The Sickness In Our Food Supply?

A very long article by Michael Pollan but is worth reading if you want to understand the complexities of our food system. It involves the “elephant in the room” consisting of  Covid -19 that  exposes the interrelated factors associated with our our current food system and health care costs. Based on this essay, our “diets may be killing us” as a few recent articles have suggested. Click the link below or find it on the Website of Michael Pollan of (“eat food, not too much, mostly plants” fame).

A quote from Forbes, May 12, 2000 in an article from Nav Athwal sums it up:

“One thing the coronavirus pandemic has taught us is the level of control we have over our lives is not as great as we think.  Whether it be our ability to be mobile, our ability to meet with friends or the food we eat and how we eat it, the conveniences we took for granted not long ago are luxuries in a post-coronavirus world.”

Any suggestions for a solution?

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The Blue Zone: A Book Review

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By Sally J. Feltner, M.S., Ph.D.

Ponce de Leon began his quest for the fountain of youth in 1531 and humans have been seeking magical solutions for keeping us younger and living our later years in relatively good health.

In 2009 with the backing of the University of Minnesota School of Public Health, AARP and the National Geographic, Dan Buettner established the Blue Zone Project and authored The Blue Zones: 9 Lessons for Living Longer from the people who lived the longest, He interviewed those who were either centenarians or those in their later years and began to investigate what factors may have contributed to five regions of longevity hot spots in the world that included:

  • Sardinia in Italy with the highest concentration of centenarian men.
  • Seventh Day Adventists in Loma Linda, California, where some residents live ten more healthy years than the average American.
  • The Nicoya Peninsula in Costa Rica that has the world’s lowest rates of middle-age mortality and the second highest concentration of male centenarians.
  • Ikaria, Greece that has one of the world’s lowest rates of middle age mortality and lowest rates of dementia. Only 20 percent of people over 80 showed any signs of dementia, whereas a similar study of long-lived people near Athens showed an almost 50 percent rate of dementia- a rate similar to that for older Americans.”
  • Okinawa, Japan home to the world’s longest living women.

Remarkably, all the regions had common characteristics that included family and purpose, community and spirituality, stress reduction and physical activity. Mr. Buettner later published The Blue Zones Solution and coauthored with Ed Diener, The Blue Zones of Happiness.

One major practice was that all their diets, though not vegan, were predominantly based on plants. Meat and other animal products are either the exception or used as a condiment. Okinawans, practice a philosophy called hara-hachi bu regarding food; they only eat until they are 80% full

In the Costa Rican Zone, everyone feels like they have a plan de vida or life plan. Even at ages above 60 and 70, inhabitants don’t stop living. They keep themselves busy; they love to work. It provides them a “reason to waking up in the morning” called ikigai. There is no word for “retirement” in Okinawa.

The book introduces some very interesting longevity “superstars.”

  • Marge Jones, at 100 years old from Loma Linda begins every day with a mile walk, a stationary bicycle ride, and some weight lifting. “I’m for anything that has to do with health”, she says
  • Kamada Nakazitam, 102 years old from Okinawa says “To be healthy enough to embrace my great – great grandchild is bliss.”
  • Ellsworh Wareham, age 91 from Loma Linda, assists during heart surgery procedures, something he does about two or three times a week
  • Abuela Panchita, 100 year old Costa Rican woman whose 80 year old son, Tommy bicycles to see her every day, spends every day cooking, splitting logs and using a machine to clear brush from her
  • The notion of moai in Okinawa stands for “a social support network. Says 77 year old Klazuko Mann, “each member knows that her friends count on her as much as she counts on her friends.”
  • From the author: “I once pressed a 101-year-old woman in Ikaria, Greece to tell why she thought people there lived so long. ‘We just forget to die,’ she said with a shrug. None of them went on a diet, joined a gym, or took supplements. They didn’t pursue longevity – it simply ensued”

The final chapters in the first book boil it all down into nine lessons and a cultural distillation of the worlds’ best practices in longevity. Buettner provides credible information available for “adding years to your life and life to your years.”

However, there is a downside that is currently happening. From the Author: “Sardinians today have already taken on the trappings of modern life. For example, junk foods are replacing whole-grain breads and fresh vegetables traditionally consumed here. Young people are fatter, less inclined to follow tradition, and more outwardly focused.”

The first book concludes with a chapter on Your Personal Blue Zone. Other books give us more explicit ways to establish Blue Zones in other areas such as the U.S.

From the back cover of The Blue Zones Solution – “Propagating the Blue Zones would not only prevent a rise in the prevalence of diabetes (and other misfortunes) it would allow us to eliminate more than 80 percent of the burden we have now. That’s revolutionary.”

