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

Red meat intake has been associated with elevated risk of cardiovascular disease and cardiovascular death.^1-5 For example, combined data from the Nurses’ Health Study and Health Professionals Follow-up study, comprising over 120,000 people, estimated that each serving (100 grams) of red meat raises the risk of cardiovascular death by 18 percent. 

Two widely accepted factors that are thought to link red meat to increased cardiovascular disease risk are the high saturated fat and heme iron contents of red meat. Saturated fats are known to elevate total and LDL cholesterol levels, and excess iron is associated with oxidative stress, which promotes atherosclerosis.^6-9 However, scientists have theorized that these factors alone do not explain the contribution of red meat to cardiovascular risk.³ Additional properties of red meat are likely involved.

Fascinating new research presents a new potential mechanism by which red meat may increase cardiovascular risk – by modulating the species of bacteria that populate our digestive tract!

We are now learning that our intestinal flora interacts with the cells of the intestinal wall to exert profound effects on our health. Beneficial microbes produce vitamins, protect us against pathogenic microbes, promote healthy immune function, facilitate energy extraction from food, and break down fiber and resistant starch into beneficial short chain fatty acids, which protect us against colon cancer. Importantly, what we eat determines which species of bacteria thrive in our digestive tract. Healthful, fiber-rich plant foods provide an energy source (“prebiotics”) for beneficial bacteria to grow.^10,11

Is the reverse true? Do unhealthy foods promote proliferation of unhealthy gut bacteria?

Carnitine is an amino acid involved in energy production, and it is abundant in animal products, especially red meat; there is little or no carnitine in plant foods, and the human body can produce adequate carnitine from other amino acids, lysine and methionine. Studying mice, the scientists found that carnitine was metabolized by intestinal bacteria, producing trimethylamine-N-oxide (TMAO), a substance previously shown to contribute to atherosclerotic plaque development by slowing the removal of cholesterol from the arterial wall. They then sought to confirm these findings with human subjects. When analyzing the blood levels of carnitine and TMAO in human subjects, they found that the combination of high carnitine and high TMAO was associated with increased likelihood of cardiovascular disease or cardiovascular events (heart attack and stroke). When they gave humans carnitine supplements, they interestingly found that omnivores produced far more TMAO in response to carnitine than vegans and vegetarians. In addition, the species of gut bacteria in omnivores were different from those in vegetarians and vegans. These results suggest that regularly eating carnitine-containing foods promotes the growth of gut bacteria that can metabolize carnitine into a heart disease-promoting substance.^12-14  

Our overall dietary pattern determines the bacteria that live in our gastrointestinal tract, and this research indicates that eating red meat regularly promotes the growth of bacteria that produce harmful substances from the components of red meat. It also indicates that those of us that regularly consume a healthful diet of whole plant foods have a healthier microbial profile, and we are less susceptible to the disease-promoting effects of high-carnitine meats. Future studies will continue to uncover more of these intriguing links between diet, gut bacteria, and health. 

Carnitine content of animal foods:¹⁵

This new research highlights an additional way that red meat likely increases heart disease risk, but certainly the high amount of carnitine in red meat does not exonerate fish, chicken, eggs and dairy products. We already have plentiful evidence that excessive consumption of animal products in general are associated with increased risk of death from all causes. Animal products overall are micronutrient-poor, void of phytochemicals and antioxidants, contain pro-inflammatory fats, increase cholesterol levels, calorically concentrated, promote weight gain, and most importantly elevate IGF-1 which increases heart disease and cancer risk.

 

References:

1. Sinha R, Cross AJ, Graubard BI, et al: Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009;169:562-571.
2. Bernstein AM, Sun Q, Hu FB, et al: Major dietary protein sources and risk of coronary heart disease in women. Circulation 2010;122:876-883.
3. Pan A, Sun Q, Bernstein AM, et al: Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies. Arch Intern Med 2012.
4. Ascherio A, Willett WC, Rimm EB, et al: Dietary iron intake and risk of coronary disease among men. Circulation 1994;89:969-974.
5. Larsson SC, Virtamo J, Wolk A: Red meat consumption and risk of stroke in Swedish men. Am J Clin Nutr 2011.
6. Tholstrup T, Hjerpsted J, Raff M: Palm olein increases plasma cholesterol moderately compared with olive oil in healthy individuals. Am J Clin Nutr 2011;94:1426-1432.
7. de Oliveira Otto MC, Alonso A, Lee DH, et al: Dietary intakes of zinc and heme iron from red meat, but not from other sources, are associated with greater risk of metabolic syndrome and cardiovascular disease. J Nutr 2012;142:526-533.
8. Ahluwalia N, Genoux A, Ferrieres J, et al: Iron status is associated with carotid atherosclerotic plaques in middle-aged adults. J Nutr 2010;140:812-816.
9. Brewer GJ: Iron and copper toxicity in diseases of aging, particularly atherosclerosis and Alzheimer's disease. Exp Biol Med 2007;232:323-335.
10. Neish AS: Microbes in gastrointestinal health and disease. Gastroenterology 2009;136:65-80.
11. Backhed F: Host responses to the human microbiome. Nutr Rev 2012;70 Suppl 1:S14-17.
12. Koeth RA, Wang Z, Levison BS, et al: Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013.
13. Wang Z, Klipfell E, Bennett BJ, et al: Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature 2011;472:57-63.
14. Woolston C: Red meat + wrong bacteria = bad news for hearts. 2013. Nature. http://www.nature.com/news/red-meat-wrong-bacteria-bad-news-for-hearts-1.12746. Accessed April 12, 2013.

