General principles of a healthy
lots of fruits and vegetables.
moderate amounts of whole grains (pastas, breads, cereals, and
moderate amounts of nuts and seeds (unsalted, not roasted)
moderate amounts of fatty fish (BEWARE of tuna and farmed salmon)
meat, especially red meat.
fatty, greasy, fried foods.
low-fat or no-fat varieties for milk and milk products
Organic foods – see way below in this outline
Whole foods vs. refined foods: primitive diets vs. modern
diets and physical degeneration (Weston Price, DDS. Nutrition and Physical Degeneration. 1939)
Price’s review of the research in his “search for the cause of
degeneration of the human face and dental organs” led him to conclude that
“The evidence seemed to indicate clearly that the forces that were at work
were not to be found in the diseased tissues, but that the undesirable
conditions were the result of the absence of something, rather than the
presence of something.” (16th Printing. 2004. Pg 21).
Price thus decided in 1930 to travel the world and seek out primitive
cultures with no exposure to the “white man’s diet” of refined grains, and
analyze the nutrient content of these primitive diets, and correlate this
information with careful analysis of the prevalence of dental caries
(cavities) and deformities of the dental arch (the cause of the need for
visited the Eskimos in Alaska,
native American Indians in multiple locations,
African tribes, and Australian Aborigines.
found that the diets were tremendously diverse, depending on geographic
location. “Some were based on sea foods, some on domesticated animals,
some on game and some on dairy products. Some contained almost no almost
no plant foods while others contained a variety of fruits, vegetables,
grains, and legumes…However, these diets shared several underlying
characteristics…All the diets contained animal products of some sort and
all included some salt” (16th Printing. Prologue. 2004. xv-
found that consumption of primitive diets was associated with a much
lower incidence of dental caries, deformities of the dental arch, and
of the primitive diets showed “that all contained at least four times the
quantity of minerals and water-soluble vitamins of the American diet of
his day” and “at least TEN times the amount of fat-soluble vitamins found
in animal fats” (16th Printing. Prologue. 2004. xvi). He
attributes much of the insufficiency of vitamins and minerals in the diet
to depletion of the soil (pg 392).
USDA (United States Department of Agriculture) Guidelines
for healthy eating
- The Basic 12 1940's
- The Basic 7
1956 - The Basic 4
dairy products Milk, milk
sweet potatoes Tomatoes and
peas, beans, nuts Leafy
veggies Butter and
Lean meat, poultry, fish
- Eggs Flour
meat, poultry, fish
argue that the creation of the "Basic Four" was heavily
influenced by the meat and dairy industry lobbies. Either way, as
scientific understanding of healthy nutrition advanced, it became clearer
that the "Basic Four" was an inadequate guide for the public
with regard to healthy eating.
food pyramid released by the USDA in 1992 is an improvement conceptually,
but not ideal.
scientific limitation of the food pyramid based on emerging understanding
of nutrition is that it does not distinguish between types of fat or
types of carbohydrate and also does not distinguish the source of
part of the objective of the USDA in 1992 was to keep things simple
for the public
USDA EATING RIGHT FOOD PYRAMID
/ fats \
/ milk, meat, nuts, eggs\
USDA on 4/19/05 revealed ‘MyPyramid’ by turning the old food pyramid on
its side, adding exercise in the form of steps up the side of the pyramid,
and showing each food group as a triangle in the pyramid from the base to
the apex, with the base representing healthier choices within the food
group, such as whole grains as opposed to highly refined carbohydrates.
food groups are grains, vegetables, fruits, milk, meat and beans, and
are 12 pyramids which provide quantities of food based on individual age,
sex, and weight
information at www.mypyramid.gov
– this site is interactive and includes:
Plan – quick estimate of how much food to eat based on age, sex, and weight.
§ MyPryramid Tracker – more detailed information on
individual diet quality and physical activity status.
MyPyramid – in-depth information for every food group.
Today – provides tips and resources.
pyramid is more representative of scientific understanding of nutrition
than the 1992 pyramid, but many experts feel that it still has
couple of examples include lack of attention to trans fats, and encouragement
of excess consumption of dairy.
excellent critique appears in Integrative
Medicine: A Clinician’s Journal. 2005. 4 (6). 14-19.
that while there is published data that the Mediterranean diet is associated
with increased longevity, lower incidence of metabolic syndrome, decreased risk
of cardiovascular disease, and a reduced risk of death from cancer (see
references in the section on Mediterranean diet at the bottom of this outline),
there is no research to show that the MyPyramid dietary protocol reduces the
risk of disease or death.
USDA in June 2010 replaced ‘MyPyramid’ with ‘MyPlate,’
- ‘MyPlate’ divides the plate into approximate quarters,
with just over ¼ of the plate with vegetables, just less than ¼ of the
plate with fruit, ¼ of the plate with sources of protein, and ¼ of the
plate with grains (and dairy as a side dish).- more info at www.choosemyplate.gov
limitation of MyPlate is that the pictorial
does not distinguish between refined grains and whole grains.
- The Dietary Guidelines for Americans are
released every 5 years by the USDA – they were released 1/12/05, and
updated in January, 2011
are based on recommendations from a 13 member advisory committee
full 70 page report and 9 page consumer pamphlet are available at www.healthierus.gov/dietaryguidelines/
serve as the foundation for federal nutrition policy and education.
with past guidelines, the 2005 guidelines are much more specific about
what to eat and how much to exercise.
½ of grain intake to whole grains
4 ½ cups of fruits and vegetables per day, nearly double the previous
daily physical activity
that the USDA is the agency responsible for both the food pyramid and
promoting the livestock industry, which is viewed by many as an
institutional conflict of interest.
1991, Time magazine addressed
this in an article entitled “Playing Politics with Our Food: While the
Food and Drug Administration reforms labels, the Agriculture Department
drags its feet, thanks to its cozy relations with the meat industry” (Time. 7/15/91. 57-58).
1999, the Physicians Committee for Responsible Medicine (PCMR) sued the
USDA, charging that it had hidden from the public information about the
background of some members of its advisory committee. It turns out
that more than half of the 11 members of the advisory committee have ties
to the meat, dairy, and egg industries.
won the lawsuit in 2000, so during the next revision of the guidelines
after the 2001 revision, the advisory committee selection process must be
made more public (Natural Health,
nutrition experts recommend that the Department of Health and Human
Services assume responsibility for revising the food pyramid, to avoid
the above conflict of interest.
- Food Politics (2002) by Marion
Nestle, chair of the Nutrition Department at NYU, provides an excellent
critique of this inevitable conflict of interest.
that research sponsored by manufacturers or groups with commercial
interest was four to eight times more likely to be favorable than research
that wasn’t industry sponsored, and most published studies nowadays are
financed by organizations with commercial ties, rather than by the
government (PLoS Medicine. 1/07).
Harvard School of Public Health
Guidelines for healthy eating - formulated by Walter Willett, MD, DrPH is an alternative construct which is representative of
current scientific understanding of nutrition.
WALTER WILLETT PYRAMID (1994)
red meat \
/ sweets \
/ fish, poultry, eggs \
/ dairy or Ca suppl
/ most veg
EATING PYRAMID IN EAT, DRINK, AND BE
/_____high glycemic index carbohydrates_____\
/__dairy food or calcium supplement 1-2 times/day__\
/__________fish, poultry, eggs 0-2 times/day__________\
/____________nuts and legumes 1-3 times/day____________\
/_______vegetables in abundance, fruits 2-3 times/day________ __\
/___________whole grain foods and plant oils__________________\
daily exercise and weight control
Alcohol in moderation, multiple vitamin
University of Michigan Integrative Medicine Clinical Services
has developed and alternative pyramid, released 3/7/05, available as an
interactive web-based nutrition tool at www.med.umich.edu/umim.
Summary article: (Explore. 2006. 2.
and healthy fats________________\
The American Institute for Cancer
Research (AICR) in 1999 launched the ‘New American Plate’ approach to meal
planning – the plate is divided into 2/3 (or more) vegetables, fruits, whole
grains, beans, and nuts and 1/3 (or less) sources of animal protein, including
lean meat, poultry, fish, cheese, and yogurt.
Andrew Weil, MD has outlined an
anti-inflammatory diet pyramid (www.healthyaging.com)
Macronutrient composition of the
societies estimated macronutrient ratio: 19-35% protein, 22-40% carbohydrate,
28-47% fat (Mayo Clin
Proc. 2004. 79. 101-108).
diet macronutrient ratios according to NHANES III: 15.5% protein, 49% carbohydrate,
34% fat, 3.1% alcohol.
guidelines from the Institute
of Medicine (www.iom.edu) – 20-35% fat, 45-65% carbohydrate,
is estimated that carbohydrates constitute 70-80% of calories consumed by
fat is best because it lowers total cholesterol.
fat is worst because it raises total cholesterol.
fat is bad because it has a neutral effect on total cholesterol.
fat should be limited because of the association between fat intake and
wisdom - the form of fat is important:
3 polyunsaturated fats are best for a variety of reasons (see below).
fat is very good because it raises HDL and lowers LDL cholesterol.
6 polyunsaturated fats are essential in small amounts (3-6% of total
calories, which is roughly one tablespoon daily) but should be limited
because they may lower HDL cholesterol disproportionately, may trigger free
radical chain reactions which increase the risk of cancer and
atherosclerosis, and may lead biochemically to increased production of
fat is okay in moderate quantities; even though it raises LDL cholesterol
(bad cholesterol), it also raises HDL, and scientists are now questioning
the past conclusions that saturated fat intake increases the risk of
heart disease (Commentary. Ravnskov U et al. Mayo Clin
Proc. 2014. 89. 451-453; Time.
- Trans fat is worst - it lowers HDL cholesterol and
raises LDL cholesterol, and has a number of other deleterious effects
fat intake can comprise up to 40% of total caloric intake, as long as it
is predominantly good fats which are consumed.
all fats are calorie dense, containing 9 calories per gram whereas
carbohydrates and protein contain 4 calories per gram. This is not bad per se but reminds us of
the importance of limiting the quantity of fat consumed.
the National Academy of Sciences reported in 1989 that, contrary to
previous popular wisdom, total fat intake alone is not associated with
heart disease risk.
that the ratio of fat to carbohydrate used in the fuel mix for most cells
in our body is determined by the prevailing insulin level - hyperinsulinemia (an insulin level that is always high
such as in insulin resistant individuals) means the cells are constantly
required to burn carbohydrate and dietary fat ends up stored as body fat
instead of burned as fuel.
categorization of fat.
dietary fat is in the form of triglycerides, which are composed of three
fatty acid molecules bound together by a glycerol molecule.
acids are straight chain hydrocarbon chains with a methyl group (CH3) at
one end and a carboxyl group (COOH) at the other end.
fat is composed of fatty acids with no carbon-carbon double bonds and is
solid at room temperature, mono-unsaturated fat is composed of fatty
acids with one carbon-carbon double bond and is liquid at room temperature,
and polyunsaturated fat is composed of fatty acids with two or more
carbon-carbon double bonds and is also liquid at room temperature.
omega classification of fats is based on the location of the first
carbon-carbon double bond, with carbons counted from the methyl end of
acids are classified as very-short-chain (VSCFA) containing 2-3 carbon
atoms, short-chain (SCFA) containing 4-6 carbon atoms, medium chain
(MCFA) containing 8-14 carbon atoms, and long chain (LCFA) containing 16
or carbon atoms.
in the body exists in two main structural forms:
chain fatty acids – phospholipids, sphingolipids,
glycosphingolipids. These are
structures –sterols – cholesterol, phytosterols. These are hydrophobic and rigid in
description of fat – it is a lipid (i.e. substances insoluble in water,
soluble in organic solvents, and able to be used by the body).
of fats - energy source, components of cell membranes, precursors to
eicosanoids (prostaglandins, leukotrienes), precursors to hormones,
regulate gene expression (via activation or inhibition of NF-KB and
acid, a short chain fatty acid, is the preferred fuel for colonic
epithelial cells (colonocytes).
triglycerides, and specifically those containing caprylic
acid (8 carbon atoms) and capric acid (10
carbon atoms), have been shown to improve the course of many health
problems such as pancreatic insufficiency, liver cirrhosis, epilepsy, and
glycogen storage diseases.
consumption and satiety
in part by release of CCK.
research on satiety in experimental situations shows that fat consumption
has a weak effect on satiety; consumption of low energy density foods
such as fruits and vegetables has a stronger effect on satiety.
- Essential fatty acids – omega 3
and omega 6 polyunsaturated fatty acids are essential in mammals because
mammals do not synthesize desaturase enzymes that can insert a double bond
closer than 7 carbon atoms away from the methyl end of the carbon chain.
fat includes animal fat (red meat, poultry skin, milk products), and
tropical oils (palm oil and coconut oil).
fat consumption and risk of coronary heart disease – the generally accepted
conventional dogma is that saturated fat consumption is associated with an
increased risk of coronary artery disease.
this association was based on interpretation of data from 16 cohorts in
the Seven Countries Study (Keys A. Circulation.
1970. 41 [Suppl 1]. 1-211).
of this conclusion indicate significant heterogeneity in the data, and
various ways of interpreting the same data (Commentary. Ravnskov U et al. Mayo Clin Proc. 2014. 89.
analysis of data from the Seven Countries Study shows that processed
foods, consisting primarily of carbohydrates, were misclassified as
saturated fats (Food Nutr Sci. 2013. 4. 240-244).
American Heart Association diet-heart guidelines published in 1982 were based
in part on Keys’ interpretation of his data; this interpretation was
questioned in a 1983 paper (Temple NJ. Med Hypotheses. 1983. 10. 425-435).
prospective cohort studies show a correlation between saturated fat
consumption and risk of coronary artery disease
studies include the Nurses’ Health Study in 80,082 women (N Engl J Med. 1997. 337. 1491-1499) and
the Ireland Boston Diet-Heart Study in 1001 men (N Engl J Med. 1985. 312. 811-818).
note, data from the Nurses’ Health Study indicates that replacing 5% of
energy from saturated fats with energy from nonhydrogenated,
unsaturated fats could reduce the risk of CHD by 42% (N Engl J Med. 1997. 337. 1491-1499).
data supporting a link between saturated fat consumption and risk of
coronary artery disease comes from cross-population studies such as the
Japan-Honolulu-San Francisco Study in 11,900 men (J Chronic Dis. 1974. 27. 345-364).
is however data that fails to show an association between saturated fat
consumption and risk of coronary artery disease
terms of cross cultural data, in two Polynesian populations living near
the equator, saturated fat intake is very high, estimated at 47% of
total energy, mostly from coconut, but vascular disease is uncommon (Am J Clin Nutr. 1981;34:1552-1561).
observed association between saturated fat consumption and risk of
coronary artery disease in many studies may be a function on how the
foods are prepared. Specifically, the association between saturated fat
consumption and risk of coronary artery disease might be a function
advanced glycation end products and cholesterol oxides which form during
the cooking and processing of foods such as dairy and meat (cited by
Alan Gaby, MD in a Commentary in Townsend
Letter. June 2010. Pg 24).
meta-analysis of 21
prospective cohort studies in a total of 347,747 subjects, and with 5 to
23 years of follow up failed to show a correlation between saturated fat
consumption and risk of coronary artery disease, stroke, or
cardiovascular disease, even when adjusted for age, gender, and study
quality (Am J Clin
Nutr. 2010. 91. 535-546).
meta-analysis of 7 RCTs
(n=11,275) with follow up of 2-8 years reported that replacing saturated
fatty acids with omega 6 polyunsaturated fatty acids (3 trials) or mixed
omega 3/omega 6 polyunsaturated fatty acids did not reduce all cause or
coronary heart disease mortality (the substitution of mixed omega
3/omega 6 polyunsaturated fatty acids was associated with a 20%
reduction of cardiovascular mortality, NNT of 32) [BMJ. 2013. 346. e8707).
meta-analyses of prospective epidemiologic studies fail to find an
association between saturated fatty acid intake and CVD mortality (J Clin Epidemiol. 1998. 51. 443-460; Am J Clin Nutr. 2010. 91. 535-546).
meta-analysis of 16 long-term cohort studies found a reduction in risk
of all-cause death, ischemic heart disease, stroke, and diabetes in
those individuals with the highest dairy consumption, relative to those
with the lowest dairy consumption (Eur J Nutr. 2013. 52. 1-24).
March 2014 meta-analysis of nearly 80 studies involving more than a half
million subjects, published in the Annals
of Internal Medicine, fail to report an association between
saturated fat intake and cardiovascular disease (as cited in Time. Don’t Blame Fat. 6/23/14.
meta-analysis of 16 observational studies reported that high-fat dairy
intake was inversely associated with adiposity, and was not associated
with diabetes or CVD (Lipids.
2010. 45. 925-939).
fat consumption and cholesterol levels
is “conventional wisdom” that saturated fat raises LDL cholesterol. This
conclusion is supported by a published meta-analysis of 27 trials (Arterioscler Thromb.
1992. 12. 911-919). Saturated fats in butter and other dairy products have
the most detrimental effect on LDL cholesterol, saturated fats in meat
have a less detrimental effect, and saturated fats in chocolate have the
least detrimental effect on LDL, as per Walter Willett (Eat, Drink,
and Be Healthy. 2001). Stearic
acid (the fat in chocolate) is rapidly converted into oleic acid, a
the effect of high intake of saturated fatty acids on serum cholesterol
is weak and transient in some clinical studies (J Clin Epidemiol.
1998. 51. 443-460); and 10 RTs or crossover trials have found that a high
intake of saturated fatty acids, as high as 50% of total caloric intake,
has minimal effect on total or LDL cholesterol (Ravnskov
U. Is Saturated Fat Bad? In Modern
Dietary Fat Intakes in Disease Promotion. New York, NY. Humana Press.
saturated fat intake predominantly increases large, buoyant LDL levels,
and this large, buoyant LDL seems to have a neutral effect on
cardiovascular risk, whereas small, dense LDL (increased by high carbohydrate
intake) is associated with increased cardiovascular risk.
fat also raises HDL cholesterol levels.
that the butyric acid in butter, which is a short-chain fatty acid, plays
a critical role from an energy standpoint in supporting the colonic
wisdom - it is best to take less than 10% of calories from saturated fat.
avocados, canola oil, olives, olive oil, and various nuts and seeds.
oil is composed primarily of oleic acid, and omega 9 fatty acid.
fat intake is associated with lower levels of LDL and total cholesterol,
protection against thrombogenesis, reduced LDL
susceptibility to oxidation, and better glycemic control (J Nutr.
1999. 129. 2280-2284). In a 12 week crossover trial in 26 college
students, those consuming a high monounsaturated fat diet showed less
lipid peroxidation than those consuming a high polyunsaturated fat diet (Am J Clin Nutr. 1991. 53. 899-907).
fat consumption is correlated with a decreased risk of coronary heart
disease, based on data from prospective cohort studies such as the Nurses’
Health Study in 80,082 women (N Engl J Med. 1997. 337. 1491-1499), cross
population studies such as the Seven Countries Study in 12,770 men (Circulation. 1970. 41 [4 suppl]. 1-198), and epidemiologic studies such as the
Coronary Mortality in France
study (Circulation. 1993. 88.
2771-2779). HOWEVER, a systematic
review and meta-analysis of observational and RCT trial data concluded “we
saw a null association of total and individual monounsaturated fatty acids
with coronary risk in studies using both dietary intake and circulating
fatty acid composition. This apparent lack of association is consistent
with available mechanistic data, which remain contradictory about whether
monounsaturated fatty acids promote or protect against atherosclerosis” (Ann Intern Med. 2014. 160.
monounsaturated fat created by hydrogenation of polyunsaturated fat (i.e.
stick margarine) is unhealthy because hydrogenation creates
trans-configuration fatty acids (see ‘trans fats’ below).
Polyunsaturated fats (PUFA) – these are essential; they
cannot be synthesized in the human body (a fact known since 1929)
3 fatty acids
are found in fish in the form of EPA (eicosapentanoic
acid) and DHA (docosahexanoic acid) and in
vegetable sources in the form of ALA
(alpha linolenic acid).
- ALA is a short chain fatty acid and EPA and DHA
are long chain fatty acids - in the human body, only about 15% of ALA is converted
to EPA and only about 5% to DHA, and there are a number of identifiable
factors which can inhibit this conversion even further (Am J Clin Nutr. 1999. 70. 560S-569S; Curr Opin Clin Nutr. 2004. 7. 137). Conversely, GLA may facilitate
conversion of ALA
- Omega 3 fatty acid content of fish
(grams EPA + DHA per 3 ounce serving) - atlantic
salmon (1.8), atlantic herring (1.7),
whitefish (1.4), pink canned salmon (1.4), bluefin
tuna (1.3), atlantic mackerel (1.0), wild
rainbow trout (1.0), bluefish (0.8), sardines canned in oil (0.8), blue
mussels (0.7), swordfish (0.7), white tuna canned in water (0.7),
freshwater bass (0.6). See Consumer Reports 7/03 page 32 for a complete listing of
other fish with lesser amounts of DHA (docosahexanoic
acid) and EPA (eicosapentanoic acid).
3 fatty acid content in vegetable sources (7.6 grams ALA
per tablespoon of flax oil, 1.6 grams ALA
per tablespoon of canola oil, 1.5 grams of ALA
per tablespoon of walnut oil, 2.1 grams of ALA per 3.5 ounces cooked soybeans).
of action of omega 3 polyunsaturated fatty acids (PUFAs) Consumer
- Antiarrhythmic - they may
electrically stabilize the heart muscle cells and thus reduce the risk
of sudden death due to an arrhythmia.
This protection may be effective only for arrhythmia induced by
- Anti-inflammatory - they are
converted into anti-inflammatory eicosanoids (prostaglandins and
leukotrienes), and thus may stabilize arterial plaque. EPA inhibits D5D
enzyme which converts DGLA to arachidonic acid. In a primary
prevention trial, those patients treated with 1.4 grams of fish oil
daily showed significant decrease in inflammatory markers hsCRP, TNF alpha, interleukin-6, and leukotriene B4,
as compared with placebo (Micallef MA et. al. Atherosclerosis. 9/27/08. epub).
- Antithrombotic - they may
decrease the stickiness of platelets, reducing the risk of forming a
blood clot. Decrease fibrinogen and decrease blood viscosity.
- Antiatherosclerotic - they may make the arteries
more elastic, reducing the risk of high blood pressure triggering plaque
rupture. They may also stabilize plaque - data from a RCT in 188
patients randomized to receive sunflower oil versus fish oil supplements
prior to a scheduled carotid endarterectomy found that those who
received the fish oil had had thicker fibrous caps covering the carotid
plaque (Lancet. 2003. 361.
- Improve endothelial function.
- Improved systemic arterial compliance.
- Increase vasodilatation.
- They may increase heart rate
variability (Chest. 2005. 127.
- High doses reduce the serum
triglyceride level, raise HDL, decrease Lp (a), and increase particle
size of LDL.
- Decrease free radical production.
- DHA lowers blood pressure.
- DHA reduces insulin
resistance in overweight patients, and appears to improve cell membrane
receptor function and signal transduction.
- Anti-cancer effects – reduce
inflammation, reduce angiogenesis, decrease oncogenes, induce cell
differentiation, suppress NFKB, suppress apoptosis blocker bcl-2, reduce
cachexia (J Nutr.
