Category Archives: Diet and Nutrition

What Research Says About Dieting

I am an enthusiastic subscriber to NutritionFacts.org videos. As I’ve mentioned in a prior post, Dr. Greger and his team wade through thousands of scientific articles annually to keep the general public informed on the latest findings on nutrition. And they do it for free!

On Friday, I joined thousands of other folks for a NutritionFacts.org webinar re: dieting and the efficacy of fasting. Dr. Greger shared previews of videos that will be posted on the site over the next several months in support of his upcoming book, How Not to Diet. Here are just a few of the things that I learned.

bathroom scaleA long-standing maxim regarding weight loss goes something like this: 1 pound of fat is equivalent to 3500 calories. Therefore, if you want the bathroom scale to register one less pound, simply reduce your daily caloric intake by 500 calories for 7 days. Trouble is, the body doesn’t quite work that way.

The body’s “math” says that weight loss is a function of CALORIES IN (i.e., what you eat) minus CALORIES OUT (i.e., what the body has to burn to keep you alive). A heavy person’s body at rest will burn more calories than a thin person’s body at rest because there’s a lot more tissue and blood vessels to maintain. As a heavy person loses weight, it takes increased caloric restriction over time to sustain the same rate of weight loss. But that’s not all…

Our bodies have been hard-wired over millions of years to defend against scarcity. When they confront caloric restriction, they’ll respond by lowering their metabolic rates to ensure survival. They’ll also amp up the hunger sensation to get us to forage for food. As such, it takes that much more willpower to stay the course!

Folks often complain that their diets stall after about 6 months. Both factors noted above contribute to that result. But there’s an insidious little factor that slips beneath our level of awareness. Studies show that most dieters inadvertently start eating more food over time. At the 6-month mark, they may feel as though they’re still eating 500-600 fewer calories every day, but they’re actually only eating 200 fewer. The hunger drive gets the better of them and distorts their perceptions.

Fasting has become a popular tool for weight loss due to its potential for rapid results. But the research doesn’t bode well for this approach. During fasts, the body cannibalizes itself, using lean muscle mass to create fuel. Moreover, fasting for a week or two can interfere with the loss of body fat long term. Fasting also deprives the body of essential vitamins and minerals. That deficit can result in serious (even fatal!) consequences. Breaking fast is also dangerous if not pursued intelligently. The body can’t turn up its digestive functions on a dime. Anyone considering this technique for weight loss should only do so under medical supervision with folks who know what they’re doing!

Folks who opt to lose body fat through liposuction may lower their body fat composition but do not reap the benefits of improved health. That procedure simply removes subcutaneous fat. It’s the visceral fat – i.e., the stuff that surrounds our vital organs – that wreaks havoc on our systems, leading to hypertension, arteriosclerosis, insulin resistance, etc. So while clothes may fit better, the newly thinner person is not a healthier person.

Sustained weight loss requires a consistent deficit of 300-500 calories daily. To meet this requirement, Dr. Greger tell us not to eat less food of the kinds you’ve always eaten; rather, eat better food. You can lower the caloric density of meals and keep hunger in check by pursuing a whole food plant-based diet. You also do yourself a big favor by consuming your calories earlier in the day. He tells us to eat breakfast like a king (queen), lunch like a prince (princess), and dinner like a pauper.

Exercise needs to factor into the mix. Surprisingly, it doesn’t have anywhere near the impact of calorie restriction on weight loss. BUT exercise improves muscle mass, and resistance training prevents bone loss that can occur with calorie restriction. The research also suggests that it’s best to exercise first thing in the morning before eating.

Finally, our bodies like to have a daily fast of ~12 hours in duration. So, set aside a 12-hour window for eating (e.g., 7:30am to 7:30pm) and drink water and herbal tea during the other hours. That practice alone supports weight management as we tend to eat less healthy foods at day’s end.

If you’d like to find out the optimal number of calories to drop for weight loss based on your current weight and level of activity, check out the NIH Body Weight Planner.

