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See-Food, Supplementation and Exercises for Your Eye Health

January 16, 2014 Leave a comment

Have you been spending a lot of ‘screen time’ with a new gadget from Christmas? The average American adult spends an average of 9.5 hours every day in front of a screen. Do you think that sounds too high? It adds up. Between a computer screen at work, watching the news at home, playing Candy Crush on an iPhone, browsing Pinterest on your iPad. Cooper Clinic Dietitian Meridan Zerner explained recently on Fox 4 Good Day that all of those devices (and anything with a screen) emit a blue light which is problematic for the retina. Yes, we can be more aware about our ‘screen time’, but what else can we do? Meridan gave suggestions for diet, supplementation and even eye exercises. Check it out below.

Diet

Try a “see-food” diet. Ha! Really, though—eat salmon, sardines or tuna two to three times a week to receive omega-3—this acts as an anti-inflammatory.

Meridan said to literally eat your garnish. Kale, broccoli, Brussels sprouts, collard greens and baby spinach should be in your daily diet. These veggies are not only for good health, but also for your eye health. They contain lutein and zeaxanthin, which are actually in your eyes. When I think of eating healthy for my eyes, I think of carrots. But I learned lutein and zeaxanthin have been proven to be much more effective than beta-carotene, which is found in carrots and other orange vegetables.

Supplementation

Do you really need supplements? Meridan said this is when to take a reality check. Are you going to eat perfectly every day? Are you really going to have fish two to three times a week and five to nine servings of vegetables a day? New Year’s is a great time to make healthy changes, but if the answer is no, then that’s where supplements come into play. Cooper Complete®’s newest product, MVP (Maximum Vision Performance), is a great supplement to support eye health. It includes vitamin D, omega-3, lutein and zeaxanthin. Learn more about it here.

Eye Workouts

Yes, these really help. Meridan said eye works are beneficial, especially for those of us who have a lot of screen time!

  • Do an exaggerated eye roll and blink definitively. Do it in the other direct and repeat for five reps. This exercise will stretch your eye muscles.
  • She also suggested using the 20-20-20 Rule. Every 20 minutes look away from your screen, look 20 feet away and focus for 20 seconds.

Also evaluate the distance you sit from a computer screen. Studies show that you should be at least an arm’s length away from a computer screen. Take frequent breaks for your mind, body and eyes.

For more information about Cooper Complete nutritional supplements, visit coopercomplete.com.

Dr. Cooper’s Response to Recent Vitamin Studies

December 17, 2013 9 comments

Dr. Cooper continues to provide insight as an inspiring authority in preventive medicine.

In a new editorial in Annals of Internal Medicine (Dec. 16, 2013), physicians warn that “most supplements do not prevent chronic disease or death, their use is not justified and they should be avoided.”

We spoke to our own Kenneth H. Cooper, MD, MPH, on this topic and here are his thoughts:

I’m a strong believer in objective scientific research. In 1984 it was said that exercise did nothing but make you feel good. In the 1970s I began my work to prove that exercise is medicine. Today with our over 600 research articles published on the subject [at The Cooper Institute] we can say for certain that exercise is medicine and has health benefits. On exercise we have bridged the gap between faddism and scientific legitimacy.

I feel that we are in the same place today on the subject of vitamin supplementation as we were 25 to 30 years ago on exercise. It’s my opinion that we should try to prove or disprove the use of vitamin supplementation with objective research.

Recent studies, including those in the Annals of Internal Medicine article are not objective science. The reason is that in nearly all these studies researchers do not measure the blood level of vitamins to determine whether a person needs a vitamin or not. Researchers arbitrarily put study participants on a supplement and compare them to those on a placebo.

In our studies on vitamins B12, D and omega-3 (conducted over the last eight years) we have looked at blood levels and show that they vary tremendously. Some people taking no supplements have a very high level of certain vitamins and some people taking supplements have a very low blood level of vitamins. At Cooper Clinic we treat vitamins like any drug we prescribe. We measure the blood level and recommend vitamin dosages to get blood levels up to satisfactory levels. In my opinion that’s how a vitamin has to be prescribed. In addition, we are studying the long-term benefits of these vitamins in our practice of preventive medicine.

