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Catching Up With Dr. Barry Sears

July 6, 2011 Written by JP    [Font too small?]

One of the reasons I chose the Internet as my primary mode of communication is that it allows me to continually and publicly update my points of views without much lag time. If a new study is published that contradicts or modifies my opinion about a health topic, I can spread the word about the breaking data almost immediately. The same is not true of books, magazine articles or print newsletters. This reality often leaves me wondering what some of the finest minds in integrative medicine think about current headlines that don’t make it into their finished work. Fortunately, on occasion, I’m able to follow up with some of the health experts I respect the most and ask some of the questions that have been left unaddressed.

A good deal of the material on my site is intended to help shape the future of medicine. My sincere hope is that insurers, patients, physicians and even politicians may happen upon some of my columns and tweets and use them to improve the way medicine is paid for and practiced. I plan to further this objective by including more inquiries about this topic in interviews I conduct with leading figures in the alternative and complementary medical community. It’s a downright shame and, frankly, inexplicable why thoughtful researchers such as Dr. Barry Sears aren’t being asked to play a bigger role in the present health care reform discussion.

JP – If you were put in charge of reforming the current health care system, what practical steps would you propose to improve the quality of care and reduce cost?

Dr. Sears – An ounce of prevention is worth a pound of treatment. The number one driver of future health care costs will be diabetes. However, 8-10 years before diabetes develops, a person already has pre-diabetes or metabolic syndrome. I would have a truly free (no co-payments, etc.) national diagnostic screening test program to look at the triglyceride/HDL cholesterol ratio of every American over age 40. It is a cheap test and indicates the existence of metabolic syndrome. Then reward the person with cash for meeting certain milestones. The lower the TG/HDL ratio, the greater the cash reward they receive. Japan is currently doing a variation of this approach, but penalizing the employers if their workers have metabolic syndrome. That system won’t work here, but cash rewards might.

JP – The FDA recently restricted access to high dosages of Zocor, the cholesterol lowering medication. Do you think elevated (LDL) cholesterol is an important health concern? If so, what is your preferred method of addressing it?

Dr. Sears – Elevated LDL levels are highly over-rated as a predictor of future heart disease. There are more than 200 risk factors for heart disease, and most powerful predictor is increasing age. Furthermore, the data on statins for preventing a first heart attack is weak at best. It is becoming clear that heart disease is a disease of inflammation, not of high LDL cholesterol. In fact after age 70 high cholesterol levels appear to be protective against heart disease. The recent JELIS study in Japan indicated that adding high-dose fish oil to existing statin therapy gave a significant improvement in reducing cardiovascular events. If we want to reduce LDL cholesterol, rather than taking a statin to inhibit the enzyme that makes cholesterol, simply lower insulin by the diet since insulin activates the same enzyme that statins inhibit. That is easily done just by reducing your intake of bread, grains and starches and replacing them with more fruits and vegetables. Adding fish oil further reduces inflammation, and now you have a powerful dietary approach to reduce the likelihood of a future heart disease without the side effects of statins. (1,2,3)

JP – What is your opinion about grass fed dairy and meat and organic food? Do they have a special place as part of a healthy lifestyle or are they mostly overhyped?

Dr. Sears – I am a very big believer in grass-fed beef (which is almost impossible to find) since it contains far lower amounts of omega-6 fatty acids that can cause inflammation compared to corn-fed beef. Organic fruits and vegetables are usually higher in anti-inflammatory polyphenols than are their chemically treated cousins. In both cases, the cost and availability are major problems. If so, then just consider eating more fruits and vegetables (organic or not) and less bread, grains, and starches and eat more fish and less beef.

JP – How much emphasis do you place on dietary fiber? Is there a guideline or range of intake you generally recommend?

Dr. Sears – It’s not the fiber that’s important, but where is comes from. That usually means fruits and vegetables. It’s not the fiber, but the polyphenols (these are the chemicals that provide color) that have the health benefits. That’s why I recommend eating about 10 servings of fruits and vegetables per day. If you do, then there is no reason to worry about your intake of fiber.

JP – What sources of health information do you follow to stay up to date on medical and nutritional trends? Where can my readers stay up to date with your current views on breaking news stories?

Dr. Sears – I spend at least two days a week reading original research studies in order to find connections between diet, inflammation and chronic disease. The most interesting connections (at least to me), I comment on in my blogs at www.zonediet.com

JP – Of those that succeed on the Zone Diet, have you noted any particular characteristics or commonalities that seem to contribute to their success?

Dr. Sears – The people who understand that controlling inflammation by the diet is life-long commitment are the ones who have the greatest success. These individuals tend to be more analytical in nature as they realize there is no short-term magic bullet in nutrition, but only long-term dietary strategy.

Dietary Polyphenols Protect Against Cardiovascular Disease and Diabetes

Source: Maturitas. 2010 June; 66(2): 163–171. (link)

JP – Have you investigated the relative merits of caloric restriction (CR) and periodic abstinence from food such as alternate day or intermittent fasting? Can such strategies be used in conjunction with a Zone-style eating program?

