Dr. Lawrence S. Carter Jr., MDVIP

08/22/2025

Brain Health pills? Beware

08/18/2025

Diet Rich in Ultraprocessed Grains
Ups Risk for IBD
Megan Brooks
August 12, 2025
Diets high in packaged breads, cookies, and other highly
processed grain products may raise the risk for inflammatory
bowel disease (IBD), while minimally processed grain
products may offer some protection, a large study has found.
The sweeping analysis of 124,590 adults from 21 countries
found that those eating at least 19 g of ultraprocessed grains
a day were about twice as likely to be diagnosed with IBD as
peers eating less than 9 g daily.
“Our study adds robust evidence from a large, diverse global
cohort that frequent consumption of ultraprocessed grains is
associated with an increased risk of developing inflammatory
bowel disease,” Neeraj Narula, MD, MPH, gastroenterologist
and associate professor of medicine, McMaster University,
Hamilton, Ontario, Canada, told Medscape Medical News.
The study also “further clarifies that not all grains carry risk —
minimally processed grains like fresh bread and rice were
associated with lower risk even. These results build on and
specify previous findings linking ultraprocessed foods more
broadly to IBD,” Narula said.
The study was published online on August 4 in The American
Journal of Gastroenterology.

08/04/2025

Every Step Counts: Are 10,000 Necessary?
July 29, 2025
A comprehensive review and meta-analysis published in The Lancet Public Health reveals that walking 7000 steps daily provides significant health benefits, comparable with the traditionally recommended 10,000 paces. Led by Katherine Owen, PhD, the study analyzed 57 studies, focusing on nine health outcomes: including all-cause mortality, the incidence of deaths from cardiovascular disease, dementia, cancer incidence and mortality, the incidence of type 2 diabetes, depressive symptoms, and falls. Results showed that 7000 steps per day reduced all-cause mortality by 47% and decreased risks for cardiovascular disease, cancer, type 2 diabetes, dementia, depression, and falls. The study emphasizes that while any physical activity is beneficial, 7000 steps daily is optimal for health improvements. Current guidelines for physical activity recommend 150 minutes of moderate-to-vigorous physical activity weekly but lack step targets. Researchers suggest incorporating step goals into future guidelines.

The Takeaway:Achieving 7,000 steps a day optimizes health by reducing both, mortality and chronic disease risk.

08/04/2025

Brain-Boosting Supplements: All
Hype or Some Hope?
Diana Swift
July 31, 2025
Media consumers are bombarded daily with aggressive,
testimonial-driven ads for pricey supplements purported to
sharpen memory, focus, and working brain function.
Some even claim to stop or slow the development of
dementia.
Patients, especially older adults, may express interest in these
supplements during clinic visits.
Most claim to be “clinically tested.” However, since the FDA
exercises only limited regulatory control over these products,
they are not held to the same purity, safety, and efficacy
standards as are FDA-approved drugs.
“Manufacturers have a lot of leeway to market them as they
want,” said Pieter Cohen, MD, director of the Supplement
Research Program at the Cambridge Health Alliance in
Somerville, Massachusetts, and an associate professor of
medicine at Harvard Medical School in Boston. “That’s not to
say they haven’t been studied — there might be small studies
posted online done in, say, 100 people in another country, for
example.”

