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veg in hand

Heart Disease is Preventable and Reversible through Nutritional Intervention

Heart disease is devastating to both our health and our economy. It is the number one cause of death in the country. Cardiovascular disease (CVD) accounted for 32.1 percent of deaths in the United States in 2013 – one out of every three deaths is due to this preventable disease.1 A significant number of research studies have documented that heart disease is easily and almost completely preventable (and reversible) through a diet rich in plant produce and lower in processed foods and animal products.6-9

As the prevalence of CVD escalates, medical costs are rising rapidly. The American Heart Association has projected that by 2030, 40.5 percent of the US population will have some form of cardiovascular disease, and the direct medical costs attributed to cardiovascular diseases will triple compared to 2010 costs.2

Risk factors for heart disease are commonplace for U.S. adults:32.6 percent have hypertension, 13.1 percent have total cholesterol above 240 mg/dl,3 9.3 percent of U.S. adults have diabetes,4 and 68.5 percent of U.S. adults are overweight or obese.5 As a result, it has become considered normal in our society to have atherosclerosis, and to die from cardiovascular disease. If you eat the standard western diet that most people eat in the modern world, you will surely develop heart disease and may die from it.



Fighting heart disease: Superior nutrition versus drugs and surgery

In 2015, I published a scientific article in the American Journal of Lifestyle Medicine demonstrating, with survey data and case histories, the dramatic weight loss and cardiovascular benefits possible with a Nutritarian diet. Respondents who started out obese lost an average of over 50 pounds two years after the switch to a Nutritarian diet. After one year, in those who started out with hypertension, there was a 26 mm Hg average reduction in systolic blood pressure. In respondents who were not taking cholesterol-lowering medication, there was an average 42 mg/dl decrease in LDL cholesterol, and an average decrease in triglycerides of 79.5 mg/dl.10

The surgical interventions commonly used to treat heart disease, such as angioplasty and bypass surgery are futile. The COURAGE trial and additional studies conducted since have documented that patients undergoing those invasive procedures do not live longer or have fewer heart attacks compared to those receiving medical therapy  with modest lifestyle changes.11-12 Surgical interventions are not long-term solutions to heart disease; they merely treat a small portion of a blood vessel, while cardiovascular disease continues to progress throughout the vasculature.

Drugs that treat hypertension and elevated cholesterol carry serious risks and do not stop heart disease from progressing. Cholesterol-lowering statin drugs are known to increase the risk of diabetes, impaired muscle function, cataracts, liver dysfunction and kidney injury. 13 Each different class of blood pressure-lowering medications is associated with its own risks and side effects. ACE inhibitors commonly cause a persistent cough; diuretics are linked to increased risk of diabetes; beta blockers are associated with increased likelihood of stroke; calcium channel blockers may increase risk of heart attack and breast cancer; and ARBs are associated with increased risk of lung cancer.14-20

The risk associated with these treatments is unacceptable when there is a safe, effective alternative —smart nutrition and exercise – that can actually reverse heart disease and obliterate the need for risky and even futile medical care. Atherosclerotic plaque can be reversed, and cholesterol lowered without drugs or surgery.

Rainbow heart of fruits and vegetables

Success stories (two of numerous)

Ronnie weighed over 300 pounds when he wound up needing emergency quadruple bypass surgery.  Three years later, he was back for an angioplasty and three stents, but his chest pain returned within one month of the surgery. Working with Dr. Fuhrman in the Ask the Doctor Community, Ronnie lost 140 pounds and went off all medications. He runs and plays sports and has served as an inspiration to family members who have also lost weight and begun to live healthier lives. Read his story.

Julia had three heart attacks within three months. After her fifth angioplasty, she still had constant chest pain. She was on 10 different daily medications, suffered migraines, and, at the age of 60, could not walk even one block. Today, Julia has lost 105 pounds, and now enjoys every day pleasures like exercise, gardening, and playing with her grandchildren. She went from a “cardiac cripple” to a healthy, happy woman. Read her story.

Like Ronnie and Julia, over the last 20 years hundreds of my other patients with advanced heart disease have demonstrated that dramatic reversal of advanced disease can even occur in a relatively short time.

Following the lenient recommendations of the American Heart Association and wearing a red dress pin do not form an effective strategy for protecting you or your loved ones against heart disease. Also, drugs and surgery do not cure heart disease. A health-promoting, nutrient-dense (Nutritarian) diet, that I have designed and advanced over the years (coupled with exercise) is dramatically effective and protective for preventing and reversing  high blood pressure, high cholesterol and diabetes — as well as heart disease — because it removes the primary dietary cause of heart disease, while providing the most protective and life-span promoting diet-style. For more information, check out my book, The End of Heart Disease.

Everyone needs to know that heart disease can be avoided; and those who already have heart disease deserve to know that they can reverse their disease. Conventional medical care does NOT protect against heart disease-related death. Only a Nutritarian diet can offer dramatic lifespan-enhancing benefits against both cardiovascular disease and cancer.

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient-dense, plant-rich eating style.

References

  1.  Xu J, Murphy SL, Kochanek KD, et al: Deaths: Final Data for 2013. Natl Vital Stat Rep 2016;64:1-119.
  2. Heidenreich PA, Trogdon JG, Khavjou OA, et al: Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement From the American Heart Association. Circulation 2011.
  3. Mozaffarian D, Benjamin EJ, Go AS, et al: Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016;133:e38-e360.
  4. American Diabetes Association: Diabetes statistics [http://www.diabetes.org/diabetes-basics/statistics/]
  5. Ogden CL, Carroll MD, Kit BK, et al: Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311:806-814.
  6. Ornish D, Brown SE, Scherwitz LW, et al: Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133.
  7. Ornish D, Scherwitz LW, Billings JH, et al: Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998;280:2001-2007.
  8. Esselstyn CB, Jr.: Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). Am J Cardiol 1999;84:339-341, A338.
  9. Esselstyn CB, Jr., Ellis SG, Medendorp SV, et al: A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. J Fam Pract 1995;41:560-568.
  10. Fuhrman J, Singer M: Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
  11. Boden WE, O’Rourke RA, Teo KK, et al: Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503-1516.
  12. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, et al: Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet 2009;373:911-918.
  13. Hippisley-Cox J, Coupland C: Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010;340:c2197.
  14. Simon SR, Black HR, Moser M, et al: Cough and ACE inhibitors. Arch Intern Med 1992;152:1698-1700.
  15. Bangalore S, Messerli FH, Kostis JB, et al: Cardiovascular protection using beta-blockers: a critical review of the evidence. J Am Coll Cardiol 2007;50:563-572.
  16. Gupta AK, Dahlof B, Dobson J, et al: Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial–Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. Diabetes Care 2008;31:982-988.
  17. Wassertheil-Smoller S, Psaty B, Greenland P, et al: Association between cardiovascular outcomes and antihypertensive drug treatment in older women. JAMA 2004;292:2849-2859.
  18. Group PS, Devereaux PJ, Yang H, et al: Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008;371:1839-1847.
  19. Li CI, Daling JR, Tang MT, et al: Use of Antihypertensive Medications and Breast Cancer Risk Among Women Aged 55 to 74 Years. JAMA Intern Med 2013.
  20. Sipahi I, Debanne SM, Rowland DY, et al: Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials. Lancet Oncol 2010;11:627-636.
mixed nuts

The Protein Problem: How the source affects cardiovascular risk

Thanks to popular wisdom, we tend to consider animal protein our dietary MVP – it’s associated with building muscle, and high-animal protein weight loss diets are still popular. In contrast, plant protein from vegetables, legumes, nuts and seeds is considered a “second string” source. But as usual, popular wisdom only gets part of the story right. When it comes to protecting your cardiovascular health, it is the source of your protein that matters most.