The benefits of vitamins are well documented in scientific literature. For example:

  1. Vitamin D supplementation reduces fractures from falls in the elderly (as shown in most studies).
  2. Vitamin D deficiencies can be a factor in osteopenia and osteoporosis and supplementation can be used to treat it.
  3. Vitamin D deficiency may be related to Multiple Sclerosis and in some clinics, high doses of vitamin D are being used to treat it.
  4. Vitamin B6 in some cases has been effective in treating carpal tunnel syndrome.
  5. Omega-3 supplementation has been approved by the FDA to lower blood triglyceride levels.
  6. Niacin (vitamin B3) is used to lower total cholesterol and to increase HDL (good) cholesterol.
  7. Folic acid deficiencies in women have been known to result in spinal bifida and neural tube defects in the newborn.
  8. Vitamin B12 is used as a treatment to correct pernicious anemia and is a factor in cognitive dysfunction in the elderly.
  9. Folic acid, B6 and B12 have been shown to lower Homocysteine levels, hopefully a beneficial effect on reducing the frequency of heart attacks and stroke.
  10. Niacin (vitamin B3) has been used to reduce the frequency of some cancers.

I believe that in order to practice responsible medicine we cannot make a broad based statement about vitamins. If every American ate between five to nine servings of fruit and vegetables a day we would not need additional vitamin supplementation. However, because the average American adult eats 3.1 servings of fruits and vegetables and the average teenager gets 1.6 servings, levels of vitamins in the blood can be low and supplementation becomes necessary.

While we can never replace a good diet, I continue to recommend vitamins as insurance for people who don’t follow the recommended daily serving of fruit and vegetables.

To learn more about Dr. Cooper’s work in preventive medicine as the ‘father of aerobics’, click here.

Prevent Fractures From Falls With Vitamin D Supplementation

October 23, 2013 1 comment

Sunshine vitamin DNews reports have picked up the story about a recent meta-analysis on vitamin D, and headlines have read: “Vitamin D doesn’t aid the prevention of Osteoporosis.” A meta-analysis (Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis) conducted by researchers at the University of Auckland in New Zealand and published in The Lancet earlier this month looked at 23 vitamin D studies. The studies totaled 4,082 generally healthy people (92 percent female) with an average age of 59 years. Bone mineral/density was studied at one to five sites in each study, with the sites being lumbar spine, femoral neck, total hip, femur, total body or forearm. Participants took 500-800 International Units (IUs) of vitamin D per day. Results of the meta-analysis showed a small benefit at the femoral neck in bone density, but no other areas. The lead author of the study, Dr. Ian R. Reid, said “for healthy people focused on osteoporosis prevention, vitamin D does not make a positive contribution.”

While this meta-analysis didn’t find vitamin D to be helpful in managing osteoporosis, the study doesn’t review vitamin D levels and the potential for falls. In May, 2012, the U.S. Preventive Services Task Force (USPSTF) recommended exercise or physical therapy and vitamin D supplementation to prevent falls in community dwelling adults 65 years or older who are at increased risk for falls.

Falls are the leading cause of injury in community dwelling adults 65 years or older, and 30-40 percent of adults 65 years or older fall at least once per year! Fractured bones are the result of approximately 5 percent of these falls, and two meta-analyses have found that vitamin D prevents fractures. Low vitamin D levels increases fracture risk. It has been estimated that as many as half of the older adults with hip fractures could have vitamin D levels below 30 ng/mL. (Optimal vitamin D is 30-100 ng/mL; suboptimal is 20-29 ng/mL and lower than 20 ng/mL is insufficient. Dr. Cooper likes to see levels 40-60 ng/mL in patients.)

Adult Cooper Complete multivitamins contain 2,000 IU vitamin D, and a standalone 1,000 IU Vitamin D tablet for individuals who need higher supplementation to get to an appropriate level.