Pieter Cohen,
MD
Cohen, therefore, does not generally
recommend that his patients take
them to improve brain health,
“although I do recommend
supplements to patients who need
them to treat medical conditions,” he
told Medscape Medical News.
Many contain dubious or unlisted
ingredients, he noted. In a 2021
study of over-the-counter (OTC)
cognitive enhancement supplements, Cohen and colleagues
identified unapproved drugs (omberacetam, aniracetam,
phenibut, vinpocetine, and picamilon) — as well as
compounds not listed on the label and with unknown health
effects. For those products with ingredient quantities
provided on the labels, 75% of declared quantities were
inaccurate.
These OTC brain enhancers may feature, alone or in
combination, nonpharmaceutical ingredients such as vitamins
(including vitamin E), minerals like magnesium, omega-3 fatty
acids, turmeric, and herbal compounds like ginseng, Ginkgo
biloba, and coffee fruit extract. Some feature alleged boosters
of brain performance that are less familiar, including alphaGPC (L-alpha-glycerylphosphorylcholine), huperzine A, the
Chinese mushroom lion’s mane, L-carnitine, and the
Ayurvedic medicine compound Bacopa monnieri.
Some ingredients are more exotic. The memory enhancer
Prevagen, for example, contains apoaequorin, a lab-made
version of a protein found in the bioluminescent jellyfish
Aequorea victoria.
In 2024, the Federal Trade Commission and a federal district
court in New York State ordered Prevagen’s makers to stop
their claims on the grounds they lacked reliable evidence.
Jayne Zhang,
MD
Alejandra
Sánchez López,
MD
The brain health supplements all
have one thing in common, noted
Jayne Zhang, MD, an attending
neurologist specializing in
cerebrovascular disease at Johns
Hopkins School of Medicine in
Baltimore — uncertain evidence of
claimed efficacy.
“There is some modest support for a
benefit from these products in
people who already have nutritional deficiencies or mental
degeneration, but there’s not a lot of strong evidence from
rigorous trials,” she told Medscape Medical News.
Added Alejandra Sánchez López, MD, an assistant clinical
professor of neurology and geriatric medicine at the Mary S.
Easton Center for Alzheimer’s Disease Research at the
University of California, Los Angeles, “Weak evidence of
benefit usually comes from studies with small sample sizes
and sponsored by the manufacturing company.”
Like Cohen, Sánchez López
recommends that her patients not
take the brain supplements. “They
come with palpable GI
[gastrointestinal] side effects such as
nausea and diarrhea,” she said.
Zhang is more open to patients’
hopeful inquiries. “I try not to be
dismissive. Instead, I ask them what
they’re hoping a supplement will do
for them, then I reveal what we know
about them and talk about safety.”
Zhang uses these encounters with OTC nootropics to talk
about improving cognitive function in other ways: good
nutrition, exercise, sleep, alcohol reduction, and social
engagement, as well as proven medical therapies that
mitigate cognition-impairing conditions such as depression,
hyperglycemia, and hypertension. “Patients need to
understand there is no magic pill for brain health,” she said.
The old-fashioned multivitamin tablet shows some promise,
however. In a large National Institutes of Health-funded,
placebo- and comparator-controlled randomized trial, Baker
and colleagues found that older adults given a multivitamin
had higher global cognition scores than those who did not
take it. Specific effects on global cognition, episodic memory,
and executive function were noted. The improvement was
most pronounced in those with a history of cardiovascular
disease.
Safety
Potential toxicity must be an issue with any loosely or
unregulated OTC supplement, especially if taken over the
long term.
A content analysis of 12 cognitive supplements found the
majority had at least one ingredient listed but not detected or,
conversely, contained compounds detected but not reported
on the label. And as noted, they can contain unapproved and
potentially dangerous drugs.
Drug interactions are another safety issue. Some dietary
supplements can affect the pharmacokinetics of prescription
drugs, altering their absorption, metabolism, or excretion and
decreasing or increasing their potency.
So, clinicians need to urge patients to be cautious, Sánchez
López said. “I always ask my patients to show me what
supplements they’re taking, and I go over the ingredient list.”
A Dietetic Approach to Cognitive Health
Emma Laing, PhD, RDN, a clinical professor and director of
dietetics at the University of Georgia in Athens, Georgia,
Emma Laing,
PhD, RDN
noted that a safer, proven alternative to commercial cognitive
supplements can be found in the kitchen. “While genetic
predisposition, medical conditions, and environment are
strongly linked to brain health, consuming a wide variety of
nutrient-dense foods can improve cognitive health and
reduce your risk for chronic disease,” she told Medscape
Medical News.
Minimally processed, nutrient-dense
foods have been shown to support
neurologic health, along with coffee
and tea, Laing added. And even a
small reduction in alcohol intake can
improve cognitive function.
Both the Mediterranean diet and the
“brain-healthy” MIND Diet
(Mediterranean-DASH Intervention
for Neurodegenerative Delay) — a
hybrid of the Mediterranean and DASH (Dietary Approaches
to Stop Hypertension) regimens — have been well studied for
their potential role in supporting cognitive function, memory,
and alertness.
Nootropics with cognitive potential are under ongoing
evaluation, but until large scientific studies establish a positive
effect of commercial brain health supplements on cognition, a
healthy lifestyle may deliver more solid benefits to the brain.
Cohen has reported receiving grants from Consumers Union
and PEW Charitable Trust, as well as personal fees from
UpToDate and the CDC, not relevant to his comments. Zhang,
Sánchez López, and Laing had no relevant conflicts of interest
to declare

