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

Carotenoids are a family of over six hundred phytochemicals, including alpha-carotene, beta-carotene, lycopene, lutein and zeaxanthin. Carotenoids are abundant in green and yellow-orange vegetables and fruits and help to defend the body’s tissues against oxidative damage, which is a natural byproduct of our metabolic processes; oxidative damage from free radicals contributes to chronic diseases and aging.¹

The levels of carotenoids in your skin are a good indicator of your overall health because the levels parallel the levels of plant-derived phytochemicals in general. In fact, I use a carotenoid skin testing method to non-invasively track my patients’ progress as they adopt a nutritarian diet. In a study of over 13,000 American adults, low blood levels of carotenoids were found to be a predictor of earlier death. Lower total carotenoids, alpha-carotene, and lycopene in the blood were all linked to increased risk of death from all causes; of all the carotenoids, very low blood lycopene was the strongest predictor of mortality.²

Lycopene is the signature carotenoid of the tomato. The lycopene in the American diet is 85 percent derived from tomatoes.³ Lycopene is found circulating in the blood and also concentrates in the male reproductive system, hence its protective effects against prostate cancer.⁴ In the skin, lycopene helps to prevent UV damage from the sun, protecting against skin cancer.⁵ Lycopene is known for its anti-cancer properties, but did you know that lycopene has also been intensively studied for its beneficial cardiovascular effects?

Links between blood lycopene and cardiovascular diseases

Many observational studies have made a connection between higher blood lycopene and lower risk of heart attack. For example, a study in men found that low serum lycopene was associated with increased plaque in the carotid artery and triple the risk of cardiovascular events compared to higher levels. Triple!^6-8 In a separate study, women were split into four groups (quartiles) according to their blood lycopene levels; women in the top three quartiles were 50% less likely to have cardiovascular disease compared to the lowest quartile.⁹

A 2004 analysis from the Physicians’ Health Study data found a 39% decrease in stroke risk in men with the highest blood levels of lycopene.¹⁰ New data from an ongoing study in Finland has strengthened these findings with similar results. One-thousand men had their blood carotenoid levels tested and were followed for 12 years. Those with the highest lycopene levels had the lowest risk of stroke – they were 55% less likely to have a stroke than those with the lowest lycopene levels.¹¹ Previous data from this same group of men found that higher lycopene levels were associated with lower risk of heart attack as well.¹²

How does lycopene work?

Lycopene is an extremely potent antioxidant; several studies that gave supplemental tomato products to volunteers found that their LDL particles were more resistant to oxidation – LDL oxidation is an early event in atherosclerotic plaque formation, and lycopene helps to prevent this.^13-15 Another study found improved endothelial function after just two weeks of a tomato-rich diet; endothelial function refers to the ability of the endothelium (the inner lining of blood vessels) to properly regulate blood pressure, and oxidative damage can impair endothelial function.¹⁶

Lycopene also has non-antioxidant actions that may protect against cardiovascular disease. First, there is evidence that lycopene may inhibit HMG-CoA reductase, the enzyme responsible for making cholesterol (also the enzyme that is inhibited by cholesterol-lowering statin drugs).¹⁷ So as you might expect, trials that added extra tomato products to subjects’ diets reduced their blood cholesterol levels. A meta-analysis of 12 trials found that daily supplemental tomato products (approximately 1 cup of tomato juice or 3-4 tbsp. of tomato paste) reduced LDL cholesterol by 10% - this effect is comparable to low doses of statin drugs (with no risk of side effects, of course).¹⁸ Lycopene also has several anti-inflammatory actions and may prevent excessive proliferation of vascular smooth muscle cells, which is a contributor to atherosclerotic plaque development.^19,20

Enjoy your tomatoes!

Of course, lycopene is not the only nutrient in tomatoes – tomatoes are also rich in vitamins C and E, beta-carotene, and flavonol antioxidants just to name a few.³ Single antioxidants usually don’t exert their protective effects alone; we learned this lesson from clinical trials of beta-carotene, vitamin C, and vitamin E supplements, which did not reduce cardiovascular disease risk.²¹ It is the interactions between phytochemicals in the complex synergistic network contained in plant foods that is responsible for their health effects, and this is something that we cannot replicate in a pill. Out of all the common dietary carotenoids, lycopene has the most potent antioxidant power, but combinations of carotenoids are even more effective than any single carotenoid – they work synergistically.²² Blood lycopene, as used in many of these studies, is simply a marker for high tomato product intake; similarly high alpha-carotene and beta-carotene levels are markers of high green and yellow-orange fruit and vegetable intake. Colorful fruits and vegetables provide significant protection.

In a given year, a typical American will eat about 92 pounds of tomatoes.²³ Enjoy those 92 pounds and even add some more! Add fresh, juicy raw tomatoes to your salad, diced or unsulphured sun-dried tomatoes to soups, and enjoy homemade tomato sauces and soups. Be mindful of the sodium content of ketchup and other tomato products – choose the low sodium or no salt added versions. No salt added, unsulphured dried tomatoes are also great. Also keep in mind that carotenoids are absorbed best when accompanied by healthy fats – for example, in a salad with a seed or nut-based dressing.^24,25 Lycopene is also more absorbable when tomatoes are cooked, so enjoy a variety of both raw and cooked tomatoes in your daily diet.²⁶

