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Senior-Fall-Prevention

After a fall, would you make it back up? Moves for Functional Fitness

/8 July 2021/ All MFN blog/

The primary reason we move to a long-term care facility is not an illness but dependence on others due to physical weakness. Deconditioned seniors have the greatest potential to improve functional strength. With practice, you can develop muscles to recover from a fall. Fear only increases our risk.

A Recovery

Imagine you fell. Take deep breaths. Do toes and fingers move? Where is the phone? If it’s not close, you roll, drag, crab walk or crawl. Once near a chair or low table:

  1. Roll onto your belly. Rest.
  2. Raise onto forearms and knees. Rest.
  3. Aim your buttocks toward the chair. Rest.
  4. Press up to hands and feet. Rest.
  5. Go backwards to the chair. 
  6. Back your hips onto the chair. Rest.

The 10 Moves

Hopefully, you never fall, but practiced weekly, these exercises can improve strength and stamina for moving in bed, sitting up and life. Do these on your bed. Have a friend nearby. Start with one exercise 1-3 days a week for 1-3 weeks. Then add on. To gain more, try them under the weight of your covers. Listed in progression: 

  1. Practice rolling. Lie sideways across the bed; feet hanging off. Exhale away from the bed. The exhale stabilizes your low back and releases pressure on the heart. Face up, roll to each side. Rest. Repeat 10 times. Roll from face down to your sides. Rest. Repeat. Roll from the foot of the bed to head of the bed. Rest. Repeat 10 times. Avoid rolling from edge to edge on the bed. 
  2. Lie on your side; place your upper hand on the bed. Exhale- push on your lower elbow and top hand to lift shoulders and head up. Rest. Repeat 10 times. Switch sides.
  3. With no pillow, lie on your back to lift your hips. Exhale before and during the lift. Rest. Repeat, but stay up for a count of 5. Do not hold your breath! For low back issues, try it with one leg straight. Rest. Alternate. Repeat.
  4. Lie on your side with a head pillow. Keep head, shoulders and knees down; lift your hips with an exhale. Rest. Repeat. Stay up for a count of 3. Switch sides. Try it up, on one elbow. Rise out of the shoulder. Press into your upper hand too.
  5. Practice scooting: Lie face up. Exhale- lift your hips, shift them to one side, lower hips. Then lift to return to center. Repeat, alternating sides. Try scooting twice to each side, adding your upper body to travel. Stay on the bed!
  6. Crawl onto the bed on all fours. Engage your abdominals for support. Practice staying on forearms and knees. Rest. Repeat, adding a few seconds. Practice on hands if your wrists allow. Rest. Repeat.
  7. Crawl onto your bed from the foot of the bed. Crawl to the headboard. Crawl backward. To practice crawling sideways, enter the bed from the side. No slippery bedspreads!
  8. Drag your hips or crab walk on forearms or hands. Use deep breathing to move. Rest often. Use your glutes. Stay aware of your location on the bed.
  9. Standing with back of legs touching a chair, walk hands down the legs and back up to standing. Sit to rest. Repeat. Stop if dizzy. From a fall, standing is not a goal, but prepares us for the next move.
  10. When you feel ready to walk on all fours on the floor, stay near a couch or low table. Look behind to go backward. Sit to rest. Repeat. 

Please Note

Do whatever you can. Many of us feel dizzy or have joint limitations that affect performance. The biggest mistake is to quit, because of temporary discomfort or lack of confidence. With consistent practice, discomfort typically lessens.

Another way to recover from a fall involves kneeling to a lunge position next to a chair. This works for able-bodied seniors. Find what is best for you. Every week, practice your weakest steps until you gain confidence.

As an ACE-certified Medical Exercise Specialist with decades of experience training fragile to fit seniors, Emma Spanda Johnson designs adaptive exercise programs, for clients of all abilities. She is a nationally certified personal trainer with an Orthopedic Specialty. Emma offers virtual training sessions, visit her MedFit Network profile for details.

 

References and Resources

Smiling elderly woman training in a group

It’s time to play!