06/02/2025

Physicians Weigh in on Coffee E***a Trends
Julia Senn
May 29, 2025
The social media trend of coffee e***as traces back to a medical tradition
over 150 years old. Various e***as are integral to modern medicine and
diagnostics.
Coffee consumption is associated with a reduced risk for certain cancers,
cardiovascular disease, dementia, depression, and arrhythmias and is
recommended as part of a healthy diet.
E***a History
E***as have been used in Egyptian, Greek, and Roman medicine for several
millennia. The Ebers Papyrus and texts by Hippocrates, Celsus, Galen,
Oribasius, Aetius, and Avicenna document their use, as do Ayurveda in the
sixth century BC and Chinese medicine in the third century AD.
E***as reached their heyday under Louis XIV, and from the 19th century
onward, physicians studied their applications and mechanisms.
Florence Nightingale, often regarded as the first modern nursing theorist, used
coffee e***as to relieve soldiers’ pain during the Crimean War. This practice
reportedly continued during the First World War, when doctors turned to coffee
e***as as an alternative because of opioid shortages. They were also
included in nursing manuals and listed in the editions of the Merck Manual
throughout the 20th century.
Max Gerson, MD, and William Donald Kelley, DDS, recommended several daily
coffee e***as in addition to raw, plant-based diets for the treatment of cancer.
Surgeon Ferdinand Sauerbruch observed benefits in advanced bone, joint,
and skin tuberculosis.
Gerson therapy is claimed to aid migraine, multiple sclerosis, deforming
arthritis, epilepsy, skin diseases, Graves disease, liver, gallbladder,
gastrointestinal and cardiovascular disorders, obesity, hypertension, and endstage cancer.
Several studies have reported no evidence of its effectiveness in cancer
treatment. Patient well-being improvements are often attributed to the placebo
effect, although practitioners such as Linda L. Isaacs, MD, argue that skeptical
patients experienced genuine benefits despite the cumbersome procedure
and required motivation.
Conventional E***as
In modern practice, e***as are administered before diagnostic or surgical
procedures in obstetrics and pediatrics for severe constipation, spinal cord
injury, drug administration, or as part of bowel management in inflammatory
bowel disease. E***as act mechanically, thermally, and chemo-osmotically to
stimulate the intestinal mucosa and peristalsis.
Prenatal bowel cleansing with an e***a or suppository is now obsolete, as no
reduction in perineal injuries, impaired wound healing, or infections has been
observed. Increased intestinal peristalsis also increases uterine activity.
Midwives use e***as to stimulate labor, but studies on their effect on the
duration of labor are contradictory.
Healthcare professionals reported greater satisfaction with the labor process
when e***as were used, yet women reported no difference. An e***a may
be administered during childbirth at the patient’s request or when the re**al
ampulla is full.
Coffee Effects
The alkaloid caffeine contained in coffee has positive inotropic and
chronotropic effects on the heart via catecholamine release and raises systolic
blood pressure; for instance, 250 mg raises systolic pressure by 10 mm Hg
after 15 minutes. Caffeine causes mild cerebral vasoconstriction, relaxes
bronchial smooth muscles, increases gastric acid secretion via gastrin release,
and transiently increases diuresis. Theobromine and theophylline alkaloids in
caffeine act as vasodilators, cough suppressants, and bronchodilators. The
habituation effect occurs over time.
Four to five cups of coffee daily can reduce gout attacks in men by up to 40%
through increased uric acid excretion, while more than six cups may reduce
attacks by 59%, although decaffeinated coffee is preferable as a supportive
measure.
Coffee enriched with chlorogenic acid–rich green coffee bean extracts
showed increased DNA protection against oxidative damage and increased
plasma-reduced glutathione via glutathione reductase activation. Roasting
lowers chlorogenic acid, trigonelline, cafestol, and kahweol levels while
increasing melanoidin and nicotinic acid levels.
Coffee also contains pro-oxide compounds, such as caffeic acid, which can
cause cancer at high doses.
Moderate intake of three to five cups daily is linked to a reduced risk for
endometrial and hepatocellular carcinoma and, to a lesser extent, melanoma,
other skin cancers, breast cancer, and prostate cancer.
Six to seven cups daily were not significantly associated with a 30%-50% lower
risk for type 2 diabetes. Chlorogenic acid inhibits intestinal glucose absorption
and the hydrolysis of glucose-6-phosphate, and high-volume intake can
increase homocysteine levels by 18%. Caffeine affects glucose storage, and
quinic acid increases insulin sensitivity.
Caffeine may stimulate the liver, promote bile flow by dilating the bile ducts,
and improve toxin elimination. High doses of kahweol and cafestol have antiinflammatory and anticarcinogenic diterpenes and can inhibit cholesterol7alpha-hydroxylase, which is crucial for the conversion of cholesterol to bile
acids, leading to an increase in cholesterol levels by 11%.
