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

Tomorrow evening PBS will launch a major television series about global health.

They have already launched a comprensive "Rx for Survival" website, which has lots of interesting information, essays, maps, statistics, and other fodder for discussion.

The site emphasizes infectious diseases in developing nations. One of the non-infectious diseases that is shown to be leading killer the world over, including in the world's most modern countries, is malnutrition.

As the site explains, that is not the same as starvation, and in some cases it's quite the opposite:

Malnutrition (from the French mal, meaning "bad") doesn't just mean lack of food. It might surprise some to learn that it refers to obesity, too. In addition, malnutrition describes a lack of micronutrients, including a range of vitamins and minerals.

One of the most powerful micronutrients for child survival is vitamin A. Found naturally in carrots and green and yellow vegetables, or supplied in vitamin capsules or liquid drops taken orally, vitamin A can improve children's health by preventing deaths caused by diarrheal dehydration and measles, dry eye, and nightblindness. Severe deficiencies of vitamin A can ultimately result in total blindness. Vitamin A supplement pills or drops administered twice a year in Africa were able to avert approximately 400,000 cases of childhood blindness per year. Worldwide, it's estimated that the supplements are boosting children's immune systems and saving up to a million lives a year among children at risk of infectious disease.

Pregnant women also benefit from vitamin A supplements, which help reduce maternal mortality dramatically. In a study done in Nepal, maternal mortality rates dropped by more than one-third when women took vitamin A supplements during their pregnancies. It was famously said by nutritionist EV McCollum, who identified vitamin A in 1913, that "Green leafy vegetables are unbottled medicine."

Dr. Fuhrman echoes McCollum's sentiment, but is not a fan of vitamin A supplements. He advocates getting vitamin A from vegetables instead of supplements whenever possible. From a longer post discussing supplements, here's what Dr. Fuhrman has to say about Vitamin A:

Ingesting vitamin A or beta-carotene in isolation—from supplements, instead of from food—may interfere with the absorption of other crucially important carotenoids, such as lutein and lycopene, thus potentially increasing cancer risk.

The precursor to vitamin A, beta-carotene once was regarded as a safe and beneficial antioxidant and even recommended as an anti-cancer vitamin, but it has recently been shown to increase the risk of certain cancers when administered as an isolated supplement. Scientists now suspect that problems may result when beta-carotene is ingested without other carotenoids that would have been present had it been ingested from real food. Beta-carotene is only one of about 500 carotenoids that exist. Beta-carotene supplements are poor substitutes for the broad assortment of carotenoid compounds found in plants.

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Dr. Fuhrman's recommendations to families to avoid flu, including avian flu, stirred some interesting comments--especially the idea that those with the healthiest immune systems may be less protected from avian flu than those with average immune systems. Dr. Fuhrman responds:

Clearly, the concept that powerful and competent host defenses are enabled by nutritional excellence is not merely my opinion; rather it is the reality of human physiology supported by hundreds of scientific studies.

And because I have written books on nutrition to teach applied nutritional excellence does not make my viewpoints any more or less substantiated. However, keep in mind my books contain hundreds of references for all my points and likewise my opinions expressed here are not off the cuff but reflect a lifetime of devoted study to these issues.

The idea that a person eating a nutrient-rich diet is just as likely to develop and suffer the dangerous consequences from an influenza virus as a cheese burgers and soda eating American is simply wrong. Moe importantly such opinions are dangerous as they may lead to tragic outcomes for those mistaking authority for knowledge.

Let's review just a few articles from the scientific literature that further support this concept that nutritional.excellence can offer protection from viral attacks. I will show the reference and post some explanatory comments below each reference.

1. Bendich A. Antioxidant nutrients and immune functions--introduction Adv Exp Med Biol 1990;262:1-12
This short introduction encompasses only a small portion of the literature linking free radical production and consequent effects on immune functions. The role of essential dietary components in modulating these effects is an area of intense and expanding investigation. Each of the nutrients examined in the chapters has distinct functions to support immuno-competency, but in this volume they concentrate on their shared capacity to act as antioxidants

2. Fawzi W. Nutritional factors and vertical transmission of HIV-1. Epidemiology and potential mechanisms. Ann N Y Acad Sci 2000 Nov;918:99-114
This article shows that the transmission of the AIDS virus is significantly reduced and even made improbable when the host's nutrition is excellent.

