Welcome to the October 2024 issue of Research Extracts. “The Extracts” is designed to keep busy practitioners and savvy consumers up to date on the latest research on diet, nutrients, botanicals, the microbiome, the environment, and lifestyle approaches to good health and wellness. Our medical team, including NDs, MDs, PhDs, RDs, an MS in clinical nutrition, an MS in biology, and an LAc, summarizes the essence of several interesting recent studies.

In this issue: (1) Mental Health Moment: soymilk’s positive effect on dementia risk, (2) what drives food cravings? (3) meat alternatives are no better than meat for cardiometabolic health, and (4) the sweet spot for coffee consumption and cardiometabolic benefits.

Mental Health Moment: Milk Type and Dementia Risk

As the prevalence of dementia and other neurodegenerative diseases continues to rise, interventions during the preclinical stage to protect and prevent cognitive decline are essential. Cardiovascular events and disease progression have been studied as potential risk factors for dementia, which has led researchers to examine etiologies of cardiovascular disease, such as diet patterns. 

This cohort study explored the associations between consumption of different types of dairy milk and soymilk and dementia risk over a median follow-up time of 12.3 years. More than 500,000 participants, ages 37-73, across England, Wales, and Scotland were recruited from the UK Biobank. Those with pre-existing cognitive decline or dementia were excluded. 

Based on their reported milk consumption, participants were grouped into full-cream milk consumers (6.7%), skim milk consumers (84.8%), soymilk consumers (4.0%), other milk consumers (1.2%), or no milk consumers (3.3%). The results showed that 1.2% of all participants developed all-cause dementia throughout the study duration. 

Compared to no milk, the soymilk-consumer group was the only one that had a statistically significant 31% decreased risk of dementia. Soymilk consumers compared to consumers of all other types of milk had a significant 24% decreased risk of dementia. There were no significant differences in dementia risk between full-cream, skim, and other milk consumers compared to no milk consumers.

The researchers also looked at risk of Alzheimer’s disease and vascular dementia. The results showed that soymilk consumption was associated with a significant 30% lower risk of Alzheimer’s disease. Although it wasn’t statistically significant, there was also a similar risk reduction with vascular dementia and soymilk consumption.

The researchers offer possible explanations for these protective associations between soymilk and dementia. They hypothesize that soy isoflavones may bind to estrogen receptors in the brain and improve mitochondrial function and stability to impact executive function and memory. In addition, they hypothesize that the soy bioactive compounds may impact the gut-brain axis and downregulate amyloid plaques and tau proteins involved in the pathophysiology of Alzheimer’s disease. Because of the reduced saturated fatty acids in soymilk compared to cow’s milk and the health-promoting vitamins and minerals, soymilk and soy foods have been shown to improve cardiovascular risk factors. 

Note: To support a healthy diet and lifestyle that promotes brain health and cognitive function, Thorne has a variety of products to consider. From fish oils to amino acids to combination formulas for brain health,* Thorne has you covered for a variety of neurological needs. 

Contributed by Carly Duffy, MPH, RD

Reference

Managing Food Cravings in Medically Assisted Weight Management 

While hunger may be easily managed with medically assisted weight loss efforts, food cravings are more complex and can be triggered by hormones, in response to stress, and by both emotional and external food-related cues. Much of the science behind food cravings is still being discovered, and a wide range of options have been suggested for managing cravings. 

So, how can you better understand your food cravings and how to manage them?

A recent review of 115 peer-reviewed articles revealed the following about the science of cravings:

  • Eating is driven by three main factors: hunger, pleasure, and cognition. All three contribute to whether or not food is consumed.
  • Hunger can intensify food cravings, but cravings can exist in the absence of hunger.
  • Food “wanting” involves the dopamine reward system, while food “liking” involves opioid and cannabinoid pathways.
  • Stress-induced cravings and uncontrolled eating have been linked to changes in production and metabolism of the hormones cortisol, via the hypothalamic-pituitary-adrenal (HPA) axis, and ghrelin, via the dopamine system. 
  • Cravings do not have objective measures, such as blood labs. Instead, they are measured using self-reported questionnaires, which can result in under-reporting of cravings.

When it comes to management of cravings, the authors described a variety of beneficial tools.

  • A high-protein, low-carbohydrate balance at meals reduces cravings, possibly through effects on the dopamine reward system. However, poor sleep can counteract the beneficial effect of protein.
  • Regular exercise likely benefits cravings and emotional eating by supporting resilience to stress and improved mood.
  • Cognitive Behavioral Therapy (CBT), present moment awareness, decentralization, mindfulness-based interventions, and acceptance-based strategies all have merit as tools to benefit the psychological components of cravings and stress-related eating. 
  • Only certain medications (mainly GLP-1 class drugs) have been studied and shown to be effective at reducing cravings. 
  • As part of an overall weight management program, cravings are best addressed through an integrative approach including lifestyle and psychological interventions.

