Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

The creativity of our readers is amazing! The following is an “experiment” that two Moms, Mandy and her friend Jessica, did over this past holiday season. 

They thought it would be interesting to keep track of all unhealthy treats, including the calories, fat grams, and sugar grams that three of their children were offered at school, church, and Grandma’s house from November 10 through December 25^th; for a total of 45 days.  They charted it below, and the following is the summary: 

In forty-five days, three children, ages 3, 5, and 7 were offered a total of 41,734 extra calories; 1,927 grams of fat; and 6,470 grams of sugar! No joke! 

And interesting to note, because the Moms had both pledged to follow Dr. Fuhrman’s Holiday Challenge during that time, Mandy thinks the numbers would’ve been at least twice that amount had they not accepted the challenge. She said the children were amazing as they brought home the treats that they had passed up and counted the days on a paper chain.  As a reward, and as a way to reinforce in them that they weren’t “giving up” something, but making a trade for something better, the Moms took them to a hotel with an indoor pool and had a mini-vacation afterward. 

For better treat options, Mandy and Jessica found lots of fun and tasty ways to eat fruit, like frozen bananas with a little peanut butter to make banana ice-cream. They also discovered that it was a huge shift in mindset to get over the idea that they “had” to have a treat after every dinner, but they succeeded!

Here is the list of combined treats passed up by all three children:

[November 10 through December 25, 2011]

Bravo to these Moms and their precious children! 

Let’s all learn from their innovative experiment that it is truly up to us, as parents, to protect our children’s health and well-being.    

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Vitamins, DHA, and the aging brain

It is known that a Western diet is associated with dementia – the risk factors for Alzheimer’s disease are almost identical to those for cardiovascular disease.¹ In contrast, higher vegetable and fruit intake is associated with decreased risk of cognitive decline and dementia.^2,3

Vitamins are essential for thousands of chemical reactions in the body, and certain vitamins and other phytochemicals have been singled out for their critically important functions in the brain. These include B vitamins, vitamins C, D, and E, and omega-3 DHA.

B Vitamins

• Vitamin B1 is needed in order for the brain to utilize glucose for energy
• Folate is crucial during early brain development and is important for memory
• Vitamin B12 is important for memory and production of neurotransmitters, and deficiency in B12 can cause nerve injury leading to impaired sensation and even blindness.⁴ Higher B12 blood levels are associated with slowed cognitive decline.⁵
• Vitamin B6 is also involved in neurotransmitter production, and deficiency is associated with seizures, chronic pain, and depression.⁶

Antioxidant Vitamins C and E

• The brain is highly susceptible to oxidative stress, which is one of the main mechanisms of brain aging and a contributing factor to neurodegenerative conditions.^7,8
• Nerve endings have highest concentrations of vitamin C found in the human body. Vitamin C is thought to function largely as an antioxidant in the brain and nervous system. Blood levels of vitamin C have been positively associated with IQ.⁴
• Vitamin E is a component of brain cell membranes, and along with vitamin A and carotenoids, protects vulnerable unsaturated fatty acids (like omega-3s) from oxidative damage. Low vitamin E status is associated with greater risk of Alzheimer’s disease.⁴
• Vitamin C and E intake were associated with higher cognitive scores in the elderly, and the association was stronger for food sources compared to supplement sources.⁹
• In addition to vitamin intake, polyphenols and other antioxidants present in plant foods are thought to contribute to protecting the brain from oxidative damage.⁴

Vitamin D

• Vitamin D is involved in regulating glucose and calcium transport to and within the brain, and may also protect cognition by reducing inflammation and increasing availability of certain neurotransmitters.4
• Vitamin D is also involved in memory formation.¹⁰ Several studies have associated vitamin D deficiency with increased risk of cognitive impairment or dementia in older adults.^11,12

DHA

• More than half of the brain consists of fat; DHA is the most abundant fat in the brain and a crucial structural component of cell membranes.¹³
• DHA supplements have been shown to produce learning and memory improvements in subjects who already were exhibiting mild cognitive impairment, however, a similar study in Alzheimer’s patients showed no benefit.^14-16 The message from these studies is that DHA is effective when taken preventively.

Effects of vitamins and DHA on brain shrinkage in the elderly

Compared to older individuals with normal cognition, those with dementia have significantly smaller brain volumes as measured by MRI.¹⁷ A recent study analyzed blood fats and micronutrients with regard to MRI measures of brain volume and cognitive function tests in older adults. The researchers found three patterns of nutrient status that correlated to brain volume and cognitive function:

1. Higher levels of vitamins B, C, D, and E – associated with greater cognitive function scores and brain volume. This pattern primarily reflected fruit and vegetable intake.
2. Higher levels of omega-3 fatty acids (DHA) – associated with greater cognitive function scores and brain volume. This pattern primarily reflected fish intake.
3. High levels of trans fats – associated with lower cognitive function scores and brain volume.^18,19

Protect your brain

The American diet is insufficient in providing these brain-healthy nutrients, but a nutritarian diet provides both the amount and variety of vitamins and other phytochemicals that support optimal brain function. It is especially important to eat healthfully, supplement with vitamin D, and get adequate DHA as we age, especially after age 50. Keep in mind that fish is not an ideal source of DHA, since mercury is toxic to the brain and reduces the body’s antioxidant status.20-23 An algae-based DHA supplement is a healthful, environmentally friendly source of beneficial omega-3 fatty acids. Eating plenty of unrefined plant foods and taking a non-fish source of DHA, such as my DHA Purity starting early in life will allow us to maintain valuable vitamins, omega-3s, and other phytochemicals in brain tissue to keep our minds sharp as we age.

