Research: Canadians Have Less Disease than Americans, Too

First the redcoats, now the red leaves! Last week Followhealthlife looked at a study published in the Journal of the American Medical Association showing the British are healthier than Americans. This week new research indicates our neighbors to the north are healthier too. MSNBC reports:

Americans are 42 percent more likely than Canadians to have diabetes, 32 percent more likely to have high blood pressure, and 12 percent more likely to have arthritis, Harvard Medical School researchers found. That is according to a survey in which American and Canadian adults were asked over the telephone about their health.

This graph from the Associated Press shows additional health disparities found during this study:

AP_HealthyCanadians.gif

The knee-jerk reaction to this study (other than panic) is to point to Canada's national health insurance program as an explanation. Some researchers adhere to the idea, but others dismiss it as anecdotal:

Canada's national health insurance program is at least part of the reason for the differences found in the study, Dr. Steffie Woolhandler, a co-author of the Canadian study said. Universal coverage makes it easier for more Canadians to get disease-preventing health services, she said.


James Smith, a RAND Corp. researcher who co-authored the American-English study, disagreed. His research found that England's national health insurance program did not explain the difference in disease rates, because even Americans with insurance were in worse health.

"To me, that's unlikely," he said of the idea that universal coverage explains international differences.

Research like this is fascinating. But it does little improve your health, no matter where you live. In the meantime do your own research. Check out all the research on a nutrient-rich vegetable-based diet and how it can protect against diseases such as cancer, diabetes, heart disease, etc.

NY Times Looks at Safe Fish

When you consider all the bad press seafood gets these days (contamination and over-fishing of certain species) staring at a menu in a seafood restaurant could provoke a panic attack. So, New York Times reporter Marian Burros did a little investigation to see which fish is safe to eat:

Like the shy kid at the dance whose charms are not readily apparent, unpopularity has kept some species in circulation, waiting to be discovered. Atlantic mackerel wears its reputation like a pocket protector and horn-rimmed glasses, but a little attention reveals its sweet side. When a vegan I know returned to eating fish, then extolled the marvels of mackerel, I knew it was time to give it a whirl.


Chilean sea bass may be everyone's delight, but it is being loved to death and needs a break from its fans. Pacific halibut, black cod and mahi-mahi are excellent substitutes for Chilean sea bass, which, if it went by its real name � Patagonian toothfish � might not be so popular.

Read Dr. Fuhrman's recommendations for fish-eaters.

Grand Rounds: Volume 2, Edition 36

Research: Mice Healthier with Japanese Diet

The standard American diet's (SAD) streak of defeats continues. According to the Associated Press researchers from Tohoku University determined the traditional Japanese diet (touted as the reason for low levels of obesity in Japan) is healthier than the American diet. Kozo Mizoguchi reports:

A nutritionist created two menus comprising 21 typical foods from the United States and Japan, according to reports of the study seen by The Associated Press.


Each meal, freeze dried and mixed into powder, was given to eight mice for a period of three weeks, the reports showed.

The American menu included hamburgers and fried chicken, while the Japanese menu included sashimi, or raw fish, and rice porridge.

The study found that several genes that work to break down cholesterol and fat were 1.5 times more active in the mice which received the Japanese menu as opposed to those fed with American food.

The study also found that the level of cholesterol was 10 percent higher in the American-food fed mice.

But Mizoguchi reports the future is uncertain:

Health experts, however, are worried about rising rates of obesity, especially among young people who prefer fast food.

Aussie Pets Plump Too

Fat Mouse.jpg

According to Reuters not a lot of people know Australia's obesity epidemic rivals that of the US. Nope, down-under isn't all sunshine and swimsuits, but who would have thought Aussie pets are getting portly too. James Grubel reports:

Obesity rates for Australians have doubled over the past 20 years, with 62 percent of men and 45 percent of women now deemed overweight or obese.


The same trend applies to household pets, with an increase in the number of overweight cats and dogs being dealt with by the Royal Society for the Prevention of Cruelty to Animals (RSPCA), and even one case of an obese pet mouse.

"It's a big problem, and quite reflective of what's happening in the human situation," said Mark Lawrie, the RSPCA's chief vet.

Coming soon...Eat to Live for Animals! Just kidding.

Nutritional Excellence vs. Menstrual Complaints and Irritable Bowels

Adapted from Dr. Fuhrman's book Eat to Live:

Other conditions that also respond exceptionally well to dietary modification include menstrual complaints and irritable bowel syndrome.

Researchers testing similar diets to the one I recommend have noted that a low-fat vegetarian diet increases sex-hormone-binding globulin as it reduces estrogen activity.1 This not only reduces one's risk of breast cancer but also significantly reduces the pain and bloating associated with menstruation.

I also see a large number of patients with irritable bowel syndrome. Some feel better within three days of following this diet, although others take a few weeks or longer to adjust to the comparatively large amount of fiber. Both animal products and flour products are triggers for bowel symptoms in many individuals.2 British researchers have documented that increased production of methane and other gaseous products representing increased fermentation in the colon from meats, dairy products, and refined grains correlate with bowel complaints. However, there are other mechanism by which a natural-food diet high in nutrients and fiber reestablishes normal gut motility and tone. It can take time to undo a lifetime of wrong eating; most of my patients need three months to see improvement. Of course, sometimes diets have to be modified for individual uniqueness. In such cases, working with a knowledgeable physician is helpful.

Most chronic illnesses have been earned from a lifetime of inferior nutrition, which eventually results in abnormal function or frequent discomfort. These illnesses are not beyond our control, they are not primarily genetic, and they are not the normal consequences of aging. True, we all have our weakest links governed by genetics; but these weak links need never reveal themselves unless our health deteriorates. Superior health flows naturally as a result of superior nutrition. Our Predisposition to certain illnesses can remain hidden.