David Katz, M.D., Director of the Yale-Griffin Prevention Research Center

 

 

Are Our Diets Killing Us?

The Corona Virus

The importance of lifestyle enters into the debate about the coronavirus pandemic and its consequences. Many reports of viral deaths are attributed loosely to underlying conditions exemplified  by the presence of hypertension, heart disease, diabetes/prediabetes, and obesity which is surmised to increase  the mortality risks of the virus. These are the leading causes of death in the U.S. and are collectively referred to as chronic diseases.

“Poor diet, a lifestyle factor among others, is the leading cause of mortality in the United States, causing more than half a million deaths per year. Just 10 dietary factors are estimated to cause nearly 1,000 deaths every day from heart disease, stroke and diabetes alone. These conditions are dizzyingly expensive. Cardiovascular disease costs $351 billion annually in health care spending and lost productivity, while diabetes costs $327 billion annually. The total economic cost of obesity is estimated at $1.72 trillion per year, or 9.3 percent of gross domestic product.” NYT.

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Ancel Keys – Big Fat Confusion ?

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An early picture of Ancel Keys, This image is ...

An early picture of Ancel Keys, (Photo credit: Wikipedia)

Time Magazine 1961. Ancel Keys appears on the cover to claim that saturated fat in the diet clogged arteries and caused heart disease.

Time Magazine, 2014. Eat Butter. Scientists were wrong about saturated fat. They don’t cause heart disease.

How did the low saturated fat message begin?  How, when and why did this confusion begin?

Ancel Benjamin Keys was born in 1904 in Colorado Springs, Colorado to teenage parents. In his younger years he had various jobs including a clerk in a Woolworth store. He finished college in 3 years with Honors at Berkeley and earned a MS in Biology followed by a PhD from the Scripps Institute of Oceanography. In 1930 he traveled to Copenhagen to work with Nobel laureate, August Krogh where he studied the ability of eels to survive in both fresh and salt-water environments. He then went to Cambridge and obtained a second PhD in animal physiology from King’s College.

What made Keys famous was his Seven Countries Study, a study that remains controversial to this day. He initially observed that heart disease rates dropped in countries forced to alter their high fat diets because of the war rationing and reversed to higher rates when these diets returned.

He suspected dietary factors, particularly saturated fat, that might play a key role in atherosclerosis. After conducting some well-designed studies to support his theory, “he formulated an equation that simply showed a 2.7% mg/dl rise in cholesterol for every 1% of calories derived from saturated fat. The equation also suggested that polyunsaturated fat lowered serum cholesterol and dietary cholesterol raised serum cholesterol but to a lesser extent than saturated fat. “ Journal of Clinical Lipidology, page 435

Keys had based his theory on when he had previously visited Italy and Spain. He observed in Naples, Italy that only heart disease patients in hospitals were wealthy men. In Madrid, Spain he took blood samples from some men in one of the poorer districts where heart disease was rare and compared them to samples of more well-off patients with heart disease. What he found were differences in their serum cholesterol values with the higher levels in the wealthy and lower values in the poorer population. The diets of the two groups also differed with the poorer diets lower in fat than those of the wealthy. These observations were central to his theory that saturated fat or animal fat and dietary cholesterol contributed to heart disease.  Levenstein, Harvey, Junk Science Week: Lipophobia and the Bad Science Diet, Financial Post, June 11,2012.

The theory gained some steam when in 1955, President Dwight David Eisenhower had a heart attack at age 64, “ Over the next six weeks, twice-daily press conferences were held on his condition. After his attack, he dieted religiously with a low-fat diet and had his cholesterol measured ten times a year (it had been 165 mg initially)”. Taubes, Gary. Good Calories, Bad Calories, page 1-4.   The low-fat diet had little effect and his cholesterol continued to rise as well as his weight.

Between 1955 and 1958, Keys began to study the male population aged 40 to 59 in rural areas in certain countries. He used electrocardiograph data to detect heart abnormalities and cardiovascular disease. The countries included Yugoslavia, Italy, Greece, Finland, the Netherlands, the U.S. and Japan. The countries he had chosen represented varied intakes of saturated or animal fat; lower levels were found in some populations in Yugoslavia, Italy, Greece, and Japan. Finland, the Netherlands, and the U.S. represented higher levels of animal fat in their diets. Five and ten years later, the researchers returned to identify those who had experienced heart attacks. The lowest rates were found in Crete and Japan with the lowest levels of animal fat; the highest was found in East Finland and the U. S. with the highest levels of animal fat. All in all, Keys studied nearly 13,000 men.  From this study, he concluded that “saturated fats as a percentage of calories was the most powerful lifestyle predictor of heart disease. “Blood cholesterol was the important physiological variable. “ Journal of Clinical Lipidology, page 437.