References:

1. Fillit H, Nash DT, Rundek T, et al: Cardiovascular risk factors and dementia. Am J Geriatr Pharmacother 2008;6:100-118.
2. Morris MC, Evans DA, Tangney CC, et al: Associations of vegetable and fruit consumption with age-related cognitive change. Neurology 2006;67:1370-1376.
3. Hughes TF, Andel R, Small BJ, et al: Midlife fruit and vegetable consumption and risk of dementia in later life in Swedish twins. Am J Geriatr Psychiatry 2010;18:413-420.
4. Bourre JM: Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging 2006;10:377-385.
5. Tangney CC, Tang Y, Evans DA, et al: Biochemical indicators of vitamin B12 and folate insufficiency and cognitive decline. Neurology 2009;72:361-367.
6. Malouf R, Grimley Evans J: The effect of vitamin B6 on cognition. Cochrane Database Syst Rev 2003:CD004393.
7. Aliev G, Smith MA, Seyidov D, et al: The role of oxidative stress in the pathophysiology of cerebrovascular lesions in Alzheimer's disease. Brain Pathol 2002;12:21-35.
8. Barja G: Free radicals and aging. Trends Neurosci 2004;27:595-600.
9. Wengreen HJ, Munger RG, Corcoran CD, et al: Antioxidant intake and cognitive function of elderly men and women: the Cache County Study. J Nutr Health Aging 2007;11:230-237.
10. McCann JC, Ames BN: Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? The FASEB Journal 2007;22:982-1001.
11. Grant WB: Does vitamin D reduce the risk of dementia? Journal of Alzheimer's disease : JAD 2009;17:151-159.
12. Llewellyn DJ, Lang IA, Langa KM, et al: Vitamin D and Cognitive Impairment in the Elderly U.S. Population. J Gerontol A Biol Sci Med Sci 2010.
13. Chang CY, Ke DS, Chen JY: Essential fatty acids and human brain. Acta Neurol Taiwan 2009;18:231-241.
14. Yurko-Mauro K, McCarthy D, Rom D, et al: Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimers Dement 2010.
15. DHA Improves Memory and Cognitive Function in Older Adults, Study Suggests. 2010. ScienceDaily. http://www.sciencedaily.com/releases/2010/11/101108151346.htm. Accessed December 23, 2010.
16. Quinn JF, Raman R, Thomas RG, et al: Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA 2010;304:1903-1911.
17. He J, Iosif AM, Lee DY, et al: Brain structure and cerebrovascular risk in cognitively impaired patients: Shanghai Community Brain Health Initiative-pilot phase. Arch Neurol 2010;67:1231-1237.
18. Bowman GL, Silbert LC, Howieson D, et al: Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology 2011.
19. Diet Patterns May Keep Brain from Shrinking. 2011. American Academy of Neurology. http://www.aan.com/press/index.cfm?fuseaction=release.view&release=1010. Accessed
20. Huskies lend insight into mercury risk. 2011. EurekAlert! http://www.eurekalert.org/pub_releases/2011-11/iop-hli111711.php. Accessed
21. Oken E, Radesky JS, Wright RO, et al: Maternal fish intake during pregnancy, blood mercury levels, and child cognition at age 3 years in a US cohort. Am J Epidemiol 2008;167:1171-1181.
22. Aschner M, Aschner JL: Mercury neurotoxicity: mechanisms of blood-brain barrier transport. Neurosci Biobehav Rev 1990;14:169-176.
23. Aschner M, Walker SJ: The neuropathogenesis of mercury toxicity. Mol Psychiatry 2002;7 Suppl 2:S40-41.

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It is truly amazing how sensitive I am to the Standard American Diet (SAD)- basically anything with sugar, salt, oil or processing will make me feel positively awful.  On a recent trip to Chicago, my ultimate weakness was spotted: a chocolate shop selling extra rich, dark hot chocolate.  It was cold outside with a wind chill that would make anyone want to hibernate and I was freezing from head to toe.  And I wanted that hot chocolate.  I wanted to hold it in my numb hands and I wanted to feel it’s rich warmth flowing down my throat. 

Within a few minutes that hot chocolate was mine- I ordered it with soymilk and topped it with a wonderful sprinkling of cinnamon- and I felt a rush of glee as I sipped the warm, sweet chocolaty bit of heaven.  I could taste the sugar as it rolled off my tongue.  I wanted more even though I knew it packed a heavy sugar punch. So I drank and I drank until I reached the solid chocolate bottom.    Add in a few pieces of white bread at a dinner outing and let’s just say my body did not thank me kindly in return.

Next day of trip- runny nose, check; icky congestion, check; I think I am getting sick, check.  Determination to seek out delicious, sugar-free, healthy food, check.

This is a confession of an extremely healthy eater.  I don’t feel well when I go off my nutritarian diet for even just a few meals.  I felt so much better when I found a Whole Foods Market and I was able to load my cart with a heaping pile of greens, tomatoes, onions, mushrooms, beans and all of the other healthy foods that I adore.  I got some sweet potatoes and persimmons and I relished in a box of raspberries and blueberries.  And I bought a date sweetened, chocolate Lara bar, because I do love chocolate after all and healthy food will never equal denial for me. I felt alive and in the zone with my food purchases.  Goodbye sniffles and icky congestion! Hello tasty healthy food and feeling fresh and alive!

As anyone who has made the transition from the SAD diet to a plant-based, nutrient rich one will understand, our bodies simply feel better when we eat foods that nourish our cells with nutrients rather than foods that provide our cells with nothing but a nutrient devoid toxic load.  Not only does eating well help to prevent chronic diseases later on in life, but it helps us to live richly and feel most optimal in the here and now. 