Image credit: Flickr - MaplessInSeattle

References:
1. Krinsky NI, Johnson EJ. Carotenoid actions and their relation to health and disease. Mol Aspects Med 2005;26:459-516.
2. Shardell MD, Alley DE, Hicks GE, et al. Low-serum carotenoid concentrations and carotenoid interactions predict mortality in US adults: the Third National Health and Nutrition Examination Survey. Nutr Res 2011;31:178-189.
3. Canene-Adams K, Campbell JK, Zaripheh S, et al. The tomato as a functional food. J Nutr 2005;135:1226-1230.
4. van Breemen RB, Pajkovic N. Multitargeted therapy of cancer by lycopene. Cancer Lett 2008;269:339-351.
5. Rizwan M, Rodriguez-Blanco I, Harbottle A, et al. Tomato paste rich in lycopene protects against cutaneous photodamage in humans in vivo. Br J Dermatol 2010.
6. Rissanen TH, Voutilainen S, Nyyssonen K, et al. Low serum lycopene concentration is associated with an excess incidence of acute coronary events and stroke: the Kuopio Ischaemic Heart Disease Risk Factor Study. Br J Nutr 2001;85:749-754.
7. Rissanen T, Voutilainen S, Nyyssonen K, et al. Lycopene, atherosclerosis, and coronary heart disease. Exp Biol Med (Maywood) 2002;227:900-907.
8. Rissanen TH, Voutilainen S, Nyyssonen K, et al. Serum lycopene concentrations and carotid atherosclerosis: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr 2003;77:133-138.
9. Sesso HD, Buring JE, Norkus EP, et al. Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in women. Am J Clin Nutr 2004;79:47-53.
10. Hak AE, Ma J, Powell CB, et al. Prospective study of plasma carotenoids and tocopherols in relation to risk of ischemic stroke. Stroke 2004;35:1584-1588.
11. Karppi J, Laukkanen JA, Sivenius J, et al. Serum lycopene decreases the risk of stroke in men: A population-based follow-up study. Neurology 2012;79:1540-1547.
12. Karppi J, Laukkanen JA, Makikallio TH, et al. Low serum lycopene and beta-carotene increase risk of acute myocardial infarction in men. Eur J Public Health 2011.
13. Silaste ML, Alfthan G, Aro A, et al. Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation. Br J Nutr 2007;98:1251-1258.
14. Burton-Freeman B, Talbot J, Park E, et al. Protective activity of processed tomato products on postprandial oxidation and inflammation: a clinical trial in healthy weight men and women. Molecular nutrition & food research 2012;56:622-631.
15. Hadley CW, Clinton SK, Schwartz SJ. The consumption of processed tomato products enhances plasma lycopene concentrations in association with a reduced lipoprotein sensitivity to oxidative damage. J Nutr 2003;133:727-732.
16. Xaplanteris P, Vlachopoulos C, Pietri P, et al. Tomato paste supplementation improves endothelial dynamics and reduces plasma total oxidative status in healthy subjects. Nutr Res 2012;32:390-394.
17. Lycopene. Monograph. Altern Med Rev 2003;8:336-342.
18. Ried K, Fakler P. Protective effect of lycopene on serum cholesterol and blood pressure: Meta-analyses of intervention trials. Maturitas 2011;68:299-310.
19. Palozza P, Parrone N, Catalano A, et al. Tomato lycopene and inflammatory cascade: basic interactions and clinical implications. Curr Med Chem 2010;17:2547-2563.
20. Palozza P, Parrone N, Simone RE, et al. Lycopene in atherosclerosis prevention: an integrated scheme of the potential mechanisms of action from cell culture studies. Arch Biochem Biophys 2010;504:26-33.
21. Kris-Etherton PM, Lichtenstein AH, Howard BV, et al. Antioxidant vitamin supplements and cardiovascular disease. Circulation 2004;110:637-641.
22. Heber D, Lu QY. Overview of mechanisms of action of lycopene. Exp Biol Med (Maywood) 2002;227:920-923.
23. United States Department of Agriculture Economic Research Service. Food Availability (Per Capita) Data System. [http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system.aspx]
24. Brown MJ, Ferruzzi MG, Nguyen ML, et al. Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. Am J Clin Nutr 2004;80:396-403.
25. Goltz SR, Campbell WW, Chitchumroonchokchai C, et al. Meal triacylglycerol profile modulates postprandial absorption of carotenoids in humans. Molecular nutrition & food research 2012;56:866-877.
26. van het Hof KH, de Boer BC, Tijburg LB, et al. Carotenoid bioavailability in humans from tomatoes processed in different ways determined from the carotenoid response in the triglyceride-rich lipoprotein fraction of plasma after a single consumption and in plasma after four days of consumption. J Nutr 2000;130:1189-1196.

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People have exclaimed this phrase countless times to me when I explain to them what my diet is like. “Where is the decadence, the fat, the richness?” they proclaim when I tell them I don’t eat animal foods. “I don’t think I could live without a good steak every now and then,” I’ve heard on one too many social encounters. It seems as if a good chunk of the people I meet simply have no idea how much I love eating healthfully more than conventional food, not only because it keeps me feeling well in the present and will protect me from diseases later in life, but because it is one heck of a tasty diet. They just assume I am sacrificing enjoyment of life for a little better health, and it is not worth it.

I think people who have never given the nutritarian diet style a try might be skeptical about the taste of these foods and recipes and that is understandable. We like the foods we get used to eating. We are creatures of habit after all, and the foods we eat the most often become our comfort foods. It’s weird to me that people often believe that healthy foods are not as tasty as a bag of chips, a can of soda or even an oil heavy foie gras at a five star restaurant, for example. But I guess that is because other people get used to eating these types of foods early in their lives and I have never touched them. I’m sure that’s why people assume my diet of roasted butternut squash soups, lentil and mushroom veggie “meatloafs”, organic mesclun greens salads with pine nuts and roasted veggies, steamed edamame, and chocolate cherry smoothies (these are only a few examples of favorite foods I cook for myself) doesn’t taste very good. That’s the shame of it all- if only conventional eaters and the skeptics would give the nutritarian diet a chance to prove its deliciousness!

I’m not one to believe in sacrifice and I don’t think other people should have to either. I’ve met many people who use to eat the standard American diet (SAD) and now eat a nutritarian diet and love the variety of it, the taste of it, and the satisfaction of eating foods that promote wellness. My mom is actually one of these people. When my mom, whom was raised on a “conventional” diet, first met my dad’s sister in college (my mom and my aunt were actually good friends before she met my dad!), my mom said she felt sorry for my aunt, Gale (my dad’s younger sister) whom was raised on a healthy diet much like the one my dad advocates today. After only a few months of dating my dad when she was in her early twenties, she was converted to the nutritarian lifestyle and could no longer imagine eating the foods she previously ate regularly.  

Which brings me back to the title of this blog post and all of the implication it makes. Most people with poor eating habits don’t just “die early” but they will probably contend with illness, chronic pain, decreased brain function and reliance on expensive medications for many years before they say sayonara to this life. Taking care of oneself by making the right foods choices leads to feeling our most optimal in the present as well as protecting ourselves from future health problems. I don’t have to battle a constant cough, runny nose, colds that last for weeks, asthma, type 2 diabetes, high blood pressure, or any other chronic health malady that results from wanting to “enjoy my food and die early”. Some people might get away with eating poorly for decades and then succumb to ill health for only a few years, or maybe even a few months or weeks, before they die, but that is not the norm. Chronic weight problems face more Americans than ever before, as do cancer, heart disease, autoimmune disorders and other diet-related health conditions. 

Healthy foods become much more appealing when we understand the relationship between what we eat and how we feel now and into the future. What we have to work on is finding our favorite healthy foods and recipes, making the decision to commit to this way of life with the resolve that you can have it all- tasty food and great health. The misconception that healthy food is bland and tasteless needs to become a thing of the past and you can do it with education, commitment and experimentation with recipes that you enjoy. You really can have it all if you give this lifestyle a shot.  

The Eat To Live cookbook is coming out within the next few months (I’ve seen the recipes and tasted them) and I can testify that there are plenty of nutritious, mouth-watering recipes to come! In the mean time, there is a cornucopia of delicious recipes available on the Dr.Fuhrman.com member center like this one:

 

Golden Austrian Cauliflower Cream Soup

Serves: 4

Preparation Time: 30 minutes

Ingredients:

1 head cauliflower, cut into pieces

3 carrots, coarsely chopped

1 cup coarsely chopped celery

2 leeks, coarsely chopped

2 cloves garlic, minced

2 tablespoons Dr. Fuhrman's VegiZest (or other no-salt seasoning blend such as Mrs. Dash, adjusted to taste)

2 cups carrot juice

4 cups water

1/2 teaspoon nutmeg

1 cup raw cashews or 1/2 cup raw cashew butter

5 cups chopped kale leaves or baby spinach

1 tablespoon curry powder (optional)

 

Instructions:
Place all the ingredients except the cashews and kale in a pot. Cover and simmer for 15 minutes or until the vegetables are just tender. Steam the kale until tender. If you are using spinach there is no need to steam it; it will wilt in the hot soup. 
In a food processor or high-powered blender, blend two-thirds of the soup liquid and vegetables with the cashews until smooth and creamy. Return to the pot and stir in the steamed kale (or raw spinach).