15. Linus Pauling Institute: Carnitine. http://lpi.oregonstate.edu/infocenter/othernuts/carnitine/
 

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Closely following the news that sugary beverages may be responsible for 180,000 deaths per year, the same group of scientists has reported an estimate of the number of deaths due to excess salt consumption.

High sodium intake is associated with poor health outcomes, including elevated blood pressure, heart attack and stroke (even in the absence of high blood pressure), kidney disease, ulcers, gastric cancer, osteoporosis, and now autoimmune inflammation.^1,2  Elevated blood pressure, a consequence of excess sodium intake, is a significant threat to one’s health, and its prevalence is rising. Hypertension is one of the leading causes of death in the U.S., contributes to heart attack and stroke risk, and is associated with dementia.³

Using data gathered from the World Health Organization, the average worldwide daily sodium intake was found to be more than double the American Heart Association’s recommended limit of 1500 mg/day. Average worldwide sodium intake was 3,950 mg, and American adults came in just under that average at 3,600 mg.  Most of the world – 119 of the 187 countries studied, or 88% of all adults – consumed more than 3,000 mg sodium a day. Out of the 187 countries, only one (Kenya) had an average sodium intake meeting the American Heart Association’s guideline of 1,500 mg a day. Excess sodium has clearly become a global issue.

With excess sodium consumption now common throughout the entire world, are more people dying from heart attacks and strokes?

Higher sodium intake is consistently associated with greater risk of heart attack, stroke, and cardiovascular death in healthy populations.¹ The scientists gathered data on deaths in 50 different countries and concluded that 2.3 million deaths per year worldwide may be due to excess salt consumption, and 40% of those deaths occurred in individuals under the age of 70 – suggesting that excess sodium is needlessly cutting many lives short. They estimated that excess salt contributes to one in 10 deaths of American adults, and that 15 percent of all deaths from cardiovascular disease were a consequence of excess salt intake.^4-6

Could reducing sodium intake really prevent some of these deaths?

Clinical trials have clearly shown that reducing sodium intake reduces blood pressure in both healthy and hypertensive subjects.¹  Additional clinical trials have shown that cardiovascular events could be  reduced by 20% with sodium reduction.⁷ A recent publication in the New England Journal of Medicine used mathematical models to estimate that a 1200 mg reduction in daily sodium intake population-wide in the U.S. could result in 60,000 fewer cases of CHD, 32,000 fewer strokes, and 54,000 fewer heart attacks every year.⁸ The effort to reduce sodium intake is substantially worthwhile.

Added salt is ubiquitous in processed foods and restaurant meals, and is contributing to the rampant cardiovascular disease in the modern world. Since most of the added sodium in the American diet comes from these foods, it is simple to avoid added salt by preparing most of your meals at home.  Sodium is an essential mineral that becomes dangerous in excess; by consuming only the sodium present in natural foods, we get adequate but not disease-causing levels of sodium. 

References:
1. Whelton PK, Appel LJ, Sacco RL, et al: Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations. Circulation 2012;126:2880-2889.
2. Tsugane S, Sasazuki S: Diet and the risk of gastric cancer: review of epidemiological evidence. Gastric Cancer 2007;10:75-83.
3. Murphy SL, Xu J, Kochanek KD: Deaths: Preliminary Data for 2010. Natl Vital Stat Rep 2012;60.
4. Phend C: Whole World Uses Too Much Salt, Study Finds. 2013. MedPage Today. http://www.medpagetoday.com/Cardiology/Prevention/38011. Accessed
5. Armour S: High Salt Consumption Tied to 2.3 Million Heart Deaths. 2013. Bloomberg. http://www.bloomberg.com/news/2013-03-21/high-salt-consumption-tied-to-2-3-million-heart-deaths.html. Accessed
6. Gray N: High salt intake causes 2.3 million deaths per year. 2013. Food Navigator. http://www.foodnavigator.com/Science-Nutrition/High-salt-intake-causes-2.3-million-deaths-per-year/. Accessed
7. He FJ, MacGregor GA: Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials. Lancet 2011;378:380-382.
8. Bibbins-Domingo K, Chertow GM, Coxson PG, et al: Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med 2010;362:590-599.