/7 July 2021/ All MFN blog/

I had just returned home from an amazing educational conference in Arizona. Some of the most educated and credentialed humans in the fitness world had come together to share and learn the most up-to-date and evidenced-based systems in the fitness world. My thoughts felt like a bag of ping pong balls had been dropped, bouncing in many directions at once.

I was getting out of my car on the way to get groceries. All the lessons, lectures, and workouts swirling in my mind. I was looking for a common thread. What was the connection to all that I have learned?  Then, I hear this clippity clack clippity clack! I look over my shoulder in the parking lot of a Publix. There was this young girl holding her mother’s hand. She had her princess outfit on, crooked crown, fake jewels and plastic shoes. The shoes skipping on the pavement was the clippity clack sound that made me look. I giggled at the difference between mom’s face, stress, deep thought and worry, and the young girl’s free and happy smile. Then I see them in the store. The young princess was leaping from colored tile to colored tile. I could see the imaginary moat she might be trying to cross while being chased by the creatures below.

I flashback to a seminar and one of the drills I just experienced with Master Instructor, Andy Hainey. Bounding in multiple planes of motion to challenge the athlete’s ability to accelerate and decelerate force efficiently. This beautiful happy princess was naturally doing some of the most advanced programming I flew thousands of miles to study.

BOOM! It hit me. PLAY…. she was PLAYING! The sessions and lessons that shone brightest and stayed with me from the workshops, were those that felt like play. They were technical and evidence-based, and they were fun! No one used jargon or spoke of the sagittal plane or the eccentric phase.  They made it fun.

Benefits of Incorporating “Play” into Your Programming for All Ages

The are many studies of the benefits of play and physical relation between activity in youth populations. The evidence shows a positive relation between physically active youth, and seven areas of cognitive performance (perceptual skills, intelligence quotient, achievement, verbal tests, mathematics tests, developmental level/ academic readiness, and other). Sibley et al., 2003

Playing increases enjoyment and adherence at all ages. It creates a positive reaffirming cycle of success. The more you enjoy something, the more time spent doing it. The more time spent doing an activity, the more skilled you become. The greater the skill level you achieve or the higher the achievement, the more you will enjoy doing the activity. 

We forget what it was like to play as we age with all the responsibilities and stresses we have We are told to put childish things aside. As a “fitness professional” we are blessed to keep playing in many senses of the word. I have spent many hours of my life educating myself and gaining certifications. While I believe that time has been well spent, my clients continually tell me their favorite aspect of our time together is the fun factor.  

Many feel as though they haven’t repeated a workout ever. This is not the case. I do follow the NASM OPT model. It is a progressive system that can be applied to every aspect of fitness training. Our body has a miraculous ability to adapt to specific demands placed on it. That is my primary guide to programming for my clients. Once we establish their baseline abilities through comprehensive assessments, and what goals they want. Then we create the program based on the S.A.I.D. principle (Specific Adaptation to Imposed Demands). The assessments many times feel intimidating and clinical and set that as the tone for you and your client.  If we as trainers and coaches make the assessments fun and non-intimidating games (I use the term drills in place of games for my adults many times) or play, we can start creating a positive nurturing environment for our clients.  Don’t just show them where they are deficient. Let them show and celebrate what they are capable of.

Bottom line is, have fun and play! You will enjoy every session. Your clients will look forward to each session. They will give their all and get better results.  Keeping clients training is one of the most challenging parts of what we do.  Embrace your inner child, and theirs. Get them to hop from stone to stone in monster infested waters or bring out the agility ladder. Either way just play!

Coach Pete Guzman is a NASM Master Trainer with CES, PES, YES, CNC, SGPT MMACS and 4th degree Black Belt. Look for his upcoming seminar in June to find out more about youth programming and adding fun to your clients’ journeys.

general-pain-neck-back-pain

Fibromyalgia: Symptoms and Treatments

/6 July 2021/ All MFN blog/

Chronic pain, tender to the touch on the body, fatigue, and sleep problems, are all symptoms of fibromyalgia. This syndrome affects the muscles and soft tissue of the body. The trouble with this condition is that there is no lab test for diagnosis, rather, the culmination of symptoms leads to the fibromyalgia diagnosis for sufferers. This condition is frequently undetected and misdiagnosed for this reason. However, for people living in pain, they want a solution to their problem. Other symptoms include headaches, depression, anxiety, memory loss called “fibro fog”, numbness and tingling in the extremities, irritable bowel syndrome, and feeling body aches all over. This is no way to live. The difference between fibromyalgia and other conditions such as tendonitis, bursitis, and arthritis, is that the pain is not located in one area… it is chronic and all over the body. A lot of this pain can even be at the surface of the skin, simply triggered by touch.