Certainly, this method of health is not for everybody. Some would prefer to eat conventionally and take whatever medication is indicated for their condition. That is their inalienable right. However, it is also the right of sick and suffering individuals who seek a natural approach to be aware of how effective aggressive nutritional interventions can be. I would like to take these patients down the streets of Manhattan for a ticker-tape parade to spread the word--you don't have to be sick. Remember, health is your greatest wealth!

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Diet and Disease Prevention

A new study shows the British are healthier than Americans despite U.S. health care spending per person that is more than double what Britain spends.

The study, published in the Journal of the American Medical Association concludes:

The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer. Within each country, there exists a pronounced negative socioeconomic status (SES) gradient with self-reported disease so that health disparities are largest at the bottom of the education or income variants of the SES hierarchy. This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking, which explain very little of these health differences. These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower. These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.


Conclusion
Based on self-reported illnesses and biological markers of disease, US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution.

No one is sure why the two similar cultures have such different results. Gina Kolata of The New York Times takes a crack at it.

The question of which country is healthier, Dr. Nortin M. Hadler, professor of medicine at the University of North Carolina and others say, turns out to be a perfect illustration of an issue that has plagued American medicine: the more health problems you look for, the more you find. And Americans, medical researchers say, are avid about looking.


The British, doctors say, are different.

"The U.K. has a tradition of independent and perhaps more skeptical primary-care practitioners who are probably slower to label and diagnose people and more reluctant to follow guidelines than their U.S. counterparts," says Dr. Iona Heath, a general practitioner in London. "I have heard it argued that the U.S. believes more in the perfectibility of humanity and the role of science than the Europeans."

Some people call it disease-mongering, says Dr. Lisa Schwartz of Dartmouth Medical School. She once calculated that if everyone had the recommended tests for blood cholesterol, blood sugar, body mass index and diabetes, 75 percent of adults in the United States would be labeled as diseased. And new diseases arise by the minute, she says, her favorite example being "restless legs."

Maybe it's overanalysis. Maybe it's stress. Maybe it's something else. We can all guess why it might be that Americans are "sicker" than Brits even though we spend more money on healthcare. (Your thoughts?)

But one thing is certain: the killer diseases in America today, afflictions like type-II diabetes, cancer, and heart disease, need not ruin your health no matter where you live. On Followhealthlife we have trotted out study after study showing that we could make a huge dent in those diseases by abandoning the standard American diet (SAD) in favor a diet based on vegetables, fruit, legumes, nuts, and seeds.

This post summarizes many of the benefits of a healthy diet in preventing disease. Here is a collection of some of the most important research behind Dr. Fuhrman's work. The role diet can play in precenting cancer is discussed in detail here and here. Dr. Fuhrman says you need not settle for diabetes and that there is a counter attack for heart disease.

The result? Let's not wait around until researchers unravel the mystery of what makes English people seem to be healthier. Instead, let's do what has already been shown to be effective preventing and reversing the chronic diseases that are killing so many of us, starting with a plant-based, nutrient-dense diet that is effective in both Americans and the British.

Have a Pear or Two

Behold! The mutated pears of New Zealand's South Island. Florence Fabricant of The New York Times reports:

The skin of a Taylor's Gold pear has the matte-brown finish typical of a Bosc. But its generous, wide hips suggest Comice. Inside, the flesh is creamy white, exceptionally juicy and fragrant. It is a Comice mutation first discovered in 1986 in an orchard on New Zealand's South Island. Its season in New Zealand is fall, but below the Equator that is the equivalent of our spring, from April until mid-June.

Aren't you glad that so much good produce is in season? We're coming into the time of year when fruits and vegetables are at their best.

Grand Rounds: Volume 2, Edition 35

"Healthy" By Reputation is not the Same as Healthy

According to the Associated Press Americans are being duped by so-called "healthy foods." Claiming advertising confuses people into buying foods they perceive as healthy (yogurt, granola bars, etc.), but as it turns out are no more good for you than a bowl of sugary cereal. Candice Choi reports:

As concerns grow over rising obesity rates, so does confusion about the difference between what is healthy and what aids weight loss�with many believing the two are interchangeable.

"That's why so many people just give in and so many diets fail," said Christine Gerbstadt, spokeswoman for the American Dietetic Association.

Foods with wholesome images�nuts, yogurt and granola�are often consumed with abandon by dieters and end up sabotaging them, she said. Many brands of granola, for example, can be packed with up to 600 calories per cup and are loaded with more sugar than a cup of Cap'n Crunch.

While foods like granola and yogurt are certainly more nutritious than a bag of Cheetos, it's important to pick the lower-calorie brands that are not loaded with sugar or fat.

There are some good points in there, but why does she have to malign nuts? If you pick the right nuts, they're absolutely health food.

Ten Minutes a Day to Fight Childhood Obesity

HealthDay News reports Wellness, Academics and You (WAY) a new program designed to help schoolchildren lose weight resulted in a two percent reduction in the number of overweight kids. Appearing in the Journal of Obesity Research the pilot study appears promising:

The study also found that students who took part in the Wellness, Academics and You (WAY) program for a semester ate more fruits and vegetables and increased their levels of physical activity--from an average of just under 12 minutes during the school day to 20.5 minutes, and from about 22 minutes a day outside of school to over 37 minutes.


Under the WAY program, students take 10-minute daily classroom breaks to exercise along with a video. Lessons on nutrition, calories, goal setting and stress management are also incorporated into core subjects--math, language arts, science, and social studies.

Check out the WAY homepage.