The thing is, once you are eating healthfully for a big part of your life, your body is simply intolerant of junk foods.  You have to be unhealthy to build up tolerance to drugs, alcohol and junk food.  My father calls people intolerant of unhealthy choices, “black-belt nutritarians”  I must be a third degree black belt then, because I hate feeling icky if I eat SAD food.   I have learned the hard way, each time you feel physically bad, it makes you not want to eat the junk next time, so that these SAD events become more infrequent.  It may be a rare occasion for me, but then I get that wake-up call, which reminds me like a bolt-of-lightening that I can’t fool my body; it’s just too darn smart.  

Have you felt a difference in the way you feel when you eat a healthy, natural foods diet versus an unhealthy one? Do even small cheats make you feel icky?

Every time I don’t feel well after eating standard American fare I am reminded that feeling well truly is priceless and I am so fortunate to have the knowledge to make the right decisions about what to eat to feel my best now and into the future.  

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Twenty-four hours in a day usually doesn’t seem like enough to “get everything done,” does it? Exercise and sleep are often sacrificed in our busy lives.

You may think that you’re tough – that you can “get by” on just a few hours of sleep. I assure you, you are wrong. Your “sleep debt” (the accumulated lack of sleep that causes daytime fatigue) will catch up with you.

Consider this statement: “the effects of sleep deprivation are actually so damaging that it is now prohibited as a method of interrogation in most countries.”¹

And yet so many of us consistently deprive ourselves of sleep – by choice!

Americans are sleepy people. Sleep studies have revealed that the average American’s sleep debt is likely close to 25-30 hours at any given time.² According to the National Sleep Foundation’s most recent poll, 63% of American adults report that their sleep needs are not being met, and 43% report that they rarely or never get a good night’s sleep on weeknights. As a result, according to data from the CDC, 37.9% American adults report falling asleep unintentionally during the day in the preceding 30 days – a sign of being dangerously sleep-deprived.²

Daytime sleepiness is dangerous. Inadequate sleep is a health hazard; even worse, the resulting daytime fatigue impairs performance (just like alcohol). Sleep-deprived people perform tasks poorly, make more mistakes, and experience more accidents at work – it’s similar to being intoxicated.³ One Australian study showed that 24 hours without sleep is equivalent to a blood alcohol content of 0.1% (0.08% is legally drunk in most U.S. states) with regard to hand-eye coordination. Being awake for only 17-19 hours still impaired hand-eye coordination – this was equivalent to a blood alcohol content of 0.05%.⁴ Numerous accidents – of small and large scale – have been attributed to fatigue; from medical errors to plane crashes to the Exxon Valdez oil spill.²

More consequences of inadequate sleep:

• Impaired immune response.⁵ The quality of sleep before becoming infected is a significant determinant of the severity of cold symptoms. Even one night of inadequate sleep reduces the number and activity of natural killer cells the next day.²
• Impaired learning and cognitive function– blood oxygen levels in the brain are measurably lower after insufficient sleep.^6,7
• Increased snacking – lack of sleep results in dysregulation of hunger and satiety hormones.^8,9
• Weight gain, impaired insulin sensitivity, and increased risk of diabetes.^10-13
• Increased inflammation, high cholesterol, and hypertension.^14,15
• Diminished appearance - sleep-deprived people look less healthy and attractive than well-rested people.¹⁶
• Emotional disturbances and excessive emotional reactivity.¹⁷
• Increased risk of death.¹⁸

What is sleep and why is it so important?
The question ‘what is sleep?’ is still somewhat of a mystery. Sleep occurs in 90-minute cycles of REM (rapid eye movement) and non-REM sleep; REM sleep is thought to be the most restorative part of the sleep cycle; REM sleep is thought to contribute to brain development, and almost all dreaming occurs during REM sleep. Tissue repair and growth (in children) is heightened during sleep.² Also during sleep, our brains ‘stabilize’ newly formed memories, which is one reason why lack of sleep can impair learning (caffeine does not help, by the way). This is thought to occur by the brain ‘replaying’ brain activity from waking experiences during sleep. Interestingly, the greatest impact of sleep deprivation is on memories associated with positive emotions, compared to those associated with neutral or negative emotions.¹⁷ Sleep is also thought to fuel creativity, since creativity is dependent on learning, memory, and motivation.²

Sleep, like good nutrition and exercise, is an essential component of a healthy lifestyle. Don’t try to be tough – practice self-care and make sleep a priority. Maybe you didn’t finish everything on your mile-long to-do list. Let it go - you owe yourself some rest!

References:

1. Hunter P: To sleep, perchance to live. Sleeping is vital for health, cognitive function, memory and long life. EMBO Rep 2008;9:1070-1073.
2. Dement WC, Vaughan C: The Promise of Sleep. New York: Delacorte Press; 1999.
3. Swanson LM, Arnedt JT, Rosekind MR, et al: Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll. J Sleep Res 2011;20:487-494.
4. Williamson AM, Feyer AM: Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med 2000;57:649-655.
5. Opp MR: Sleeping to fuel the immune system: mammalian sleep and resistance to parasites. BMC Evol Biol 2009;9:8.
6. Miyata S, Noda A, Ozaki N, et al: Insufficient sleep impairs driving performance and cognitive function. Neurosci Lett 2010;469:229-233.
7. Taras H, Potts-Datema W: Sleep and student performance at school. J Sch Health 2005;75:248-254.
8. Kim S, DeRoo LA, Sandler DP: Eating patterns and nutritional characteristics associated with sleep duration. Public health nutrition 2011;14:889-895.
9. Aldabal L, Bahammam AS: Metabolic, endocrine, and immune consequences of sleep deprivation. Open Respir Med J 2011;5:31-43.
10. Gangwisch JE, Heymsfield SB, Boden-Albala B, et al: Sleep duration as a risk factor for diabetes incidence in a large U.S. sample. Sleep 2007;30:1667-1673.
11. Spiegel K, Leproult R, Van Cauter E: Impact of sleep debt on metabolic and endocrine function. Lancet 1999;354:1435-1439.
12. Mozaffarian D, Hao T, Rimm EB, et al: Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392-2404.
13. Patel SR, Malhotra A, White DP, et al: Association between reduced sleep and weight gain in women. Am J Epidemiol 2006;164:947-954.
14. Gangwisch JE, Malaspina D, Babiss LA, et al: Short sleep duration as a risk factor for hypercholesterolemia: analyses of the National Longitudinal Study of Adolescent Health. Sleep 2010;33:956-961.
15. Gangwisch JE, Heymsfield SB, Boden-Albala B, et al: Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension 2006;47:833-839.
16. Axelsson J, Sundelin T, Ingre M, et al: Beauty sleep: experimental study on the perceived health and attractiveness of sleep deprived people. BMJ 2010;341:c6614.
17. Walker MP: The role of sleep in cognition and emotion. Ann N Y Acad Sci 2009;1156:168-197.
18. Cappuccio FP, D'Elia L, Strazzullo P, et al: Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 2010;33:585-592.

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A while back I was looking through some old picture files and found these two images; both were taken on a hot, July day about a year a part. I really had no idea how pale my skin had become from years of stuffing my body with mashed potatoes, cereal, milk, pasta, dinner rolls, butter, cheese, chicken, beef 'n noodles, pizza, etc. . . . until I saw these pictures. 

About six months into consistently eating high-nutrient foods, I clearly remember the day that I looked “tan” in the dead of winter in Indiana. I was recovering from major surgery in a hospital room; in fact, it was two days post surgery, and I had managed to stand up long enough to capture a glimpse of myself in a mirror. My body felt like it had just been plowed under by a bulldozer, but my skin looked alive, refreshed and glowing! Instead of an expected paleness, it had color! Surprisingly, with each shift of new nurses that were caring for me, the first question was always, “Where did you get your tan?”  

For many of us who live in the northern states, winter can be sort of colorless. Blahh. Leafless trees silhouetted against bleak, gray skies. Dead branches. Dark mornings and evenings. Brown grass peaking through melted, dirty snow. Dreary blahh.  

However, our food and our skin can be beaming with bright color! Not only do those plates of colorful vegetables and fruits nourish our bodies to optimal health and longevity, they add visual beauty to our otherwise, potentially colorless environment. They brighten up our kitchens and dining tables, and our skin even reflects the beauty of those colors. 

 

How about you? Got color?   

Related post by Dr. Fuhrman: The human mind prefers a healthy carotenoid glow over a suntan

Image credit:  vegetables by Esther Boller

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Gluten-free foods are all the rage these days.  Gluten free breads, pizzas, muffins, cookies, cakes, crackers, pretzels and more are everywhere. If there was a good time to have Celiac Disease, today is the day.  Now more than ever we can find goodies in the grocery stores labeled “Gluten-free,” advertised ostensibly in shinny, attractive print.  Pop-culture abounds with messages to, “go gluten free” and the media shouts to us to, “become a gluten free goddess and embrace feeling better and more energetic.” Just as low-carb everything was in vogue during the days of Atkins and South Beach, gluten-free foods have become the new go-to products for health conscious consumers and weight loss seekers. However, does avoiding gluten really confer health benefits? For most people, the answer is an unequivocal no.

First of all, it would be helpful to us to understand what gluten is so we know what we are avoiding.  Gluten is simply a compound made of two proteins, gliadin and glutelin, bound together by starch (a carbohydrate). Grains themselves contain three parts: the bran (or hull), the germ and the endosperm.  Whole grains contain all three parts, while processed or refined grains contain just the endosperm.  Because gluten is found in the endosperm, it can be found in all grain products, regardless of processing.  Gluten is pretty much your typical grain product’s reliable sidekick, but unlike processed white bread, odds are eating it will not make you look like Gwyneth Paltrow in Shallow Hal (in which she wore a fat suit).  Additionally, unless you count yourself among the less than 10 percent of people with gluten sensitivity, the consumption of gluten will not be too difficult for your digestive organs, or result in undesirable aches and pains or an allergic reaction.

Celiac disease, aka gluten-sensitive enteropathy, is a disease in which the immune system attacks gluten as if it were a threatening invader, such as a pathogen or a parasite.  The inflammation that results can damage the intestinal lining, leading to malabsorption of many nutrients – including many essential vitamins and minerals.  Symptoms for a person with this carb-lovers nightmare can range from abdominal discomfort, to an itchy rash, to the manifestation of nutrient deficiencies.  Over time, for someone with celiac disease, the ingestion of gluten can increase the risk of intestinal cancer.  There is no doubt that celiac disease can be lethal if gluten is continually eaten and failing to address this condition can result in an tragic, early visit from the grim reaper.  For most people with celiac disease, it was pretty easy to detect because the symptoms are so obvious- quite simply, you eat grains and you feel awful.  However, this can be a hidden cause of health problems, especially in its milder forms that then go undetected. 

