Looking for a Good Plant-based Diet?

Plant -based diets are the newest trend in lifestyle medicine, although vegan diets have been with us for decades. Now there is some competition along with their gimmicks and do’s and don’ts that we have heard for years.

Nevertheless, these diets have a nutrition seal of approval as we attempt to give up the unhealthy Standard American Diet and good riddance to that. My favorite is the Mediterranean Diet as it is more balanced as far as flavor and taste is considered. It adds some meat as well as allows some wine in moderation. All of these diets are beneficial and plant-based diets have shown to have health benefits in research studies. Any diet must be able to be sustained and those diets that are highly restrictive don’t seem to be followed for long periods of time. You ideally should consider one of these diets as a plan you can follow as part of your new healthy lifestyle.

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The Health Benefits of Extra Virgin Olive Oil

Olive oil has gained its fame with the advent of the Mediterranean Diet and the prevalence of its use in Mediterranean countries, especially Greece and Italy. Olive oil plays a major role in the diets of the majority of the Blue Zone cultures that boast of their longevity and as a part of a group of the longest living cultures on the planet. Tons of research supports the statement that olive oil has some serious health benefits.

So what is in olive oil? And what in the heck does it do for us? The primary fatty acid found in olive oil is a monounsaturated fat called oleic acid and from research is found to be a heart healthy oil. Olive oil is very high in phytonutrients called polyphenols which are potent antioxidants.

Refined vs extra virgin olive oil

The problem is that olive oil is not all alike. Commercial producers have often promoted inferior or even imitation products that on the label says olive oil but has questionable benefits. So what is the extra virgin hype? First of all, it is not refined and processed as the regular refined oil that is harvested by machine and processed with heat – this damages the polyphenols responsible for its health benefits and washes them away since they are water-soluble.

The extra virgin olive oil is often harvested by hand and separated without the use of heat, hot water, or solvents and is primarily left unfiltered, which preserves the delicate polyphenols. The first pressing produces the “best stuff,” known as “extra virgin” olive oil. Seek out the best – it’s worth it and your heart will thank you.

Recent Research

One study compared two groups of people with high blood pressure. One group was given sunflower oil and one group received extra virgin olive oil. In the olive oil group, blood pressure was decreased by a significant amount; it also decreased the need for blood pressure medicines in this group by a whopping 48 percent.

Results of a large clinical trial published in two prestigious medical journals, Journal of the American Medical Association (JAMA) and the New England Journal of Medicine demonstrate that a diet supplemented with extra virgin olive oil provides other health benefits.The PREDIMED study enrolled adults age 55 to 80 who were considered at high risk for cardiovascular disease based on various factors.

Participants were assigned to a Mediterranean diet, one with supplemental extra virgin olive oil (at least 4 tablespoons) and the other supplemented with mixed nuts. The third group was assigned to a control, low fat diet.

Over almost five years of follow-up, cardiovascular outcomes including heart attack, stroke, and death from any cardiovascular cause, were noted. The Mediterranean diet groups had a significantly lower rate of negative cardiovascular outcomes. This association was particularly strong for the supplemental extra virgin olive oil group, which had a 31 percent reduction in risk for cardiovascular disease outcomes compared to the control diet group.

The researchers also observed data of breast cancer risk in the women enrolled. Here too, the diet supplemented with extra virgin olive oil was most protective, reducing rates of breast cancer by nearly 70% compared to the control diet. Interestingly, the group that supplemented with mixed nuts did not show a significant benefit in terms of breast cancer risk.

The study’s authors report that this was the first human trial to find a beneficial effect of a dietary intervention on breast cancer risk. Together, these results suggest that a Mediterranean diet with supplemental extra virgin olive oil is protective against both cardiovascular disease and breast cancer in older adults with existing risk factors.

A 2013 study showed that olive oil contributes to satiety and so helps with weight loss. FYI: Satiety is a feeling of fullness of having enough to eat) In a German study, subjects who ate yogurt laced with olive oil had higher satiety compared to those eating yogurt containing other fats. They also had higher levels of serotonin (a brain neurotransmitter) and improved mood. The olive oil group lost weight, while the other groups actually gained weight over a three month study.

