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

 An article by Christina Pirello, an advocate of natural foods nutrition and professor of culinary arts at Drexel University, on Huffington Post states the uncomfortable truth about healthcare reform that the mainstream media consistently fails to report:

“Healthcare reform is irrelevant until Americans improve their lifestyles.”

The fact is, our healthcare costs are out of control because the diet and lifestyle that has become the societal norm in this country causes disease.  As Ms. Pirello mentioned in her article:

“We are willing to tolerate this revolutionized food because it's cheap. But it comes at a high price to our health. We spend less on food today than any other people at any other time in recorded history. And the less we spend on food, the more we spend on health care.”¹

 Here are some numbers:

- Overweight and obesity rates are at an all time high – 73% of Americans are either overweight (38.8%) or obese(34.2%).² In 1980, 15% of adults were obese – over the past 30 years,that number has more than doubled.³

- According to the CDC, U.S. obesity-related health costs totaled $117 billion in 2000, and if current trends continue, that figure is projected to reach $344 billion per year by 2018.^3,4

- Coronary heart disease costs are estimated at $177 billion for 2010, costs for stroke at $74 billion, costs for hypertension at $77 billion. ⁵

- Health insurance premiums have gone up 131% in the last 10 years.⁶

- Over 50% of insured Americans take prescription drugs for a chronic condition – the majority of these drugs are for blood pressure or cholesterol.⁷  

These costly diseases are caused by poor lifestyle choices, and they are also preventable by positive lifestyle choices.

The problem is not the fact that there are so many uninsured Americans – the problem is that there are so many unhealthy Americans. Do we need a better health care system? Of course. But not as desperately as we need better health. Better health through improved lifestyle choices is also fiscally responsible. Vegetables are cheaper than statin drugs. A gym membership is cheaper than bypass surgery.

Health care costs are the symptom, poor lifestyle choices are the cause. If we want to improve the situation, we need to address the cause. The only way to reduce these costs is to reduce the prevalence of these devastating (but preventable) diseases.

No matter how many confusing messages the American public gets about nutrition, there are some very simple truths. Fruits and vegetables are healthy, processed foods and fast food are not. If you follow a nutritarian diet, it will cost less to keep you healthy. 

Ms. Pirello suggests a healthcare system in which individuals are rewarded for having healthy habits – sounds like a great idea to me. She also mentions Whole Foods Market’s new Health Starts Here program, for which I provide nutritional guidance.

“They are about to implement a program that encourages their employees to get and stay healthy. Beginning with a simple blood test and survey, each employee who chooses to participate will receive a diet plan. Each benchmark they hit (lower cholesterol and blood pressure, healthier BMI, etc., will result in a greater discount on their groceries purchased at Whole Foods Market. Imagine a health care plan that does the same thing.”¹

No matter what the outcome of healthcare reform in Washington D.C., if enough of us develop and practice healthy habits, it will be to the benefit of our healthcare system.

References:

1. http://www.huffingtonpost.com/christina-pirello/healthcare-reform-is-irre_b_440589.html

2. Ogden CL et al. Prevalence of High Body Mass Index in US Children and Adolescents, 2007-2008. JAMA. 2010;303(3)

Flegal KM et al. Prevalence and Trends in Obesity Among US Adults, 1999-2008. JAMA. 2010;303(3)

3. http://www.cdc.gov/nchs/data/hestat/overweight/overweight_adult.htm

http://www.cdc.gov/nccdphp/publications/AAG/pdf/obesity.pdf

4. http://www.americashealthrankings.org/2009/obesity/ECO.aspx#2018

5. http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.109.192667

6. http://money.blogs.time.com/2009/09/30/a-dozen-disturbing-health-care-statistics/

7. http://www.cbsnews.com/stories/2008/05/14/health/main4094632.shtml?source=related_story

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Both iron and copper serve vital functions, but as we age excess stores of these metals may build and become toxic. A report from the American Chemical Society¹ suggests that iron and copper toxicity are unrecognized but significant threats to public health, in particular for adults over the age of 50.