2002. 132. 3508S-3512S).
therapeutic uses of omega 3 fatty acids, including supplements, return to
Home Page, click on “Dietary Supplements” and scroll to ‘Fatty acids’
then scroll on to ‘Fish oil capsules.’
6 fatty acids
are found primarily in vegetable oils (corn, safflower, sesame, soy, and
oils are added to many baked goods and prepared foods.
are now fed soy meal and corn meal, often rather than grazing, so the fat
in animals is composed of predominantly omega 6 fatty acids.
pasture raised animals are likely to have more omega 3 fatty acids and
less omega 6 fatty acids than animals fed corn meal or soy meal.
(linoleic acid) is the fatty acid which is the biochemical precursor to
all other omega 6 fatty acids in the body.
- Omega 6 fatty acids can be converted
either into pro-inflammatory or anti-inflammatory eicosanoids, with
research ongoing to determine factors which influence which biochemical
pathway is followed.
- There is controversy regarding whether
higher intake of omega 6 fats is good or bad:
tens of thousands of years ago, it is estimated that the dietary intake
of omega 6 polyunsaturated fatty acids to omega 3 polyunsaturated fatty
acids was 2:1 or even 1:1, with 25-50% of protein derived from
aquatic sources. Data to support
this 1:1 ratio includes carbon and nitrogen isotope measurement of femur
collagen, paleoarcheological samples, dental
wear patterns, cave art, and artifacts (Richards et al. Proc Natl Acad Sci. 2001). The ratio of omega 6 to omega 3
in the standard American diet is estimated at 20:1 (Am J Clin Nutr.
1999. 70. 560S-569S). An optimal ratio of omega 6 to omega 3 fatty
acids is believed to be 4:1 (Am
J Clin Nutr.
1999. 70. 560S-569S).
- There is evidence that omega 6 fats
promote inflammation, thrombosis, and insulin resistance (Lipids. 2001. 36. 1007-1024; Ann N Y Acad
Sci. 1997. 827. 287-301; Eur J Clin Invest. 1997. 27. 780-787).
- Administration of omega 6 fatty acids
removes EPA from cell membranes, relocating EPA from phospholipids to triacylglycerols (J Lipid Res. 1992. 33. 1431-1440). Evidence suggests that EPA must be
incorporated into cell membrane phospholipids in order to exert its
beneficial effect on eicosanoid metabolism.
- There is competing evidence that
linoleic acid decreases thrombosis (Am
J Clin Nutr.
1997. 65. 1687S-1698S), decreases arrhythmias (Am J Clin Nutr.
1991. 53. 1047S-1049S), and improves insulin sensitivity (Diabet Med. 2002. 19. 456-464).
- In a population-based cohort of 1551
middle-aged men whose dietary composition was estimated with a 4-day
food record, linoleic acid intake was correlated with a cardioprotective benefit over a 15-year follow-up (Arch Intern Med. 2005. 165.
- A review of the evidence article
concludes that “the relevance of the
concept of omega 6: omega 3 ratio to CHD risk is unclear” (Altern Ther
Health Med. 2005. 11(3). 24-30).
first step, and also the rate limiting step, in biochemical conversion of
both ALA and LA into longer chain fatty acids is catalyzed by the D6D
enzyme - this enzyme requires zinc, magnesium, and vitamins B3, B6, and C
as cofactors. Furthermore, hypercholesterolemia, trans fats, and
excess sugar consumption impair D6D function (Nutr Clin Pract.
1992. 7. 179-186).
polyunsaturated fats are biochemically unstable - exposure to heat or air
or light cause biochemical breakdown of the fat and free radical chain
reactions which may predispose one to atherosclerosis or cancer, and may
increase the risk of inflammatory diseases, degenerative diseases, and
immune system disorders. For
information on how to prevent biochemical breakdown of polyunsaturated
fatty acids, scroll down in this outline to ‘Oils.’
conjugated linoleic acid, is a trans chemical configuration
polyunsaturated fat found in small amounts in meat and dairy products
which shows promise as a dietary supplement in reducing body fat (Am J Clin Nutr. 2004. 79. 352), increasing muscle mass, and
possibly preventing cancer.
of the isomers acts like ALA,
a polyunsaturated fat which inhibits the enzyme responsible for synthesis
of precursors of both pro-inflammatory and anti-inflammatory eicosanoids.
one of the isomers in the
synthetic version (i.e. dietary supplement) causes an increase in insulin
resistance in humans, as per Barry Sears, PhD (The Anti-Inflammation Zone. 2005. Pg
Trans (chemical configuration) fats
discovered in late 1800’s; exist in very small quantities naturally in
dairy and meat products from cows, goats, sheep, and other ruminants (i.e.
trans-fats – introduced by Proctor and Gamble in 1911 (Perspective. N Engl J Med.
2014. 370. 1773-1775).
which is chemically altered either as part of the manufacturing process
or by repeatedly heating cooking oils past their smoking point. Trans
fatty acids are made by adding hydrogen to polyunsaturated oil molecules
(usually omega 6 fats) under high temperature and pressure. Nickel is typically used as a catalyst,
then removed by filtration at the end of the manufacturing process. The end result chemically is that
hydrogen atoms end up on opposite sides of the fatty acid molecule at the
site of a double bond. This alters
the structure of the fatty acid (individual molecules elongate and pack
closer to one another) and this alteration of structure at a molecular
level interferes with the function of the fatty acids in the cell membrane
(i.e. altered receptor structure interferes with cell signaling).
hydrogenation was patented in 1903; Crisco in 1911 was the first product
marketed with artificial trans fats (Perspective. Ann Intern Med. 2009. 151. 129-134).
the turn of the century, 79% of US trans-fat consumption is artificial
trans-fats; 21% is from meat and dairy (FDA Consum. 2003. 37. 20-26).
2005 in the North America, 25 billion
pounds of edible oils were consumed, and more than 9 billion of these
were artificial trans fats (Circulation.
2007. 115. 2231-2246).
that manufacturers use trans fatty acids
shelf life (i.e. delays rancidity).
a solid out of a semi-solid (i.e. margarine).
during deep frying.
cookies and crackers and baked goods it is less expensive for the
manufacturer to create trans fats than to use saturated fats.
some snack foods, market research shows that the trans-fat is associated
with good taste or ‘mouth feel.’
fats in the food supply
fats are found in many snack foods, some margarines, some peanut butter
spreads, some breads, and some dry cereals.
fast food products in restaurants may contain 10 grams of trans fat per
2000, estimated that trans fats compose 3% of calories in standard
American diet, which corresponds to 6 gm/day in an individual consuming
2000 calories per day.
it was thought that using trans-fats (i.e. margarine) in place of
saturated fat (i.e. butter) would be of benefit to individuals; it was
hoped that trans fats would have the same favorable effects on lipid
profile as natural unsaturated fats.
Scientists have known for years though that this notion was
incorrect - trans fats increase LDL cholesterol levels as much as
saturated fat, but also lower HDL cholesterol levels, whereas saturated
fat typically raises HDL, so the effect of trans fats on the lipid profile
is double the bad effect of saturated fat (N Engl J Med. 1999. 340. 1994-1998).
effects of trans fats – studies in the early 1990’s began to reveal
harmful health effects, and by mid-2000’s it became clear from scientific
study that trans-fats had a number of deleterious health effects
(Perspective. N Engl
J Med. 2014. 370. 1773-1775).
fats increase lipoprotein a, raise LDL cholesterol, raise triglycerides,
and lower HDL cholesterol (N Engl J Med. 1990. 323. 439-445; J Lipid Res. 1992. 33. 399-410; Am J Clin Nutr. 1994.
59. 861-868; N
Engl J Med. 1999. 340. 1933-1940; J Nutr. 2001. 131. 242-245; Am J Clin Nutr. 2003.
fat intake increases hs-CRP (J Nutr. 2005. 135. 562-566).
fats may be associated with activation of systemic inflammatory responses
and endothelial dysfunction (Atheroscler
Suppl. 2006. 7. 29-32).
fats may increase the risk of becoming obese, via binding to PPAR nuclear
receptors (Hyman M. Ultrametabolism. 2006).
fats interfere with B and T cell functions, impairing immune system
fats increase insulin resistance, and increase the risk of developing
fats may interfere with fertility.
fats interfere with normal cell membrane function.
data shows that a diet high in trans fats is associated with a
significantly increased risk of coronary heart disease. A 2% increase in
the energy intake from trans-fat is correlated with a 14-36% increase in
the incidence of coronary heart disease – 14% in the ATBC Cancer
Prevention Study in 21,930 male smokers (Am J Epidemiol. 1997. 145.
876-887), 28% in the Zutphen Elderly Study in
667 men (J Nutr.
2001. 131. 242-245), 33% in the Nurses’ Health Study in 80,082 women (N Engl J Med. 1997. 337. 1491-1499), and
36% in the Health Professionals Follow-Up Study in 43,757 men (Lancet. 2001. 357. 746-751). Data
from the Nurses’ Health Study in 80,082 women indicates that replacing 2%
of energy from trans fats with energy from nonhydrogenated,
unsaturated fats could reduce the risk of CHD by 53% (N Engl J Med.
1997. 337. 1491-1499). For more information on trans fats and coronary
heart disease, return to the Home Page and go to the outline on
‘Prevention of MI’ and the first section on ‘Primary Prevention.’
data shows that a diet high in trans-fats is associated with an increased
risk of cancer.
of trans fats (Perspective. N Engl J Med. 2014. 370. 1773-1775).
banned partially hydrogenated oils in 2003
2006, NYC passed a ban on trans fats in restaurant foods
1/1/06 (based on a 1999 FDA ruling), the trans-fat content of all foods
is included in the ‘Nutrition Facts’ box on the label.
2008, California passed a ban on trans fats in restaurant foods
2014, the FDA has proposed a regulation which would declare partially
hydrogenated oils unsafe (not GRAS), and thus they would need to be
regulated as a food additive rather than a food. If implemented, the
effect of this regulation would be to allow only a small amount of trans
fats in food
caveat is that the FDA allows foods with less than ½ gram of trans fat
per serving to list 0 grams of trans fat in the ‘Nutrition Facts’ box.
with less than ½ gram of trans fat per serving still must show this
information in the ingredients list – look for the terms ‘partially
hydrogenated vegetable oil’ or ‘vegetable shortening’ in the ingredients
by chemically inserting saturated fatty acids into the molecular backbone
of vegetable oil to make it more stable (Consumer Reports on Health. 1/09. Pg
manufacturers are using this form of fat in place of trans-fats; it is
unclear though whether interesterified fat is
any less harmful than trans-fat.
carbohydrates like white flour and polished rice are acceptable
alternatives in the diet to whole grains - they are just as good as
only disadvantage of refined carbohydrates is that they don't have the
additional fiber and vitamins.
wisdom - the form of the carbohydrate is very important:
carbohydrates like white flour and polished rice can deplete the body of
nutrients and they temporarily raise insulin levels, which then leads to
a drop in blood sugar and hunger a few hours later. Refined carbohydrates
and sugar may also suppress immune system function.
insulin level at a given instant determines the ratio of fat to
carbohydrate used in the fuel mix for most cells in our body - the higher
the insulin level, the more carbohydrate in the fuel mix. The less
fat in the fuel mix for the cells, the more dietary fat is converted into
fat stores in the body (i.e. adipose tissue).
have learned that the glycemic index of carbohydrates is very
important. For information on the glycemic index of specific foods,
go to www.glycemicindex.com.
food sources of carbohydrate include fruits and vegetables and grains -
grains are generally more calorie dense than fruits and vegetables (i.e.
more calories per unit size) and thus it is easier when consuming grains
to inadvertently consume excess calories.
of carbohydrates - energy source, structural element in plant cell walls,
structural element in myelin sheath of nerves, cell adhesion, cell
development and differentiation, and cell to cell communication.
classification of carbohydrates.
- 1 saccharide.
- 2 saccharides.
- more than 10 monosaccharides.
of carbohydrates as simple versus complex carbohydrates.
chemical meaning - simple refers to monosaccharides and disaccharides,
complex refers to polysaccharides (this classification does not account
many years it was automatically assumed that starches would be slowly digested
and absorbed, and a few simplistic experiments on raw starches and pure
sugars supported this assumption, so for decades this was taught as fact
in nutrition courses.
classification of carbohydrates as simple versus complex is not
meaningful from a physiologic perspective.
"simple" monosaccharides can have a very complex metabolic
have known since the 1980's, when scientists finally started to study
the actual blood-glucose response to common foods (i.e. how the
carbohydrates in food change the blood sugar level), that many complex
carbohydrates have a greater short term effect on raising the blood
sugar than do "simple" disaccharides.
classification of carbohydrates
- monosaccharides and disaccharides, including glucose, galactose,
fructose, maltose (glucose + glucose), sucrose (table sugar: glucose +
fructose), and lactose (milk sugar: glucose + galactose).
– 6 carbon sugar, consumption of which potentially stimulates insulin
secretion, promoting glycogen synthesis in the liver and glucose uptake
by tissues throughout the body.
(Viewpoint. JAMA. 2013. 310.
carbon sugar; more than twice as sweet as glucose.
concentrated in honey, fruits, and some vegetables).
does not directly stimulate insulin secretion and the consequent
increase in leptin, a satiety hormone.
is taken up almost exclusively by the liver, and rapidly undergoes
does not require insulin for absorption into cells – once inside the
cells it becomes an uncontrolled source of carbon (acetyl Co-A).
is a highly reactive reducing sugar, and therefore promotes the
formation of advanced glycation endproducts.
studies show adverse metabolic effects associated with intake of
fructose – these studies have been criticized for providing
unrealistically high amounts of fructose in isolation, and thus the
significance of findings from feeding studies is questionable. A
meta-analysis found no adverse effects of isocaloric
substitution of fructose and glucose at average consumption levels for
body weight (Adv Nutr.
2013. 4. 246-256).
fructose in fruits and vegetables is not considered problematic because
the fiber in fruits and vegetables markedly slows absorption of the
fructose from the GI tract. Observational studies show an inverse
association between fruit consumption and body weight or obesity
associated diseases (J Hum Hypertens. 2007. 21. 717-728).
fructose corn syrup (HFCS)
AR. Adverse effects of dietary fructose. Altern Med Rev. 2005. 10. 294-306.
- Sievenpiper JL et al. Effect of fructose on body
weight in controlled feeding trials. Ann Intern Med. 2012. 156. 291-304.
from 1970 to 1997, annual per capita consumption of high fructose corn
syrup (HFCS) increased from 0.5 pounds to 62.4 pounds, while sucrose
consumption decreased from 102 pounds to 67 pounds per year.
of HFCS may be more detrimental than intake of sucrose.
a study of 48 young, generally healthy adults, comparing consumption of
25% of daily energy as beverages sweetened with high-fructose corn
syrup, as compared with 25% of daily energy as glucose, those consuming
the high-fructose corn syrup showed a 40% increase in postprandial
triglycerides at 2 weeks (J Clin Endocrinol Metab. 2011. 96. 1596-1605).
of high fructose corn syrup is strongly correlated with fatty liver,
hypercholesterolemia and hyperlipidemia – this may be a causal
be contaminated with mercury, as a consequence of chlor-alkali
products used in its manufacturing (Environ
Health. 2009. 8. 2).
(table sugar). Sucrose is a disaccharide of glucose and fructose.
contains 97% monosaccharides (55% fructose, 42% glucose).
sucrose requires hydrolysis by a gut disaccharidase
before its components are absorbed, the fructose and glucose in HFCS
are presumably absorbed more rapidly. In the presence of even small
amounts of glucose, the absorption of fructose is markedly enhanced,
through facilitated transport.
protest from the food lobby, the World Health Organization in 2002
recommended that a healthful diet should contain no more than 10% of
calories from sugar that are not inherently part of a food (i.e. lactose
in milk, fructose in fruit). This 10% figure corresponds to 50
grams (13 teaspoons) in a 2000 calorie diet - the average American eats
more than twice that much sugar!
labels do not distinguish between intrinsic sugar in foods like fruits
and extrinsic sugar which is added. Ingredients which indicate added
sugar include "corn syrup, crystalline fructose, dextrose,
fructose, fruit juice concentrates, glucose, high-fructose corn syrup,
high-maltose corn syrup, honey lactose, invert sugar, lactose, malt,
maltose, molasses, sucrose, syrup" (Consumer Reports. 1/04. 12-16).
that over 200 monosaccharides occur naturally in plants, but the human
body is known to use fewer than 10.
only monosaccharides commonly included in the current Western diet are
glucose, fructose, and galactose - the others can be synthesized from
these two in the human body, but many factors may interfere with
important monosaccharides from a functional perspective include mannose,
fucose, xylose, N-acetylglucosamine,
N-acetylgalactosamine, and N-acetylneuraminic acid.
- 2 to 10 saccharides.
is a food that may have drug-like effects in some people.
is intertwined with our psychology - it is often a reward.
is ‘empty calories’ – it dilutes nutrient levels in the diet.
health experts believe that sucrose causes immune system suppression.
Ingestion of 100 grams (25 teaspoons) transiently reduces neutrophil
phagocytosis (Am J Clin Nutr. 1973. 26.
may reduce HDL cholesterol levels; increase serum triglycerides, uric
acid, cortisol, and blood pressure; and increase platelet aggregation
and fasting serum insulin - this occurs in about one-third of the
population (Postgrad Med J.
1969. 45. 602-607; Ann Nutr Metab. 1983. 27.
intake may exacerbate chronic candidiasis in sensitive individuals.
sensitive individuals, high sucrose intake contributes to anxiety,
depression, fatigue, migraines, PMS, and tension headaches
fructo-oligosaccharides (FOS), galacto-oligosaccharides, and soy oligosaccharides.
- Fructo-oligosaccharides (FOS) and galacto-oligosaccharides escape degradation in the
upper GI tract and travel to the large intestine where they selectively
support the growth of friendly bacteria which break down undigested carbohydrates
into short chain fatty acids which supply 70% of the energy used by the
colonic epithelial cells.
- Fructo-oligosaccharides are breakdown products from
inulin, which is a polysaccharide composed of repeating fructose units
with a terminal glucose unit.
proteins have oligosaccharide side chains – see ‘glycobiology’
below for more details on the function of oligosaccharides in
which function as the predominant food reserve in plants.
labeled as either amylose (straight chain glucose polymers) or
amylopectin (branched-chain polymers of glucose).
is less susceptible to digestion than amylopectin due to the tight
labeled as either rapidly digestible starch, slowly digestible starch,
or resistant starch, based on the amount of amylase versus amylopectin –
glycemic index is highest for rapidly digestible starch.
starch when acted upon by friendly bacteria in the colon produces short
chain fatty acids (propionate, acetate, butyrate) which supply fuel for
colonic epithelial cells.
essential carbohydrates - humans can synthesize all of the
carbohydrates we need to live, so no carbohydrates are essential in the
diet. HOWEVER, the amount of certain sugars such as fucose, mannose, and xylose in the diet is often less
than required for optimal biochemical functioning in many individuals, so
these nutrients may be classified as conditionally essential. See ‘glycobiology’ just below for more information on the
eight saccharides believed to play an important role in cell-to cell
Glycemic index (www.glycemicindex.com)
carbohydrate molecules (polysaccharides) not broken down by human
digestive enzymes (i.e. indigestible).
is distinguished from starch in that it is a component of cell walls in
in the colon by bacteria - produces methane gas (flatulence) and
short-chain fatty acids which are the energy source for colonic
fiber - can be dissolved in water (i.e. forms a colloidal suspension in
gums, some pectins, some hemicellulose.
found in fruits, vegetables, and nuts.
gastric emptying, increases satiety, decreases cholesterol, glucose,
and insulin levels.
with resistant starch (see above) serves as fuel for colonic epithelial
fiber - cannot be dissolved in water (i.e. does not form a colloidal
suspension in water).
some hemicellulose, some pectins, some lignins.
found in cereal.
fecal bulk, binds toxins and bile salts, and decreases the risk of
constipation, diverticulosis, and possibly hemorrhoids and colon
resistant starch, acted upon by friendly bacteria in the colon and
degraded to short chain fatty acids (propionate, acetate, butyrate)
which supply fuel for colonic epithelial cells.
the categorization of fiber by the foods that contain it (i.e. cereal
fiber, fruit fiber, vegetable fiber) used in many epidemiological studies
is not nearly as meaningful from a functional standpoint as the
classification of fiber as either soluble or insoluble.
that konjac root fiber (glucomannan)
and rye fiber appear more potent at lowering cholesterol and blood sugar
than wheat fiber, psyllium, oat fiber, or guar gum. Konjac
root and rye fiber are sometimes referred to as ‘superfibers.’
National Cancer Institute recommends 25-35 grams per day of fiber in the
consumption of fiber averages 50-75 grams per day.
in the Paleolithic diet estimated at 100-150 grams per day.
studies indicate that consumption of 75-100 grams of fiber per day may
consumption in the U.S.
is less than 10 grams per day.
tablespoon of Metamucil contains 3 grams of fiber - 2.4 grams of this
is soluble fiber.
must increase water intake when one increases fiber intake, or the
increased fiber can actually worsen constipation.
the amount of fiber in the diet gradually to avoid GI distress.
intake can affect estrogen status – higher fiber intake is associated
with higher serum concentrations of SHBG (and thus less free estrogen)
and higher fiber intake is associated with decreased activity of beta-glucuronidase (and thus less enterohepatic
recirculation of estrogen).
that fiber may be antigenic (i.e. gluten intolerance).
that fiber will interfere with absorption of vitamins and minerals
consumed at the same time.
- Fiber and health outcomes
fiber intake was associated with a significantly
lowered risk of total mortality
in both men and women, in the NIH-AARP Health Study, during an average
of 9 years of follow up in the cohort of 569,167 AARP members, aged
50-71. Dietary fiber intake was associated in this study with lower risk
of death from cardiovascular disease, infections, and respiratory
disease (and, in men only, cancer). Dietary fiber intake from grains
was more highly correlated with improved health outcomes than dietary
fiber intake from other sources (Arch
Intern Med. 2011. 171. 1061-1068 and invited commentary 1069-1070).
fiber intake lowers serum cholesterol levels, lowers blood pressure,
lowers blood sugar via improved insulin sensitivity, and promotes
weight loss (Nutr Rev. 2009. 67. 188-205; Arch Intern Med. 2007. 167.
956-965; J Hypertens.
2005. 23. 475-481; Am J Clin Nutr, 1999. 69.
based measure of carbohydrate quality - a comparison of carbohydrates
based on their immediate effect on blood glucose levels.
glycemic index measures the rate of digestion.
first defined in 1981 (Jenkins DJ et al. Glycemic index of foods: a physiological
basis for carbohydrate exchange. Am
J Clin Nutr.
