the New York Times Best Seller list.
Many of us believe that a celebrity or a doctor with an impressive medical career lends credibility and that we can take their dietary advice as gospel. That would be false. As Dr. Scott Haig, M.D., Assistant Clinical Professor of Orthopedic Surgery at Columbia University College of Physicians and Surgeons, has noted, the lucrative profits behind diets and anti-aging alternative modalities have proven irresistible to cardiologists and even the most brilliant medical specialists. The You doctors, have become regulars on Oprah, offering health and diet advice. Dr. Mehmet C. Oz, M.D., is on the RealAge Scientific Advisory Board which is chaired by Dr. Michael Roizen, M.D., cofounder of RealAge. RealAge, Inc., is a health communication company that offers internet tools for health assessments and sponsored messages targeted for consumers about health conditions, “life-enhancing products” and medications. The RealAge brands includes books, television segments and brand licensing reaching 80 million Americans. It is sponsored by 29 different pharmaceutical companies and other advertisers representing 46 medical product categories. According to RealAge, we can control the rate at which we age and their test can tell us how fast we are aging. People are urged to take their RealAge test — and since 1999 more than 17 million people have — which is purported to tell people their biological age and give them a personalized plan to youth and longevity. RealAge is intensely and widely marketed and the diet doctors have appeared often on Oprah, the Today Show, 2020, Good Morning America and mainstream women’s and consumer magazines. Sunday, February 25 on KOAT-TV in New Mexico, Dr. Barry Ramo interviewed his family friend, Dr. Oz, and endorsed his diet and health prescriptions in multiple segments over two days. The promises made by the RealAge doctors are a mixture of inspirational messages and popularly-believed ideas. They say that they can help everyone live longer, look younger and become smarter patients. According to their tenets, “80-90% of all cancers are due to environmental causes, such as exposures to toxins or poor diet.” They recommend certain foods for “Age Reduction®” which include a diet high in fiber, largely fish and vegetarian-based proteins, omega-3 fatty acids and vitamins. An ounce of nuts a day will make women 4.4 years younger, and 3 servings of fish a week are said to make us 2.8 years younger. RealAge nutritional recommendations are not in compliance with those of the FDA because, they say, “FDA guidelines cover minimal nutrient requirements to avoid a deficiency” while their recommendations “provide the optimal nutrient requirements for longevity, disease prevention and good health.” Their new diet book is not a diet, we’re told, but a way of eating that is so easy, we’ll never realize we’re dieting while losing a pound a month. Their diet is supposed to help us burn fat, feel healthy and never hungry, and “avoid the internal aging that causes heart disease, memory loss and even wrinkles.” As Dr. Oz said Sunday, the obesity epidemic can be eliminated if everyone just ate 100 calories a day less for life. Instead of a scale, we’re told to get a tape measure because our waist size is most important for health and should be half of our height. Their diet prescriptions, as described in a November 2006 segment on Oprah, this week with Dr. Ramo, the RealAge website and books, includes eating a high fiber cereal at breakfast because “we need fiber to slow down food in the intestine” and that our breakfasts and lunches should be automated so that our choices are limited and we eat the same things every day. Among their weight loss secrets is to “drink 1 or 2 glasses of water before every meal to help fill you up.” Dinners should eliminate bread and butter and desserts because every calorie needs to count. “Bread, rice and potatoes should be avoided because those are empty calories and white foods are nutrient poor.” The most important muscle in our body making us fat is our tongue, Dr. Oz told Oprah viewers. Of course, many people as Oprah noted, believe that they have “issues” with food and that their emotions control what they eat. Our food cravings, said Dr. Oz, indicate our moods: * Meat means we’re angry * Sweets are a sign of depression * Ice cream means we’re anxious * Salty snacks could mean we’re stressed * Pasta might signal loneliness or sexual frustration * All of the above might mean you're just a little bit jealous Another diet secret revealed to Oprah audiences was that for most women, simply getting regular sex results in effortless weight loss all by itself. Wew! Clearly, presenting the evidence to address each of these claims is far more than can be included in a single post, so we’ll address many of these commonly-held beliefs in more detail over upcoming months. The evidence they provide for their claims is surprisingly unsubstantial and absent from their website. “Healthy lifestyles” and aging It is popular to believe this. Anti-aging products and “healthy” eating and lifestyle programs are prolific and consumers are spending billions of dollars on them, moreso as Babyboomers head into retirement age. Fifty-one of the world’s most recognized scientists in