Pharmacist Roman Moretti

04/15/2024

This is the last video of my series of Internet links that I found useful.

04/11/2024

This is video 4 out 5 of resources that I have found useful.

04/08/2024

This is part 3 of 5 of my video series about resources that I found useful about Lifestyle Medicine.

04/04/2024

This is video 2 of 5 that explains resources that I have found useful in Lifestyle Medicine.

04/01/2024

I have resources on my website. This video is part 1 of 5 showing links that I think are helpful.

03/28/2024

Medical references to articles are important for a health care professional to speak with authority. Here is a list of medical conditions that Lifestyle Medicine can help.

Conditions helped/prevented by lifestyle medicine
• Angina(Ref #1)
• High Blood Pressure(Ref #2)
• Heart Failure with Preserved Ejection Fraction (Ref #4)
• Type 2 Diabetes(Ref #10)
• Type 1 Diabetes(Ref #11)
• Obesity (Ref #13)
• Osteoporosis (Ref #14)
• Preventing multiple Types of Cancer (Ref #15)
• Fertility (Ref #3)
• Painful Diabetic Neuropathy (Ref # 16)
• Mood-Increased Happiness (Ref #5)
• Migraine Headache (Ref # 17, 18)
• Rheumatoid Arthritis (Ref #6)
• High Cholesterol (Ref #7)
• Asthma (Ref #8)
• Stroke Prevention (Ref #9)
• Chronic Kidney Disease (Ref #12)
• Atrial Fibrillation (Ref #19)
• Crohn’s Disease (Ref #20)
• Irritable Bowel Syndrome (Ref #21)
• Anxiety, Depression, and PTSD symptoms through movement (Ref #22)

1. Agarwal, Ulka, et al. “A Multicenter Randomized Controlled Trial of a Nutrition Intervention Program in a Multiethnic Adult Population in the Corporate Setting Reduces Depression and Anxiety and Improves Quality of Life: The GEICO Study.” American Journal of Health Promotion, vol. 29, no. 4, Mar. 2015, pp. 245–254, doi:10.4278/ajhp.130218-QUAN-72.
2. Shivam Joshi, MD, Leigh Ettinger, MD, MS, Scott E. Liebman, MD, MPH. Plant-Based Diets and Hypertension.American Journal of Lifestyle Medicine, First Published 24 Sep 2019.
3. Amanda McKinney, MD. A Lifestyle Perspective on Infertility and Pregnancy Outcome. American Journal of Lifestyle Medicine, vol. 9, 5: pp. 368-377. , First Published April 24, 2015.
4.Lindsey Cilia, MD, Anum Saeed, MD, Harsha V. Ganga, MD, Wen-Chih Wu, MD, MPH. Heart Failure With Preserved Ejection Fraction: Prevention and Management. American Journal of Lifestyle Medicine, vol. 13, 2: pp. 182-189. , First Published February 1, 2017.
5.Redzo Mujcic, Andrew J.Oswald. Evolution of Well-Being and Happiness After Increases in Consumption of Fruit and Vegetables.American Journal of Public Health. Aug 2016.
6. Alwarith et al. Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review. Front. Nutr., 10 September 2019.
7. Jenkins DJA, Kendall CWC, Marchie A, et al. Effects of a Dietary Portfolio of Cholesterol-Lowering Foods vs Lovastatin on Serum Lipids and C-Reactive Protein. JAMA. 2003;290(4):502–510. doi:https://doi.org/10.1001/jama.290.4.502
8. Lindahl O, Lindwall L, Spångberg A, Stenram A, Ockerman PA . Vegan regimen with reduced medication in the treatment of bronchial asthma. J Asthma. 1985;22(1):45-55.
9. Micha R, Peñalvo J, Cudhea F, Imamura F, Rehm C, Mozaffarian D. Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States JAMA. 2017 Mar 7; 317(9): 912–924.
10. Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Green A, Ferdowsian H. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr. 2009 May;89(5):1588S-1596S.
11. Nansel TR, Lipsky LM, Liu A. Greater diet quality is associated with more optimal glycemic control in a longitudinal study of youth with type 1 diabetes. Am J Clin Nutr 2016.
12. Campbell TM, Liebman SE. Plant-based dietary approach to stage 3 chronic kidney disease with hyperphosphataemia. BMJ Case Reports CP 2019;12:e232080.
13. Turner-McGrievy G, et al Comparative effectiveness of plant-based diets for weight loss: A randomized controlled trial of five different diets. Nutrition Volume 31, Issue 2, February 2015, Pages 350-358.
14. Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. J Bone Miner Res. 2018;33(2):211-220.
15. Song M, Giovannucci E. Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States. JAMA Oncol. 2016;2(9):1154–1161.
16. Milton G. Crane & Clyde Sample (1994) Regression of Diabetic Neuropathy with Total Vegetarian (Vegan) Diet, Journal of Nutritional Medicine, 4:4, 431-439.
17. Ferrara LA, Pacioni D, Di Fronzo V, et al. Low-lipid diet reduces frequency and severity of acute migraine attacks. Nutr Metab Cardiovasc Dis. 2015;25(4):370–375.
18. Bunner AE, Agarwal U, Gonzales JF, Valente F, Barnard ND. Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain. 2014;15(1):69.
19. Marcus, GM et al. A Randomized, Double-Blind, Placebo-Controlled Trial of Intravenous Alcohol to Assess Changes in Atrial Electrophysiology. JACC Clin Electrophysiol. 2021 May;7(5):662-670. doi: 10.1016/j.jacep.2020.11.026
20. Sandefur, K et al. Crohn’s Disease Remission with a Plant-Based Diet: A Case Report. Nutrients 2019, 11(6), 1385;https//doi.org/10.3390/nu11061385.
21.D’Silva, A., MacQueen, G., Nasser, Y. et al. Yoga as a Therapy for Irritable Bowel Syndrome. Dig Dis Sci 65, 2503–2514 (2020). https://doi.org/10.1007/s10620-019-05989-6
22. Park, C.L.; Slattery, J.M. Yoga as an Integrative Therapy for Mental Health Concerns: An Overview of Current Research Evidence. Psychiatry Int. 2021, 2, 386-401. https://doi.org/10.3390/psychiatryint2040030

