Wednesday, March 31, 2010
Not only is fresh pineapple juicy, delicious, and refreshing, but it is also very good for you. Pineapple belongs to the bromeliacea family Bromeliacae foods are named as such because they are packed with bromelian enzymes. Bromelian enzymes help the body balance and neutralize the fluids in the body, ensuring the body is neither too acidic nor too alkaline, it stimulates the pancreas to secrete hormones that aid in digestion and is also an anti-inflammatory. These awesome enzymes promote healing in the body and can only be found in fresh pineapple. The enzymes are destroyed during the canning process (heating/pasteurizing for preservation).
In addition to the bromelian enzymes, pineapples are packed with vitamin C, B1 (smaller amounts of B2, B3, B5 and B6) and it's a great source of manganese, copper, magnesium, potassium, beta-carotene, folic acid and even dietary fiber (that vitamin list makes pineapple a GREAT pre-conception food!). For a detailed nutritional analysis check this site.
Considering the globalization of this great big world of ours, pineapple is readily available throughout the United States 12 months of the year, even if you don't live in Hawaii. Many grocery stores such as Wegmans, Whole Foods and even Acme now neatly package fresh pineapple. If you don't want to pay extra for the convenience purchasing the full pineapple and cutting it yourself is a bit more economical.
When shopping for pineapple, choose one that is golden, heavy and smelling sweet. Be sure to check the bottom is free from decay or moldy spots. Cut off the crown of the pineapple, turn it upside down on a plate and leave it in the fridge a few hours before you plan to eat it. This allows the sweetness of the juice (at the bottom of the pineapple) to evenly distribute throughout the entire fruit. To store cut pineapple, keep it in an airtight container and let it soak in it's own juice. It should keep for up to 1 week.
Please note, pineapple is an extremely sweet fruit with high fructose levels. If you are in good health, pineapple should not pose a problem, however diabetics or those with blood sugar issues should consult their doctor.
I am off to eat some pineapple and plain Greek yogurt for breakfast. Yum!
Keep it Fresh!
We are implementing some changes at the Senior Management Team, effective Thursday, April 1, 2010.
The purpose of these changes is to better align portfolios with the evolving needs of our hospital, our corporate objectives and enhance the strong leadership skill set of our team.
Natalie Bubela will now have the title of Vice-President Regional Programs, Program Integration and Chief Nursing Executive (CNE). As CNE Natalie will have responsibility for the ongoing development and improvement of nursing and allied health professional practice. As VP Integration, she will be responsible for advancing RVHS’ participation in the implementation of the Central East LHIN Clinical Services Plan as well as the development of new program integration and program development opportunities. As VP Regional Programs, Natalie will have ongoing operational leadership for the Cardiac, Cancer and Women’s and Children’s programs.
Sonia Peczeniuk will continue as Vice-President Clinical Support, but will also take on responsibility for the Surgical Program. She will relinquish her role as VP Medical Affairs when our new Chief of Staff starts, likely towards the end of May.
Michele Jordan will be Vice-President Quality Improvement and Transformation. Michele will continue to lead transformation and the deployment of Lean organization wide. She will also take on the role as leading the improvement of quality organization wide. This will include clinical quality, customer service and safety. Michele will also work with me to develop the next iteration of our Strategic Plan on a Page.
John Aldis will continue as Vice-President Corporate Services, but will also take on responsibility for Post Acute Care.
I would also like to welcome Cheryl Williams to the Senior Management Team as Vice-President Acute Care Services. Cheryl will have responsibility for Emergency, Medicine and Critical Care, Mental Health and Patient Flow.
There are no immediate changes to the responsibilities of Darrell Sewell, Rick Gowrie or Dave Brazeau. Dr. Naresh Mohan and Dr. Romas Stas will continue in their roles as key members of the Senior Management Team.
I ask you all to continue to support our new leadership structure and I wish each of our VPs great success in their new roles and responsibilities.
President and CEO
Tuesday, March 30, 2010
Elevated levels of adiponectin are associated with increased insulin sensitivity, and increased fat catabolism (i.e., fat burning). And these associations appear to be causal. That is, adiponectin levels do not seem to be only markers, but causes of increased insulin sensitivity and fat catabolism.