Since falling is such a risk for older adults, it makes sense to stay aware of vitamin D levels through an annual blood test and to supplement as appropriate to get levels where they need to be. In addition, as Dr. Cooper has long advocated, it makes sense to commit, at every stage of life, to move and exercise like your life depends on it.

For our latest recommendations subscribe to our free e-newsletter The Cooperized here.

Interview with Cooper Clinic Head of Cardiology Dr. Nina Radford about Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events

September 18, 2012 2 comments

Dr. Nina Radford, Cooper Clinic

Todd Whitthorne talked with Dr. Nina Radford, about the systematic review and meta-analysis Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events published in the JAMA September 12, 2012, Vol 308, No 10 issue. Click here if you would prefer to listen to the interview.

Todd:  Hello once again this is Todd Whitthorne with another healthy living podcast and I’m joined today by Dr. Nina Radford, the Head of Cardiology for the Cooper Clinic and we’re going to talk about a recent article in JAMA that discussed a meta-analysis of omega-3 as it relates to the cardiovascular benefits.  So Dr. Radford, this can be a rather complicated topic because we’re talking about statistics and scientific research, but I do know we have a very educated and inquisitive listening audience, so let’s walk through this paper because the headlines we’ve seen in the newspapers or heard on the radio basically came out and said that “omega-3, or fish oil, did not show benefit for cardiovascular health.” Can we dig a little deeper and explain really what this paper was investigating, and what the results showed?

Dr. Radford: Absolutely! I’m just delighted to discuss this with you because as we both know, sometimes these very important papers get condensed into a single, simple sentence or headline that may peak an individual’s attention but doesn’t always tell the whole story…, and this paper I think is a good example of that.

So this paper is a meta-analysis, and what that means is it is combining information from multiple studies, and why would you want to do that? Well, if you combine studies together your population will grow, so for example in this meta-analysis they combined the data from 20 studies so it included almost 69,000 patients.  When you have a larger patient population, it’s easier to see small effects that may occur that may be statistically significant. The problem with combining studies is that all studies are a little bit different… the ages of the patient may be different; the formulation of the omega-3 being used may be different; they time they use the omega-3 may be very different; it may be in a different country where native foods are very different for example, from the United States. So, one of the problems is that when you combine studies that are very different, and you reach conclusions from them, your house is sort of built of rickety wood, so you have to be careful in terms of how you interpret it. That being said, what we have are this combination of 20 studies. The median age is 68, and I’ll remind you median means that 50% or below that age, and 50% are above, and in these studies the age range was 49 to 70. In these studies, the median dose of omega-3 was about a gram, and that’s probably less than most people consider taking daily today.

Todd:  I’m sorry. That’s a gram of EPA plus DHA, not a gram of fish oil, correct?

Dr. Radford: That’s correct. And the range was from .53, so half a gram, which most of us would consider on the lower side, to 1.8 grams per day. The treatment duration was about two years and spanned from one to six, and the important thing about these studies is that 13 of the 20 were secondary prevention studies.  What that means is those participants had already been diagnosed with heart disease. They had heart attack, bypass, heart failure, sudden death, stents, but they were not people who were taking it to prevent the first event. Rather, these were people who were put on fish oil to prevent a second cardiovascular event or death. Four of the studies were mixed primary secondary, you couldn’t really sort out which was which, and three of the studies had to do with preventing sudden death in people who had implantable cardiac defibrillators (those are the internal defibrillators that shock you if you have a potentially life-threatening heart rhythm abnormality). So again, these are patients who are older, they have known heart disease, and they’re taking EPA plus DHA at a median of a gram for about two years.

Now, one of the things that we have to remember in all of this is that there’s pretty good reason to think that fish oil may help when we look at basic science. There have been studies that suggest it lowers blood pressure, lowers triglycerides, may stabilize heart rhythms, may reduce the stickiness of the blood to form to form blood clots, so there’s some good rationale from which these studies were conducted, and that’s always sort of reassuring to know there’s some basic science that underlies these. So in this analysis, they looked at five major outcomes  – all cause mortality (that’s the risk of dying of anything); cardiac death (dying of heart attack); they looked at sudden death (which is a heart rhythm abnormality); rather than having a heart attack and then having heart failure, for example; having a nonfatal heart attack; or stroke.