Many studies have demonstrated that plant protein is beneficial – and animal protein is harmful – regarding outcomes such as cardiovascular disease, cancer, and death from all causes. But new data, gathered by the Adventist Health Study 2, takes a more nuanced look at exactly which types of plant and animal proteins have the greatest impact on your risk of heart disease. Researchers decided to ask which protein-containing foods in particular contribute to increasing or decreasing cardiovascular risk. It will come as no surprise to Nutritarians that nuts and seeds emerged as the most beneficial source of this vital nutrient.

All protein is not equal

In this new study, researchers focused on the specific sources of the subjects’ protein intake. A total of 81,337 participants were asked about their usual intake of these foods during the previous year, and then they were followed for 6-12 years. Data was analyzed to determine the percentage of total protein that came from these animal and plant sources.

Of all the plant and animal protein sources analyzed, risk of cardiovascular deaths steadily climbed with higher consumption of meat protein, and steadily fell with greater consumption of protein from nuts and seeds.

In the groups with the highest meat intake, risk was about 60 percent higher than in the group with the lowest intake. In the group with the highest intake of nuts and seeds, the cardiovascular risk was about 40 percent lower compared to the group with the lowest intake of nuts and seeds.1

These results are consistent with previous research that has compared nuts to meat as a major calorie source.2 Plus, there have now been numerous studies linking higher nut intake to longevity.3

Why is meat so harmful to the cardiovascular system?

  • Meat is high in Advanced Glycation End Products (AGEs), which contribute to vascular damage, especially in people with diabetes.4,5
  • Meat is high in heme iron, which has pro-oxidant effects that promote cardiovascular disease.6
  • Meat contains pro-inflammatory components such as arachidonic acid,7 saturated fat,8 and carnitine.9
  • Meat consumption (and animal protein consumption in general) is associated with weight gain.10,11
  • Meat promotes the growth of unfavorable bacteria that lead to the production of TMAO, which inflames the endothelium and promotes atherosclerosis.9

In addition to cardiovascular disease, diets high in animal protein also promote cancer. Animal protein, which has a higher biological value (compared to plant protein) because of its greater essential amino acid content, is absorbed and utilized quickly by the body. This raises IGF-1 to dangerous levels, which promotes the growth of tumors and enhances fat storage.12-15

Why are nut and seeds so protective?

  • Nuts and seeds are the optimal protein choice for a cardio-protective diet.
  • They are rich in a variety of heart-healthy nutrients: potassium, magnesium, fiber, plant sterols, tocopherols (vitamin E), flavonoids and other polyphenols.16
  • They have been shown to reduce total and LDL cholesterol.17
  • The fat-binding fibers are not absorbed, carrying fat into the stool and toilet.
  • They are highly satiating, promoting a healthy weight.18-20
  • Nuts are rich in arginine and glutamic acid, which aid in the production of nitric oxide and are important for maintaining a favorable blood pressure. 21,22
  • They promote favorable blood glucose levels in studies on patients with type 2 diabetes.16
  • Nut consumption is associated with better vascular (blood vessel) function and reduced oxidative stress.23-25

In addition to their cardiovascular benefits, nuts also facilitate the absorption of vegetable-derived phytochemicals, which increases the anti-oxidant potential and the protective function of immune system cells.24 Calories from nuts and seeds are absorbed very slowly, which means that the body is more likely to use them for energy rather than storage. IGF-1 levels that are too high or too low are detrimental to health, and the major determinant of IGF-1 levels is essential amino acid intake.14,27  A diet rich in plant protein sources (such as seeds, nuts, and beans) provide adequate but not excessive amounts of all of the essential amino acids, enabling the body to modulate (lower) IGF-1 to the most protective levels, without getting too low.28

As protein and fat sources, nuts and seeds are the clear winner over animal products. Nuts and seeds are crucial for cardiovascular health and longevity. Now that’s the kind of wisdom that deserves to be popular.

Quick and delicious ways to put some muscle in your protein

Now that you know why your protein should come from the dirt rather than off the hoof, here are a few easy ways to improve the quality of your diet. And if you have any great tips that work for you, please share them in the comments section!

  • Limit animal protein to no more than 2 ounces in a day.
  • If you have animal protein, skip a day (at least) between servings.
  • Use mushrooms, beans and even crumbled tofu to add a meaty texture to a dish.
  • Eat nuts and seeds with leafy greens to aid in the absorption of fat-soluble nutrients from the greens.
  • Eat some omega-3-rich chia seeds, ground flaxseeds, and/or walnuts every day.
  • Add hemp seeds to a smoothie for a protein (and omega-3) boost.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.

References

  1. Tharrey M, Mariotti F, Mashchak A, et al. Patterns of plant and animal protein intake are strongly associated with cardiovascular mortality: the Adventist Health Study-2 cohort. Int J Epidemiol 2018.
  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. Grosso G, Yang J, Marventano S, et al. Nut consumption on all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies. Am J Clin Nutr 2015, 101:783-793.
  4. Goldberg T, Cai W, Peppa M, et al. Advanced glycoxidation end products in commonly consumed foods. J Am Diet Assoc 2004, 104:1287-1291.
  5. Goldin A, Beckman JA, Schmidt AM, Creager MA. Advanced glycation end products: sparking the development of diabetic vascular injury. Circulation 2006, 114:597-605.
  6. Brewer GJ. Iron and copper toxicity in diseases of aging, particularly atherosclerosis and Alzheimer’s disease. Exp Biol Med 2007, 232:323-335.
  7. de Lorgeril M, Salen P. New insights into the health effects of dietary saturated and omega-6 and omega-3 polyunsaturated fatty acids. BMC Med 2012, 10:50.
  8. Kennedy A, Martinez K, Chuang CC, et al. Saturated fatty acid-mediated inflammation and insulin resistance in adipose tissue: mechanisms of action and implications. J Nutr 2009, 139:1-4.
  9. Koeth RA, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013.
  10. Bujnowski D, Xun P, Daviglus ML, et al. Longitudinal Association between Animal and Vegetable Protein Intake and Obesity among Men in the United States: The Chicago Western Electric Study. J Am Diet Assoc 2011, 111:1150-1155 e1151.
  11. Rosell M, Appleby P, Spencer E, Key T. Weight gain over 5 years in 21,966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford. Int J Obes (Lond) 2006, 30:1389-1396.
  12. Key TJ, Appleby PN, Reeves GK, Roddam AW. Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. The lancet oncology 2010, 11:530-542.
  13. Rowlands MA, Gunnell D, Harris R, et al. Circulating insulin-like growth factor peptides and prostate cancer risk: a systematic review and meta-analysis. Int J Cancer 2009, 124:2416-2429.
  14. Thissen JP, Ketelslegers JM, Underwood LE. Nutritional regulation of the insulin-like growth factors. Endocr Rev 1994, 15:80-101.
  15. Levine ME, Suarez JA, Brandhorst S, et al. Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population. Cell Metab 2014, 19:407-417.
  16. Kim Y, Keogh JB, Clifton PM. Benefits of Nut Consumption on Insulin Resistance and Cardiovascular Risk Factors: Multiple Potential Mechanisms of Actions.Nutrients 2017, 9.
  17. Del Gobbo LC, Falk MC, Feldman R, et al. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr 2015, 102:1347-1356.
  18. O’Neil CE, Fulgoni VL, 3rd, Nicklas TA. Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005-2010. Nutr J 2015, 14:64.
  19. Jackson CL, Hu FB. Long-term associations of nut consumption with body weight and obesity. Am J Clin Nutr 2014, 100 Suppl 1:408S-411S.
  20. Mattes RD, Dreher ML. Nuts and healthy body weight maintenance mechanisms. Asia Pac J Clin Nutr 2010, 19:137-141.
  21. Vasdev S, Gill V. The antihypertensive effect of arginine. Int J Angiol 2008, 17:7-22.
  22. Stamler J, Brown IJ, Daviglus ML, et al. Glutamic acid, the main dietary amino acid, and blood pressure: the INTERMAP Study (International Collaborative Study of Macronutrients, Micronutrients and Blood Pressure). Circulation 2009, 120:221-228.
  23. Katz DL, Davidhi A, Ma Y, et al. Effects of walnuts on endothelial function in overweight adults with visceral obesity: a randomized, controlled, crossover trial. J Am Coll Nutr 2012, 31:415-423.
  24. Kris-Etherton PM. Walnuts decrease risk of cardiovascular disease: a summary of efficacy and biologic mechanisms. J Nutr 2014, 144:547S-554S.
  25. Bullo M, Juanola-Falgarona M, Hernandez-Alonso P, Salas-Salvado J. Nutrition attributes and health effects of pistachio nuts. Br J Nutr 2015, 113 Suppl 2:S79-93.
  26. Brown MJ, Ferruzzi MG, Nguyen ML, et al. Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. Am J Clin Nutr 2004, 80:396-403.
  27. Clemmons DR, Seek MM, Underwood LE. Supplemental essential amino acids augment the somatomedin-C/insulin-like growth factor I response to refeeding after fasting. Metabolism 1985, 34:391-395.
  28. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994, 59:1203S-1212S
beans-legumes