Find the Right Balance of Acid and Alkaline Foods

Long ago in science class, I learned about the pH scale which measures the relative acidity of a solution. Acid solutions generally measure between 0 and 7, while base (or alkaline) solutions measure between 7 and 14. At room temperature, pure water is neither acidic nor basic and has a pH of 7.

balance acid and alkaline foodsAs the human body is predominantly liquid, it has a pH as well. It runs between 7.35 and 7.45, which is alkaline. It must maintain this environment for all necessary cellular functions and reactions to occur. When faced with an influx of acidic material, the body has the ability to neutralize it within reasonable limits. But this activity can have unwanted consequences – e.g., leaching the calcium out of our bones. Excess acid load disrupts the delicate machinery of the body.

An acid-forming diet introduces excess acids into our bodies. Until I read a little booklet about it, I had no idea what that statement meant. I didn’t know which foods were acid and which were alkaline. At a high level, here’s how they play out:

Alkaline-Forming Acid-Forming
Most fruit
Most vegetables
Lentils
Most spices
Most herbs and seasonings
Most seeds and nuts
Meat
Fish
Poultry
Eggs
Most Grains
Most Legumes

The worksheet on acid/alkaline foods provides more detailed information. Looking through it, I found many things that seemed counterintuitive. For example, I would have thought that citrus fruits (lemons, limes, grapefruits, oranges) were acidic, but they’re alkaline! I also noticed that honey, maple syrup, sugar, and cocoa sit on the acid side of the divide. Finally, sea salt is “most alkaline” while common table salt is “most acid.” (Fortunately, I’m not big on salt, period!)

A health-promoting diet ensures that the body is not battling an excess of acid. The 5 principles of the Alkaline Way® Diet are:

  1. Eat high quality foods – fresh fruits and vegetables, free-range poultry, grass-fed meats
  2. Restore health by eating 80% of foods from alkaline sources; maintain health by eating 60% of food from alkaline sources.
  3. Eat a wide variety of high quality foods as each delivers its special blend of vital nutrients and helps sustain healthy digestion.
  4. Strike the right balance of acid and alkaline foods at each meal. (When your plate is filled with colorful produce, you’re on the right path!)
  5. Consume enough fiber and pure water to keep things moving smoothly through the digestive tract.

Some quick tips to boost your daily dose of alkaline foods:

  • Drink the juice of a half of a lemon or lime or a teaspoon of apple cider vinegar in 6-8 ounces of water a few times during the day.
  • Add lentils, yams, and sweet potatoes to your diet regularly.
  • Eat at least 1 cup of alkalizing greens daily – i.e., kale, mustard greens, collard greens, or endive. (Note: Spinach is acid-forming!)
  • Add miso and seaweed soups as a precursor to meals. They are alkalizing and aide in digestion.
  • Give preferential treatment to oats, quinoa, and wild rice when choosing grains.
  • Enjoy liberal amounts of fresh fruit and avoid dried fruit.

Note: The Alkaline Way® Diet was developed by Susan Brown, PhD, CCN and Russell Jaffe, MD, PhD, CCN.

The Vitamin C Controversy

According to the Mayo Clinic, the recommended daily amount (RDA) for vitamin C is 65 to 90 mg with an upper limit of 2,000 mg. This RDA is intended to prevent scurvy, a fatal disease caused by Vitamin C deficiency. They further state that while megadoses are unlikely to cause serious harm, certain side effects might be experienced – e.g., diarrhea, nausea, heartburn, cramping, headache, insomnia.

vitamin cDecades ago, Dr. Linus Pauling – a two-time Nobel prize winning biochemist – took these recommendations to task. In Vitamin C, the Common Cold, and the Flu, he cited multiple randomized, double-blind, placebo-controlled studies in which elevated intake of vitamin C significantly reduced the frequency, severity, and duration of colds and flus.

How does a cold or flu virus work?

Viruses cause the common cold and the flu (among other things). They are teeny, tiny microorganisms that worm their way into the body at the cellular level. They direct the cell’s biomachinery to produce lots of viral copies instead of the cell’s usual products. These copies then insinuate themselves into other cells and continue ramping up viral production. Along the way, they release poisons and toxins that make us feel lousy.

Our immune system fights back once a viral infection has taken hold. B cells generate virus-specific antibodies that bind to the microorganisms and stop them from replicating. They also tag viruses so that other cells called phagocytes know to destroy them. Viruses may also become inactive or destroyed by heat. (Note: Antibiotics only work on bacterial infections, not viral infections!)

So how might vitamin C work to ward off the common cold?