Iron is crucial for oxygen transport and the proper function of several enzymes and proteins. Similarly, copper is also a component of enzymes that catalyze important reactions in several of the body’s cells and tissues. The human body evolved to store excess iron and copper to fuel these vital processes in case of extreme conditions like bleeding or famine, but their accumulation over time may be detrimental because both metals are involved in the production of reactive oxygen species (ROS).

It is now generally accepted that oxidative damage, a byproduct of oxygen-dependent energy production, contributes to chronic diseases and aging.

Oxidation of LDL cholesterol is one of the initial steps of atherosclerotic plaque development. Epidemiological associations between body stores of each of these metals and atherosclerosis have been found, and this is thought to be due to ROS production.² 

Oxidative damage and depletion of the brain’s natural antioxidant defenses are implicated in the neurodegeneration associated with Alzheimer’s disease. Because the brain uses more oxygen and produces more energy than any other organ, it is the most vulnerable organ to oxidative damage. The high iron content of the brain, even higher in those with excessive iron stores, makes the brain even more vulnerable to oxidative stress.³

In people at least 65 years of age who consumed diets high in saturated and trans fats, copper intake was associated with accelerated cognitive decline. Copper bound to cholesterol is also commonly found in the β-amyloid plaques characteristic of Alzheimer’s disease.⁴

Excess quantities of these metals primarily come from meat, followed by multivitamin/multimineral supplements. Copper in supplements and drinking water is even more toxic than copper derived from food sources.¹   

The author of this new report has outlined steps that we can take to limit our exposure to copper and iron, including:

• Avoiding or minimizing red meat consumption

• Avoiding drinking water from copper pipes

• Choosing a multivitamin that does not contain copper and iron. 

Dr. Fuhrman designed his Gentle Care Formula multivitamin/multimineral to be free of potentially toxic ingredients like copper and iron.

References:

1. American Chemical Society (2010, January 22). Consumers over age 50 should consider cutting copper and iron intake, report suggests. ScienceDaily. Retrieved January 29, 2010, from http://www.sciencedaily.com /releases/2010/01/100120113553.htm 

Brewer GJ. Risks of Copper and Iron Toxicity during Aging in Humans. Chem Res Toxicol. 2009 Dec 7. [Epub ahead of print]

2. Brewer GJ. Iron and Copper Toxicity in Diseases of Aging, Particularly Atherosclerosis and Alzheimer’s Disease. Exp Biol Med 232 (2): 323. 2007

3. Kidd PM. Neurodegeneration from Mitochondrial Insufficiency: Nutrients, Stem Cells, Growth Factors, and Prospects for Brain Rebuilding Using Integrative Management. Alternative Medicine Review 2005;10(4):268-293

4. Morris MC et al. Dietary copper and high saturated and trans fat intakes associated with cognitive decline. Arch Neurol. 2006 Aug;63(8):1085-8.

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On Wednesday, January 20th, about a week after NYC Mayor Bloomberg proposed his controversial salt reduction initiative, evidence was presented in the New England Journal of Medicine that salt reduction truly can save lives.

Using mathematical models, the authors were able to make estimates of cardiovascular disease rates based on a population-wide 3 g decrease in salt consumption (1200 mg sodium). 

By their projections, a 3 g salt reduction would result in 60,000 fewer cases of coronary heart disease, 32,000 fewer strokes, and 54,000 fewer heart attacks each year. This is comparable to the cardiovascular benefit from smoking cessation efforts.   These estimates don’t even take into account the beneficial effects on other diseases related to salt excess, like osteoporosis, kidney disease, and stomach cancer.

Health care costs were predicted to decrease by $10 billion to $24 billion, making this type of intervention much more cost-effective than medicating people who have hypertension. With health care reform at the forefront of American politics, this study highlights the value of prevention in bringing down costs. Since about 80% of salt in the diet is already in the food when it is purchased, this intervention must occur at a national policy level rather than a personal responsibility level – hopefully, these data will not be ignored by policymakers.

A 1200 mg decrease in sodium consumption would represent a 34.3% drop in sodium consumption of average Americans, somewhat more ambitious than the 25% reduction proposed by Mayor Bloomberg. But based on the above figures even a 25% reduction is likely to bring cardiovascular benefits.