Dr. Sears – I wrote an entire book on calorie restriction (The Anti-Aging Zone) in 1999. Calorie restriction without deprivation of essential amino acids and essential fatty acids is the most powerful approach we have to extend the quality of life. I am personally not too keen on alternate day fasting or intermittent fasting anymore than I am about driving a car on empty. A consistent calorie restriction plan can be maintained as long as you aren’t hungry between meals. That is only possible by maintaining a consistent hormonal balance at each meal. It takes some effort, but the end result is worth it.

JP – Do you support the use of natural weight loss aids in the form of nutritional supplements? If so, which ingredients do you consider the most promising?

Dr. Sears – The best natural weight loss aid is an anti-inflammatory diet. Weight gain is not due to a breakdown in willpower, but caused by subtle increases in cellular inflammation that causes a disruption of the intricate balancing act between fat storage and fat release from the adipose tissue. Once inflammation disturbs those signaling mechanisms, you develop a fat trap in which incoming calories get stored in the fat cells and can’t be readily released. The best supplement to reduce the inflammation in the fat cells is high-dose fish oil. Not nearly as powerful as fish oils, but still beneficial are polyphenols.

JP – I’ve come across a great deal of positive research about non-alkalized cocoa. Do you include dark chocolate in your diet and/or recommend it as a health promoting dessert?

Dr. Sears – It’s the polyphenols in the chocolate that give these health benefits. Unfortunately, polyphenols are incredibly bitter. To reduce the bitterness of polyphenols (especially those in chocolate), you add sugar that wipes out much of their potential health benefits. If you want to add chocolate as a dessert, stick to the 95% cocoa versions or higher. You will get more polyphenols and less sugar. That means better health.

JP – What’s next for you? Are you working on any new projects that we can look out for in the near future?

Dr. Sears – I am doing a lot of clinical research in using high-dose fish oil to reduce neuro-inflammation. This would include brain trauma (concussions) as well as in the treatment of Alzheimer’s, Parkinson’s and multiple sclerosis. At the same time I am working on my next book that recounts my 30 years of research in anti-inflammatory nutrition. I guess if I was a better writer, then everyone would have understood what I was talking about with the publication of my first book, The Zone, more than 16 years ago.

If you want to stay up to date on Dr. Sears’ most recent commentary about health and nutrition, I strongly encourage you to bookmark his excellent blog. I just rediscovered it myself and I’m already benefiting from it. Some of the compelling topics of late have included information about: the importance of mindfulness, the relative merits and shortcomings of a Mediterranean-style diet and the role that genetics play in obesity. We don’t always come to the exact same conclusions. However, this is all the more reason to consider Dr. Sears’ valuable input. We all need to expose ourselves to a variety of informed opinions if we hope to piece together the puzzle known as modern medicine. In closing, I’d like to take this opportunity to thank Dr. Barry Sears and Kristin Sears for graciously sharing time with us. It’s greatly appreciated.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP


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Posted in Diabetes, Heart Health, Interviews

5 Comments & Updates to “Catching Up With Dr. Barry Sears”

  1. Ted Slanker Says:

    You claim you are an internet man consequently I find this puzzling. You say: “I am a very big believer in grass-fed beef (which is almost impossible to find).” But it is easy to find. We’ve been shipping grass-fed meats coast to coast to people’s doorsteps for 15 years. We have a huge selection of grass-fed meat that defies the meat selections of the major food chains. Our prices re very competitive too. Contrary to misguided beliefs Grass-Fed meats are the most planet friendly food known. They are the easiest foods to digest. (It is farming that is unnatural and destructive to the soils while contributing to global warming.) Grass-fed meats are the most perfect food for man too. In addition, we never ever go after lean. We go after fat. The n6 to n3 ratio in the fat is 0.85:1. Why pass up the best fats for heart health and brain function by demanding lean. BTW, same rule applies to grass-fed cheeses which we sell. Never ever opt for lean when eating the most perfect foods for man. Check us out.

  2. JP Says:

    Thanks for your input, Ted. I’m in agreement with you that grass fed dairy and meat is easily attainable these days – in many health food stores, markets and online. Such products, especially grass fed meat, can be a valuable addition/substitution is most diets. Personally, I include it in my dietary program and recommend it to my clients, family and friends.

    Be well!

    JP

  3. JP Says:

    Updated 09/28/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26400433

    J Am Coll Nutr. 2015 Sep 15;34(sup1):39-41.

    The ZONE Diet and Metabolic Control in Type 2 Diabetes.