Use olive oil as your main fat for cooking (such as sauteing and roasting) and in salads. Store olive oil in a cool dark area, as it is susceptible to oxidation as many oils are.

Diet and Inflammation

Diet, Chronic Disease and Inflammation

By Sally J. Feltner, MS, PhD

A lot of recent attention has been paid to the role of lifestyle in many chronic diseases (lately referred to as underlying causes of mortality in the Covid-19 viral pandemic). Deaths due to this virus have been strongly associated with age, obesity, high blood pressure and diabetes to name a few. Many people with the viral infection have reported to have had at least one or two of these chronic conditions. Obesity alone has been known to be associated with low-grade inflammation.

Diet is one of those lifestyle factors in which somehow, we have gone astray. As we often hear, the Standard American Diet (SAD) is becoming more and more to be a causative factor of our ill health. As a result, body weight is on the rise and we are becoming more sedentary. Obesity is linked to the metabolic syndrome and type-2 diabetes and has come to be called the diabesity pandemic.

Recently, we have changed our ideas about diet and heart disease. Many doctors still think the high fat, high cholesterol diet of the last decade was to blame. However, this is a simplified view that dismisses the research that now supports the possibility that heart disease is mediated by other biological events other than cholesterol, including oxidative stress (free radicals), insulin sensitivity, endothelial dysfunction and blood clotting mechanisms and most importantly low-grade inflammation. Also, heart disease is now thought to have other risk factors such as high LDL cholesterol, high triglycerides and low HDL cholesterol that may be or not be related to dietary factors.

(FYI – endothelium is the tissue which forms a single layer of cells lining various organs and cavities of the body, especially the blood vessels, heart, and lymphatic vessels.)

We should be aware that inflammation is a double-edged sword. Inflammation in the body is necessary to protect us from infections and cancer and when appropriate from diseases. In its acute state as when you cut your finger, its reactions are self-limiting and resolve rapidly; the process is meant to heal and repair tissue damage. However, when inflammation is inappropriate, it can get out of hand and contribute to disease, especially chronic diseases. That is when inflammation can become your enemy. In this type, the inflammatory response needs be controlled or managed or at least short lived. Should it continue on, persisting cytokines of the immune system can produce excessive damage, leading to a number of diseases, including fibromyalgia, lupus, MS, and more. Cytokines can persist and overwhelm the immune response by releasing signals in the nervous system and and may contribute to a “cytokine storm” killing healthy cells as well as the offending agents (bacteria or virus).

(FYI – cytokines are small proteins produced by immune defensive cells that affect other cells and the immune response to an infectious agent. They act as cell messengers.

Can Diet as a Lifestyle Make a Difference in our Susceptibility to Disease and Affect Our Overall Health??

Recently, much has been written about specific foods and dietary approaches you can do to that either promote or reduce low grade inflammation. Keep in mind that this is only speculation, and some is just pure marketing by the food industry to promote a certain brand. At this point, we are beginning to research this more conclusively and in order to do that, studies have to measure whether a certain substance in the diet either raises or depresses what is known as inflammatory biomarkers in the body. The most used is one called high sensitivity C-Reactive protein (hsCRP). Others include inflammatory markers interleukin-1 or interleukin-6 as well as others. To do this involves a simple blood sample. I have had one to measure my inflammatory status a few years ago. If you see a study that claims to have noninflammatory properties, look for the way the study was performed – i.e., did it measure the effects on these inflammatory markers.

The goal of this blog post is to guide us to the right anti-inflammatory foods to reduce your risk of illness. Consistently, pick the wrong ones, and you could accelerate the inflammatory disease process.

Foods that allegedly promote inflammation – try to limit these foods as much as possible:

Refined carbohydrates such as white bread and pastries; choose whole grains instead. They need not be gluten-free unless you have some issues with wheat and need to limit its intake.
French fries and other fried foods
Soda and other sugar-sweetened beverages
Red meat (burgers, steaks) and processed meat (hog dogs, sausage)
Margarine, shortening, lard (high levels of trans fatty acids)

Foods that allegedly reduce inflammation – include in the diet as much as possible

Tomatoes rich in lycopene and carotenoids – healthy phytochemicals usually with antioxidant propertiesHigher
Olive oil – rich in monounsaturated fat and phytochemicals
Green leafy vegetables such as spinach, kale, collard and other greens – a randomized German study showed that 8 servings of fruits and vegetables for 4 weeks in men had lower levels of hsCRP.
Nuts like almonds and walnuts – high in monounsaturated fats
Fatty fish like salmon, mackerel, tuna, sardines – Diets rich in omega-3 fatty acids reduced inflammation.
Fruits such as strawberries, blueberries, cherries, and oranges
Higher fiber consumption was associated with less inflammation in seven studies, using hsCRP as a marker.