1981. 34. 362-366) and first glycemic index tables completed in 1995.
most foods, the glycemic index correlates well with the insulin index of
the food. Dairy products are an exception.
of the glycemic index
amount of food containing 50 grams of carbohydrate is given to a
volunteer to eat.
glucose is measured at 15, 30, 45, 60, 90, and 120 minutes, and the
area under the curve of time versus blood glucose is measured using a
response is compared to that volunteer's response to 50 grams of
glucose. The glycemic index of 50 grams of glucose is arbitrarily
set at a value of 100.
reference food is tested on several separate occasions and an average
value is calculated for that individual.
average glycemic index values in 8-10 individuals are then averaged to
determine the glycemic index value of the food.
that some glycemic index charts use a 50-gram carbohydrate portion of white
bread as the reference food with a value of 100 - it is possible to
convert from the glucose scale to the white bread scale using the factor
0.7 (i.e. the glycemic index of white bread is 70 when the glycemic index
of 50 grams of glucose is set at 100).
the glycemic index of a meal can be calculated as long as one has access
to food composition tables to determine the amount of carbohydrate in
each item in the meal - this calculation is demonstrated on page 36 of The New Glucose Revolution (2003). There is some controversy however about
the validity of this measurement.
that the glycemic index of
any given food may vary somewhat based on the ripeness, method of
preparation used, growing conditions, number of times reheated.
that the glycemic index is only one factor to consider in determining
whether a food is healthy.
which influence the glycemic index value of a food
gelatinization - the less gelatinized (swollen) the starch, the lower
the glycemic index. Al dente spaghetti has a lower glycemic index
than overcooked spaghetti.
entrapment - the fibrous coat around beans and seeds slows digestion
because it takes more time for digestive enzymes to access the starch
inside the fibrous coat.
amylose to amylopectin ratio - amylose is a straight chain starch and
absorbs less water than the branched chain amylopectin, and thus is
digested more slowly.
size - finely milled flours with a small particle size have a higher
glycemic index because it is easier for water and enzymes to
penetrate. Thus finely ground wheat fiber, such as is found in
whole wheat bread, has a glycemic index similar to its white
of fiber - viscous fiber has a lower glycemic index.
- foods with sugar actually have a somewhat lower glycemic index because
half of the sugar molecules are fructose.
- this slows down gastric emptying and is thus associated with a lower
- this also slows gastric emptying.
- this also slows gastric emptying.
glycemic index is a clinically proven tool in its applications to
diabetes and appetite control (but not coronary health).
low glycemic index diet in diabetics leads to better control of blood
of high glycemic index foods leads to a transient high insulin level and
this drives blood sugar down and increases appetite. Conversely,
consumption of low glycemic index foods promotes weight loss in
overweight people by delaying hunger pangs.
low glycemic index diet reduces oxidative stress in the coronary
arteries. In the Nurses' Health Study, those with a BMI over 23
who ate lots of high glycemic index foods had twice the rate of heart
attack as those eating low glycemic index diets (The New Glucose Revolution. 2003. pg
meta-analysis of 8 prospective studies (n=220,050), with prespecified subgroup analysis, concludes that high
dietary glycemic index and glycemic load significantly increased the
risk of CHD in women but not in men, with more pronounced effects
observed in overweight and obese patients (Am J Cardiol. 2012. 109.
trial – OmniCarb trial – this was a 5 week
randomized crossover-controlled feeding trial of 163 overweight adults.
In this trial, low glycemic index diets were not associated with
improvements in insulin sensitivity, lipid levels, or systolic blood
pressure, as compared with high glycemic index diets (JAMA. 2014. 312. 2531-2541 and
as the (glycemic index x grams of carbohydrate per serving) divided by
value is more helpful in predicting the effect of a particular food on
blood glucose level.
example, carrots have a relatively high glycemic index value of 47, but a
low glycemic load value of 3 because there is relatively little
carbohydrate in an average serving of carrots.
from animal sources (i.e. meat and milk products) is preferable to
protein from vegetable sources because vegetable protein is
"incomplete," meaning that it does not contain all 8 essential
meat is preferable to red meat because the bad saturated fat is mostly in
the skin rather than in the meat itself. Thus one can avoid excess
saturated fat by eating skinless chicken or turkey.
vegetable protein is not a problem as long as one eats a variety of
vegetables and grains and legumes over the course of a day, because the
combination of these foods provides all 8 essential amino acids; the body
does not actually need all 8 in the diet at the same meal.
meat provides us with excess arachidonic acid - this fat is converted to
prostaglandins which promote inflammation in the body.
is an excellent source of protein because the fat in the fish is a healthy
omega 3 fat.
(beans, peas, lentils, soy products) are excellent sources of protein
because they also have lots of fiber and phytochemicals.
and seeds are excellent sources of protein because they also have lots of
fiber and minerals and monounsaturated fat.
protein is less atherogenic than animal-based
protein, and this seems to be a function of the arginine: lysine ratio,
which is higher in plant-based protein.
of vegetable protein – not as easily digestible and totally lacking in
the conditionally essential amino acid taurine (Shealy
N. Life Beyond 100. 2005. pg 82).
acid classification (biochemical)
base, aliphatic, aromatic, based on side chain. Proline has a
chain amino acids (leucine, isoleucine, valine) – differ metabolically
from all other amino acids.
building blocks of protein - human proteins are composed of 20
biochemically distinct amino acids.
communication – connexins
are amino acid chains which aggregate to form tunnel-like structures
which embed themselves in cell membranes and facilitate intercellular
communication (Tanelian DL. Molecular Fitness: The Connexin Connection to Optimal Health).
processes - creatine, carnitine, betaine, taurine, ornithine, and citrulline are amino
acids which are not used as building blocks of protein, but are
nonetheless important in human metabolism. Many essential amino acids are also
important in metabolic processes.
is a methyl donor in many biochemical pathways, including conversion of
homocysteine to methionine.
and betaine are also methyl donors. Methylation of DNA is one of the
mechanisms of controlling DNA expression.
is a sulfur donor for one of the Phase II detoxification pathways.
- Gycine, serine, taurine, and glutamine are important
in Phase II detoxification.
is important in the synthesis of nitric oxide, which is important in
branched chain amino acids can be oxidized completely in the
mitochondria to provide energy.
and carnitine play key roles in energy metabolism.
is an important nutrient for mucosal cells in the small bowel and also
important in regulation of acid/base balance.
is an excitatory neurotransmitter responsible for many neurological
of the 20 amino acids in human protein cannot be synthesized by humans,
and thus must be consumed in the diet.
amino acids such as taurine cannot be synthesized in quantities for
optimum metabolic functioning (i.e. detoxification) - these amino acids
are conditionally essential.
and proteoglycans – important in cell to cell recognition and adhesion.
contain 1-60% carbohydrate by weight, and have a sialic acid residue at
the end of each polysaccharide.
– 90-95% carbohydrate by weight, all of which is in the form of
glycosaminoglycan chains, which are polysaccharides with at least one
amino sugar and no sialic acid residues.
synthesized amino acids are all of the L form chemically, whereas
chemically synthesized amino acids are of the combined DL form. The
only D amino acids which the body can use are D-phenylalanine and
balance studies are the method of determining protein requirements - the
flaw is that this method assumes that all amino acids are equal in terms
of their importance to proper function in the body.
carbohydrates and fats which "burn clean" and break down into
carbon, hydrogen, and oxygen; protein produces nitrogen when it is
degraded, and this nitrogen must be metabolized by the liver into urea,
then eliminated by the kidneys. Thus protein in the diet taxes the liver
and kidneys. It is unclear whether this is harmful for a healthy
person, but this biochemistry is the basis of recommendations for those
with advanced kidney or liver disease to limit protein consumption.
is a diuretic; the kidney must excrete lots of water in order to excrete
effects of protein – ingestion of protein stimulates release of glucagon
from the liver. A delicate balance
must be maintained between insulin and glucagon to maintain a normal blood
sugar level and also to maintain the proper ratio of fat to glucose in the
bloodstream in terms of the brain depending on glucose for energy needs
while the body at rest derives most of its energy needs from fat.
plant protein intake is associated with lower rates of hypertension in
Cholesterol – go to Home Page and click on “Cholesterol”
of deceptive labeling. Plant products such as cooking oils do
not have cholesterol in them and never have had cholesterol in them.
Despite a bold NO CHOLESTEROL label, they are often loaded with unhealthy
- The trans fat and saturated fat content of the diet, and
possibly the amount of refined carbohydrate in the diet, is a much more
important determinant of blood cholesterol levels than the cholesterol
content of the diet (80% of total body cholesterol is synthesized in the
Chocolate (Altern Med Alert. 2005. 8. 138-142)
there has been a dual aspect to chocolate: chocolate as food and chocolate
chocolate has been primarily served as a beverage, including by the Olmecs, Mayans, and Aztecs.
is produced from seeds of a tropical tree, Theobroma cacao.
number of psychoactive compounds are found in chocolate
amines (tyramine and phenylalanine) –
sympathomimetic effects, stimulate dopamine release, MAY modulate mood.
- Methylxanthines (theobromine, caffeine, theophylline)
– competitive inhibitors of adenosine.
Adenosine facilitates sleepiness.
fatty acids (N-acetylethanolamine) – either
acts at cannabinoid receptors in the brain or potentiates anandamide.
cravings – research suggests that these are a function of the sensory
experience of consuming chocolate and not pharmacological factors (Physiol Behav.
1994. 56. 419-422).
is rich in a variety of minerals, especially copper, iron, magnesium,
potassium, and zinc.
ORAC value of dark chocolate is higher than that of blueberries, broccoli,
and kale. Dark chocolate possesses a higher polypenol
content per gram than wine, tea, or berries.
chocolate consumption and potential
health benefits. These benefits are attributed to the flavonoid
content of cocoa, specifically the polyphenol content, and more
specifically to the compound (-)-epicatechin (Proc Natl Acad Sci USA. 2006. 103.
effects (Am J Clin
Nutr. 2001. 74. 576-602).
blood clotting (J Am Coll Nutr. 2001. 20.
lowering effect (Hypertension. 2005. 46. 398-405; Arch Intern Med. 2006. 166.
411-417; JAMA. 2007. 298.
49-60), with benefit also reported in a meta-analysis of 5 trials (Arch Intern Med. 2007. 167.
HDL: LDL cholesterol ratio (Brit J Nutr. 2002. 88. 479-488).
cocoa has been shown to induce nitric-oxide dependent vasodilation (J Hypertens.
2003. 21. 2281-2286) and improve endothelial function (J Am Coll Nutr. 2004. 23. 197-204).
a randomized trial in 25 male smokers, 40 grams of polyphenol-rich dark
chocolate produced rapid improvement in endothelial and platelet function
(Heart. 2006. 92. 119-120).
meta-analysis of RCTs of chocolate, cocoa or cocoa flavan-3-ols
identified 42 trials (n=1297) reported reductions in diastolic BP,
reductions in fasting insulin, and improvements in flow mediated dilation
(Am J Clin
Nutr. 2012. 95. 740-751).
the food label and look for a cocoa content >60%, and make sure that
the label lists chocolate liquor, cacao, or cocoa as the first ingredient.
- Flavanol levels currently are not listed on the
and chemical reactions as cocoa is made tend to reduce flavanol content.
- CocoaVia is a dark chocolate bar made by Mar’s Corp.
and has a very high flavanol content and less
fat than an ordinary candy bar – 100 mg of flavonoids and only 80 calories
per 23 gram serving, compared with a typical chocolate bar with little
flavonoids and 250 calories per 43 gram serving. Bars cost about $1 per very small bar
and the bars are available in the healthy food section of grocery stores
and also at www.cocoavia.com.
contains several psychoactive substances – phenylethanolamine
(a stimulant) and methylxanthines (caffeine,
theobromine, and theophylline - stimulants).
- N-acetylethanolamine in chocolate prevents the
degradation of anandamide, an endogenous chemical which interacts with the
acid, a fat which represents approximately 30% of the fatty acids in
chocolate is a saturated fat, but does not raise the serum cholesterol (Am J Clin Nutr. 1999. 70. 951-952).
chocolate contains less cocoa than dark chocolate and more hydrogenated
fats, milk, or corn syrup. White
chocolate typically contains no cocoa at all.
may exacerbate migraines and GERD.
in large quantities can inhibit sulfation reactions, which are important
- Coffee and all-cause mortality
consumption is not associated with an increase in all-cause mortality,
with a trend noted toward a decrease, based on 24 years of data in 41,736
men the Health Professionals Follow-up Study and 86,214 women in the
Nurses’ Health Study. Coffee consumption in these cohorts was estimated
by self report (Ann Intern Med. 2008. 148. 904-914).
consumption is inversely associated with total and cause-specific
mortality during 5,148,760 years of follow up among 229,119 men and
173,141 women (aged 50-71) in the NIH-AARP Diet and Health Study (N Engl J Med.
2012. 366. 1891-1904).
consumption is associated with all-cause mortality in men and women
younger than 55 years old, based on 17 year median follow up data in the
Aerobics Center Longitudinal Study of 43,727 participants (Mayo Clin
Proc. 2013. 88. 1066-1074).
and cancer - overall, coffee does NOT increase cancer risk (Eur J Cancer Prev. 2000. 9. 241-256).
data that it does not increase the risk of colon cancer (J NCI. 2005. 97. 282-292) or
breast cancer; data more limited regarding the association of coffee
consumption with other cancers.
protect against liver cancer.
Compared to those who never consume coffee, liver cancer risk in
those consuming 1-2 cups per day is 0.52, 3-4 cups per day is 0.48, and 5
or more cups per day is 0.24 (J NCI.
2005. 97. 293-300).
publicized association of coffee consumption and increased risk of
pancreatic cancer has not been confirmed by recent studies, as per 2006
Guidelines published by the American Cancer Society.
and cardiovascular disease – effect may vary based on genetic
polymorphisms, or based on smoking status
analysis of data in 44,005 men in the Health Professionals Follow-up
Study and 88,488 women in the Nurses’ Health Study did NOT show an
increased risk of CHD in coffee drinkers. Adjusting for other CHD risk
factors, in men the risk was 1.0 for those who drank less than a cup of
coffee per month, 1.02 for those who drank 1 cup daily, and 0.72 for
those who drank 6 or more cups daily; in women the risk was 1.0 for those
who drank less than a cup of coffee per month, 1.02 for those who drank 1
cup daily, and 0.87 for those who drank 6 or more cups daily (Circulation. 2006. 113.
prospective study in 127,212 subjects found that coffee consumption was
unrelated to CAD risk in never smokers, but associated with a higher CAD
risk in ex-smokers and current smokers (Am J Cardiol. 2008. 101. 825-827).
coffee consumption has a detrimental effect on aortic stiffness (Am J Clin Nutr. 2005. 81. 1307-1312).
increases the risk of MI in slow metabolizers (variant CYP1A2 1F allele) but
decreases the risk of MI in rapid metabolizers (CYP1A2 1A allele), based
on a case control study in Costa Rica between 1994 and 2004, examining
2014 cases with first MI and 2014 controls (JAMA. 2006. 295. 1135-1141). Estimated that 50% of Caucasians
have slow variant whereas only 14% of Japanese have the slow variant (Cancer Epidemiol
Biomarkers Prev. 1994. 3. 413-421).
caffeine ingestion (200 mg) significantly improves endothelial function
in subjects with and without CAD, based on data from a cross-over RCT in
80 subjects in which endothelial function was assessed by brachial artery
flow-mediated vasodilation (Am J Cardiol. 2011. 107.1255-1261).
and depression – coffee consumption may be protective, based on data in
50,739 women in the Nurses’ Health Study (Arch Intern Med. 2011. 171. 1571-1578).
and diabetes – coffee may be protective
term coffee consumption is associated with a statistically significantly
lower risk of developing diabetes, with this association persisting
independent of BMI, smoking status, and other dietary and lifestyle
relative risk in men consuming >6 cups per day is 0.46 and the
relative risk for women consuming >6 cups per day is 0.71. The
statistical association with prevention of diabetes was also present in
both sexes for consumption of 4-5 cups/day (0.71 in men and 0.70 in
women). This data is based on
41,934 men followed from 1986 to 1998 in the Health Professionals=
Follow-up Study and 84,276 women followed from 1980-1998 in the Nurses=
Health Study (Ann Intern Med. 2004. 140. 1-8).
data on 88,259 women in the Nurses’ Health Study II also showed that
coffee even at mild-moderate intake is associated with a reduced risk of
diabetes – RR = 0.87 for 1 cup daily, 0.58 for 2-3 cups daily, 0.53 for 4
or more cups daily (Diabetes Care.
2006. 29. 398-403).
systematic review “supports the hypothesis that habitual coffee
consumption is associated with a substantially lower risk of type II
diabetes” (JAMA. 2005. 294.
risk of diabetes also seen in association with coffee consumption after
11 years of follow up in the cohort of 28,812 postmenopausal women in the
Iowa Women’s Health Study (Arch
Intern Med. 2006. 166. 1311-1316).
reduces the risk of diabetes in those with impaired glucose tolerance at
baseline, based on a prospective study in 317 adults who were part of the
Rancho Bernardo Study, and then developed impaired glucose tolerance. In
this study, no dose-response relationship was observed (Diabetes Care. 2006. 29.
and endometrial cancer – in a prospective study of 60,634 women
participating in the Swedish Mammography Cohort, during 17.6 years of
follow up, women drinking 4 or more cups of coffee per day had a 25% lower
risk of developing endometrial cancer. The reduction in risk was
restricted to overweight and obese women (Int J Cancer. 2009. 125. 2413-2417).
and gallstones – in the Health Professionals Follow up Study in 46,008
men, long term consumption of 2-3 cups of coffee per day was associated
with a 40% reduction in the risk for symptomatic gallstones; consumption
of 4 cups of coffee per day was associated with a 45% reduction in risk (JAMA. 1999. 281. 2006-2012).
and HTN – probably does not increase the risk (JAMA. 2005. 294. 2330-2335; Arch Intern Med. 2002. 162. 657-662).
and Parkinson’s disease – coffee may be protective
increased risk in the Nurses’ Health Study (Circulation.
decreased risk at 10 years of followup in the
34,670 women in the Swedish mammography cohort study (Stroke.
increase the risk of anxiety, blood sugar dysregulation, cardiac
arrhythmias, fibrocystic breast disease, headaches, infertility,
osteoporosis, and urinary stress incontinence.
cause depletion of calcium and magnesium.
approximately 85 mg caffeine per 8 ounce cup of drip-brewed cup.
are actually over 60 plant species which naturally contain caffeine – it
is hypothesized that this is because caffeine is a natural pesticide (it
is stored in specialized vacuoles because it is otherwise toxic to the
coffee and tea, other popular natural sources of caffeine include the
kola nut, yerba mate, chocolate, and guarana.
coffee – as per Dr. David Perlmutter,
chemical solvents are used in some cases to decrease the caffeine content
of water – make sure to purchase water-decaffeinated coffee.
are bad because there are 200 mg of cholesterol in each egg yolk.
capita egg consumption dropped from 400 to 250.
individuals do not experience an increase in serum cholesterol in
association with increased dietary intake of cholesterol.
20-25% of the population will have a significant increase in serum
cholesterol in response to an increase in dietary cholesterol. Possible
mechanisms to explain the lack of rise in serum cholesterol in 75-80%
include (1) a decrease in efficiency of cholesterol absorption and (2)
increased conversion to and excretion of bile acids (N Engl J Med. 1991. 324. 912-913).
6 week RCT in 96 hypercholesterolemic men
assigned to a low fat, low cholesterol diet containing no eggs versus a
low fat diet containing 12 eggs per week found no significant
differences at the end of the study in total, LDL, or HDL cholesterol (J Appl Nutr. 1993. 45. 73-84).
eggs versus egg substitutes – in a randomized, single blind 12 week trial
of 40 men and women with metabolic syndrome, significant reductions in
plasma triglycerides (p<0.05) and significant increases in HDL
cholesterol levels (p<0.05) were observed in both the group randomized
to consume 3 whole eggs daily and in the group randomized to consume an
equivalent amount of yolk-free egg substitute; there was a trend toward
greater improvement in these values in the group randomized to consume whole eggs (Metabolism. 2013. 62. 400-410).
and heart disease – the data is mixed (and based on population data, so
does not necessarily indicate cause and effect)
prospective study of the egg eating habits of 37,851 men in the Health
Professionals Follow-up Study and 80,082 women in the Nurses’ Health
Study showed no difference in risk of heart attack or stroke in those who
ate up to one egg a day, compared to those who ate less than one egg a
week (JAMA. 1999. 281.
a meta-analysis of 14 studies found that those who consumed the most
eggs had a 19% increased risk of cardiovascular disease and a 68% increased
risk of diabetes, compared with those who consumed the least eggs (Li Y
et al. Atherosclerosis. Epub 4/17/13).
fat in eggs is unsaturated fat.
are an excellent source of protein, phospholipids (i.e.
phosphatidylcholine), and a multitude of vitamins and minerals.
3 enriched eggs are a way of supplementing omega 3 fat intake in the
downside to egg yolks is that they are rich in arachadonic acid, which is
converted into pro-inflammatory eicosanoids. Omega 3 enriched eggs probably contain
less arachadonic acid.
- Shelton is
considered a reputable brand for organic eggs.
Fish (Ann Intern Med.
2004. 141. 977-980)
have found associations between fish consumption and reduced risk for
asthma, dementia, diabetes, kidney disease, and stroke.
estimated that fish consumption in the U.S. increased 50% between
1980 and 2000.
- Omega 3 fatty acid content of fish which
are sustainably harvested and do not contain excessive mercury or PCBs
(grams omega 3 per 3 ounce serving, as per Self Healing 8/08, pg 3) – Pacific herring (sardines) 1.6; Sablefish
(black cod) 1.4; European anchovies 1.25; Spanish mackerel 1.25; wild
sockeye salmon 0.95; farmed rainbow trout 0.84; Albacore tuna 0.8. See Consumer Reports 7/03 page 32 for a
complete listing of other fish with lesser amounts of DHA (docosahexanoic acid) and EPA (eicosapentanoic
fish to consume – issues include (1) mercury, (2) PCBs and dioxins, and
which include no known risk to the consumer include anchovies, flounder,
sole, and farmed clams, farmed rainbow trout, and farmed shrimp.
which are fine to eat in moderation (once/week) include cod, farmed
catfish, mahi, mahi,
wild salmon, tilapia, and canned chunk tuna.
to avoid include Chilean sea bass, Atlantic cod, Atlantic flounder and
sole, grouper, farmed salmon and orange roughly, and red snapper.
- Mercury (specifically
methylmercury) in fish is an issue:
is found naturally in the environment – it is estimated that roughly half
of the methylmercury in the oceans has been there for millennium.
Additional mercury is released through industrial practices such as the
burning of industrial waste and fossil fuels. Fish are the main source of
methylmercury exposure in humans.
Note that elemental mercury and inorganic
mercury are dangerous to humans only when inhaled rather than ingested and thus
problematic only for individuals with occupational exposure.
Note that the mercury in dental fillings is
inorganic and thus not dangerous when swallowed.
Methylmercury is excreted in the feces;
inorganic mercury is excreted in the urine.
Mercury is a neurotoxin, and pregnant women and
young children are especially susceptible to its effects.
The U.S. EPA states that blood levels of mercury
greater than 5 micrograms per liter or hair levels greater than 1 microgram per
gram are potentially hazardous to the developing fetus, and these levels
correlate with an exposure of 0.1 microgram/kilogram of body weight per day.
Blood levels over 50 micrograms per liter can
cause tremor, difficulty with concentration, visual problems, and numbness and
tingling in adults – these symptoms do not usually occur unless blood levels
exceed 200 micrograms per liter.