Vitamin C contributes to the formation of the colloidal substrate that binds tissues together. Pauling likens it to the rebar we use to lend strength and stability to a block of cement. Low Vitamin C weakens these substrates, making the cell more vulnerable to invasion. Vitamin C may also be implicated in the production and activation of interferons that inhibit viral production.

Infection-fighting leukocytes need Vitamin C to render them effective at destroying pathogens. Regular ingestion of Vitamin C keeps them in an appropriate state of readiness and may increase their motility. Levels deplete when combatting active infections. Therefore, an extra measure of Vitamin C may be required at such times to keep them in good working order.

Pauling notes that Vitamin C has been shown to deactivate herpes virus, vaccinia virus, hepatitis virus, bacterial viruses, and others. However, the rate of inactivation is proportional to dosage. One needs a large enough dose to generate favorable results.

How much should I ingest as a vitamin supplement?

If a person eats at least 5-7 serving of fresh fruits and vegetables daily, he or she is likely to get sufficient Vitamin C to prevent scurvy. When cooking, it’s best to steam or microwave veggies lightly to minimize nutrient loss.

To reap the health-promoting advantages touted by Dr. Pauling, one needs 1000-2000 mg supplemental Vitamin C spread through the day to maintain optimal blood levels. A large dose all at once may have a laxative effect. He notes, however, that the optimal dose for each individual varies based on his or her genetic profile and general state of health.

Dr. Pauling notes that the larger to the dose of Vitamin C, the greater the elimination of Vitamin C in the urine. This fact has been used by his detractors to suggest that excess dosage is a waste of money. However, even at higher doses, a percentage of the intake continues to remain bioavailable. It still proves beneficial as an antioxidant and as an essential coenzyme for important biochemical reactions. Moreover, Vitamin C in urine may prevent bladder infections and bladder cancer.

Some folks have an allergic reaction to the fillers used in the manufacture of Vitamin C tablets. Therefore, Dr. Pauling advocates use of sodium ascorbate in powdered form. Beyond the benefits for those prone to allergy, this formulation creates a lower acidic load in the bloodstream.

Has anything changed in the 4 decades since the publication of Dr. Pauling’s book?

In “Criteria and Recommendations for Vitamin C Intake” published in January 2006 by the Journal of the American Medical Association, the authors demonstrated that recommended intake of Vitamin C could be increased up to 200 mg per day. No change appears to have been made in the RDA. However, as Dr. Douglas Gildersleeve, MD notes:

“Having worked as a researcher in the field, it is my contention that an effective treatment for the common cold, a cure, is available that is being ignored because of the monetary losses that would be inflicted on the pharmaceutical manufacturers, professional journals [as recipients of pharmaceutical advertising revenue], and doctors themselves.”

How to Eat to Promote Sleep

It seems like every time I turn around these days I come across another book about the adrenal glands. Who knew that these tiny little glands that sit atop the kidneys could be so interesting?

The latest tome to grace my nightstand is entitled The Adrenal Reset Diet: Strategically Cycle Carbs and Proteins to Lose Weight, Balance Hormones, and Move from Stressed to Thriving, by Dr. Alan Christianson, NMD. Here are the key messages that I got out of his book.

The adrenal glands produce cortisol, the hormone that opens up cell walls to let other hormones in. They are also implicated in regulating our electrolyte balance, immune function, fight-or-flight response, blood sugar, and sleep-waking cycles. The latter is of particular interest to me.

The adrenal gland works in tandem with the pineal gland to manage our circadian rhythm – that is, our wakefulness and sleepiness across a given 24 hour day. The adrenal gland produces cortisol which acts as a stimulant. The pineal gland produces melatonin, which makes us sleepy. When we’re operating at peak efficiency, our blood levels of these two compounds looks something like this:

cortisol-melatonin cycle

We run into trouble when our cortisol is too low in the morning, thereby denying us that jolt of energy that we need to greet the day and sustain our energy. We also suffer if we get an undesirable boost of cortisol in the evening, causing us to be wakeful when we should be sleeping.

According to Dr. Christianson, meals with a higher percentage of protein and fat cause more cortisol to be released as an aid to digestion. It also has the effect of decreasing fat storage. By contrast, a higher intake of carbohydrates causes less cortisol to be released. With that in mind, he advocates the following pattern of eating:

Breakfast

Lunch

Dinner

Protein

One serving (roughly the size of the palm of your hand)

Fat

One smallish serving

Carbohydrate

1 serving

2 servings

3 servings

Carb cycling keeps the cortisol levels at the proper levels given the time of day.