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Just a week after the New York Supreme Court struck down Mayor Bloomberg’s proposed large sugary drink ban, which would have prohibited the sale of beverages larger than 16 ounces in many food outlets, research was presented at an American Heart Association meeting that linked consumption of sugar-sweetened beverages to hundreds of thousands of deaths worldwide – 180,000 deaths per year.

Fruit-flavored drinks, sports drinks, energy drinks, soda, sweetened iced teas, etc. are consumed in huge quantities in the modern world. The average American consumes 22.2 teaspoons of added sugar daily, equating to 355 calories. Teens consume even more – 34.3 teaspoons or 549 calories a day, and half of the added sugars in the typical American diet come from sweetened drinks, mostly soda.^{1, 2}

It is no secret that these sugary beverages are a threat to human health. Sugary drinks have very low satiety value, and extremely low to zero micronutrient content; the link between these beverages and weight gain is well-documented.³ However, these liquid calories carry more danger than excess calories alone – sugary drinks are powerfully disease-promoting.

Sugary drinks provide their huge calorie load with no fiber, and no chewing required; the sugar is consumed and then hits the bloodstream almost instantly. The surge of glucose in the blood (and fructose in the liver) sets off complex pathways in the body that, over time, contribute to insulin resistance, increased visceral fat mass, elevated cholesterol, triglycerides and blood pressure, and cancer cell survival and proliferation.^4-8 Consumption of added sugars or sugar-sweetened beverages has been linked to diabetes, cardiovascular disease, and cancers.^{2, 9-15} There are also strong links between hyperinsulinemia (excess insulin in the blood, a consequence of excess blood glucose) and certain cancers.^{7, 16-19}  

Researchers gathered data from the World Health Organization on sugary drink consumption, obesity and chronic disease in 114 countries. Knowing that sugary drinks promote obesity, and obesity is a risk factor for chronic diseases, they investigated the association between sweetened beverage consumption and obesity in the different countries, and then analyzed deaths from obesity-related chronic disease.  

These are their conclusions – estimates of the number of deaths per year that may be attributed to sugar sweetened beverages:²⁰

• Total deaths worldwide: 180,000

• Total deaths in the U.S.: 25,000

• Deaths from diabetes worldwide: 133,000

• Deaths from cardiovascular disease worldwide: 44,000

One-hundred and eighty thousand deaths each year could possibly be prevented by simply drinking water instead of soda?

These estimates don’t even take into account the added sugars in breakfast cereals, baked goods, candy and ice cream that are so prevalent in the American diet – not to mention the oils, fried foods, white flour, white rice and animal products. Imagine the number of deaths that could be prevented, the health care costs that could be saved, and the excellent health our nation could enjoy by not just cutting out sugary drinks, but following a health-promoting Nutritarian lifestyle. Preventable diseases are our major killers, and we have the power to protect ourselves with superior nutrition.

It is clear that sugary drinks are disease-causing and each of us can make the simple choice to avoid disease-causing substances. The addictive properties of excessively sweet foods may make this choice difficult for many people, but hopefully research like this will reach many who are sick and overweight on the American diet, and help them to build the motivation they need to abstain from disease-causing sugary drinks. 