3. Beck MA; Levander OA Dietary oxidative stress and the potentiation of viral infection. Annu Rev Nutr 1998;18:93-116. Beck MA Antioxidants and viral infections: host immune response and viral pathogenicity. J Am Coll Nutr 2001 Oct;20(5 Suppl):384S-388S; discussion 396S-397S. Beck MA; Levander OA; Handy J Selenium deficiency and viral infection. J Nutr 2003 May;133(5 Suppl 1):1463S-7S. Rayman MP; The argument for increasing selenium intake Proc Nutr Soc 2002 May;61(2):203-15
These articles above review the literature and studies showing nutritional deficiencies lead to more serious infections. They contain the interesting science that describes how a diet low in anti-oxidents and phytochemicals can enable genetic sequences in the pathogen to alter allowing more serious outcome. Oxidative stress is implicated in the pathogenesis of several viral infections, including hepatitis, influenza, and AIDS. Dietary oxidative stress due to either various nutritional deficiencies such as selenium or vitamin E increases cardiac damage in mice infected with a myocarditic strain of coxsackievirus B3. Poor diet allows a normally benign (i.e., amyocarditic) coxsackievirus B3 to convert to virulence and cause heart damage. These findings were then documented to occur in humans too. It was found that cardiomyapathy as well as viral induced neuropathy have a dual etiology involving a nutritional deficiency along with a enterovirus that now can create a serious outcome, not permitted in a more nutritionally adequate host. More recently research has shown that the influenza virus also exhibits increased virulence in a nutritional deficient host allowing multiple changes in the viral genome. Interestingly, the influenza virus causes more serious lung pathology and HIV infection progresses more rapidly to AIDS in the micronutrient poor host. Although it has been known for many years that poor nutrition can affect host response to infection, the finding that host nutrition affects the genetic sequence of a pathogen is an important field of future investigations.

4. Levander OA. Nutrition and newly emerging viral diseases: an overview. J Nutr 1997 May;127(5 Suppl):948S-950S. Amati L; Cirimele D; Pugliese V; Covelli V; Resta F; Jirillo E Nutrition and immunity: laboratory and clinical aspects. Curr Pharm Des 2003;9(24):1924-31 Irshad M; Chaudhuri PS Oxidant-antioxidant system: role and significance in human body. Indian J Exp Biol 2002 Nov;40(11):1233-9
Malnutrition has long been associated with increased susceptibility to infectious disease due to an impaired immune response. Now more data has emerged to substantiate the view that oxidants, anti-oxidants and nutritional factors have dramatic positive effect on host recovery, response, resistance and also to protect the virus from mutating into a more dangerous forms. When discussing interactions of nutrition and infection, nutritionists have traditionally considered only the effects of diet on the host. Recent data, however, indicate that host nutrition can influence the genetic make-up of the pathogen and thereby alter its virulence. These symposiums and articles were designed to alert the community of nutritional scientists to this discovery and possible implications for the improvement is public health.

When derived of anti-oxidant nutrients viral infections can cause serious even fatal diseases, that don't occur when deficiency is not present. Immunity when optimized can ward off infection and when infected is more likely to have harmless outcome. It is well known that inappropriate nutrient intake accounts for the maintenance of the immunological equilibrium, in humans and animals. Vitamins, elements, lipids, proteins. phytonutrients, and nucleic acids play an important role in the regulation of cellular and humoral immune responses since single or multiple deficits of these food components have been shown to cause immune abnormalities.

5. Reid AH; Taubenberger JK; Fanning TG. The 1918 Spanish influenza: integrating history and biology. Microbes Infect 2001 Jan;3(1):81-7. Afkhami A Compromised constitutions: the Iranian experience with the 1918 influenza pandemic. Bull Hist Med 2003 Summer;77(2):367-92
The global demographic impact of the 1918-19 influenza pandemic continues to fascinate researchers and scholars. These papers examine the social and demographic effects of this outbreak on society, through a comprehensive investigation of the modes of transmission and propagation, mortality rates, and other distinctive features of various regions, and reveals the importance of taking a country's unique settings into account. For example, Iran was one of the regions hit hardest by the pandemic, with mortality rates significantly higher than in most regions of the world. Contrary to the prevailing notion that the 1918 influenza targeted the young and healthy, this paper suggests that famine, opium, malaria, and anemia were fundamentally responsible for the high mortality in Iran. Clearly those with compromised immunity suffered the most damage.