Besides celiac disease, it is possible to have gluten sensitivity, which is more common than celiac disease, but much less worrisome.   It is very different from celiac disease because there are no antibodies for gluten present or observed damage to the lining and architecture of the intestine.  People with gluten sensitivity are not at risk for intestinal cancer and are less likely to have nutrient deficiencies as a result of gluten ingestion.  What is intriguing is the numbers of people who are showing signs of gluten intolerance today.   

Compared to ladies living a half-century ago, the women of today are up to four times more likely to develop celiac disease or an intolerance to gluten.¹  I repeat, four times from just 50 years ago! This is shocking and I am disturbed that increasing numbers of women cannot enjoy a hearty, all natural fruit pie, or pita pocket unless going out of their way to find gluten-free bread or other grain product.  More women than ever are dealing with grain product hell and no one really understands why it’s happening, although there are a few theories.

It’s been suggested that there are new-age exposures to gluten that may be more likely to trigger immune system responses. Genetic modifications to grain products have increased the gluten content of wheat and other grains in some cases.  It’s also possible that genetic modifications are introducing new chemical compounds into our diets, and some reactions to gluten may be a result of the new company it keeps.  Also all the processed foods eaten today, including white flour products, oils and fried foods damage human immune function.  And thanks to modern food processing, we are now finding the presence of gluten in everything from candy and meats to potato chips and processed breakfast cereals.  The addition of gluten to these low-fiber and low micronutrient-containing products might spark immune reactions in some people.  All of this is speculation and further studies need to be done to figure out why more people are developing adverse reactions to gluten. 

While this mystery remains, what is important to keep in mind is that while the number of people with gluten sensitivities may be rising, the number of people who don’t digest it well is still relatively small.  Only 1 percent of the entire population has celiac disease, and gluten sensitivity still only effects 5-10 percent of the population.^2,3  For all other people, avoiding gluten provides no health benefits.  Avoiding gluten for 90 percent of the population is like avoiding peanuts when you don’t have a peanut allergy. It is totally needless.  If you experience unpleasant symptoms or stomach upset after eating grain products, then it is well worth a trial of avoiding all gluten containing grains and products and also getting a blood test done to test for celiac disease. 

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The Women’s Healthy Eating and Living (WHEL) Study was a randomized controlled trial that was designed to test whether adhering to a diet high in vegetables, fruits, and fiber would reduce the risk of recurrence in breast cancer survivors. The study was conducted from 1995-2006, and the subjects were 3,088 women who had been treated for early stage breast cancer. Women were either in a control group or an intervention group.

The daily dietary goals given for the intervention group in the WHEL study were as follows:

• 5 servings of vegetables
• 16 ounces of vegetable juice
• 3 servings of fruit
• 30 g of fiber
• 15-20% of calories from fat.¹

The overall results of the WHEL study were published in 2007 and were disappointing. Women in the intervention group on average increased their vegetable intake by 65%, their fruit intake by 25%, and their fiber intake by 30%; they also decreased their energy percentage from fat by 13%. However, there were no significant differences in the number of breast cancer recurrences or deaths between the control and intervention groups.²

Why did this intervention fail?

There were likely many contributing factors. This dietary intervention was started after the women had already been diagnosed and treated for breast cancer; after eating the Standard American Diet for decades and developing cancer; moderate dietary improvements at that point may be too late to prevent recurrence. The dietary advice was likely not specific enough or rigorous enough to have a significant effect. For example, vegetables with breast cancer preventive properties, such as cruciferous vegetables and mushrooms, were not emphasized over starchy vegetables – women were simply advised to eat 5 servings of vegetables daily. Plus, 75% of the women were already consuming 5 servings of vegetables daily before being randomized to control or intervention groups. ²

Women were not instructed to eat less of anything except fat or to decrease their caloric intake – so it is unsurprising that there was no significant change in body weight in the intervention group. ² This is an important issue, since excess weight is strongly linked to breast cancer risk.^3-7 Plus, these women were also consuming significant amounts of animal protein, which increases cancer risk by increasing IGF-1. ^8-11

Another potential issue was the advice to reduce percentage of calories from fat, but no advice on limiting refined carbohydrates. Advising women to decrease their calories from fat without direction on what to replace those calories with likely resulted in the women choosing more pasta, rice, white potatoes, bread, and low fat processed foods. These women received no guidance on limiting refined carbohydrates, which is an important point here. Refined carbohydrates are higher in glycemic index and contain less fiber and more starch compared to natural carbohydrate foods. High dietary glycemic index is known to be associated with increased breast cancer risk.¹² In contrast, consuming high-fiber foods increases the excretion of estrogen and decreases breast cancer risk.^13-15 Now, new research coming out of the original WHEL data suggests that starch intake may play a role in breast cancer risk as well.

Starch intake and breast cancer recurrence

In new research presented at the San Antonio Breast Cancer Symposium in December, data from the WHEL Study were re-analyzed with respect to changes in carbohydrate intake. Women from both the control and intervention groups were included in the analysis.

The subjects were arranged into four groups based on how much their starch intake changed over the first year of the study: in the group who had the greatest decreases in starch intake, the likelihood of recurrence was 9.7%; in the group with the greatest increases in starch intake the likelihood of recurrence was 14.2%.^16,17 The women who increased their starch intake were at greater risk of recurrence.

Although this particular study did not investigate specific foods, we know that white rice, white flour products, and white potatoes are some of the highest starch foods – these are also low nutrient, high glycemic foods and staples in the Standard American Diet. Breast cancer survivors and all women who want to prevent breast cancer must focus on protective foods (GOMBBS) such as mushrooms, green vegetables, beans, and onions; and avoid low-nutrient disease-causing foods, like refined starches and sugars, animal products, and oils. Too often, researchers do not study dietary patterns with the best anti-cancer potential.