Persons with fibro just feel exhausted all the time. Even with quality sleep, the body is still tired. This is disruptive to one’s lifestyle and includes lack of energy to work, exercise, and or even just going to the grocery store. These activities take large amounts of energy. Imagine being too tired to even fold laundry. This is frustrating and mentally exhausting as a person is expected to participate in daily life, but physically too tired to do so. Waking up in the morning is when the body just feels stiff. What sleep a person with fibro does get is easily disrupted. Brain activity continues as if the person were awake. This, in turn, affects one’s mood. A person becomes worried they won’t be able to keep up with daily activities, and this reality leads to depression and anxiety. Relationships can become affected. Short-term memory also starts to suffer. Paresthesia (tingling and numbing feeling in the hands and feet) can stop a person in their tracks. All of these factors seem like walls in the way of being able to accomplish regular daily tasks.

A doctor can prescribe medication to help with the pain and the key is remembering to consistently take these medications . There are also alternative methods such as acupuncture, massage, and physical therapy. Exercise, especially walking, can help increase blood flow and decrease pain, along with balance and resistance training exercises. Keeping the mind active is also important. A person with fibro should pace themselves as they learn to adapt to their energy demands. Trying not to become overwhelmed or easily discouraged is important. Making sure to eat a nutrient-filled diet is critical, and especially including vitamin D. Caffeine should be avoided because the sleep cycle of a person with fibro is easily disturbed. Although caffeine might feel like an energy booster, drinking caffeine has been associated with increased fibro pain.

Communication is important with relationships and with employers. The lack of energy can be perceived as a lack of effort, but when a person with fibro expresses their medical concerns with others, one can aim to find a balance to life’s demands.

Fibromyalgia needs more medical research to help sufferers and alleviate their pain. Living a life with the physical struggles associated with fibromyalgia is no way to live but there is hope with the right pain management treatments.

Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health, and is a current doctoral candidate in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.

 

References

woman-and-baby-exercise-fitness

Can Exercise help treat women with postpartum depression?

/5 July 2021/ All MFN blog/

According to several studies, exercise has been proven as an effective method of treating and preventing depression. Some studies suggest that physical activity may be as powerful as anti-depressants for treating mild to moderate depression over time. The same is true for women experiencing mild to moderate postpartum depression. It’s important to note that there are different levels of postpartum depression and screening is available through hospitals and doctors’ offices if PPD is suspected. Both the Edinburgh Postnatal depression scale questionnaire and a PAR-Q medical history questionnaire will help give insight to healthcare practitioner and patient on treatment methods.

outdoor-fitness-class

Moving Together Outside

/2 July 2021/ All MFN blog/

Every afternoon around 4:00 pm, just outside my study window, I can hear the sounds of outdoor physical activity classes held in a nearby park. Instructors calling, students responding, joyful sounds of activity and movement—the opposite of what I am doing as I start my seventh Zoom meeting of the day.  

Along with the majority of Americans, I am sitting more and moving less during the pandemic. In fact, physical activity levels are down around 32% in a nation where only 23% of us met recommended guidelines for both aerobic and strength training activities before the pandemic. Shockingly, but somehow not surprisingly, 61% of Americans report experiencing undesired weight gain—29 pounds on average—during the pandemic.

The fitness professionals leading those classes outside my window provide an outstanding case study in the value of adaptability and sheer determination to get people moving. 

During the early stages of the pandemic, their studios were closed. Later on, capacity limits were too constraining, and their studios were too small and poorly ventilated to hold their classes indoors. Therefore, they needed to come up with an innovative solution to keep their businesses open. They worked with our city government to secure permits—at an affordable price—to move their classes to an outdoor public park that was accessible to all community residents.