Protein must be high quality protein – e.g., free range poultry, grass-fed beef, mercury-free fish, protein powder (from a reputable source). Carbohydrates must come from whole fruits, vegetables, legumes, grains, and nuts. No processed foods! Whole foods with a high fiber to fructose ratio are preferred.

Skipped meals are a big no-no. It amps up cortisol as a means of helping the body adjust to its depleted energy resources. This is bad news for those of us who don’t feel hungry in the morning! However, his protein shake recipe looks appetizing and relatively easy to prepare: 1 scoop protein powder, 1/4 cup berries, 1 cup unsweetened nondairy milk, 2 TBSP flax seeds, 1 handful of frozen spinach, and 1/4 cup cooked navy beans.

Dr. Christianson favors outdoor exercise where possible. Apparently, fresh air is good for the daily biorhythms. Exercise should be limited to yoga or walking after 2 pm to avoid an inauspicious jolt in cortisol. A gentle 10-15 minute walk after dinner helps the body prepare for sleep.

The optimal biorhythm? Early to bed (no later than 10 pm) and early to rise… Not so good for the night owls among us!

Why We Follow a Whole Foods Plant Based Diet

health and nutritionMy husband and I followed the Standard American Diet most of our lives. We had a particular fondness for the South Beach Diet which eliminated processed foods, supplied tasty recipes, and helped us manage our waistlines. But we opted to move to a predominantly whole foods plant based diet a couple of years ago, thanks in large part to the work of Dr. Neal Barnard, Dr. Jeffrey Bland, Dr. T. Colin Campbell, Dr. Caldwell Essylstein, Dr. Michael Greger, and Dr. Dean Ornish.

Here’s what they taught me about the negative effects of eating animal-based foods and their byproducts:

Saturated fats in animal based proteins are associated with elevated levels of serum cholesterol, a risk factor for heart disease (the nation’s number one killer). Moreover, a single meal containing fat and animal products can thwart the heart’s ability to produce nitric oxide. Nitric oxide relaxes the blood vessels, prevents white blood cells and platelets from becoming sticky, and keeps the smooth muscle cells from accumulating plaque. By contrast, nutrients from plant based foods are associated with decreased serum cholesterol. (Esselstyn)

Autopsies performed during World War II revealed that 80% of young American soldiers had arterial plaque, a condition not shared by their Japanese counterparts. However, with their shift to the Standard American Diet, the Japanese have dramatically increased their incidence of arterial plaque and heart disease. This problem begins early. In the United States, 70% of children have fatty deposits in their arteries by age 12. (Esselstyn)

Diets high in animal protein (>10% of caloric intake) are associated with increased risk of developing cancerous tumors. In one study, animal test subjects were exposed to a high level of carcinogens while fed a low protein diet (5% of calories). Their counterparts were exposed to a low level of carcinogens while fed a high protein diet (20% of calories). The high-protein subjects developed more tumors! Furthermore, tumor growth could be turned on and off by varying the amount of animal-based protein in the diet. (Campbell)

Animal based protein (including dairy products) increase the acid load in the bloodstream. Our bodies leech calcium from our bones to neutralize the acid. The countries that use the most cow’s milk and related products have the worst bone health. By contrast, vegetarians excrete less calcium in the urine, absorb more calcium from their diets, and have lower rates of osteoporosis. (Campbell)

When milk floods the body with calcium, we experience a substantial drop in activated Vitamin D. Persistently low levels of activated Vitamin D creates an inviting environment for certain cancers, autoimmune conditions, osteoporosis, and other disease. (Barnard, Campbell)

Vegetarians often use cheese as a source of dietary protein. Beyond its deleterious effect on acid load and calcium in the bloodstream, cheese gets 70% of its calories from milk fat which, pound for pound, delivers more cholesterol than steak. (Barnard)

Here’s what we get by shifting to a predominantly whole foods plant based diet:

whole food plant based diet

A whole food plant based diet provides just the right amount of protein (~10% of calories) to sustain our bodies. Plants support a slow and steady synthesis of protein that is least disruptive to the body’s carefully controlled alkaline blood serum. (Campbell)