References:
1. Center for Science in the Public Interest. Sugar: Too Much of a Sweet Thing [http://cspinet.org/new/pdf/infographic_full.pdf]
2. Johnson RK, Appel LJ, Brands M, et al: Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation 2009, 120:1011-1020.
3. Malik VS, Schulze MB, Hu FB: Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006, 84:274-288.
4. Stanhope KL, Schwarz JM, Keim NL, et al: Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest 2009, 119:1322-1334.
5. Cohen L, Curhan G, Forman J: Association of Sweetened Beverage Intake with Incident Hypertension. J Gen Intern Med 2012.
6. Maersk M, Belza A, Stodkilde-Jorgensen H, et al: Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr 2012, 95:283-289.
7. Arcidiacono B, Iiritano S, Nocera A, et al: Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res 2012, 2012:789174.
8. Port AM, Ruth MR, Istfan NW: Fructose consumption and cancer: is there a connection? Curr Opin Endocrinol Diabetes Obes 2012, 19:367-374.
9. Fagherazzi G, Vilier A, Saes Sartorelli D, et al: Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr 2013.
10. Malik VS, Hu FB: Sweeteners and Risk of Obesity and Type 2 Diabetes: The Role of Sugar-Sweetened Beverages. Curr Diab Rep 2012.
11. Malik VS, Popkin BM, Bray GA, et al: Sugar Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A Meta-analysis. Diabetes Care 2010.
12. Basu S, Yoffe P, Hills N, et al: The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data. PLoS One 2013, 8:e57873.
13. Bernstein AM, de Koning L, Flint AJ, et al: Soda consumption and the risk of stroke in men and women. Am J Clin Nutr 2012.
14. Friberg E, Wallin A, Wolk A: Sucrose, high-sugar foods, and risk of endometrial cancer--a population-based cohort study. Cancer Epidemiol Biomarkers Prev 2011, 20:1831-1837.
15. De Stefani E, Deneo-Pellegrini H, Mendilaharsu M, et al: Dietary sugar and lung cancer: a case-control study in Uruguay. Nutr Cancer 1998, 31:132-137.
16. Bowker SL, Majumdar SR, Veugelers P, et al: Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin: Response to Farooki and Schneider. Diabetes Care 2006, 29:1990-1991.
17. Gunter MJ, Hoover DR, Yu H, et al: Insulin, insulin-like growth factor-I, endogenous estradiol, and risk of colorectal cancer in postmenopausal women. Cancer Res 2008, 68:329-337.
18. Gunter MJ, Hoover DR, Yu H, et al: Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 2009, 101:48-60.
19. Pisani P: Hyper-insulinaemia and cancer, meta-analyses of epidemiological studies. Arch Physiol Biochem 2008, 114:63-70.
20. 180,000 deaths worldwide may be associated with sugary soft drinks. American Heart Association Meeting Report.

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For anyone who has done their reading on the deleterious consequences of regularly consuming dairy products, perhaps you can relate to my reaction when I look at dairy loaded foods.  For those that aren’t enlightened about the chemicals present in a piece of cheese or a stick of butter, this article will point out a few things that may alter the way you view these foods and heighten your willpower to turn down a slice of cheese-loaded pizza or pasta inundated with cheese sauce. 

Being in my early twenties results in attending quite a few gatherings with friends in which pizza is the meal of choice.  I need to spread the word more about what’s in the cheese! I don’t want my friends consuming foods that promote ill health and increase the body’s toxic load.  Heck, I don’t want anyone consuming these types of foods.

Dairy products are produced under mega dirty conditions and these conditions result in the production of “dirty” milk. Blood, fecal matter, pus, E. coli and other dangerous pathogens found in the raw milk at factory farms are routinely boiled off to convert the “dirty” milk to “clean” milk. This probably doesn’t have much to do with the nutritious properties of the milk, but it’s gross to think about.  Due to pasteurization procedures that boil the heck out of the milk, factory farms are able to avoid washing their milk machines, don’t have to sterilize milk container, don’t have to make employees wash their hands or make the dairy production environment clean in any way.  That’s lovely to imagine, right?!

Then there is the whole issue of dioxin.  Without intentions to scare anyone (because it is scary), I must be honest and report that dioxin happens to be one of the most toxic chemicals known to science and is present in dairy and other animal products.1,2 Dioxin describes a group of chemicals that are highly persistent in the environment and are the unintentional byproducts of industrial processes involving chlorine.  The Environmental Protection Agency explains that dioxin builds up in the environment and as such, accumulates in the bodies of farm animals that eat contaminated feed or grass.3 Humans are exposed to dioxin primarily via consuming animal products, with concentrated dairy products, such as cheese and butter, being the worst offenders.4 Researchers at the University of Texas at Houston found that Americans get 22 times the maximum dioxin exposure suggested by the EPA through food alone.5 However, vegans were found to have much lower levels of dioxin. Due to measured levels of dioxin that exceed safety standards, the National Academy of Science has for years recommended that people avoid eating a diet rich in animal fats. Obviously, consumers have not taken heed of this advice. 

Pesticides are also the most concentrated in animal products like dairy because pesticides accumulate in fatty tissues over time and aren’t excreted very quickly.6,7  Not only are livestock fed animal feed that has been sprayed with massive amounts of pesticides, but many pesticides are used in livestock facilities themselves to kill off flies, mites, spiders cockroaches, ticks and other pests that creep up on the skin, fur and feathers of livestock.8

Dairy products already appear thoroughly off-putting by the above information alone, but I haven’t even touched upon the hormones or antibiotics present in these foods. The stone cold truth is that because dairy products come from animals, we are really eating everything stored in that animal’s tissues.  Antibiotics can lead to health problems in large doses and so can synthetic hormones.  Did you know that 70 percent of the antibiotics sold in the United States go to livestock? In short, dairy products like cheese are not clean, and I don’t consider it a legitimate food choice, regardless of what it tastes like. Dump on the white flour and oil, coat it with cheese, and you’ve got a typical cheese pizza. I say no to cheese pizza, do you?   