When coffee is filtered through a paper filter, most harmful compounds are
removed, unlike boiled coffee or metal filters, such as those used in espresso
machines. As a result, this method of preparation is considered healthier and
does not increase cardiovascular risk.
Low to moderate coffee consumption was associated with an 11%-20% lower
risk for stroke and a reduced risk for dementia. However, drinking more than
six cups of caffeinated coffee per day was associated with a smaller total brain
volume and a 53% higher risk for dementia.
High coffee and tea intake may reduce the risk for depression, unlike soft
drinks. Coffee elevates mood and improves cognitive performance. Four to
five cups can reduce the mortality risk by up to 12%. Increased caffeine intake
is also associated with a lower risk for arrhythmias, such as atrial fibrillation and
supraventricular tachycardia, independent of genetically varying caffeine
metabolism.
Moderate coffee consumption is recommended, as it may alkalize the body.
Caution is advised in peptic ulcer disease, cardiovascular disease, renal
impairment, hyperthyroidism, seizure disorders, histamine intolerance,
attention-deficit/hyperactivity disorder, and high doses during pregnancy.
Interactions with certain antibiotics, specifically gyrase inhibitors, can interact
with caffeine, leading to reduced caffeine metabolism, prolonged effects, and
potentially increased gastrointestinal side effects or, with caffeine intake
exceeding 1.5 g, restlessness, insomnia, palpitations, dizziness, hypertension,
headaches, and vomiting. Therefore, active ingredient extracts should be
investigated rather than whole coffee for therapeutic benefits. However, coffee
can be used in unexpected ways beyond mere consumption.
Positive Effects
Patients reported relief from headaches, myalgia, arthralgia, chronic fatigue,
cognitive difficulties, malaise, and constipation, as well as improved well-being;
these effects were not observed with coffee alone.
Physicians use coffee e***as to support the treatment of atropine poisoning,
postoperative anesthetic effects, shock, and pyloric obstruction. The
controversial self-poisoning hypothesis, which links intestinal disorders to
psychological conditions, is gaining renewed attention amid emerging
microbiota research on the gut-brain axis.
E***as may enhance bile flow in the liver and gallbladder, stimulate
peristalsis, and promote excretion of metabolic by-products and bowel
emptying. The isolated caffeine was ineffective, suggesting that other
compounds were responsible. A gallbladder-cleansing study before capsule
endoscopy demonstrated increased bile flow using a coffee e***a.
Oral coffee increases gallbladder contraction and plasma cholecystokinin and
glutathione levels. Oral absorption of caffeine is more efficient than re**al
absorption, although re**al delivery is slightly faster, which is potentially true
for other compounds.
Coffee e***as may exhibit detoxification, cleansing, anti-inflammatory,
antioxidant, metabolism-stimulating, and pain-relieving effects. However, they
should be prepared using green coffee rather than roasted or decaffeinated
varieties because of their higher caffeine and palmitic acid content.
These active compounds reach the liver directly via portal circulation, thereby
avoiding irritation of the gastric mucosa. As a result, even individuals with
coffee intolerance may tolerate the procedure when used at a reduced dose
and for a shorter duration.
For administration, the brewed coffee was diluted and cooled to a body
temperature not exceeding 40 °C. Low volume and gentle pressure were
intended to target the re**um and extend only to the descending colon.
Side Effects
Proctocolitis
Re**al burns at temperatures above 37 °C
Electrolyte disturbances such as hypokalemia, hyponatremia with
dehydration, nausea, muscle weakness, cardiac arrhythmias, and seizures
Weakening of the re**al/intestinal muscles with a tendency to constipation
and inflammation
Hemorrhoidal injury
Disruption of intestinal microbiota with cramps, diarrhea, bloating, and
infection risk
Circulatory strain
Water intoxication due to non-isotonic fluids
Rare fatalities attributed to coffee e***as likely reflect underlying terminal
illnesses with vomiting-related electrolyte disturbances, ascites, pleural and
pericardial effusions, immunosuppression, and susceptibility to infection with
sepsis.
Caution
E***as should be used with caution or avoided in early pregnancy in cases of
vomiting, acute abdomen, post-intestinal surgery, gastrointestinal bleeding,
inflammatory bowel disease, mechanical ileus, immunosuppression, fluid
overload, renal insufficiency, and severe cardiac disease.
Conclusion
Regular defecation supports natural cleansing of the body. A diet rich in fiber,
fruits, vegetables, whole grains, pseudocereals, nuts, seeds, and fermented
foods with adequate hydration underpins good intestinal health and reduces
the risk for cancer.
Intermittent or short-term fasting is effective without colon cleansing. E***as
may support preparation for therapeutic fasting lasting several days by
preventing hunger pangs or fasting crises

