Disease Proof

Green and orange vegetable consumption - an indicator of longevity

No matter how many different dietary theories there are out there, pretty much everyone agrees that vegetables are “good for you”. But how good they truly are has been debated – there are plenty of observational studies linking vegetable consumption to favorable health outcomes, but other studies have made headlines by casting doubt on how powerful plant foods are for preventing disease. The data from these observational studies is often flawed simply because the majority of people in the Western world don’t eat enough vegetables to have a measurable impact on their risk of chronic disease – only about 25% of Americans eat the recommended three one-cup servings of vegetables each day.[1] Also, total vegetable consumption isn’t necessarily an accurate indicator of the healthfulness of one’s diet, since some vegetables are far more nutrient-dense than others. Of course, long-term controlled trials of consumption of a high-nutrient vegetable-based (nutritarian) diet have not yet been published (with the Nutritional Research Project, I aim to fill this gap in the medical literature). Some long-term observational studies, however, do provide clear, high-quality data demonstrating that vegetable consumption is an important factor in chronic disease prevention – a recent study on serum α-carotene levels and risk of death provides such data.

Carrots - Flickr: ccharmon

Alpha-carotene is one of over six-hundred different carotenoids, a family of antioxidants that also includes β-carotene, lycopene, lutein, zeaxanthin, and astaxanthin. Carotenoids help to defend the body’s tissues against oxidative damage, which is a natural byproduct of our oxygen-dependent metabolism. [2] Oxidative damage to DNA, proteins, and lipids is a known contributor to chronic disease and an accepted mechanism of aging. The body’s defenses against oxidative damage consist of naturally produced as well as diet-derived antioxidant molecules.

Many prospective studies in the past few years have supported the epidemiologic association between plasma carotenoids and reduced risk of disease and/or death. [3-6] However, these studies didn’t differentiate between carotenoids from food and those from supplements. Carotenoid supplements have failed to duplicate this effect in clinical trials. In fact, supplemental carotenoids are likely to be harmful. A recent meta-analysis of several trials found a 7% increase in mortality risk in subjects taking β-carotene supplements. [7, 8] Also, high serum β-carotene has been associated with decreased lung cancer risk, but β-carotene supplements may increase the risk of lung cancer, especially in smokers.[9] Attempting to duplicate the beneficial effects of carotenoid-rich foods with isolated nutrients is foolish - it completely neglects the contribution of additional and/or synergistic effects of other nutrients contained in those foods.

Beta-carotene is the most widely studied carotenoid, but α-carotene more accurately reflects vegetable intake because α-carotene is not present in most multivitamins and supplements. It is also an excellent marker of high-nutrient vegetable intake, since dark green and orange colored vegetables are the richest sources of alpha carotene. Green vegetables are the highest in overall nutrient density, and of course they are the foods richest in alpha carotene.

This study measured baseline serum α-carotene and tracked deaths in the 15,318 participants over a fourteen-year follow-up period. After controlling for potential confounding factors, the researchers found a significant trend – increasing serum α-carotene associated with decreased risk of death from all causes. Those with the highest serum α-carotene had a 39% decrease in risk of death compared to those with the lowest serum α-carotene. Similar relationships were found between serum α-carotene and risk of death from cardiovascular disease, all causes other than CVD, and cancer.

Serum α-carotene % Decrease in risk of death from all causes
0-1 µg/dl (Reference group)
2-3 µg/dl 23%
4-5 µg/dl (average 4.79 µg/dl) 27%
6-8 µg/dl 34%
≥9 µg/dl  39%

Alpha-carotene itself does provide significant antioxidant benefit –but more importantly α-carotene is a marker of the thousands of additional compounds, working synergistically to keep the body healthy present in green and orange vegetables. [10]

These results suggest that not only quantity of vegetable consumption, but the type of vegetables consumed has a major impact on health. This is the main principle behind the nutritarian diet – eating according to nutrient density. This large, long term study gives much support to the concept of nutritarianism, as many foods high in α-carotene tend to be high in micronutrients overall – the foods that make up the base of the nutritarian food pyramid. And of course keep in mind, even in the highest alpha carotene group in this study, the levels of vegetable consumption as a percent of total calories are likely not nearly as high as in someone following a nutritarian diet. Also, the serum level of alpha carotene in someone following a typical Western diet likely reflects mostly carrot consumption compared to the wide variety of green and yellow vegetables that would be consumed as part of a nutritarian diet, from which further benefits would be expected to accrue from the variety of phytochemicals contained within those vegetables.

Examples of foods with a high α-carotene to calorie ratio[11]:Cabbage - Flickr - La Grande Farmers' Market

  • Bok choy
  • Cabbage
  • Red peppers
  • Carrots
  • Swiss chard
  • Green peppers
  • Asparagus
  • Collards
  • Broccoli
  • Winter squash
  • Peas

 

 

 

 

 

Now imagine if such a study was done on people eating the dietary quality I recommend, which would result in levels even much higher than those in the study, and imagine if a diet of this quality was done for more than 10 years and with other synergistic foods, such as mushrooms, onions, berries and seeds. Just imagine...