References:

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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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The average American drinks 216 liters of soda each year.¹ Soda drinking has previously been associated with lower bone mineral density in women and children,^2,3 and one study in particular has focused specifically on the effects of diet soda on bone health.  The authors commented that this research was sparked by the observation that diet soda drinking behaviors are often different than regular soda drinking behaviors – women often use diet sodas in an effort to avoid weight gain – either to stave off hunger between meals or as a replacement for calorie-containing beverages.  Many women drink over 20 diet sodas per week.⁴

These researchers discovered that parathyroid hormone (PTH) concentrations rise strongly following diet soda consumption.  PTH functions to increase blood calcium concentrations by stimulating bone breakdown, and as a result release calcium from bone.

In the study, women aged 18-40 were given 24 ounces of either diet cola or water on two consecutive days, and urinary calcium content was measured for three hours. 

Women who drank diet cola excreted more calcium in their urine compared to women who drank water.  

The authors concluded that this calcium loss may underlie the observed connection between soda drinking and low bone mineral density.⁵

Although caffeine is known to increase calcium excretion and promote bone loss,⁶ caffeine is likely not the only bone-harming ingredient in sodas.  A 2006 study in the American Journal of Clinical Nutrition found consistent associations between low bone mineral density and caffeinated and non-caffeinated cola (both regular and diet), but not other carbonated beverages.⁷ One major difference between the two is the phosphoric acid in colas, absent from most other carbonated beverages. 

In the Western diet, phosphorus is commonly consumed in excess – at about 3 times the recommended levels, whereas dietary calcium often low.  Although phosphorus is an important component of bone mineral, a high dietary ratio of phosphorus to calcium can increase parathyroid hormone secretion, which is known to increase bone breakdown.   Studies in which women were given increasing quantities of dietary phosphorus found increases in markers of bone breakdown and decreases in markers of bone formation.^8,9 Therefore it is likely that the phosphorus content of colas  triggers calcium loss.

There is nothing healthy about diet soda.  It is simply water with artificial sweeteners and other chemical additives, such as phosphoric acid. 

The safety of artificial sweeteners is questionable, and they provoke the release of insulin and other hormones that regulate blood glucose; their intense sweetness confuses the body, which naturally associates sweet taste with calories – over time, these mixed signals can lead to increased appetite and weight gain.¹⁰ 

Diet sodas don’t just weaken our bones, they are linked to kidney dysfunction and promote obesity.

Furthermore, in a recent study, older adults who drank diet soda daily had a 43% increased risk of heart attack or stroke compared to those that never drank diet soda.¹¹

References:

1. Nation Master.  Statistics: soft drinks. http://www.nationmaster.com/graph/foo_sof_dri_con-food-soft-drink-consumption

2. McGartland C, Robson PJ, Murray L, et al. Carbonated soft drink consumption and bone mineral density in adolescence: the Northern Ireland Young Hearts project. J Bone Miner Res. 2003 Sep;18(9):1563-9.

Mahmood M, Saleh A, Al-Alawi F, Ahmed F. Health effects of soda drinking in adolescent girls in the United Arab Emirates. J Crit Care. 2008 Sep;23(3):434-40.

3. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr. 2006 Oct;84(4):936-42

4. Frieden J. ENDO: Diet Soft Drinks Deplete Urinary Calcium. Medpage Today. http://www.medpagetoday.com/MeetingCoverage/ENDO/20831

5. NS Larson, et al "Effect of Diet Cola on urine calcium excretion" ENDO 2010; Abstract P2-198.

http://www.endojournals.org/abstracts/P2-1_to_P2-500.pdf

6. Vondracek SF, Hansen LB, McDermott MT. Osteoporosis risk in premenopausal women. Pharmacotherapy. 2009 Mar;29(3):305-17.

Massey LK, Whiting SJ. Caffeine, urinary cal- cium, calcium metabolism and bone. J. Nutr. 19923 Sep;123 (9): 1611-14

7. Tucker KL, Morita K, Qiao N, et al. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr. 2006 Oct;84(4):936-42.

8. Kemi VE, Kärkkäinen MU, Karp HJ, et al. Increased calcium intake does not completely counteract the effects of increased phosphorus intake on bone: an acute dose-response study in healthy females. Br J Nutr. 2008 Apr;99(4):832-9.

9. Kemi VE, Kärkkäinen MU, Lamberg-Allardt CJ. High phosphorus intakes acutely and negatively affect Ca and bone metabolism in a dose-dependent manner in healthy young females. Br J Nutr. 2006 Sep;96(3):545-52.