A single 6 ounce serving of some fish can exceed
the U.S. FDA recommendation that a 120 pound person consume no more than 38.5
micrograms of mercury per week.
reaches its highest levels in large, predatory fish and in bottom feeders
Fish highest in mercury in terms of mean values
of methylmercury concentration in ppm are tilefish (1.45), swordfish (1.00),
king mackerel (1.00), shark (0.96) [Perspective: Mercury and Health. N Engl J Med.
2002. 347. 1735-1736]. For reference purposes, sardines have 0.02 ppm and
sardines 0.01 ppm (Consumer Reports.
Other fish highest in mercury as per Natural
Resources Defense Council and Consumer
Reports October 2014 include marlin, orange roughy,
and tilefish (Gulf); additional fish high in mercury include and bluefish,
grouper, halibut, mackerel (Spanish, Gulf), sablefish (black cod), sea bass
(Chilean), and tuna (tuna (Ahi, Bigeye, canned albacore, canned yellow fin).
Fish low/moderate in mercury as per Natural
Resources Defense Council and Consumer
Reports October 2014 include bass, carpa,
catfish, cod, crab, crawfish (domestic), croaker (Atlantic), flounder, haddock,
halibut, jacksmelt, lobster, mackerel (Atlantic), mahi mahi, monkfish, mullet,
perch (freshwater), pollock, skate, snapper, trout,
tuna (canned chunk light and skipjack), and weakfish.
Fish lowest in mercury as per Natural Resources
Defense Council and Consumer Reports
October 2014 include anchovies, butterfish, clam, hake, herring, oyster, perch
(ocean), plaice, salmon, sardines, scallops, shad, shrimp, sole, squid, tilapia,
whitefish, and whiting.
to Dr. Andrew Weil, halibut, grouper, and Chilean sea bass are also high
in methylmercury, and trout and flounder have moderate amounts of
to Consumer Reports on Health
(July, 2006. 20-21), Chilean bass, American lobster, Spanish mackerel,
and halibut occasionally contain high mercury content.
light tuna is generally much lower in mercury than albacore (white) tuna,
but the FDA reports that 6% of light
tuna samples contain at least as much methylmercury as the average
is scientific debate regarding the extent of the harmful effects of
mercury in fish. The Seychelles Child Development Study, initially
presented in 2005 found no mercury-related health/developmental problems
in this population eating 10-12 seafood meals per week. A landmark 1997
study of Faroe islands people did show
developmental problems in children with the highest mercury exposures,
but the author attributed much of the risk to whale meat consumption
rather than fish consumption. Whale meat does not have high selenium
levels (see just below regarding selenium).
which is plentiful in wild ocean
fish, may cancel some of the harmful effects of mercury – mercury and
selenium have a high binding affinity for one another and form a harmless
selenium-mercury compound which is excreted. Theoretically, consuming 1-2
Brazil nuts (each Brazil nut contains approximately 100 mcg of selenium)
with a portion of fish may protect against the mercury in the fish (Holistic Primary Care. Winter
of mercury in blood and urine is inexpensive. A ‘provoked’ test may be
more meaningful than a random test.
- www.catchofthesea.com, www.tunalovers.com, and www.vitalchoice.com are web sites
with information on brands of tuna lower in mercury, as per Dr. Andrew
biphenyls (PCBs) in fish are an issue:
retardants, electrical equipment, pesticides, paints, varnished, and ink
were made with PCBs until banned in 1979.
levels of PCBs dropped rapidly after the ban in 1979, but they continue
to be released from sediment and are mostly insoluble in water, so they
accumulate in fish living in polluted waters and some farmed fish.
affected by PCBs in polluted waters vary by locality – check local state
advisories at www.epa.gov/waterscience/fish/states.htm.
in farmed fish is a function of PCB contaminated feed.
are thought to be carcinogenic and also appear to affect the central
nervous system, cause immune suppression, and cardiovascular disease.
a study published in 2004, it was reported that PCB levels in farmed
salmon sold in the U.S. and Canada were approximately 30 ppb, which is
2-10 times the level in beef and 5 times the amount that EPA guidelines
say is safe (Science. 2004.
303. 226-229). The authors concluded that more than 8 ounces of farmed
salmon a month posed an “unacceptable cancer risk.” Industry in response to this study is
changing the way farmed fish are fed.
that EPA guidelines set a much lower limit of acceptable intake of PCBs
than does the WHO. One may eat
4-10 meals per month of farmed salmon per month (depending on where the
salmon is raised) or 1 meal per day of wild salmon in terms of the WHO
guideline for safe exposure to PCBs (Environ
Health Perspectives. 2005. 113. 552-556).
of PCB levels is extremely expensive.
has led to a decline of as much as 90% of the biomass of large predatory
fish such as cod, haddock, and tuna.
- Best choices of fish from an
environmental perspective include wild Alaskan salmon and Pollack, wild
Pacific halibut, herring, sardines, and farmed arctic char.
in terms of the size of the catch is unregulated in international waters.
which refers to the unwanted marine life caught in fishing nets, is a
significant problem. An estimated 88 billion pounds of sea creatures are
killed unnecessarily each year. The good news is that much by-catch can
be prevented with changes in fishing techniques.
is a potential solution to overfishing which at least in principle has
the support of fishermen and conservationists.
is associated with multiple environmental and health issues
of the world’s fish farms are in Southeast Asia, or South
America, where regulations are lax.
farms sometimes destroy coastal marshlands and mangrove forests, which are
habitats for many indigenous wild fish species.
and salmon farms often use large quantities of antibiotics to protect the fish
farms are big polluters – they generate tons of filth which diffuses out and
adversely affects neighboring ecosystems.
fish may escape and breed with wild fish, resulting in hybrids that don’t
reproduce well. Escaped farm fish may also carry parasites foreign host waters.
quantities of marine biomass are needed to feed the farmed fish.
fish may be fed vegetable oils and even grains, leading to a much lower omega 3
content of farmed fish may be lower, and thus mercury exposure to farmed fish
may be a more significant health issue.
§ Not all fisheries are eco-unfriendly though
– US farmed tilapia and catfish are raised in an eco-friendly manner, as are
farm raised mussels and clams.
regarding information on toxins in fish and ecological concerns regarding
Healing. 5/06. 3)
Seafood Selector – lists fish as eco-best, eco-OK, or eco-worst based on
average content of mercury and PCBs. www.oceansalive.org
Watch – categorizes seafood into green, yellow, and red categories based on
to Ocean Friendly Seafood – color-coded key to evaluate abundance, fishing or
farming methods, environmental concerns. www.blueocean.org
information on toxins by waterway – www.epa.gov/waterscience/fish/states.htm
Healing. 5/06. 3)
are no USDA standards for ‘organic’ for seafood in 2009 (i.e. this term
is not defined for fish from a regulatory standpoint).
of 2005, it is required to label the country of origin for fish other
than sushi, canned fish, and processed fish such as fish sticks (but
compliance with this new law may be lax).
fish has been shown on occasion by independent testing to be erroneously
labeled as wild fish.
- Trusted label – Marine
Stewardship Council’s seal, blue oval, that tells you you’re buying from
an environmentally responsible fishery.
Fruits and Vegetables (see also section on Vegetables below)
Analysis of the diets of over 71,000 men and
women aged 45-83, and followed for 13 years, showed that less than 5 servings
per day of fruits and vegetables was associated with progressively shorter
survival rates (Bellavia A et al. American Society
for Nutrition 2013 presentation).
A meta-analysis of 16 prospective studies, ranging
from 4.6 to 26 years, found that was associated with a significantly lower risk
of all-cause mortality, with a threshold of approximately 5 servings per day (BMJ. 2014. 349. g4490).
grains contain all three parts of the plant kernel – the outer layer of
bran, the inner germ of the plant, and the largest part of the kernel,
called the endosperm.
bran provides fiber, B vitamins, iron, and antioxidants.
germ provides B vitamins, vitamin E, minerals, and healthy fats.
endosperm contains carbohydrates.
grains are stripped of the nutritious bran and germ during milling,
leaving behind the carbohydrate-rich endosperm.
grains are refined grains to which the manufacturer has added back some of
the vitamins and minerals lost during refinement.
USDA as of the 2005 Dietary Guidelines specifically recommends 3 ounces of
whole grains per day.
that when whole grains are ground to flour (i.e. whole wheat flour) the
glycemic index can be high even though it is a whole grain product.
– see “rice” just below
labels and color
that are mostly or completely whole grain list the word “whole” with the
first ingredient. Ingredients are
listed in descending order by weight.
that healthful-sounding words like ‘multi-grain’ and ‘seven-grain’ are
marketing terms and do not mean the product is whole grain.
that brown-colored bread is often is often refined white bread with added
that not all foods made with whole grains are good sources of fiber, so
check the fiber grams on the label too.
is a highly hybridized grain; many health authorities recommend minimizing
consumption of all wheat products.
– cultivated by the Aztecs, gluten free, high fiber content and complete
amino acid profile, slightly sweet taste. Traditionally eaten as
–high in beta-glucans, which lower cholesterol;
tastes similar to oats, contains gluten. Whole-grain hulled barley has
more fiber than any other whole grain.
– native to southeast Asia, gluten free
– quick cooking time
– gluten free, grain as well as a vegetable, has the highest level of
antioxidants of any grain
- Farro – domesticated in the Near
East, resembles barley
- Kamut – chewy and nutty tasting, contains gluten
– staple in Africa, China,
gluten free, alkaline, buttery flavor similar to rice
- gluten free, high beta glucan content
– grown in Andean region of South America,
gluten free, quick cooking time, nutty tasting, complete amino acid
profile. Rinse to reduce bitter taste.
- gluten free. Arsenic contamination is an issue. Rinse raw rice prior to
cooking, use a ratio of 6 cups of rice to 1 cup of water for cooking, and
drain the excess water afterward – traditional method of cooking in Asia. Some loss of nutrients, but this method
removes about 30% of rice’s inorganic arsenic content. NOTE as per
Consumer Reports testing (Consumer
Reports on Health. February 2015. Page 2), white basmati rice, brown
basmati rice, and sushi rice have ½ - 1/3 arsenic as compared with other
types of rice.
- Rye - contains
- Seminola - contains gluten
– popular in Africa, gluten free, high
- contains gluten
- Teff – tiny grain, gluten free
- Tricale - contains gluten
consumption and associations with disease and mortality
from two prospective cohorts, the Nurses’ Health Study (83,644 women
followed from 1980-2008) and Health Professionals Follow-up Study (37,698
men followed from 1986-2008) shows that “red meat consumption is
associated with an increased risk of total, CVD, and cancer mortality.
Substitution of other healthy protein sources for red meat is associated
with a lower mortality risk.” Questionnaires were administered biennially
in both of these studies (Arch
Intern Med. 2012. 172. 555-563).
from 3 cohorts of US adults and an updated meta-analysis concluded that
red meat consumption is associated with an increased risk of type 2
diabetes (Am J Clin
Nutr. 2011. 94. 1088-1096).
meta-analysis of data from cohort studies concludes that consumption of
red meat and processed meat increase the risk of colon cancer. Gram for
gram, processed meat consumption is associated with double the risk of
colon cancer, as compared with red meat consumption (PLoS One. 2011. 6. e20456).
large cohort study (over 500,000 people) with 10 years of follow up
showed that higher intake of total red meat and total processed meat was
associated with higher mortality (Arch
Intern Med. 2009. 169. 562-571).
issues aside from the nutritional value of the meat include:
given to the animals to promote growth.
contamination of ground beef – fresh oregano, 1 tablespoon per pound of
burger meat or meat loaf, has an antibacterial effect.
of the conditions in which the animals are raised.
type of food given to the animals (i.e. corn and soy versus grass) – see Time 6/12/06 pp. 76-78
fat content of the meat is lower in grass fed animals (Asia Pac J Clin Nutr. 2006. 15. 21-29).
3 fatty acid content, CLA content, and vitamin A and vitamin E content
are slightly higher in grass fed animals (J Anim Sci. 2002. 80. 1556-1563; Asia Pac J Clin Nutr. 2003.12. S38).
The explanation for this is as follows: The first chamber of a grass-fed
cow's stomach has a pH of 7, and is colonized by bacteria that
synthesize high levels of omega 3 fats and CLA. The first chamber of the
stomach of a cow that eats grains is much more acidic, and the acidic pH
fosters the growth of bacteria which synthesize far more omega 6 fats
than omega 3 fats and CLA. The omega 6: omega 3 content of the meat of a
grass fed cow or lamb is similar to that of salmon, 1.5 to 1, whereas
the omega 6: omega 3 content of
the meat of a grain fed cow is 7 to 1 (Time. 8/30/10. 30-40).
ulcers and liver abscesses much more common in cows fed a grain-based
(corn, soy) diet.
resistant E coli bacteria much more common in the stomach of cows fed
corn and soy, and this bacteria can spread from the feces to the meat
and cause human disease in those who consume the meat (if not detected
by USDA inspections).
of environmental toxins at the top of the food chain.
of world resources to raise cattle versus planting vegetables and grains.
amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) are produced by
cause cancer in lab animals.
temperatures in excess of 300 degrees Fahrenheit, cooking times in excess of 2
minutes, charring of food, and frying, grilling, broiling, or BBQ all increase
production of these compounds.
production by choosing lean meats, trimming fats, using marinades (combination
of vinegar, citrus juice, herbs, spices, and olive oil), microwaving briefly
before cooking, and cooking small portions to minimize grill time, cooking with
lower temperatures and turn the meat frequently.
of deceptive labeling (Consumer Reports. 6/04. 5)
free and antibiotic free in beef by regulation means only that no
hormones or antibiotics have been administered within 90 days of
USDA in 2007 required that ‘grass-fed’ cows obtain 100% of their daily
calories from grass; prior to this the USDA did not verify the accuracy
of this description. Look for “USDA-verified grass-fed” beef.
organic’ or ‘certified biodynamic’ are terms verified by the USDA which
indicate that the animals are fed no animal parts.
- Lean meat by definition contains
less than 3 grams of fat per ounce.
when metabolized creates acidic byproducts and some experts hypothesize
that slight increases in acidity in the body even when within normal range
acid in meat increases production of pro-inflammatory eicosanoids in the
body; grass fed beef probably has less arachidonic acid.
Manning, B3R, and New
Zealand beef are considered reputable
- Bison (Time. 3/26/07)
do not tolerate confinement well, so they must be allowed for most of
their lives to roam on the range and eat grass, and consequently they are
leaner, with less saturated fat. They also likely have a higher content
of omega 3 fat than grain fed cows.
bison are corralled and fed grain just prior to slaughter, in order to
make the meat richer – this type of bison meat is not as healthy.
USDA has developed regulations for shooting bison in the field, and this
is considered more humane than killing them in a slaughter house.
Milk (and dairy products)
dietary guidelines recommend consuming “3 cups per day of fat-free or
low-fat milk or equivalent milk products.”
content – mostly saturated fat.
2% low fat milk is 2% fat by weight, 35% fat by calories.
milk is made into cheese the fat is concentrated so the fat content of
cheese is often 50-70%.
in milk – milk is a complex colloidal dispersion of fat globules (3.9%),
and protein (3.5% casein and whey) in an aqueous solution (87%) of lactose
(4.9%), minerals, and other minor constituents (0.7%).
is a good source of calcium, magnesium, phosphorus, potassium, zinc, and
vitamins A, B1, B2, B6, B12, and D.
“Price Factor” (a fat soluble catalyst that encourages optimal assimilation
of vitamins and minerals) is present in milk from cows which graze,
absent when cows are fed soy or cottonseed
that 25% of Americans have lactose intolerance (Pediatrics. 2000. 110. 826-832), and thus may experience
bloating, flatulence, and abdominal pain with milk or dairy
consumption. Many of these
individuals though can tolerate 1-2 cups of milk if spaced throughout
milk may be easier for some to digest than cow's milk.
– the quality of the protein in milk (i.e. essential amino acid
composition) is good.
rarely causes symptoms, and is insulinotropic
(Am J Clin
Nutr. 2004. 80. 1246-1253) and a potent
stimulus for secretion of glucagonlike peptide
(Arch Intern Med. 2005. 165.
(which is also present in yogurt) based on anecdotes can increase mucous
production and aggravate asthma, bronchitis, sinusitis, allergies, and
autoimmune problems (lupus, multiple sclerosis, rheumatoid arthritis) in
CLA (amount is 500% higher in exclusively grass-fed cows) which may
assist with weight loss and prevent cancer.
2% low fat milk is 2% fat by weight, 35% fat by calories.
when milk is made into cheese the fat is concentrated so the fat content
of cheese is often 50-70%.
– pasteurization destroys many of the digestive enzymes. The enzyme xanthine oxidase in
homogenized milk is surrounded by a protective coating of fat molecules,
allowing it to escape degradation by digestive juices and to be absorbed
into the bloodstream intact. This substance may promote atherosclerosis
(Gaby A. Preventing and Reversing
Osteoporosis. 1994. Pg. 117).
dairy farming involves milking the cows when they are pregnant (because pregnant
cows produce more milk than nonpregnant cows), and
this practice is associated with higher levels of estrogen and progesterone in
milk, which in turn may increase risk of premature sexual development and also
of cows in the U.S.
are injected recombinant bovine growth hormone in order to increase output of
milk. These cows are more susceptible to
infections and thus receive more antibiotics.
Milk from these cows may have higher IGF-1 levels, and this protein may
pass into the bloodstream. IGF-1 may
increase the risk of breast, colon, and prostate cancer. Organic milk comes from cows which do not
receive rBGH and many other countries have banned rBGH because of the adverse effects on cows who are
administered this hormone (Self Healing. 1/05).
Antibiotics - “Milk is allowed to contain a
certain concentration of 80 different antibiotics – all used on dairy cows to
prevent udder infections. With every
glassful, people swallow a minute amount of several antibiotics.” (Newsweek. 3/28/94. 47-51).
associated with milk and dairy consumption
– reduced risk seen (J Natl Cancer Inst. 2002. 94. 1301-1311).
– reduced risk seen (Cancer Epidemiol Biomarkers Prev. 2005. 14. 2898-2904).
- Colon cancer –
reduced risk seen (Cancer Causes
Control. 2000. 11. 459-466).
artery disease – reduced risk seen (Am
J Epidemiol. 1999. 149. 151-161; J Epidemiol
Community Health. 2001. 55. 379-382).
Type II – reduced risk seen in men in association with dairy consumption,
especially low-fat dairy consumption, based on prospective data on 41,254
male participants in the Health Professionals Follow-up Study with no
history of diabetes, cardiovascular disease or cancer at baseline (Arch Intern Med. 2005. 165.
reduced risk seen in men (N Engl J Med. 2004. 350. 1093-1103).
– favorable effects seen in prospective studies (Hypertension. 1996. 27. 1065-1072; Circulation. 1989. 80. 1320-1327).
resistance – strong inverse relationship seen between dairy intake and
risk of insulin resistance in overweight young adults in the CARDIA study
(JAMA. 2002. 287. 2081-2089).
– CONTROVERSIAL FINDING
risk seen in one trial (J Am Coll Nutr. 2000. 19.
benefit seen in a one year trial in 90 obese subjects (Obes Res. 2005. 13. 1344-1353).
benefit seen in 51,529 men ages 40-75 in the Harvard Health Professional
Follow-up Study, when analysis is adjusted for possible confounders (Am J Clin Nutr. 2006. 83. 559-566).
- Stroke – reduced risk seen (Stroke. 1996. 27. 813-818).
loss – there are three small published studies showing that milk
facilitates weight loss – these studies were funded by the National Dairy
Council, and have methodological flaws.
Out of 27 RCTs investigating the effects of dairy products on body
weight, the only positive ones were the three sponsored by the dairy
industry, and conducted by Michael Zemel, PhD.
On 6/28/05 PCRM (Physicians Committee for Responsible Medicine) filed
lawsuits to stop an advertising campaign claiming that milk facilitates
weight loss, and in 5/07 the FTC announced that it was banning the
advertisements promoting dairy consumption as a means of achieving weight
associated with milk and dairy consumption (and see just above
‘Ingredients in milk’)
Type I – NOTE however that the issue may be an enhanced immunity to
proteins in general and proteins in wheat and soy appear to be more
potent diabetogens than those found in milk (Arch Intern Med. 2005. 165.
– increased risk of infertility associated with two or more servings of
low fat dairy per day, based upon data from 18,555 premenopausal women in
the Nurses’ Health Study II (Hum Reprod. 2007. 22. 1340-1347).
the advertisements for milk for osteoporosis prevention, epidemiologic
and cross cultural data actually show a positive correlation between
intake of milk products and osteoporotic fractures (Hippocrates. July/August 1999. 53-55).
12 year Harvard study which prospectively tracked the dietary intake and
medical histories of 77,761 women showed an increased risk of
osteoporotic fractures associated with increased milk consumption (Am J Pub Health. 1997. 87.
a review of 37 studies of dairy or unsupplemented
dietary calcium intake in children, adolescents, and young adults, 27
studies found no relationship between dairy or dietary calcium intake
and measures of bone health (Pediatrics.
2005. 115. 736-743).
cancer – increased risk, based on a meta-analysis (Int J Cancer. 2005).
Individual studies which showed an increased risk include the
Harvard Nurses’ Health Study (Int J Cancer.
2004) and the Iowa Women’s Health Study (Am J Epidemiol. 1999).
– increased risk based on data in 388 men and women with Parkinson’s
participating in the ACS Cancer Prevention Study II (Am J Epidemiol. 2007. 165.
review of 14 case-control studies and 9 cohort studies concludes that
dairy intake “is one of the most consistent dietary predictors for
prostate cancer in the published literature (Epidemiol Rev. 2001. 23. 87-92).
the Physicians’ Health Study in 20,885 male physicians, data at 11 years
of follow-up showed a relative risk of prostate cancer of 1.34 in those
who consume > 2.5 servings of dairy products compared to those who
consume 0.5 servings per day (Am J
Clin Nutr. 2001.
of 2776 men in the French SU.VI.MAX Study showed a higher risk of
prostate cancer in those with higher dairy and calcium intake. A harmful
effect of yogurt consumption on prostate cancer risk was identified in
this study (Br J Nutr. 2006. 95. 539-545).
meta-analysis of 12 studies found that men with the highest intake of dairy
and calcium had a higher risk of prostate cancer (J Natl Cancer Inst. 2005. 97.
a prospective study in a cohort of 27,028 smokers age 50-69 (ATBC
study), increased dairy intake and increased dietary calcium intake was
associated with an increased risk of prostate cancer at 17 years of
follow-up. Of note, when dietary calcium or calcium from dairy products
was controlled for, the association between total dairy intake and
increased risk of prostate cancer became statistically nonsignificant (Int J Cancer. 2007. 120. 2466-2473).
experts assert that organic milk (Horizon is a reputable brand) is
preferable to ‘ordinary’ milk, and that if available, raw milk is best
from a health standpoint. Note
availability of raw milk is often limited, but raw milk cheese is
available in many health food stores.
JC. The milk debate (editorial). Arch
Intern Med. 2005. 165. 975-976.