 

References:

1. State-Specific Trends in Fruit and Vegetable Consumption Among Adults --- United States, 2000--2009. U.S. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report September 10, 2010 November 24, 2010]; Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5935a1.htm.
2. Krinsky, N.I. and E.J. Johnson, Carotenoid actions and their relation to health and disease. Mol Aspects Med, 2005. 26(6): p. 459-516.
3. Lauretani, F., et al., Low total plasma carotenoids are independent predictors of mortality among older persons: the InCHIANTI study. Eur J Nutr, 2008. 47(6): p. 335-40.
4. Akbaraly, T.N., A. Favier, and C. Berr, Total plasma carotenoids and mortality in the elderly: results of the Epidemiology of Vascular Ageing (EVA) study. Br J Nutr, 2009. 101(1): p. 86-92.
5. Ito, Y., et al., A population-based follow-up study on mortality from cancer or cardiovascular disease and serum carotenoids, retinol and tocopherols in Japanese inhabitants. Asian Pac J Cancer Prev, 2006. 7(4): p. 533-46.
6. Ray, A.L., et al., Low serum selenium and total carotenoids predict mortality among older women living in the community: the women's health and aging studies. J Nutr, 2006. 136(1): p. 172-6.
7. Bjelakovic, G., et al., Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev, 2008(2): p. CD007176.
8. Bjelakovic, G., et al., Systematic review: primary and secondary prevention of gastrointestinal cancers with antioxidant supplements. Aliment Pharmacol Ther, 2008. 28(6): p. 689-703.
9. Druesne-Pecollo, N., et al., Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials. Int J Cancer, 2010. 127(1): p. 172-84.
10. Li, C., et al., Serum {alpha}-Carotene Concentrations and Risk of Death Among US Adults: The Third National Health and Nutrition Examination Survey Follow-up Study. Arch Intern Med, 2010.
11. NutritionData.com: Nutrient Search Tool. 2009]; Available from: http://www.nutritiondata.com/tools/nutrient-search.

 

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Comments (13) Read through and enter the discussion with the form at the end
Eileen - December 3, 2010 12:16 PM

It has been the worst November/December in my life and that is because my beloved Father passed away November 2nd having suffered a massive stroke. I want to share this because I believe so deeply in the principles of high nutrient eating. It will prolong your life. Eating the standard American diet will shorten it, by decades! My Father was only 60 years old!!!

My Dad ate McDonalds several times a week, cookies, ice cream, candy, and sodas almost daily, on top of a fatty meats and white rice for most of his dinners. It breaks my heart to know that he would be alive today if he wasn't a prisoner to the addictive qualities of these foods. It's almost unbearable at times. I miss him tremendously.

I have become obsessed with avoiding such gross and deadly foods for not only myself, but for everyone else that I care about. I have made a promise to myself to share all that I know about nutrition and the dangers of the SAD every chance I get. It is a hard battle to fight though. So many people are not willing to open their minds to the fact that animal and processed foods are detrimental to ones health and that a ETL will provide many health benefits and that it is really quite simple to follow.

It is wonderful to see more of the mainstream media embracing the value of promoting healthier food choices such as fresh fruits and vegetables. It is because of blogs like this that I was able to find a new way to really LIVE life and enjoy the benefits of nutrient dense eating. I feel empowered when I feed my daughter and other loved ones properly. Thank you Dr. Furhman, Emily, Talia, and all the others that contribute to this site. It is the most valuable and appreciated information I have ever found online. My only wish is that I found it sooner.

Gerry - December 3, 2010 12:36 PM

Exellent article Dr. Fuhrman.

The weaknesses in this impressive study, in terms of it's failure to include nutritarian level vegetable consumption, at least in significant numbers, in it's study population is something that is rarely if ever discussed in scientific circles, more less the lay press.

As you well point out, what if the actual effects of a nutritarian diet were measured on a large scale, well controlled population?

Please keep up your work in this important area, maybe society will one day wake up.

Johanna - December 3, 2010 7:30 PM

I was angry when I found out I was eating wrong. We don't learn this information in school, and I certainly didn't learn it at home. Like Eileen, I am extremely grateful that Dr. Fuhrman, Talia, and everyone else is sharing information.

I also try to share this with everyone who will lend their ear. The more people who seek this lifestyle, the more variety and the more the produce department at our local grocery store will stock items of interest to us as nutritarians. Also, the more local restaurants will serve food we prefer to eat. Spreading the word is important!

Chad - December 4, 2010 1:06 AM

Well-written blog with good support. It's so logical when you put it this way. Thanks for making it so clear Dr Fuhrman. I will continue trying to eat the nutritarian way and hope that friends and family will follow suit.