In other words, an increase in circulating adiponectin seems to lead to increased insulin sensitivity and increased fat catabolism. Insulin sensitivity is the opposite of insulin resistance. The latter is a precursor to diabetes type 2, and is associated with elevated fasting and postprandial (i.e., after a meal) glucose levels.
Adiponectin also seems to work closely with leptin, another hormone implicated in a number of diseases of civilization. It appears that adiponecting and leptin modulate each other’s secretion and effects in metabolic processes.
So what do we do to increase our levels of circulating adiponectin?
Well, apparently there is only one guaranteed way, and that is to lose body fat!
Adiponectin is unique among hormones secreted by body fat in that it increases as body fat decreases. Other important body fat hormones, such as leptin, decrease with body fat loss.
The figure below (from: Poppitt et al., 2008) shows a graph where adiponectin levels are plotted against body mass index (BMI). BMI is strongly correlated with body fat percentage.
The linear (Pearson) correlation between BMI and adiponectin levels is indicated as a high 0.551. The fluctuations around the line (the "line" looks more like a quasi-linear curve obtained through quadratic regression), which are why the correlation is not 1, are probably due chiefly to two factors:
- BMI is not a very precise measure of body fat. A very muscular person will have a high BMI and low body fat. That person will consequently have much higher adiponectin levels than an obese person with equal BMI.
- Adiponectin levels are naturally higher in women than in men. This is another point in favor of adiponectin, as women have always been the evolutionary bottleneck among our Paleolithic ancestors.
Now you know why doctors prescribe weight loss to patients with diabetes type 2.
And, when we look at various hunter-gatherer groups that were apparently free of diseases of civilization prior to westernization, there are only a few common denominators. Diet was not one of them, as Weston Price and others have shown us, at least not in the sense of what they included in their diet.
One of the few common denominators was arguably the fact that those hunter-gatherers typically had relatively low levels of body fat; an almost universal feature among non-westernized hunter-gatherers.
Poppitt, S.D. et al. (2008). Postprandial response of adiponectin, interleukin-6, tumor necrosis factor-α, and C-reactive protein to a high-fat dietary load. Nutrition, 24(4), 322-329.
In my opinion, we need to begin at the family level to reeducate families as to what types of foods are good. We need to make better quality food cheaper rather than cheaper foods such as starches (pasta). Instead of paying farmers to grow corn (corn sweetners, ethanol), we should supplement them to grow food and make better foods cheaper. I believe this would be a better way of handling the poor food consumption problem. Perhaps, over time, we will see our diets change for the better
Sunday, March 28, 2010
- This post is a joke, admittedly a weird one, which is why it is labeled “humor” and is filed under “Abstract humor”.
- I apologize for this spoiler. Some people probably like humor posts better if they do not know what they are in advance, but several others may think that reading a post like this is a waste of their time. If you are in the latter category, move on to another post! If not, here it goes …
Today I was spending some time under the sun, in one of the year’s 364 sunny days in Laredo, Texas. The goal was to see if I could obtain a precise count of the number of advanced glycation endproducts (a.k.a. AGEs) that would form as my skin was exposed to the sun’s damaging rays.
Then I read a post by Peter at Hyperlipid, and inspiration consumed me. A new theory was born regarding the interplay of LDL, chylomicrons, HDL, and atherosclerosis. By the way, Peter is a fat genius, by which I mean a genius regarding all fat issues – who happens to be thin.
A key observation forms the main pillar on which this new theory solidly rests:
The endothelium gaps, which let atherogenic particles enter into the forbidden area and do their damage, are around 25 nanometers in diameter. And what is the typical size of LDL particles? You guessed it, 25 nanometers in diameter! And guess what more, quite a few of the chylomicrons, another group of particles that would elicit immediate revulsion in any normal human being, are even smaller than 25 nanometers in diameter; those atherogenic pests!
So here is the theory, in a nutshell. A 500-page book will clearly be needed to discuss it in more detail.