the field of human aging were so concerned about the misrepresentations of the science concerning health and aging, that they recently collaborated and examined the scientific research and various controversies. They concluded that the claims had little or no scientific basis. Their extensive position statement on human aging was published in Scientific American Magazine and the Journal of Gerontology: Biological Sciences and is available online here. They stated in their concluding remarks: Since recorded history individuals have been, and are continuing to be, victimized by promises of extended youth or increased longevity by using unproven methods that allegedly slow, stop or reverse aging. Our language on this matter must be unambiguous: there are no lifestyle changes, surgical procedures, vitamins, antioxidants, hormones or techniques of genetic engineering available today that have been demonstrated to influence the processes of aging. According to these scientists, “aging is the greatest risk factor for the leading causes of death and other age-related pathologies.” We all undergo biological aging and about that they concluded: Scientists believe that random damage that occurs within cells and among extracellular molecules are responsible for many of the age-related changes that are observed in organisms... each individual is genetically unique. As such, the rate of aging also varies from individual to individual. Despite intensive study, scientists have not been able to discover reliable measures of the processes that contribute to aging. For these reasons, any claim that a person’s biological or “real age” can currently be measured, let alone modified, by any means must be regarded as entertainment, not science. Last year, Photon in the Darkness did a concise summary explaining lifespan science and lifespan potential. After we survive especially risky stages of life, such as infancy and early adulthood, mortality rates remain fairly constant. The primary factors affecting longevity are accidents, infancy-related conditions, Alzheimer’s disease of old age and infection, yet, “none of the currently popular nostrums or programs for life extension address these.” Nor do they offer any real evidence to support their claims, he said. People have been trying to find the “secret” to longer life for all of recorded history, and none have found it yet. Even careful examination of people who have lived over 100 years fails to reveal any consistent “secret” except one: Have long-lived parents. Vitamins As Dr. Sidney M. Wolfe, M.D. and colleagues wrote in Worst Pills, Best Pills—A consumer’s guide to avoiding drug-induced death or illness, the prevailing myth that the recommended daily allowances are just the amount of a vitamin or mineral needed to prevent deficiencies is not true. In establishing the RDA, the amount needed by the average person is first determined and then raised to cover the needs of 98% of the healthy population. “This number is set at a level that is often two to three times higher than people’s needs, resulting in a significant safety margin —the government’s own insurance for your health.” While clearly there are special nutritional needs for those with specific medical issues, such as malabsorption after bariatric surgeries or organ failures, what may be surprising to learn is that most people with proven nutrient needs were taken into account when the RDAs were determined, according to Drs. Barrett and Herbert. These included people taking prescription drugs, dieters, women of childbearing age, smokers, the elderly, postmenopausal women on estrogen, those with osteoporosis, those with chronic infections or stress, teenagers, alcoholics, vegetarians, pregnant women, and lactating women. There is no medical evidence to support taking supplements when a specific deficiency doesn’t exist, said Dr. Wolfe. Credible nutritional science shows benefits of nutrients for improving health when deficiencies (scurvy, anemia, rickets, etc.) are present, but not for improving health in normal people. And there is no credible evidence to support taking mega-doses or more vitamins and minerals than the body needs to prevent deficiences. Instead, there is evidence of harm in many instances. And do not buy vitamins and nutritional supplements for which there are no known requirements or ‘new’ vitamins, they wrote. “Emerging science” you hear in the media supporting all sorts of pills and “functional” foods is usually a euphemism for no credible evidence! As that aging position paper noted: The scientifically respected free-radical theory of aging serves as a basis for the prominent role that antioxidants have in the antiaging movement. The claim that ingesting supplements containing antioxidants can influence aging is often used to sell antiaging formulations. The logic used by their proponents reflects a misunderstanding of how cells detect and repair the damage caused by free radicals and the important role that free radicals play in normal physiological processes (such as the immune response and cell communication). While free radicals promote beneficial oxidation, in excess they produce harmful oxidation that can cause cell damage, Drs. Barrett and Herbert explain. Vitamins C and E and beta-carotene are