Fish Fat Affects Heart's Electrical Function

HealthDay News is reporting Omega-3 fats might heighten the risk of potentially dangerous heart condition in some people. New research claims individuals who consume fish more than five times a week are 61 percent more likely to develop atrial fibrillation. Randy Dotinga reports:

In recent years, many doctors have urged patients to eat oily fish�such as mackerel, herring, albacore tuna and salmon�or take fish oil supplements. Both contain omega-3 fatty acids, which have been linked to better recovery from heart disease and a lower risk in older people of atrial fibrillation, in which the heart's electrical system malfunctions, and the muscle fails to beat in an orderly fashion.


But it's not entirely clear that omega-3 fats are good for the general population without heart disease. And some research has suggested they may actually boost the risk of atrial fibrillation in certain people, such as those younger than 60.

In the new study, researchers analyzed data from nearly 17,700 U.S. male doctors who took part in the Physicians' Health Study. The men answered questions about their fish consumption in 1983 and were asked in 1998 if they had developed atrial fibrillation.

After adjusting the data to account for factors like existing heart disease, the researchers found that men who ate fish more than five times a week were 61 percent more likely to develop atrial fibrillation, compared to those who ate fish once a month. In total, about 7 percent of all the men in the study said they developed the condition, which is somewhat common among the elderly but rarer among younger people.

First mercury contamination and now this! Fish is certainly earning an unsavory reputation. If you're alarmed by this research, remember Dr. Fuhrman's recommendation: Only eat lean fish like flounder, sole, or tilapia no more than once or twice a week.

Now, incase you think you're not getting enough Omega-3, consider another recommendation from Dr. Fuhrman's book Eat to Live:

Have a tablespoon of ground flaxseed everyday. This will give you those hard-to-find omega-3 fats that protect against diabetes, heart disease, and cancer.1 The body can manufacturer EPA and DHA from these omega-3 fats for those of us who do not consume fish. An additional source of omega-3 fat might be a few walnuts or soybeans. Edamame, those frozen green soybeans in the freezer of most health-food stores, taste great and are a rich source of omega-3 fat. A nutritional supplement containing DHA fat is also a good idea, especially for those who are poor DHA converters (which can be determined via a blood test). Vegetable-derived (from microalgae) DHA fat can be found in most health-food stores.

Dr. Fuhrman points out that his DHA Purity is not only a high grade, vegetable-derived DHA supplement (it's made from algae) but it is the only DHA available in America that is kept refrigerated for freshness since the day of manufacturing. Children and adults like the taste, too.

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Carnival of the Green #28

Americans Crazy for Vitamins

According to Reuters experts are questioning why Americans take so many vitamin supplements. Maggie Fox reports:

"Half of American adults are taking multivitamins and minerals and the bottom line is that we don't know for sure that they're benefiting from them," said Dr. J. Michael McGinnis, a senior scholar with the Institute of Medicine, who chaired the panel.

"In fact, we're concerned that some people may be getting too much of certain nutrients," added McGinnis, whose organization advises the federal government on health issues.

The 13-member panel included experts in nutrition, biostatistics, biochemistry, toxicology, geriatric medicine, family medicine, pediatrics, cancer prevention, consumer protection and other fields.

They said much more study was needed on what vitamins Americans lacked in their diets and whether taking supplements provided actual benefit.

Many people may assume that because vitamins and minerals are vital for health, that more is better. But some are toxic at high levels, including vitamin A and iron, and others are simply excreted in the urine.

Where Junk Food Cravings Are Born

Last year NPR posed the question: "Why do we seem to relish salty, sweet, high-fat and fried foods?" After all, anybody on the street will tell you they're no good for us. So why do we eat them? Gary Beauchamp, director of Philadelphia's Monell Chemical Senses Center weighs in:

Our human ancestors were largely herbivores, and one of their primary concerns was consuming enough calories.


"Sweet things tend to be calorie-rich and tend to be high in vitamins in the real world," Beauchamp says. "Most or all plant-eating animals have evolved an ability to taste sweet compounds, particularly carbohydrates, and a liking for them."

Likewise, salt is a signal for nutrients such as sodium. As for fat, our cravings become less clear. Some studies suggest people like the buttery texture. Fat is also the richest source of calories. "One way to think about this is that people and animals learn to associate this feel with the feeling of calories in the gut�and that association is what makes these things so attractive," Beauchamp says. He speculates that fatty acids may also enhance the sweetness of sugar and the saltiness of salt.

Similarly, an aversion to bitter foods�including vegetables�may have evolved from the need for early humans to avoid poisonous plants, which often tasted bitter.

Check out the podcast that accompanies the NPR report.

The podcast suggests people have learned to acquire some nasty eating habits: overeating and gobbling up lots of salt and fat to new a few. According to Onlyourhealth Your Child this is a dangerous combination, especially in young children:

The unnaturally high level of sugar, salt, and artificially heightened flavors in processed (fake) foods will lessen or deaden the sensitivity of the taste buds to more subtle flavors, making natural food taste flat. For example, the higher the salt content of your diet, the more your taste buds lose their ability to taste salt. After your taste has toned down its sensitivity to salt, salty things don't taste so salty and your deadened taste buds have lost the ability to enjoy the subtle flavorings in more delicately flavored natural foods. Vegetables have less flavor, fruit isn't as sweet, and nuts taste like wood after just one month of over stimulation with industrial-designed flavors.


Children eat little real food today. By real food, I mean things that are eaten in their natural state. Is an ice pop real food? Are Kool-Aid or macaroni and cheese? Were these foods eaten by primitive man or other primates? Do they contain a reasonable complement of the trace elements, phytochemicals, minerals, and fibers that nature placed in real food? With so much fake food around, why would we expect our children to choose to eat vegetables, fruits, beans, and nuts, those foods that all the health-giving nutrients?