References:

Bibbins-Domingo K et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. NEJM. Published at www.nejm.org January 20, 2010 (10.1056/NEJMoa0907355)

Appel LJ and Anderson CAM. Compelling Evidence for Public Health Action to Reduce Salt Intake. Published at www.nejm.org January 20, 2010 (10.1056/NEJMe0910352)

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Data collected between 1988 and 2006 and presented at the American Heart Association’s annual meeting last month showed modest improvements in two risk factors for cardiovascular disease: the number of Americans who do not smoke increased from 45% to 50%, and the number of Americans who have achieved optimal (below 100 mg/dl)  LDL levels increased from 22% to 28%.

But these improvements are counteracted by the rapidly growing prevalence of obesity that has occurred in the same time frame. 

American adults’ average body mass index (BMI) went from 26.5 to 28.8 (25 and above is overweight, 30 and above is obese). Incidence of overweight in children went from 20% to 35%.

What have been the consequences of this increase in body weight?

“Obesity is not benign.”

-Dr. Tiffany Powell, lead author of the study¹

Obesity robs people of their quality of life as they age – as reported in the International Journal of Obesity, obese individuals had double the rates of disability compared to normal-weight individuals.²

The number of Americans with healthy blood pressure has fallen by 5%. The number of those with good blood sugar control have decreased by 9%. Most alarming is that left ventricular mass in children, a predictive indicator for future heart disease and stroke, has also risen - their hearts are being forced to work too hard to pump blood to their excess body fat.

How will this affect the incidence of cardiovascular disease in this country?

“Many people feel the decline in [heart] risk factors is leveling off and there will be an acceleration of cardiovascular disease.”

-AHA spokesman Dr. Roger Blumenthal¹

A large part of the problem is that our society views these factors – hypercholesterolemia, poor blood sugar control, hypertension, obesity – each as a separate issue with its own drug-based method of management. But they are not separate. The truth is, the same nutrient-rich, vegetable-based diet combined with regular exercise is effective in preventing and reversing all of these conditions. 

References:

1. http://www.forbes.com/feeds/hscout/2009/11/17/hscout633216.html?feed=rss_forbeslife_health

2. Walter S et al. Mortality and disability: the effect of overweight and obesity. International Journal of Obesity (2009) 33, 1410–1418

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Coronary artery calcification is essentially the beginning of bone formation – except it’s happening in the arteries.^1-2 Sound scary? It is. Calcification is associated with a 3-4 fold increased risk of death from cardiovascular disease.³ And strangely enough, those who have vascular calcification usually have low bone density or even osteoporosis⁴ – hard arteries and weak bones??

Previous studies had tested the effects of cholesterol-lowering drugs (statins) on the progression of arterial calcification, and they were found to be ineffective. These scientists were looking for another solution. Vitamin D deficiency is known to produce a risk of cardiovascular disease, but had not been investigated for effects on arterial calcification. Because of the protective effect of Vitamin D on both bone and cardiovascular tissues, scientists thought that Vitamin D might be a player in this complex interplay between bone precursors and blood vessel walls.

Subjects with no previous heart disease symptoms but a high coronary calcium score (CCS) were included in the study. They supplemented with omega-3 fatty acids  and sufficient Vitamin D3 to achieve greater than 50ng/ml serum levels of 25(OH) Vitamin D. The response of these subjects to these therapies varied 18 months later. About half saw a decrease in CCS, and about half experienced no change or a small increase in CCS. Also about half of the subjects experienced slowed atherosclerotic plaque growth.⁵

What do these results tell us? It is difficult to interpret these results because of the lack of a control (no treatment) group, but it definitely opens the door to more studies on the role of Vitamin D in coronary artery calcification. 

We also don’t know anything about the diets of the subjects of the study. A phytochemical-rich diet plus Vitamin D and omega-3 supplementation could have achieved dramatic improvements in calcium score!

For now, we can now tentatively add coronary calcification to the long list of detrimental consequences of Vitamin D deficiency. Our best protection against these consequences, in addition of course to a high nutrient diet, is a good Vitamin D supplement.

References:

1. Fitzpatrick LA et al. Endochondral bone formation in the heart: a possible mechanism of coronary calcification. Endocrinology. 2003 Jun;144(6):2214-9.