This is not the only example of fitness professionals successfully securing permits or shared use agreements from their local governments. There are success stories from San Diego, Long Beach, Washington, DC, Austin and Boston. However, these stories are too few and far between.  

Our attention over the past year has been almost single-mindedly focused on an infectious disease, yet beneath the COVID-19 pandemic that raged lay the dual epidemics of physical inactivity and obesity that helped fuel it. People with obesity have more than double the risk for hospitalization from COVID-19 and a nearly 50% higher risk of death. The odds of death are 2.5 times greater for people who are consistently physically inactive, compared with people who consistently meet recommended guidelines, and physical inactivity was found to be the strongest modifiable risk factor for severe COVID-19.

Qualified, credentialed fitness professionals have an important role to play in getting people moving. We have worked hard to gain the expertise to provide safe, structured physical activity programming for different types of populations. We are true believers in the mental and health benefits of physical activity and are trained in helping others change their behavior to experience these benefits.  

The American Council on Exercise has launched a grassroots campaign—Moving Together Outside—to support qualified fitness professionals in their efforts to get people moving by expanding access to community spaces. I see it as a win-win-win. For fitness professionals, seeking ways to work with students and clients outdoors during and after the pandemic. For municipalities, seeking safe and affordable physical activity options to offer to residents. For community residents, seeking opportunities for social connection and movement.  

I am proud to be the national spokesperson for the Moving Together Outdoors Campaign. I invite my fellow fitness professionals to become a campaign supporter at advocacy@acefitness.org. Let’s help good ideas spread, so the daily physical activity classes that I hear from the park next to my home are sounds heard daily from parks across the nation.   

Dr. Amy Bantham, DrPH, MS, MPP, is the CEO/Founder of Move to Live More, a research and consulting firm addressing physical inactivity, chronic disease and social determinants of health through cross-sector collaboration and innovation. A certified health and wellness coach, personal trainer, and group exercise instructor, Amy holds a Doctor of Public Health from the Harvard School of Public Health. She can be reached at movetolivemore.com or @MovetoLiveMore

 

References

  • American Psychological Association. Stress in America: One Year Later, a New Wave of Pandemic Health Concerns. 
  • Meyer, J., McDowell, C., Lansing, J., Brower, C., Smith, L., Tully, M. & Herring, M. (2020). Changes in physical activity and sedentary behaviour due to the COVID-19 outbreak and associations with mental health in 3,052 US adults. 
  • Popkin, B. M., Du, S., Green, W. D., Beck, M. A., Algaith, T., Herbst, C. H., … & Shekar, M. (2020). Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships. Obesity Reviews.
  • Sallis, R., Young, D. R., Tartof, S. Y., Sallis, J. F., Sall, J., Li, Q., … & Cohen, D. A. (2021). Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British journal of sports medicine.
  • U.S. Department of Health and Human Services. (2018a). 2018 Physical activity guidelines advisory committee scientific report. 
Hearts_of_Palm

The Naturopathic Chef: Plant Based Ceviche

/30 June 2021/ All MFN blog/

Summertime is the perfect time for anything yummy on a chip!

Ceviche is a delicious example of cold, crisp summer fare. With the huge shift to a more plant-based lifestyle, I wanted to offer a veggie ceviche. Palm Hearts, take the place of fish and introduce a much-overlooked ingredient. 

Ingredients

  • 1 14-oz can hearts of palm, drained and chopped (diced looks like scallops and white fish; sliced looks like calamari)
  • 2 chopped and seeded heirloom tomatoes
  • 1 diced Persian cucumber
  • ½ cup finely chopped purple onion
  • 2 tbsp chopped fresh cilantro
  • 2 tbsp each: lemon, lime, and ruby grapefruit juice
  • 1 small avocado (dice and fold in right before serving)
  • ¾ tsp salt

Mix everything together except the avocado. Chill 1 hour. Fold avocado in right before you serve. Carve cucumber cups and fill with finished ceviche for a beautiful and easy party platter. 

Phyte Facts

Hearts of Palm are nutrition powerhouses and should be included more often due to many health-enhancing benefits. Heart and gut health are improved due to the high fiber content and natural inulin, which acts as a prebiotic, feeding healthy gut bacteria. Blood sugar stays level throughout the day and our blood pressure and vascular system relax.