Hunting for Calories in the Supermarket is Cheap and Easy

On his blog "On the Table" New York Times contributing writing Michael Pollan provides a compelling take on people's dietary selections, citing low income levels and high cost of fresh produce as major reasons why people eat poorly. Research indicates junk food is more cost effective:

A 2004 article in the American Journal of Clinical Nutrition by Adam Drewnowski and S.E. Specter offers some devastating answers. One dollar spent in the processed food section of the supermarket � the aisles in the middle of the store � will buy you 1200 calories of cookies and snacks. That same dollar spent in the produce section on the perimeter will buy you only 250 calories of carrots. Similarly, a dollar spent in the processed food aisles will buy you 875 calories of soda but only 170 calories of fruit juice. So if you're in the desperate position of shopping simply for calories to keep your family going, the rational strategy is to buy the junk.


Mr. Drewnowski explains that we are driven by our evolutionary inheritance to expend as little energy as possible seeking out as much food energy as possible. So we naturally gravitate to "energy-dense foods" � high-calorie sugars and fats, which in nature are rare and hard to find. Sugars in nature come mostly in the form of ripe fruit and, if you're really lucky, honey; fats come in the form of meat, the getting of which requires a great expense of energy, making them fairly rare in the diet as well. Well, the modern supermarket reverses the whole caloric calculus: the most energy-dense foods are the easiest � that is, cheapest � ones to acquire. If you want a concise explanation of obesity, and in particular why the most reliable predictor of obesity is one's income level, there it is.

Grand Rounds: Volume 2, Edition 34

The new Grand Rounds is up on Doc Around The Clock, take a look. This week's edition includes Dr. Fuhrman's post Heart Attack Counterattack.

Wal-Mart Going Organic

Wal-Mart, the nation's largest grocery retailer, will soon be selling a vast array of organic products, including organic produce, breakfast cereals, and macaroni and cheese. According to The New York Times the move is an attempt broaden its appeal to urban and other upscale consumers. The initiative has met mixed reviews, Melanie Warner reports:

Wal-Mart's interest is expected to change organic food production in substantial ways.


Some organic food advocates applaud the development, saying Wal-Mart's efforts will help expand the amount of land that is farmed organically and the quantities of organic food available to the public.

But others say the initiative will ultimately hurt organic farmers, will lower standards for the production of organic food and will undercut the environmental benefits of organic farming. And some nutritionists question the health benefits of the new organic products. "It's better for the planet, but not from a nutritional standpoint," said Marion Nestle, a professor of nutrition, food studies and public health at New York University. "It's a ploy to be able to charge more for junk food."

Nestle makes an interesting point. Just how beneficial is all this organic food?

In a previous post entitled "Is Organic Safer?" Dr. Fuhrman talks about organic produce:

Organic food is certainly your best bet, to further limit exposure to toxic chemicals. No one knows for sure how much risk exists from pesticide residue on produce, but here's what we do know: the younger you are, the more your cells are susceptible to damage from toxins. It seems wise to feed our young children organic food whenever possible.


Of course, wash your vegetables and fruit with water and when possible, use a drop of dishwashing detergent and then rinse well to remove all detergent residues for a little more efficient cleaning. Specialty pesticide removal products have not clearly demonstrated any more effectiveness than mild soap and water.

Besides the heightened exposure to chemicals and pesticides from animal products, the most hazardous pesticides are used on some plant foods responsible for the majority of the plant-food-related dietary risk. These foods with the most pesticide residue are: strawberries, peaches, raspberries, blackberries, grapes, cherries, apples, and celery. Imported produce is also more likely to contain higher levels of pesticides.1

There is another reason to feed our children organic food when possible. Organic food usually has more nutrients than conventional.2 One study performed at the University of California at Davis found that foods grown organically had higher amounts of flavonoids, which have protective effects against both heart disease and cancer. The researchers found flavonoids were more than 50 percent higher in organic corn and strawberries. They theorized that when plants are forced to deal with the stress of insects, they produce more of these compounds, which are beneficial to humans.3 Overall, organic foods taste better, and organic agriculture protects farmers and our environment.

But here's the important thing to remember: when it comes to nutrition, what you eat is much more important than whether it's organic or not. Processed cereal, frozen pizza, and macaroni and cheese don't magically become health foods when they're organic. And, watermelon or apples don't become unhealthy when they're not organic. Again Dr. Fuhrman:

The large amount of studies performed on the typical pesticide-treated produce have demonstrated that consumption of produce, whether organic or not, is related to lower rates of cancer and disease protection, not higher rates. Certainly, it is better to eat fruits and vegetables grown and harvested using pesticides than not eating them at all. The health benefits of eating phytochemical-rich produce greatly outweigh any risk pesticide residues might pose.

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Stricter Food Regulations Squelched

Despite the global obesity epidemic the United States and the European Union ruled out enacting new laws designed to further regulate the food industry. Reuters reports:

European Union Health Commissioner Markos Kyprianou and Deputy U.S. Health Secretary Alex Azar told Reuters they would not bring in laws such as those used to reduce smoking.


"The government can't tell someone what to eat. They can't say that something is tasty if it's not tasty," Azar said in an interview with Reuters television.

"The business case has to be there for healthy food. If there's not a business case for it, it won't happen."

Food and drink companies breathed a sigh of relief at the news that their industry was being left to regulate itself.

Carnival of the Green #27

This week's Carnival of the Green is now up on EarthEcho, click here. Dr. Fuhrman's post Early Exposure to Pesticide: Revisited joins the festivities.

