What the Experts Say

1. Probiotic supplements have been found to help balance the good and bad bacteria not only in the gut but also in the mouth. 

Q: I’m worried about gum disease. Do probiotics really work?

A: In terms of managing periodontal disease, certain probiotics do seem to help. But this research is still in its infancy, and there are no studies supporting the use of probiotics to prevent gum disease.  

—John D. Meola, DD

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2. New research linked taking antacids with a vitamin B12 deficiency, which can damage the brain and nervous system over the long term.

Q: Should I stop taking so many antacids?

A: Low vitamin B12 levels can lead to a variety of disorders. According to recent studies, it does appear possible that reduced acid in the intestine might reduce the absorption of vitamin B12 from food, but acid blockers are not likely to affect the absorption of B12 taken in supplement form. A recent study in The Journal of the American Medical Association didn’t look at antacids like Tums, but it is possible that those taking such antacids may be at risk for B12 deficiency. The most prudent recommendation is to review the possibility of vitamin B12 deficiency with a personal physician. 

—Brian S. Morris, MD, Associate Director, UCLA Executive Health

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3. In a comparative overview of mortality,researchers found that exercise may be as effective as medication in preventing negative outcomes for people diagnosed with pre-diabetes, stroke, or heart disease after a heart attack.

Q: I currently take insulin but have always hated taking medicine. Can I replace my shot with a daily walk?

A: It is important for everyone to exercise regularly, but it is especially important for the overall health of a diabetic person. Walking 150 minutes a week is the most common recommendation. Whether this can replace an insulin shot depends on many factors. In many cases, you will need insulin no matter what, but a healthy diet, weight loss, and regular exercise under a doctor’s guidance may allow you to decrease the amount of insulin you are taking. 

—Betul Hatipoglu, MD, endocrinologist at Cleveland Clinic

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4. Researchers have reported a clear connection between an imbalance of good and bad intestinal bacteria—too little of the former and too much of the latter—and colorectal cancer.


Q: Can I have my gut flora tested? And should I start taking probiotics and consider not taking antibiotics when I have an infection?

A: We do not yet understand the cause and effect underlying this observed relationship. Since we do not yet know what drives the differences in gut bacteria observed between individuals with and without colorectal cancer, we cannot make clear recommendations. 

—Carrie Daniel-MacDougall, PhD, nutritional epidemiologist at MD Anderson Cancer Center 

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5. A recent study confirmed the decreased risk of coronary heart disease for people who eat a significant quantity of citrus fruits, green leafy vegetables and those rich in beta-carotene and vitamin C.

Q: If I already have heart disease, can eating these fruits and vegetables reverse the damage and boost my longevity?

A: The study mentioned evaluated only the risk of developing coronary heart disease and did not include people who already had the disease. Recent studies have shown that plant-based diets and diets that are higher in fiber, including the Mediterranean diet, have benefits in people with known heart disease. Based on this and other research, the answer is yes, there is a benefit to eating a diet rich in fruits and vegetables if you have heart disease already.

—David Frid, MD, cardiologist, Cleveland Clinic Miller Family Heart & Vascular Institute

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6. In a study on the effects of sugar and fat on the brain, sugar caused a stronger response in the brain’s reward centers, suggesting it could be more addictive and lead to obesity.


Q: I have been on a low-fat diet. Should I abandon that for a low-sugar regimen instead?

A: There is no simple answer to this question. A diet should take into account existing health problems or risks for an individual. For example, people with high cholesterol or cardiovascular disease should control fat intake, while carbohydrate and sugar intake is of primary concern for people with diabetes. Having said that, there is consensus that added sugars (beyond the natural sugar content of whole foods) are to be discouraged in all healthy diets. 

—John Nadai, MD, Obesity Medicine Specialist, Massachusetts General Hospital Weight Center

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7. Aspartame was just deemed to have no cancer-causing effects in current food-safety amounts after passing rigorous testing in Europe.

Q: Is it safe to return to my much-missed diet soft drink habit?

A: From a human and epidemiologic perspective, long-term studies in which healthy individuals are followed to see if they develop cancer haven’t shown anything convincing for aspartame or artificial sweeteners. The best message is “everything in moderation.” And keep in mind that although diet soda may not contribute much in the way of calories, it often contains caffeine and other additives and preservatives and is not as healthy as drinking water. 

—Carrie Daniel-MacDougall, PhD, nutritional epidemiologist at MD Anderson Cancer Center