The Palm Heart is high in vitamin B6 which is the nutrient that controls our immune function.

Lastly, our brain efficiency can be maintained simply by keeping a variety of foods in our daily nutrition intake. This veggie is easy to add to a variety of foods, is readily available, and is relatively inexpensive. This is a great food for our aging population!

Get more great recipes from Tina Martini — her book, Delicious Medicine: The Healing Power of Food is available to purchase on Amazon. More than a cookbook, combining 20+ years of experience, along with her love of coaching, cooking and teaching, Tina offers unexpected insights into the history and healing power of clean eating, along with recipes to help reduce your risk of disease and improve overall wellness so you can enjoy life!

Affectionately referred to as The Walking Encyclopedia of Human Wellness, Fitness Coach, Strength Competitor and Powerlifting pioneer, Tina “The Medicine Chef” Martini is an internationally recognized Naturopathic Chef and star of the cooking show, Tina’s Ageless Kitchen. Tina’s cooking and lifestyle show has reached millions of food and fitness lovers all over the globe. Over the last 30 years, Tina has assisted celebrities, gold-medal athletes and over-scheduled executives naturally achieve radiant health using The Pyramid of Power: balancing Healthy Nutrition and the healing power of food, with Active Fitness and Body Alignment techniques. Working with those who have late-stage cancer, advanced diabetes, cardiovascular and other illnesses, Tina’s clients are astounded at the ease and speed with which they are able to restore their radiant health. Tina believes that maintaining balance in our diet, physical activity, and in our work and spiritual life is the key to our good health, happiness and overall well being. Visit her website, themedicinechef.com

 

Dont-panic

Pandemic of Panic Is Worse than COVID-19

/29 June 2021/ All MFN blog/

While the threat of the COVID-19 needs to be taken with great concern, it is as important to understand the useless and counterproductive effects of panicking. Whether you take the vaccine or not, prevention is the best approach to any viral challenge. Panic is an extreme fear response triggering stress hormones that suppress immune function increasing susceptibility to any pathogen, including viruses.

plant-protein

Eat Plant Protein to Live Longer

/28 June 2021/ All MFN blog/

Scientific research continues to show consuming red and processed meats or a high-animal protein diet has a profoundly damaging effect on overall health and longevity. It is vitally important that red meat in our diet should be replaced (or at least greatly limited) in favor of foods that are proven to offer protection against cancer – such as green vegetables, berries, beans, nuts and seeds. This should not be seen as controversial and is supported by an overwhelming amount of data. 

Long-term studies

Large, long-term studies investigating intakes of animal and plant protein with regard to mortality have consistently concluded that more plant protein and less animal protein is linked to a longer life. (1-4) Studies consistently link greater red meat consumption to a greater risk of premature death. (5-7)

Here’s an example:

A 2016 study published in JAMA Internal Medicine investigated the relationship between animal vs. plant protein sources and mortality risk from almost 30 years of follow-up from the Nurses’ Health Study and Health Professionals Follow-up Study. Together, these two studies included over 170,000 participants.

Interesting findings came out of one particular question the researchers asked: What would happen if the participants replaced some of their animal protein with plant protein?

They analyzed the data to estimate how participants’ risk of death from all causes over the follow-up period would change if some of the animal protein sources (equivalent to 3 percent of total daily calories) were replaced with plant protein sources:

  • Replace processed red meat: 34 percent decrease in risk
  • Replace unprocessed red meat: 12 percent decrease in risk
  • Replace poultry: 6 percent decrease in risk
  • Replace fish: 6 percent decrease in risk
  • Replace eggs: 19 percent decrease in risk
  • Replace dairy: 8 percent decrease in risk3

Higher intake of plant protein sources is associated with better health: for example, seeds and nuts reduce the risk of cardiovascular disease and are linked to longevity, and micronutrient and fiber-rich beans are linked to improved blood pressure, LDL cholesterol, body weight, insulin sensitivity and enhanced lifespan. (4, 8-13)

Prospective cohort studies are observational and cannot prove causality, but these studies are crucial to our understanding of health and longevity, because heart disease and cancer – our two biggest killers – develop over the course of multiple decades, not just a few months. Studies that follow tens of thousands of people for 10 or 20 years or more, and evaluate hard endpoints (death, heart attack, stroke, cancer, etc.) provide valuable insights into the habits that may promote or prevent these diseases. The significance of findings from observational studies is supported by laboratory studies showing there are plausible mechanisms for the association – good reasons why it’s not just a random correlation, but likely a causal relationship.