The Obesity Myth?

The other day I found this video clip of The Obesity Myth author Paul Campos (via ZestyPing) giving a speech at a conference in Massachusetts.

Campos contends that the obesity epidemic in this country is a media construct and not based in fact. Here are some more of his points:

  • The correlations between obesity and illness/mortality are weak
  • Weight cycling is bad
  • Good diet and exercise = health at any size
  • Weight loss programs don't inspire health or improved mortality

Intrigued by the video, I passed it along to Dr. Fuhrman. Here's what he had to say:

Since almost all typical diets fail and result in regain of the weight anyway, Mr. Campos is correct that weight cycling is bad and weight loss programs don't work. A truly good diet and exercise are the key points; the main problem with his reasoning is that he doesn't know what a good diet is. If he did he would find that people who follow a good diet stop being overweight and are no longer overweight. He is also wrong about the correlation between obesity and mortality.


So the difference is that Eat to Live was designed first as the healthiest way to eat. The side effect is that people gravitate pretty rapidly to their ideal weight and furthermore, it is a knowledge-based approach that makes the client the nutritional expert, so they gain back control of their health destiny and their weight. It is not a diet, if a diet means restricting calories, portions or trying to lose weight.

Your health and weight are governed by the law of cause and effect. Most people don't fail because of lack of effort. The most common mistake that prevents people from achieving their goals is that they do the same thing over and over expecting a different result. They get locked into a single way of looking at things. Taking a different approach requires us to think differently. The standard diet is so nutrient-poor that it leads to a tremendous drive to over eat calories and causes withdrawal symptoms leading to cravings and food addictions (toxic hunger).

Eat to LiveStandard American Diet (SAD)
Vegetable-basedGrain-based
Lots of beans, nuts and seedsLots of dairy and meats
5 - 10 fresh fruits dailyLots of refined sweeteners
Oil used sparinglyOils supply a major caloric load
Animal products 2 - 5 times a weekAnimal products 2- 5 times a day
Focused on nutrient-dense calories Focused on nutrient-poor calories


The thought process behind the diet-style described in my book entitled, Eat to Live differs from conventional diets. When I first developed the Eat to Live approach, I started by asking: what is the healthiest way to eat? The fact that it is also the most effective way to lose weight is a great bonus. Other diets seem to be based on the premise: How can we make a popular diet and what type of gimmick or hook will sell books? My primary goal was not popularity or economic success. I have a duty to patients who rely on me for life saving advice. My goal was to be scientifically accurate and the most effective for both weight loss and disease reversal, bar none.

My book, Eat to Live has succeeded beyond my expectations. The people who have adopted this plan have achieved remarkable success, reversed their chronic diseases, and achieved a consistent healthy weight. The book has been translated into many foreign languages and has become a best seller. However, Eat to Live was written to speak to people who could not lose weight, no matter what they tried. It was not written for the masses and has limitations for wide acceptance by our society. Most people are looking for magic and are not interested in what the healthiest way to eat is, or the healthiest way to lose weight.

And lastly, taste is learned and food preferences can change and the myth that healthy eating has to take a second seat regarding taste or pleasure in life is simply incorrect. When people realize they can eat as much as they desire, not be hungry and uncomfortable, lose lots of weight and have the food taste as good or better than their prior diet, it is a no-brainer and they keep the weight off for life. But it takes time for food preferences to change, to learn the recipes and science that supports it.

Health News Bits and Pieces

On any given day you'll find hundreds of health-related news stories circulating throughout the web. Here are a few Associated Press stories that caught my eye:

The Phytochemical Revolution

From Dr. Fuhrman's book Eat to Live:

We are on the verge of a revolution. Substances newly discovered in broccoli cabbage sprouts sweep toxins out of cells. Substances found in nuts and beans prevent damage to our cells' DNA. Other compounds in beets, peppers, and tomatoes fight cancerous changes in cells. Oranges and apples protect our blood vessels from damage that could lead to heart disease. Nature's chemoprotective army is alert and ready to remove our enemies and shield us from harm.

Hardly a day goes by when some new study doesn't proclaim the health-giving properties of fruits, vegetables, and beans. Unprocessed plant foods contain thousands of compounds, most of which have not yet been discovered, that are essential for maintaining health and maximizing genetic potential. Welcome to the phytochemical revolution.

Phytochemicals, or plant-derived chemicals, occur naturally in plants (phyto means "plant"). These nutrients, which scientists are just starting to discover and name, have tremendously beneficial effects on human physiology. The effects of our not consuming sufficient amounts of them are even more astounding--premature death from cancer and atherosclerosis.

Eating a wide variety of raw and conservatively cooked plant foods (such as steamed vegetables) is the only way we can ensure that we get sufficient amount of these essential health-supporting elements. Taking vitamin and mineral supplements or adding some vitamins to processed foods will no prevent the diseases associated with eating a diet containing a low percentage of calories from whole natural foods.

Scientists cannot formulate into pills nutrients that have not yet been discovered! If the pills did contain sufficient amounts of all the phytonutrients and other essential substances, we would have to swallow a soup bowl full of pills and powders. To date, researchers have discovered more than ten thousand phytochemicals. No supplement can contain a sufficient amount. Thankfully, you can get all these nutrients today by eating a wide variety of plant-based foods.

Please bear in mind that I am not against nutritional supplements. In fact, I recommend various supplements to many of my patients with various health problems, and a high-quality multivitamin/multi-mineral to almost everyone.

I do not recommend that most people consume supplements containing vitamin A, isolated beta-carotene, or iron, as there are risks associated with excess consumption of these nutrients. The point to be emphasized is that supplements alone cannot offer optimal protection against disease and that you cannot make an unhealthy diet into a healthy one by consuming supplements.