    Obesity is associated with chronic inflammation of the adipose tissue, which contributes to obesity-associated complications such as insulin resistance and type 2 diabetes. The increased inflammatory response seems to be directly related to modern nutrition, particularly aspects of fat quality and macronutrient composition. We have recently published an observational study investigating the practicability and effects of a combined dietary intervention with increased relative protein content and low-glycemic-index carbohydrates, supplemented with omega-3 polyunsaturated fatty acids (PUFAs), on metabolic control and inflammatory parameters in real-life situations in patients with type 2 diabetes. The primary efficacy parameter was the change in HbA1c, and secondary parameters included change in systemic inflammation (measured by ultrasensitive C-reactive protein), body weight, waist circumference, fat mass, and homeostasis model assessment-insulin resistance. Counseling a protein-enriched and low-glycemic-index diet supplemented with long-chain omega-3 PUFAs in a real-life clinical setting improved glycemic control, waist circumference, and silent inflammation in overweight or obese patients with type 2 diabetes.

    Be well!

    JP

  4. JP Says:

    Updated 09/27/16:

    http://www.plefa.com/article/S0952-3278(15)00172-6/abstract

    Prostaglandins Leukot Essent Fatty Acids. 2016 Mar;106:19-25.

    Polyunsaturated fatty acids moderate the effect of poor sleep on depression risk.

    Although potentially modifiable risk factors for interferon-alpha (IFN-α)-associated depression (IFN-MDD) have been identified, it is not currently known how they interact to confer risk. In the present study we prospectively investigated interactions among poor sleep quality, high-stress, pre-existing depressive symptoms, and polyunsaturated fatty acid status. Non-depressed hepatitis C patients (n=104) were followed prospectively during IFN-α therapy. IFN-MDD occurs in 20-40% of patients and was diagnosed using the Structured Clinical Interview of DSM-IV (SCID-IV), with incidence examined using Cox regression. Baseline Pittsburgh Sleep Quality Inventory (PSQI), Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), and a range of plasma long-chain fatty acid levels were measured (gas chromatography) – focusing on the ratio of arachidonic acid (AA) to docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) (AA/EPA+DHA). The AA/EPA+DHA ratio (Β=0.40 ± 0.16; p=0.006), PSQI (Β=0.12 ± 0.04; p=0.001), PSS (Β=0.07 ± 0.02; p<0.001), and baseline BDI (Β=0.05 ± 0.02; p<0.001) each individually predicted IFN-MDD incidence. In step-wise Cox regression eliminating non-significant variables, two interactions remained significantly predictive: PSQI*AA/EPA+DHA (p=0.008) and PSS*AA/EPA+DHA (p=0.01). Receiver Operator Curves (ROC) were used to examine the specificity and sensitivity of IFN-MDD prediction. When sleep was normal (PSQI<5), AA/EPA+DHA was strongly predictive of IFN-MDD (AUC=91 ± 6; p=0.002). For example, among those with AA/EPA+DHA less than the median (4.15), none with PSQI<5 developed depression. Conversely, neither PSS nor PSQI was statistically associated with depression risk in those with an elevated AA/EPA+DHA ratio. These data demonstrate that the AA/EPA+DHA ratio moderates the effect of poor sleep on risk for developing IFN-MDD and may have broader implications for predicting and preventing MDD associated with inflammation.

    Be well!

    JP

  5. JP Says:

    Updated 06/06/18:

    https://www.plefa.com/article/S0952-3278(17)30295-8/abstract

    Prostaglandins Leukot Essent Fatty Acids. 2018 May;132:23-29.

    Supplementation with eicosapentaenoic acid and docosahexaenoic acid reduces high levels of circulating proinflammatory cytokines in aging adults: A randomized, controlled study.

    BACKGROUND: High levels of circulating proinflammatory cytokines are characteristic of inflammaging, a term coined to describe age-related chronic systemic inflammation involved in the etiology of many age-related disorders including nonhealing wounds. Some studies have shown that supplementing diets with n-3 polyunsaturated fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) lowers systemic levels of key proinflammatory cytokines associated with inflammaging. However, findings from the few studies that have focused exclusively on older adults are inconclusive. As such, the objective of this randomized controlled study was to test the effects of EPA+DHA therapy on circulating levels of proinflammatory cytokines in adults in middle to late adulthood.

    METHODS: Plasma levels of fatty acids and interleukin (IL)-6, IL-1β and tumor necrosis factor-α (TNF-α) were measured in 35 participants with chronic venous leg ulcers (mean age: 60.6 years) randomnly assigned to 8 weeks of EPA+DHA therapy (2.5 g/d) or placebo therapy.

    RESULTS: EPA+DHA therapy had a significant lowering effect on levels of IL-6, IL-1β and TNF-α after 4 weeks of therapy and an even greater lowering effect after 8 weeks of therapy. Further, after adjusting for baseline difference, the treatment group had significantly lower levels of IL-6 (p = 0.008), IL-1β (p < 0.001), and TNF-α (p < 0.001) at Week 4 and at Week 8 [IL-6 (p = 0.007), IL-1β (p < 0.001), and TNF-α (p < 0.001)] compared to the control group. CONCLUSION: Adults in middle to late adulthood receiving EPA+DHA therapy demonstrated significantly greater reductions in circulating levels of proinflammatory cytokines compared with those receiving placebo therapy. EPA+DHA therapy may be an effective low-risk dietary intervention for assuaging the harmful effects of inflammaging. Be well! JP

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