10. Swithers SE, Martin AA, Davidson TL. High-intensity sweeteners and energy balance. Physiol Behav. 2010 Apr 26;100(1):55-62.

Ma J, Bellon M, Wishart JM, et al. Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects. Am J Physiol Gastrointest Liver Physiol. 2009 Apr;296(4):G735-9.

Liang Y, Steinbach G, Maier V, Pfeiffer EF. The effect of artificial sweetener on insulin secretion. 1. The effect of acesulfame K on insulin secretion in the rat (studies in vivo). Horm Metab Res. 1987 Jun;19(6):233-8.

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A large, long-term study from Harvard School of Public Health published last week confirmed what we already know – red meat is a disease-promoting food whose consumption leads to premature death.¹ This is an important study because of its lengthy follow-up time, distinction between unprocessed and processed red meats, and findings of a dose-response relationship between red meat intake and risk of death – in short, the authors concluded each daily serving of unprocessed red meat increased risk by 13% and processed meat by 20%. However, the bottom line “red meat increases risk of mortality” certainly isn’t news. This is not the first study to link meat consumption to premature death, and it certainly will not be the last.^1-5

Of interest though, is the accompanying commentary by Dean Ornish, M.D., a respected and widely known figure in lifestyle medicine. In his comment, Dr. Ornish leaves the physician-sanctioned territory of human health and nutrition makes a call to action to reduce red meat consumption to protect the health of our planet, not just ourselves:⁶

“In addition to their health benefits, the food choices we make each day affect other important areas as well. What is personally sustainable is globally sustainable. What is good for you is good for our planet...
… choosing to eat more plant-based foods and less red meat is better for all of us—ourselves, our loved ones, and our planet. In short, don't have a cow!”>6

We already know that red meat is a contributory factor in the development of cancer⁷ – plus, we know from epidemiologic findings from rural areas that the etiology of this relationship will not be negated by eating grass-fed beef.^8-13 We know that heme iron is an oxidant that accumulates in the body over time, contributing to cardiovascular disease and dementia.^14,15 We know that heme iron and proteins in meats form N-nitroso compounds in the digestive tract that can damage cellular DNA, potentially leading to stomach and colorectal cancers.^16-18 We know that cooking meats (all meats, not just red meat) at high temperatures forms carcinogens called heterocyclic amines.¹⁹ Plus, we are now finding that chronic inflammation results from newly discovered compounds such as Neu5Gc, which accumulate from eating red meat.²⁰ Furthermore, higher levels of meats (animal protein) lead to higher circulating levels of IGF-1 that promote cell division and fuel growth of cancerous cells.^21,22 These issues related to heme iron and animal protein will also not be resolved by simply switching to grass-fed beef.

The “red meat is good for you” slogan is dead – its proponents don’t have a scientific leg to stand on. Atkins, Dukan, Sugar Busters, Weston Price, and all the other meat-promoting and protecting people need to keep out of this discussion and finally stop protesting and promoting death. Now, the new question has become: are red meat consumers and promoters destroying our environment also?

There is certainly no need to debate the health issues any further. With global livestock production expected to double by 2050,²³ now is the time for the public to become better aware of the environmental impact of consuming meat. Dr. Ornish brings up these important points regarding the impact of animal agriculture on our environment:

• Greenhouse gas emissions: The livestock sector generates more greenhouse gas emissions than transportation – about 18% of total emissions; emissions include carbon dioxide and to a greater extent, methane and nitrous oxide, which are considered to be more harmful than carbon dioxide.
• Deforestation: Currently, animal agriculture uses 30% of the Earth’s land surface, and 70% of forests in the Amazon are no longer forests – they have become grazing land for livestock, resulting in depletion of wildlife and natural ecosystems.
• Use of resources and energy: Almost 40% of the world’s grain (and over 50% in the U.S.) is fed to livestock and 33% of arable land on Earth is devoted to growing feed for livestock. The production of 1 pound of beef requires almost 20,000 liters of water, and is a significant contributor to water pollution.^6,23

What do you think?
Especially considering red meat is harmful to human health, and to our environment do you agree with Dr. Ornish? Should all of us, including informed physicians make it our responsibility to promote dietary change for environmental reasons as well, or should we doctors stick to health and medical topics?