 

Cheers to enjoying food AND living long, disease-free lives!

image credit: flickr by Marc_Smith

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As I get older, I’ve learned to really be grateful for everything I have in my life to help me stay healthy- the knowledge about what to eat, the resources to buy healthy foods, taste buds that can appreciate the colorful flavors of a broad spectrum of plants, and waking up in the morning knowing that each day is a new day to treat my body well and enjoy the day.  Life is beautiful and so are the natural plant foods that keep us healthy.  Walk into a supermarket in America and we have a cornucopia of vegetables and fruits to choose from.  Now that it’s summer, we can purchase fresh cherries, blueberries, and peaches. We can open a watermelon on a hot day and relish in its ability to quench our thirst.  We have so much opportunity to make the right eating choices, even if it is as simple as eating an apple instead of a bag of chips. 

We are a lucky bunch. Unlike our parents, we have access to nutritional resources to educate ourselves about why plants are so protective against diseases, can keep us looking young by fighting free radicals and promote weight loss all while keeping us full and satisfied.  Healthy plant foods right from mother earth, deserve to be celebrated and every effort we make to keep ourselves healthy by eating them deserves to be celebrated too.

Each time we chose to eat a meal filled with real produce right as it comes from the earth, we deserve to give ourselves a pat on the back and feel gratitude for the simple wonderfulness that comes with the healing powers that plants can provide to us.  We owe it to ourselves to be reminded that taking care of ourselves is not something to be taken for granted and neither is the ability to buy healthy foods.  The knowledge we have in the fields of health and nutrition is unprecedented and even though most doctors aren’t taught a single nutrition class in medical school and the obesity epidemic continues to plague our country, we can do our part by setting a good example with our own eating choices, sharing what we’ve learned with our family and friends and continuing to model great health and spread positive health messages wherever we go. 

I’m beginning to see a growing movement of mindful eaters who are educating themselves about the true connection between chronic disease prevention and what we feed ourselves.  Eat To Live just became the #1 book on the New York Times bestseller list under paperback advice this week (congrats dad!).  While we still have a long way to go to get our nation on the path towards ideal health, I think we are living during an exciting time of a budding health conscientiousness movement.  I want to help this movement grow and flourish and I’ll bet lots of you do too.  ,I know we have all experienced that enhanced eating enjoyment when we eat meals that are flavorful, look great and are health promoting as well.  We have the knowledge, we have access to the right foods, and now we have people like you who continue to help spread the word that we truly are what we eat. 

Peace, Love, and Kale!

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In preparation for my recent appearance on The Dr. Oz Show (you can watch online here), I was asked to share a recipe for a healthful drink that would support weight loss efforts and promote detoxification – something satisfying and delicious while low in calories; most important to me was that this drink would be packed with disease-fighting nutrients.

I chose a simple blended frozen drink of whole strawberries and pomegranate juice with ice plus a squeeze of lemon for a tangy flavor. Why strawberries and pomegranate juice? I did not make those choices arbitrarily – these are powerful foods with several human studies to substantiate their profound benefits.

Antioxidant phytochemicals:

• Anthocyanins (the most abundant antioxidants in berries) provide antioxidant protection on their own, plus they increase the production of cells’ own antioxidant enzymes.¹ A 1.5 cup serving of strawberries increased antioxidant capacity in the blood of human subjects, building protection against oxidative damage.²
• Pomegranate contains a unique antioxidant called punicalagin; it is the most abundant antioxidant in pomegranate, responsible for more than half of the antioxidant activity of pomegranate juice.³ Pomegranate juice has been found to reduce oxidative stress markers in healthy humans.⁴

Detoxification:

• Ellagic acid, an antioxidant derived from berries and pomegranate interacts with a protein called Nrf-2 to increase expression of the body’s natural detoxification enzymes.⁵

Anti-cancer effects:

• Strawberry and pomegranate extracts slowed cell growth and induced cell death in human cancer cells from several cancer types.^6-9
• Pomegranate and strawberries are both anti-angiogenic – strawberry extracts help to prevent growing tumors from acquiring a blood supply – preventing those tumors from receiving the nutrients that would allow them to grow larger.^10-13
• Pomegranate is one of the few foods (mushrooms are another) that contain natural aromatase inhibitors – this means that they inhibit the production of estrogen, which can reduce breast cancer risk.¹⁴
• Strawberries and pomegranate have anti-inflammatory effects that may protect against cancer and other chronic diseases.^5,15,16
• Patients with precancerous esophageal lesions ate strawberries each day for six months.  The results were amazing – 29 out of the 36 patients in the study experienced a decrease in the histological grade of their lesion – this means that the progression toward cancer began to reverse, and the risk of the lesions becoming cancerous had decreased.¹⁷ 

Cardioprotective effects:

• Higher strawberry intake is associated with reduced risk of death from cardiovascular disease.¹⁸
• Human trials have found that daily consumption of strawberries decreases total and LDL cholesterol, and pomegranate phytochemicals reduce LDL oxidation (a contributor to atherosclerotic plaque development).^19-22
• Strawberry and pomegranate phytochemicals have blood pressure-reducing properties.^23-25
• In a study of patients with severe carotid artery blockages, after one ounce of pomegranate juice daily for one year, there was a 30 percent reduction in atherosclerotic plaque. In striking contrast, in the participants who did not take the pomegranate juice atherosclerotic plaque increased by 9 percent.²²

Anti-diabetes effects:

• Strawberry and pomegranate phytochemicals have actions on certain digestive enzymes that can result in reduced glucose levels following a meal.²⁶
• Ellagic acid, which can be derived from berries or pomegranate, reduced secretion by fat cells of an inflammatory molecule that is thought to contribute to insulin resistance.²⁷
• Adding strawberries to a meal was shown to reduce the insulin response in overweight adults.¹⁵

Looking at these effects all together, it is astounding what these foods can do for our health. The “Skinny Shake” has much more to offer than taste and satisfaction with minimal calories. Berries (and pomegranate) make up the second ‘B’ in G-BOMBS, my list of super foods with good reason!

Dr. Fuhrman’s Skinny Shake

Ingredients:

4 ounces pomegranate juice

1 cup frozen strawberries

1 cup of ice

Squeeze of lemon

Directions: Blend all ingredients in a high-powered blender.