For those who worry about protein intake, look to our nearest animal relatives, gorillas and chimps. They eat a whole food plant based diet and have strong bones and impressive musculature! (Campbell)

Plants are rich in phytonutrients, chemical compounds that offer plants protection from external threats. When we eat them, we get some of these protective benefits. They target cancer cells with antioxidant, anti-inflammatory, and immune enhancing activities. They also appear to inhibit bone loss. Organic foods have the most phytonutrients as they don’t get help fending off threats from pesticides or herbicides. (Bland, Greger)

Fruits, vegetables, and whole grains are loaded with soluble and insoluble fiber. It gives us a sense of fullness so that we are less likely to overeat. It also supports the digestive process, promotes nutrient absorption, feeds healthy bacteria in the gut, and keeps refuse moving through the colon. (Greger)

Antioxidants are plentiful in whole plant based foods and provide a shield against free radicals. Free radicals are unstable molecules that cause cellular damage and accelerate disease processes and aging. (Campbell, Greger)

People who pursue low fat, low protein diets tend to burn calories at a faster rate. As such, they have less difficulty controlling their weight. (Campbell)

Truth be told: We eat meat on occasion when invited out for dinner, experimenting with an interesting recipe, or tantalized by barbecued ribs at the local grocer. But we really do try to keep these dietary excursions to a minimum.

A Brief Tutorial on Dietary Fiber

All successful diets share two attributes: they’re low in sugar and high in fiber. Most of us intuitively get the restriction on sugar. After all, a minute on the lips can mean a lifetime on the hips! But few of us understand the role that fiber plays in weight management, let alone its other health benefits.

As a rule, our bodies do not use dietary fiber as energy sources. The overwhelming majority of it passes through our digestive tract without being metabolized. Yet it performs vital functions along the way. Dietary fiber takes two forms: soluble and insoluble.

Soluble fiber shows up in foods such as oat bran, barley, legumes (beans, lentils, peas), nuts, seeds, and some fruits and vegetables. When consumed, it forms a soft, sticky, gel-like substance that slows down the digestion and absorption of glucose, fructose, and fat. This delay gives the liver a chance to fully metabolize the incoming food. Soluble fiber provides the raw materials for bonding with bile acids to lower cholesterol, a known risk factor for heart disease. It regulates blood sugar to minimize insulin surges, a risk factor for diabetes. Soluble fiber also promotes colonization of good bacteria in the gut, which improves nutrient absorption and immune function.

Insoluble fiber shows up in foods such as whole grains, nuts, and fruits and vegetables (notably in the stalks, skins, and seeds). It’s the tough stuff that doesn’t dissolve in water, often referred to as “roughage.” It adds bulk to move food through the digestive track; it helps prevent constipation and diverticulitis. Like soluble fiber, it decreases cholesterol and lowers blood glucose.

fiber-rich foods

High fiber foods support weight loss and healthy weight management. They dilute the caloric content of our diets while simultaneously requiring more time to chew and process. They delay the rate at which food empties from the stomach into the intestines, thereby creating a sense of fullness. A slower rate of digestion gives the body time to generate and release the satiety hormone leptin which tells the brain that it has taken in enough food. The measured release of sugar into the bloodstream improves insulin sensitivity. And higher fiber consumption has been associated with lower rates of cancer in the colon and rectum.

In order to gain all of these health benefits, fiber must be eaten in whole, intact food. Whole grains must be uncracked, uncrushed, and unadulterated. Fruits and vegetables must go from the tree, vine, or ground to the table, relatively unchanged. As a case in point: When juicing fruits and vegetables, the sheering action destroys the insoluble fiber and causes sugar absorption into the bloodstream to soar.

So how are Americans doing with fiber consumption?

The Institute of Medicine tells us that women should consume a minimum of ~25 grams of fiber per day and men should consume ~38 grams per day. Yet according to the USDA, fiber intake among women and men comes in at 15 and 18 grams per day, respectively. The standard American diet features an excess of meats, fats, and processed foods, and too little fiber-rich foods.

To increase your fiber intake, consider shifting your eating habits toward a whole foods plant based diet. Fiber is naturally concentrated in fruits, vegetables, legumes, whole grains, nuts, and seeds. These foods are also rich in vitamins, minerals, and phytonutrients. There are lots of delicious recipes for preparing these foods. (Check out Maren’s Kitchen to see what my husband and I have been cooking!) Over time, you’ll find that you won’t miss all of the processed foods that used to adorn your meals and snacks. And you’ll gain a whole lot of other health benefits while you’re at it!