Grand Rounds: Volume 2, Edition 33

The new Grand Rounds is up on Aetiology, click here. This week's edition includes Followhealthlife's post Case Histories: The Atkins Diet.

Dr. Fuhrman Addresses Osteoporosis and Protein

In a comment to last week's post Choose Vegetable Calcium Over Animal Calcium Helena sought Dr. Fuhrman's thoughts about Gabe Mirkin's opinion on animal protein and calcium absorption. Here's what Dr. Fuhrman had to say:

Gabe Mirkin, M.D.: Studies done many years ago suggested that eating a lot of protein increases calcium loss in the urine and therefore it was thought that eating protein weakens bones by taking calcium out of them. However, recent studies show that eating protein increases calcium absorption so the extra calcium in the urine comes from increased absorption, not from being take out of bones. Reports in the American Journal of Clinical Nutrition (Volume 78, Issue 3, 2003) show that eating plenty of protein and lots of foods from plants helps to keep bones strong. Most scientists now feel that a very low-protein diet can cause osteoporosis, while a moderately high-protein diet may help to prevent it.

Dr. Mirkin is not giving enough information to understand the entire story. Let's review some of the evidence from the studies in question and come to some recommendations that are more specific. Even though excessive consumption of animal protein over many years does encourage bone disease and bone loss and a higher consumption of vegetable protein over animal protein is conducive to less osteoporosis it is also true that too little protein in later life (after age 70) when digestive efficiency declines could lead to less calcium absorption, muscle wasting and bone thinning. Studies suggest that both too much protein (animal protein) and too little protein are unfavorable to bone mass. Therefore, it may be advisable as we age to assure adequate protein intake and pay more attention to it especially if we find a decrease in weight and muscle mass with later life aging. Let's review the following relevant studies:

Rapuri PB ; Gallagher JC ; Haynatzka V. Protein intake: effects on bone mineral density and the rate of bone loss in elderly women. Am J Clin Nutr. 2003; 77(6):1517-25.
This study investigates the associations of dietary protein intake with baseline bone mineral density (BMD) and the rate of bone loss over 3 y in postmenopausal elderly women. It finds " no association seen between protein intake and the rate of bone loss (in a three-year period). The study did note that all these elderly women did not eat much protein in general and the highest range of protein consumption was only about 70 grams a day. Elderly women with low protein intake at baseline (before the study began were noted to have lower bone mineral density, likely because of a little less muscle mass), because muscle mass and strength is linked to bone mass. This study does not tell us much more than logic and common sense would. Protein digestive efficiency declines in the elderly and getting adequate protein is necessary for adequate muscle and bone mass in later life.

Sellmeyer DE ; Stone KL ; Sebastian A ; Cummings SR. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. Am J Clin Nutr. 2001; 73(1):118-22.
This study followed over 1000 elderly women over a 7 - 10 year period. The study scientists concluded that animal foods provide predominantly acid precursors, whereas protein in vegetable foods is accompanied by base precursors not found in animal foods. Imbalance between dietary acid and base precursors leads to a chronic net dietary acid load that may have adverse consequences on bone. The study found increase bone loss and risk of hip fracture in those with a higher ratio of animal protein to vegetable protein. The study scientists concluded that an increase in vegetable protein and a decrease in animal protein may decrease the risk of hip fracture in the elderly. This study illustrates the importance of getting the majority of calories (and protein) from plant sources and cautions that protein from animal food sources should be a minor contributor to total protein requirements for maximizing bone health. Even if some animal protein is added to a diet, it should not be the major source of protein, green vegetables, beans, nuts and seeds, should be the major source of protein and animal source a minor source.

Devine A ; Dick IM ; Islam AF ; Dhaliwal SS ; Prince RL Protein consumption is an important predictor of lower limb bone mass in elderly women. Am J Clin Nutr. 2005; 81(6):1423-8.
This study compared protein intake with bone mineral density in the heel in 75 year old women and illustrated at this later age the higher range of protein intake (above 80 grams a day) had better bone mineral density. They did not follow hip fracture rates. This study shows that as we get older it is important to assure adequate intake of protein (as well as other nutrients).

Kerstetter JE ; O'Brien KO ; Insogna KL. Dietary protein, calcium metabolism, and skeletal homeostasis revisited. Am J Clin Nutr. 2003; 78(3 Suppl):584S-592S.
This study showed reduction in calcium absorption and very low protein intakes below .8 mg per kg, and support the other evidence that elderly women should strive to maintain their total protein intake above a gram per kilogram of body weight.

Conclusion

  • It is important to keep exercising to maintain muscularity in our later years.
  • To maximize mineral absorption and bone health, supplements of D and many other nutrients are advisable and become increasingly important as we age as digestive efficiency may decrease.
  • Vegetable protein sources, beans, edamame, nuts, seeds, and green vegetables are the most favorable sources of protein for long life and bone health. Adequate protein intake is important and vegetarian diets should be designed so that adequate protein intake is consumed. Vegetarian diets where the vast majority of calories come from grains and roots such as rice and potato are not ideal for long-term health.
  • Attention to protein intake with supplements or some animal products may be a useful to maintain peek muscle and bone mass to prevent the occurrence of increasing frailty, common in the elderly, but for reasons of cardiovascular health, diets should be designed so that animal products are used sparingly and not the major source of protein in the diet.

Pediatric Grand Rounds: Volume 1, Edition 2

The newest Pediatric Grand Rounds is now up on Unintelligent Design, click here to take a look. Followhealthlife's post NY Times Questions Diet as Cancer Prevention joins the discussion.