Many meat-centered diet proponents dismiss these important studies out of hand, ignoring the careful collection of data and complex mathematical analysis by skilled epidemiologists that control for potential confounding factors and detect potentially significant associations. 

The correlations between animal protein intake and all-cause mortality in long-term prospective studies are consistent with other observational studies on specific diseases, and are backed up by laboratory studies that have uncovered the plausible cellular and molecular mechanisms behind the correlations:

  • High animal protein intake excessively elevates insulin-like growth factor 1 (IGF-1), which promotes cancer development. (14-18) 
  • Research on nutrient-sensing pathways that respond to protein intake suggests reducing essential amino acid intake (i.e. reducing animal protein) promotes longevity. (19) (Note that the elderly require more protein than younger adults. (20, 21))
  • The pro-inflammatory effects of dietary saturated animal fats. (22-25)
  • The pro-oxidant and pro-inflammatory properties of excess heme iron. (26, 27)
  • Cooking-produced carcinogens in meats, such as heterocyclic amines and polycyclic aromatic hydrocarbons. (28-31)
  • Genotoxic N-nitroso compounds produced from processed meats. (30-33)
  • Detrimental effects of carnitine and choline on the gut microbiome that promote inflammation. (34-37)

Although eating a keto or carnivores’ diet can lower blood sugar and promote weight loss in the short term, the long-term effects of a diet so high in animal products (according to the preponderance of evidence) is damaging over the long term. That is why I reiterated that it is important to see the long-term studies with hard endpoints. Looking at short-term weight loss studies will lead you on a path to damage your potential for optimal longevity.

Although the disease-promoting effects take many years to build up, several short-term studies point to the beginnings of the damage of a high-animal product diet:

  • Measured after a single meal, butter impaired vascular function compared to nuts and other predominantly unsaturated plant fats. (38)
  • A study comparing Atkins, South Beach, and Ornish weight maintenance diets (all with the same calorie counts) assigned participants to each diet for four weeks each. At the end of the Atkins diet phase, LDL cholesterol was higher and vascular function lower compared to the other diets. (39) 
  • Participants (who lived at the study site during the study) were fed 420 g red meat or a vegetarian meal daily for 15 days, with the rest of their diets kept exactly the same. Stool samples and colon cells collected after 10 days on each diet showed an increase in production of carcinogenic N-nitroso compounds during the red meat diet compared to the vegetarian diet, and an increase in N-nitroso compounds binding to DNA in colon cells (which leads to DNA damage and colon cancer). (40)
  • A study comparing about two servings daily of fiber-rich whole grains to red meat for three weeks each suggested the whole grain diet improved gut microbiome diversity compared to the red meat diet. Body fat mass was also lower after the whole grain intervention. (41)
  • After four weeks, a diet containing red meat increased production of the pro-inflammatory compound TMAO, compared to white meat and vegetarian diets. (36)

Meat-heavy diets get one important thing right: They cut out weight gain-promoting, disease-promoting high-glycemic refined carbohydrates. But large amounts of animal products are unquestionably disease-promoting, too.  The Nutritarian diet does more than just restrict one type of harmful food. It limits or completely avoids all other disease-promoting foods and focuses heavily on foods that are richest in protective nutrients and are linked in scientific studies most consistently to a lower risk of cardiovascular disease, cancer, and other chronic diseases.

 

Joel Fuhrman, MD is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 7 New York Times bestselling books, including his most recent book, “Eat to Live”. Visit his website, DrFuhrman.com.

👉👉Get $10 off $150 or more on Dr. Fuhrman’s website. Use coupon LS10OFF150.

Originally posted on DrFuhrman.com. Reprinted with permission.