Dr. Axe Says: “Eat Dirt”

In an earlier post, I discussed the importance of maintaining a healthy microbiome – i.e., the population of microscopic organisms that live symbiotically in our small intestines and colons. They aid in digestion, help regulate metabolism and hormone levels, support immune function, protect the gut lining, and ward off harmful microorganisms. Diversity is the hallmark of a healthy microbiome with no more than 15% of its residents deemed potentially harmful.

When our microbiome is out of balance, we are far more susceptible to chronic illness and disease. According to Dr. Josh Axe, author of Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems, a number of factors compromise our microbiome:

  • A poor diet characterized by excess sugar and nutritionally bankrupt processed food
    (Note: A test subject’s biodiversity dropped by 40% after eating a diet based wholly on fast food for 10 days!)
  • Dietary gluten that triggers production of zonulin, a hormone that causes the tight junctions of our gut lining to loosen up
  • Overuse of antibiotics and antimicrobial sanitizers which kill off good bacteria with the bad
  • Environmental toxins
  • Stress

eat dirtMicrobes die off and must be replenished. To nourish the good microbial population, we need regular exposure to the soil-based microbes found in dirt and other plant life. While it isn’t necessary to serve ourselves daily spoonfuls of dirt, it certainly doesn’t hurt to leave a little bit of dirt on the fruits and vegetables we consume. Microexposures reinforce good bacteria and help our bodies respond appropriately to pathogens. Those of us who own dogs and cats get a little dose of dirt every time we handle their dirty paws!

As an aside: I’ve always noshed on baby carrots at parties to keep me away from higher calorie snack foods. Until reading this book, it never occurred to me that packaged carrots tend to be bathed in chlorine to increase their shelf life. Chlorine kills bacteria in the gut!

Other than becoming a pet owner, what dietary and lifestyle practices support the cultivation of a healthy microbiome?

Dr. Axe favors getting back to nature. A few simple lifestyle adjustments might include: (i) walking barefoot on the ground daily; (ii) working in the garden; (iii) showering with water and no soap a few days per week to help maintain beneficial microorganisms on the skin; (iv) washing hands with water and certified organic therapeutic oils (e.g., tea tree, orange, melaleuca, rosemary) or Dr. Bronnor’s Pure Castile Soap; and, (v) swimming in the ocean.

As for food, Dr. Axe offers the following recommendations:

  • Eat probiotic rich foods such as kefir, yogurt, and fermented vegetables.
    (Note: Commercially prepared sauerkraut may or may not have been fermented; it could just be cabbage seasoned with vinegar.)
  • Drink raw, fermented, organic goat or sheep milk and cheese.
    (Homogenization destroys essential enzymes and probiotics as well as oxidizes fats and creates free radicals.)
  • Substitute coconut flour or almond flour for wheat-based flour.
  • Use extra virgin coconut oil for cooking and ghee, olive oil, or flaxseed oil for dressings, et al.
  • Use bone broth and collagen powder to repair the gut’s mucosal lining and provide a rich source of minerals that the body can readily absorb.
  • Avoid sugar and artificial sweeteners.

Famed Scientist Calls Sugar “Pure, White, and Deadly”

In 1955, American physiologist Ancel Keys delivered a presentation to the World Health Organization that linked coronary artery disease (CAD) to blood serum cholesterol based on epidemiological data from seven industrialized nations. His research turned the tide of American eating habits away from saturated fats toward diets rich in protein and carbohydrates.

British physiologist and nutritionist John Yudkin was not convinced that eliminating saturated fats from would lower rates of CAD. For one thing, two independent examinations of epidemiological data from 20+ industrialized countries failed to support Dr. Keys’ findings. Since affluent populations tend to consume more fat and sugar, smoke more, and lead more sedentary lives, one could argue perhaps that all of these factors contribute to CAD, not just fat consumption. Moreover, Dr. Yudkin claimed that no one has been able to demonstrate that people with CAD on average consume more fat that people without it. He did, however, have his suspicions about the relationship between sugar and CAD, and chased that theory by conducting his own research and reviewing a host of studies by peers.