Note: Thorne’s Craving and Stress Support formula helps minimize stress-related eating and may be appropriate as part of a medically assisted weight loss program.* To learn more, check out Thorne’s Medically Guided Weight Loss support guide and talk to your physician about which integrative therapies are right for you.

Contributed by Jennifer L. Greer, ND, MEd

Reference

No Cardiometabolic Benefits of Plant-Based Meat Compared to Animal Foods

Although many people choose plant-based meat alternatives for their potential health benefits, the results of an eight-week, parallel design, randomized, controlled trial of patients at risk for cardiometabolic disease did not identify any cardiometabolic benefits of consuming these alternatives compared to their equivalent animal foods. 

A total of 89 non-diabetic participants (54 women, 35 men; average age 59) with elevated blood sugar (HbA1c ≥5.4 and ≤6.4%) were initially enrolled, and 82 completed the study. Participants were excluded if they were smokers, obese, had a history of bariatric surgery, or a present/past diagnosis of cardiometabolic, hepatic, or endocrine disorders.

Going into the study, participants were omnivorous, consuming an average of 3.1 servings of protein daily, including 2.3 servings of animal-based protein and 0.8 servings of plant-based protein. 

Participants were instructed to replace their regularly consumed protein-rich foods with fixed quantities (2.5 servings daily) of plant-based meat alternatives (n=40) or corresponding animal foods (n=42). The rest of their diets remained unchanged.

Participants had blood drawn at baseline (week 0) and post intervention (week 8) following a minimum of a 10-hour overnight fast. The following cardiometabolic outcomes were assessed:

  • LDL cholesterol
  • Triglycerides, HDL cholesterol, and total cholesterol
  • High sensitivity C-reactive protein (hsCRP)
  • Fasting glucose, fructosamine, and insulin
  • HOMA-IR (insulin resistance) calculated
  • HOMA-β (beta-cell function) calculated

A subset of participants underwent screening for the following:

  • Clinic and 24-hour ambulatory blood pressure measurements (n=40)
  • 14-day continuous glucose monitoring (glucose homeostasis-related outcomes) (n=37)

To match the protein content of the diets, the plant-based meat alternative group ended up consuming higher carbohydrate, fiber, sodium, and potassium, whereas the animal-protein group had increased intake of dietary trans-fat comparatively.

Despite this, the study did not find any significant differences between groups in any of the assessed cardiometabolic markers. 

The study highlights that, while traditional plant-based protein options (nuts, seeds, legumes, tofu, tempeh) have known cardiometabolic benefits, the meat-alternative products that have emerged have vastly different nutritional composition and do not confer the same benefits for cardiometabolic health. 

Note: For those seeking support for cardiometabolic health, Thorne’s Metabolic Health features the well-absorbed phytosome forms of curcumin and bergamot, which have been clinically researched to maintain healthy cholesterol and blood sugar levels and support a healthy weight.*

Contributed by Carina Toledo, MS, MHI, CNS

Reference

Coffee Drinking Decreases Cardiometabolic Disease Risk

Perhaps eating plant-based “meats” does not decrease cardiometabolic disease risk but apparently coffee does.

A prospective study enrolled participants from the UK Biobank – 88,204 to assess caffeine consumption and 96,393 to assess tea and coffee intakes, both in relation to cardiometabolic disease risk. Baseline assessments were between 2006 and 2010; none of them had cardiovascular disease (defined as stroke, type 2 diabetes, or coronary heart disease) at the time of enrollment. Participants were then followed until recently and coffee, tea, and total caffeine consumption assessed during that time. A total of 168 metabolites were measured with about half of them being different in habitual coffee drinkers. 

Three cups of coffee or 200-300 mg caffeine daily resulted in the lowest risk of developing cardiometabolic disease, compared to no coffee or less than 100 mg caffeine daily; a 49% decreased risk with three cups of coffee daily and 41% decreased risk with 200-300 mg caffeine daily. The metabolites most associated with the beverages’ effect on risk were: (1) VLDL metabolites increased disease risk and were decreased with coffee/caffeine consumption; (2) saturated fats increased risk and were decreased with beverage consumption, and (3) histidine metabolites decreased the risk and were increased with beverage consumption.

Note: In addition to feeling good about your coffee consumption, don’t forget to consider Metabolic Health (discussed above).

Contributed by Kathi Head, ND

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