The touted concept that the pandemic flu of 1918 target the "young and healthy" is not quite accurate. First of all, like today the diet in Western Europe in those days was largely meat, bread, potato, lard, butter and cheese with minimal fresh produce. The so-called, "young and healthy" back then, like today could not be used as an example of those eating a diet to assure nutritional adequacy. The diets of yore were grossly deficient. Today most industrialized nations eat less than five percent of total calories from fresh produce: fruit, vegetables, seeds, nuts and beans. In spite of the fact that we have new science pointing to the impressive disease protection against heart disease, strokes, dementia, cancer and yes, serous infections, our society still consumes a diet assuring nutritional compromise and tragic medical outcomes..

Those of you naysayers who would like to stay on your chicken and pasta "low fat diet" or your cheeseburger and cokes with your heads buried deeply in the French fries, I say that is your prerogative. As for me, I will use and apply the science of today that shows the protection offered by cruciferous vegetables, raw vegetables and fruits, nuts and seeds and beans to give myself, my family and my patients the greatest potential to live a live a long, healthy life. This is not alternative medicine, it is good medicine.

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Research suggests a little less meat on the plate could mean less bulk on your frame. In a study, women who consumed few or no animal products were less likely to be overweight or obese than self-identified meat eaters.

In their American Journal of Clinical Nutrition article, researchers PK Newby, Katherine L Tucker and Alicja Wolk conclude:

Even if vegetarians consume some animal products, our results suggest that self-identified semivegetarian, lactovegetarian, and vegan women have a lower risk of overweight and obesity than do omnivorous women. The advice to consume more plant foods and less animal products may help individuals control their weight.

Make fresh fruit, vegetables, whole grains, and legumes your diet staples. For a protein fix, opt for low- or non-fat dairy, skinless chicken, nuts, or fish to control saturated fat.

Plant-based diets consisting of fruits, vegetables, legumes, and whole grains are high in fiber and nutrients and low in fat and calories, all of which may help you lose weight. This study suggests that people who classify themselves as vegetarian, semivegetarian, or vegan are much less likely to be overweight or obese than meat eaters.

However, you don't need to go completely meatless if that doesn't suit your lifestyle. Just choose appropriate portion sizes and low-fat cooking methods. A serving of meat is equal to three ounces, about the size of a deck of playing cards. If you eat red meat, limit consumption to no more than one serving per week. Also, limit intake of meats high in saturated fat, such as bacon, sausage, and fatty cuts of beef.

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Laura Landro is an assistant managing editor of The Wall Street Journal, who wrote a well-reviewed book about her own struggle with breast cancer.

In her column today, she addresses something lots of people are worried about these days: cold and flu season. She cites good research in recommending lots of fruits and vegetables, limiting saturated fat, avoiding processed and junk foods, exercising, and maintaining a normal weight.

As cold-and-flu season arrives, so do the pitches for products that claim to increase the body's natural immunity and ward off infection. And with alarming reports about avian flu and a threatened global pandemic, it may be tempting to load up on mega doses of vitamins, minerals and herbal supplements as an added precaution.

But as scientists delve more deeply into how the immune system works, they are finding evidence that it is the complex interaction of nutrients in food that helps the body build its defenses against disease and infection, in part by controlling some types of inflammation that can weaken the immune system. Single nutrients and cocktails of nutrients consumed alone can't provide the same benefit, they warn, and large doses of some supplements such as selenium, zinc, vitamin A, vitamin B6 and vitamin E may even harm and suppress the immune response.

The best defense against influenza is getting vaccinated as soon as possible -- and the most important way to prevent the spread of colds is frequent hand washing. But experts say that following the most basic tenets of good nutrition -- consuming a balanced diet rich in fruits and vegetables and low in saturated fats, and eliminating highly processed and junk foods -- can actually help ward off illness.

"There is lot people can do with proper nutrition to improve their chances of warding off the flu or making the disease less pathogenic," or harmful, says Simin Nikbin Meydani, director of the nutritional immunology laboratory at Tufts University's Jean Mayer USDA Human Nutrition Research Center on Aging.

