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

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

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

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

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

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

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

More consequences of inadequate sleep:

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

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

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

References:

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

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Dr. Fuhrman was recently asked by the scientific journal Current Sports Medicine Reports to write a review of the literature and accordingly provide dietary recommendations for vegan athletes. His review was published in the July/August 2010 issue. An abstract of the article, "Fueling the Vegetarian (Vegan) Athlete", can be found on the American College of Sports Medicine's website here. 

A complete summary of Dr. Fuhrman's specific recommendations, specific considerations, a menu plan and recipes for maximum performance can be found in Dr. Fuhrman's Healthy Times Newsletter Issue #42 (available free to Members in the Member Center library). Dr. Fuhrman discusses the links between diet and athletic performance, specifically the role of plant foods in maintaining the health and performance of serious athletes. 

Athletes have specific nutritional needs due to the long-term physical stress of daily intense physical activity.

Athletes require a greater amount of caloric energy than sedentary individuals in order to fuel their training, and are particularly susceptible to certain micronutrient deficiencies as well as viral infections. Dr. Fuhrman's review provides guidance on using dietary means to maintain immunocompetence and to avoid exercise-induced oxidative stress as well as supplementing properly to circumvent deficiencies.

There is a widely held belief that a large amount of animal protein is required in order to build significant muscle or to sustain intense physical activity.

Plant foods are health-promoting, but lower in caloric density than animal foods. They are therefore thought by many to be inferior forms of fuel for athletes, especially in size and strength sports such as bodybuilding. However, the micronutrients in plant foods are indispensable for overall health; maximizing long-term athletic performance requires much more than protein (macronutrient) adequacy, micronutrient density and adequacy are crucial as well. Dr. Fuhrman addresses these issues and gives recommendations for obtaining adequate but not excessive amounts of protein with whole plant foods and also discusses the potentially deleterious effects of excess protein consumption by athletes.

Read Dr. Fuhrman's Newsletter, Fueling the Vegan Athlete.

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People are getting unnecessary medicals test that cost a ton of money? No, you don’t say! A new study in the Journal of the National Cancer Institute reveals large-scale screening for prostate cancer using the prostate-specific antigen, or PSA, test has resulted in mass over-diagnosis and over-treatment:

The death rate from prostate cancer has fallen in the United States, but not necessarily because of mass screening, study co-author Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Medical School's Institute for Health Policy and Clinical Practice contended. "There are a number of reasons why mortality might fall, but the most obvious is that we have better treatment," he said. "Even without early detection, I expect mortality would fall."

Results of a European study reported earlier this year indicated that "to save the life of one man, 50 must be over-diagnosed," he said.

Guidelines for screening for blood levels of PSA -- a protein produced by the prostate gland -- differ widely. The American Cancer Society does not recommend PSA screening. But, the society says a PSA test can be offered to men, starting at age 50, during a discussion with their physician. That discussion should also include an explanation of the potential benefits and limitations of such screening.

It all comes down to money! I asked Dr. Fuhrman about it and he said, “It’s true. Prostate cancer screening in general is flawed, but it is big business and the business of medicine trumps science because of the money to be made.” And Dr. Fuhrman insists the PSA test does not accurately detect cancer anyway.

An important thing to remember is prevention, prevention, prevention! Reports come out all the time highlighting the benefits of plant foods on prostate cancer prevention:

• Less Meat, More Veggies Prevents Prostate Cancer
  

• Pomegranates Slow Prostate Cancer
  

• Vitamin K Battles Prostate Cancer!

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I’ve heard Dr. Fuhrman say that we still don’t know all the healthful properties of plant foods, and a new study seems to confirm that, claiming scientists underestimate the amount of nutrients in fruits and vegetables:

While the polyphenol content of fruits usually refers to extractable polyphenols, new research published in the Journal of Agricultural and Food Chemistry reports that the non-extractable polyphenol content is up to five times higher than extractable compounds.