The Devil created LDL particles to kill us all. But LDL particles were not such effective killers, because the Devil, trying to pack as much killer cholesterol into them, ended up making them too big! At 25 nanometers in diameter, on average, they basically had to squeeze their way into the forbidden area.
Since LDL particles were not doing a good enough job, the Devil also created chylomicrons, and those chaotic pests come in all sizes. In fact, it is well known that the word chylomicron has a Greek origin: chylo = killer, micron = particle (Deth & Disis, 1999; full reference at the end of this post).
And, needless to say, LDL particles and chylomicrons are fat particles that make the blood kind of taste and smell like butter, a toxic substance often fed to laboratory rats and known for its powerful carcinogenic properties among all living creatures except descendants of Vlad the Impaler. The latter has long been rumored to have been one of the Devil's best buddies, so no surprise there.
Michael the Archangel, who dislikes the Devil, and usually takes a hands-on approach to dealing with those he dislikes, the Devil in particular, gave us HDL particles. If you have any doubts about Michael’s hands-on approach, check the picture below (from: Wikipedia), which clearly shows what Michael had already done to the Devil. And that was over a relatively minor disagreement.
And don’t think about trying to discredit this theory by asking why HDL particles are so small compared with LDL particles and chylomicrons! This is easy. For the same reason that David was small and Goliath big!
But those nasty particles, the LDLs and chylomicrons, weren't only two big bullies, they were two against one. HDL particles were doing a valiant job at fighting the damage done by the Devil’s two evil particles, but not quite enough to save everybody from atherosclerosis.
Michael cried foul, and threatened to give the Devil another lesson. God, seeing this, said: Michael, no, mankind must be given a choice! If men and women want to gorge on the fatty flesh of the beasts they savagely slaughter, let them sin and face the consequences.
And so it was.
This theory probably needs some adjustments and refinements based on analysis of refereed research, especially solid research supported by drug manufacturers, and consultation with the most interesting man in the world. But I am pretty confident it can, after adjustments and refinements, pass the test of time.
The only nagging problem is the Original Sin. To the best of my knowledge, it was not eating the fatty flesh of beasts. It was eating a very sweet apple …
Deth, R., & Disis, M. (1999, Feb 31). The origins of killer lipids: An evolutionary-theological perspective. The Lipid Review, 123(7), 77-66.
This year I had the opportunity to meet Bijan Anjomi, the author of an amazing book, Absolutely Effortless Prosperity. This book has changed my way of living and my life forever. Bijan helped me realize it's more enjoyable to enjoy the journey (toward the goal). Here are a few tips that may help you be present. Ways to pull yourself out of the past and future, places of residences preferred by the ego and to truly be present in the moment.
1. Each day, spend some time alone. Spend time in silence, meditation or even yoga. Time just sitting. Not reading, knitting, watching TV, talking, scratching, or sleeping. Just sitting. Not even thinking. As thoughts pop up, let them drift away, like clouds floating across the sky.
2. Each day, find something simple in your life that is beautiful, interesting, wondrous, or amazing. Like a spider web. Or a flower. Or the sun reflecting off a colorful bird. Or a sunset. Maybe the moon. A smile. Or the memory of your dog. Something that simply warms your heart. Living in gratitude makes every day better, and there is always something to be grateful for.
3. Each day, decide to listen completely in every conversation. Without second guessing the content you are expecting from the other person. Without finishing the sentences for him or her. Without already preparing your rebuttal to the anticipated conversation. Just listen. Listening is a rare skill these days. It takes practice, and is enhanced considerably by having a quiet, still mind.
4. Quit fighting "what is." Whatever is happening in the present moment is happening, whether or not you like it. It is as it is for now, so increase your level of contentment by accepting each moment as if you have chosen it. Of course, you can take actions to improve your life, but you can't change the present moment because it already is.
This way of being (not doing) takes a little getting used to, but once mastered, it will change your life dramatically. If you want to dive deeper into living in the moment, and attaining effortless prosperity, highly recommend Bijan's book.
Savor every juicy moment!
Keep it Fresh!