How fiber-rich foods protect against breast cancer

Breast cancer —  two words that strike fear in every woman.  The good news is women can help lessen their risk.  One important defense is to consume a high fiber diet.

A 2011 meta-analysis of 10 scientific studies found that higher fiber intake is associated with lower risk of breast cancer.1 In 2012, another meta-analysis of 16 studies came to the same conclusion.2 In the Nurses’ Health Study, higher fiber intake during childhood and adolescence was linked to a decrease in the risk of breast cancer in adulthood.3

How fiber impacts breast cancer risk

Given that animal products, refined grains, sugars and oils contain little or no fiber, fiber intake is a marker for greater intake of natural plant foods, many of which are known to have a variety of anti-cancer phytochemicals. Some breast cancer protective substances that have already been discovered include isothiocyanates from cruciferous vegetables4, organosulfur compounds from onions and garlic,5 aromatase inhibitors from mushrooms,6 flavonoids from berries,7,8 lignans from flax, chia and sesame seeds,9 and inositol pentakisphosphate (an angiogenesis inhibitor) from beans.10

Influence of fiber, glucose, insulin on breast cancer

High-fiber foods help to slow emptying of the stomach and absorption of sugars, which decreases the after-meal elevation in glucose. This is meaningful because elevated glucose levels lead to elevated insulin levels, which can send pro-cancer growth signals throughout the body, for example via insulin-like growth factor 1 (IGF-1).11 As such, high dietary glycemic index and glycemic load (characteristic of refined grains and processed foods) are associated with an increase in breast cancer risk.12-14  Accordingly, a study on Korean women found that higher white rice intake was associated with higher breast cancer risk.15

Fiber, estrogen, and breast cancer

Increased exposure to estrogen is known to increase breast cancer risk.16-18 A woman may be exposed to estrogen via her ovaries’ own production, estrogen production by excess fat tissue, or environmental sources such as endocrine-disrupting chemicals (like BPA, a chemical added to many consumer products). Fiber can reduce circulating estrogen levels, thereby reducing breast cancer risk, because it helps to remove excess estrogen from the body via the digestive tract. Fiber binds up estrogen in the digestive tract, accelerates its removal, and prevents it from being reabsorbed into the body.19-21

In addition, soluble fiber (as shown in studies using prunes and flaxseed) seems to alter estrogen metabolism so that a less dangerous form of estrogen is produced, whereas insoluble fiber (wheat bran) did not have the same effect. 22,23  For this reason, beans, oats, chia seeds and flaxseeds may provide some extra protection due to their high soluble fiber content.

Foods rich in fiber

Although most people probably just associate whole grains with fiber, beans contain more fiber than whole grains, and vegetables and fruits (and some seeds) contain comparable amounts – here are a few examples:

  • 1 cup cooked quinoa – 5 grams fiber
  • 1 cup cooked brown rice – 4 grams fiber
  • 1 cup cooked kidney beans – 11 grams fiber
  • 1 cup cooked broccoli – 6 grams fiber
  • 1 cup blueberries – 4 grams fiber
  • 1 tablespoon chia seeds – 6 grams fiber

Overall benefits of fiber: promotes weight loss and digestive health

Fiber, by definition, is resistant to digestion in the human small intestine. This means that during the digestive process, fiber arrives at the large intestine still intact. Fiber takes up space in the stomach but does not provide absorbable calories, and it also slows the emptying of the stomach.24 These properties of fiber make meals more satiating, slow the rise in blood glucose after eating and promote weight loss. In the colon, fiber adds bulk and accelerates movement, factors that are beneficial for colon health. Soluble fiber (primarily from legumes and oats) is effective at removing cholesterol via the digestive tract, resulting in lower blood cholesterol levels. Some types of fiber are fermented by intestinal bacteria. The fermentation products, short-chain fatty acids (SCFA) such as butyrate and propionate, have anti-cancer effects in the colon and also serve as energy sources for colonic cells. These SCFA are also thought to contribute to promoting insulin sensitivity and a healthy weight.25,26

Fermentable fiber also acts as a prebiotic in the colon, promoting the growth of beneficial bacteria. Fiber intake is associated with a multitude of health benefits, including healthy blood pressure levels and reduced risk of diabetes, heart disease and some cancers.24,27

Importance of choosing high-fiber and high-nutrient foods

Yes, fiber itself has some breast cancer-protective properties, like limiting glycemic effects of foods and assisting in estrogen removal, but we get optimal protection when we focus on foods that are both rich in fiber and rich in micronutrients and phytochemicals.

G-BOMBS contain fiber along with numerous anti-cancer phytochemicals, however, green (cruciferous) vegetables, mushrooms, flax and chia seeds in particular contain anti-estrogenic substances in addition to fiber, making them more effective breast cancer fighters than whole grains. Remember, beans are higher in fiber (and resistant starch) and lower in glycemic load than whole grains, making beans a better carbohydrate choice.

A Nutritarian diet is designed to include a full portfolio of the most protective foods to prevent cancer and slow the aging process.  Advances in nutritional science make winning the war against cancer a reality in our lifetime.

Dr. Fuhrman has created a Breast Cancer Lecture Series that Will Help Educate On How to Avoid Breast Cancer Through the Power of Nutrition. CLICK HERE to rent or buy!

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.