2. Aigner T et al. Expression of cartilage-specific markers in calcified and non-calcified

atherosclerotic lesions. Atherosclerosis. 2008 Jan;196(1):37-41. Epub 2007 Feb 28.

3. Rennenberg RJ et al. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vasc Health Risk Manag. 2009;5(1):185-97. Epub 2009 Apr 8.

4. Hmamouchi I et al. Low bone mineral density is related to atherosclerosis in postmenopausal Moroccan women. BMC Public Health. 2009 Oct 14;9:388.

5. Davis W et al. Effect of a combined therapeutic approach of intensive lipid management, omega-3 fatty acid supplementation, and increased serum 25 (OH) vitamin D on coronary calcium scores in asymptomatic adults. Am J Ther. 2009 Jul-Aug;16(4):326-32.

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(Image credit: denn @Flickr)

The evidence connecting Vitamin D deficiency with chronic disease continues to mount. Vitamin D deficiency has been linked to osteoporosis, multiple cancers, musculoskeletal diseases, thyroid disease, depression, and Type II diabetes. This is especially troublesome since several studies have found that most Americans are Vitamin D deficient.

Now, a long-term study has examined the connection between blood Vitamin D levels and death from cardiovascular disease – and the results were dramatic:

Serum Vitamin D levels were measured at the beginning of the study, and subjects were followed for 26 years. The researches found that those individuals with the highest blood levels of Vitamin D were 24% less likely to die from any cardiovascular disease, and 52% less likely to die from stroke.¹

This new data supports results from the Framingham Heart Study, in which subjects were followed for 5 years – even after 5 years, those with low blood levels of vitamin D had a 60% greater risk of heart disease.²

How might Vitamin D affect cardiovascular health? Vitamin D localizes to most tissues and cells in the human body and is involved in several vital processes – to name a few - insulin production, immune cell function, inflammation, and heart contractility. Vitamin D deficiency could possibly lead to a pro-inflammatory environment, which would promote cardiovascular disease.³

How can you get adequate Vitamin D? Food sources of Vitamin D are scarce, and it is almost impossible for your body to produce sufficient Vitamin D from a safe amount of sun exposure, especially if you work indoors and don’t live in the tropics. So a Vitamin D supplement is your best bet. Remember – the standard dose of Vitamin D found in most multivitamins is not enough to assure adequate blood Vitamin D levels. In order to support all of Vitamin D’s important actions in the body, additional supplementation is necessary. Be cautious of Vitamin D supplements geared toward bone health – they may also contain excessive amounts of calcium, which can result in poor absorption of other minerals. Dr. Fuhrman’s Osteo-Sun was designed to deliver adequate amounts of Vitamin D along with a low dose of calcium in order to promote bone health without causing adverse effects associated with excess calcium intake.

References:

1. Kilkkinen A et al. Am J Epidemiol. 2009 Oct 15;170(8):1032-9. Epub 2009 Sep 17. Vitamin D status and the risk of cardiovascular disease death.

2. Wang TJ. Circulation. 2008 Jan 29;117(4):503-11. Epub 2008 Jan 7. Vitamin D deficiency and risk of cardiovascular disease.

3. Holick MF. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1678S-88S. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease.

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All the different types of nutrients are vital to achieving and maintaining optimal health and nutritional excellence; however, phytochemicals hold a special, elite place in the nutritional landscape. When consistently consumed in adequate quantity and variety, phytochemicals become super-nutrients in your body. They work together to detoxify cancer-causing compounds, deactivate free radicals, protect against radiation damage, and enable DNA repair mechanisms.1 When altered or broken strands of DNA are repaired, it can prevent cancer from developing later in life.

Consuming phytochemicals is not optional. They are essential in human immune-system defenses. Without a wide variety and sufficient amount of phytochemicals from unprocessed plant foods, scientists note that cells age more rapidly and do not retain their innate ability to remove and detoxify waste products and toxic compounds. Low levels of phytochemicals in our modern diet are largely responsible for the common diseases seen with aging, especially cancer and heart disease. These are diseases caused by nutritional ignorance and, in many cases, can be prevented. Approximately 85 percent of our population acquires and eventually dies from heart disease, strokes, and cancer. This is extremely high compared to other populations around the world and at earlier points in human history.