Bottom Line:

If you’re looking for an eating plan that closely follows the tenets of anti-inflammatory eating, consider the Mediterranean Diet which is high in fruits, vegetables, nuts, whole grains, fish and healthy oils (primarily olive oil).

In addition to lowering inflammation, a more, natural, less processed food diet can have noticeable effects on your physical and emotional health.

The Mediterranean Diet In A Nutshell

A Mediterranean diet is a good example of a diet that reduces low-grade inflammation and at the same time appears to reduce the risk of heart disease. It is a diet pattern that has been studied extensively and without a doubt scores high in the healthy column. It comes highly recommended and contains most of the foods labeled Anti-inflammatory.

High in fresh fruits and vegetables, olive oil, legumes, unrefined grains

Moderate in low-fat dairy

Low in meat

Moderate to high in fish

Moderate alcohol intake

Is All Sugar Equal?

Simple sugars are considered simple because they are small molecules that require little or no digestion before they can be used by the body. They come in two types: monosaccharides and disaccharides. First, here is a little sugar biochemistry.

Types of Carbohydrates

Carbohydrates are chemical compounds that contain carbon, hydrogen, and oxygen. Simple carbs, also called sugars include monosaccharides (fructose, glucose, and galactose) and disaccharides (sucrose, lactose, and maltose). They are found in foods such as table sugar, honey, milk, and fruit.

Complex carbohydrate include oligosaccharides and polysaccharides. Glycogen is a polysaccharide found in animals, and starch and fiber polysaccharides are found in plants. Sugars and starches consumed in food are broken down in the digestive tract to monosaccharides which can be absorbed in the bloodstream.

The simple sugars the body uses directly to form energy are glucose and fructose. Galactose is readily converted to glucose by the body. So, basically, all sugars and starches (chains of glucose) end up as glucose in the body. When the body has more glucose than it needs for energy, it converts the excess to fat and and glycogen. The glycogen is stored in the liver and muscles. When the body needs energy, glycogen is broken down making glucose available for energy formation. Glucose can also be obtained from certain amino acids and the glycerol part of fat. A constant supply is needed for the brain, red blood cells, white blood cells and some special cells in the kidney.

What are Added Sugars?

It is now a requirement to state the amount of added sugars on the Nutrition Facts Panel of most food products. Most of the simple sugars in our diet comes from foods and beverages sweeteners as sucrose and high-fructose corn syrup. Added sugars make up 15% of the total caloric intake of Americans.

High-fructose corn syrup is a liquid sweetener found in many soft drinks, fruit drinks, breakfast cereals and other food products. It consists of 55% fructose and 45% glucose, compared to sucrose that contains 50% glucose and 50% fructose. For example, one 12 oz serving of a soft drink contains about 9 teaspoons of sugar. That’s a lot of sugar and far more than is good for health.

The American Heart Association recommends that women consume no more than 6 teaspoons a day and men only 9 teaspoons a day.

Source: Judith E. Brown, Nutrition Now, 7th Edition.

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The Essence of Mindfulness

“Mindful eating is very pleasant” – Thich Nhat Hanh

The following excellent article first caught my eye due to its title – “Of Onions and Olive Oil”? After reading it, I fully appreciate what mindfulness is all about. How apart the thoughts presented are from our typical American way of eating – standing, sitting in the car, in front of the TV, or consuming a whole bag of potato chips in one sitting.

Maybe we should take this time of quarantines, lockdowns, politics and distancing to practice the art of mindfulness even in isolation or with family. It supports the crazy notion that it is not what we eat, but how we eat. SF

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Epidemics and Pandemics: In 3 Acts

” Epidemics unfold as social dramas in three acts,” said by one man named Charles Rosenberg who found inspiration in Albert Camus’s La Peste.