Friday, March 26, 2010
Here are some of my notes on a recent trip to Europe. In this trip I spent time in two cities: Amsterdam, Netherlands and Antwerp, Belgium. Below is a set of the photos I took in Antwerp, of a statue depicting the roman soldier Silvius Brabo holding the severed hand of the giant Druon Antigoon.
According to legend Druon Antigoon had terrorized and extorted the people of Antwerp, cutting off the hands of several people and throwing them in the nearby Scheldt River, until the brave Silvius Brabo came into the scene and not only cut off the giant’s hand but also killed him.
This legend has probably been concocted toward the end of the Roman Empire, largely by the Romans, who first established Antwerp as a Roman outpost.
After this small digression, here are some health-related routines that I followed during this trip, and some of my main observations regarding diet and health issues.
On the plane:
- The meals were a festival of hyperglycemic and pro-inflammatory refined carbohydrates, unhealthy vegetable oils, and sugars – white bread, pasta, various sweets, pretzels, chips loaded with supposedly healthy omega 6 fats, margarine etc. I skipped all of the snacks and one of the meals, the breakfast. At the main meal of each flight I ate only meat, veggies, and some of the fruits.
- The flights over and back were very comfortable since I was water-fasting most of the time. Not a hint of indigestion or abdominal discomfort of any kind. These were 9 to 10 hour flights, from Houston to Amsterdam and back.
At business luncheons:
- The idea of having a sandwich for lunch seems to be getting popular in Europe. At least I have been seeing that happening more and more often lately. At these sandwich luncheons, I ate only the content of some sandwiches (basically cold cuts, cheese and veggies), and left the bread slices untouched.
- Some people noticed that I was not eating bread. I told them about insulin, lectins etc. A few looked at me as though I was insane; others with a disapproving look – dontchano, the lipid hypothesis!? A notable exception was a German gentleman who said that Germans were too pragmatic not to notice that they were getting fat on low fat diets, and are now reverting back to their staple diet of meats, fish, vegetable stews, and cheese.
At restaurants for dinner:
- This was fairly easy. I ate basically fish or meat dishes with veggies, and enjoyed them a lot. I skipped the deserts; again much to the surprise of some of my European colleagues.
- Skipping the desserts seems to have helped me cope with jetlag a lot better than I usually do. On my second day in Europe I slept quite well, and was unusually rested on the next day.
At the hotel:
- The breakfast buffets were a mix of: (a) breads, pastries, sweetened cereals, sugary items, and fruits; and (b) meats (often cured), some fish, cheeses, eggs, nuts, and some veggies. There were also fruit juices. I had solid breakfasts with (b)-type items, with a few fruits added (cantaloupe and berries). I had regular coffee with cream and no sugar, and stayed away from fruit juices.
- I did not use soap, shampoo etc. at the hotel; just plain water. Occasionally the soap used in hotels is very caustic, or rich in other chemicals, causing rashes. I stuck with showers and had no baths, as sometimes the bathtubs are not properly cleaned after their last use.
- At the end of my trip I took a train from Antwerp to Amsterdam, and stayed at a hotel near the Schiphol Airport (which has its own train station) since my flight back to the U.S. was in the morning. I had dinner by myself at the hotel, which was easy. I stopped at a place called Food Village at the Airport (visible from the Airport’s main entrance) and bought a water bottle, a piece of Gouda cheese, a can of sardines, and a box of seaweed. That was a very good dinner, and cost me about 6 euros.
The outcomes for me:
- I had no hint of indigestion at all throughout the trip, in spite of eating way more cheese than I normally do. The cheese that I ate was natural, aged cheese, not the processed kind.
- I had no need for more or less use of the bathroom than I usually do, and remained “regular” throughout the trip. No sign of constipation at all.
- I had no body odor (at least none that I could notice), even though I used no soap. My hair was fine too; I used no shampoo or conditioner.
- Jet lag problems were less pronounced than they usually are when I travel to Europe. The time difference is about 7 hours from Texas. Usually, I tend to feel very sleepy in the afternoon and wide awake around 3 am. Not this time.