When we look at whether or not a result is statistically significant, we look at something called the P value, and the P value helps us decide if this result that could happen by chance, or is this the result that can withstand rigorous statistical testing? And we rely on that P value as readers of medical science, to let us know yes, that’s statistically significant, or no it’s not.  We don’t just rely on the number that we see, we have to rely on the statistics to back it up, so in this population is that meaningful.

Now, in most studies that I read, a P value of significance is a P value less than 0.05. When you know that the P value is less than that, you know it’s statistically significant. And when we look at that range of P value in this study, there was actually a demonstrated benefit in terms of reducing cardiac death. It reduced it by about 9 percent. Now, what’s made this somewhat controversial is these authors have decided to make a much more limited P value of .0063, and that’s rather usual, and that requires that the effect be more robust if you will, in order to prove that it’s present.

And when we look at studies – for example you may remember testing hormone replacement, and did hormone replacement reduce the risk of death for example? In all of those studies the P value is 0.05. If you look at whether statin medications reduce the risk of dying from heart disease, the P value is 05. So the use of this very, very small P value, is a little unusual and not everybody is accepting it when we look at this study. So certainly, what I would conclude from this study, based on a P value I think is reasonable, is that there is likely a small reduction in cardiac death in the studies of patients who are older and already had advanced heart disease.

One of the things I think is very interesting in this paper is that they provide sort of a chronologic history. They start with studies done in the mid- 1995’s and they go through the studies that were published more recently in 2012.  And what’s interesting is in the studies that were published in the in the mid-to-late 90s until 2005, there was a benefit of omega-3 in terms of all cause mortality. But when you look at the most recent studies that were published in 2010 or 2012 you did not see that effect. So does that mean that the studies that were done early on were wrong? Absolutely not!  What we see is an effect of improving medical science and improving technology. Compared to 1995, patients who are treated after a heart attack today are treated with much more sophisticated medications. Their lipids are much more aggressively lowered compared to patients in 1995, so if I add a therapy like omega-3 fatty acids, which have a small benefit compared to those other therapies, it may be hard to see that benefit unless you have an extraordinarily large number of patients in the trial. And so, I don’t see this as being a call to throw away all your fish oil.  Rather, I see this as a recommendation that there is likely is benefit, but it’s small, compared to the other known therapies that we have for patients treated after a heart attack.  Now let me be very clear that this has no bearing on patients who haven’t heart disease yet; who haven’t had their first heart attack yet. Maybe they have high cholesterol.  Maybe they have a strong family history of developing heart disease and they want to prevent their first event.  This paper doesn’t address population all.

Todd:  Clearly, what’s interesting about omega-3, is that there are literally thousands of studies that have been done looking at the various and assorted benefits and in a variety of areas, but in particular cardiovascular disease.  So for someone healthy, someone that is just looking to improve their overall cardiovascular risk profile, omega-3 still make sense from your perspective as a cardiologist?

Dr. Radford: I think that they definitely ought to be offered to patients. I think that they definitely may have some benefits in terms of reducing death from cardiovascular disease. I think compared to their other therapies, like statin medications or low dose daily aspirin, that effects may be small, but every little bit helps if we’re talking about reducing your risk of dying of heart disease.

Todd:  And that main benefit as we hear so much about inflammation, that seems to be the benefit of omega-3, as an anti-inflammatory?

Dr. Radford: And there may be benefits well beyond that, that we simply don’t have enough knowledge about.

Todd:  Very good. Well Dr. Radford, as always I appreciate your insight.  It’s like going to Paul Harvey for the rest of the story, to break it down and simplify something that is very, very complex, so we appreciate it.

Folks, if you want more information, you can sign up for The Cooperized Newsletter. As always, we’ll keep you updated with whatever we can here on the podcast and on the website. Until next time, this is Todd Whitthorne. Have a great day. Be healthy.