According to studies with apple, peach and nectarine, previous measures to quantify polyphenols may have been limited by the extraction technique.

"These [non-extractable] polyphenols need to be treated with acid to extract them from the cell walls of fruit in the lab," said lead author Sara Arranz from the Spanish Council for Scientific Research (CSIC) in Madrid. "If non-extractable polyphenols are not considered, the levels of beneficial polyphenols such as proanthocyanidins, ellagic acid and catechin are substantially underestimated."

I asked Dr. Fuhrman about this and his quick answer was, “Repeat after me, fruits, vegetables, seeds, nuts and beans! When you eat whole foods, you get much more than science has been able to measure so far.” And here Dr. Fuhrman explains why foods like green vegetables are so healthy:

While fruits and vegetables are excellent sources of nutrients, the consumption of vegetables is more helpful in reducing cancer because they contain much higher amounts of cancer-protective compounds--especially green vegetables. Among these green vegetables, the cruciferous family has demonstrated the most dramatic protection against cancer. Cruciferous vegetables (broccoli, brussels sprouts, cauliflower, kale, bok choy, collards, arugala, watercress, and cabbage) contain a symphony of phytonutrients with potent anti-cancer effects.

Isothiocyanates (ITCs), which are perhaps the best studied, have been shown to provide protection against environmental carcinogen exposure by inducing detoxification pathways, thereby neutralizing potential carcinogens. These vegetables also contain indole-3-carbinol (I3C). Indole-3-carbinol has been shown to reduce the risk of breast cancer by decreasing estrogen activity.

In related news, researchers determined nutrients and antioxidants in fruits and vegetables, like apples, broccoli and berries, help improve oxygen intake and exercise endurance.

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

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

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

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

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

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

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

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

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

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

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

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This is creepy! A new study in the journal Human Brain Mapping claims obese people have 8% less brain train tissue than normal-weight people. I guess you really do have to be stupid to eat fast food:

Obese people had lost brain tissue in the frontal and temporal lobes, areas of the brain critical for planning and memory, and in the anterior cingulate gyrus (attention and executive functions), hippocampus (long-term memory) and basal ganglia (movement), the researchers said in a statement today. Overweight people showed brain loss in the basal ganglia, the corona radiata, white matter comprised of axons, and the parietal lobe (sensory lobe).

"The brains of obese people looked 16 years older than the brains of those who were lean, and in overweight people looked 8 years older," Paul Thompson, senior author of the study and a UCLA professor of neurology said.

No pun intended, but this is a no-brainer. Dr. Fuhrman insists its America’s poor diet that makes us overweight and sick with chronic disease, same goes for dementia:

The same factors that cause atherosclerosis, leading to heart attacks and strokes, also create dementia, and I am referring to both vascular dementia and Alzheimer’s. This includes the same diets that are high in animal fat and low in vitamins, minerals, fruits, and green vegetables.1 Of course, smoking and lack of physical exercise play a role in these common diseases, but the point is that it does not have to happen to you. These diseases, and others that plague modern America, are not the inevitable consequences of aging. They can actually resolve and improve with age or can be avoided entirely. They are simply the result of years of poor nutrition and an unhealthy lifestyle.

My hope for you is that through this eating-style, you, like my patients who have embraced this program, can rid yourself of migraine headaches, acne, autoimmune diseases, and diabetes. So many of my patients have restored their health after conventional physicians—and the conventional beliefs about the inevitability of disease— told them their problems were going to be life long. Their doctors were wrong.

So to help ensure your diet doesn’t make you demented. Dr. Fuhrman suggests eating plenty of nuts and seeds, like walnuts and pumpkin seeds. They’re packed with brain-building omega-3 fatty acids.

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

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

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

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

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

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

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

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A new study in Journal of the American Medical Association sings the praises of the HPV vaccine Gardasil. Many doctors are hailing it, but others have common sense.

"I don't think we yet know the long term benefits or risks," ABC News Chief Medical Editor Dr. Timothy Johnson said. "I'm taking a pass on this one and saying to parents, 'Study the issue, read the editorial... talk to your doctor.'"