Photo by Element5 Digital: https://www.pexels.com/photo/assorted-books-on-book-shelves-1370295/

03/25/2024

Medications and Health
I came across an interesting study that medical students submitted to the American Heart Association. They found that the more medications people were prescribed, the greater the chance of death. Medications do not make you healthy. They slow down the disease process without treating the underlying cause. If you want to die slower, lifestyle medicine will help!

Another way of looking at medications is through a harm-reduction perspective. The medication methadone is prescribed for people who are addicted to narcotics. Some people believe that the goal of this therapy is to replace the addictive drugs with methadone and then wean the person from this replacement. This rarely happens. Studies have shown that keeping some people on methadone is safer than slowly decreasing it. Safer, in this context, means that the patients live longer because they are less likely to use street drugs. This approach is known as harm reduction and can be applied to prescription medications. Without changing your lifestyle, medications are a harm-reducing strategy to deal with the underlying disease. To be fair, some medications cannot be reduced because of deficiencies in peoples’ bodies. However, most medications can be reduced or eliminated with lifestyle changes.

The study went one step further to look at the health behaviours of participants. Regardless of the number of medications, the more healthier behaviours people adopted, the longer the participants lived.

Reducing medications should only be done under supervision by an appropriate health care professional. Please contact me if you would like more information about how Lifestyle Medicine can help you replace medications with healthy lifestyle choices. I offer a complimentary 15-minute consultation by phone or Zoom. Thanks for reading!

Here is the link.

https://www.ahajournals.org/doi/10.1161/circ.142.suppl_3.16923

Photo by Gabriele Lässer on Unsplash

03/14/2024

High Fiber Intake is Associated with Decreased Breast and Colorectal Cancers

I read Fiber Fueled by Dr. Will Bulsiewicz, a gastroenterologist. He stated that eating fiber decreases the risk of developing breast cancer and colorectal cancer. These two cancers are among the most common, with breast cancer accounting for 25% of new cancer cases and colorectal cancer 12% of new cases.

The risk of breast cancer decreased by 8% for the group who ate the most fiber compared to the group that ate the least in this meta-analysis. A separate study showed that the recurrence of breast cancer decreased by 8% comparing the group who ate the most fiber to the group who ate the least.

One study I read showed that for every 8 grams of fiber that was consumed, the risk of getting colorectal cancer decreased by 8%. Another study showed that every five-gram increase in fiber (prior to diagnosis) resulted in 18 % lower risk of dying from colorectal cancer.

Please consider changing to a whole-food, plant-based diet for your health. Thanks for reading!

Here are the links.
https://www.kfpl.ca/c/catalogue/record/1.509301
https://cancer.ca/en/research/cancer-statistics/cancer-statistics-at-a-glance
https://pubmed.ncbi.nlm.nih.gov/32249416/
https://www.tandfonline.com/doi/full/10.1080/01635581.2020.1803928
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext
https://jamanetwork.com/journals/jamaoncology/fullarticle/2661061?utm_campaign=articlepdf&utm_medium=articlepdflink&utm_source=articlepdf&utm_content=jamaoncol.2017.3684&alert=article =_

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03/11/2024

Can COVID-19 mRNA vaccines change our DNA?