References:
  1. Dong JY, He K, Wang P, et al. Dietary fiber intake and risk of breast cancer: a meta-analysis of prospective cohort studies. Am J Clin Nutr 2011.
  2. Aune D, Chan DS, Greenwood DC, et al. Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 2012.
  3. Farvid MS, Eliassen AH, Cho E, et al. Dietary Fiber Intake in Young Adults and Breast Cancer Risk. Pediatrics 2016, 137:1-11.
  4. Liu X, Lv K. Cruciferous vegetables intake is inversely associated with risk of breast cancer: A meta-analysis. Breast 2012.
  5. Powolny A, Singh S. Multitargeted prevention and therapy of cancer by diallyl trisulfide and related Allium vegetable-derived organosulfur compounds. Cancer Lett 2008, 269:305-314.
  6. Chen S, Oh SR, Phung S, et al. Anti-aromatase activity of phytochemicals in white button mushrooms (Agaricus bisporus). Cancer Res 2006, 66:12026-12034.
  7. Stoner GD. Foodstuffs for preventing cancer: the preclinical and clinical development of berries. Cancer Prev Res (Phila) 2009, 2:187-194.
  8. Kristo AS, Klimis-Zacas D, Sikalidis AK. Protective Role of Dietary Berries in Cancer. Antioxidants (Basel) 2016, 5.
  9. Bergman Jungestrom M, Thompson LU, Dabrosin C. Flaxseed and its lignans inhibit estradiol-induced growth, angiogenesis, and secretion of vascular endothelial growth factor in human breast cancer xenografts in vivo. Clin Cancer Res 2007, 13:1061-1067.
  10. Maffucci T, Piccolo E, Cumashi A, et al. Inhibition of the phosphatidylinositol 3-kinase/Akt pathway by inositol pentakisphosphate results in antiangiogenic and antitumor effects. Cancer Res 2005, 65:8339-8349.
  11. Gallagher EJ, LeRoith D. The proliferating role of insulin and insulin-like growth factors in cancer. Trends Endocrinol Metab 2010, 21:610-618.
  12. Dong JY, Qin LQ. Dietary glycemic index, glycemic load, and risk of breast cancer: meta-analysis of prospective cohort studies. Breast Cancer Res Treat 2011, 126:287-294.
  13. Romieu I, Ferrari P, Rinaldi S, et al. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 2012, 96:345-355.
  14. Sieri S, Pala V, Brighenti F, et al. High glycemic diet and breast cancer occurrence in the Italian EPIC cohort. Nutrition, metabolism, and cardiovascular diseases : NMCD 2012.
  15. Yun SH, Kim K, Nam SJ, et al. The association of carbohydrate intake, glycemic load, glycemic index, and selected rice foods with breast cancer risk: a case-control study in South Korea. Asia Pac J Clin Nutr 2010, 19:383-392.
  16. Hankinson SE, Eliassen AH. Endogenous estrogen, testosterone and progesterone levels in relation to breast cancer risk. J Steroid Biochem Mol Biol 2007, 106:24-30.
  17. Pike MC, Pearce CL, Wu AH. Prevention of cancers of the breast, endometrium and ovary. Oncogene 2004, 23:6379-6391.
  18. Bernstein L, Ross RK. Endogenous hormones and breast cancer risk. Epidemiol Rev 1993, 15:48-65.
  19. Aubertin-Leheudre M, Gorbach S, Woods M, et al. Fat/fiber intakes and sex hormones in healthy premenopausal women in USA. J Steroid Biochem Mol Biol 2008, 112:32-39.
  20. Aubertin-Leheudre M, Hamalainen E, Adlercreutz H. Diets and hormonal levels in postmenopausal women with or without breast cancer. Nutr Cancer 2011, 63:514-524.
  21. Goldin BR, Adlercreutz H, Gorbach SL, et al. Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 1982, 307:1542-1547.
  22. Haggans CJ, Travelli EJ, Thomas W, et al. The effect of flaxseed and wheat bran consumption on urinary estrogen metabolites in premenopausal women. Cancer Epidemiol Biomarkers Prev 2000, 9:719-725.
  23. Kasim-Karakas SE, Almario RU, Gregory L, et al. Effects of prune consumption on the ratio of 2-hydroxyestrone to 16alpha-hydroxyestrone. Am J Clin Nutr 2002, 76:1422-1427.
  24. Higdon J, Drake VJ: Fiber. In An Evidence-based Approach to Phytochemicals and Other Dietary Factors New York: Thieme; 2013: 133-148
  25. Canfora EE, Jocken JW, Blaak EE. Short-chain fatty acids in control of body weight and insulin sensitivity. Nat Rev Endocrinol 2015, 11:577-591.
  26. Sonnenburg ED, Sonnenburg JL. Starving our microbial self: the deleterious consequences of a diet deficient in microbiota-accessible carbohydrates. Cell Metab 2014, 20:779-786.
  27. Carbohydrates. In Nutritional Sciences: From Fundamentals to Food. Edited by McGuire M, Beerman KA; 2013
Senior Couple Cooking In The Kitchen

A Mature View on Sugar

Sure, there’s nothing new about saying added sugar is bad for you (regardless of your age). Your mom told you, and your doctor says so, too, but you can’t sugar-coat the truth — you love the sweet stuff. So what else is new? Well, it turns out that there is something that is both new and troubling about sugar.

A new study reported that added sugars have been found to have a profound effect in causing frailty in adults over 60. Frailty is defined by meeting three out of five of these criteria: unintentional weight loss, exhaustion, low physical activity, slow walking, and weak grip strength. The frightening consequences of frailty are an elevated vulnerability to falls, disability, and earlier death. (1)

In the study, participants were divided into three groups based on their intake of added sugars. Three years later, those participants who consumed at least 36 g sugar per day (about the amount in one 12-ounce can of soda) had more than double the risk of becoming frail over the follow-up period compared to those who consumed less than 15 g per day. Even after adjusting the group’s results for physical activity, the risk was still elevated more than two-fold in the high-sugar group. (2)

The reason? It could be sugar’s impact on muscle mass. Other research has found that high sugar intake may diminish the body’s ability to maintain muscle mass with age. (3)

And if that wasn’t enough to sour your taste for sweet, the study also found that sugars in processed foods were the most strongly associated with frailty. Given the fact that added sugar is often hidden in processed food — think tomato sauces, yogurt, ketchup and granola bars — this is concerning news for all.

Satisfy Your Sweet Tooth

Fortunately, you can still enjoy the deliciousness of naturally occurring sugars. They were not associated with an increase in frailty risk (naturally occurring sugars in this study included those in fruits and vegetables, but not fruit juices).

Instead of seeking out added sugars, try adding naturally sweet fruits and vegetables (such as carrots and sweet potatoes) to your diet. They provide valuable phytochemicals, such as flavonoids and carotenoids, and – importantly – fiber, which slows the absorption of their sugars, minimizing their glycemic effect.

The Standard American Diet: lots of sugar, very little fruit: (4)

But don’t go overboard with dates and dried fruit. Avoid all sweetening agents including maple syrup and honey.  Excessively sweet foods keep your taste buds accustomed to that excessive sweetness, perpetuating the desire for more sweet foods, which also promotes weight gain. When you consume overly sweetened foods regularly it makes real food such as fresh fruits not taste as spectacular. A piece of fruit for dessert or a small amount of dried fruit to sweeten a sauce or salad dressing is all you need.

Don’t Let Sugar Sour a Good Diet

A healthy diet excludes processed foods and includes a wide assortment of fruits, vegetables, beans, seeds and nuts—with their vast array of phytonutrients.

In a systematic review of many studies, researchers found a low intake of several micronutrients — including vitamin D, vitamin E, vitamin C, folate, vitamin A, vitamin B6, and carotenoids alpha-carotene, beta-carotene, and cryptoxanthin — also had links to frailty. Similarly, biomarkers of nutrient inadequacy were also linked to frailty, such as MMA (a marker of B12 deficiency), and low levels of serum carotenoids, alpha-tocopherol (vitamin E), vitamin D, and vitamin B6. (5) So you see, it is important to not only be aware of the harm caused by add sugar, but also to keep eating healthfully.

The Bottom Line

The good news? A diet with higher antioxidant capacity (like a Nutritarian diet) was associated with a lower risk of frailty.(4)

One of the most important benefit of a Nutritarian diet is that, coupled with exercise, it allows you to enjoy life in your 80s and 90s while gobbling up delicious dishes that even your sweet tooth will appreciate. This eating style not only promotes weight loss in the short term, it is designed to slow aging and maximize longevity. Here’s why:

  • It provides a excellent exposure to micronutrients and antioxidants,
  • It  prevents age-related chronic diseases
  • It helps avoid muscle loss and bone fractures,
  • It optimizes immune function and brain function with aging.