JP, Folta SC. Milk: can a ‘good’ food be so
bad? Pediatrics. 2000. 110.
in general are good sources of protein, fiber, monounsaturated fat, plant
sterols, and minerals.
nuts (almonds, Brazil nuts, cashews, hazel nuts, macadamia nuts, pecans,
pine nuts, pistachios, and walnuts).
are rich in monounsaturated fat, which is "good fat." Brazil
nuts, cashews, macadamia nuts, and pine nuts though do have higher
saturated fat content than almonds, hazel nuts, pecans, pistachios, and
are an excellent source of vitamin E. NOTE almonds must be pasteurized in
(as of 9/07) based on outbreaks of Salmonella traced to raw almonds.
Chemical pasteurization in the U.S. may involve the use of
propylene oxide, a potential carcinogen. Choosing organic varieties
allows one to avoid almonds pasteurized with this chemical (Self Healing.
1/08. Pgs 6-7).
nuts are an excellent source of selenium.
are an excellent source of copper and manganese.
nuts are an excellent source of vitamin K.
are an excellent source of gamma tocopherol (a form of vitamin E),
thiamine and potassium.
are an excellent source of alpha linolenic acid
(omega 3) and antioxidants
- The FDA has approved a qualified
health claim for almonds, hazel nuts, pecans, pistachios, and walnuts,
stating that there is supportive data that consumption of 1.5 ounces (45
grams) per day reduces the risk of heart disease.
(actually legumes and not true nuts) are slightly less healthy overall
than many other nuts in terms of having more saturated fat; aflatoxin
contamination of peanuts is believed to affect only nuts grown and stored
nuts are an excellent source of soy protein, which is associated with
cardio protective effects.
data – in general, epidemiologic studies have shown that tree nut consumption
decreases the rates of coronary disease events, sudden cardiac death,
diabetes, and gallstones. A variety of types of clinical studies have been
conducted using almonds, hazelnuts, macadamia nuts, pecans, pistachios,
and walnuts (Alt Med Alert. 2007.
studies show an inverse correlation between nut consumption and BMI (Am J Clin Nutr. 2003. 78. 647S-650S).
studies show an inverse relationship between intake of both almonds and
walnuts and the risk of heart disease. The Seventh Day Adventist
Study which had more than 31,000 participants found that those who
reported eating nuts more than 4 times per week had a 50% lower risk of
CAD than those who rarely ate nuts (Arch
Intern Med. 1992. 152. 1416-1424). Similar results were seen in
the Nurses’ Health Study, with a 35% lower risk of CAD (BMJ. 1998. 17. 1341-1345).
systematic review of 23 published studies of the effect of nut
consumption on lipid profiles found that nut consumption is associated
with improvement in blood lipid values. The investigators suggest intake
of 50-100 grams of nuts five days per week (J Nutr. 2005. 135. 2082-2089).
a prospective cohort study of 83,818 women from 11 states in the Nurses' Health
Study, nut consumption and peanut butter consumption were inversely
associated with the risk of developing type II diabetes (JAMA. 2002. 288. 2554-2560).
consumption is inversely associated with the risk of gallbladder disease
in the Health Professionals Follow-Up Study in men (437,305 person years
of follow up) [Am J Epidemiol. 2004. 160. 961-968], and in Nurses’
Health Study in a cohort of 80,718 women (Am J Clin Nutr.
2004. 80. 76-81).
consumption is inversely correlated with total mortality and inversely
correlated with deaths due to cancer, heart disease, and respiratory
disease, based on data in 76,464 women in the Nurses’ Health Study
(1980-2010) and 42,498 men in the Health Professionals Follow-Up Study
1986-2010), representing 3,038,853 person years of follow up (N Engl J Med.
2013. 369. 2001-2011).
- For much more information on nuts
and their beneficial effects on lipid profiles, and also on cardiovascular
events, go to the outline on this website, ‘Prevention of MI’ and scroll
down to ‘nuts’ in the category of ‘Primary Prevention – Diet.’
of oils, especially polyunsaturated oils, to air or heat or light leads to
oxidation of the oil, which produces a rancid oil, which is dangerous to ones health.
the risk of oxidation of the oil by purchasing all oils in darkened
containers to protect from light.
cooking oils in small quantities to protect the rest of the oil in the
container from the air in the container once the container has been
oils to protect from heat.
oils beyond their smoking point causes chemical changes which are
detrimental to a person’s health. Fast food restaurants do this all the
time. Furthermore there is data that there are chemical changes in many
oils well below their smoking point – this information should be available
from Omega Nutrition, a reputable manufacturer of oils, 1-800-661-3529.
cooking: best to use coconut oil, peanut oil (organic preferred), or high
oleic safflower oil.
cooking: may use olive oil, corn oil, or hazelnut oil.
cooking: may use almond oil, sesame oil, sunflower oil, or butter.
of oil from the plant
least damaging way to extract oil is to press the nut, seed or fruit
until it oozes – this is called “cold-pressed” but it works only with
soft raw materials.
‘cold-pressed’ is not defined from a regulatory
standpoint in terms of maximum temperature at which the oil is expressed
– it means that no added heat
has been used, but there is no limit on the temperature achieved as a
function of the pressure used to express the oil. These temperatures as a function of the
high pressure alone may reach 200 degrees Fahrenheit. Expeller processed
oils by voluntary standard should be manufactured at temperatures less
than 118 degrees Fahrenheit.
to cold-pressed are (1) expeller pressed or (2) chemically processed, in
which the plant product is dissolved with toxic solvents and then the oil
is refined, heated, and filtered. Oils extracted using chemicals usually
will not say this on the label – look for the terms cold-pressed,
expeller-pressed, and/or unrefined on the label to indicate that
chemicals were not used.
oils are typically bleached, degummed, deodorized, and then stabilizers
are added to the oil to increase shelf life. There is concern that these processes
may cause undesirable chemical changes in the oil.
oils are preferable, because many toxins are concentrated in the oil of
high in omega 6 fatty acids may have pro-inflammatory effects in the body,
but this is controversial.
of oils (Dr. Andrew Weil):
oil - mostly monounsaturated fats.
oil – probably very good. It is
obtained from rapeseed, and consists of mostly monounsaturated fat. Buy
organic, expeller-pressed products as per Dr. Andrew Weil (Self Healing.
2/05. 3). The concern with canola
oil is that rapeseed oil is toxic to animals and must be irradiated to
create canola oil and the long term effects of this are unknown.
oil/butter – controversy regarding health benefits
Weil skeptical due to high saturated fat content
benefits are the focus of a book by Bruce Fife, The Coconut Oil Miracle (2004).
stable to 375 degrees Fahrenheit.
lauric acid, an antibacterial compound which
may boost immunity..
source of medium chain triglycerides, which are readily converted to
oil – high in polyunsaturated fats and most often produced at high
temperatures and using toxic solvents.
oil – not as high as other oils in polyunsaturated fats, but rich in
saturated fat, and contains manufactured and natural toxins. Cotton is often sprayed with pesticides
and herbicides banned for use on food crops, because it is not classified
by the USDA as a food.
– brand name of an oil touted to facilitate weight loss. Contains chemically altered fats.
oil – this is considered a dietary supplement. For more information on therapeutic
uses of fish oil, return to Home Page, click on “Dietary Supplements” and
scroll to ‘Fatty acids’ then scroll on to ‘Fish oil capsules.’
oil – this is a source of ALA,
a short chain omega 3 fatty acid which is inefficiently converted into
longer chain fatty acids
- Grapeseed oil – advantage is high smoking point,
potential disadvantage is polyunsaturated fat content.
oil – highly unsaturated, may be used as seasoning in cold dishes, but
should never be heated.
oil - mostly monounsaturated fats., and a very high smoking point, so
good for cooking.
oil - very good. It is mostly monounsaturated fat and also has
antioxidant-rich polyphenols and flavinoids.
Heat stable to 300 degrees Fahrenheit.
present predominantly in extra-virgin olive oil, appears to inhibit
enzymes which involved in the production of pro-inflammatory
eicosanoids. Hydroxytyrosol is also a potent antioxidant with a very
high ORAC value. Olive oil rich
in this compound can be purchased at www.Olio2go.com
– it is expensive as per Barry Sears, Ph.D.
- Oleocanthol, a phytochemical with COX-1 and COX-2
inhibiting properties, is found in extra-virgin olive oil, and appears
to have anti-inflammatory activity similar to that of ibuprofen (Nature. 2005. 437. 45-46). This
phytochemical causes a stinging sensation in the throat.
polyphenols, which are most abundant in extra virgin olive oil, are cardioprotective – they inhibit platelet aggregation
and LDL oxidation (Am J Clin Nutr. 2006. 84.
oil is the lowest grade of olive oil available, manufactured by applying
heat and/or solvents to the paste leftover after higher grades of oil
have been extracted – it is thus inexpensive.
fruit oil is 50% saturated fat, 40% monounsaturated fat, and 10%
polyunsaturated fat, and has moderate antioxidant activity.
kernel oil is >80% saturated fat, and often used in processed foods.
oil – 50% monounsaturated fats, 30% polyunsaturated fats.
oil – mostly monounsaturated fats.
oil – highest in polyunsaturated fats. Safflower's history as a food
plant in the Western world is very recent, and ancient medical texts in India
recommend against consumption of this plant as food.
oil – high in polyunsaturated fats, but richly flavored, and contains
small amounts of lignans, including sesamin, which is a direct inhibitor of the enzyme
that facilitates production of arachadonic acid.
oil – also called ‘vegetable oil.’
High in polyunsaturated fats, but inexpensive. Due to difficulty in extracting oil
from soybeans, soybean oil is often damaged in the process.
oil – second highest in polyunsaturated fats.
oil – advantage is high smoking point (over 400 degrees Fahrenheit) and
composition, which is mostly monounsaturated fat, but it is expensive,
and available only via www.republicoftea.com.
Buy an organic, expeller-pressed product as per Dr. Andrew Weil (Self Healing.
oil - highly unsaturated, may be used as seasoning in cold dishes, but
should never be heated.
of deceptive labelling (Consumer
Reports. 2/14/ Pg 33)
– loophole in labelling is that chickens treated with antibiotic while in
egg stage are considered organic; organic means no antibiotic
administered from first day of life until slaughter. A “no antibiotics”
label means that antibiotics are not used, including in the egg.
range’ - defined by USDA as daily "access" to the outdoors.
“The USDA considers opening the chicken coop door for 5 minutes each day
adequate for the free-range distinction. The animal doesn’t even have to
step outside” (Self
Healing. 3/07. Pg 3. Pointer on
Picking out Poultry).
free” – essentially meaningless term
synthetic hormones used’ is meaningless because federal law prohibits use
of synthetic growth hormones in poultry (and in pork).
TERMS: Certified Humane (inspections required to use this label),
American Humane Certified (inspections required to use this label),
Animal Welfare Approved (inspections required to use this label),
pasture-raised (but this does not require inspections)
to minimize risk of human bacterial infection from bacteria in/on the skin
chicken last in the store, put in an additional plastic bag at the store
to minimize cross contamination, place in refrigerator at home ASAP, wash
hands after handling even the bag
cutting board designated for raw meat
NOT wash chicken before cooking – this spreads bacteria
hands after IMMEDIATELY after handling raw chicken
a meat thermometer, and cook to at least 165 degrees Fahrenheit.
salt intake in the U.S. in 2005-2006 was 10.4 grams per day for males (2
teaspoons) and 7.3 grams per day for females (USDA data posted on the USDA
website). NOTE 1 gram of salt =
0.4 grams sodium. In the U.S.
there has been a 55% increase in sodium intake from the 1970s to 2000 (Prog Cardiovasc
Dis. 2006. 49. 59-75). 77% of salt comes from processed and restaurant
food, 12% occurs naturally in foods, 6% is added at the table, and 5% is
added during cooking (J Am Coll Nutr. 1991. 10.
ratio of potassium: sodium may an important determinant of health - in
Western diet, it is estimated at 3:1, whereas ratio in Paleolithic diet,
it is estimated at 10:1 (Eur J Nutr. 2001. 40. 200-213).
and blood pressure
Cochrane analysis showed that reducing dietary salt intake lowers blood
pressure (Cochrane Database Syst Rev. 2004. 3. CD004937), but only a subset
of hypertensive individuals experience a decrease in BP with salt
review of 167 studies, mostly small and short-term, found that low sodium
intake was associated with reductions of SBP of 1-4 mm Hg in individuals
in various ethnic groups without hypertension, and reductions of SBP of
6-10 mm Hg in individuals in various ethnic groups with hypertension (Am J Hypertens.
2012. 25. 1).
gathered on 102,216 adults in 18 countries (PURE study), in which sodium
intake was estimated based on a calculation of 24 hour sodium excretion
(24 hour excretion calculated based on measurement in a fasting morning
urine sample) showed a correlation between sodium intake and diastolic
and systolic BP, with the slope of the curve steeper at higher sodium
intakes. In this same study, potassium excretion (a surrogate for
potassium intake) was inversely related to BP, with a steeper slope for
those with HTN and with increased age (N Engl J Med. 2014. 371. 601-611).
See below for results of this study pertaining to sodium and potassium
and cardiovascular disease
and cardiovascular disease
the conclusion that reducing salt intake will reduce the risk of risk of
CVD and CVA is based on the assumption that reductions in BP will reduce
the risk of CVA and CHD (i.e. that BP is a surrogate marker). Some
experts express concern that reduction in salt intake may unfavorably
impact other cardiovascular disease surrogates, and thus reducing salt
intake may not reduce risk of CVD and CVA (Commentary. JAMA. 2010. 303. 448-449).
data from NHANES III, with mean follow-up of 14.8 years in 12,267 US
adults show that higher sodium intake was associated with increased
all-cause mortality. In addition, higher sodium to potassium ratios of
dietary intake were associated with increased all cause and CVD mortality
(Arch Intern Med. 2011. 171.
1183-1191 and invited commentary 1191-1192). Additional prospective data
from 8699 participants in NHANES III (J
General Intern Med. 2008. 23. 1297-1302), 7154 participants in NHANES
II (Am J Med. 2006. 119.
E7-e14), and 20,729 participants in NHANES I (Lancet. 1998. 351. 8781-785) show an inverse correlation
between sodium intake and cardiovascular mortality.
authors of a systematic review and meta-analysis of 13 prospective
studies representing data on 19 independent cohort samples with more than
175,000 subjects, conclude that
cutting average salt intake by half might reduce the risk of stroke by
23% and heart disease by 17% (Strazzullo P et
al. BMJ. 2009. 339. b4567).
Salt intake was estimated in some studies by 24 hour dietary recall, in
others by food-frequency questionnaire, and in others by measurement of
24 hour urine excretion; follow up ranged from 3.5 to 19 years. The
higher the salt intake the higher the risk of CVD (RR 1.14) and CVA
(1.23). The longer the period of follow up, the greater the risk of CVA.
study exploring the potential impact of modest reduction in dietary salt
on US population health, using a computer simulation of heart disease in
US adults age 35-84 concludes that reducing dietary salt by 3 grams per
day (dietary sodium by 1.2 grams per day) is projected to is projected to
reduce the annual number of new cases of CHD by 60,000 to 120,000; the
annual number of new cases of CVA by 32,000 to 66,000; the annual number
of new cases of MI by 54,000 to 99,000, and the annual number of deaths
from any cause by 44,000 to 92,000 (N
Engl J Med. 2010. 362. 590-599). This
intervention could save $10 - $24 billion annually in health care costs.
The conclusion of the editorialist is that “The evidence supporting the
call to reduce salt intake as a means of preventing cardiovascular
disease is compelling.” (Editorial. N
Engl J Med. 2010. 362. 650-652).
cost effectiveness analysis using a Markov model concluded that
“Strategies to reduce sodium intake on a population level in the United
States are likely to substantially reduce stroke and MI incidence, which
would save billions of dollars in medical expenses.” (Ann Intern Med. 2010. 152. 481-487
and editorial 526-527).
meta-analysis identified only 7 RCTs of dietary sodium restriction in
which cardiovascular disease incidence or mortality were used as
endpoints; the results of the analysis showed no strong effect of sodium
reduction on cardiovascular disease incidence or mortality (Am J Hypertens.
2011. 24. 843).
of 2012, there are no large RCTs showing that sodium restriction lowers
the risk of MI, stroke or death (The
Medical Letter. 2012. 54. 13).
Cochrane analysis of 7 RCTs (n=6489) showed that “Interventions to reduce
dietary salt do not reduce mortality or cardiovascular morbidity in
persons with normotension or hypertension” (Cochrane Database Syst
Rev. 2011. CD009217 as cited in ACP
Journal Club. 2012. 156. JC1-4).
2013 narrative review concludes “low sodium diets have not been shown to
reduce cardiovascular events … Low sodium diets may adversely affect
insulin resistance, serum lipids, and neurohormonal
pathways, leading to increases in the incidence of new cardiometabolic disease, the severity of existing cardiometabolic disease, and greater cardiovascular
and all-cause mortality” (Am J Med.
2013. 126. 951-955).
gathered on 101,945 adults in 17 countries (PURE study), in which sodium
intake was estimated based on a calculation of 24 hour sodium excretion
(24 hour excretion calculated based on measurement in a fasting morning
urine sample), “an estimated sodium intake between 3 g per day and 6 g
per day was associated with a lower risk of death and cardiovascular
events than was either a higher or lower estimated intake.” In this same
study, a higher potassium excretion (a surrogate for potassium intake)
was inversely related to risk of death and cardiovascular events (N Engl J Med.
2014. 371. 612-623). See above for results of this study pertaining to
sodium and potassium and effect on BP.
in a modelling study reported in the same issue of NEJM, analysis of data on estimated sodium intake in persons
in 66 countries concluded that “1.65 million deaths from cardiovascular
causes that occurred in 2010 were attributed to sodium consumption above
a reference level of 2.0 g per day” events (N Engl J Med. 2014. 371. 624-634).
An accompanying editorial states “However, given the numerous assumptions
necessitated by the lack of high-quality data, caution should be taken in
interpreting the results of this study” events (N Engl J Med. 2014. 371. 677-679).
harms of a low salt diet
to randomized, controlled clinical trial data showing a decrease in blood
pressure in conjunction with reduction in salt intake, population data
from NHANES I and NHANES III (Am J
Hypertension. 2005. 18. 261) showed that low dietary intake of salt
was associated with an
increased risk for HTN.
patients with CHF, those randomized to a sodium intake of 1840 mg/day had
significantly increased hospitalization and mortality compared to those
randomized to 2760 mg/day, based on data from an 8-arm, 6 month trial of
410 patients (Am J Cardiol. 2009. 103. 93-102).
patients with type II diabetes, a low sodium diet is associated with
cardiovascular and all-cause mortality, based on date from a cohort study
in which 638 diabetic persons were followed for a period of 9.9 years (Diabetes Care. 2011. 34. 703-709).
one study in ~3000 hypertensive men, low salt intake was associated with
an increased risk of MI (Hypertension.
1995. 25. 1144-1152).
in salt intake sufficient to lower BP increases sympathetic nervous
system activity, decreases insulin sensitivity, activates the
rennin-angiotensin system, and stimulates aldosterone secretion (JAMA. 1998. 279. 1383-1391; J Hypertens.
2007. 25. 903-907).
salt intake is associated with hyperinsulinemia
(J Intern Med. 1993. 233.
salt diet increases serum cholesterol and LDL (Klin Wochenschr. 1991. 69 [suppl XXV]. 51-57).
the half-life of bromine in the body, based on a study in rats (Chem Toxic. 1983. 21. 379).
salt is a processed “food” (Salt
Your Way to Health by David Brownstein, MD. 2006)
salt has all minerals (other than the sodium) removed and iodide added.
The minerals are removed from the brine with chemicals such as chlorine
or sulfuric acid. Next the water is evaporated under high pressure and
heat. Dextrose is used as a stabilizer so that iodide will stay in salt.
Refined salt is bleached so that it maintains the white color. Refined
salt has a very long shelf life. More information on the refining process
is available at www.saltinstitute.org.
National Academy of Science Food Chemicals Codex Sodium Chloride
Monograph (1996) permits food grade salt to contain anti-caking,
free-flowing, and conditioning agents, such as sodium ferrocyanide,
ammonium citrate, and aluminum silicate as long as the additives
constitute no more than 2% of the contents of the final food grade salt
salt consists of approximately 39% sodium, approximately 60% chloride, up
to 2% additives (see just above), 0.01% iodide.
salt contains more than 80 minerals and elements in minute amounts, along
with the sodium and chloride.
Sea Salt contains 33% sodium, 50.9% chloride, 1.8% minerals and trace
elements, and 14.3% moisture. More information on Celtic Sea Salt is
available through The Grain & Salt Society (800-867-7258).
- Redmond’s Real Salt
contains 37.6% sodium, 59.1% chloride, approximately 1% minerals and
soda – see ‘artificial sweeteners’ below in this outline. In addition to
the detrimental effects of the artificial sweeteners, the caffeine prompts
conversion of ATP to AMP, and detection of this ‘spent fuel’ may increase
appetite and thirst.
- In a
meta-analysis of 88 studies, the authors found clear associations of soft
drink intake with increased energy intake and body weight, and with an
increased risk of several medical problems such as diabetes. The studies
using the most reliable statistical methods showed the largest effects.
Several studies found that the caloric increase is actually greater than
that contained in the soda, raising “the possibility that soft drinks
increase hunger, decrease satiety or simply calibrate people to a high
level of sweetness that generalizes to preferences in other foods… These
results, taken together, provide clear and consistent evidence that people
do not compensate for the added calories they consume in soft drinks by
reducing their intake of other foods” (Am
J Public Health. 2007. 97. 667-675).
- In a
study of 91,249 women followed for eight years, those who consumed one or
more soft drinks per day were twice as likely as those who consumed less
than one per month to develop diabetes.
is associated with an increased risk of gout in men, with the risk 85%
higher in men who consumed two or more servings daily, compared with men
consuming no soda (BMJ. 2008.
- High fructose corn syrup is soda –
for details on potential harmful health effects scroll up to the section
of this outline on ‘Functional Classification of Carbohydrates’
(approximately page 16 of this outline).
of one soda daily is associated with a 20% increased risk of coronary
heart disease (Circulation. 2012; DOI: 10.1161/CIRCULATIONAHA.111.067017).
genetic association with adiposity appeared to be more pronounced with
greater intake of sugar-sweetened beverages,” based on cohort data in 6934
women in the Nurses’ Health Study and 4423 men in the Health Professionals
Follow-up Study (N
Engl J Med. 2012. 367. 1387-1406 and editorial 1462-1463).
an 18 month trial in 641 primarily normal weight children, “Masked
replacement of sugar-containing beverages with noncaloric
beverages reduced weight gain and fat accumulation …” (N Engl J Med. 2012. 367. 1397-1396
benzoate, a common preservative found in many soft drinks, might damage
mitochondrial DNA, based on laboratory data in living yeast cells
(accessed 6/19/07 at www.mercola.com). Sodium benzoate, which occurs naturally
in berries in small amounts, is used in large quantities to prevent mold
in soft drinks such as Sprite, Diet Pepsi, Coca-Cola, and Dr Pepper.
that soda with added vitamin C and with sodium benzoate as a preservative
may have benzene levels above the EPA limit of 5 ppb for drinking water.
In a recent FDA and EPA study, almost 5% of 200 beverage samples had
benzene levels above 5 ppb (accessed 1/26/08 at www.mercola.com).