In 1961 Keys appeared on the cover of Time magaine with the Seven Countries Study’s alleged link between fat, cholesterol and heart disease that fueled the fear of dietary fat in America. Two weeks later the American Heart Association (AHA) endorsed the theory.  With this announcement, the vegetable oil producers could not get their advertisements out fast enough. Wesson Oil said: “polyunsaturated Wesson is unsurpassed by any leading oil in its ability to reduce blood cholesterol.” Nutrition scientists jumped on the bandwagon. For example, Harvard nutritionist, Frederick Stare advised swallowing three tablespoons of polyunsaturated oil each day. Lipophobia had begun in earnest. Levenstein, Harvey, Lipophobia and the bad science.

Consumption of margarine doubled from 1950 to 1972 and that of vegetable oil rose by over 50% in the 10 years from 1966 to 1976. Ironically, based on the thesis of Keys that saturated fat was the culprit, the AHA and other agencies had urged food processors to use trans fats to replace the alleged deadly saturated fat. Ironically, the most common source of trans fats turned out to be the very margarine they had promoted as heart healthy. From 1956 to 1976, per-capita butter consumption fell by over half.

Key’s hypothesis strengthened in 1977 with Senator George McGovern’s publication of the First Dietary Goals for the U.S., which was the first time that any government group had told Americans to eat less fat and cholesterol to improve health. The document became gospel and had a tremendous impact on consumers and the food industry. In 1980, Hegsted and McGinnis produced the USDA Dietary Guidelines for Americans that concurred with “avoiding too much fat and cholesterol and eating more foods with adequate starch and fiber.”

However, three major studies failed in their support for Key’s hypothesis and without going into the details, each one raised doubts about the  hypothesis.

The Key’s Seven Countries Study, so pivotal in lipophobia has been debunked by many, particularly those who favor the idea of eating meat.. On the other hand, vegans favor the thesis. Here is what the critics of the study say: First, Keys did not randomly choose countries but is accused of picking those countries most likely to support his theory. He excluded France whose diet has been notoriously rich in saturated fat along with a low heart disease rate (The French Paradox). He also excluded Switzerland, Sweden, and West Germany with the similar higher saturated fat intakes but with lower rates of heart disease. He originally gathered data from 22 countries.   However, some point out that even when all 22 countries are analyzed, the trend that fat intake is associated with heart disease still weakly exists.

Ancel Keys died in November of 2004 at the age of 100 years old.

Key’s thesis is still hotly debated to this day because of its limitations and lack of  conclusive support from the research community. There are still adherents of the efficacy of the low fat diet, particularly in its effects on atherosclerosis regression or prevention.  The debate has now switched to which diet is heart healthy – a low-fat or a low-carbohydrate diet. However, that is another story.

I truly don’t know if Keys was right or wrong. The purpose of this post is to point out that his legacy remains as one of the leading food crusaders that changed the American plate.  Is the low fat craze finally coming to an end?  Has this national experiment failed?  Will the low carbohydrate diet help curb the obesity epidemic or prevent heart disease?  Sounds like a “soap opera, doesn’t it?  One thing is certain – atherosclerosis is a complicated disorder and until its origin and pathology is conclusively determined, no one will know who was right.

 

The Pandemic and the Mind

The pandemic is making us depressed and anxious – can healthy food provide relief?

To the average person, it may seem eminently reasonable to assume that food affects our brains along with the rest of our bodies. But only within the past decade or so have researchers begun to establish the crucial link between diet and the mind.

The U.K. Mental Health Foundation reports that food plays an important role not only in depression but in schizophrenia, attention deficit hyperactivity disorder (ADHD) and Alzheimer’s disease as well.

The coronavirus pandemic has changed every aspect of our lives, including our eating habits. Comfort food was made for times like these, and it seems the healthy food trend that took root in recent years is reversing, at least for the time being. Shopping habits have shifted in favor of old processed favorites like frozen pizza, toaster waffles and canned spaghetti. These are convenience foods with long shelf lives that are designed to deliver pleasure. The typical American diet is often loaded with processed foods, pizza, fast food, white flour and sugary sodas.

Money is tight in many households, and busy parents are putting breakfast, lunch and dinner on the table instead of home cooking and using whole food. Open a box and there is dinner.  Besides, convenience foods are engineered  by the food industry to taste good and make us feel good at least in the short term.