sugarYudkin published his findings in Pure, White, and Deadly: How Sugar is Killing Us and What We Can Do to Stop It, my latest bedside read. The book warns that excess consumption of sugar produces a host of unpleasant biological responses that are detrimental to our health, including:

  • Elevated blood serum cholesterol and triglycerides
    (How about that? Sugar holds the smoking gun on cholesterol!)
  • Hormonal imbalance cause by increased blood serum levels of insulin, cortisol, and estrogen
  • Increased “stickiness” of platelets
  • Increased acidity and digestive activity of the gastric juices
  • Enlargement of the liver and kidneys
  • Elevated risk of CAD, hypertension, diabetes, insulin resistance, gall stones
  • Tooth decay

Dr. Yudkin also theorized that excess sugar interferes with the balance of good and bad bacteria in the gut microbiome – a theory that has subsequently proven correct.

Dr. Yudkin is quick to point out that his research on sugar should not give rise to a new wave of simplistic advice regarding CAD. People with coronary artery disease tend to have multiple “disturbances” that impact their conditions – e.g., genetic predisposition, unhealthy diets, excess body fat, tobacco use, physical inactivity, stress. So giving up sugar is not a “silver bullet”… even though abstinence comes highly recommended.

So with all this bad news regarding sugar, why do we eat so much of it? One clear answer lies in the fact that sugar tastes good. It makes foods highly palatable and motivates us to eat more and more of it. As such, U.S. food manufacturers have found ways to add sugar into nearly everything they produce. Is it any wonder that our per capita sugar consumption is skyrocketing?

sugar consumption in the usa

A second major factor lies in the fact that most of us are unaware of how much sugar we’re eating. Very little of Americans’ daily sugar intake comes from table sugar. Most of us aren’t diligent about reading labels and may not even recognize the various forms of sugar that are listed there. And, we may be so used to food tasting sweet that we don’t even register the presence of sugar anymore.

The good news: If you choose to eat whole foods, you won’t have to worry about reading labels, and you won’t ingest hidden quantities of sugar, salt, or fat. And as I’ve learned over the past couple of years, there are lots of ways to make whole foods highly palatable while benefitting from all that good nutrition. Once you’ve broken the sugar cycle, you’ll start to notice all the subtle flavors… and, perhaps, not miss it so much.

How the Healthiest, Longest-Lived People Live

In 2009, National Geographic Fellow Dan Buettner published findings from his quest to find the world’s longest-lived, healthiest human beings and identify common threads that unite them. Dubbed the Blue Zones®, he found these exemplary communities in California (a Seventh Day Adventist community), Costa Rica, Greece, Sardinia, and Japan.

blue zone communities

In The Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest, he shares nine secrets to their success:

  1. Sustained movement through acts of daily living – walking, preparing meals using whole foods, doing chores, gardening
  2. Purpose – a reason outside of work that makes life worth living
  3. Daily routines through which they relax and relieve stress
  4. Leisurely meals during which they eat to ~80% capacity (leaving ample room for digestion)
  5. One or two glasses of wine daily with good friends
  6. Primarily plant-based diets with small, intermittent servings of meat, poultry, and fish
  7. Social circles that encourage and reinforce their healthy behaviors
  8. Participation in faith-based communities
  9. Focus on family as witnessed by committed marriages, attentive parenting, care and concern for the elderly

Unlike the average American, these folks do not obsess over the latest health fad. They don’t count calories or worry about the optimal ratio of protein, carbohydrates, and fats. They simply live the way their parents and parents’ parents lived without the specter of heart disease, obesity, cancer, diabetes, and dementia looming in their advanced years.

In The Blue Zones Solution: Eating and Living Like the World’s Healthiest People, Buettner takes a closer look at food choices in the 5 communities. While the composition of their diets vary according to tradition and available raw materials, all 5 communities place little emphasis on fish, meat, poultry, and eggs. Here are their average daily intakes by food group:

CA CR GR IT JP
Vegetables 33% 14% 46% 12% 32%
Fruits 27% 9% 16% 1%
Legumes 12% 7% 11% 4% 16%
Grains, Rice, Pasta 7% 26% 6% 47% 23%
Fish, Meat, Poultry, Eggs 6% 7% 11% 5% 15%
Dairy (e.g., goat’s milk) 10% 24% 26% 8%
Oils 2% 2% 6% 2%
Sweets 1% 11% 4% 3%
Other 2% 6%

Based on his research, Buettner suggests the following practices:

  • Make your first meal of the day the largest, lunch the second largest, and dinner the smallest; add one light snack, as needed.
  • Cook at home using fresh, high quality ingredients (e.g., organic produce, free range poultry, grass fed meats).
  • Don’t eat while standing, driving, watching TV, reading, or using electronic devices. Rather, invite family and friends to dine with you.
  • Stop eating when you are 80% full. Either pre-plate the food, or eat slowly enough that the body can register its food consumption and signal when full.
  • Make meal time a celebration!