Exercise and maintaining a normal weight are equally important, Dr. Meydani adds, because obesity can also impair immune function and make people more susceptible to many types of infections. Tufts researchers have shown that moderate caloric restriction in humans appears to be beneficial for immunity.

Dr. Fuhrman's take on all this? He could talk all day. His books are essentially all about how to use the lessons of the best research to get your immune system performing at a high level. Certainly his approach is consistent with the core recommendations: lots of fruits and vegetables, limiting saturated fat, avoiding processed and junk foods, exercising, and maintaining a normal weight--but he makes many more specific recommendations about what exactly to eat for optimum health.

For instance, in Disease-Proof Your Child he discusses phytochemicals, which are a recently discovered class of more than 12,000 nutrients that are the subject of a lot of new research. Phytonutrients do all sorts of good things, from detoxifying certain harmful compounds, deactivating free radicals, and enabling DNA-repair mechanisms. From the book:

We cannot acquire a sufficient amount and diversity of phytochemicals in supplements; we must get them from real food, especially because many of them have not been discovered yet. When we pass up eating fruits and vegetables, we are turning our backs on a host of nutrients that can keep us from developing disease.

(In another part of Disease-Proof Your Child he adds that "cold breakfast cereals have as much phytochemical nutrition as the cardboard box they are found in.")

In case you needed another reason to eat your broccoli... (And what if you don't like broccoli? There are plenty of good, healthy recipes in his books, and right here on DiseaseProof.)

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As we have discussed previously, many studies point to a link between diet and cancer. Studies that consider long-term diets, and the diets of the very young, suggest particularly strong ties. Studies in which middle-aged people have made modest dietary changes for only a few years have had mixed results (which can create confusion and be discouraging for those who are interested in eating the healthiest diet possible).

In May, however, a study was released showing that women who had been treated for breast cancer decreased their likelihood of a recurrence with a modest reduction of fat intake. In a a question-and-answer session describing his study, Rowan Chlebowski of Harbor-UCLA Medical Center explains that the research involved more than 2,400 women as part of the Women's Intervention Nutrition Study.

After an average of five years, 9.8 percent of the women on the low-fat diet had a recurrence of cancer. Meanwhile, 12.4 percent of the women on a standard diet had recurrences. That's a 24 percent reduction. Impressively, women with cancers that were not sensitive to estrogen--and who therefore are not candidates for drugs like tamoxifen--had their risk fall even more, by about 42%.

The only dietary adjustment these women made was to eat an average of 33.3 grams of fat per day, compared to the "average diet" which contained 51.3 grams of fat. That is a very modest dietary adjustment.

In his books, Dr. Fuhrman describes a diet that is low in fat, but otherwise very different from the diet these women were following. Dr. Fuhrman's recommendations for cancer patients include fresh squeezed vegetable juices, blended salads, and his cruciferous vegetable containing soups. His menus are designed to contain optimal levels of phytonutrients as they occur in nature. Phytonutrients have been shown in scientific studies to boost the immune system's ability to defend itself against a cancer and actually enable the body to stop the growth of cancer cells. His results with many cancer patients have been dramatic, and make clear that the marginal benefits of reducing fat intake is only the beginning of what diet can do to ward off cancer.

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This spring, Dr. Fuhrman was interviewed by Marshall Glickman of Green Living Journal. The conversation gives an overview of the unique equation that underlies Dr. Fuhrman's approach (health = nutrition/calories), touches on the social challenges of healthy eating, and concludes with some meaningful news for those concerned about heart disease. With Mr. Glickman's permission, here is some of their conversation:

Thanks so much for the chance to ask you some questions, and especially for the huge amount of hours you've put into research. It seems hard to disagree with the formula Health = Nutrients/Calories. Can you flesh out your approach a bit, with a quick summary of what you advocate in Eat to Live?
Sure. There are a few points that together make the H = N/C approach unique. One is the concept of nutrient density; that is, as you start to meet the body's nutrient needs, it desires less food. This mean we're not going to crave food as much or want to eat as often.