References:

1. Pan A, Sun Q, Bernstein AM, et al: Red Meat Consumption and Mortality: Results From 2 Prospective Cohort Studies. Arch Intern Med 2012.
2. Sinha R, Cross AJ, Graubard BI, et al: Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009;169:562-571.
3. Major JM, Cross AJ, Doubeni CA, et al: Socioeconomic deprivation impact on meat intake and mortality: NIH-AARP Diet and Health Study. Cancer Causes Control 2011;22:1699-1707.
4. Key TJ, Fraser GE, Thorogood M, et al: Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr 1999;70:516S-524S.
5. Fraser GE: Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr 1999;70:532S-538S.
6. Ornish D: Holy Cow! What's Good For You Is Good For Our Planet: Comment on "Red Meat Consumption and Mortality". Arch Intern Med 2012.
7. Continuous Update Project Interim Report Summary. Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer. . World Cancer Research Fund / American Institute for Cancer Research.; 2011.
8. Campbell TC, Parpia B, Chen J: Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Am J Cardiol 1998;82:18T-21T.
9. Campbell TC, Junshi C: Diet and chronic degenerative diseases: perspectives from China. Am J Clin Nutr 1994;59:1153S-1161S.
10. Esselstyn CB, Jr.: Is the present therapy for coronary artery disease the radical mastectomy of the twenty-first century? Am J Cardiol 2010;106:902-904.
11. Strom A, Jensen RA: Mortality from circulatory diseases in Norway 1940-1945. Lancet 1951;1:126-129.
12. Gjonca A, Bobak M: Albanian paradox, another example of protective effect of Mediterranean lifestyle? Lancet 1997;350:1815-1817.
13. Helsing E: Traditional diets and disease patterns of the Mediterranean, circa 1960. Am J Clin Nutr 1995;61:1329S-1337S.
14. Brewer GJ: Iron and copper toxicity in diseases of aging, particularly atherosclerosis and Alzheimer's disease. Exp Biol Med 2007;232:323-335.
15. Brewer GJ: Risks of copper and iron toxicity during aging in humans. Chem Res Toxicol 2010;23:319-326.
16. WCRF/AICR Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. pp. 93: World Cancer Research Fund:93.
17. Lunn JC, Kuhnle G, Mai V, et al: The effect of haem in red and processed meat on the endogenous formation of N-nitroso compounds in the upper gastrointestinal tract. Carcinogenesis 2007;28:685-690.
18. Kuhnle GG, Story GW, Reda T, et al: Diet-induced endogenous formation of nitroso compounds in the GI tract. Free Radic Biol Med 2007;43:1040-1047.
19. Zheng W, Lee S-A: Well-Done Meat Intake, Heterocyclic Amine Exposure, and Cancer Risk. Nutr Cancer 2009;61:437-446.
20. Padler-Karavani V, Yu H, Cao H, et al: Diversity in specificity, abundance, and composition of anti-Neu5Gc antibodies in normal humans: potential implications for disease. Glycobiology 2008;18:818-830.
21. Thissen JP, Ketelslegers JM, Underwood LE: Nutritional regulation of the insulin-like growth factors. Endocr Rev 1994;15:80-101.
22. Kaaks R: Nutrition, insulin, IGF-1 metabolism and cancer risk: a summary of epidemiological evidence. Novartis Found Symp 2004;262:247-260; discussion 260-268.
23. Livestock's Long Shadow: Environmental Issues and Options. Food and Agriculture Organization of the United Nations; 2006.

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By now many of us are familiar with the infamous news of the man who suffered a heart attack last week while eating a Triple Bypass Burger at the Heat Attack Grill in Las Vegas. The very sad part is that onlookers thought it was a stunt and were actually taking pictures of the man’s suffering. Thankfully, as of today, he has survived, but this incident brings up the question, “How did we, as a culture, get to this point?” How did we go from my parents’ generation of surviving the Great Depression by eating dandelion greens and growing gardens out of necessity ~ to today’s Heart Attack Grill slogan that touts, “Tastes Worth Dying For,” and having their 575 lb spokesman die last year at the age of twenty nine?  

And it’s not just the Heart Attack Grill, but popular TV reality shows like Man v. Food where the “big food” offerings of different American cities face off against a pre-existing eating challenge at a local restaurant. During one episode, the show’s host and a group of 40 regional eaters attempted to set a Guinness World Record by eating a 190 pound burger in two hours, in which case “food” won the epic battle with about 30 pounds left of the burger. The Travel Channel, which hosts the show, received its highest rating ever when Food v. Man debuted. Reviews claim, “It’s all in good fun.”

Believe it or not, there’s actually a term for all of this called “food porn.” Basically food porn is glamorizing high fat, high calorie foods and exotic dishes that arouse the desire to indulge in and glorify food. There are many high profile restaurants now sprouting up all over the US that are famous for serving extreme, artery-clogging entrees that customers boast about eating as if they accomplished an Olympic feat.        