References:

1. Shih PH, Yeh CT, Yen GC. Anthocyanins induce the activation of phase II enzymes through the antioxidant response element pathway against oxidative stress-induced apoptosis. Journal of Agricultural and Food Chemis ry 2007;55:9427-9435.
2. Cao G, Russell RM, Lischner N, et al. Serum antioxidant capacity is increased by consumption of strawberries, spinach, red wine or vitamin C in elderly women. J Nutr 1998;128:2383-2390.
3. Heber D: Pomegranate Ellagitannins. In Herbal Medicine: Biomolecular and Clinical Aspects 2nd Edition. Edited by Benzie IFF, Wachtel-Galor, S.: CRC Press; 2011
4. Aviram M, Dornfeld L, Rosenblat M, et al. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E-deficient mice. Am J Clin Nutr 2000;71:1062-1076.
5. Panchal SK, Ward L, Brown L. Ellagic acid attenuates high-carbohydrate, high-fat diet-induced metabolic syndrome in rats. Eur J Nutr 2012.
6. Stoner GD, Wang LS, Casto BC. Laboratory and clinical studies of cancer chemoprevention by antioxidants in berries. Carcinogenesis 2008;29:1665-1674.
7. Kim ND, Mehta R, Yu W, et al. Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat 2002;71:203-217.
8. Kohno H, Suzuki R, Yasui Y, et al. Pomegranate seed oil rich in conjugated linolenic acid suppresses chemically induced colon carcinogenesis in rats. Cancer Sci 2004;95:481-486.
9. Kawaii S, Lansky EP. Differentiation-promoting activity of pomegranate (Punica granatum) fruit extracts in HL-60 human promyelocytic leukemia cells. J Med Food 2004;7:13-18.
10. Roy S, Khanna S, Alessio HM, et al. Anti-angiogenic property of edible berries. Free Radic Res 2002;36:1023-1031.
11. Khan N, Afaq F, Kweon MH, et al. Oral consumption of pomegranate fruit extract inhibits growth and progression of primary lung tumors in mice. Cancer Res 2007;67:3475-3482.
12. Toi M, Bando H, Ramachandran C, et al. Preliminary studies on the anti-angiogenic potential of pomegranate fractions in vitro and in vivo. Angiogenesis 2003;6:121-128.
13. Sartippour MR, Seeram NP, Rao JY, et al. Ellagitannin-rich pomegranate extract inhibits angiogenesis in prostate cancer in vitro and in vivo. Int J Oncol 2008;32:475-480.
14. Adams LS, Zhang Y, Seeram NP, et al. Pomegranate ellagitannin-derived compounds exhibit antiproliferative and antiaromatase activity in breast cancer cells in vitro. Cancer Prev Res (Phila) 2010;3:108-113.
15. Edirisinghe I, Banaszewski K, Cappozzo J, et al. Strawberry anthocyanin and its association with postprandial inflammation and insulin. Br J Nutr 2011;106:913-922.
16. Adams LS, Seeram NP, Aggarwal BB, et al. Pomegranate juice, total pomegranate ellagitannins, and punicalagin suppress inflammatory cell signaling in colon cancer cells. Journal of Agricultural and Food Chemis ry 2006;54:980-985.
17. American Association for Cancer Research. Strawberries May Slow Precancerous Growth in Esophagus. 2011. http://aacrnews.wordpress.com/2011/04/06/strawberries-may-slow-precancerous-growth-in-esophagus/. Accessed
18. Mink PJ, Scrafford CG, Barraj LM, et al. Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women. Am J Clin Nutr 2007;85:895-909.
19. Basu A, Lyons TJ. Strawberries, Blueberries, and Cranberries in the Metabolic Syndrome: Clinical Perspectives. Journal of Agricultural and Food Chemis ry 2011.
20. Zunino SJ, Parelman MA, Freytag TL, et al. Effects of dietary strawberry powder on blood lipids and inflammatory markers in obese human subjects. Br J Nutr 2011:1-10.
21. Basu A, Wilkinson M, Penugonda K, et al. Freeze-dried strawberry powder improves lipid profile and lipid peroxidation in women with metabolic syndrome: baseline and post intervention effects. Nutr J 2009;8:43.
22. Aviram M, Rosenblat M, Gaitini D, et al. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clin Nutr 2004;23:423-433.
23. Cassidy A, O'Reilly EJ, Kay C, et al. Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 2011;93:338-347.
24. Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis 2001;158:195-198.
25. Aviram M, Volkova N, Coleman R, et al. Pomegranate phenolics from the peels, arils, and flowers are antiatherogenic: studies in vivo in atherosclerotic apolipoprotein e-deficient (E 0) mice and in vitro in cultured macrophages and lipoproteins. Journal of Agricultural and Food Chemis ry 2008;56:1148-1157.
26. McDougall GJ, Stewart D. The inhibitory effects of berry polyphenols on digestive enzymes. Biofactors 2005;23:189-195.
27. Makino-Wakagi Y, Yoshimura Y, Uzawa Y, et al. Ellagic acid in pomegranate suppresses resistin secretion by a novel regulatory mechanism involving the degradation of intracellular resistin protein in adipocytes. Biochem Biophys Res Commun 2012;417:880-885.

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A few days ago, I was explaining my nutritarian diet to an acquaintance when he made a remark about the apparently dreadful sounding blandness of my diet. “You just eat plants? What?! You poor dear. That must be horrible, honey.” Boy did this get me frustrated! Putting aside the fact that I think the foods I eat taste divine, his comment got me thinking, what’s really sad here is our nation of over-processed eaters whom have become so far removed from the taste of real foods. The reality at the heart of his comment was that most people have now been conditioned to only enjoy the taste of heavily salted or overly sweetened processed foods.

While this shouldn’t come as a surprise to anyone, Americans are obsessed with the flavors of packaged foods and we are now eating 31 percent more packaged food than fresh, and we consume more processed foods per person than the individuals of any other country. We certainly do love our TV dinners, chips, sweet and salty snacks and ready-to-eat meals.  My theory is that if we have to tear open a bag, unwrap plastic or open a box, people will assume the food will be tasty.

I recently read Fast Food Nation by Eric Schlosser, which is a sobering account of how far off the deep end we’ve become as a nation of processed food loving peoples.  I’m sure any reader will agree with me that a meal of fresh tropical mango and papaya salad with thinly-sliced raw greens and coconut-lime dressing is just not going to maintain its natural flavors (or even stay fresh), if it were shipped from California to Connecticut and then had to stay on the shelf in a grocery store for a few more days after that. While French fries might not be as prone to perish as a tropical mango and papaya salad, those little fritters just aren’t going to maintain their natural freshness or flavors of the original potato either.  In reality, almost all of the foods we buy in packages contain artificial flavors produced by food scientists in white lab coats in factories in northern New Jersey.  I learned this and infinitely more in Fast Food Nation, and besides being a huge walking and writing advertisement for the book, my point is that our bodies haven’t evolved to eat this artificial processed junk yet and until we do, we need to begin evaluating where our food comes from and what ingredients are added to them.