Carnival of the Green #26

Check out this week's Carnival of the Green hosted by HippyShopper, click here. Dr. Fuhrman's post Pomegranate Power was included in the mix.

Big Portions, Small Waistlines

The driving force behind permanent weight control is not eating less, it's eating more! No, not more chips, cookies, and cheeseburgers (staples of the standard American diet), but rather large quantities of nutrient-dense appetite-blunting foods like fruits and vegetables. Dr. Fuhrman elaborates in Eat to Live:

Eating large quantities of high-nutrient foods is the secret to optimal health and permanent weight control. In fact, eating much larger portions of food is one of the beauties of the Eat to Live diet. You eat more, which effectively blunts your appetite, and you lose weight�permanently.


Once you being to learn which foods make the grade�by having a high proportion of nutrients to calories�you are on your way to lifelong weight control and improved health.

A recent report on MSNBC.com discusses a new Penn State University study uncovering similar findings to Dr. Fuhrman's claim. Karen Collins, R.D. reports:

In the second half of the Penn State study, when portion sizes were kept the same and subtle changes were made to the foods so that they were 25 percent lower in calories, the women ate virtually the same portion as before. Since they did not eat more food to compensate for the lower calorie content, their calorie consumption dropped by 24 percent, or about 575 calories a day. The women's calorie intakes were slightly below what they needed to maintain their weight. If they continued eating this way for a longer period, they could expect to see weight loss of about one pound a week.

While the first round of research only decreased the amount of food eaten by participants (without focus on nutrient density), the next phase did the opposite; portion size remained the same, but the participants were supplied better nutrition. Collins' report closes with the following recommendations:

When you prepare your own meals and snacks, it's easy to make them less concentrated in calories by substituting ingredients with less fat or calories and increasing the proportion of vegetables and fruits. However, when you eat foods prepared by others, it's harder to judge the number of calories.


In these studies, despite dramatic differences in calorie content, the women thought the foods were equal in calories. Although they could usually tell when foods were lower in fat, lowfat foods are not always low-calorie. When you do eat foods prepared by others, watch your portions and choose plenty of vegetables and fruits.

Click here to read the skinny on nutrient density--and the thinking behind Dr. Fuhrman's approach. And a few parting words of inspiration from Dr. Fuhrman:

The Eat to Live diet does not require any deprivation. In fact, you do not have to give up any foods completely. However, as you consume larger and larger portions of health-supporting, high-nutrient foods, your appetite for low-nutrient foods decreases and you gradually lose your addiction to them. You will be able to make a complete commitment to this diet for the rest of your life.

Do You Need Animal Protein?

Adapted from Dr. Fuhrman's book Onlyourhealth Your Child:

Animals eat their macronutrients; they don't fabricate them from the air. All protein, all fat, and all carbs are made from soil and water with energy from the sun via photosynthesis. Animals then get all the fat, protein, and carbohydrates for energy from plants. Amino acids are the building blocks of protein. All animals, directly or indirectly, receive protein (amino acids) from plants. The lion eats the antelope; the antelope got the protein it supplied to the lion from the grass. Green vegetables (the soil) supplied the nitrogenous compounds to make the protein for the antelope and ultimately the lion.

In North America, about 70 percent of dietary protein comes from animal foods. Worldwide, plants provide 84 percent of calories. In the 1950s human protein requirements studies were first conducted that demonstrated that adults require twenty to thirty-five grams of protein per day.1 Today, the average American consumes 100 to 120 grams of protein per day, mostly in the form of animal products. People who eat a completely vegetarian diet (vegan) have been found to consume sixty to eighty grams of protein a day, well above the minimum requirement.2 Vitamin B12, not protein, is the missing nutrient in a vegan diet.

In modern times, the plant foods we eat are well washed and contain little bacteria, bugs, or dirt, which would have supplied B12 in a more natural environment such as the jungle or forest. To assure optimal levels of B12 in our diet, we require some form of B12 supplementation when eating a diet with little or no animal products.

UPDATE: Animal protein can be part of an extremely healthy diet! Dr. Fuhrman explains this in detail in an earlier post.

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Choose Vegetable Calcium Over Animal Calcium

A lot of people believe a vegetable-based diet, which excludes milk and cheese, doesn't provide enough calcium. According to Eat to Live fruits and vegetables contain ample amounts of calcium and this veggie-calcium is actually retained more efficiently in our bodies. Dr. Fuhrman explains:

Green vegetables, beans, tofu, sesame seeds, and even oranges contain lots of usable calcium, without problems associated with diary. Keep in mind that you retain the calcium better and just do not need as much when you don't consume a diet heavy in animal products and sodium, sugar, and caffeine.

Dr. Fuhrman points out that despite its reputation, milk's calcium-absorption rate is lower than what you might think:

Many green vegetables have calcium-absorption rates of over 50 percent, compared with about 32 percent for milk.1 Additionally since animal protein induces calcium excretion in the urine, the calcium retention from vegetables is higher. All green vegetables are high in calcium.

Given the concentrated calcium dose in green vegetables and the health risks associated with of diary products, veggies are a great tool for protecting yourself against bone debilitating diseases like osteoporosis. The Chicago Tribune agrees�kind of.

In an article entitled Shoring Up Your Bones reporter JoAnn Milivojevic re-hashes a lot of the same recommendations for keeping bones strong and dense that you heard as a kid:

An easy way to combine calcium and vitamin D, according to Blatner, is to have an 8-ounce serving of milk and/or fortified soymilk three times a day. She recommends pouring the fortified beverage of your choice on cereal in the morning, blending it with frozen fruit for a smoothie, drinking a glass with lunch or having a glass of hot chocolate for dessert. Cosman cautioned that the milk be low-fat or non-fat: "There's no way taking in all that saturated fat is good for you," she said.