He also recommends food choices for longevity. Based on his experience and a confluence of nutritional research, 95% of the diet should come from a whole plant. Meat, poultry, and fish should make occasional appearances in small portions – i.e., servings roughly the size of a deck of cards. Eat at least one-half cup beans daily as they’re high in protein and fiber. Minimize dairy as we don’t digest it well (although fermented goat’s milk seems to be OK). Replace common bread with sourdough or whole wheat. Snack on nuts. Slash sugar.

Note: Blue Zones® is a registered trademark of Blue Zones, LLC. Blue Zones is dedicated to creating healthy communities across the United States. Visit their website at https://bluezones.com/.

Will the Real Expert Please Stand Up?

A little over a year ago, my husband and I converted to a whole foods plant based diet in the wake of reading books by Drs. Campbell, Esselstyn, Greger, and Ornish. Their research suggested that the healthiest eating pattern consisted of roughly 80% carbohydrates, 10% proteins, and 10% fat, all from whole plant foods. (You know you’re eating whole plant foods when you don’t have to read a label to know what’s in it!) We affirmed our decision after watching the documentary film Knives Over Forks and reporting significant reductions in our LDL cholesterol.

questionsWhen I was diagnosed with Hashimoto’s thyroiditis a couple of months ago, I read several books by self-professed autoimmune experts who advocate for a modified Paleo Diet. It’s a high protein (meat, poultry, fish), high fat, low carbohydrate diet that eliminates night vegetables (potatoes, tomatoes, peppers, and eggplants), legumes, grains, nuts, and seeds. In other words, it’s pretty much the polar opposite of the whole foods plant based diet.

It’s a testament to the marvel of our digestive system that we can accommodate such widely different food choices. Of course, our digestive system can also handle a junk food diet, but that’s hardly an endorsement for that style of eating! With both parents living well into their nineties, I’m interested in finding the best diet to promote long-term health and cognition. So… to whom should I bend my eyes and ears?

Of late, I’ve been subscribing to a daily dose of videos from Dr. Michael Greger’s NutritionFacts.org website. Dr. Greger is a practicing physician and the best-selling author of How Not To Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease. In a recorded primer on the site, he describes the process through which he prepares his materials:

  • An “army of volunteers” downloads and categorizes the latest peer reviewed scientific journals (roughly 2,000 per week).
  • A staff of ~20 researchers reviews the literature to arrive at topics that satisfy three criteria: (i) novelty (i.e., groundbreaking news); (ii) practicality (i.e., actionable for viewers); and, (iii) engagement (i.e., “hooks” that will make the material interesting).
  • Having sifted through the journals, staff determines if the selected works are actually true. They look to the source of funding to see if patronage influenced the findings. They check to see if the author cited best evidence and interpreted the data correctly. And, of course, they go to the original source material to ensure that all citations align with the author’s claims.
  • They set each of the vetted peer reviewed journals in context to see if the findings resonate with similar studies given variations in research design, methodology, and data sets. The team looks for a weight of evidence before carrying a message to the general public.

Each 5-7 minute video delivers material in sufficient depth to back-up the general thesis of the piece without overwhelming the viewer with details. You get to read direct quotes from the studies and track down the source materials for additional information. His daily briefs generally contain links to related videos on the subject matter.

approved expertI’m impressed by the fact that Dr. Greger provides the information free to the public without taking a dime in compensation for his time and effort. He does not accept corporate sponsorships or advertising revenue to fund the site. Revenues from his books and DVDs plus free will donations defray the costs of running this not-for-profit enterprise.

I’m still on the journey of figuring out what I’ll be eating for the rest of my life (and in what proportions). I’ll continue to read books, watch videos, and listen to podcasts. But I’ll also pay close attention to what my body seems to be telling me.