So, not only do I love the natural, unprocessed foods that I cook for myself, I know there won’t be any of the ingredients that go into producing the artificial flavorings of a Burger King strawberry milkshake, such as amyl acetate, amyl butyrate, anethol, butyric acid, hydroxyphrenyl-2-butanone, methyl benzoate, or other obscure most of us have never heard of.  Mind you, there are no real strawberries added to processed strawberries flavorings like this one. As my dad likes to say, our taste buds are adaptable and it takes time to adjust to the subtler flavors of natural plant foods.  Once going nutritarian for even just a few weeks, taste buds can change and fruits, vegetables, legumes, nuts and seeds become more desirable. My mouth waters at the thought of a fresh kale salad with lemon-tahini dressing, a Portobello mushroom burger or chocolate cherry “ice cream” made from bananas and almond milk.  I love the taste of the foods I eat, I love that I’m not consuming any ethyl methylphenylglyci-date (an actual chemical used as an ingredient in many artificial flavors), and most importantly, I love being healthy.  So who’s with me on a quest to avoid processed foods for good? For all of you already healthy eaters, how do you feel when someone thinks your diet is absolutely tasteless and you know it can be knock-your-socks-off delicious? As our obesity epidemic and disease riddled society continues to flourish, we are going to have to say no to those processed packages and hello to the new age of unprocessed, nutrient-rich plant foods.   

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What are lignans?

Plant lignans are one of the four classes of phytoestrogens (isoflavones, lignans, stilbenes, coumestans), phenolic compounds that are structurally similar to the main mammalian estrogen, estradiol.¹ Plant lignans are modified by bacteria in the human digestive tract into enteroligans. It is important to recognize the role of healthy bacteria in this process, because antibiotics can destroy beneficial bacteria in the gut resulting in long-term reduction in enteroligans.² Eating commercial meats exposes us to antibiotics, as does the overuse and inappropriate prescribing by physicians.

Which foods are good sources of plant lignans?

Flaxseeds are the richest source of plant lignans, having about 8 times the lignan content of sesame seeds [note that flaxseed oil does not contain lignans – they bind to the fiber]. The other plant foods on the list have about one-tenth or less the amount of lignans as sesame seeds per serving.^2,3 Chia seeds are also a rich source of lignans, however the exact amount is still debatable, so that number will be made available at a later date.

• Flaxseeds (85.5 mg/ounce)
• Sesame seeds (11.2 mg/ounce)⁴
• Kale (curly; 1.6 mg/cup)
• Broccoli (1.2 mg/cup)

Anti-cancer effects of lignans

Enterolignans are structurally similar to estrogen and can bind to estrogen receptors – this capability allows lignans to either have weak estrogenic activity or block the actions of estrogen in the body. For this reason, plant lignans are classified as phytoestrogens, and there has been much interest in the potential contribution of lignan-rich foods to reduced risk of hormone-related cancers.^2,5 Enterolignans inhibits aromatase⁶ and estradiol production in general, lowering serum estrogen levels.⁷ Plant lignans also increase concentration of sex hormone binding globulin, which blunts the effects of estrogens.^8-10 These benefits were documented when 48 postmenopausal women consumed 7.5 g/day of ground flax seeds for 6 weeks, then 15 g for 6 weeks – and significant decreases in estradiol, estrone, and testosterone were noted with a bigger decrease in overweight and obese women.¹¹

In a mouse model, a flaxseed diet (5%, 10%) shows dose-dependent inhibition of breast tumor growth.¹² Human trials also confirmed similar beneficial effects. A double-blinded, randomized controlled trial of dietary flaxseed demonstrated dramatic protection. Women ate either a control muffin with no flax seeds imbedded or 25g flax-containing muffin starting at time of diagnosis of breast cancer for just 32-39 days until surgery. Tumor tissue analyzed at diagnosis and surgery demonstrated surprising benefits even in this short timeframe. There was a significant apoptosis (tumor cell death) and reduced cell proliferation in the flaxseed group in just the one month.¹³ Likewise women eating more flaxseeds with a documented higher serum enterolactone were found to have a 42% reduced risk of death from postmenopausal breast cancer and a dramatic (40 percent) reduction in all causes of death.^14,15 Flaxseeds are clearly super foods; even with a mediocre diet they offer powerful protection against certain types of breast cancer. Another interesting study on flax followed women for up to 10 years and found a 51% reduced risk of all-cause mortality and a 71% reduced risk of breast cancer mortality. The intake of dried beans was also associated with a 39% reduced risk of all-cause mortality.¹⁶ Endometrial and ovarian cancer have not been as extensively studied, but the few studies that have been conducted suggest a protective effect.^2,17

Bottom line; don’t forget to take your ground flax seeds (or chia seeds) every day. I sometimes forget too, but reviewing the science encourages me to remember. When used in conjunction with dietary exposure to greens, onions, mushrooms and beans, dramatic reductions in the risk of breast cancer are possible.

My newest book, Super Immunity, addresses my full nutritional program to win the war against breast cancer.

References:
1. Mense SM, Hei TK, Ganju RK, et al: Phytoestrogens and breast cancer prevention: possible mechanisms of action. Environ Health Perspect 2008;116:426-433.
2. Higdon J: Lignans. In An Evidence-Based Approach to Dietary Phytochemicals. New York: Thieme; 2006: 155-161
3. Milder IE, Arts IC, van de Putte B, et al: Lignan contents of Dutch plant foods: a database including lariciresinol, pinoresinol, secoisolariciresinol and matairesinol. Br J Nutr 2005;93:393-402.
4. Coulman KD, Liu Z, Hum WQ, et al: Whole sesame seed is as rich a source of mammalian lignan precursors as whole flaxseed. Nutr Cancer 2005;52:156-165.
5. Adlercreutz H: Lignans and human health. Crit Rev Clin Lab Sci 2007;44:483-525.
6. Adlercreutz H, Bannwart C, Wahala K, et al: Inhibition of human aromatase by mammalian lignans and isoflavonoid phytoestrogens. J Steroid Biochem Mol Biol 1993;44:147-153.
7. Brooks JD, Thompson LU: Mammalian lignans and genistein decrease the activities of aromatase and 17beta-hydroxysteroid dehydrogenase in MCF-7 cells. J Steroid Biochem Mol Biol 2005;94:461-467.
8. Adlercreutz H, Mousavi Y, Clark J, et al: Dietary phytoestrogens and cancer: in vitro and in vivo studies. J Steroid Biochem Mol Biol 1992;41:331-337.
9. Adlercreutz H, Hockerstedt K, Bannwart C, et al: Effect of dietary components, including lignans and phytoestrogens, on enterohepatic circulation and liver metabolism of estrogens and on sex hormone binding globulin (SHBG). J Steroid Biochem 1987;27:1135-1144.
10. Low YL, Dunning AM, Dowsett M, et al: Phytoestrogen exposure is associated with circulating sex hormone levels in postmenopausal women and interact with ESR1 and NR1I2 gene variants. Cancer Epidemiol Biomarkers Prev 2007;16:1009-1016.
11. Sturgeon SR, Heersink JL, Volpe SL, et al: Effect of dietary flaxseed on serum levels of estrogens and androgens in postmenopausal women. Nutr Cancer 2008;60:612-618.
12. Chen J, Power KA, Mann J, et al: Flaxseed alone or in combination with tamoxifen inhibits MCF-7 breast tumor growth in ovariectomized athymic mice with high circulating levels of estrogen. Exp Biol Med (Maywood) 2007;232:1071-1080.
13. Thompson LU, Chen JM, Li T, et al: Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer. Clin Cancer Res 2005;11:3828-3835.
14. Buck K, Vrieling A, Zaineddin AK, et al: Serum enterolactone and prognosis of postmenopausal breast cancer. J Clin Oncol 2011;29:3730-3738.
15. Buck K, Zaineddin AK, Vrieling A, et al: Estimated enterolignans, lignan-rich foods, and fibre in relation to survival after postmenopausal breast cancer. Br J Cancer 2011;105:1151-1157.
16. McCann SE, Thompson LU, Nie J, et al: Dietary lignan intakes in relation to survival among women with breast cancer: the Western New York Exposures and Breast Cancer (WEB) Study. Breast Cancer Res Treat 2010;122:229-235.
17. Bandera EV, King M, Chandran U, et al: Phytoestrogen consumption from foods and supplements and epithelial ovarian cancer risk: a population-based case control study. BMC Womens Health 2011;11:40.