MIke Rubino - December 4, 2010 5:59 AM

It would be wonderfull to think that every father and mother would want nothing but the best for their children and start them from before birth on a colorfull plant based diet full of the vegetables you name . Can you imagine what a healthy nation we would be if that happened ? People are too invested in their food choice to do so however.

Gigi - December 4, 2010 11:55 AM

Thank you so much for this article, I enjoy reading all of the articles on this site.

Bob - December 4, 2010 5:41 PM

In contrast to Eileen's sad story, my dad personifies the superiority of the nutritarian diet. He has been a vegetarian most of his long life, and quit eating dairy and eggs clear back in the 1960s. He is now 96 years old and has a very active life and clear mind. Yesterday he drove 300 miles to be with me and my daughter for our birthdays this weekend. He walks 3 miles per day at least 3 days per week, and does each 3-mile walk in an hour or less. Much of his diet over the years has been from his vegetable garden, and he lives in a place where much fresh fruit is grown, so he can get fruit in inexpensive abundance. He rarely eats anything refined, and only does so when visiting in someone's home who still hasn't learned about the evils of refined foods. Dad continues to be my inspiration as I near retirement age, able to continue a very active lifestyle due to lack of bodily deterioration, I believe mainly due to eating this way as well.

Keep up the great work!

John-Allen Mollenhauer - December 6, 2010 12:51 PM

I find it really exciting to read about new discoveries in nutrient rich nutrition, what Dr Fuhrman is referring to when he says...

"Now imagine if such a study was done on people eating the dietary quality I recommend, which would result in levels even much higher than those in the study, and imagine if a diet of this quality was done for more than 10 years and with other synergistic foods, such as mushrooms, onions, berries and seeds. Just imagine.are revealing the soundness of the nutritarian food pyramid".

...that's a whole new level of nutritional understanding that most of the nutritional research world has yet to enter and the reason NutritionalResearch.org, the project lead by Dr Fuhrman and the National Health Association is so important.

In a world where there are new scientific discoveries every day, most of which are completely out of context and focused on mediocre levels of eating; so many people are unsure about their dietary choices. And this is in light of the overwhelming evidence that a diet, at least 90% or more plant based, nutrient rich whole foods is the way to go.

Articles like this make the difference.

RawGuru - December 6, 2010 5:31 PM

Dark green leafy veggies and dark/bright orange vegetables and fruits have always been what i gravitate towards, especially in the winter. LOVE kobocha squashes and winter squash in general, chard, kale, collards...yummy!

Barb - December 6, 2010 8:09 PM

It is also a very sad time for me. My mother passed away three weeks ago. She had just turned 83 years old. She lived a very healthy & active lifestyle. She was meticulous in her diet consisting mostly of fruits, vegetables, & nuts. She followed many health regimes & practices to ensure & promote a healthy body. Unfortunately, we was diagnosed with a G.I.S.T. tumor 5 years ago. She had surgery to remove the tumor, within 18 months she had another bout with more tumors. She was bedridden until she starting taking Gleevac; it was a miracle drug for her. Never in her life has she had to take medications. However, last November, after taking Gleevac for 3 years her body became immuned to it and it was no longer effective. This past year she tried many different things to no avail and 3 weeks ago passed away. Seeing how religious my mother was with her diet makes it hard for me to understand how/why she came down with cancer. I question how much diet really does matter in the scope of things. She was a wonderful influence & always promoting a healthy lifestyle to her family. I am so disheartened to see how cancer got her in the end. I'm having a hard time believing in a healthy diet.

sandy - December 8, 2010 1:51 PM

I share the anger and sadness about not knowing more sooner. My thoughts after reading Eat to Live were: If only my parents had known this and followed it and taught me.....

I share information on what I eat and why - but mostly people don't want to hear it, say "I could never do that", or are just too lazy. We have been so desensitized to the truth and the POWER of nutrition. I've had to conclude it isn't my job to change the worlds' eating habits - but it is my job to share information. Maybe I'll influence even just one person to make healthier choices.

sally clark - December 8, 2010 4:27 PM

It is up to each one of us to take responsibility for our own health and what food we put into our bodies. Everyone can point to someone who ate the SAD diet and lived longer than would be expected. My father lived to be 95 eating a meat based diet with lots of fat and sweets. However, his generation didn't begin life with alot of processed foods like mine did. I still choose to use my intelligence and eat a vegan diet because I know statistically I am helping my immune system remain strong and will be better able to fight off disease. I have excellent health but I still remain faithful to eating with a conscience. Once you start eating clean, whole foods the thought of contaminating your body with dead meat is revolting..

Ilene - December 10, 2010 9:22 AM

Dear Barb.

I am very sorry for your loss of your mother. When someone loses her mother, it's a loss for us all.

I am also sorry that you might come to the conclusion that your mother's healthy eating lifestyle was a failure, or worse, a fraud. As we know, EFL does not provide immortality, just very high quality living for the number of days that we are allotted. While I know this does little to diminish your grief at this time, I hope it will offer you some hope to continue EFL for yourself. You deserve it.

Very kind regards in this difficult period.

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