Another is that when you eat foods that have toxic properties or that aren't healthy for you, they create addictive withdrawal symptoms once you stop eating them. Since those addictive withdrawal symptoms are relieved by frequent eating, they drive people to eat more frequently than is necessary. For example, if you stop drinking coffee, you get headaches. You can get rid of the headaches by breaking the caffeine habit or by drinking more coffee. Likewise, a diet that contains processed foods and trans fats, lots of saturated fats and plenty of salt is relatively toxic, and when you stop eating for a few hours, you start to feel lousy. Weakness, achiness, abdominal spasms, and headaches are not symptoms of true hunger. Like thirst, true hunger is felt in the throat, not the stomach. So the point is, in order to stop the addictive drives and perverted cravings that lead to compromised health and our current obesity epidemic, we must restore nutritional excellence. This puts people back in touch with the amount of calories they actually need. Dieting doesn't work because you are always fighting your addictive sensations.

Restoring nutritional excellence not only improves health, drops weight, and lowers cholesterol, once the perverted food cravings and addictions are gone, you can make appropriate connections between the body's natural signals--directing you to the right amount of calories needed to maintain an ideal weight. Otherwise, dieting becomes a guessing game of how much food to eat, measuring of calories, walking around starving all the time, and fighting against the natural drive to eat.

The third point is taste. As you start to eat more healthfully in a nutrient-dense diet, your taste adjusts itself so that you actually get more pleasure from eating, not less. That's why I say this is a knowledge-based system. You need to know that giving up some of your favorite, unhealthy foods requires only a temporary loss, but after a while you'll actually like this way of eating as much or more than your old way. When you're eating food that tastes good and aren't restricted on the quantity, you don't feel deprived.

Continue Reading...

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If you're someone who prefers listening to reading, and you're wondering what Dr. Fuhrman is all about, here's a little sample: about a five-minute-long interview he did upon the arrival of his book Eat to Live.

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These people are really into mushrooms.

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Every parent wants their child to enjoy the benefits of excellent nutrition.

Many parents have good ideas about which foods their children would ideally eat.

Yet somehow it seems very few parents actually succeed in getting their children to eat a healthy diet.

How can you get your kids to eat well? With four children of his own, and hundreds he has successfully treated with excellent diet, Dr. Fuhrman has a wealth of experience and plenty of tricks.

Dr. Fuhrman gives parents techniques they can use to end "the food wars," and encourage children to joyfully consume things like kale, tomatoes, and carrots. (It happens. Really.)

This DiseaseProof.com podcast is about twenty minutes long, and you can listen directly on the web or by downloading to your portable media player.

Listen to an mp3 of Dr. Fuhrman on Getting Children to Eat Well.

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Eureka! Some good news about the health of Americans. The website of the magazine Cooking Light offers these numbers:

The new USDA guidelines recommend we eat between five and 13 servings of fruit and vegetables a day, and we're starting to hear the message. The average American consumed roughly 332 pounds of fresh produce in 2004, up from 287 pounds in 1990. Plus, with the growth of America's farmers' markets, the introduction of Consumer Supported Agriculture, where community members buy produce from local farmers each month, and home delivery from many supermarkets, opportunities for Americans to have fresh produce abound.

The article also references the work of Dr. Frank Hu.

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According to this Reuters story, researchers had two groups of women. One group was instructed to eat a low-carbohydrate diet. The other was intructed to eat a diet free of animal products including, meat, eggs, and milk. Even though the vegan group had no portion restrictions, they ended up losing significantly more weight.

Researchers found that of 64 postmenopausal, overweight women, those assigned to follow a low-fat vegan diet for 14 weeks lost an average of 13 pounds, compared with a weight loss of about 8 pounds among women who followed a standard low-cholesterol diet.

The weight loss came despite the fact that the women were given no limits on their portion sizes or daily calories -- and despite the fact that the vegan diet boosted their carbohydrate intake.

Please note, Dr. Fuhrman's diet, as described in his books, isn't vegan, and isn't even necessarily vegetarian. But his diet does involve a lot of the same healthy foods that the women in the vegan group of this study reported eating, including vegetables, beans, fruit, and nuts.

CORRECTION: In the first paragraph, I should have said low-cholesterol. My mistake, and thanks for the comment catching it. (The confusion came from the the line saying the vegan diet "boosted their carbohydrate intake.")

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