Everyone should read this historical look at epidemics/pandemics of the past and what they tell us about their characteristics and outlooks. There are lessons here to learn and we hope that it is not too late to exercise many of these in our own current dilemma. It was written by David S. Jones and was published in The New England Journal of Medicine, March 12, 2020.

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The Rising Rate of Obesity and Its Consequences

“The headlines this week broadcast the following research: Doctors at NYU Langone Health center conducted the largest study so far of US hospital admissions for COVID-19, focused on New York City. They found obesity, along with age, was the biggest deciding factor in hospital admissions, which may suggest the role of hyper-inflammatory reactions that can happen in those with the disease.”

Just what are the latest facts and implications about our obesity epidemic in the U.S.?

This data is from the U.S. Centers of Disease Control and Prevention in February 2020 and presented in Life Extension Magazine, May 2020.

A startling result is that 42.4% of adults are obese. Additionally, 31.8% were overweight.
This situation is expected to not improve statistically. A study in the New England Journal of Medicine estimates that by 2030, the percentage of obese American adults will rise to 48.9%. These percentages reflect a total of $446 billion dollars of medical costs annually.
Women, African Americans, and those with a low socioeconomic status are affected at a significantly higher rate.

What are the medical implications?

Excess body weight increases the risk of developing and dying from a broad spectrum of cardiovascular diseases, cognitive disorders (e.g. Alzheimer’s) and at least 13 different types of cancers.
Obesity has been determined to be the underlying cause of approximately 20% of deaths in the United States.
An analysis of 57 studies encompassing 900,000 individuals published in Lancet found that for every 5 point increment in Body Mass Index was associated with a 30% increased mortality risk.
Additional negative effects of excess weight include fatty liver disease, sleep apnea, chronic pain syndromes like low back pain, IBS, osteoarthtis, depression, negative pregnancy outcomes, and chronic inflammation.

Foods that Kill

There are many factors that contribute to the rise in obesity rates; however, diet and lifestyle have recently been identified and collectively referred to as components of the Standard American Diet (SAD). One of these is processed food.

Processed foods tend to be high in added sugar, salt, oil and unhealthy fats are often mentioned as well as ultra-processed foods that are so altered that they hardly resemble their original whole-food state.
The food industry refers to them as an “industrial product” loaded with additives that attempt to enhance the food’s characteristics such as food stability, shelf life, textures, colors, and flavors. They are often referred to as emulsifiers, humectants, and sequestrants or others that have barely recognizable names. Ultra-processed foods are often ready-to-eat, require minimal preparation and are highly marketed. Ultra-processed foods account for more than 60% of dietary energy in the U.S.
Populations that have the lowest intake of processed foods exist and have been recently studied and known as the Blue Zones. These are groups of individuals that live an average of 10 years longer than those in cultures who consume the SAD, otherwise known as the Western diet. These areas are found around the globe in Sardinia, Italy, Ikaria, Greece, Okinawa, Loma Linda, California, and Nicoya, Costa Rica.
An observational study of Spanish university graduates followed participants for a median of 10.4 years. Consumption of an average of 5.3 servings of ultra-processed food per day, compared to an average of less than 1.5 servings per day, was associated with a 62% increase for all-cause mortality. For each additional serving, this risk increased by 18%.

What Is the Optimal Diet?

There are numerable reports on the health benefits of vegan, vegetarian, or plant-based diets. However, there is one diet that has been studied extensively for its healthy effects called the Mediterranean Diet. There is no one Mediterranean diet; however, it is usually associated with the intake of vegetables, fruits, whole grains, beans, nuts and seeds, extra-virgin olive oil, fish, seafood, moderate amounts of poultry, eggs, and dairy products. Red meat and sweets are limited as well as a low intake of processed foods. A moderate intake of wine is acceptable. (moderate = 1-2 glasses).

Conclusions:

A possible molecular explanation for why overweight is harmful has been discovered by researchers. They suggest that overeating increases the immune response. This response causes the body to generate excessive inflammation during the COVID-19 infection and that inflammation is at the core of many other chronic diseases.

University of Oslo. “Being overweight causes hazardous inflammations.” ScienceDaily, 25, August 2014.