- In spite of not exercising for about 7 days, except for walking, I was able to lift slightly heavier weights at a workout the day after my return than I did before my trip.
- According to the scale, I lost 1 pound during this trip. I do not know whether this was body fat or just water. It is unlikely that there was any muscle loss.
From what I could see, Europeans are generally thinner than Americans (particularly Texans), and also seem to be healthier. None of the people I met, not one, was clearly obese. On the other hand, the majority seemed to be somewhat overweight.
My impression was that the Europeans consume lesser amounts of refined carbohydrates and sugars than Americans, on a weekly basis, even though they currently consume more of those items than they should, in my opinion.
Consumption of vegetable oils other than olive oil is also lower than in the U.S; consumption of butter and cheese seems to be a lot higher.
From my conversations with several people during this trip, it seemed that the health of Europeans, like that of their American counterparts, is strongly correlated with the extent to which they are overweight. The more body fat, the more common was to hear complaints about pain here or there, fatigue, degenerative diseases, or talk about surgeries.
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- Decrease free-radical damage to DNA, which is known to produce cancerous mutations;
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- Brussels sprouts
- Black pepper
- Green tea
- Brussels sprouts - ½ cup
- Broccoli, cauliflower, cabbage - ½ cup
- Garlic - 2 cloves
- Onions, shallots - ½ cup
- Spinach, watercress - ½ cup
- Soy (edamame, dry roasted beans) - ½ cup
- Freshly ground flaxseeds - 1 tablespoon
- Tomato paste - 1 tablespoon
- Turmeric - 1 teaspoon
- Black pepper - ½ teaspoon
- Blueberries, raspberries, blackberries - ½ cup
- Dried cranberries - ½ cup
- Grapes - ½ cup
- Dark chocolate (70 percent cacao) - 40 g
- Citrus juice - ½ cup
- Green tea - three 250 ml servings
- Red wine - 1 glass (5 ounces)
Click here for more information about James P. Meschino, DC, MS.
In todays health care environment, we have used fear quite effectively in getting people to undergo many tests and screenings of dubious value and placing them on substances all paid for by a system that is slowly going broke by this. The worst part of it all, is that people are not necessarily leading better lives because of these interventions and periodically have procedures done at great cost that left them worse off with no benefit, all paid for by us. I question all the people on cholesterol meds who would likely feel better and have fewer problems in their muscles and bodies without them. I question all the people taking Dexxa scans and being put on bone forming meds which have their own side effects which is done because there is a remote possibility that they will have problems when they are in their 80's from compression fractures maybe.
Of course, in the article it also raises the point of when to use technologies. At the end of life, we still die yet many of us die in the ICU rather than in the comfort of our homes and at great cost as well. As your parting gift, we drain your bank account for you and you die miserably. Is this an intelligent and even humane paradigm (pardon my sarcasm).
Maybe, we need the wellness model after all, where people are taught how to stay healthy vs. obsess about weather we are going to be sick or not.
What do you think? I welcome your thoughts and comments.
Thursday, March 25, 2010
1. Dr. Neil D. Barnard reviews food consumption patterns in the US from 1909 to 2007 (1). This is something I've written about a number of times. The most notable change is that industrial seed oil use has increased by more than 3-fold in the last 40 years, and even more in the last 100 although he doesn't provide those numbers. Butter and lard use declined sharply. Meat consumption is up, but the increase comes exclusively from poultry because we're eating the same amount of red meat we always have. Grain consumption is down, although it peaked around 1900 so it may not be a fair comparison with today:
In the late 1800s, wheat flours became more popular and available due to the introduction of new [high-gluten] wheat varieties, [low extraction] milling techniques, and transport methods, and during this time new breakfast cereals were introduced by John Harvey Kellogg, CW Post, and the Quaker Oats Company. Thereafter, however, per capita availability of flour and cereal products gradually dropped as increased prosperity, improved mechanization, and transport (eg, refrigerated railway cars) increased competition from other food groups. [Then they partially rebounded in the last 40 years]2. Dr. S.C. Larsson published a paper showing that in Sweden, multivitamin use is associated with a slightly higher risk of breast cancer (2).