- EXCELLENT REVIEW ARTICLE (120
references): D’Adamo CR and Sahin
A. Altern Ther Health
Med. 2014. 20[suppl 1]. 39-51.
REVIEWS: Alternative Medicine Alert.
2004. 7. 49-55; Consumer Reports.
2005, Americans were estimated to spend $4.7 billion on soy foods, an
844% increase over 1990.
of soy supplement pills rose more than 500% between 1997 and 2002
according to the Nutrition Business
protein contains the 8 essential amino acids also present in animal
protein. Soy protein has the
highest nutritive value of any plant source; the overall quality of the
protein is similar to that of meat, milk and eggs. HOWEVER, soy has
suboptimal amounts of sulfur-containing amino acids (cysteine and
methionine) and modern processing of soy denatures some of the lysine.
is rich in essential fatty acids, but contains much less saturated fat
than animal protein, and no cholesterol.
is rich in minerals, but also rich in “antinutrients
(oxalates, saponins, lectins, phytates, and others) which may interfere with
absorption of vitamins and minerals. Fermentation, germination, soaking
for at least 12 hours, and cooking all may reduce the concentration of antinutrients.
contains vitamin E, oligosaccharides, lecithin, and saponins,
all of which are bioactive compounds.
contains isoflavones (soy foods on average contain 3.5mg isoflavones/gram
main isoflavones in soy are genistein, daidzein,
are believed to act as weak estrogens, reversibly binding to estrogen
receptors, with a greater affinity for the beta isoform (found mostly in
the nervous system, cardiovascular system, bone, and skin) than the
alpha isoform (found mostly in the uterus and breast).
are two types of isoflavones in soy - aglycones
- Aglycones are the active ingredient, and are found
in fermented soy foods, as a result of enzymatic hydrolysis during
- Glucosides are aglycones
with a glucose molecule attached – the isoflavones in non-fermented soy
foods exist in this form. These
are converted by intestinal bacteria into the biologically active aglycone form, but the conversion rate is only
approximately 60%. Human GI juices do not contain glycosidases.
- Daidzein is converted in the gut into a bioactive
metabolite named equol which is a more potent,
possessing estrogenic activity approximately five times greater than its
precursor. The extent of this conversion is dependent in part upon the
amount of prebiotic in the diet and in part upon the composition of the
GI flora – some lactobacilli such as Lactobacillus
sporogenes facilitate this conversion.
that ipriflavone is a synthetic isoflavone,
derived from soy isoflavones.
of soy products:
soy foods - historical use of soy by the Japanese is use of predominantly
fermented products such as tempeh, miso (soup), and natto
(a fermented cheese). Fermentation reduces the levels of isoflavones 2-3
soy foods – there is some historical use of these non-fermented whole
foods such as tofu, soy nuts, soy milk and edamame (lightly broiled
though that American strains of soya plants have significantly higher
levels of isoflavones than Japanese or Chinese ones because of selective
breeding in the U.S.
to promote pest resistance of the plants.
hexane is typically used in the processing of soy milk and tofu; health
effects are unknown. Hexane is a neurotoxin.
is young green beans which are lower in estrogens and antinutrients than the mature plant.
soy – soy protein concentrate, soy protein isolates, texturized soy
protein. Processing with alkaline solutions creates the unnatural amino
acid lysinoalanine and also creates D-isomers
of naturally occurring L-amino acids - may have unfavorable health
are not whole foods and there is no significant historical use, so
safety is unknown.
by isolating the soy protein from the carbohydrate and fat.
found in cereals, energy bars, patties, crackers, spaghetti sauce, and
as an inexpensive filler to lower a food’s overall fat content.
- Controversy about relative benefit
versus risk of soy
soy-related articles published between 1990 and 2005, and the literature
is conflicting, so anyone can selectively use the published literature to
argue any point about safety or risk.
that fermented soy foods in moderation are safest, whole soy foods in
moderation are safe too, with long-term safety of processed soy products
and supplements an unknown.
the therapeutic health claim for soy and cholesterol-lowering (See Health
Benefits just below) the concern of some is that the long-term safety of
these quantities of soy, even if consumed in whole foods form, is unknown
because it exceeds historical use of 10 grams of soy protein per
day. Two FDA scientists formally
protested the decision to grant a therapeutic label claim due to lack of
data on long-term safety of this magnitude of daily consumption.
- An evidence-based report, “Effects
of Soy on Health and Outcomes” was requested and funded by NCCAM and NIH
Office of Dietary Supplements, and published in 2005. It concluded that
eating soy protein daily may have some health benefits, but overall the
health effects of soy are uncertain and need further investigation.
Summary of report available at www.ahrq.gov/clinic/epcsums/soysum.htm
prevention – soy may be beneficial based on data that genistein inhibits
thrombin formation and platelet aggregation, and inhibits cell adhesion
prostate hypertrophy (BPH) – the beta-sitosterol
in soy is beneficial (Lancet.
1995. 345. 1529-1532).
RCT in 40 men and women showed that soy milk 500 ml bid, as compared with cow’s
milk 500 ml bid, was associated with a 17/12 mm Hg decrease in BP (J Nutr. 2002.
longitudinal study of soy food intake and blood pressure in 45,000 Chinese
women aged 40-70 showed that women who consumed more than 25 grams of soy per
day had on average a 1.9 mm Hg lower systolic BP and a 0.8 mm Hg lower
diastolic blood pressure (Am J Clin Nutr. 2005. 81. 1012-1017).
8 week crossover RCT in 60 healthy postmenopausal women found that substituting
soy nuts (25 gm of soy protein per day) lowered SBP 9.9% and DBP 6.6% in
hypertensive (SBP > 140) women; lowered SBP 5.2% and DBP 2.9% in normotensive
(SBP < 120) women (Arch Intern Med.
2007. 167. 1060-1067).
prevention - data is mixed.
Epidemiological studies show a decreased risk of breast, colon,
lung, and prostate cancer. The
epidemiological data on lung cancer comes from a case control study in
1674 patients and 1735 matched controls (JAMA. 2005. 294. 1505-1510).
Soy isoflavones shift estrogen metabolism toward more beneficial
metabolites (i.e. 2 hydroxyestrone). Isoflavones interfere with angiogenesis
in vitro (Nutr Cancer. 1994b. 21. 113-131). Soy increases synthesis of SHBG
and inhibits aromatase.
lowering - based on a meta-analysis of 38 controlled clinical trials
showing a 9% decrease in total cholesterol and a 13% decrease in LDL
cholesterol in patients taking 25-50 grams per day of soy (New Engl J
Med. 1995. 333. 276-282), the FDA as of 1999 actually allows a
therapeutic label on soy rich foods (6.25 grams of soy per serving) -
"capable of decreasing the risk of heart disease."
Presumed mechanism of action – reduced hepatic cholesterol synthesis. It
has been proposed that only the 1/3 of individuals who convert daidzein to equol benefit
from soy with regard to the lipid profile. The ability to convert daidzein to equol appears
to be related to specific gut flora.
function preservation - data is promising.
Coronary heart disease prevention - Effective
October 1999, the FDA allows for labeling on soy rich foods (defined as having
at least 6.25 grams of soy per serving, and assuming 4 servings per day) as
"capable of decreasing the risk of heart disease" (Fed Regist.
1999. 64. 57700-57733) based on a meta-analysis of 38 clinical trials showing a
9% decrease in total cholesterol and a 13% decrease in LDL cholesterol in
patients taking 25-50 grams of soy per day (N Engl
J Med. 1995. 333. 276-282).
rate variability – increased with consumption of soy (Chest. 2005. 127. 1102-1107).
flashes - clinical trials is mixed; a meta-analysis of 17 RCTs of soy
isoflavones found a pooled reduction of 20.6% in frequency and 26.2% in
duration of hot flashes (p<0.0001) [Menopause. 2012. 19. 776-790].
prevention - animal data very promising, but human data mixed. A
literature review suggests that soy supplementation does not offer
protection against osteoporosis (Altern Ther Health Med. 2014. 20[suppl
atrophy prevention - data is mixed.
foods are presumed safe because they have been consumed in Asia for thousands of years - consumption of up to
100 mg of aglycone isoflavones per day (10
grams of soy protein) in food is presumed safe.
processing to create textured soy protein and hexane processing in the
production of soy milk and tofu – health effects unknown.
- it is estimated that 5 to 7% of babies and 1 to 2% of adults are
allergic to soy.
- Antinutrients (oxalates, saponins,
lectins, phytates, and others) - may interfere
with absorption of vitamins and minerals. Fermentation, germination,
soaking for at least 12 hours, and cooking all may reduce the
concentration of antinutrients.
cancer – there are concerns that soy might stimulate breast cancer cells,
or alter the effectiveness of hormonal therapy for breast cancer.
However, most epidemiologic data shows an inverse correlation between soy
consumption and breast cancer, and several studies of soy intake in those
with breast cancer also show a protective effect
hyperplasia - soy isoflavones 150mg/day for 5 years caused endometrial
hyperplasia in 3.9% of women, although no endometrial hyperplasia seen
after 2.5 years (Fertil Steril.
2004. 82. 145-148).
stones - soy may increase the risk of calcium oxalate kidney stones.
(a) - soy may increase lipoprotein (a) levels.
consumption may affect an infant's hormone levels – theoretical concern
consumption may affect reproductive hormone levels in men – theoretical
concern, but a meta-analysis shows no significant effect on total
testosterone, free testosterone, SHBG, or free androgen index. (Fertil Steril.
2010. 94. 997-1007).
findings in published studies – the authors of a review article (Altern Ther
Health Med. 2014. 20[suppl 1]. 39-51)
conclude “these inconsistent findings are suggestive that soy
supplementation can indeed interfere with thyroid function in an
unpredictable manner.” The authors state further in the final
“Discussion” section of the article “This review revealed evidence from
randomized, controlled trials that soy supplementation can both increase
and decrease thyroid activity among people with normal thyroid function.
These variable effects provide cause for concern, and more studies are
consumption may increase the risk of hypothyroidism in the presence of
an iodine deficiency; the effect may be offset by iodine
RCT in 38 postmenopausal women not on HRT and taking a product with 90
mg/day of isoflavones found no changes in serological assessment of
thyroid function (J Med Food.
2003. 6. 309-316).
medications - soy may interfere with absorption.
endothelial function - soy intake in men has been associated with a
decline in vascular endothelial function.
on food and supplements:
- Consumer Reports found that eleven
of the foods analyzed overstated their level of isoflavones.
food's label often does not distinguish the amount of aglycone
isoflavones versus glucoside isoflavones.
soy protein is used as an inexpensive filler to lower a food’s fat
content, it may appear under deceptive label terms such as ‘natural
flavors’ or ‘vegetable protein.’
Sugar – see section on ‘Sugar’ in the category
‘Carbohydrates’ at the top of this outline.
A systematic review of 12 studies (n = 409,707;
6 studies cross sectional; 6 studies prospective found that all 12 studies
showed a correlation between increased intake of sugar-sweetened beverages and
HTN, with 10 of the 12 studies showing a statistically significant correlation.
Of the 12 studies, 5 reported an increase in mean BP; 7 reported an increase in
the incidence of HTN.
nectar – glycemic index lower than other natural sweeteners, secondary to
high ratio of fructose to glucose.
malt – mostly maltose, which does not directly activate an insulin
sugar and/or Birch syrup
rice sugar – mild sweetener which is a healthier alternative than brown
- Csweet – brand name for a product in which the
natural ingredient is brazzein, a sweet protein
from the berries of a West African plant named Pentadiplandra Brazzeana,
and said to be 1,000 times sweeter than sugar with no undesirable
- Erythritol (Sweet Simplicity) – sugar alcohol
- Fructooligosaccharides (FOS) – this natural product
also serves as nutrition for friendly bacteria in the gut.
– made from flower nectar of honeybee, contains vitamins and minerals and
– sweet probiotic.
Like Sugar – ingredients include chicory root dietary fiber, calcium,
vitamin C, and natural flavors from the peel of the orange. www.justlikesugarinc.com
fruit (Sweet Balance) – 250 times as sweet as sugar, contains a small
amount of sugar, and may contain antioxidants.
- Maltitol (Nature Sweet) – sugar alcohol
sugar and/or Maple syrup
(blackstrap) – originally from Caribbean
islands, rich in minerals.
fruit (BioVittoria) – grown in Southern China, 300 times as sweet as sugar
- Rapadura – brand name product derived from juice of
- sugar alcohol
Stevia, Truvia) – 250-300 times as sweet as
for centuries in South America (in
small quantities). There is a
slightly bitter aftertaste.
in Japan as a
sweetener, but not approved as a sweetener in the U.S., in Canada, or by the European
in the U.S.
as a ‘dietary supplement.’
- In 1998, a United Nations expert
panel identified unresolved concerns about its toxicity.
- Animal studies identify
reproductive problems, cancer, and interference with energy metabolism
as areas of potential concern, especially if large quantities are
- Nonprofit Center for Science in the Public Interest
recommends avoiding it.
- Tagatose – made from milk sugar, approximately as
sweet as sugar with 1/3 the calories and appears safe.
– first manufactured in 1891, became popular in Finland after World War II.
substance (a 5 carbon sugar alcohol) found in fibrous vegetables and fruit, and
in various hardwood trees.
synthesize up to 15 grams per day during normal metabolism.
1/3 the calories of sucrose (table sugar), and is approximately 2/3 as sweet as
and cannot be converted to acid by oral bacteria, and thus inhibits
dose required to prevent cavities is 6 grams/day
index is 7 when a scale designating sucrose as 100 is used.
- Zsweet – erythritol (a
sugar alcohol found in many fruits) – approximately 70% as sweet as
sugar. Considered safe by the FDA.
is no data and has never been any data that artificial sweeteners assist
in weight loss.
stimulate appetite through the cephalic phase response - the brain
associates sweet taste with introduction of new energy (i.e. food) into
the body. thinks real sugar is in the system. Production of insulin is
triggered – insulin then halts the production of sugar from protein and
starch reserves, and facilitates storage in the cells of metabolic fuel
circulating in the blood. Since no new energy (i.e. glucose) has actually
been introduced into the body, relative hypoglycemia develops, and this
triggers hunger, which prompts intake of food.
- Acesulfame potassium (Sunett,
Sweet One) – 200 times sweeter than sugar, safety questionable based on
energy content as sucrose (4 kcal/g), but 160-220 times sweeter than sugar.
is composed of phenylalanine (50%), aspartic acid (40%) and methanol (10%).
Phenylalanine plays an important role in neurotransmitter regulation. 10% of
aspartame by weight is converted to methanol (wood alcohol), which in turn is
converted in the body to formate, which can either be
excreted or can give rise to formaldehyde, diketopiperazine
(a carcinogen) and a number of other highly toxic derivatives.
is concern that one of the metabolites, aspartate, an excitatory
neurotransmitter may increase the risk of a variety of conditions, including
ADHD, ALS, Alzheimer's disease, brain tumors, headaches, Parkinson’s disease,
who are heterozygous for PKU ( approximately 4 million Americans) may be
especially sensitive to the effects of aspartame.
methyl esters in aspartame are also of concern, in terms of both neurological
and endocrine toxicity.
are published case reports of grand mal seizures, urticaria,
angioedema, mania, panic attacks, migraines, and headaches associated with
lead to increased food/calorie intake (Physiol Behav. 1990.
47. 555-559; Int J Obes Relat Metab
Disord. 1997. 21. 37-42).
term intake may deplete the body of glutathione, an important antioxidant (Food Chem Toxicol. 2011. 49. 1203-1207).
review articles which have concluded that aspartame does not increase cancer
risk (Regul Toxicol Pharmacol. 2002. 35. S1-93; Ann Oncol. 2004. 15. 1460-1465), there is
evidence of carcinogenicity in a study in Sprague-Dawley rats, animals which
are deemed a consistent predictor of human cancer risk (Environ Health Perspect. 2006. 114.
review concluded that “Aspartame disturbs amino acid metabolism, protein
structure and metabolism, integrity of nucleic acids, neuronal function,
endocrine balances and changes in the brain concentrations of catecholamines. It was also reported that aspartame and its
breakdown products cause nerves to fire excessively, which indirectly causes a
very high rate of neuron depolarization. The energy systems for certain
required enzyme reactions become compromised, thus indirectly leading to the
inability of enzymes to function optimally. The ATP stores in the cells are
depleted, indicating that low concentrations of glucose are present in the
cells, and this in turn will indirectly decrease the synthesis of
acetylcholine, glutamate and GABA (gamma-aminobutyric
acid). The intracellular calcium uptake is altered, thus the functioning of
glutamate as an excitatory neurotransmitter is inhibited. Furthermore,
mitochondria are damaged, which could lead to apoptosis of cells and also a
lowered rate of oxidative metabolism, which in turn could lead to lower
concentrations of the transmitters glutamate and production of GABA. The
cellular walls are destroyed with the result that the endothelial cells
of the capillaries are more permeable, leading to a compromised blood
brain barrier. Thus, overall oxidative stress and neurodegeneration are
present” (Eur J Clin Nutr. 2008. 62. 451-462).
per Mark Hyman, MD, of 166 studies on the safety of aspartame,100% of the 74
studies funded at least in part by industry found aspartame safe, while 92% of
the 92 independently funded studies identified potential safety and adverse
effect issues (Ultrametabolism.
2006. Pg 99).
information in the movie Sweet Misery: A
Poisoned World by Cory Brackett (which can be ordered at www.soundandfury.tv) and the books Excitotoxins:
The Taste that Kills by Russell L. Blaylock, MD and Sweet Deception by Joseph Mercola, DC.
(Necta Sweet, Sweet ‘N Low) – 300-700 times
sweeter than sugar; linked with cancer in animals in high doses, but
probably safe in humans.
in 2000; 600 times sweeter than sugar.
is a sugar alcohol created via chemical substitution of 3 hydroxyl
groups with 3 chloride atoms, creating a chlorocarbon
(similar in chemical structure to DDT).
is concern amongst some experts that this chemical structure may
adversely affect normal metabolism.
animal study found that sucralose (1) alters gut microflora, reducing
good gut bacteria, increases intestinal p-glycoprotein, and (3) alters
the function of the cytochrome P450 enzyme system (and thus reduces
bioavailability of some orally administered medications (J Toxicol
Environ Health. 2008. 71. 1415-1429).
cause GI side effects in some indiiduals.
trigger migraines in some individuals (Headache. 2006. 46. 1303-1304).
- Tagatose ((Naturlose)- derived
Derived from the plant Camellia sinensis.
Black tea is fermented (oxidized), oolong tea is
partially fermented, and green tea and white tea are unfermented. Black tea has
the most caffeine and is lowest in antioxidants whereas white tea has the least
caffeine and is highest in antioxidants.
Of the approximately 2.5 million metric tons of
dried tea manufactured, only 20% is green tea and less than 2% is oolong tea.
Historically, green tea has been consumed
primarily in Japan, China, and a few countries in North Africa and
the Middle East.
Tea contains over 400 volatile compounds,
including polyphenols, which are potent antioxidants.
The four major polyphenols in green tea are EC,
EGC, ECG, and EGCG. The usual concentration of total polyphenols in dried green
tea leaves 8-12%.
Tea contains approximately 35-50 mg caffeine per
8 ounce serving. The L-theanine in tea may moderate
the effects of the caffeine.
From a scientific nomenclature standpoint,
herbal ‘teas’ are actually herbal infusions, and tea refers only to the beverage
derived from the plant Camellia sinensis.
Practical tips (Self Healing. 12/08)
that adding ice may cause the polyphenols and caffeine to bind together and
sink to the bottom of the cup, where they are less likely to be consumed.
that adding milk to tea may interfere with the absorption of the beneficial
tea - look for varieties that use carbon dioxide and water rather than a
solvent such as ethyl acetate, as use of solvents is associated with a lower catechin content.
Benefits of green tea
data suggests benefits of green tea
include antiviral, antifungal, and antioxidant effects; protection against
cancer (stimulates apoptosis, antiangiogenic effect), heart disease, and
neurological disease; treatment of diabetes, HIV, and inflammatory bowel
disease; and increased thermogenesis (Pastore R and Fratellone P. Potential Health Benefits of Green Tea: A
Narrative Review. Explore. 2006. 2.
531-539. 68 references; Mayo Clin Proc. 2007. 82. 725-732. 82 references).
found in tea inhibit the growth of pathogenic intestinal bacteria while leaving
beneficial bacteria unharmed (Res Microbiol. 2006. 157. 876-84).
tea consumption has a beneficial effect on endothelial function, improving
flow-mediated dilation of the brachial artery in a study in 14 healthy
individuals (Eur J Cardiovasc Prev Rehabil. 2008. 15.
300-305). EGCG “can augment nitric oxide status and reduce endothelin-1
concentrations and thereby may impove endothelial
function” (Am J Clin
Nutr. 2008. 88. 1018-1025).
tea extract reduces BP, LDL cholesterol, and inflammation (Nantz
MP et al. Nutrition. Epub 10/8/08).
Safety of green tea
interfere with warfarin, based on case reports (Ann Pharmacother. 1999. 33. 426-428).
significant effects on blood counts or blood chemistry profiles of healthy
individuals after repeated administration of 800 mg of EGCG daily (Clin Cancer Res. 2003. 9. 3312-3319).
tea plant absorbs fluoride (and aluminum), with the amount depending in part on
the acidity of the soil (Toxicol
Lett. 2003. 137(1-2):111-120). In one study, the fluoride level
increased with the decline in quality of the green tea product (J Agric Food Chem.
52(14):4472-4476). Interestingly, in low-fluoride water,
fluoride is easily released from tea leaves into the beverage. Conversely, in high-fluoride water,
dried tea leaves are able also to absorb fluoride. Thus, if a cup of tea is
made from high-fluoride water, the fluoride concentration of the infusion may
actually be lower than the original fluoride concentration of the water (Sci Total Environ. 2006. 366(2-3):915-917).
vegetables contain natural toxins which are inactivated by steaming or
boiling for a few minutes.
Andrew Weil specifically recommends against eating raw peas,
chickpeas, beans, alfalfa sprouts, lentil sprouts, mung bean sprouts, and
celery with brown patches because they are caused by a fungus which
contains natural toxins.
vegetables may destroy the enzymes which help us to digest them; this is
the rationale for supplemental digestive enzyme therapy.
vegetables instead of microwaving them will preserve more of the
antioxidants in the vegetables.
vegetables (broccoli, Brussels sprouts, cabbage, cauliflower, collard,
kale, radishes, and turnips) probably protect against breast and prostate
on safety of drinking water by community available at www.epa.gov/safewater/dwinfo.htm
and information on certified testing labs available at www.epa.gov/safewater/labs
or by calling 800-426-4791.
tap water to run for 30 seconds before drinking it eliminates much of the
of public water is essential at the source to kill bacteria in the water,
but if there is residual contamination of water with byproducts of
sewage, the chlorine may convert these into carcinogenic agents (chlorine
combines with naturally occurring organic matter in water to form trihalomethanes [THMs], which have been linked to an
increased risk of bladder and colorectal cancers). Chlorine consumption
is not ideal for human health - boiling tap water or allowing it to sit
in an open-mouth pitcher for 1-2 days before use eliminates much of the
chlorine, because chlorine is volatile and evaporates.
of water is controversial regarding whether there is a beneficial effect
with regard to decrease in dental caries – fluoride consumption is not
ideal for human health.
people at greatest risk from contaminants in tap water are the 28 million
Americans served by small public water systems which serve fewer than
3300 customers each, because these are inspected less frequently than
larger systems. Large systems are usually quite safe. Reports of levels
of chemicals present in public water systems are readily available to the
tap water may signal a problem with parasitic contamination, because
cloudy water indicates that the filters at the intake are letting through
particles, and thus may be letting through parasites too. Parasites are
not effectively killed by chlorination.
magnesium and calcium; prevalent east of the Mississippi
from heart disease are less in locations with hard water.
softened water is unsafe – the magnesium and calcium are often replaced
by sodium when water is artificially softened, and this can leach cadmium
out of pipes into the water.
water is classified as a food and therefore not regulated very well, and
often may not be much safer than tap water. Aquafina is a brand which is filtered,
and thus a good quality brand.
water sold in soft plastic may be dangerous - there is some concern that
chemicals from the plastic leach into the water.
of bottled water (NOTE ‘glacier water’ and ‘mountain water’ have no
– water obtained from a well that taps a confined aquifer (underground
layer of rock or sand which contains water).