If current trends continue and we find that 50% of our population is in the obese weight category, there will be alarming rates of catastrophic health consequences. Our health care costs will become unsustainable. It is a common belief that as long as you are not obese, you can be overweight and still be healthy. This is not always true. Many studies have found that a higher weight was associated with a higher risk of dying; however, this has remained a major debate issue among obesity experts.

How Safe are Salad Bars?

I may be paranoid but salad bars have never been appealing to me. The lettuce alone sits there sometimes for long periods of time and the temperature is almost impossible to maintain to be constant at less than 40 degrees. F. Anything above that for cold foods is called the danger zone for microbe growth. That zone is so important in practicing food safety principles and your health.

Note: The coronovirus itself has never been implicated in any food safety issue to my knowledge. However, until it is determined what its modes of transmission are beyond any doubt, food safety is a good idea for general healthy principles anyway.

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Food for Thought?

Reliable nutrition research is hard to find – at least the kind of studies that have no obvious conflicts of interest or bias from the food industry. Here are two recent studies that I found that appeared to have some legitimacy and no conflicts of interest. Source: Life Extension

Weight Loss and Breast Cancer Risk

It has been known for some time that excess body weight raises the risk of breast cancer.

Study Method: A large study that included 180,000 female subjects over 50 years of age had their weight assessed three times in 10 years by researchers from the American Cancer Society, the Harvard T.H. Chan School of Public Health, and others. They found that women who lost about 4.4 lbs to 10 lbs. had a 13% lower risk, women who lost 10 lbs to 20 lbs had a 16% lower risk, and those who lost 20 lbs or more had a 25% lower risk.

Women who lost weight, and then regained some of it back, also had a reduced risk of breast cancer compared to women whose weight remained stable.

Conclusions/Authors: “Our results suggest that even a modest sustained weight loss is associated with lower breast cancer risk for women over 50. These findings may be a strong motivator for the two-thirds of women who are overweight to lose some of that weight, one author said.

Source: Journal of the National Cancer Institute, 2019 Dec.

Blueberries and Metabolic Syndrome

Researchers evaluated the effects of blueberry consumption on indicators of oxidative stress (free radicals) and inflammation in patients with metabolic syndrome. Oxidative stress occurs when cells are exposed to more oxidizing molecules (free radicals) than to antioxidant molecules that neutralize them. Over time, it increases the risk of heart disease, type 2 diabetes, cancer and other diseases. Blueberries have been found to have antioxidant functions as a result of phytochemicals called polyphenols.

Metabolic syndrome is a cluster of conditions that includes some combination of high blood pressure, abdominal obesity, high blood sugar, and abnormal lipid profiles (HDL, LDL, trigycerides, total cholesterol). The syndrome is associated with a highly pro-inflammatory environment in the body and a sharp increase of risk for heart disease, stroke, and diabetes.

Method: For the study, one group of patients received a smoothie containing 22.5 grams of freeze-dried blueberries, (about 2 cups of fresh blueberries.) The other group received a placebo smoothie twice a day.

Results: After six weeks, blueberry supplementation markedly decreased oxidative stress in whole blood and monocytes (white blood cells as part of the immune system). Supplemented patients also had a reduced expression of inflammatory markers in the monocytes.

The researchers noted that to their knowledge, this was the first study to yield significant improvements in oxidative and inflammatory parameters in patients with metabolic syndrome just after six weeks of blueberry consumption.

Note: As with all research, one study is not sufficient to form conclusions – the study results need to be replicated.

Looking for more reasons to eat blueberries? A University of Illinois study tested different fruits for the presence of a particular polyphenol that inhibits a cancer-promoting enzyme. Of all the fruits tested, wild blueberries showed the greatest anticancer activity.

Throw them on a salad, in blender with a protein powder, eat them frozen with a dollop of yogurt. Put them on your morning cereal.

How much sugar?

We know in times like these, our sugar intake is the last concern on our minds. In fact, we may be eating more of it due to stress and discontent of our current environment. But when this horrible pandemic is over, we have to try to get back to improving our diets as much as possible to make up for lost time. Here is a good article about sugar intake that is in reality reasonable and informative in general about the glycemic index, fructose, and artificial sweeteners and processed foods.

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