But wait – there’s more. That’s because a growing body of research is showing that our food choices don’t just affect our waistlines. What we eat also may affect our mood and behavior. In other words, there may be something in the food we’re eating (or not eating) that’s influencing our state of mind.

The emerging field of nutritional psychology contends that modern western diets have contributed to increased rates of mental illness, particularly depression. Diets that follow a Mediterranean pattern of eating a lot of fruits and vegetables, whole grains, nuts, beans, fish and olive oil, have been linked to lower rates of depression. A diet change of just a few weeks has been found to lift moods. In a 2010 study, women who ate diets high in vegetables, fruit, fish and whole grains were less likely to suffer from depression.

As a third of all Americans are reporting that the coronavirus pandemic has taken a toll on their mental health, we might now need nutritious foods more than ever. One way to start is to simply cut down on “junk” foods and look for simple ways to prepare whole nutritious foods.

Source: Discover Magazine, September/October, 2020

Vitamin D and Infectious Disease

Vitamin D Foods

Immunologic Effects of Vitamin D on Human Health and Disease

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Abstract

Vitamin D is responsible for regulation of calcium and phosphate metabolism and maintaining a healthy mineralized skeleton. It is also known as an immunomodulatory hormone. Experimental studies have shown that 1,25-dihydroxyvitamin D, the active form of vitamin D, exerts immunologic activities on multiple components of the innate and adaptive immune system as well as endothelial membrane stability. Association between low levels of serum 25-hydroxyvitamin D and increased risk of developing several immune-related diseases and disorders, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19, has been observed. Accordingly, a number of clinical trials aiming to determine the efficacy of administration of vitamin D and its metabolites for treatment of these diseases have been conducted with variable outcomes. Interestingly, recent evidence suggests that some individuals might benefit from vitamin D more or less than others as high inter-individual difference in broad gene expression in human peripheral blood mononuclear cells in response to vitamin D supplementation has been observed. Although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40-60 ng/mL (100-150 nmol/L) to achieve the optimal overall health benefits of vitamin D.

This abstract and article was published in Nutrients, 2020: 12(7), 2097

In light of the current Covid-19 pandemic, questions are raised and answers sought about the role of nutrition in the prevention of infectious diseases. In this case, vitamin D (a fat soluble vitamin stored in the body) is examined.

Vitamin D Facts:

RDA Women: 600 IU; Men: 600 IU; UL: 4000 IU. Toxicity possible with long-term use of 10,000 IU daily. 1 microgram (mcg) vitamin D = 40 IU.

Primary Functions: Needed for absorption of calcium and phosphorus for bone formation nerve and muscle activity. Inhibits inflammation and is involved in insulin secretion and blood glucose level maintenance.

Consequences of Deficiency: Weak, deformed bones (children), loss of calcium from bones (adults), osteoporosis.

Concenquences of Overdose: Mental retardation in young children, abnormal bone growth and formation. Nausea, diarrhea, irritability, weight loss. Deposition of calcium in organs such as kidneys, liver and heart.

Primary Food Sources: Vitamin D – fortified milk, cereals, and other foods. Fish

Highlights: Vitamin D3, the most active form is manufactured from a form of cholesterol in skin cells upon exposure to ultraviolet rays from the sun. Inadequate vitamin D status is common. Breast-fed infants with little sun exposure benefit from vitamin D supplements. People with very dark skin, especially from Asian and Afro-Carribbean descent find it difficult to make vitamin D from limited sunlight.

NOTE: It’s important to know that megadoses of any vitamin or mineral are never recommended, unless there is a medical reason for doing so. In this case, a Canadian study reported that among 303 middle-aged and older adults (who were not vitamin D deficient), those who were randomly assigned to get 4,000 IU  of vitamin D  a day for 3 years lost more bone in their arms  than those who got 400 IU a day. Those who got 10,000 IU a day lost more bone in their arms and shins than those who got 400 IU a day.  See the consequences of overdose. 

 

 

Chronic Disease: Can Your Lifestyle Make a Difference?

 

Lately in the literature, lifestyle medicine has been mentioned as an effective practice that influences our overall health and risk of diseases in general. Many of the  leading causes of death in developed countries have been referred to as chronic diseases and ways to prevent these diseases is to practice a “healthy lifestyle”. But what does that exactly mean? Some research has suggested that our susceptibility to Covid-19 may even be altered by our lifestyles, obesity being named a risk factor.