References

  1. Budhathoki S, Sawada N, Iwasaki M, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med 2019. doi: 10.1001/jamainternmed.2019.2806
  2. Huang J, Liao LM, Weinstein SJ, et al. Association Between Plant and Animal Protein Intake and Overall and Cause-Specific Mortality. JAMA Intern Med 2020. doi: 10.1001/jamainternmed.2020.2790
  3. Song M, Fung TT, Hu FB, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med 2016, 176:1453-1463. doi: 10.1001/jamainternmed.2016.4182
  4. Tharrey M, Mariotti F, Mashchak A, et al. Patterns of plant and animal protein intake are strongly associated with cardiovascular mortality: the Adventist Health Study-2 cohort. Int J Epidemiol 2018. doi: 10.1093/ije/dyy030
  5. Wang X, Lin X, Ouyang YY, et al. Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies. Public Health Nutr 2016, 19:893-905. doi: 10.1017/S1368980015002062
  6. Pan A, Sun Q, Bernstein AM, et al. Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies. Arch Intern Med 2012. doi: 10.1001/archinternmed.2011.2287
  7. Sinha R, Cross AJ, Graubard BI, et al. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009, 169:562-571. doi: 169/6/562 [pii] 10.1001/archinternmed.2009.6
  8. Grosso G, Yang J, Marventano S, et al. Nut consumption on all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies. Am J Clin Nutr 2015, 101:783-793. doi: 10.3945/ajcn.114.099515
  9. Jenkins DJ, Kendall CW, Augustin LS, et al. Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial. Arch Intern Med 2012, 172:1653-1660. doi: 10.1001/2013.jamainternmed.70
  10. Bazzano LA, Thompson AM, Tees MT, et al. Non-soy legume consumption lowers cholesterol levels: a meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011, 21:94-103. doi: 10.1016/j.numecd.2009.08.012
  11. Papanikolaou Y, Fulgoni VL, 3rd. Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002. J Am Coll Nutr 2008, 27:569-576. doi:
  12. Darmadi-Blackberry I, Wahlqvist ML, Kouris-Blazos A, et al. Legumes: the most important dietary predictor of survival in older people of different ethnicities. Asia Pac J Clin Nutr 2004, 13:217-220. doi:
  13. Li SS, Blanco Mejia S, Lytvyn L, et al. Effect of Plant Protein on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2017, 6. doi: 10.1161/JAHA.117.006659
  14. Travis RC, Appleby PN, Martin RM, et al. A Meta-analysis of Individual Participant Data Reveals an Association between Circulating Levels of IGF-I and Prostate Cancer Risk. Cancer Res 2016, 76:2288-2300. doi: 10.1158/0008-5472.CAN-15-1551
  15. Vigneri PG, Tirro E, Pennisi MS, et al. The Insulin/IGF System in Colorectal Cancer Development and Resistance to Therapy. Front Oncol 2015, 5:230. doi: 10.3389/fonc.2015.00230
  16. Anisimov VN, Bartke A. The key role of growth hormone-insulin-IGF-1 signaling in aging and cancer. Crit Rev Oncol Hematol 2013, 87:201-223. doi: 10.1016/j.critrevonc.2013.01.005
  17. Key TJ, Appleby PN, Reeves GK, Roddam AW. Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. Lancet Oncol 2010, 11:530-542. doi: 10.1016/S1470-2045(10)70095-4
  18. Kaaks R. Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence. Novartis Found Symp 2004, 262:247-260; discussion 260-268. doi:
  19. Mirzaei H, Raynes R, Longo VD. The conserved role of protein restriction in aging and disease. Curr Opin Clin Nutr Metab Care 2016, 19:74-79. doi: 10.1097/MCO.0000000000000239
  20. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013, 14:542-559. doi: 10.1016/j.jamda.2013.05.021
  21. Volpi E, Campbell WW, Dwyer JT, et al. Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J Gerontol A Biol Sci Med Sci 2013, 68:677-681. doi: 10.1093/gerona/gls229