References:

1. Pierce JP, Faerber S, Wright FA, et al: A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women's Healthy Eating and Living (WHEL) Study. Control Clin Trials 2002;23:728-756.
2. Pierce JP, Natarajan L, Caan BJ, et al: Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women's Healthy Eating and Living (WHEL) randomized trial. JAMA 2007;298:289-298.
3. American Institute for Cancer Research. New Estimate: Excess Body Fat Alone Causes over 100,000 Cancers in US Each Year [http://www.aicr.org/site/News2/153571380?abbr=pr_&page=NewsArticle&id=17333&news_iv_ctrl=1102]
4. Trentham-Dietz A, Newcomb PA, Storer BE, et al: Body size and risk of breast cancer. Am J Epidemiol 1997;145:1011-1019.
5. Ballard-Barbash R, Schatzkin A, Taylor PR, et al: Association of change in body mass with breast cancer. Cancer Res 1990;50:2152-2155.
6. Vrieling A, Buck K, Kaaks R, et al: Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis. Breast Cancer Res Treat 2010;123:641-649.
7. Parker ED, Folsom AR: Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study. Int J Obes Relat Metab Disord 2003;27:1447-1452.
8. Rinaldi S, Peeters PH, Berrino F, et al: IGF-I, IGFBP-3 and breast cancer risk in women: The European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer 2006;13:593-605.
9. Hankinson SE, Willett WC, Colditz GA, et al: Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet 1998;351:1393-1396.
10. Sugumar A, Liu YC, Xia Q, et al: Insulin-like growth factor (IGF)-I and IGF-binding protein 3 and the risk of premenopausal breast cancer: a meta-analysis of literature. Int J Cancer 2004;111:293-297.
11. Shi R, Yu H, McLarty J, et al: IGF-I and breast cancer: a meta-analysis. Int J Cancer 2004;111:418-423.
12. Dong JY, Qin LQ: Dietary glycemic index, glycemic load, and risk of breast cancer: meta-analysis of prospective cohort studies. Breast Cancer Res Treat 2011;126:287-294.
13. Goldin BR, Adlercreutz H, Gorbach SL, et al: Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 1982;307:1542-1547.
14. Zhou Y, Zhuang W, Hu W, et al: Consumption of large amounts of Allium vegetables reduces risk for gastric cancer in a meta-analysis. Gastroenterology 2011;141:80-89.
15. Park Y, Brinton LA, Subar AF, et al: Dietary fiber intake and risk of breast cancer in postmenopausal women: the National Institutes of Health-AARP Diet and Health Study. Am J Clin Nutr 2009;90:664-671.
16. Emond JA, Patterson RE, Pierce JP: Change in Carbohydrate Intake and Breast Cancer Prognosis. In San Antonio Breast Cancer Symposium, vol. Presentation #P3-09-01; 2011.
17. Starch Intake May Influence Risk for Breast Cancer Recurrence. 2011. AACR in the News. http://www.aacr.org/home/public--media/aacr-in-the-news.aspx?d=2654. Accessed December 29, 2011.

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The science on food addiction has now established that highly palatable foods (low-nutrient, high-calorie, intensely sweet, salty, and/or fatty foods - those that make up the majority of the Standard American Diet) produces the exact biochemical effects in the brain that are characteristic of substance abuse.

Junk food is ubiquitously available, legal, cheap, and socially accepted; therefore, it becomes the drug of choice for many of us.

The following are some characteristics of addiction to a substance or behavior:¹

• Compulsive use of the substance despite negative health and social consequences
• Tolerance - over time, progressively greater amounts of the substance are needed to reach and maintain the “high”
• Withdrawal symptoms (toxic hunger) when the substance is discontinued
• Activation of reward pathways (including the dopamine system) in the brain

Many of us have had the experience of tasting a junk food or dessert, and then feeling the intense demand from our brain: “MORE!” We feel a complete lack of control, and our commitment to excellent health all of a sudden doesn’t matter. These feelings originate from the dopamine reward system – dopamine is a neurochemical that regulates motivation, pleasure, and reinforcement related to certain stimuli – such as food.  The amount of pleasure we derive from eating a food correlates with the amount of dopamine released in the brain.²

Obese individuals have a diminished number of dopamine receptors

Obese humans are known to have fewer dopamine receptors (called D2 receptors) compared to lean individuals –their reward response from food is not as sensitive and it is thought that they compensate by overeating.^1,3

Overeating blunts the dopamine reward response, encouraging more overeating

Why do obese individuals have lower numbers of dopamine receptors? In substance abuse, over time the brain adapts by downregulating dopamine receptors. It turns out the same happens in overeating.⁴ A 2011 study revealed that women who had gained a significant amount of weight over a 6-month period reduced their dopamine system response to palatable food over that time period. Similar reductions in the reward response to palatable foods have been reported in women with bulimia nervosa. These results suggest that overeating diminishes the reward from palatable food, driving further overeating and future weight gain.^5,7

Desire for highly palatable food is intensified in obese individuals and overeaters

Although actual dopamine reward is diminished in obese individuals compared to lean individuals, dopamine release in response to pictures of palatable food is actually enhanced.^4,6

In summary, recent research suggests that overeating and obesity cause greater desire for palatable food, but diminished reward from consuming palatable food - resulting in a progressively worsening addiction.