In 1999, a Harvard-trained cardiologist, James E. Rippe published a textbook entitled Lifestyle Medicine in which he expressed his hope for a “new emphasis in medicine related to the links between daily behaviors and outcomes”. The idea slowly took root. In 2006, Loma Linda University School of Medicine, a Seventh Day Adventist institution in California, debuted the country’s first lifestyle medicine education program. A few years later the School of Medicine Greenville at the University of South Carolina went a step further, integrating lifestyle medicine into every facet of the curriculum and requiring prospective physicians in medical schools to spend 50 hours over two years covering the ways in which diet, nutrition and exercise impact the various organs and systems. Several other medical school programs have followed, that have been dedicated to the principals that healthy food, rich in nutrients, healthy fats, and lean protein, can be a potent weapon in the doctor’s bag.”

“How much a role does nutrition play in health? “It is the thing, says Jennifer Trilik , an associate professor at USC Greenville who directs the schools lifestyle medicine program. “if we’re talking about obesity, cardiovascular disease,  cancer, there’s so much evidence that saturated fat and trans-fat cause chronic inflammation, damaged the DNA and create growths in an adult body that shouldn’t be there. On the other hand, apples and blueberries have so many healthy antioxidants. We were made to eat whole foods and plant based foods, not processed ones out of a bag.

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Vitamin C and Respiratory Infections

What Do We Know About Vitamin C?

Vitamin C is an essential nutrient in humans. Without it we die.

Most animals internally produce their own vitamin C; humans do not so we need to obtain it from the diet or other external sources  (supplements). It is a water-soluble vitamin and cannot be stored in the body.

Severe deficiency may develop within three weeks of very low intake. This can result in a sub-clinical form of scurvy that can be manifested in increased susceptibility to infections. This is often shown initially by easy bruising.

Diets lacking in fruits and vegetables (such as a low-carbohydrate diet) often do not provide enough vitamin C.

Functions of vitamin C

  • Needed for manufacture of collagen
  • Helps the body fight infections, repair wounds
  • Act as antioxidant
  • Enhances iron absorption.

Primary food sources:

Fruits: guava, oranges, lemons, limes, strawberries, cantaloupe, grapefruit, kiwi fruit

Vegetables: broccoli, green and red peppers, collards, tomato, potatoes, ready to eat cereals (fortified)

FYI: The RDA for vitamin C is 15-75 mg/d for children, 75 mg/d for adult women, 90 mg/d for adult men, and 85 to 120 mg for pregnant and breastfeeding women.

The Tolerable Upper Limit is 2000 mg/d. Oral Intakes of 1 gram or more a day can cause nausea, cramps, and diarrhea and may increase the risk of kidney stones.

Impact on Infections

Some studies show that in common infectious diseases, supplemental vitamin C lessens the severity and duration of symptoms.

In severe respiratory diseases such as bronchitis or pneumonia, vitamin C has been shown to reduce symptoms and shorten hospital stays. Some studies report rapid clearance on chest x-rays of patients with lung infections, following intravenous vitamin C treatment.

From the Linus Pauling Institute (LPI) at Oregon State University comes this:

“March 13, 2020 – The Linus Pauling Institute is closely watching the clinical trials with intravenous (IV) vitamin C and COVID-19-related pneumonia with great interest. However, there currently are no available data to show vitamin C can prevent or successfully treat COVID-19 infections. Once the trial data are available for review, the LPI will comment on the efficacy of IV vitamin C in COVID-19.

In 1970, Dr. Linus Pauling, Nobel Prize winner,  published Vitamin C and the Common Cold, a book that revolutionized the way the world viewed vitamin C and infectious disease. Dr. Pauling believed that increasing the daily dose of vitamin C could help the body mount a strong immune response when confronted with a respiratory infection.

Many people worldwide have reported better health after taking large amounts of vitamin C. To date, clinical trials have shown that vitamin C supplements can shorten the duration of the common cold. However, there are no data to suggest that vitamin C supplements can stop respiratory infections in the general population.  Results from trials with participants undergoing heavy physical activity indicate a benefit of oral vitamin C on common cold incidence. There are no such trials on influenza or coronavirus.

The LPI continues to advocate for rigorous research on both oral and IV vitamin C for treating both inflammation and infection. Yet, the facts are that there have been few rigorous studies on vitamin C and respiratory infections. Clinical trials with IV vitamin C and coronavirus-related pneumonia are currently underway in China. These trials are of great interest to the LPI, and we will monitor them closely.

Meanwhile, the LPI recommends taking these steps to support a healthy immune system: Eat a healthy diet and ensure that you meet the recommended intakes of all micronutrients, especially vitamins A, C, D, E, as well as zinc

Oregon State University has established a COVID-19 website to provide detailed and updated information; links to OSU, local, state and federal resources; and some frequently asked questions. Please regularly check this website for important updates.”

Source: Nutrition Now, Brown, Seventh Edition

Linus Pauling Institute, Oregon State University