A last note about protein: The loss of muscle mass associated with frailty can be due in part to undernutrition, inadequate protein in particular. The elderly may have less efficient absorption and utilization of protein, which could lead to excessively low IGF-1 levels. Older folks may require a higher and evenly distributed protein intake compared to younger and middle-aged adults to maintain muscle mass. (Read more about this topic.)

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
 
For over 25 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.

References

  1. Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med 2011, 27:1-15.
  2. Barzilay JI, Blaum C, Moore T, et al. Insulin resistance and inflammation as precursors of frailty: the Cardiovascular Health Study. Arch Intern Med 2007, 167:635-641.
  3. Cleasby ME, Jamieson PM, Atherton PJ. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol 2016, 229:R67-81.
  4. Lorenzo-Lopez L, Maseda A, de Labra C, et al. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr 2017, 17:108.
fruits veggies colorful

5 Ways to Amp Up Your Nutrient Intake

Thanks to fad diets, everyone has their own idea of what constitutes a healthy diet – and has a mental list of which foods will never touch their lips again. We’ve all been there: Low-Carb, No-Carb, Paleo, South Beach, Atkins, Gluten-Free, Foods That Match Your Eye Color – you name it. But these diet trends simply cherry-pick a few nutritional facts, served up alongside lots of disinformation.

The simple truth is that a healthful, nutritionally favorable diet means consuming a variety of vegetables, fruits, legumes, nuts, seeds and herbs. Fun fact: each and every plant food has its own distinct nutritional profile. More importantly: there are over 100,000 biologically active chemicals found in plants, agents that offer anticancer, antimicrobial, antioxidant, analgesic, and wound healing effects.

So how do you get those active chemicals to up our chances of living a long and healthy life? Let’s break it down:

1. Eat “the rainbow,” using a variety of natural plant foods.

Ensure that you consume a wide range of phytonutrients, many of which are antioxidants that offer a range of health benefits, from helping you lose excess weight and preventing disease, to slowing brain degeneration. The red in tomatoes comes from lycopene, the orange in carrots and sweet potatoes from alpha- and beta-carotene, the blues and reds of berries from anthocyanins, and the green in spinach and kale from lutein and chlorophylls. A variety of colors means a variety of health-promoting nutrients. 

2. The next time you load up at the grocery store, be sure your cart has these Superfoods.

Greens, Beans, Onions, Mushrooms, Berries and Seeds, known collectively to Nutritarians as G-Bombs. The planet’s best foods should be a part of everyone’s diet every day. Why? According to Dr. Fuhrman, these six magical foods benefit the immune system, can make you slim and healthy, and keep you that way while protecting you from cancer. Here’s just a taste of the power they possess and a simple recipe to help you reap some of their amazing benefits:

  • Greens, cruciferous vegetables in particular provide unique phytochemicals (ITCs) with a variety of cancer-fighting effects. Greater consumption of these vegetables is linked to reduced risk of cancer and cardiovascular disease and a longer life.1-3
  • Beans and other legumes  are rich in fiber and resistant starch, which help keep blood glucose, blood pressure, and LDL cholesterol down, promote weight loss, promote colon health, and nourish the microbiome.4-7
  • Onions and garlic are linked to a reduction in the risk of several cancers, and their distinctive sulfur-containing phytochemicals have a number of actions that benefit the cardiovascular system.8-11
  • Mushroom phytochemicals are unique in their promotion of immune system function and their abiity to inhibit of estrogen production; mushroom consumption is associated with a reduced risk of breast cancer.12-15
  • Berry phytochemicals have anti-cancer and blood pressure-lowering effects, and are linked to a reduced risk of heart attack.  Blueberries in particular have also shown promise for improving brain health, in studies on memory and cognitive function.16-22
  • Seeds and nuts: Eating nuts regularly is associated with longevity, reduced risk of cardiovascular disease, and a healthy body weight. Different seeds have different nutritional benefits; flax and chia, for example, are rich in omega-3 ALA and lignans, anti-estrogenic phytochemicals linked to a reduction in breast and prostate cancer risk.23-27

3. Focus on the nutrient-density of your diet.

A standard weight loss “diet” is one that focuses on controlling portion size and cutting down on junk food. The absolute best diet is one that concentrates on the amount of nutrients that food can provide and their phytonutrient power to protect against cancer. Natural foods with a high nutrient-density contain a significant amount of vitamins, minerals and other healthful substances with respect to their calories. This way of eating, called a Nutritarian Diet, has surged in popularity just as interest in the health benefits of various ingredients – kale, turmeric, berries – has spiked. Superfoods describe not only G-Bombs, but many others, too. For the list of some of Dr. Fuhrman’s must-eat foods, download his infographic 10 Best and 10 Worst Foods. Or for a deeper dive into the foods that benefit health and longevity, read Dr. Fuhrman’s magazine to learn his choices for the planet’s 100 Best Foods.

4. Break the junk food habit.

Processed junk foods are incredibly harmful to our health. They lead to obesity and illness, and cause detrimental chemical changes in the brain, affecting our emotional well being and drive cravings for more junk food. Eating junk food is a learned habit. These foods need to be eliminated entirely from your diet.

Kick start your transformation by cleaning out your refrigerator and pantry so you won’t be tempted with unhealthy foods. Here’s some easy ways to start:

  1. Sauté with water or low-sodium vegetable broth instead of oil
  2. Switch from cow’s milk to unsweetened soy, hemp, or almond milk
  3. Switch from sugar-sweetened breakfast cereal to steel cut oats topped with flax or chia seeds and berries
  4. Add tofu into a veggie scramble instead of eggs
  5. Say no to cheese
  6. Finish your meals with fresh fruit rather than sugary desserts

5. Don’t snack on healthy foods, either.

Learn to eat only at mealtimes, and only when you are hungry. If you are hungry between meals, it means you didn’t eat enough during the meal, so adjust your portions accordingly. Refraining from snacking might be hard to do at first, but it will become second nature after a while.  It is especially important not to eat after dinner before bedtime.

Originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease. Visit him at DrFuhrman.com.

References:

  1. Zhang X, Shu XO, Xiang YB, et al. Cruciferous vegetable consumption is associated with a reduced risk of total and cardiovascular disease mortality. Am J Clin Nutr 2011, 94:240-246
  2. Pollock RL. The effect of green leafy and cruciferous vegetable intake on the incidence of cardiovascular disease: A meta-analysis. JRSM Cardiovasc Dis 2016, 5:2048004016661435.
  3. Higdon J, Delage B, Williams D, Dashwood R. Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis. Pharmacol Res 2007, 55:224-236.
  4. Papanikolaou Y, Fulgoni VL, 3rd. Bean consumption is associated with greater nutrient intake, reduced systolic blood pressure, lower body weight, and a smaller waist circumference in adults: results from the National Health and Nutrition Examination Survey 1999-2002. J Am Coll Nutr 2008, 27:569-576.
  5. Jayalath VH, de Souza RJ, Sievenpiper JL, et al. Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials. Am J Hypertens 2014, 27:56-64.
  6. Bazzano LA, Thompson AM, Tees MT, et al. Non-soy legume consumption lowers cholesterol levels: a meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011, 21:94-103.
  7. Sievenpiper JL, Kendall CW, Esfahani A, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diab tologia 2009, 52:1479-1495.
  8. Rahman K, Lowe GM. Garlic and cardiovascular disease: a critical review. J Nutr 2006, 136:736S-740S.
  9. Powolny A, Singh S. Multitargeted prevention and therapy of cancer by diallyl trisulfide and related Allium vegetable-derived organosulfur compounds. Cancer Lett 2008, 269:305-314.
  10. Bradley JM, Organ CL, Lefer DJ. Garlic-Derived Organic Polysulfides and Myocardial Protection. J Nutr 2016, 146:403S-409S.
  11. Galeone C, Pelucchi C, Levi F, et al. Onion and garlic use and human cancer. Am J Clin Nutr 2006, 84:1027-1032.
  12. Borchers AT, Krishnamurthy A, Keen CL, et al. The Immunobiology of Mushrooms. Exp Biol Med 2008, 233:259-276.
  13. Jeong SC, Koyyalamudi SR, Pang G. Dietary intake of Agaricus bisporus white button mushroom accelerates salivary immunoglobulin A secretion in healthy volunteers. Nutrition 2012, 28:527-531.
  14. Li J, Zou L, Chen W, et al. Dietary mushroom intake may reduce the risk of breast cancer: evidence from a meta-analysis of observational studies. PLoS One 2014, 9:e93437.
  15. Chen S, Oh SR, Phung S, et al. Anti-aromatase activity of phytochemicals in white button mushrooms (Agaricus bisporus). Cancer Res 2006, 66:12026-12034.
  16. Krikorian R, Shidler MD, Nash TA, et al. Blueberry supplementation improves memory in older adults. Journal of agricultural and food chemistry 2010, 58:3996-4000.
  17. Bowtell JL, Aboo-Bakkar Z, Conway M, et al. Enhanced task related brain activation and resting perfusion in healthy older adults after chronic blueberry supplementation. Appl Physiol Nutr Metab 2017.
  18. Stoner GD, Wang LS, Casto BC. Laboratory and clinical studies of cancer chemoprevention by antioxidants in berries. Carcinogenesis 2008, 29:1665-1674.
  19. Cassidy A, Mukamal KJ, Liu L, et al. High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation 2013, 127:188-196.
  20. Cassidy A, O’Reilly EJ, Kay C, et al. Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 2011, 93:338-347.
  21. Johnson SA, Figueroa A, Navaei N, et al. Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial. J Acad Nutr Diet 2015, 115:369-377.
  22. Whyte AR, Schafer G, Williams CM. Cognitive effects following acute wild blueberry supplementation in 7- to 10-year-old children. Eur J Nutr 2016, 55:2151-2162.
  23. Mattes RD, Dreher ML. Nuts and healthy body weight maintenance mechanisms. Asia Pac J Clin Nutr 2010, 19:137-141.
  24. Grosso G, Yang J, Marventano S, et al. Nut consumption on all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies. Am J Clin Nutr 2015, 101:783-793.
  25. Kris-Etherton PM, Hu FB, Ros E, Sabate J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008, 138:1746S-1751S.
  26. Buck K, Zaineddin AK, Vrieling A, et al. Meta-analyses of lignans and enterolignans in relation to breast cancer risk. Am J Clin Nutr 2010, 92:141-153.
  27. Thompson LU, Chen JM, Li T, et al. Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer. Clin Cancer Res 2005, 11:3828-3835.
park-walk-biking

Heart-brain connection: Fitness now protects your brain in your 70s and 80s

Stay fit today; avoid dementia tomorrow

It’s well-known exercise plays a vital role in your physical health, and now studies propose staying fit in midlife may protect your brain as well, avoiding mental deteriation in later years.

A new study, published in Neurology, that followed Swedish women for more than 40 years,  suggests one’s level of physical fitness predicts the amount of protection from dementia decades later.1

Swedish dementia/exercise study began 50 years ago

At the onset of the study in 1968, 191 Swedish women ranging in age from 38 to 60 took part in a vigorous stationary cycling test to measure their exercise work capacity. Based on work capacity, women were split into low, medium, and high fitness categories. The women were followed from 1968 to 2012, and dementia diagnoses were recorded.

The measurement of exercise capacity is an important aspect of the strength of this study –  it was based on the participants’ actual performance rather than relying on participants’ subjective reports of how much, how vigorously, and how often they exercised.

Strong association between fitness and likelihood of dementia decades later

Dementia incidence correlated with fitness level, the greater the fitness level, the less the dementia: 32 percent, 25 percent, and 5 percent of women developed dementia in the low, medium, and high fitness groups, respectively.1 This particular study is one of the longest, following participants for up to 44 years, but shorter studies have come to similar conclusions.2-4

Another very interesting finding: in the subset of women whose initial exercise tests had to be stopped because of issues such as excessively high blood pressure, chest pain, or an abnormal EKG change, almost half (nine out of twenty women) developed dementia. Fit women who did develop dementia did so much later in life. Among the five percent of fit women who eventually developed dementia, the average age of development of dementia was eleven years later compared to the medium fitness group – age 90 vs. 79 – an extra eleven years of dementia-free life.

Midlife fitness also linked to brain volume 19 years later

In another study, the effects of midlife physical fitness on the brain were visualized with MRI. Participants at an average age of 40 performed a treadmill test to determine their exercise capacity. Lower exercise capacity at midlife was associated with smaller total cerebral brain volume 19 years later, suggesting having a higher fitness level helps prevent brain shrinkage with age.5

Diet determines your propensity for fitness

Important to note, one’s fitness level is strongly linked to what you eat.  People who are overweight  as well as those who don’t eat healthfully, do  not have the will, energy or capacity for regular exercise.  When you eat right, you’re more likely to get fit; when you don’t eat right it is very difficult to get fit.

A nutrient-dense, plant-rich diet (Nutritarian) is the most critical determinant influencing whether one gets dementia or not.  When you eat right  you automatically crave exercise and it becomes pleasurable to do so.

This study also demonstrates the wide variety of health benefits, including reduced risk of cardiovascular disease and several cancers when you get fit. Mixing together nutritional excellence and exercise is when the magic happens to protect yourself from the common diseases of aging.  Exercise offers additional benefits to cardiovascular health and insulin sensitivity, as well as some direct effects in the brain, such as the release of protective compounds called neurotrophins.6,7

At any age, fitness is vital for your present and future brain health.

It is never too late to start exercising and you are never too old. Studies have documented cognitive benefits from exercise (strength training and aerobic training) in all age groups, from children to the elderly.6-9  Today is the day to make sure you do both; eat right and get fit.

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
 
For over 25 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.

References

  1. Horder H, Johansson L, Guo X, et al. Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology 2018.
  2. Defina LF, Willis BL, Radford NB, et al. The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study. Ann Intern Med 2013, 158:162-168.
  3. Liu R, Sui X, Laditka JN, et al. Cardiorespiratory fitness as a predictor of dementia mortality in men and women. Med Sci Sports Exerc 2012, 44:253-259.
  4. Willis BL, Gao A, Leonard D, et al. Midlife fitness and the development of chronic conditions in later life. Arch Intern Med 2012, 172:1333-1340.
  5. Spartano NL, Himali JJ, Beiser AS, et al. Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later. Neurology 2016, 86:1313-1319.
  6. Kandola A, Hendrikse J, Lucassen PJ, Yucel M. Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Front Hum Neurosci 2016, 10:373.
  7. Kirk-Sanchez NJ, McGough EL. Physical exercise and cognitive performance in the elderly: current perspectives. Clin Interv Aging 2014, 9:51-62.
  8. Fiatarone Singh MA, Gates N, Saigal N, et al. The Study of Mental and Resistance Training (SMART) study-resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. J Am Med Dir Assoc 2014, 15:873-880.
  9. Mavros Y, Gates N, Wilson GC, et al. Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training. J Am Geriatr Soc 2016.
antioxidant-3445989_640

Does juicing really “detox” the body?

Anything that promises detoxification sounds a little questionable – like products that claim to “pull toxins out of your system” or “cleanse the liver.”  The body does have detoxification mechanisms that are working all the time, and both healthful eating and intermittent fasting can accelerate those processes. Several-day juice “fasts” are one way to tap into the benefits of intermittent fasting and enhance removal of toxins from the body, because the body enhances the removal of toxins when not digesting food and burning more fat for its energy needs. Our fat supply stores toxins, and when we lose body fat we release more toxic waste simultaneously. The body also needs adequate phytochemical and antioxidants for the liver to most effectively process fat-soluble toxins so they can be excreted via the urine.