Those who search for more information on the vaccine may also find stories from other parents who say the vaccine had ill effects on their daughters. One of these parents, Emily Tarsell, started her daughter Christina on Gardasil -- a vaccine that protects against four of the most common cancer-causing strains of the human papilloma virus (HPV) -- after her first visit to a gynecologist and at the doctor's recommendation.

Eighteen days after Christina received her final vaccine shot, she died.

And the movement to push legislation requiring Gardasil vaccination in young girls is even more unbelievable. Dr. Fuhrman thinks it’s un-American, comparing it to the Taliban.

The point here is that in this country we allow legislatures to mandate which medications we must give our children? People are not allowed to have an opinion about drugs and vaccines different from the majority opinion, in spite of the controversies and poorly studied short and long-term risks.

Remember this is not about arguing about the effectiveness or value of vaccines, just whether we should mandate medical care and take another freedom away from Americans. We no longer have the freedom to take or not take medications. Sounds like the Taliban to me.

Dr. Fuhrman also points out that Gardasil only protects against 4 strains of the 100 strains of HPV. To learn more about Gardasil’s shortcomings, check out Questioning Gardasil's Safety.

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Alcohol can destroy your health. Last month, studies found alcohol heightens risk of both colon and prostate cancer, but now, new findings in the Journal of Food Science suggest nutrients in asparagus may protect the liver against alcohol toxins associated with hangovers.

Researchers at the Institute of Medical Science and Jeju National University in Korea analyzed the components of young asparagus shoots and leaves to compare their biochemical effects on human and rat liver cells. "The amino acid and mineral contents were found to be much higher in the leaves than the shoots," says lead researcher B.Y. Kim.

Chronic alcohol use causes oxidative stress on the liver as well as unpleasant physical effects associated with a hangover. "Cellular toxicities were significantly alleviated in response to treatment with the extracts of asparagus leaves and shoots," says Kim. "These results provide evidence of how the biological functions of asparagus can help alleviate alcohol hangover and protect liver cells."

Booze is no party, even moderate drinking is suspect. Dr. Fuhrman insists moderate drinking—commonly defined as one drink a maximum of one drink per day for women and two drinks for men—may cause health problems, such extra body fat, cancer and atrial fibrillation.

Consuming more than this is associated with increased fat around the waist and other significant health problems.1 Even a moderate amount of alcohol may also increase the risk of breast cancer in susceptible women.2 The other problem with alcohol, especially more than one drink a day, is it can create mild withdrawal sensations the next day.

These sensations are commonly mistaken for hunger, which leads people to eat more than is necessary. Because of this, moderate drinkers are usually overweight. Furthermore, recent studies have also shown that even moderate alcohol consumption is linked to a significantly increased incidence of atrial fibrillation, a condition that can lead to stroke.3

But asparagus is amazing! Dr. Fuhrman says it’s full of health-promoting vitamins and nutrients, such as calcium and folate. All these plant nutrients help protect against cancer.

Asparagus is one of the most healthful foods on the planet. It leads nearly all fruits and vegetables in the wide array of nutrients it supplies. Ten ounces (one box of frozen spears) have only 68 calories and 9 grams of protein, yet it is like a vitamin pill, giving you a variety of minerals such as selenium, zinc, calcium, copper, and manganese. Plus, it is very rich in folate.

Asparagus has an exceptionally high nutrient-per-calorie ratio and is the perfect weight-loss food. Anti--cancer compounds that have been shown to prevent tumors and cancers in animals are plentiful in asparagus. Asparagus also contains isothiocyanates, indoles, and sulforaphane, powerful compounds that promote cellular rejuvenation with anti-cancer properties.

According to Dr. Fuhrman, asparagus is also an excellent source of Vitamin E, along with whole grains, seeds, nuts, avocados, berries, green leafy vegetables and tomatoes.

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

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

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

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

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

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

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

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

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