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“GOMBBS” is an acronym you can use to remember the most nutrient-dense, health-promoting foods on the planet.   These are the foods you should eat every day, and they should make up a significant proportion of your diet – these foods are extremely effective at preventing chronic disease and promoting health and longevity.

G – Greens

Raw leafy greens contain only about 100 calories per pound, and are packed with nutrients. Leafy greens contain substances that protect blood vessels, and are associated with reduced risk of diabetes.¹ Greens are an excellent tool for weight loss, since they can be consumed in virtually unlimited quantities. Leafy greens are also the most nutrient-dense of all foods, but unfortunately are only consumed in miniscule amounts in a typical American diet. We should follow the example of our closest living relatives – chimpanzees and gorillas – who consume tens of pounds of green leaves every day. The majority of calories in green vegetables, including leafy greens, come from protein, and this plant protein is packaged with beneficial phytochemicals: Green vegetables are rich in folate (the natural form of folic acid), calcium, and contain small amounts of omega-3 fatty acids.  Leafy greens are also rich in antioxidant pigments called carotenoids, specifically lutein and zeaxanthin, which are the carotenoids known to promote healthy vision.² Also, several leafy greens and other green vegetables (such as bok choy, broccoli, and kale) belong to the cruciferous family of vegetables.

All vegetables contain protective micronutrients and phytochemicals, but cruciferous vegetables have a unique chemical composition; they contain glucosinolates, and when their cell walls are broken by blending, chopping, or chewing, a chemical reaction converts glucosinolates to isothiocyanates (ITCs) - compounds with a variety of potent anti-cancer effects. Because different ITCs can work in different locations in the cell and on different molecules, they can have combined additive effects, working synergistically to remove carcinogens, reduce inflammation, neutralize oxidative stress, inhibit angiogenesis (the process by which tumors acquire a blood supply), and kill cancer cells.³

O – Onions

Onions, along with leeks, garlic, shallots, and scallions, make up the Allium family of vegetables, which have beneficial effects on the cardiovascular and immune systems, as well as anti-diabetic and anti-cancer effects. Allium vegetables are known for their characteristic organosulfur compounds, Similar to the ITCs in cruciferous vegetables, organosulfur compounds are released when onions are chopped, crushed, or chewed. Epidemiological studies have found that increased consumption of Allium vegetables is associated with lower risk of gastric and prostate cancers.    These compounds prevent the development of cancers by detoxifying carcinogens, halting cancer cell growth, and blocking angiogenesis.⁴ Onions also contain high concentrations of health-promoting flavonoid antioxidants, predominantly quercetin, and red onions also contain at least 25 different anthocyanins.^5,6 Quercetin slows tumor development, suppresses growth and proliferation and induces cell death in colon cancer cells.⁷ Flavonoids also have anti-inflammatory effects that may contribute to cancer prevention.⁸

M - Mushrooms

Consuming mushrooms regularly is associated with decreased risk of breast, stomach, and colorectal cancers.  In one recent Chinese study, women who ate at least 10 grams of fresh mushrooms each day (about one mushroom per day) had a 64% decreased risk of breast cancer. Even more dramatic protection was gained by women who ate 10 grams of mushrooms and drank green tea daily - an 89% decrease in risk for premenopausal women, and 82% for postmenopausal women.^9,10 White, cremini, portobello, oyster, shiitake, maitake, and reishi mushrooms all have anti-cancer properties - some are anti-inflammatory, stimulate the immune system, prevent DNA damage, slow cancer cell growth, cause programmed cancer cell death, or inhibit angiogenesis.In addition to these properties, mushrooms are unique in that they contain aromatase inhibitors - compounds that can block the production of estrogen. These compounds are thought to be largely responsible for the preventive effects of mushrooms against breast cancer - in fact, there are aromatase-inhibiting drugs on the market that are used to treat breast cancer. Regular consumption of dietary aromatase inhibitors is an excellent strategy for prevention, and it turns out that even the most commonly eaten mushrooms (white, cremini, and portobello) have high anti-aromatase activity.¹¹

B – Berries

Blueberries, strawberries, and blackberries are true super foods. Naturally sweet and juicy, berries are low in sugar and high in nutrients - they are among the best foods you can eat. Their vibrant colors mean that they are full of antioxidants, including flavonoids and antioxidant vitamins - berries are some of the highest antioxidant foods in existence. Berries’ plentiful antioxidant content confers both cardioprotective and anti-cancer effects, such as reducing blood pressure, reducing inflammation, preventing DNA damage, inhibiting tumor angiogenesis, and stimulating of the body’s own antioxidant enzymes.  Berry consumption has been linked to reduced risk of diabetes, cancers and cognitive decline.¹² Berries are an excellent food for the brain – berry consumption improves both motor coordination and memory.¹³

B - Beans

Beans (and other legumes as well) are a powerhouse of superior nutrition, and the most nutrient-dense carbohydrate source. They act as an anti-diabetes and weight-loss food because they are digested slowly, having a stabilizing effect on blood sugar, which promotes satiety and helps to prevent food cravings. Plus they contain soluble fiber, which lowers cholesterol levels.¹⁴ Beans are unique foods because of their very high levels of fiber and resistant starch, carbohydrates that are not broken down by digestive enzymes.  Fiber and resistant starch not only reduce the total number of calories absorbed from beans, but are also fermented by intestinal bacteria into fatty acids that help to prevent colon cancer. Eating beans, peas, or lentils at least twice a week has been found to decrease colon cancer risk by 50%. ^15,16 Legume intake also provides significant protection against oral, larynx, pharynx, stomach, and kidney cancers.¹⁷

S - Seeds

Nuts and seeds contain healthy fats and are rich in a spectrum of micronutrients including phytosterols, minerals, and antioxidants. Countless studies have demonstrated the cardiovascular benefits of nuts, and including nuts in the diet aids in weight maintenance and diabetes prevention.^18,19 The nutritional profiles of seeds are similar to nuts when it comes to healthy fats, minerals, and antioxidants, but seeds are also abundant in trace minerals, higher in protein than nuts, and each kind of seed is nutritionally unique. Flax, chia, and hemp seeds are extremely rich sources of omega-3 fats. In addition to the omega-3s, flaxseeds are rich in fiber and lignans. Flaxseed consumption protects against heart disease by a number of different mechanisms, and lignans, which are present in both flaxseeds and sesame seeds, have anti-cancer effects.²⁰ Sunflower seeds are especially rich in protein and minerals.  Pumpkin seeds are rich in iron and calcium and are a good source of zinc. Sesame seeds have the greatest amount of calcium of any food in the world, and provide abundant amounts of vitamin E. Also, black sesame seeds are extremely rich in antioxidants.²¹ The healthy fats in seeds and nuts also aid in the absorption of nutrients when eaten with vegetables.