Get into the catabolic phase

We’re always either in a fed state or a fasting state; you’ve likely read about the anabolic and catabolic phases of digestion in my books or articles that discuss toxic hunger. When we are eating, digesting, and absorbing nutrients from food, we are in the anabolic phase; think of it like filling your car’s tank with gas. That is followed by the catabolic phase, between meals, in which our energy needs are met by burning energy that we stored during the anabolic phase.

The catabolic phase is when most healing and self-repair happens, and there is evidence that prolonged time in this fasting (catabolic) state has significant health benefits. Also, these benefits don’t necessarily require an extended, several-day water fast, which is difficult for most people to commit to.

I always say, the longer you live in the catabolic phase, the longer you live. Here’s why: Being in a fasting state shifts the body’s cells away from growth, and instead toward a mode of maintenance and repair.1,2 This repair mode is associated with a reduction in insulin and insulin-like growth factor-1 (IGF-1) production; two hormones that play a huge role in health and longevity.3,4 These hormonal changes lead to reduced inflammation, improved insulin sensitivity and stress resistance, slower cell growth, improved immune function, and reduced oxidative stress.5,6  Fasting also stimulates autophagy, an important self-repair process. Autophagy removes damaged components from cells and tissues.7

Eating right is already detox; calorie restriction enhances the benefits

On a cellular level, many dietary phytochemicals – such as isothiocyanates derived from cruciferous vegetables, sulfur compounds from garlic and onions, and carotenoids from a variety of colorful produce – drive the production of enzymes that enable the excretion of carcinogens and other potentially harmful compounds. This detoxification system counteracts oxidative stress, inflammation, and DNA damage.8  Eating right, in itself, enables valuable detoxification mechanisms.

Caloric restriction adds to this, and has been the one intervention that extends life in a number of different species. Adding periodic calorie restriction to an already nutrient-rich diet could intensify the body’s ability to heal and repair by extending the amount of time in the fasting repair mode and reducing growth-related signals.4  It also can enhance the breakdown and excretion of fat-soluble toxins; lowering the body’s toxic load.

Intermittent fasting

Intermittent fasting or a juice detox could also be a warm-up to incorporating occasional water fasting. Back in 1995, in my book, Fasting and Eating For Health, I discussed my experience of how fasting improved health parameters in my patients. I also co-authored a series of case reports documenting remission of autoimmune diseases following supervised fasting.9  More recently, fasting has been shown to have dramatic regenerative effects on the immune system. Studies over the past few years in animals and humans have suggested that fasting signals the immune system to discard old and damaged cells and generate new cells by increasing hematopoietic stem cells. The reduction in IGF-1 signaling was a necessary factor in this immune boosting. 6,10

Intermittent fasting – usually by reducing calorie intake dramatically a few days per week – is a method for getting some of the benefits of longer-term fasting. Human studies on intermittent fasting suggest it improves insulin sensitivity and promotes weight loss.2,11,12

I recommend incorporating a juice detox into your life, with vegetable juices plus one salad per day for several days, to act as a method of intermittent fasting, to slow aging and prolong lifespan as an easier alternative to water fasting.  Water fasting has a rapidly decreasing effect at removing toxins, as nutrients necessary for the removal also decrease as the fast progresses. Also, juice fasting enables the participants to continue to work and is safer, compared to water fasting, as it prevents dehydration, loss of electrolytes and fainting. It is also compatible for people who must remain on medications, so almost anyone can participate.

Tips for juicing wisely

  • Figure out a timeline you’re comfortable with. You may want to try juicing one day a week, or you may want to try a week-long juice cleanse.
  • Juice should be mostly vegetables, not fruit. Apple juice with a little kale added doesn’t bring much benefit. The maximum amount of fruit in a vegetable juice should be one serving of a low-sugar fruit, such as green apple or berries. The rest should be nutrient-rich vegetables, leafy greens in particular. Lemon and lime juice can be added to flavor your juice without counting toward the fruit serving. Include cucumber, lettuce and celery juice, along with carrots, beets, and some leafy cruciferous greens such as cabbage, kale or bok choy.
  • Follow it up with a health-promoting diet. A few days of juicing can be a great way to reset your taste buds and jumpstart a new, healthful, nutrient-rich diet. However, there is no health benefit of trying to use a juice cleanse as temporary detox, just a break from an everyday junk food diet. This only works if you stick with a Nutritarian diet for the rest of your life, incorporating some juicing and caloric restriction episodically.
  • If you have a serious medical condition or are on any medication, consult a physician before starting a juice detox.

Originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease. Visit him at DrFuhrman.com.

References

  1. van Niekerk G, Hattingh SM, Engelbrecht AM. Enhanced Therapeutic Efficacy in Cancer Patients by Short-term Fasting: The Autophagy Connection. Front Oncol 2016, 6:242.
  2. Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev 2017, 39:46-58.
  3. Pan H, Finkel T. Key proteins and pathways that regulate lifespan. J Biol Chem 2017, 292:6452-6460.
  4. Solon-Biet SM, Mitchell SJ, de Cabo R, et al. Macronutrients and caloric intake in health and longevity. J Endocrinol 2015, 226:R17-28.
  5. Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab 2014, 19:181-192.
  6. Cheng CW, Adams GB, Perin L, et al. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell 2014, 14:810-823.
  7. Mattson MP, Allison DB, Fontana L, et al. Meal frequency and timing in health and disease. Proc Natl Acad Sci U S A 2014, 111:16647-16653.
  8. Stefanson AL, Bakovic M. Dietary regulation of Keap1/Nrf2/ARE pathway: focus on plant-derived compounds and trace minerals. Nutrients 2014, 6:3777-3801.
  9. Fuhrman J, Sarter B, Calabro DJ. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med 2002, 8:112, 110-111.
  10. Wu S. Fasting triggers stem cell regeneration of damaged, old immune system. In USC News2014 [http://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/]
  11. Antoni R, Johnston KL, Collins AL, Robertson MD. Effects of intermittent fasting on glucose and lipid metabolism. Proc Nutr Soc 2017, 76:361-368.
  12. Tinsley GM, La Bounty PM. Effects of intermittent fasting on body composition and clinical health markers in humans. Nutr Rev 2015, 73:661-67
fries

Eating Junk Food Raises Cancer Risk, Even for Slim Women

Whether you are slim or obese, one thing is clear: calorie-dense processed foods increase cancer risk, regardless of body weight.

Researchers studied data from 92,000 postmenopausal women who took part in the Women’s Health Initiative, a 15-year study of health in postmenopausal women. They focused on the energy density of the women’s diets – “high energy” diets are synonymous with “high calorie” diets – and noted the number of calories per gram of the total diet.

The researchers made an unexpected finding: Women in the top fifth of energy density were 10 percent more likely to be diagnosed with an obesity-related cancer compared to the bottom fifth, and this relationship was found in women who were at a normal weight at baseline.2 These cancers include colorectal, pancreatic, endometrial, ovarian, liver, kidney, gallbladder, and postmenopausal breast cancers.1 This increase in risk was associated with the calorie density of the women’s diets.2

The results suggested: If you choose low-nutrient, energy-dense foods, it will affect your health even if it doesn’t affect your waistline. Just because you’re slim doesn’t mean junk food isn’t damaging your health.

Energy density vs. nutrient density

Dietary energy density in this study was defined as the number of calories per gram in a food of the entire diet. For the most part, typical high energy-dense foods, such as baked goods, French fries, burgers, pizza and desserts, are low in nutrient density (micronutrients per gram). High nutrient-dense foods, such as vegetables, fruits, and legumes, tend to be low in energy density.