3. Soy protein and isoflavones, which have been proposed to do everything from increase bone mineral density to fight cancer, are slowly falling out of favor. Dr. Z.M. Liu and colleagues show that soy protein and/or isoflavone supplementation has no effect on insulin sensitivity or glucose tolerance in a 6 month trial (3). This follows a recent trial showing that isoflavones have no effect on bone mineral density.
4. Dr. Ines Birlouez-Aragon and colleagues showed that high-heat cooked (fried and sauteed) foods increase risk factors for diabetes and cardiovascular disease (insulin resistance, cholesterol, triglycerides), compared to low-heat cooked foods (steamed, stewed) in a one-month trial (4). The high-heat diet also reduced serum levels of long-chain omega-3 fatty acids and vitamins C and E.
5. Dr. Katharina Nimptsch and colleagues showed that higher menaquinone (vitamin K2) intake is associated with a lower cancer incidence and lower cancer mortality in Europeans (5). Most of their K2 came from cheese.
6. And finally, Dr. Zhaoping Li and colleagues showed that cooking meat with an herb and spice blend reduced the levels of oxidized fat during cooking, and reduced serum and urinary markers of lipid oxidation in people eating the meat (6).
The take-home message? Eat stewed beef with herbs, but don't pre-brown it in vegetable oil. Throw out the tofu and have some artisanal cheese instead.
In case you're wondering, that's not a picture of the Jersey Shore, it's a picture of South Beach, Miami - where I was this past weekend. Don't be too jealous, the weekend wasn't all sun and fun. In fact, out of 4 days, I think I spent a total of 30 minutes on the beach. I was in Miami for an Integrative Nutrition conference and spent each day in the chilly, air conditioned Miami Beach Conference Center. While I am not returning to to a cooler Jersey Shore completely sun kissed, I am completely rejuvenated and inspired! The conference was about taking your health coaching practice to the next level.
The majority of the weekend consisted of copious amounts of important tips and information on marketing, social networking and the like from healthy marketing rock stars Robert Notter and Karin Witzig Rozell. Totally helpful and definitely important. But I really have to say that the highlight of the conference for me was the talk given by one of our Friday Friends, Taraleigh Silberberg, the Health Hippie. While Tara is a friend and a mentor, hearing her speak in front of over 100 other health coaches was completely different....and not to be melodramatic, but life altering. Yep. I said it. Life altering.
Tara spoke about writing your own person/business mission statement so you can life a life of purpose and passion. Even though it sounds simple, I can't begin to articulate how empowering it was. In my final hours in Miami, I gained so much clarity and felt so much passion for what I do and where I want to take my business. I came back to the Jersey shore on a wellness high. That clarity is the catalyst for this post about change.
Change is a little scary, but this change resonates so deeply with me I am positive it it the right choice. My newsletter (Vibrant Health, Green Living) won't be going out won't be going out to my subscribers for another week or so, but as one of the 3 Healthy Chicks I thought I should give my readers a glimpse of what's in store as it affects my blogging here!
First, a name change. Terra Wellness is now Sprouting Wellness.
Second, it is my intention to keep my blog entries for 3HC Living Fresh in line with my business mission:
Don't worry, I wont ostracize the men folk and if I feel the need to blog about something not even remotely related to girly bits, like my dog or cute yoga clothes, you bet I will. :)
Change is GREAT!!!
Keep it Fresh!
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Keep it fresh!
Wednesday, March 24, 2010
Let us take a look at the actual Harvard study itself (i.e., the study discussed in the BBC article). The Harvard study is linked here.
This post, by Stephan Guyenet, already pointed out several problems with the study. Stephan actually reviewed the studies used in the meta-analysis, and also some that were excluded in the meta-analysis and that he believes should have been included.
Here are a few other problems, in addition to the ones already pointed out by Stephan:
One thing that looks suspicious about this Harvard meta-analysis study is that they say that: “Statistical evidence for substantial between-study heterogeneity was not present (Q-statistic p = 0.13; I2 = 37%).”