mischaracterized as "antioxidants," when in fact, they are redox agents (antioxidants in some instances and pro-oxidants in others, producing billions of harmful free radicals). That may explain why some early studies suggesting that ingesting antioxidant supplements or fruits and vegetables high in antioxidants might reduce certain degenerative diseases of aging and cancers have not proven out in clinical trials on real people. While some believe that high amounts of Vitamin C, for example, can strengthen the immune system and prevent cancer, “no responsible medical or nutrition scientists share these views,” said Dr. Barrett. In a review of the science of this belief which originated from Linus Pauling, he wrote: “Although Pauling’s megavitamin claims lacked the evidence needed for acceptance by the scientific community, they have been accepted by large numbers of people who lack the scientific expertise to evaluate them.” We’ve looked at the flawed science in support of claims for folic acid and vitamins in reducing the risk for heart disease and stroke here and those for vitamin E here. Will taking vitamins help us to be younger or healthier? The U.S. Preventive Services Task Force — which you may remember is under the Agency for Healthcare Research and Quality, the Federal government’s lead agency under the U.S. Health and Services Department and is charged with issuing careful, evidence-based findings that are used to develop clinical guidelines for healthcare providers — recently reviewed the randomized clinical trials on vitamin supplementation to prevent cancers and heart disease. Their findings stated that there was insufficient evidence to recommend supplements of vitamins A, C or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease. Some have indicated increased mortality rates. The growing body of evidence since their review has found null support for the benefits of vitamins and supplements. For example, a recent review of clinical trials using antioxidants (vitamins E, C, beta-carotene, or selenium) and B vitamins and evaluating the progression of atherosclerosis using B-mode ultasound, intravascular ultrasound or angiography, found no evidence of any protective effect of vitamins. In the issue of the American Journal of Clinical Nutrition where their results were published, Dr. Donald McCormick of the department of biochemistry at Emory University, Atlanta, Georgia, wrote of the belief that we should try to achieve a state of “optimal nutrition” by taking a vitamin-mineral supplements: [N]early 50% of our population may be spending >1.5 billion dollars each year in this practice of “securing" their health. The presumption held by some that vitamin-mineral supplements may have the potential to prevent and treat certain chronic diseases, such as some cancers and cardiovascular disease...is derived from in vitro studies or from studies that were generally observational and often marginal in statistical significance or control. On the basis of the body of evidence, “antioxidants and B vitamins should not be used to prevent cardiovascular disease,” he said. “One can hope that the exuberant use of vitamin-mineral supplements may be tempered somewhat by such findings, which carefully separate fact from faith.” “Healthy eating” If we set aside the idea that there is such a thing as a ‘healthy' or ‘unhealthy' food, and instead eat a wide range of foods, then we might just end up with a diet that is not only balanced and reasonably healthy but also enjoyable. It could also be that deriving pleasure from food, rather than living in fear of it, might soon be shown to be a critical factor in a truly healthy lifestyle. The best science shows that — rather than restricting our diets or eliminating foods — enjoying everything is most likely to help ensure we get the full range of good things in our foods and prevent deficiences. White foods and the staples that have supported and meant survival for human peoples for ages — potatoes, rice, breads, corn — are certainly worthy of continued inclusion in our diets. The most common cause of poor nutrition isn’t eating “bad” foods or “junk,” but eating too few calories, according to Dr. Wolfe. A diet that restricts choices or supplies less than 1,500 calories a day leaves us most vulnerable to deficiencies. We’ve looked at fears of fat and red meat and claims that fruits and vegetables have special abilities to help prevent cognitive decline. And, despite what some people believe, there is no credible evidence that eating “junk” food can make us or our children grow a foot taller and get big feet. :) Upcoming posts will look at the evidence surrounding other specific dietary beliefs, such as low-fat or that fruits and vegetables prevent cancers; and address our fears about certain ingredients such as sugar and fructose, flour, processed foods, fish, and food additives. They each deserve their own post and more in-depth treatment. But I will share one note of caution from doctors Barrett and Herbert who wrote in “Twenty-Five Ways to Spot Quacks and Vitamin Pushers:” Many vitamin pushers would have us believe that refined (white) sugar is "the killer on the breakfast table" and is the underlying cause of everything from heart disease to hypoglycemia. The fact is, however, that