05/29/2025

Expect Increases in FoodborneIllness
Christopher J. Harrison, MD
DISCLOSURES | May 02, 2025
Christopher J.
Harrison, MD
Growing up, “food poisoning,” to me, meant throwing up repeatedly after
eating the mayo-based potato salad several hours after it was put on the picnic
table on July 4. But that version (probably Staphylococcus aureus–toxin
mediated) is not the most common form. US data from 2024 showed 1392
bacterial caused foodborne illnesses from contaminated food, a nearly 25%
increase from 2023.
But wait — there’s more! Reported bacterial/protozoan
foodborne hospital admissions and deaths increased more
than 100% from 2023 to 2024. The 2024 increases were
mostly concentrated in 13 outbreaks, 12 due to Listeria spp,
Salmonella spp, or Escherichia coli. It is important to realize
that reported numbers are probably huge underestimates of
the actual foodborne illness burden (an estimated 48 million
illnesses; 1 out of 6 Americans each year) because most
people with foodborne illnesses do not seek medical care
and, thus, the illness is not reported. One estimate is that only
1 in 30 actual cases is reported. Among the 10 million foodborne illnesses or so
that are reported annually, 128,000 require hospitalization and 3000 are fatal.
The US Food and Drug Administration (FDA)/US Department of Agriculture
(USDA) sent notices for 296 food recalls in 2024. One that made news
involved E coli O157:H7 in quarter pounders in more than a dozen states.
Another 2024 food recall was related to Salmonella-contaminated cucumbers
in nearly three dozen states. Several recent Listeria monocytogenes notices
included one in 2024 related to Boar’s Head deli meat in 19 states and another
in 2025 due to supplement shakes in 21 states.
And these are just the bacterial/protozoan-driven cases. Food is also a
common vehicle for Norovirus transmission particularly if a Norovirus-infected
person handles food. Among foodborne pathogens, Norovirus, along with
Shigella spp, is one of the lowest inoculum infectors (as little as 10-100 virions),
so both can spread like wildfire from the index case. Uncommonly, Rotavirus
spp, astroviruses, adenoviruses, and Sapovirus spp are associated with
foodborne illness.
Over 30 pathogens cause foodborne; the box shows the top offenders and
their outcomes. However, in most years, “the big 6” comprise most US cases:
Norovirus (5 million per year), Campylobacter spp (~2 million per year),
nontyphoidal Salmonella spp (~1.5 million per year), Clostridium perfringens
toxin (900,000 per year), E coli (360,000 per year), and Listeria spp (125,000
per year).
SUGGESTED FOR YOU
Most Common Foodborne
Pathogens in Persons of All
Ages in the US, by Outcome
Top 5 foodborne germs causing illness:
1. Norovirus
2. Salmonella (nontyphoidal)
3. Clostridium perfringens toxin
4. Campylobacter spp
5. Staphylococcus aureus toxin
Top 5 foodborne germs causing hospitalizations:
1. Salmonella (nontyphoidal)
2. Norovirus
3. Campylobacter spp
4. Toxoplasma gondii
5. Escherichia coli O157
Top 5 foodborne germs causing deaths:
1. Salmonella (non-typhoidal)
2. Toxoplasma gondii
3. Listeria monocytogenes — invasive
4. Norovirus
5. Campylobacter spp
Adapted from https://www.cdc.gov/food-safety/about/index.html
That said, hepatitis A, Shigella spp, S aureus toxin, Cryptosporidium, and
Cyclospora are major players in some years and in some regions.
Cryptosporidium (in contaminated irrigation water) and Cyclospora (in imported
produce) are the most common parasites. Toxoplasma gondii is also an
unusual but medically important cause of food poisoning (undercooked meat).