– water that has been boiled to kill microbes, then recondensed
from steam. Distillation also removes minerals.
– groundwater that naturally contains at least 250 ppm of dissolved
– public water source (i.e. Aquifina bottled
– water from any source that has been treated to remove chemicals and
pathogens; must contain no more than 10 ppm of dissolved solids (i.e. Aquifina and Dasani bottled water)
– water that contains carbon dioxide at an amount equal to what it
contained when it emerged from the source (i.e. Perrier)
– water derived from an underground formation from which water flows
naturally to the Earth’s surface (i.e. Arrowhead, Evian)
benefits of water – this notion is advocated by Dr. F Batmanghelidj,
who suggests daily consumption of 1 ounce of water/kg body weight, and
asserts that this high level of daily water consumption can heal
allergies, anxiety, asthma, depression, hypertension, migraines, obesity,
peptic ulcers, and rheumatoid arthritis.
- Water testing - test your water if
not on a public system (public system reports are available to all consumers
once a year) – to find a certified lab, contact the local health
department or call the federal Safe Drinking Water Hotline at
filters (Consumer Reports. 2/12.
44-45; 5/10. 33-35; 5/07. 38-40). To choose a water filter effective for
specific contaminants (based upon testing of your water supply), go to www.consumerreports.org and
search for “water filters.”
is no water filter on the market which eliminates 100% of all potentially
hazardous substances in tap water.
- Purchase a water filter which is
certified by the Water Quality Association (www.wqa.org) and which meets NSF standards (www.nsf.org),
specifically NSF Health Effects Standard 53 for cysts as well as the
standards for VOCs (pesticides, herbicides, chemicals), endocrine
disrupters (PCBs), trihalomethanes, heavy
metals, MBTE, chloramines, and asbestos.
of water filters
filters remove lead, chlorine, and a variety of sediments, but do not
remove nitrates, microbial organisms, or pesticides. They come as
pitchers, and cost $20-$40. Replacement filters cost $40-$100 per year.
filters remove lead, chlorine, and a variety of sediments. Models vary
with regard to what they do not remove. The filter should be briefly
flushed before use because the organic contaminants which build up in
the filter provide an ideal breeding ground for bacteria. The filters
cost $15-$35. Replacement filters cost $30-$100 per year.
– no installation needed
– filter life relatively short; not suited for households requiring
more than a couple of gallons per day of filtered water
filters remove lead, chlorine, and a variety of sediments, may also
remove nitrates, microbial organisms, or pesticides. The filter should
be briefly flushed before use because the organic contaminants which
build up in the filter provide an ideal breeding ground for bacteria.
The filters cost $50-$300. Replacement filters cost $50-$100 per
– easy installation and quick switching between filtered and unfiltered
– slow rate; filter life relatively short; cannot be used with most
pull down or spray faucets
Undersink filters remove lead, chlorine, and a
variety of sediments, may also remove nitrates, microbial organisms, or
pesticides. The filter should be briefly flushed before use because the
organic contaminants which build up in the filter provide an ideal breeding
ground for bacteria. The filters cost $100-$550. Replacement filters
cost $50-$150 per year.
– good at filtering large quantities of water without modification of
plumbing; infrequent changes of filter
– flow rate may be slow; cannot be used with most pull down or spray
faucets; create countertop clutter
osmosis systems remove chlorine, fluoride, lead, nitrates, organic
chemicals, microbial organisms, pesticides, and even dissolvable
substances. These are the most effective means of removing fluoride.
Water is flushed through two carbon filters and a synthetic
semi-permeable membrane. Reverse osmosis water is very corrosive to metal pipes, so
the units should be installed at the tap, not on the main line leading
into the house. Cost of the system is about $150-$900 with an additional
$300 for installation. The carbon filters need to be replaced yearly, at
a cost of $100-$200. The synthetic membrane screen needs to be replaced
every 3-5 years at a cost of $100.
– filters large volumes of water, rarely plugs with sediment; doesn’t
clutter countertop, no need to modify faucet, infrequent changes of
- generally require installation by a plumber at an installation cost
of $120 plus $150, takes up cabinet space; requires a hole in the sink
for the dispenser
filters – NOTE one can connect an undersink
filter to the fridge and bypass the appliance’s filter.
– removes widest range of contaminants, including arsenic
– bulky and requires plumbing modifications, wastes 3-5 gallons of water for every gallon of water
filtered; removes beneficial trace minerals from the water; flow rate
may be slow; takes up cabinet space
- improve taste; convenient
- as per Consumer Reports testing are only so-so at removing
impurities; replacement filters are costly
Reports on Health. 1/03. Is Your Diet Up-To-Date?)
neurotoxin, and a likely carcinogen, found in many plastics.
by Swedish researchers in various fried high carbohydrate foods such as french fries and potato chips at levels far above that
allowed in drinking water by the EPA. Subsequent reports indicate
high levels in some breads, cereals, and crackers, but with tremendous
variability from sample to sample within the same product.
significance unclear – there is data that acrylamide can inactivate creatine kinase (CK), thereby depleting the body’s
energy stores, and also deplete glutathione, an important endogenous
in mice indicate that resveratrol (found in red wine and red grapes), tea
polyphenols, and diallyl trisulfide
(present in processed garlic) inhibit the body’s ability to retain
acrylamide (Xie Q et al. J Agric Food Chem. 2008. epub).
in human liver cells exposed to acrylamide shows that curcumin reduces the
production of free radicals, and thus curcumin may mediate
acrylamide-mediated genotoxicity (Cao J et al. J Agric Food
Chem. 2008. epub).
Advanced glycation end products (AGEs)
by the interaction of a reducing sugar and a protein or an amine
in food are absorbed
intact, persist in tissues, increase the immunogenicity of proteins,
promote the development of atherosclerosis and complications of diabetes,
promote cross-linking of protein, accelerate the aging process, and
increase the inflammatory response.
methods affect AGE content of food significantly – see just below.
content of typical diet is16,000 kU/day, much
higher than optimal.
is a highly reactive reducing sugar, and therefore promotes the formation
of AGEs during cooking. Sucrose is not a reducing sugar. Furthermore, the
increase in serum fructose concentrations after ingestion of large amounts
of fructose may promote the formation of AGEs in vivo.
Cooking methods and health (also see Microwaves below)
produces cholesterol oxides, lipid peroxides, heterocyclic amines, and
advanced glycation end products (see just above).
method affects advanced glycation end products (AGE) content of food.
temperature (higher temperature generates more AGEs) – important factor.
(water inhibits AGE formation) – important factor.
time (longer time generates only slightly more AGEs) – less important
produces relatively few AGEs, but see below for other issues related to
boiling, poaching, and stewing over frying, broiling, and roasting may
decrease daily AGE intake by up to 50%.
chicken has 9,000 kU of AGEs, whereas boiled
chicken has only 1,000 kU of AGEs.
food French fries (100 gm) have1,522 kU of
AGEs, whereas a potato boiled for 25 minutes (100 gm) has only17 kU of AGEs.
walnuts (15 gm) have1183 kU of AGEs, whereas
raw walnuts have no AGEs.
formula (100 ml) has 487 kU of AGEs, whereas
breast milk (100 ml) has 7 kU of AGEs.
Cookware (also see Microwaves below)
– conducts heat well and easy to care for, but aluminum may leach into
food, especially acidic food.
iron – iron can leach into the food, especially acidic food, and too much
intake of iron can cause health problems (this is an issue primarily for
men and postmenopausal women). Enamel
coated iron cookware is considered by some to be ideal – it is
expensive, and it weighs a lot.
– conducts heat well, but difficult to maintain, and copper may leach into
– safest, but does not conduct heat well.
– nonstick surface, considered safer than Teflon
– safe, conducts heat well, BEWARE might crack if exposed to direct flame
or wide temperature extremes
steel – safe, but does not conduct heat well, and some individuals may
have allergic reactions to the nickel in stainless steel.
heat resistant plastic used to coat pans.
heated to 600 degrees, the coating can break and release perfluorooctanoic
animals, PFOA can cause cancer, immune system damage and death.
of Americans have traces of PFOA in their blood – sources include waterproof
fabrics and electronic parts as well as Teflon pans.
NEWS – Consumer Reports (June 2007, pg 7) reports in ‘Up
Front’ that testing of air samples showed barely measurable emissions, and that
the experts consulted by Consumer Reports agreed that emissions of PFOA from
cookware probably don’t contribute much to overall PFOA exposure.
precautions – discard pans which have begun to flake, use ventilation when
cooking, and don’t put empty pans over high heat.
2700 food and chemical additives are allowed into the U.S. food supply,
including colorings, sweeteners, preservatives, flavorings, emulsifiers,
1984 3200 tons of coal tar dyes were added to foods.
average American eats 14 pounds of food additives per year.
(alum) in baking soda and pickles is best avoided.
– may trigger ADHD, allergic rhinitis, asthma, erythema multiforme, urticaria, and
vasomotor rhinitis in susceptible individuals
and BHT (synthetic preservatives added to foods to prevent rancidity and
thus increase shelf life) may promote carcinogenic changes in cells.
- Carageenan (Townsend
Letter. July 2011. 89-91)
grade carageenan is used to improve the texture
of foods (also used in cosmetics, pharmaceuticals, and toothpaste),
granted GRAS status by FDA in 1959.
carageenan is a known carcinogen – there is
concern that gastric acid and acid contained in foods, as well as the effects
of intestinal flora, may cause degradation of food-grade carageenan into a carcinogen.
- Food dyes (Self Healing. 4/09. Pg 7)
8 synthetic dyes allowed in the US are Yellow 5 (tartrazine) and 6, Red 3 and 40, Blue 1 and 2, Green
3 and Orange B. These are petroleum-based coloring agents.
are natural alternatives to synthetic dyes, such as beet juice (red) and
are concerns that synthetic food dyes may be carcinogenic, may cause
asthma and hives in adults, and may cause hyperactivity and other
behavioral problems in children.
June 2008, the CSPI petitioned the FDA to ban the 8 approved food dyes.
information on food dyes and foods containing synthetic dyes at www.iatp.org.
vegetable protein, sometimes referred to as just 'vegetable oil' in
the ingredients list on the label, contains glutamate and aspartate, both
excitatory neurotransmitters which may cause cell death.
which commonly have MSG or hydrolyzed vegetable protein added include
soups, salad dressings, steak sauce, croutons, chips, creamy sauces, some
gravies, and some gourmet foods.
more information, read Excitotoxins: The Taste that Kills by
Russell L. Blaylock, MD.
glutamate (MSG) is a source of excess sodium, and is degraded to
glutamate, an excitatory neurotransmitter which in excess may cause death
of cells in the brain. In addition, there are case reports of MSG as a
trigger for ADHD, asthma, chest pain, depression, epilepsy, fibromyalgia,
headaches, perennial rhinitis, and PVCs.
which are added to many cured meats can react with protein breakdown
products in the digestive tract to form highly carcinogenic nitrosamines. Vitamin
C can block the conversion of nitrites to nitrosamines.
trigger anaphylactic shock, asthma, and urticaria
in susceptible individuals.
of asthmatics experience an exacerbation of symptoms after ingestion of
Genetically modified food (GMO)
· Soy, corn, canola
are the major GMO foods.
· Rationale for
genetic modification – confers herbicide tolerance, or induces production of a
toxin by the plant which kills insects.
· Many critics
assert that GMO foods have been approved by the U.S. government despite very little
human research and some animal research suggesting associated harms.
inserted into GMO crops may be inserted into our DNA or the DNA of our gut
data - animals avoid eating GMO foods
a gene is inserted into a plant and then cloned, there might be collateral
damage in other genes – in one study, 5% of genes were affected when a
gene was inserted
create a new allergen (new protein)
Soy has increased lectin and lignin content, and is epidemiologically
associated with increased likelihood of soy allergy
information is available in the book Seeds
of Deception and at www.seedsofdeception.com
and at www.GMFreeSchools.org.
heat food by causing it to resonate at very high frequencies - this causes
a change in the chemical structure of the food that can lead to health
causes the formation of potentially toxic cis-isomers and D-isomers of amino
causes the formation of substantial amounts of lipid peroxides.
- A study published in the November 2003 issue of The Journal of the Science of Food and
Agriculture found that broccoli heated in the microwave with a little water
lost up to 97 percent of the beneficial antioxidant chemicals
it contains. By comparison, steamed broccoli lost 11 percent or fewer of
- When microwaving food in plastic containers or on
paper plates, carcinogenic toxins may be released into the food.
- A Turbo Oven is an alternative to a microwave.
Food in a Turbo Oven is cooked from all around whereas food in a
convection oven is cooked just from above and below.
– sales of organic food in the US increased from $1 billion in 1990 to
$26.7 billion in 2010, according to the Organic Trade Association.
labels effective 10/21/02, based on guidelines published by the USDA in
1990, Congress passed the Organic Food and Production Act (OFPA), which
instructed the USDA to establish uniform national standards for organic
food and farming. The 1990 law banned the use of additives and synthetics
in organic food.
USDA issued an initial set of standards in 1997 which would allow for the
use of genetically modified crops, irradiation, and sewage sludge in
organic food production –much of the organic food industry strongly
objected to these specifications.
USDA 2000 guidelines did not allow for antibiotics, hormones, genetically
modified crops, irradiation, or sewage sludge in the production of
organic products, but did allow for additives and synthetics, and
required only that cows “access to pasture,” an undefined term which is
unenforceable, meaning that organic meat and milk most often comes from
cows fed corn and soy rather than grass, and cows who spend most of their
lives in confinement, similar to the cows on non-organic factory farms.
are more than 50 organic certification agencies that will ensure that
food companies and organic farms meet the new standards, as per Natural Health, Oct/Nov 2002.
Organic - products produced without bioengineering, radiation,
antibiotics, growth hormones, fertilizers, or conventional
pesticides. It must be at least 3 years since pesticides were used
on the land before food grown on that land can be labeled as organic - if
at three years the soil still tests positive for pesticide residues,
testing needs to be done yearly and the food cannot be labeled as organic
until all pesticide residue is gone from the soil.
- at least 95% of the ingredients must be certified organic.
with Organic - at least 70% of the ingredients must be certified organic.
- Why choose organic? Organic farming is better for the
environment, organic foods have less pesticide, and may be more
longitudinal 15 day study in 23 children in Seattle age 3-11 concludes
that dietary intake of pesticides represents a major source of exposure
for infants and children and that an organic diet provides a dramatic
and immediate protective effect against exposure to commonly used
organophosphate pesticides, which are known to cause neurological
effects in some humans (Environment
Health Perspect at http://dx.doi.org/ and reviewed in Alt Med Alert. 2006. 9. 11-12).
crops most likely to be contaminated with pesticides varies over
time. The Environmental Working
Group periodically updates its list of “dirty dozen” fruits and
vegetables most contaminated with pesticides - for an updated list, go
‘Food News from the Environmental Working Group’ and scroll to the
bottom of the page for a ranking for fruits and vegetables with the most
to the least amount of pesticide residue. This list is periodically
Nutritional content – data is MIXED
study - a systematic review identified 162 studies using one of three designs:
field trials (comparing adjacent parcels of land), farm surveys (comparing
products from organic and conventional farms), and basket studies (comparing
foods available through retail outlets). The authors examined only those
nutrient categories reported in at least 10 studies (11 nutrients – vitamin C, phenolics, magnesium, potassium, calcium, zinc, copper,
total soluble solids, titratable acid, phosphorous,
and nitrogen) or at least 4 livestock studies (ash and unspecified fats). The
only differences were that conventional crops contained more nitrogen whereas
organic crops contained more phosphorous and titratable
acid, and these differences might be due to differences in ripeness or
fertilizer use (Dangour AD, et al. Am J Clin Nutr. Epub 7/29/09). The
studies identified were heterogeneous and often of poor quality (Greenfield RH.
Commentary. Alt Med Alert. 2009. 12.
§ A survey of the literature comparing nutrient content
of organic and conventional crops, which used published comparative
measurements of organic and conventional nutrient content which were entered
into a database for calculation, found that organic crops contained
significantly more vitamin C, iron, magnesium, and phosphorus and significantly
less nitrates than conventional crops (J Altern Complement Med. 2001. 7(2). 161-73). Some of the
original data was presented 2/23/95 by J.B. Pangborn
and B. Smith at the 13th Annual International Symposium on Man and
His Environment in Health and Disease, Dallas, TX (cited by Dr. William Rea at
IFM International Symposium 4/20/06).
higher levels of total phenolics were consistently
found in organically and sustainably grown foods (blackberries, corn,
strawberries) as compared to those produced by conventional agricultural
practices (J Agric Food Chem. 2003. 51
(5). 1237 -1241).
levels of polyphenols found in organically grown peaches (Food Chem. 2001. 72. 419-424).
Health benefits – a systematic review of 7
databases identified 17 studies in humans and 223 studies of nutrient and
contaminant levels in foods (Ann Intern
Med. 2012. 157. 348-366).
3 of the 17 human studies examined clinical outcomes and these 3 studies found
no significant differences in clinical outcomes.
studies of vitamin and nutrient levels did show differences; the results were
not consistent except for phosphorus (higher levels in conventional produce, a
difference of uncertain clinical significance).
risk for contamination with detectable pesticide residues was 30% lower (CI 23%
- 37%) among organic produce.
risk for isolating bacteria resistant to 3 or more antibiotics was 33% higher
(CI 21% - 45%) in conventional produce.
- How to determine quickly if fresh
produce is organic – check the Produce Look-Up (PLU) sticker. Organic
PLU codes begin with a ‘9’ and have 5 digits.
- Why choose ‘local’ produce over
organic produce is raised on industrial farms, with conditions similar in
many ways to non-organic farms.
organic produce is shipped thousands of miles to market, requiring the
use of much petroleum to get the food to market.
in 2005 there are no organic standards for fish.
When it pays to buy organic. Consumer
Reports. 2/06. 12-17.
- Non-digestible food products
that provide substrates that nourish the intestinal microflora.
fructo-oligosaccharides (FOS), galacto-oligosaccharides, and inulin.
- Food sources of FOS include
asparagus, banana, burdock root, honey, Jerusalem artichoke, maple sugar,
oats, onion, oats, and rye.
Probiotics – return to Home Page and go to “Dietary
is no single diet or set of rules that is right for everyone.
dietary systems conflict totally.
fresh yogurt and white rice are best, brown rice is worst.
brown rice is best, milk products are worst.
1978 in the United
States, 36% calories come from fat; in
1994, 34% of calories come from fat. Obesity continues to increase
nonetheless. This is in part due to substitution of high glycemic
index carbohydrates for fat in the diet.
is a clear epidemiologic association between obesity and consumption of
high fructose corn syrup which is in soda and other prepared foods.
disease is 90% less common in Greece even though the diet
approaches 40% fat, presumably because most of the fat is monounsaturated
fat (i.e. olive oil).
TYPES OF DIETS AND
THE SCIENTIFIC DATA
Low-Carbohydrate Diets (generally defined as 20-60 gm
carbohydrate/day, or approximately 20% of daily calories from carbohydrate) –
these are typically high in protein. The
theory is that limited carbohydrate will force the body to use stored fat
as fuel through ketosis, resulting in loss of fat, and that ketosis will
suppress appetite. Atkins diet and South Beach diet are low carbohydrate
protein (low carbohydrate) diets initially produce rapid weight
loss through a diuretic effect.
protein diets are contra-indicated in cirrhosis and other causes of liver
failure, as well as advanced kidney disease, and relatively
contra-indicated in even mild kidney disease. In a subgroup of the Nurses’
Health Study, high dietary protein intake was associated with a decline in
renal function only in women with mild renal insufficiency at baseline (Ann Intern Med. 2003. 138.
- In a
6 month prospective trial funded by the Atkins Center, 70% of
participants experienced constipation, 65% halitosis, 54% headaches, and
10% hair loss.
to Dr. Andrew Weil, high protein diets impose a considerable workload on
the digestive system and may contribute to feelings of fatigue.
increase the risk of calcium oxalate kidney stones, based on data from a
6 week metabolic study in 10 healthy subjects (Am J Kid Dis. 2002. 40. 265-274).
increase the risk of osteoporotic fractures in women, based on data in a
cohort of 85,900 women followed for 12 years in the Nurses’ Health Study. The association was observed only for
animal protein, not vegetable protein (Am J Epidemiol. 1996. 143.
Associated with muscle insulin resistance (Wang
CC et al. Metabolism. Epub 11/19/12), antioxidant nutrient deficiencies (Br J Nutr.
2011. 106. 282-291) and worsened endothelial function (Hypertension. 2008. 51. 376-382; J Intern Med. 2010. 267. 452-461).
worsen development of atherosclerosis, through mechanisms independent of
known markers (obesity, total cholesterol, triglycerides, glucose,
fasting insulin, oxidized LDL, inflammatory cytokines) and may impair
neovascularization in response to ischemia, based on data in a mouse
model of atherosclerosis (Proc Natl Acad Sci U S A. 2009. 106. 15418-15423 as cited in Alt Med Alert. 2009. 12. 125-126).
- May increase all-cause mortality
26 years of prospective data from the Nurses’ Health Study (1980-2006)
and 20 years of prospective data from the Health Professionals’
Follow-up Study indicates that a low carbohydrate diet based on animal
sources is associated with higher all-cause mortality in both men and
women, whereas a low carbohydrate diet based on vegetable sources is
associated with lower all-cause mortality and cardiovascular disease
mortality in both men and women. Diet composition was computed based on
data gathered in validated food frequency questionnaires. The
accompanying editorial addresses limitations of conclusions drawn from
observational data, as opposed to RCT trial data (Ann Intern Med. 2010. 153. 289-298 and editorial 337-339).
cardiovascular and all-cause mortality rates reported in a cohort of
Swedish women (J Intern Med.
2007. 61. 575-581).