when sugar is used in moderation as part of a normal, balanced diet, it is a perfectly safe source of calories and eating pleasure. Sugars and other sweeteners have been extensively studied for over half a century and surprisingly, our consumption has remained stable for nearly 40 years. Research shows people who enjoy sugar as currently consumed better meet the RDAs than those who consume high or low amounts and sweeteners don’t lead to obesity or the development of any chronic disease. More later. Because the dietary evidence is so extensive and this post is already reaching bandwidth limits, I’ll refer to a nice overview written by Gina Kolata for the New York Times, looking at the science behind our beliefs about cancer-preventing foods. She wrote: [D]espite the often adamant advice, scientists say they really do not know whether dietary changes will make a difference....It is turning out to be much more difficult than anyone expected to discover if diet affects cancer risk. Hypotheses abound, but convincing evidence remains elusive. Dr. Barnett Kramer, deputy director in the office of disease prevention at the National Institutes of Health, said: “Over time, the messages on diet and cancer have been ratcheted up until they are almost co-equal with the smoking messages. I think a lot of the public is completely unaware that the strength of the message is not matched by the strength of the evidence." The fiber hypothesis had enormous appeal....Based on these indications, the cancer institute financed two studies on high-fiber diets and colon polyps... “We had high expectations and good rationale," said Dr. Arthur Schatzkin, [chief of the nutritional epidemiology branch in the National Cancer Institute division of cancer epidemiology and genetics.] But, he said, “we got absolutely null results." As for Dr. Tim E. Byers, [professor of preventive medicine at the University of Colorado Health Sciences Center in Denver,] who once had such high hopes for the diet and cancer hypotheses, he says he is sadder now, but wiser. “The progress has been different than I would have predicted," Dr. Byers said. At the time of Ms Kolata’s article, she mentioned that the largest randomized clinical trial ever conducted looking at cancers and mortality against every tenet believed to be part of a “healthy” diet was nearing completion. I’ll report those findings here soon. They countered beliefs about “healthy eating” so dramatically that even a major size acceptance organization refused to publish the findings for their members. Since Kolata’s article, some of the world’s largest studies on nutrition and cancer have been released. The large EPIC (European Prospective Investigation Into Cancer and Nutrition) study of nutrition and cancer conducted in 8 countries among 285,526 women, ages 25-70, recently reported that after 1.5 million person-years there was no relationship between breast cancer and total or any specific fruit and vegetable consumption. Harvard School of Public Health researchers reported in the Journal of the American Medical Association the results of an analysis of 13 prospective studies of more than 725,000 men and women followed for 6 to 20 years which found no association between dietary fiber from fruits, vegetables and grains and risks of colorectal cancer. If the science on food seems overwhelming to sift through, keeping one simple fact in mind may help allay concerns. Over the past fifty years, while we’re eating all of that supposedly “bad” food and Western diet (and our average weights and heights have increased), health and life expectancies in the U.S. have “dramatically improved,” according to former Health and Human Services Secretary Tommy Thompson at his September 12, 2002 press conference releasing the CDC’s Health, United States, 2002 report. Cancer rates and deaths from cancer have continued to fall every year since the early 1990s, including nine of the top ten cancers commonly “associated” with “obesity.” According to the CDC report, even deaths from the leading causes of death among older people have dropped, such as heart disease by 70%. Just eat less Which brings us to the notion that by just eating a few fewer calories we can all lose weight and be slim. If eating fewer calories really worked to reduce “obesity” rates, we’d have seen that long ago. According to the U.S. Department of Agriculture Center for Nutrition Policy and Promotion and a review of 171 published dietary studies, total caloric intake among all Americans steadily decreased from 1965 to 1990. Yet, throughout this period, “obesity” rates dramatically increased. And in clinical studies, women who dutifully watch what they eat and are dainty eaters actually weigh more than those who don’t restrict their foods — even though one clinical study, for example, found those women were eating about 410 fewer calories a day! Multiple controlled clinical studies published in peer-reviewed journals have documented this seeming implausibility. Restrained eating diminishes the body’s burning of calories, which makes sense from an evolutionary standpoint, as in times of limited food supplies our bodies would be designed to do everything to preserve themselves. Obesity researchers concluded long ago that even if everyone ate a limited number of