Our level of susceptibility to addictive behaviors varies by genetic predisposition and emotional state. Nevertheless, highly palatable food has physiologically addictive properties that will make almost anyone experience a lack of control.  “Just one bite” doesn’t work because that single bite activates the dopamine reward system, causing the brain to demand more.  Willpower, logic, and common sense are no match for addictive drives. As with other addictions, recovery requires abstaining from the addictive substance. An alcoholic can’t have “just one drink” without grave risk of relapse. The same is true for food addicts.

Natural plant foods are not as intensely sweet, salty, or fatty as the processed junk foods that are purposely engineered to excite our reward systems.  Eating whole, natural foods provides enjoyment of taste without activating addictive drives.  

Be vigilant this holiday season – stick to the foods that nourish you, and steer clear of any foods that cause you to lose control.   

Note: Addictive drives are powerful. If you are suffering from food addiction, make sure you read Eat to Live and take advantage of our supportive Member Center at DrFuhrman.com.  Support from others can help you stay on track with your health goals and prevent relapse.

References:

1.         Taylor VH, Curtis CM, Davis C: The obesity epidemic: the role of addiction. CMAJ 2010;182:327-328.

2.         Small DM, Jones-Gotman M, Dagher A: Feeding-induced dopamine release in dorsal striatum correlates with meal pleasantness ratings in healthy human volunteers. Neuroimage 2003;19:1709-1715.

3.         Volkow ND, Wang GJ, Telang F, et al: Low dopamine striatal D2 receptors are associated with prefrontal metabolism in obese subjects: possible contributing factors. Neuroimage 2008;42:1537-1543.

4.         Gearhardt AN, Yokum S, Orr PT, et al: Neural correlates of food addiction. Arch Gen Psychiatry 2011;68:808-816.

5.         Stice E, Yokum S, Blum K, et al: Weight gain is associated with reduced striatal response to palatable food. J Neurosci 2010;30:13105-13109.

6.         Stoeckel LE, Weller RE, Cook EW, 3rd, et al: Widespread reward-system activation in obese women in response to pictures of high-calorie foods. Neuroimage 2008;41:636-647.

7.         Bohon C, Stice E: Reward abnormalities among women with full and subthreshold bulimia nervosa: a functional magnetic resonance imaging study. Int J Eat Disord 2011;44:585-595.

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At Dr. Fuhrman's Weekend Immersion in Princeton, New Jersey last month, sharing scrumptious meals together with others was a highlight for me. That’s when I had the awesome opportunity to step away from my computer screen and interact with so many wonderful people from all over the country! I loved listening to the heartbeat of what’s happening in the day-to-day lives of those who’ve committed to a lifetime of eating for health, and especially those who were making the commitment to eat for health over the holidays. 

Unfortunately, pushy in-laws and overbearing relatives and friends were a topic of discussion for many in overcoming obstacles during the upcoming holidays.

Hmmm, shall I be so bold to call these pushy relatives and friends, “Food bullies?”

Bullies have a strong need to control and dominate, and usually envy and resentment are at the root of their behaviors. 

If a food bully’s intended target exhibits a “defeated attitude” in response to the pushiness, then the bullying is likely to continue. 

However, as in most all cases with bona fide bullies, if the intended target responds with a clear attitude of self-confidence and a strong boundary line, the bully’s attempt to dominate will quickly diminish. 

Recently I asked Dr. Fuhrman about food bullies, and the following was his response:

 

"One has to tell relatives and friends now, not later at the dinner table, that he/she is on a special, healthy diet prescribed by Dr. Fuhrman to lose weight and prevent cancer so don’t be offended that conventional foods will not be eaten at the holiday get-togethers. 

Giving into food bullies is just another dysfunctional excuse to continue in food addiction. The inability to speak one’s feelings for fear of a reprimand is also toxic and may be cancer causing. By not addressing it, and by not taking a stand with pushy relatives and friends, giving into food bullies is ill-will and selfish; because one is not giving loved ones a chance to learn what they should be considering for their lives also; whether they do it or not."  

 

How about you? Do you have a tangible plan of action to deal with the food bullies in your life this holiday season?

Related post:

Is pleasing Grandma ruining your health?

image credit:  flickr by Dinner Series

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by Jerry Deutsch, President, Nutritional Research Project

The Nutritional Research Project and Joel Fuhrman, MD are teaming up with top researchers throughout the US to show that chronic disease can be prevented and reversed with the Eat to Live (nutritarian) lifestyle!

We want you to be among the first to know about this groundbreaking research. Rather than focusing on drugs as most researchers are doing, we are examining the power of a high nutrient density diet to reverse obesity, heart disease and cancer! 

These studies are supported by people like you who are interested in the benefits of a healthful lifestyle and want to be part of the solution to most, if not all, of our planetary problems.  The Nutritional Research Project of the National Health Association is the oldest health promoting 501(c)3 nonprofit in the United States, providing healthy lifestyle education and research for over 60 years!  We are thrilled to be working with Dr. Fuhrman to pursue his and your research interests.

The Vitamix Company has given us a wonderful challenge.  Donate today and you will be have a chance to win a reconditioned Vitamix.  These come with the full Vitamix 7 year guarantee.  Every $10 you donate gets you one entry ($100 = 10 entries).  Vitamix will be giving away one vitamix for every $1000 in donations to the NRP through December 31, 2011.   Click here to donate. 