Following a diet that is high in nutrient density and low in energy density is essential for good health. This is the origin of my health equation H = N/C (Health = Nutrients per Calorie). A high ratio of micronutrients to calories is the basis of a healthful diet.

How energy density might promote cancer

Obesity contributes to cancer in a variety of ways: for example, excess fat tissue causes a state of low-grade inflammation, promotes insulin resistance, and produces estrogen.1,3-5 6 However, calorie-rich junk food has effects – other than weight gain – that could contribute to cancer development:

  • Elevated insulin and IGF-1 levels: From high-glycemic processed foods and high animal protein foods, respectively. Excess of these pro-growth hormones is linked to an increased risk of several cancers.4
  • Oxidative stress and inflammation.7
  • Nutrient inadequacies:8 Many Americans do not meet recommended intakes of magnesium, calcium, vitamin C, vitamin E, and vitamin K.9
  • Lack of protective phytochemicals from natural plant foods (such as glucosinolates from cruciferous vegetables and lignans from flax and chia seeds).10,11
  • Excess folic acid from fortified refined foods:  Anyone in the U.S. who eats a typical diet (especially those who also take a conventional multivitamin) is exposed to excessive amounts of folic acid due to mandatory fortification of refined grain products. Although rates of neural tube defects have gone down, there are serious concerns about the potential cancer-promoting effects of exposing the whole population to synthetic folic acid daily in the food supply. 12-15  (Read more: Folate Position Paper)

When you eat a diet with more micronutrients and fewer calories, you age more slowly, and also improve immune system protection against cancer.  When you eat excess calories, especially excess calories that do not contain a significant micronutrient load, you accelerate aging and increase your risk of cancer.  You can exercise off those extra calories, but they will still negatively affect your health. It is not enough to be at a healthy weight – you must actually eat healthfully to age more slowly, prevent cancer, and live a long healthy life.

Originally printed on DrFuhrman.com. Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease.  Visit him at DrFuhrman.com

References:

  1. National Cancer Institute: Obesity and Cancer. In 2017 [https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet]
  2. Thomson CA, Crane TE, Garcia DO, et al. Association between Dietary Energy Density and Obesity-Associated Cancer: Results from the Women’s Health Initiative. J Acad Nutr Diet 2017.
  3. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci 2013, 9:191-200.
  4. Cohen DH, LeRoith D. Obesity, type 2 diabetes, and cancer: the insulin and IGF connection. Endocr Relat Cancer 2012, 19:F27-45.
  5. Kolb R, Sutterwala FS, Zhang W. Obesity and cancer: inflammation bridges the two. Curr Opin Pharmacol 2016, 29:77-89.
  6. Cleary MP, Grossmann ME. Minireview: Obesity and breast cancer: the estrogen connection. Endocrinology 2009, 150:2537-2542.
  7. Saha SK, Lee SB, Won J, et al. Correlation between Oxidative Stress, Nutrition, and Cancer Initiation. Int J Mol Sci 2017, 18.
  8. Ames BN. Prevention of mutation, cancer, and other age-associated diseases by optimizing micronutrient intake. J Nucleic Acids 2010, 2010.
  9. Fulgoni VL, 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr 2011, 141:1847-1854.
  10. Stefanson AL, Bakovic M. Dietary regulation of Keap1/Nrf2/ARE pathway: focus on plant-derived compounds and trace minerals. Nutrients 2014, 6:3777-3801.
  11. Shukla S, Meeran SM, Katiyar SK. Epigenetic regulation by selected dietary phytochemicals in cancer chemoprevention. Cancer Lett 2014, 355:9-17.
  12. Smith AD, Kim YI, Refsum H. Is folic acid good for everyone? Am J Clin Nutr 2008, 87:517-533.
  13. Figueiredo JC, Grau MV, Haile RW, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst 2009, 101:432-435.
  14. Kim YI. Will mandatory folic acid fortification prevent or promote cancer? Am J Clin Nutr 2004, 80:1123-1128.
  15. Mason JB. Folate, cancer risk, and the Greek god, Proteus: a tale of two chameleons. Nutr Rev 2009, 67:206-212.
heart-stethoscope

Body Fat Promotes Heart Disease

Risk factors for heart disease – elevated LDL cholesterol, hypertension, elevated triglycerides, inflammation, and blood glucose – are all exacerbated by excess body fat, and overweight/obesity itself is considered a risk factor.1-3

Is it beneficial to be a little overweight?

However, there has been controversy about a potential “obesity paradox” in heart disease: the idea that some amount of excess weight either does not pose any risk or is even protective. Unfortunately, the studies that suggest there may be a protective effect of body fat are often the ones that get more news coverage; but this does a disservice to an already overweight and nutritionally misguided public, allowing them to believe that excess body fat won’t harm their health.

Is there really an obesity paradox? Or is it just that BMI is not a good measure of body fat?

Many of these studies have used body mass index (BMI), however BMI, which only takes into account height and weight, is not an accurate indicator of body fatness. BMI does not distinguish between fat mass and lean mass, nor does it take into account fat distribution (visceral fat vs. subcutaneous fat). Many people whose weights are within the “normal” BMI range are still carrying excess fat.

There has been no evidence providing a convincing explanation of how excess fat could possibly provide a cardiovascular advantage.  Plus, there are numerous medical conditions may cause unintentional weight loss, including depression, anxiety, autoimmune diseases, cancers, and digestive disorders. In the elderly especially, a low BMI may be an indicator of muscle loss and frailty rather than an indicator of a healthy low level of body fat. In short, people who are thinner are not necessarily healthier.

Relationship between body fat and heart disease: using better measures than BMI

A new study  is helping to clear this issue up,4 in a cohort of almost 300,000 people in the UK (age 40-69) who were followed for an average of 5 years. Their first analysis puts the optimal range of BMI for heart disease prevention at 22-23 kg/m2. It was a “J-shaped” association, meaning risk rose both above and below the 22-23 range. But the researchers went further. They used multiple measures of body fatness to get a more accurate picture: waist circumference, waist-to-hip ratio, waist-to-height ratio, and percent body fat.

Ultimately, what the researchers found was that using BMI produces different results than the other indicators. BMI was the only one that showed an increase in risk at the low end (<18.5 kg/m2). When they excluded smokers and participants with pre-existing diseases, the increase in risk associated with low BMI almost disappeared.  The more accurate measures of body fatness – body fat percentage, waist circumference, waist-to-hip-ratio, and waist-to-height ratio – showed a clear trend: more body fat, greater risk.4

More body fat, greater cardiovascular risk

The researchers concluded that the obesity paradox observation mainly occurs due to confounding effects of disease and other factors on BMI, and that the “public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged.”4

As discussed above, a low BMI is often an indicator of disease, rather than an indicator of a healthy weight resulting from healthful eating. The standard American diet (SAD) is fattening. If someone is eating the SAD and is not overweight, there is likely something wrong.

Lose weight permanently on a Nutritarian diet

The dramatic weight loss-promoting effect of the Nutritarian diet contributes to cardiovascular protection. A 2015 study published in the American Journal of Lifestyle Medicine analyzed and reported weight loss results provided by 75 obese patients who had switched to a Nutritiarian diet. The average weight loss was 55 pounds, and very importantly, they kept the weight off. None of these respondents had gained back the lost weight after three years.5

Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease.  Visit him at DrFuhrman.com

References

  1. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci 2013, 9:191-200.
  2. Tchernof A, Despres JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013, 93:359-404.
  3. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017, 135:e146-e603.
  4. Iliodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J 2018:ehy057-ehy057.
  5. Fuhrman J, Singer M. Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.