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Planning in advance to eat healthfully is quite easy – but what happens when you are confronted with an immediate decision between healthy and unhealthy food – especially when you are hungry?

Here’s an example: you’re at a party where everyone is munching on chips, cheesy dips, and greasy finger foods. You see a platter of raw vegetables and fresh fruit, but you feel tempted by the junk food. Do you stick with the produce or indulge in the calorie-laden snacks?  What goes on in your brain while you’re making that decision?

Subconsciously, we assign a certain value to each food, asking ourselves, “How will each of these foods taste? How healthy is each one? What is more important to me right now, taste or healthfulness?”

Decision-making is thought to be controlled by part of the brain called the ventromedial prefrontalcortex (vmPFC), which also plays a role in regulating emotions and emotional reactions.  A 2009 study found that another region, the dorsolateral prefrontal cortex (dlPFC), may help the vmPFC to decide that healthfulness is more important when making food decisions.   In people who showed more self-control in their food choices, the vmPFC was activated by pictures of foods they had as healthy and foods they rated as tasty; however, in people with less self-control, the vmPFC was only activated by foods they rated as tasty, not the ones they rated as healthy. Also, those with more self-control had more activity in the dlPFC during food decisions.  These results suggest that the dlPFC may reduce the value that the vmPFC assigns to tempting unhealthy foods, helping us to exert self-control in our food decisions.¹

So, can we choose to activate the dlPFC to have more self-control when making food decisions?  If so, how? 

That’s exactly the question that this research group’s newest study tried to answer. Subjects were asked to fast for at least three hours prior to the experiment. They were shown pictures of 180 different foods and asked to respond within three seconds “yes” or “no” to whether they’d want to eat the food.  Before they experiment, they were told that one of their choices would be randomly selected, and if they answered “yes” for that food, it would be served to them later. 

Before each group of 10 food photos, a message would be displayed on the screen saying either "consider the healthiness," "consider the tastiness," or "make decisions naturally." These messages were designed to shift the subjects’ attention toward either taste or health – if they were reminded to think about health, would it change their brain activity and cause them to make a healthier choice?

The answer was yes. After seeing the “consider the healthiness” message, subjects were less likely to choose unhealthy foods, and more likely to choose healthy-untasty foods.  They also said “no” to foods more often after seeing the “healthiness” message than after seeing the “naturally” message.  

What was going on in the brain? In response to pictures of healthy foods, the vmPFC showed more activity in the presence of the “healthiness” message compared to the other messages.  The dlPFC was more active in response to all of the food pictures in the presence of the “healthiness” message compared to the other messages.  This result suggests that the dlPFC was more able to help the vmPFC put more value on healthiness after the “healthiness” message.   The subjects made healthier choices when they were reminded to do so.^2,3

The message here is that making the tough decisions between taste and health is easier than we think – if we can remind ourselves that health is the more important quality, we can alter the way the brain values the foods involved.  When faced with a decision between delicious healthy food and tempting unhealthy food, we can use reminders to shift our attention toward health:

• Post sticky notes in your kitchen, or on your desk at work, saying “Choose the healthiest foods” or something similar.   

• Make a sign that says “GOMBS* fight cancer in every bite.”

• When you are looking at a menu in a restaurant, or making a food choice outside of your home, remind yourself “I choose to eat healthy foods,” or “I do not eat disease-causing foods.” Write these statements on a visible card you keep in your wallet or pocketbook.

• As Dr. Fuhrman recommends, put a sign on your refrigerator that says “The salad is the main dish!” 

According to this research, reminders like these do work.  We can train ourselves (and our dlPFCs) to use healthfulness as the most important quality by which we value foods.

*GOMBS  = Greens, Onions, Mushrooms, Beans, Berries, Seeds

References:

1. Hare TA, Camerer CF, Rangel A: Self-control in decision-making involves modulation of the vmPFC valuation system. Science 2009;324:646-648.

2. Think healthy, eat healthy: Caltech scientists show link between attention and self-control. EurekAlert! http://www.eurekalert.org/pub_releases/2011-07/ciot-the072611.php. Accessed August 15, 2011.

3. Hare TA, Malmaud J, Rangel A: Focusing Attention on the Health Aspects of Foods Changes Value Signals in vmPFC and Improves Dietary Choice. J Neurosci 2011;31:11077-11087.

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Pistachio nuts have a unique nutritional profile – they are especially rich in plant sterols, carotenoids, tocopherols (vitamin E), and arginine.  Plant sterols are structurally similar to cholesterol, and provide a cholesterol-lowering benefit.¹ All nuts have cholesterol-lowering and other cardioprotective effects, but pistachios (in a tie with Mediterranean pine nuts) have the highest plant sterol content of all nuts.  Studies investigating the effects of pistachios on cardiovascular disease risk factors not only reported reduced cholesterol levels, but also decreased inflammatory markers, increased blood antioxidant levels and reduced oxidative stress.^2-4 In addition to antioxidants and plant sterols, pistachios are also rich in arginine, an amino acid that is involved in nitric oxide production, which regulates relaxation of arterial smooth muscle and therefore blood flow.  In a previous study, pistachio supplementation resulted in enhanced endothelial cell function, which means that nitric oxide availability was increased.⁴

Erectile dysfunction (ED) is primarily a disorder of penile blood flow, most often accompanied by chronic conditions that affect the vasculature, such as diabetes, hypertension, and high cholesterol. Atherosclerosis in peripheral arteries is known to contribute to the impaired blood flow in this condition.  Atherosclerosis is usually preceded by endothelial dysfunction, which decreases nitric oxide bioavailability, leading to impaired blood flow regulation.  Since pistachios have confirmed cholesterol-lowering effects and are rich in arginine (which helps to produce nitric oxide), scientists tested whether pistachios could enhance erectile function in men with ED.