 
OBESITY STUDY

The day after this year's Immersion in Princeton, N.J., Dr. Fuhrman came to North Carolina to meet with researchers from The University of North Carolina and the Director of the Nutrition Research Institute (founded by David Murdoch and located in Kannapolis, North Carolina).  Dr. Fuhrman, the NRP and the NRI have agreed to collaborate on a 2-year obesity study, to discover how successful his high nutrient diet will be when taught to overweight subjects. Although most diets will produce weight loss initially, weight loss is typically not sustained beyond about 6 months.  If we can demonstrate 2 years of statistically significant results we should be on CNN and in the NY Times and Wall Street Journal! 

Please help us bring this study to the next level with a small (or large) donation. Every donation of any size will help.

DHA Study

Our DHA study has received approval from the University of San Diego Institutional Review Board and we will begin recruiting subjects soon.  We are determining blood levels of omega-3 fatty acids (EPA and DHA) in vegans and examining associations with dietary intake.  Perhaps you can help us get the word out?  We need at least 250 subjects who have been vegan for at least 3 years and have not supplemented with DHA during the last 3 years. 

To learn more, read a summary of the study and sign up for email updates. Please support this study with a small (or large) donation. 

CARDIOVASCULAR DISEASE STUDY

Our Cardiovascular study will be in conjunction with the University of Colorado.  Dr. Fuhrman will be working with cardiologists at the University hospital.  Dr. Fuhrman's nutritional protocol will be utilized with serious cardiac patients.  This study will show that his nutritional intervention can reverse heart disease and is more effective than surgery! 

Please help us bring this study to the next level with a small (or large) donation. Every donation of any size will help.

CANCER PREVENTION STUDY

Dr. Fuhrman has made a loud and clear call for cancer prevention.  We all know someone that has been afflicted with cancer, so awareness is not the problem.  We need a solution now.  The NRP will soon begin a study to support women to avoid breast cancer and live cancer free.  As the national averages are well known, we plan to show that women who follow the ETL lifestyle are far less likely get breast cancer and women already diagnosed with cancer will dramatically enhance their longevity. 

Please help us establish this study and other studies mentioned above with a tax deductible donation.  Your donation of any size will help Dr. Fuhrman and the NRP implement the scientific research to have a huge impact on the world.

Please donate whatever amount you can.  We really appreciate your tax deductible contribution! Remember to donate today and you will have a chance to win a reconditioned Vitamix.  These come with the full Vitamix 7 year guarantee.  Every $10 you donate gets you one entry ($100 = 10 entries).  Vitamix will be giving away one Vitamix for every $1000 in donations to the NRP through December 31, 2011. 

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Congratulations to all who have committed to following Dr. Fuhrman’s Holiday Challenge! We tend to think of giving tangible gifts and purchasing presents for others this time of year, but if you have been sticking to the pledge to eat only healthful foods and avoid junk foods, you have been granting yourself the greatest gift of all: the gift of health. That is something to be proud of. The gift of health will stay with you for the rest of your life, a life that will be set free from the waves of chronic diseases and health problems that beset most Americans.  

Most whom embark on Dr. Fuhrman’s Holiday Challenge probably do not contemplate how eating heaping salads, hearty vegetable and bean dishes, and other satisfying natural plant foods effects our skin. Hence, this post is a reminder that following this powerfully disease preventative and figure slimming lifestyle enhances the beauty and clarity of our skin as well.    

In a blog post I wrote last year, I explained the science behind how food is an enormous contributor to whether or not we will attain healthy, blemish free complexions. Here I will summarize that article as a reminder of why politely declining that homemade, yet sugar loaded cookie your co-worker urges you to sample or resisting the saturated fat laden eggnog at a holiday party will result in gorgeous skin and prepare you for any spontaneous holiday picture taking that comes your way. 

The beauty of our skin is remarkably influenced by the amount of hormones circulating inside of our bodies. Insulin, in particular, is associated with the health of our skin. Insulin is most commonly known as the hormone for regulating blood sugar and is associated with diabetes, yet it also happens to increase oils that appear on the surface of our skin. Insulin levels fluctuate based on what we eat, and these fluctuations can affect other hormones such as testosterone that also promote acne and dull skin.

Processed foods made with white flour and sugar lead to blood sugar spikes, causing insulin levels to go into the dreaded “pimple-producing zone”. Sugar and processed foods are awful for our skin!

Dairy products are just as noxious skin foes as processed foods and sugar.  Research conducted at Harvard University School of Public Health showed that milk contains bioactive molecules that act on the glands where blackheads are formed. William Danby MD, a dermatologist at Dartmouth, noted in an editorial accompanying this study that 70 to 90 percent of all milk comes from pregnant cows and that the milk contains hormones such as progesterone, testosterone precursors and insulin-like growth factor releasing hormones, all linked to acne. High levels of these hormones are linked to breast cancer and prostate cancer so avoiding foods that lead to breakouts and dull skin also helps us prevent these cancers.

The foods you should eat for radiant skin? Green vegetables, fruit, beans, nuts, seeds, avocadoes, starchy vegetables, and whole grains- all of the foods that are associated with longevity, disease prevention and succeeding on Dr. Fuhrman’s Holiday Challenge. These foods are loaded with thousands of potent phytochemicals like carotenoids and lycopene, substances that help our skin repair damage and remove and detoxify waste products and toxic compounds.  Skin damage occurs due to exposure to free radicals, which results in oxidative damage to our cells. By eating plenty of antioxidant loaded fruits and vegetables, our body becomes equipped with tiny chemical warriors that continuously fight free radical damage. The result is glowing, healthy looking skin. Now that is something worth being jolly about. 

 

Cheers to good health and I wish you much success and joy into the New Year!

The image at the top of the post is Talia a few years ago.  The second picture is Talia with her mother, Lisa Fuhrman, taken this past Thanksgiving. 

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