Barry Sears argues very low carbohydrate diets are associated with an
increase in cortisol so that individuals can break down muscle to create
enough glucose for the brain, and that the high cortisol level is the
reason individuals regress at 6 months, even if compliant with the diet.
to Dr. Andrew Weil, high protein diets can aggravate allergies and autoimmune
meta-analysis of RCTs comparing the effects of low-carbohydrate diets
without energy restriction to low-fat, energy restricted diets, and with
at least 6 months of follow-up found that in the 5 trials with a total
of 447 participants who met inclusion criteria, weight loss was 3.3 kg
greater (1.4-5.3 kg) at 6 months in the low-carbohydrate group, but
equivalent in both groups at 1 year. There were no differences in BP
between the two groups. At 6 months, triglycerides and HDL changed more
favorably in the low-carbohydrate group, but TC and LDL changed more
favorably in the low-fat group. A
limitation of the analysis was a high dropout rate of 31-48% in the
low-carbohydrate trials individuals and 37-50% of the low-fat
individuals (Arch Intern Med.
2006. 166. 285-293).
a 12 month RCT of 148 obese men and women without clinical
cardiovascular disease, funded by the NIH and conducted at a large
academic medical center, “The low-carbohydrate diet was more effective
for weight loss and cardiovascular risk factor reduction than the
low-fat diet.” Strengths of the study include an approximately 80%
completion rate in both diet groups, high rates of dietary adherence
based on 24-hour recall and measurement of urinary ketone levels, and a
substantial proportion of black participants (Ann Intern Med. 2014. 161. 309-318).
in HDL (JAMA. 2005. 293. 43-53)
– NOTE though that the higher HDL levels noted in the RCTs of the Atkins
diet don’t necessarily translate to a lower cardiovascular risk, because
the higher dietary cholesterol intake may require a higher HDL level to
remove the extra cholesterol from the bloodstream.
in LDL – compared with low fat diets, low carbohydrate diets were
associated with more significant reductions in total cholesterol, LDL
cholesterol, and triglycerides, and an increase in HDL cholesterol (Am J Epidemiol.
2012. 176[Suppl]. S44-S54). However, cohort trial data shows
an association between low carbohydrate diets and increased
cardiovascular and all-cause mortality rates (J Intern Med. 2007. 61. 575-581).
individuals with symptoms of hypoglycemia on a high complex carbohydrate
diet may feel better on a high protein diet.
who believe that they have a condition labeled by some health authorities
as "chronic yeast syndrome" may find that they feel better on
the high protein "MEVY" diet (that is meat, eggs, vegetables,
of deceptive labeling (Consumer
Reports. 6/04. 12-15)
is not an agreed-upon definition of low-carbohydrate (the FDA is
carbohydrates generally refers to the total grams of carbohydrates per
serving minus the grams of fiber and sugar alcohols. Research shows
that this is a meaningful measurement in whole foods, but there is no
research to show that this value is of an significance in designer foods
with carbohydrate removed and sugar alcohols or fermentable carbohydrates
added. This term currently has no legal standing.
attention to the number of calories per serving on the label, not just
the grams of carbohydrate, because some low carbohydrate foods have added
fat and thus are loaded with calories.
nice review article is Very-low-carbohydrate weight-loss diets
revisited. Cleveland Clinic Journal of Medicine. 2002.
Low Fat (High Carbohydrate) Diets
advantages – fat is calorie dense (9 kcal/gm versus 4 kcal/gm) and
relatively less satiating than protein or carbohydrate (Obes Rev. 2003. 4. 83-90).
fat diets can be problematic if simple carbohydrates replace fat –
triglycerides will go up and HDL will go down.
published data on the effectiveness of low fat diets for weight loss,
compared with other types of diets, is mixed.
Low glycemic index
or load diets
- Resting energy expenditure (measured
after a 10 hour fast and after achievement of 10% reduction in body
weight) decreased less (p=0.04) with a low glycemic load diet than with a
low fat diet, even though body composition by DEXA did not differ between
the two groups. The difference in
resting energy expenditure between the two groups was 80 kcal/day (1 kg =
7500 kcal). Less hunger also
reported amongst those on low glycemic load diet (p=0.04). This means that physiologic adaptations
that serve to defend baseline body weight can be modified by dietary
composition (JAMA. 2004. 292.
- Most studies report beneficial health
outcomes with a low GI/GL diet (Clinical update: the low glycameic-index diet. Lancet. 2007. 369. 890-892).
- Insulin resistance, serum triglycerides,
CRP levels, and blood pressure improved more with low glycemic load diet,
compared with low fat diet (JAMA.
2004. 292. 2482-2490).
- Weight loss – data from 6 RCTs indicates
that overweight and obese people lose significantly more weight on low
GI/GL diets than on other diets (Cochrane
Database Syst Rev. 2007. 3:CD005105).
- Cardiovascular risk reduction – a 12
week RCT in 129 overweight or obese adults assigned to one of 4
reduced-fat, high-fiber diets (1) 55% carbohydrate, high GI (2) 55% carbohydrate,
low GI (3) 25% protein, high GI and (4) 25% protein, low GI found that all
groups lost a similar amount of weight, but cardiovascular risk reduction
was optimized by high carbohydrate, low GI diet (Arch Intern Med. 2006. 166. 1466-1475).
specifically as a treatment for hypertension – the diet consists of
increased fruits and vegetables and low fat dairy products and lean meat,
restricted in saturated fat and total fat intake.
Assessment of diet 7 times over 24 years by FFQ in
a cohort of 88,517 nurses in the prospective Nurses’ Health Study, and
calculation of a DASH score at each assessment, based on 8 food and nutrient
components (fruits, vegetables, whole grains, nuts and legumes, low fat dairy,
red and processed meats, sweetened beverages, and sodium) showed that adherence
to a DASH-style diet is associated with a lower risk of heart disease and
stroke (Arch Intern Med. 2008. 168.
principle components of Mediterranean diet include (1) plant based foods,
(2) locally grown minimally processed food, (3) fish and poultry, (4)
infrequent red meat consumption, (5) olive oil as principle source of fat,
(6) moderate amounts of red wine with meals, and (7) desserts primarily of
fresh fruit. Of note, “this dietary pattern of eating was not observed
until the decade after World War II - an artifact of postwar
impoverishment that proved beneficial to health.” (History of Medicine
Commentary. N Engl
J Med. 2013. 368. 1274-1276).
large French study reported reduced mortality in patients after a MI with
a Mediterranean diet (Lancet.
1994. 343. 1454-1459).
showing an association between the Mediterranean diet and increased
longevity include N Engl J Med. 2003. 348. 2599-2608 and Br J Nutr.
1999. 82. 57-61.
showing a either a decrease in cardiovascular risk or improvement in risk
factors in those following a Mediterranean diet include J Nutr.
2005. 135. 410-415 and Nutr J. 2003.
2. 1 and Am J Clin
Nutr. 2004. 80. 1012-1018.
European cohort study (HALE project) shows that the Mediterranean diet in
conjunction with physical activity, nonsmoking status and alcohol in
moderation is associated with a 50% reduction in all-cause mortality in
70-90 year olds (JAMA. 2004.
- A 2
year randomized, single-blind trial in 180 patients with metabolic
syndrome comparing a Mediterranean-style diet (intervention group) with a
"prudent" diet similar in composition to the Step I AHA diet
found significantly more weight loss in the intervention group (4 kg
vs.1.2 kg, P<0.001), a significantly greater decrease in hs-CRP levels
(P=0.01), and greater improvement in endothelial function score
(P<0.001). Only 40 of the 90 patients in the intervention group
still had features of metabolic syndrome at the end of two years, compared
with 78 of 90 patients in the control group (JAMA. 2004. 292. 1440-1446).
large prospective cohort study, the EPIC-Elderly Prospective Study Group
which monitored dietary intake in 74,607 men and women over age 60 in nine
European countries, found a clear association between a
Mediterranean-style diet (polyunsaturated fats were allowed in place of
monounsaturated fats in calculating a score to reflect the Mediterranean
diet) and increased survival amongst the elderly (BMJ. 2005. 330. 991-995).
Mediterranean diet was associated with a reduced all-cause mortality and
cause-specific mortality at 5 years of follow up in 214,284 men and
166,012 women in the NIH-AARP Diet and Health Study, a prospective study (Arch Intern Med. 2007. 167.
A prospective cohort study in Spain found that healthy patients
who adhered closely to this diet had a 35% relative reduction in the risk of
developing diabetes (BMJ. 2008. 336.
meta-analysis shows that the Mediterranean diet is associated with a
reduced risk of cardiovascular disease, cancer, and mortality (Sofi F et
al. BMJ. 2008. 337. a1344).
Mediterranean diet is associated with a decreased risk of Alzheimer
Disease, independent of benefit associated with higher levels of physical
activity (JAMA. 2009. 302.
- A 4
year randomized single-center study in 215 overweight individuals newly
diagnosed with type II diabetes found that those who consumed a
Mediterranean diet had better glycemic control, more favorable changes in
coronary risk factors, and a delayed need for antihyperglycemic
drug treatment, compared with control subjects who followed a low fat diet
(Ann Intern Med. 2009. 151.
the PREDIMED trial, a 3-arm, multicenter, RCT of 7447 individuals who were
at high risk of cardiovascular disease at baseline, but with no
cardiovascular disease at enrollment, the incidence of major
cardiovascular events (composite endpoint, defined as MI, stroke, or death
from cardiovascular causes) was reduced in those randomized to the
Mediterranean diet group supplemented with extra-virgin olive oil, and
also reduced in those randomized to the Mediterranean diet group
supplemented with mixed nuts, as compared with those randomized to a
control diet (advice to reduce dietary fat).The trial was stopped after a
median follow up of 4.8 years, based on interim analysis showing benefit,
with hazard ratios of 0.70 (0.54 – 0.92) in the group assigned to the
Mediterranean diet group supplemented with extra-virgin olive oil, and
0.72 (0.54 – 0.96) in the group assigned to the Mediterranean diet group
supplemented with nuts (N Engl J Med. 2013. 368. 1279-1290). In an
accompanying editorial, the authors comment that analysis of the dietary
intake of each of the 3 groups in this trial suggests that “the most
striking differences between the randomized groups resulted from the
supplemental foods” (i.e. extra virgin olive oil versus mixed nuts), and
thus the results of this trial seem more a testament to the health
benefits of mixed nuts and/or extra virgin olive oil, as opposed to the
Mediterranean diet per se (N Engl J Med. 2013. 368. 1353-1354).
a subgroup analysis of individuals in the PERIMED trial who did not have
diabetes at baseline, the Mediterranean diet supplemented with
extra-virgin olive oil had a significantly lower rate of onset of diabetes
at 4 years of follow-up (RR 0.60, 95% CI 0.43 – 0.85, as compared with a
control diet), even though calorie intake was not restricted. The group
randomized to Mediterranean diet supplemented with mixed nuts had a nonsignificant decrease in rate of onset of diabetes
at 4 years of follow up (RR 0.80, 95% CI 0.61 – 1.10) [Ann Intern Med. 2014. 160. 1-10].
8.1 year follow up of a RCT of 215 newly diagnosed type II diabetics, a low-carbohydrate
Mediterranean diet was associated with delayed start of glucose lowering
medications, as compared with a low-fat diet (Diabetes Care. 2014. 37. 1824-1830).
Emphasizes plentiful consumption of vegetables,
fruits, nuts, and meats, and prohibits dairy, legumes, and cereal grains (as
these did not become part of the human diet until 10,000 years ago).
Outcomes data from long term RCTs are lacking
Benefits – improved blood pressure, improved glucose
tolerance, decreased insulin secretion, increased insulin sensitivity, and
improved lipid profile, even in the absence of weight loss (Frassetto
LA et al. Eur J Clin Nutr. 2009. 63. 947-955).
vegetarian diet is epidemiologically associated with a decreased risk of
cancer, diabetes, diverticulosis, gallstones, heart disease, high blood
pressure, and osteoporosis (Nutr Rev.
2009. 67. 255-263).
diet and mortality in prospective cohort studies
pooled analysis 5 cohorts, including more than 76,000 men and women with
an average follow up of 10.6 years, did find a reduced risk of CV
mortality, RR=0.76 (Key TJ et al. Am
J Clin Nutr.
1999. 70[Suppl]. S516-S524).
the Oxford Vegetarian Study in 6000 vegetarians and 5000 nonvegetarians, at 12 years of follow up, vegetarians
had a lower total mortality (RR=0.80) and a lower mortality from
malignant neoplasms (RR=0.61), with a nonstatistically
significant trend toward lower cardiovascular mortality (Appleby PN et
al. Am J Clin
Nutr. 1999. 70[Suppl].
American Dietetic Association published a position paper stating that
appropriately planned vegetarian diets are healthful, nutritionally
adequate, and provide health benefits in the prevention and treatment of
certain diseases (J Am Diet Assoc.
2003. 103. 748-765).
2.5% of adults in the U.S.
follow vegetarian diets.
tend to have a lower BMI than non-vegetarians.
carnitine can be a problem, especially in children who are strict
vegetarians – this amino acid is essential for conversion of fat into
energy (i.e. ATP)
iodine intake can be a problem if non-iodized salt is used – seaweed and
kelp are good vegetarian sources of iodine.
iron intake can be a problem.
- Heme iron in meat is 15-35% absorbed; non-heme iron is 1-7% absorbed. However, digestion in
long-term vegetarians may adjust to allow increased percentage of iron
of non-heme iron, predominantly found in dark
green, leafy vegetables, may be increased up to 5-fold by vitamin C (eat
fruits with vegetables).
content of the diet can be increased 4-fold by using iron pots and
of heme iron is usually unaffected by the rest
of the diet, but absorption of non-heme iron is
hindered by caffeine, tea (tannic acid and polyphenols), and phytates found in many legumes and grains
probably competes with other minerals for binding sites at the intestinal
wall, so supplements of any one mineral may lead to decreased absorption
of other minerals (iron, calcium, copper, zinc, selenium).
lysine intake can be a problem – lysine is plentiful in legumes, but
relatively deficient in wheat.
omega 3 fatty acid intake can be problematic – consider supplements. There are vegan supplements of DHA made
from microalgae; these are expensive.
taurine (an amino acid) can be problematic – this conditionally essential
amino acid which is essential for detoxification/biotransformation is
absent in all vegetable protein.
vitamin B12 intake can be a problem in vegans who do not take
supplements. Measuring vitamin B12
levels can be deceiving because vegetarian diets may contain vitamin B12
analogues which will cause a false normal vitamin B12 level (measure
MMA). In some vegans, the bacteria
in the mouth and the colon make enough vitamin B12 so that deficiency is
zinc intake can be a problem, especially at the time of conversion to a
vegetarian diet, probably because the intestinal phytase
required to break down phytic acid and thus
allow absorption of calcium, iron, etc. from fiber, is a zinc dependent
enzyme. Zinc supplements, 15-20 mg/day, are probably advisable at the time
of transition to vegetarianism.
to include in a vegetarian diet (Natural Solutions. 1/09)
butter -good source of protein, calcium, iron, and zinc.
- fermented soy product which is loaded with protein, iron, and vitamin
yeast - natural source of vitamin B12.
- source of all 8 essential amino acids, good source of iron and zinc,
high protein content (truly a seed and not a grain).
seeds - good source of iron and zinc.
seeds - good source of iron and zinc.
- fermented soy product which is loaded with protein.
germ - good source of iron and zinc
Vegetarian Resource Group www.vrg.org.
Diet and cancer (Arch Intern Med. 1993. 153. 50-56)
fat intake is associated with an increased risk of cancer in animal
calorie intake is associated with increased risk of cancer.
acid intake is associated with increased risk of cancer.
wide variety of dietary substances exhibit anti-carcinogenic activity in
animal models, including vitamins A, C, E, beta-carotene, calcium,
selenium, some forms of fiber, and CLA, which is a class of fatty acids
closely related to linoleic acid, which are found in dairy products,
ruminant animal meat, and turkey.
dose anti-oxidants in supplemental form may have a paradoxical
and smoked foods as they are prepared in the United States are probably
not carcinogenic. Different methods of food preservation in other
countries may be responsible for contamination of food with carcinogens.
intake of man-made pesticides in the U.S. is 0.09 mg/person/day,
50% of which is due to 4 chemicals that are not carcinogens, but intake
of natural pesticides is about 1.5 gm/person/day, and many are known
carcinogens. Furthermore, stress, such as that induced by insect attacks
on plants, leads to an increase in natural pesticide production in
fruit and vegetable consumption is linked with reduced cancer risk. The
reasons are not fully known.
for the recent National Cancer Institute study of 30,000 Chinese, no
other studies document an epidemiologic association between fat
consumption and cancer.
and minerals – Go back to Home Page and click on “Vitamins and Minerals”
– scientific appreciation of the health benefits of phytochemicals
(chemical compounds found in plants) is a much more recent phenomenon than
the scientific appreciation of the health benefits of vitamins and
may be as many as 1000 different phytochemicals, with over 500
phytochemicals identified in fruits, vegetables, and grains as of 2005
of these phytochemicals have more than one function in the body.
Phytochemicals for which dietary intake is associated with
- Allicin - reduced risk of cancer spread and heart
attacks, lower cholesterol and blood pressure, enhance infection defenses.
in garlic, leeks, white onions.
- Anthocyanins (a category of flavonoids) - decrease
blood clots, improve night vision, combat macular degeneration, lower
blood pressure, and may protect against age related changes in the brain.
in beets, bilberries, blackberries, black currants, blueberries,
cranberries, elderberries, kidney beans, purple grapes, raspberries, red
apples, red cabbage, red onions, strawberries, sweet cherries.
8 ounce glass of purple grape juice may be as effective as aspirin at
preventing a heart attack.
carotene – reduced risk of cancer and heart disease, increased ability to
fight infection, maintenance of good vision.
in apricots, butternut squash, cantaloupe, carrots, mangos, peaches,
pumpkin, sweet potatoes.
- painkiller, anticancer effects.
– family of pigments (more than 600 now identified), including alpha
carotene, beta carotene, lutein, lycopene, zeaxanthin.
- Catechins - decrease oxidation of LDL cholesterol, and
may decrease cancer risk. Catechins are
in green tea, and in smaller quantities in black tea.
- Curcuminoids – polyphenols from turmeric,
– see ‘tea’ above, and specifically benefits
of green tea. EGCG is a flavonoid.
- Ellagic acid – in pomegranate, anticancer effects
in raspberries, strawberries.
(flavonoids are a subgroup of plant polyphenols; there are 6 types of
flavonoids, as per the Linus Pauling Institute)
- Anthocyanins – see above.
- Food sources include apples, apricots, green tea, red grapes, red wine
- Food sources include citrus fruits and juices
- Flavonols - Food sources include apples, blueberries,
broccoli, cranberries, kale, leeks, onions
- Food sources include celery, hot peppers, parsley, thyme
– see just below.
- antioxidant and anti-cancer properties.
in asparagus, avocado, broccoli, cauliflower, fresh grapefruit,
okra, fresh oranges, fresh peaches, white potatoes, squash, strawberries,
raw tomatoes, and watermelon.
- antioxidant properties, reduced risk of breast and prostate cancer.
in arugala, broccoli, brussels
sprouts, cabbage, cauliflower, horseradish, kale, mustard, radish, Swiss
chard, turnip, and watercress.
(a category of flavonoids) - phytoestrogens which combat menopausal
symptoms, strengthens the bones, lowers cholesterol levels, raises HDL
cholesterol levels, and may decrease cancer risk.
in some soy products, including raw soybeans, soy milk, soy nuts, tempeh,
and tofu. Not present in soy sauce, soy oil, or in many brands of soy
burgers, soy cheeses, or soy hotdogs.
protein is probably a surrogate marker for isoflavones, with 20 - 60
grams per day of soy protein recommended for maximum benefit.
(a carotenoid) - antioxidant properties, reduced risk of cataracts and
macular degeneration, reduced risk of colon cancer.
in broccoli, green peas, honeydew, kale, kiwi fruit, leafy greens,
romaine lettuce, and spinach.
(a carotenoid) - antioxidant properties, anti-cancer properties.
in pink grapefruit, guava, tomatoes, and watermelon.
- Phenolics – slow effects of aging.
in eggplant, plums, prunes, raisins.
- heart protective benefits and anti-cancer properties.
in red wine, red grapes, cranberries, dark chocolate, nonherbal
teas (black, green, white, and oolong).
are subdivided into categories of flavonoids, phenylpropanoids (i.e. lignins), and
- Proanthocyanidins – polyphenols found in grape skin,
pine bark, and cocoa; anti-inflammatory and antioxidant effects
- antioxidant properties. Quercitin is a
in broccoli, cherries, red grapes, yellow and red onions, and Italian
– a polyphenol in grape skin and red wine which lowers CRP, has anti-aging
- Sulforaphane - anti-cancer properties.
in bok choy,
sprouts, cabbage, and cauliflower.
- Agatston, Arthur. The South Beach
- Ballentine, Rudolph. Transition to Vegetarianism
- Ballentine, Rudolph.
Diet and Nutrition
- Batmanghelelidj, F. Your Body’s Many Cries for Water
Russell L. Excitotoxins: The Taste that Kills
- Brand-Miller, Jennie et al. The
New Glucose Revolution
- Campbell, T. Colin. The China
Jean. Food-Your Miracle Medicine
Kayla. The Whole Soy Story
- Enig, Mary. Know
U. Fats that Heal, Fats that Kill
- Falon, Sally. Eat
Fat, Lose Fat
- Falon, Sally. Nourishing
- Galland, Leo. The
Fat Resistance Diet
RF and Kushner N. Dr. Kushner’s Personality Type Diet
Marion. What to Eat
- Pollan, Michael. The
Weston. Nutrition and Physical
Steven and Kathy Mathews. Superfoods
Rx: Fourteen Foods That Will Change Your Life.
Sheila (ed). Clinical
Nutrition: A Functional Approach
Barbara and Barnett RA. The Volumetrics
Weight Control Plan
Lisa. The Perfect Fit Diet
Barry. The Anti-Inflammation Zone
Andrew. Eating Well for Optimum
Walter. Eat, Drink, and Be Healthy
- Consumer Reports. 1/90. 27 - 40.
Fit to Drink?
- Hippocrates. 5/94. 30-37. The Man
Who Has a Beef With Your Diet.
- Consumer Reports on Health. 1/03.
Is Your Diet Up-To-Date?
- Consumer Reports. 1/03. 33-38.
Clear Choices for Clean Drinking Water.
- www.aicr.com. American Institute of Cancer
Research web site with abundant information
on a healthy diet.
Government page which includes nutrition information on more than 8,000
foods, recommended by Consumer
Leo Galland’s Drug-Nutrient Interactions
Workshop Software from Allergy Research Group 800-545-9960 www.allergyresearchgroup.com
Activity, Variety, and Excess (WAVE) tool – facilitate dialogue between
physician and patient; formatted as a pocket card with assessments on one side
and recommendations on the other side http://outside.utsouthwestern.edu/chn/naa/wave/wave_instruct.htm
(Diabetes Educ. 2001. 27.
Eating and Activity Assessment for Patients (REAP) assesses dietary intake
related to 2005 dietary guidelines (J
Nutr. 2003. 133. 556S-562S)
Heart, Lung, and Blood Institute interactive menu planning guide http://hin.nhlbi.nih.gov/menuplanner/menu.cgi
- University of Wisconsin Integrative Medicine www.fammed.wisc.edu/integrative/modules Patient Handouts on “The
Anti-Inflammatory Diet” and “Detoxification Program: 7 Day Appendix, pgs 1-2
[Last Updated January 26, 2015] [Return
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