All of this reminds me of the story of the frog who died in the pot of boiling water. A frog was sitting in a pot filled with tepid water that was placed on top of a stove. One day, someone came along and turned the burner on; and slowly, but surely, the water became warmer. It was such a gradual, incremental increase of temperature that the frog didn’t notice the heat until it was too late and the boiling water killed it.

Have we become so incrementally desensitized by the sensationalism and preoccupation of eating for disease (aka food addiction) that it’s actually celebrated as a victory to achieve such demise? Is it any wonder that a bag of Doritos can now be considered an afternoon snack before a Super Size Big Mac Meal and large Dairy Queen Blizzard?

It’s all in good fun?

What are your thoughts?

Click here to read the true account of Ronnie Valentine’s bypass surgery at the age of 46.  

image credit:  flickr by Joel Washing

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The intimate link between what we eat and the chemistry of our bodies has been demonstrated once again in a provoking new studying published in the Journal of Clinical Investigation.¹  This study found that high-fat foods, like hamburgers, onion rings, oily pizzas and other regularly consumed fatty foods, actually lead to brain scarring and damage to the hypothalamus- the area of the brain responsible for hunger, thirst and the body’s natural rhythms and cycles.  While the study was done on rodents, its findings remain insightful about what might happen to the human brain when we feed our bodies the unhealthful, high fat diets consumed by most Americans. 

The most prominent finding of the study was that inflammation, or neuron injury, developed in rats and mice just three days after consuming foods fatty meats and refined oils.  Additionally, when the rats remained on this diet long term, permanent damage to the neurons occurred. On the long-term high fat diet, the brain’s attempt to heal the injured neurons resulted in gliosis, a process that leads to scarring in the central nervous system.  The brain’s POMC cells, which play an important role in the body’s fat control system, regulate appetite and prevent excess weight gain, were reduced by over 25 percent.

Given these findings, scientists on the team surmise that losing these critical brain cells is related to why most people who attempt to lose weight by simply reducing calories and exercising more fail to keep the pounds off- they are still consuming high fat American fare that continues to damage the brain’s receptor cells for appetite control and weight gain prevention.

There is much reason to believe that brain damage due to greasy, high fat diets occurs in humans as well as rats.  When examining MRIs of obese and normal weight humans, obese individuals had significantly higher levels of gliosis (brain scarring) that those at healthy weights.  Further studies need to be conducted to determine the connection between brain scarring, brain functioning and weight loss, but it’s safe to say that it’s a good idea to pass on the French fries and cheeseburger. 

It’s also worth noting that fat itself is not bad; it is the type of fat that counts.  The rats in this study were not fed whole food, healthy fats in the form of nuts, seeds and avocadoes, but high fat animal products and fried foods, the deleterious processed types.  As Dr. Fuhrman mentions in detail in his book, Super Immunity, low fat diets can lead to dry skin, thinning hair, muscle cramps, insomnia and poor exercise tolerance among other health problems. 

The moral of this blog post is to avoid processed high fat foods and get enough healthy fats in the form of nuts, seeds, and avocadoes and from supplemental docosahexaenoic acid (DHA) to keep your brain healthy and in tip top shape.

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Olive oil has been hailed as the healthy oil for far too long and it’s about time science triumphed over the almighty media on this relentless myth.  Most people have been taught at some point or read somewhere that olive oil is a healthy oil to be consumed with fervor.  It’s a key component to the Mediterranean diet, which itself has been touted as a heart healthy diet. However, the evidence for these claims just do not stack up and for many people striving to lose weight, it is sabotage city.  

This is the reality: just like all other oils, olive oil is 100 percent fat, lacks a significant nutrient load, contains a whopping 120 calories per tablespoon, that’s fattening.

Some have proposed that extra virgin olive oil is heart healthy because it is rich in polyphenols.  Polyphenols have antioxidant characteristics and studies show that they reduce the risk of cardiovascular disease and cancer.   However, all plant foods are rich in polyphenols and most deliver much more polyphenols (and far fewer calories) than olive oil.   If you rely on olive oil for your polyphenols, good luck getting enough.  You’d need to consume 5 tablespoons of olive oil, the equivalent of 600 calories, just to get 150 mg of polyphenols, the same amount in 55 calories of lettuce, not to mention hundreds of other nutrients and documented benefit in greens.  Study after study links the consumption of leafy greens with healthier, longer, disease-free lives.  Probably because they are loaded with all sorts of nutritious compounds, among them vitamins, minerals, fiber, polyphenols, and various carotenoids.  In comparison, olive oil, has little or none of these.1 In fact, phytosterols and vitamin E are a few of the slim pickings of nutrients found in olive oil that I decided to do a bit more digging on.  Compared to the amount of phytosterols and vitamin E in other foods, olive oil really doesn’t contain that much, as represented in the following chart:

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