I am trying something new for this blog. I have an audio recording of it at the bottom of this blog. Please let me know if you prefer the audio version.

I have heard many experts state that the COVID-19 vaccine is safe. Some of the COVID-19 vaccines are designed to have a piece of mRNA of COVID-19 inside. The mRNA is the blueprint for creating proteins in a cell. The mRNA is surrounded by a lipid (fat) layer to help it merge with the cell membrane. The mRNA enters the cell and floats in the cell’s cytoplasm - the area of the cell that is contained by the outer cell membrane and the inner nuclear membrane. The nuclear membrane separates the cytoplasm from the nucleus. (I realize this is pretty technical, but the details are necessary for the blog!)

Once inside, the mRNA wanders into a ribosome (a protein factory). The ribosome in the cytoplasm of the cell reads the mRNA and creates the spike protein of COVID-19. This spike protein then moves to the outer cell membrane. The immune system detects the spike protein and creates an immune response against COVID-19.

One concern that I have heard about the vaccine is that the piece of mRNA will fuse with a person’s DNA, thus changing their DNA. The experts have stated that this does not happen, and the discussion ends. Since I am a curious person, I tend to ask a lot of “Why” questions. I want to understand what is happening!

I spent many hours looking into this question. The nuclear membrane separates the cytoplasm from the nucleus of a cell. Otherwise, it would be a huge mess with DNA strewn all over the place! This would be a bigger mess than someone walking on a recently cleaned kitchen floor with muddy boots!!

The nuclear membrane must allow raw molecules that are needed for the nucleus to function to get through. Also, the products that are made in the nucleus must get to the cytoplasm. You can think of it like a factory. Components must be shipped to the factory to make the product. The finished product must be shipped out of the factory to go to market.

Some molecules can float through the nuclear membrane. Other need to be actively shipped through channels in the nuclear membrane. A molecule that is like a boat for these channels is called importin. Importin allows for certain proteins to get through. This is what stops mRNA from entering a cell. Its molecular structure is not a protein. The COVID-19 mRNA vaccines area huge molecules that cannot float through the nuclear membrane and therefore cannot change the DNA.

So, that is the explanation. The mRNA is not a protein and it is too big to get through the nuclear membrane. Thus, the COVID-19 vaccine does not change DNA! Thanks for reading!

03/07/2024

Emulsifiers and the Microbiome

I listened to a presentation by Dr. Janese Laster, a gastroenterologist. She mentioned the harmful effects of emulsifiers on the digestive microbiome. The microbiome is the collection of microorganisms that live on or in the human body. Emulsifiers are food additives that help oil parts in an ultra-processed food mix with the water parts to form a consistent mixture.

If you have eaten old fashioned peanut butter, the oily part separates from the solid part. People tend to mix these parts together before consuming. Commercial versions of peanut butter never separate because they have added emulsifier agents. (For a list of approved emulsifiers by name in Canada, please go to
the end of the blog.)

Dr. Benoit Chassaing has researched two emulsifiers called carboxymethylcellulose and polysorbate-80 in mice. He used these two emulsifiers because they are not absorbed by digestion. When he put these two chemicals in mice chow, their body weight increased. He showed that the mucous layer that protects the intestinal cells from the microbiome became thinner. This is a problem because the microbiome has a greater chance of eliciting an immune response which causes inflammation. More breaks in the tight junctions between intestinal cells were found. This is also bad because food and the microbiome can more readily enter the bloodstream and elicit an immune reaction. Scientifically, this is called hyperpermeability, also known as leaky gut syndrome. These two chemicals caused metabolic syndrome in the mice. According to the National Institutes of Health, metabolic syndrome is a group of risk factors that raises your chance of disease. To listen to Dr. Chassaing describe his research, please go to https://www.youtube.com/watch?v=jb3Q4vD_52k&ab_channel=USFMicrobiome

Dr. Kevin Hall, at the National Institutes of Health (NIH), did a similar study in humans. He compared an ultra-processed diet to an unprocessed diet. He found that people who ate the ultra-processed diet showed signs of metabolic syndrome.

Dr. Hall’s processed diet would contain emulsifiers similar to those used in Dr. Chassaing’s research. Both the mice and the humans showed signs of metabolic syndrome when eating ultra-processed food containing these chemicals. The inference is the emulsifiers are responsible.