Overall, foodborne illnesses peak in summer, mostly due to bacteria/protozoa,
but show secondary winter peaks due to Norovirus (~25% of all Norovirus
infections are foodborne).
Symptom onset varies widely, from less than 12 hours (S aureus toxin) to more
than a month (hepatitis A) (Figure). Presentations may or may not involve acute
systemic signs or symptoms (fever, myalgia, headache, fatigue) but most
include vomiting/diarrhea. Frankly bloody stools are characteristic of
nontyphoidal Salmonella spp, Shigella spp, and Campylobacter spp. Certain
pathogens produce downstream or nongastrointestinal signs or symptoms (eg,
jaundice for hepatitis A, joint symptoms after infection with Campylobacter spp,
hemolytic uremic syndrome after infection with E coli O157:H7).
The many clinical variations for the more than 30 pathogens are beyond the
scope of this discussion, but information on each is found on the Centers for
Disease Control and Prevention (CDC) website.
The foods most often associated with foodborne illnesses are leafy produce
and unpasteurized dairy products, followed by poultry (particularly ready-to-eat
products), beef, pork, and eggs. Scenarios commonly associated with
foodborne illnesses include prepared foods left at unsafe temperatures
(picnics, buffets, restaurants); incompletely washed (particularly imported)
produce; incompletely sanitized counters, sinks, cutting boards, and prep
areas; and contaminated meat grinders, slicers, and packaging machinery.
Although foodborne illnesses occur at all ages, pediatric providers know that
children younger than 5 years are more susceptible (as are older adults and
immunocompromised hosts) and more affected than older children or adults.
Among children younger than 5, Norovirus, nontyphoidal Salmonella (40% of
pediatric foodborne bacterial illnesses) and Campylobacter are generally the
most frequent pathogens.
Although less common than Salmonella and Campylobacter, Shiga toxin–
producing E coli (in undercooked meat) leads to hemolytic uremic syndrome in
1 in 7 children under the age of 5.
Listeria (usually from processed meats, raw milk, and raw or soft cheeses) is an
important although uncommon foodborne illness that is dangerous for
pregnant mothers and infants (and immune-compromised hosts). Cronobacter
sakazakii is also uncommon but important with a high mortality rate in infants
and has been associated with powdered infant formula, where it sometimes
survives in a dry state for over 2 years.
A helpful site for families concerned about foodborne illness in their children is
https://www.foodsafety.gov/people-at-risk/children-under-five. Also, the
Consumer Reports May-June 2025 edition has a nice section on foodborne
illnesses that may help your patients’ families. Note that other top offenders
include raw shellfish, sprouts, ground meats, unpasteurized juices or cider, and
raw flour (eg, in cookie dough).
The US food supply has been among the safest in the world, but that seems to
be changing. Expect more frequent issues since many FDA/USDA safety
systems are being reduced or eliminated. Some systems remain intact as of
April 20, 2025, such as the CDC’s FoodNet surveillance system. That said,
examples of dismantled systems include the March 2025 elimination of the
National Advisory Committee on Microbiological Criteria for Foods and the
National Advisory Committee on Meat and Poultry Inspection. So, expect more
foodborne outbreaks.
Finally, so much of foodborne illnesses would be eliminated if we could begin
irradiating food. Given popular resistance to things being irradiated and the
healthcare retrenchment underway, this is not likely.