calories, there would still be people who would become fat, thin and everything in between. The calorie theory doesn’t work in reality because at our natural weights, our bodies are remarkably adept at keeping our weights at a fairly narrow range, our set-point, even with daily fluctuations in our dietary intake. Short-term diet stunts aside, it is extremely difficult, and there is no proven way, to healthfully maintain a weight much higher or lower for very long by trying to control our calories. As one of the country’s foremost obesity researchers, Jeffrey M. Friedman, M.D., Ph.D., head of the Laboratory of Molecular Genetics at Rockefeller University, New York, explained in a recent issue of Nature Medicine, the “simplistic notion” that obese individuals can ameliorate their condition by simply deciding to eat less and exercise more is “at odds with substantial scientific evidence illuminating a precise and powerful biological system that maintains body weight within a relatively narrow range.” Our body shapes and sizes are, to a significant extent, genetically determined. “The heritability of obesity is equivalent to that of height and greater than that of almost every other condition that has been studied,” according to Friedman. Someone genetically predisposed to obesity will become obese independent of their caloric intake even when it’s restricted to that of thin counterparts, he says. Sure, most everyone can starve and exercise to lose a few pounds for a spell, but even the soundest, most conservative of diets don’t work long-term. Our genes will stubbornly return us to whatever weight range we were destined to be (or higher), no matter how intently we exercise and diet. (It takes increasingly unhealthy and drastic measures to maintain a weight much below that natural for us.) That goes the reverse for thin people. “People can exert a level of control over their weight within a 10-, perhaps a 15-pound range,” Friedman’s research has found. That’s never going to be enough to transform anyone into a different body type. Obesity isn’t due to gluttony or sloth. “Just as willpower cannot make fat people thin, a lack of it does not make thin people fat,” he said. “It makes no scientific sense.” The take-home message is that the soundest science for decades is to just eat normally, enjoy everything, and don’t worry so much. When we enjoy a variety of foods, as everyone naturally does when they’re not trying to control their eating, we’ll get the nutrients we need to prevent deficiencies — and that is the only thing that nutritional science can credibly support. Everything else is dietary religion. Don’t let anyone try to scare you, threaten you, or cajole you into believing that if you don’t eat “right” you’ll get fat, a chronic disease or die sooner; or believe that if you eat “right,” you’ll stay slim, avoid disease and live longer. © 2007 Sandy Szwarc. All rights reserved.
There are also “five food ingredients that should be banned from our diet forever.” Those include hydrogenated oils, sugar, high fructose corn syrup (“we eat 63 pounds of HFCS a year and it puts 33 pounds on the typical American,” said Dr. Roizen.), enriched flour and white foods including bleached flour.
Let’s begin with their core premise. Can we really increase our lifespan — let alone slow, stop or reverse the process of aging — by following the “right” lifestyle and diets? 
In The Vitamin Pushers: How the "Health Food" Industry Is Selling America a Bill of Goods, doctors Stephen Barrett, M.D., and Victor Herbert, M.D., J.D., M.A.C.P., F.R.S.M., note that nutritional quackery often appeals to fears with claims that most of us are poorly nourished. “It is falsely alleged that Americans are so addicted to “junk” foods that an adequate diet is exceptional rather than usual,” they wrote, or claims are made that “today’s lifestyles, eating habits and processed foods” make it hard to get the vitamins and nutrients our bodies need. But the science demonstrates that “it is not necessary for every morsel of food we eat to be loaded with nutrients...no normal person eating a balanced diet is in any danger of vitamin deficiency, subclinical or otherwise.” And it is simply not true that most diseases are due to faulty diets or that they can be treated with nutritional measures, they said. 
Eating “right” is probably where there is the most misinformation, bad science and unproven hypotheses. As has already been noted above, the belief that by diligently eating a certain way (i.e. “healthy,” as often defined as low-fat, low-salt, high-fiber, abundant in fruits and vegetables, and avoiding added sugars, processed and other “bad” foods) we can prevent chronic diseases, cancer and live longer has weak to nonexistent evidence and has not held up to careful clinical trials or observational studies on millions of people. No food when eaten as part of a varied diet has special abilities to help or hurt us, either. People around the world have a wide range of diets with no common relationships to lifespans. When the scientists of Social Issues Research Centre in Oxford examined the dietary advice through the ages, the only consistency they found was that “healthy eating” involves eating a variety of foods:
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