This is not conclusive proof. However, given the detrimental health risk of ultra-processed foods, this would be another reason to avoid them. I have switched brands of coconut milk to avoid the emulsifiers. I am applying the precautionary principle until more research becomes available. Please consider a whole-food, plant-based diet. Your microbiome and body will thank you. Thanks for reading!

Here are the links for the blog.
https://www.nhlbi.nih.gov/health/metabolic-syndrome
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(19)30248-7?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1550413119302487%3Fshowall%3Dtrue
https://www.canada.ca/en/health-canada/services/food-nutrition/food-safety/food-additives/lists-permitted/4-emulsifying-gelling-stabilizing-thickening-agents.html ).

USF Microbiome Webinar: Host - Dr Benoit Chassaing

03/04/2024

The 5 Whys

You may have already made some New Year’s Resolutions to enhance your health. Motivation is the key to sustain lifestyle changes.

One tool to understand the deeper reason for your resolution is the 5 Whys. Start by asking yourself “Why I want to make this change?” You are asking why is this important. You continue this process until you have questioned your previous answer five times.

For example, Why do I want to have lifestyle medicine practices in my life? Answer: I want more energy.
Why do I want to be energetic? Answer: I want to be able to experience life to the fullest.
Why do you want to experience life to the fullest? Answer: I want to enjoy life.
Why do I want to enjoy life? Answer: I witnessed my mother die from breast cancer at age 50.
Why is my mother’s death from breast cancer important to me? Answer: I am afraid of getting cancer myself.

My motivation for lifestyle medicine is not actually because I want more energy, but because I am afraid of getting cancer. Lifestyle changes are challenging to make. Please write down your answers to the 5 Whys and put in a prominent place where you can read it often. This way you can return to your list to remind yourself of your motivation when challenges arise. Thanks for reading.

02/29/2024

What is the secret to influencing those you care about to adopt healthy behaviours?

One of questions that people ask me is how to get their parents/spouse/children/friends to adopt healthy behaviours. The root of this issue is that you want someone to change and they are unable or unwilling to change. For this blog, I will assume that the change is in their best interest and they are able to change. Otherwise, using influence techniques would be unethical.
I watched a presentation by Dr. Ed Tori. He stated that that influence has seven dimensions: authority, liking, reciprocity, social proof, scarcity, commitment and consistency. Social proof was defined as watching the behaviours of others and then following their lead. This has also been called “following the herd.” Less cognitive skills are needed with this approach. It becomes an easy solution in an unfamiliar situation. Most times by repeating the social behaviours of others, positive outcomes will result.
Social proof is an interesting idea. People adjust their behaviours to fit in with the crowd. Sometimes, this is positive. For example, more people than ever are eating a whole-food, plant-based diet. This would encourage people who are not these eating this way to meet the social norm and eat more plants. In other cases, the social proof can be negative. For example, too many people are eating the Standard American (SAD) Diet. This would not encourage the adoption of the whole-food, plant-based diet because the social norm is eating the SAD Diet. So, if I eat the SAD Diet, I will be following the herd, even though science has shown this to be unhealthy!
He mentioned a reference book called “Yes:50 Scientifically Proven Ways to be Persuasive” by Dr. Robert Cialdini which is available at the Kingston Frontenac Public Library. Dr. Cialdini elaborated on the influence principles using scientific studies to back up his claims. The social scientists’ research was amazing. He explained that fear becomes paralyzing when there are no solutions. Thus, he stated that an effective plan must be easy, clear and achievable. If not, the influence strategy would backfire and more of the unhealthy behaviour would continue. This research lends more evidence to small steps leading to major lifestyle changes.
He remarked that having people write down their goals is more powerful than giving them a piece of paper with their typed goals. They will be more active in their commitment when they write.
Older people tend to be more consistent and resistant to change. To help them remain consistent and save face, you can tell them that their previous decisions were aligned with the knowledge that they had at that time. However, the new knowledge that you are imparting will help their health, as they were attempting in the past.
Likability can be enhanced by mirroring behaviours. For example, if a person crosses their arms, you cross your arms. If they state an idea, repeating their terminology was the best bet. This point is different from what I learned about paraphrasing being the best technique, However, if repeating their words back to them is more effective in influencing their behaviour, then I will try it.
I hope that some of these influence strategies will help you in your next conversation. Little things can go a long way! Thanks for reading.

Here are the links.
https://www.youtube.com/watch?v=GLhuznP1RFg
https://www.kfpl.ca/c/catalogue/record/1.288425

Ed Tori, D.O., FACP, CH is the Director of Presence, MedStar Institute for Innovation (MI2). The 2012 Forum begins with a different kind of health innovation...