Let’s take heart disease as an example. Heart attacks are extremely rare occurrences in populations that eat a diet rich in protective phytochemicals, such as the Okinawans of Japan, but are omnipresent in populations, such as ours, that eat a diet low in protective nutrients.2 Compelling data from numerous population and interventional studies shows that a natural, plant based diet rich in antioxidants and phytochemicals will prevent, arrest, and even reverse heart disease.3 With what we know about heart disease causation, no one needs to die of heart disease today.

Only via nutritional excellence can you address all the invisible, but potentially dangerous, plaque throughout your coronary arteries. Unlike surgery and angioplasty, the dietary approach addressed in this book does not merely treat a small segment of your heart, but rejuvenates all your blood vessels and protects your entire body against heart attacks, strokes, venous thrombosis and pulmonary embolisms, peripheral vascular disease, and vascular dementia. Eating this way is your most valuable insurance policy to secure a longer life, free of medical problems. Thousands of people following my eating-style have reversed their high blood pressure, high cholesterol, diabetes, and heart disease and have been able to discontinue their medications. Nutritional excellence simply made them well when drugs did not. You can see once again, the most effective prescription is excellent nutrition.

To receive the benefits of nutritional excellence, however, you must actually eat well. Many people believe they can meet all of their nutrient needs by taking supplements; however, supplements can’t match or duplicate all the protective, strengthening elements of real fruits and vegetables. There are too many unknown and undiscovered factors in these natural foods. There are more than 10,000 identified phytochemicals, with more being discovered all the time. Only by eating a diet rich in whole foods can we assure ourselves a full symphony of these disease-protecting, anti-aging nutrients. Supplements can be useful in delivering micronutrients found in foods that would be very difficult to incorporate into our diet, such as fatty fish. This is why the word “supplement” is a good one: the pill is supplemental to a healthy diet and cannot take the place of one.

Our bodies were designed to make use of thousands of plant compounds. When these necessary compounds are missing, we might survive because our bodies are adaptable; however, we lose our powerful potential for wellness. Chronic diseases often develop, and we are robbed of living to our fullest potential in good physical, emotional, and mental health. Ultimately, we are what we eat. We get the materials to build our cells from our diet because food provides the raw materials that our bodies use to create tissue and to function at a high level. Consumption of healthy foods leads to disease resistance; consumption of unhealthy foods makes us disease-prone.

Eating right enables you to feel your best everyday. You may still get sick from a virus, but your body will be in a far better position to defend itself and make a quick and complete recovery. Optimal nutrition enables us to work better, play better, and maintain our youthful vigor as we age gracefully.

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Oh, those silly low-carb diets. Will they ever learn! Here’s more bad news for low-carb. A new study in the journal Proceedings of the National Academy of Sciences found low-carb, high-protein diets damage arties:

Diets based on eating lots of meat, fish and cheese, while restricting carbohydrates have grown in popularity in recent years.

But the Beth Israel Deaconess Medical Center in the US found such habits caused artery damage in tests on mice.

The researchers and independent experts both agreed a balanced diet was the best option…

…Lead researcher Anthony Rosenzweig said the findings were so concerning to him that he decided to come off the low-carb diet he was following.

He added: "Our research suggests that, at least in animals, these diets could be having adverse cardiovascular effects.

"It appears that a moderate and balanced diet, coupled with regular exercise, is probably best for most people."

And in 2007, a study found low-carb diets, like Atkins, cause long-term damage to blood vessels. Dr. Fuhrman is no fan of high-protein diets, all that saturated fat and insufficient plant nutrients increases risk of heart disease and cancer:

The Atkins diet (and other diets rich in animal products and low in fruits and unrefined carbohydrates) is likely to significantly increase a person's risk of colon cancer. Scientific studies show a clear and strong relationship between cancers of the digestive tract, bladder, and prostate with low fruit consumption. What good is a diet that lowers your weight but also dramatically increases your chances of developing cancer?