The daily recommended value for vitamin D is 400 international units (IU). You may need more or less depending on your age or food habits. For example, the NOF suggests that postmenopausal women need more because a decline in estrogen means a decline in calcium absorption. Vegans (vegetarians who don't eat eggs or dairy) may also need to take extra steps to ensure they're getting enough calcium through the plant-based foods they eat.

Good sources of calcium include fortified breakfast cereals, milk, yogurt, cheese, tofu and greens such as collards and kale. To get the most nutritional bang for your bite, create such tasty combinations as broccoli and cheese. A half cup of steamed broccoli with an ounce of cheese gets you 20 percent of your daily recommended value of both calcium and vitamin D.

It's encouraging to see mass-media even suggesting vegetables as a sufficient source of calcium, but Milivojevic, like some many others, is clearly reluctant to wipe away her milk mustache permanently. For those loyal to bovine juice Dr. Fuhrman recommends restricting milk consumption to only fat-free skim and taking supplements as needed.

From his book Eat to Live Dr. Fuhrman provides additional insight on role of animal calcium in the standard American diet (SAD):

The American "chicken and pasta" diet style is significantly low in calcium, so adding dairy as a calcium source to this mineral-poor diet makes superficial sense�it is certainly better than no calcium in the diet. However, much more than just calcium is missing. The only reasons cow's milk is considered such an important source of calcium, is that the American diet is centered on animal foods, refined grains, and sugar, all of which are devoid of calcium. Any healthy diet containing a reasonable amount of unrefined plant foods will have sufficient calcium without milk. Fruits and vegetables strengthen bones. Researchers have found that those who eat the most fruits and vegetables have denser bones.2 These researchers concluded that not only are fruits and vegetables rich in potassium, magnesium, calcium, and other nutrients essential for bone health, but, because they are alkaline, not acid-producing, they don induce urinary calcium loss. Green vegetables in particular have a powerful effect on reducing hip fractures, for they are rich not only in calcium but in other nutrients, such as vitamin K, which is crucial for bone health.3
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Childhood Obesity: Parenting a Better Solution than Manufacturing

Getting kids to eat healthy nutrient-rich food starts early, according to Onlyourhealth Your Child too many parents allow their children to consume the standard American diet. Consequently kids grow up rejecting fresh produce and opting for empty-calorie processed foods. Dr. Fuhrman explains:

The unnaturally high level of sugar, salt, and artificially heightened flavors in processed (fake) foods will lessen or deaden the sensitivity of the taste buds to more subtle flavors, making natural food taste flat. For example, the higher the salt content of your diet, the more your taste buds lose their ability to taste salt. After your taste has toned down its sensitivity to salt, salty things don't taste so salty and your deadened taste buds have lost the ability to enjoy the subtle flavorings in more delicately flavored natural foods. Vegetables have less flavor, fruit isn't as sweet, and nuts taste like wood after just one month of over stimulation with industrial-designed flavors.

Dr. Fuhrman urges that unless parents instill healthy eating habits in their children early on, kids are unlikely to make good dietary selections later:

Kids will not develop the intellectual maturity to consume broccoli and peas instead of French fries and pizza for their health. The more subtle flavors of natural food can't compete. The pizza, pasta, cheese, burger, and soft drink diet will win over the fruit-vegetable-nut diet seven days a week.

This dilemma has health agencies grasping at straws for answers. The New York Times reports the Federal Trade Commission and the Department of Health and Human Services are turning to the wrong place for help the processed food industry. Melanie Warner reports:

The report, from the Federal Trade Commission and the Department of Health and Human Services, urges food companies to develop products that are more nutritious and to "review and revise" its marketing practices. It also suggests that the Children's Advertising Review Unit, which was set up by the industry, consider creating minimum nutrition standards for foods advertised to children.


Consumer groups hailed the report as a step in the right direction. "This is the first acknowledgment by the F.T.C. that there should be nutrition standards for food that's marketed to kids," said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, a nutrition advocacy group and frequent critic of junk-food marketing.

But producers claim they are already doing their part:

The Grocery Manufacturers Association, a lobbying group that represents packaged food manufacturers, said that the food industry had already undertaken "initiatives to help families improve their health and wellness." The changes, the group says, include new and reformulated products that are healthier, products that are portion-controlled to have just 100 calories and the addition of "healthy lifestyle messages" on food package labels.

Is it really a good idea to rely on the food producers to come up with solutions? Dr. Fuhrman insists if parents really want kids to eat better, the change has to happen in the home:

If you are committed to your child eating healthfully, there is only one way to do--it make your home off-limits to processed food and low-nutrient foods. No white flour products, no cheese, no sweeteners, no ready-to-eat cereal, no fruit juice, no chips, no junk.

Nutrition for Wellness Foundation

A friend of Dr. Fuhrman's, Douglas D. Mercer has a new project and website.

Nutrition for Wellness Foundation aims to educate the community about the healthful benefits attained through proper nutrition. To achieve this, the foundation collaborates with local schools, presents speaking engagements by noted nutritional authorities, distributes informational materials, and leads a Wellness Circle that acts as a support system for those seeking to eat more healthy foods.

On the website, Dr. Fuhrman's food pyramid is looking better than ever.

Grand Rounds: Volume 2, Edition 32

The new Grand Rounds is up on Polite Dissent, click here. This week's edition includes Followhealthlife's post Beware the High Fructose Corn Syrup.

Carnival of the Green #25

Included in this week's Carnival of the Green, hosted by Spiral Visions, is Dr. Fuhrman's post "A Symphony of Phytonutrients" from Cruciferous Vegetables, click here to take a look.