Subjects in the study consumed 100 grams of pistachio nuts (about 3 ounces) each day for three weeks. Erectile function was evaluated by subjects’ reports and also by blood flow measurement with ultrasound.  After three weeks of pistachio supplementation, both the erectile function scores based on subjects’ reports and the velocity of penile blood flow were improved.  The men’s cholesterol levels also improved.⁵

The health of the heart and blood vessels is crucial to the health of the entire body.  Eating to restore cardiovascular health will improve blood flow and nutrient delivery to all tissues, improving overall health. Like several other chronic diseases, erectile dysfunction shares the same risk factors with cardiovascular disease.  Antioxidants, plant sterols, and arginine promote blood vessel health and are provided in abundance by a high nutrient diet made up of whole plant foods.

References:

1. Ellegard LH, Andersson SW, Normen AL, et al: Dietary plant sterols and cholesterol metabolism. Nutr Rev 2007;65:39-45.

2. Kay CD, Gebauer SK, West SG, et al: Pistachios increase serum antioxidants and lower serum oxidized-LDL in hypercholesterolemic adults. J Nutr 2010;140:1093-1098.

3. Kocyigit A, Koylu AA, Keles H: Effects of pistachio nuts consumption on plasma lipid profile and oxidative status in healthy volunteers. Nutrition, metabolism, and cardiovascular diseases : NMCD 2006;16:202-209.

4. Sari I, Baltaci Y, Bagci C, et al: Effect of pistachio diet on lipid parameters, endothelial function, inflammation, and oxidative status: a prospective study. Nutrition 2010;26:399-404.

5. Aldemir M, Okulu E, Neselioglu S, et al: Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction. Int J Impot Res 2011;23:32-38.

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When we use the word “metabolism,” we are usually referring to resting metabolic rate, which is the amount of energy (calories) that the body requires per day for its basic functions at rest.  Most people believe that it is desirable to raise their metabolism, because they will burn more calories and consequently lose weight.  Having a slightly lower resting metabolic rate is thought to predispose some individuals to weight gain, especially in the obesogenic food environment that we live in.^1,2  However,  there are unfavorable consequences to running your body at faster than normal speed, and raising your metabolism is not the key to weight loss.

Toxic byproducts of metabolism and biological aging

The chemical reactions of normal everyday physiology produce byproducts.  In particular, cellular energy production produces reactive oxygen species as a byproduct, which can damage DNA, proteins, and lipids.  Although we have natural antioxidant defenses, oxidative damage can still occur, especially if we don’t take in adequate antioxidants from our diet.³  Oxidative damage accelerates aging.

Aging here refers to biological aging – the progressive decline in the efficiency of the body’s physiological functions over time. This leads to tissue and organ damage, and increased risk of chronic disease and death. 

Why do our bodies age?  It is a combination of factors.   One, the accumulation of oxidative damage over time damages the body’s tissues, leading to accelerated aging.^4,5 And two, just the rate of living slowly wears out our cellular machinery, so if we function at a faster rate – i.e. a faster metabolism – the body will “wear out” more quickly.  In animals, energy expenditure is indeed inversely related to lifespan, supporting this.⁶   Though both these mechanisms of aging are related, as a faster metabolic rate means faster energy turnover and greater production of free radicals, leading to increased oxidative damage. 

Metabolic rate and lifespan

A study on thyroid function published last year further supported the idea that a slower metabolic rate could prolong lifespan.  Now, a new study has measured resting metabolic rate directly and come to the same conclusion.  Metabolic rate was measured by two different methods at the start of the study.  Subjects were followed for 11-15 years, and deaths from natural causes were recorded.  For each 100 calorie increase in 24-hour resting metabolic rate, the risk of natural mortality increased by 25-29%.  These results strongly support the hypothesis that a slow metabolic rate promotes longevity.⁷

Do we have any control over our resting metabolic rate? How can we slow it down?

Resting metabolic rate is largely genetically determined, but our calorie intake has an effect as well.⁸  Caloric restriction and negative energy balance have been shown to reduce resting metabolic rate, and in contrast overeating increases resting metabolic rate.^9,10  Furthermore, caloric restriction has been consistently shown to prolong maximal lifespan by up to 60% in animals.¹¹  My findings have demonstrated that an optimal micronutrient intake reduces the desire for calories and reduces body temperature and white blood cell counts. This means that if follow a high-nutrient eating style that reduces calorie intake while meeting micronutrient demands, we can reduce our resting metabolic rate and potentially increase our longevity potential dramatically.

Keep in mind that although exercise raises total calorie expenditure, it does not raise the body’s basal metabolism. Exercise is the only safe way to “raise metabolism” because it activates the peripheral tissues to utilize more calories and also increases muscle mass which in turn increases total calorie expenditure.¹²  Plus, exercise promotes longevity.¹³  

The goal here is to eat so healthy that it reduces your desire to overeat and reduces your metabolism slowly, so you can comfortably desire less food, though not get too thin.  My nutritarian recommendations actually makes you more satisfied with less food, and actually gives the ability to enjoy food more without overeating. 

So this new study supports what I have said previously: having a fast metabolism does not mean that you are healthier – in fact, it probably means that you are aging more quickly.  Instead of trying to increase your metabolism with the goal of losing weight, try to slow your metabolism with a low-calorie, high-nutrient diet for a longer, healthier life.

References:

1. Astrup A, Gotzsche PC, van de Werken K, et al: Meta-analysis of resting metabolic rate in formerly obese subjects. Am J Clin Nutr 1999;69:1117-1122.

2. Ravussin E, Lillioja S, Knowler WC, et al: Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med 1988;318:467-472.

3. Joseph JA, Denisova N, Fisher D, et al: Age-related neurodegeneration and oxidative stress: putative nutritional intervention. Neurol Clin 1998;16:747-755.

4. Hulbert AJ, Pamplona R, Buffenstein R, et al: Life and death: metabolic rate, membrane composition, and life span of animals. Physiol Rev 2007;87:1175-1213.

5. Farooqui T, Farooqui AA: Aging: an important factor for the pathogenesis of neurodegenerative diseases. Mech Ageing Dev 2009;130:203-215.

6. Speakman JR, Selman C, McLaren JS, et al: Living fast, dying when? The link between aging and energetics. J Nutr 2002;132:1583S-1597S.

7. Jumpertz R, Hanson RL, Sievers ML, et al: Higher Energy Expenditure in Humans Predicts Natural Mortality. J Clin Endocrinol Metab 2011.

8. Bouchard C, Tremblay A, Nadeau A, et al: Genetic effect in resting and exercise metabolic rates. Metabolism 1989;38:364-370.

9. Martin CK, Heilbronn LK, de Jonge L, et al: Effect of calorie restriction on resting metabolic rate and spontaneous physical activity. Obesity 2007;15:2964-2973.

10. Roberts SB, Fuss P, Evans WJ, et al: Energy expenditure, aging and body composition. J Nutr 1993;123:474-480.

11. Fontana L: The scientific basis of caloric restriction leading to longer life. Curr Opin Gastroenterol 2009;25:144-150.

12. Broeder CE, Burrhus KA, Svanevik LS, et al: The effects of aerobic fitness on resting metabolic rate. Am J Clin Nutr 1992;55:795-801.

13. Manini TM, Everhart JE, Patel KV, et al: Daily activity energy expenditure and mortality among older adults. JAMA 2006;296:171-179.

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