A meat-based, low-fiber diet, like the one Atkins advocates, includes little or no fruit, no starchy vegetables, and no whole grains. Following Atkin's recommendations could more than double your risk of certain cancers, especially meat-sensitive cancers, such as epithelial cancers of the respiratory tract.1 For example, a study conducted by the National Cancer Institute looked at lung cancer in nonsmoking women so that smoking would not be a major variable. Researchers found that the relative risk of lung cancer was six times greater in women in the highest fifth of saturated-fat consumption than those in the lowest fifth.

I asked Dr. Fuhrman to comment on this study. He chuckled at the news, saying, “This study definitely proves once and for all that mice should not be eating the Atkins diet. They should get Jenny Craig. Furthermore, vegetables make pigs fat, so maybe we shouldn't eat them either.”

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Not getting enough vitamin D can be harmful, just last week a report found lack of vitamin D heightens risk of metabolic syndrome and now researchers have found not getting enough vitamin D raises cholesterol.

[Researchers] obtained macrophage cells from diabetics and non-diabetics, with and without vitamin D deficiency. When the cells were exposed cells to cholesterol and low vitamin D levels, they found that low vitamin D levels in the culture dish resulted in fewer macrophages becoming foam cells.

On the other hand, when the human macrophages were placed in a vitamin D-rich environment, the uptake of cholesterol was suppressed, and they don't become foam cells, said Bernal-Mizrachi.

The researchers noted that it may be possible to delay or reverse the development of atherosclerosis in diabetics by helping them regain adequate vitamin D levels.

Recently, in a post of about children and their need for vitamin D, Dr. Fuhrman explains it get be difficult to get sufficient vitamin D from food, unless you are spending a lot time outdoors, and even then its tough.

A sufficient amount of vitamin D is difficult to obtain from dietary sources. It is possible to obtain vitamin D from direct sun exposure—without sunscreen (sunscreens block UV-B rays they in turn prevent the body from converting vitamin D). However, since the generous amount of sunshine necessary to assure sufficient vitamin D exposure is potentially harmful and because children often spend too much time indoors watching television, playing video games, or on the computer, it is advisable for all children to assure vitamin D levels with supplements, not sunshine.

To help you get your vitamin D, Dr. Fuhrman recommends his supplement Osteo-Sun, for both children and adults.

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Dr. Fuhrman says our modern diet is very low in omega-3 fatty acids, which raises risk of heart disease, diabetes and dementia. And now, a new study in American Journal of Clinical Nutrition claims omega-3’s from fish may be the key to staving off dementia and mental decline.

If fish does protect the aging brain, researchers believe that the benefits probably come from the omega-3 fatty acids found most abundantly in oily fish like salmon, mackerel and albacore tuna.

Lab studies show that omega-3 fats have a number of properties that could help stave off dementia -- including actions that protect nerve cells, limit inflammation and help prevent the build-up of the amyloid proteins seen in the brains of Alzheimer's patients.

These latest findings are based on surveys of 14,960 adults age 65 or older living in China, India, Cuba, the Dominican Republic, Mexico, Peru or Venezuela.

It’s true. Fish is high in brain-building fat, but Dr. Fuhrman points out most varieties of fish—especially tilefish and mackerel—are heavily polluted with mercury. Dr. Fuhrman’s DHA Purity is a contamination-free omega–3 fatty acid supplement, but if you must have fish, here’s Dr. Fuhrman’s opinion on it.

We are finding out each year that fish is even more polluted than we thought. Even farm raised fish not only contains mercury, but other chemicals, antibiotics and algaecides that are potentially risky for us and the environment. Of course, we have to avoid the high mercury fish such as swordfish, mackerel, pike, shark and even tuna, but the farm-raised fish is not harmless or a health food either.

Though fish is touted as a health food, because of its lower levels of saturated fats and higher omega-3, the reality is that most of the fish available in the market today is farm-raised and does not have significant amounts of omega-3, and neither should it be considered health food. Consuming too much fish has clear risks.  Instead, restrict your fish consumption and assure omega-3 adequacy with either an algae-derived DHA supplement, plus walnuts and ground flax seeds, or take a purified fish oil (certified to be contamination free). I of course would prefer people take the plant-derived DHA (cultivated for this purpose), and not harm our oceans, the wildlife, and pollute the natural habitats trying to feed the world with fish-derived omega-3.

And visit DrFuhrman.com for more on Dr. Fuhrman’s DHA Purity supplement.

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