  22. Erridge C. The capacity of foodstuffs to induce innate immune activation of human monocytes in vitro is dependent on food content of stimulants of Toll-like receptors 2 and 4. Br J Nutr 2011, 105:15-23. doi: 10.1017/S0007114510003004
  23. Erridge C, Attina T, Spickett CM, Webb DJ. A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation. Am J Clin Nutr 2007, 86:1286-1292. doi: 10.1093/ajcn/86.5.1286
  24. Masson CJ, Mensink RP. Exchanging saturated fatty acids for (n-6) polyunsaturated fatty acids in a mixed meal may decrease postprandial lipemia and markers of inflammation and endothelial activity in overweight men. J Nutr 2011, 141:816-821. doi: 10.3945/jn.110.136432
  25. Fritsche KL. The science of fatty acids and inflammation. Adv Nutr 2015, 6:293S-301S. doi: 10.3945/an.114.006940
  26. Cornelissen A, Guo L, Sakamoto A, et al. New insights into the role of iron in inflammation and atherosclerosis. EBioMedicine 2019, 47:598-606. doi: 10.1016/j.ebiom.2019.08.014
  27. Brewer GJ. Risks of copper and iron toxicity during aging in humans. Chemical research in toxicology 2010, 23:319-326. doi: 10.1021/tx900338d
  28. Zheng W, Lee S-A. Well-Done Meat Intake, Heterocyclic Amine Exposure, and Cancer Risk. Nutrition and Cancer 2009, 61:437-446. doi: 10.1080/01635580802710741
  29. National Cancer Institute. Chemicals in Meat Cooked at High Temperatures and Cancer Risk.
  30. International Agency for Research on Cancer, World Health Organization. Press Relsease No. 240. IARC Monographs evaluate consumption of red meat and processed meat. 2015.
  31. Turesky RJ. Mechanistic Evidence for Red Meat and Processed Meat Intake and Cancer Risk: A Follow-up on the International Agency for Research on Cancer Evaluation of 2015. Chimia (Aarau) 2018, 72:718-724. doi: 10.2533/chimia.2018.718
  32. Lunn JC, Kuhnle G, Mai V, et al. The effect of haem in red and processed meat on the endogenous formation of N-nitroso compounds in the upper gastrointestinal tract. Carcinogenesis 2007, 28:685-690. doi: 10.1093/carcin/bgl192
  33. Herrmann SS, Granby K, Duedahl-Olesen L. Formation and mitigation of N-nitrosamines in nitrite preserved cooked sausages. Food Chem 2015, 174:516-526. doi: 10.1016/j.foodchem.2014.11.101
  34. Koeth RA, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013, 19:576-585. doi: 10.1038/nm.3145
  35. Tang WH, Wang Z, Levison BS, et al. Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. N Engl J Med 2013, 368:1575-1584. doi: 10.1056/NEJMoa1109400
  36. Wang Z, Bergeron N, Levison BS, et al. Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women. Eur Heart J 2019, 40:583-594. doi: 10.1093/eurheartj/ehy799
  37. Wang Z, Klipfell E, Bennett BJ, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature 2011, 472:57-63. doi: 10.1038/nature09922
  38. Keogh JB, Grieger JA, Noakes M, Clifton PM. Flow-mediated dilatation is impaired by a high-saturated fat diet but not by a high-carbohydrate diet. Arterioscler Thromb Vasc Biol 2005, 25:1274-1279. doi: 10.1161/01.ATV.0000163185.28245.a1
  39. Miller M, Beach V, Sorkin JD, et al. Comparative effects of three popular diets on lipids, endothelial function, and C-reactive protein during weight maintenance. J Am Diet Assoc 2009, 109:713-717. doi: 10.1016/j.jada.2008.12.023
  40. Lewin MH, Bailey N, Bandaletova T, et al. Red meat enhances the colonic formation of the DNA adduct O6-carboxymethyl guanine: implications for colorectal cancer risk. Cancer Res 2006, 66:1859-1865. doi: 10.1158/0008-5472.CAN-05-2237
  41. Foerster J, Maskarinec G, Reichardt N, et al. The influence of whole grain products and red meat on intestinal microbiota composition in normal weight adults: a randomized crossover intervention trial. PLoS One 2014, 9:e109606. doi: 10.1371/journal.pone.0109606