Foodborne germs can lead to illness, hospitalization, and death.

05/28/2025

Higher Poultry Consumption Linked to Elevated Death Risk
Edited by Archita Rai
May 14, 2025
TOPLINE:
Weekly poultry consumption > 300 g was associated with an elevated risk for
all-cause mortality and more than double the risk for death from
gastrointestinal cancers compared with weekly consumption < 100 g, with a
higher risk observed in men.
METHODOLOGY:
Poultry consumption — widely viewed as a healthier option than red meat
— is rising; however, much of it is now consumed as processed products.
Researchers set out to evaluate the association between poultry
consumption and the risk for mortality from all causes, including
gastrointestinal cancers.
The study population included 4869 participants (51.61% men) from two
Italian cohort studies. Researchers conducted interviews to collect
information on participants’ demographic backgrounds, general health,
lifestyle habits, and personal histories; weight, height, and blood pressure
measurements were also taken.
A dietary questionnaire was administered with the help of trained
nutritionists to estimate participants’ usual food intake, and nutrient intake
was derived from food included in the questionnaire.
Participants were followed for an average duration of 19 years, with
mortality status and causes of death obtained from regional records.
TAKEAWAY:
A total of 1028 participants (21.1%) died during the observation period.
Among those deaths, 108 (10.5%) were due to gastrointestinal cancer,
including 37 from colore**al cancer, 28 from liver cancer, and 22 from
pancreatic cancer.
Individuals who died from gastrointestinal cancers ate more poultry (mean,
136.65 g/wk than those who died from other cancers (mean, 109.90 g/wk)
or from other causes (mean, 104.69 g/wk).
Individuals consuming > 300 g/wk of poultry had a 27% higher risk for
mortality from all causes (adjusted hazard ratio, 1.27; P < .05) than those
consuming < 100 g/wk.
The risk for mortality from gastrointestinal cancers was highest among
those consuming > 300 g/wk of poultry (subdistribution hazard ratio [sHR],
2.27), followed by those with poultry consumption of 201-300 g/wk (sHR,
2.11) and 100-200 g/wk (sHR, 1.65; P < .05 for all). Men with poultry
consumption > 300 g/wk faced an even higher risk (sHR, 2.61; P < .05).
IN PRACTICE:
“It is important to learn more about the long-term effects of this food category,
white meat, that is widely consumed by the world population who, perhaps
mistakenly, consider it healthy in absolute terms. We believe it is beneficial to
moderate poultry consumption, alternating it with other equally valuable
protein sources, such as fish. We also believe it is essential to focus more on
cooking methods, avoiding high temperatures and prolonged cooking times,”
the authors wrote.
SOURCE:
This study, led by Caterina Bonfiglio, National Institute of GastroenterologyIRCCS Saverio de Bellis in Castellana Grotte, Italy, was published online in
Nutrients.
LIMITATIONS:
This study lacked information about the consumption of processed poultry and
processing methods. The diet information was self-reported. Measures of
physical activity were not included.
DISCLOSURES:
This study received funding from the Italian Ministry of Health. The authors
declared having no conflicts of interest