A meta-analysis is a study that essentially summarizes, in a statistically sophisticated way, a bunch of other studies (the “sourced” studies). Too much between-study heterogeneity (i.e., widely disparate results among sourced studies) is undesirable, because it can bias the results.
The problem is similar to that of trying to summarize net worth figures (e.g., by calculating their average) in a middle class neighborhood that happens to have a few billionaires living in it. The heterogeneity in wealth may lead to a wildly overestimated average.
Now, we know that p values go down with sample size, and are usually high with small samples unless the effect measured by the statistic is very strong, regardless of the statistic used.
Well, with a sample of only 8 studies, their p value (associated with the Q statistic) is close to being significant at the 0.05 level!
If this sample of sourced studies were a little higher (say, 20), there would be significant between-study heterogeneity, which would call the meta-analysis into question. This is a big problem, since a good meta-analysis is expected to include a large number of studies (e.g., greater than 100), and this one included only 8 studies.
Moreover, to the best of my knowledge, the Q statistic is not very reliable when used with small samples, due to its low power as a test of heterogeneity. This makes the p value reported even more problematic.
Finally, the sourced study with the largest sample (n = 9,057; thus possibly the most credible), indicated as “Minnesota CS” on Figure 2 of the Harvard study, found increased risk of heart disease associated with increased consumption of polyunsaturated fats and reduced consumption of saturated fats.
Mozaffarian, D., Micha, R., & Wallace, S. (2010). Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS Med., 7(3): e1000252. doi: 10.1371/journal.pmed.1000252.
So, say you're past the honeymoon eyes phase and onto the seed germination phase....conception...baby making. Does one have to do with the other? Does it even matter what passes your lips? You betcha it does!!
Hundreds of years ago, before people really knew what vitamins, minerals and nutrients were all about, people attributed qualities such as shape (ie: foods in the shape of sexual organs such as oysters and figs) or the food's ability to make your temperature rise (e.g. chili peppers or curry) to increased potency or fertility.(P.S. That's a picture of a fresh fig, one of my favorite fruits!) Aphrodisiacs aside, diet really can affect your ability to conceive. Positively and negatively. And believe it or not, there's actually a bit more to aphrodisiacs than the shape and temperature of the food!!
The fun part is the food and creative love....aphrodisiacs! After conducting a little research on traditional aphrodisiacs and their nutritional content I found the correlation between tradition aphrodisiacs and preconception health to be uncanny! The ancient ones who ate whole foods rather than processed, chemicalized foods always got it right. Just check out a of the aphrodisiacs on the list below:
Avacado: The Aztecs called the avocado tree "ahuacuatl," which means "testicle tree" (avacados hang in pairs on the tree). Avacados provide nearly 20 essential nutrients, including fiber, potassium, Vitamin E, B-vitamins and folic acid, all of which are essential for preconception health!
Bananas: Do I really have to articulate why a banana is an aphrodisiac? Besides the banana flower's amazing phallic shape, bananas are rich in potassium and B vitamins, necessities for sex hormone production. Bananas also provide 452 milligrams of potassium, 33 milligrams of magnesium, and just over 2 grams of fiber. They are high in potassium and a respectable amount of magnesium as well.
Chocolate: See, there really IS a God and the Aztec's called chocolate the "nourishment of the Gods." Not only is chocolate a superfood, it contains more antioxidants than red wine! So if you really want more bang for your buck, try sharing a glass of Cabernet with a small piece of dark chocolate.
Oysters: have been linked with love and sexuality for hundreds of years. The ancient law of similarities reasons that their similarity to female genitalia dictates they may in fact possess sexual powers!! Similarities aside, oysters are full of vitamins and minerals like A, B1, B2 ,C and D, calcium, iodine, iron, potassium, copper, sodium, zinc, phosphorous, manganese and sulphur and the all-important omega-3 fatty acids.
Pineapple: has been traditionally used as a homeopathic treatment for impotence. It's an excellent source of the trace mineral manganese, vitamin C and a good source of vitamin B1, copper, dietary fiber and vitamin B6.
Other aphrodisiacs include almond, arugula, asparagus, basil, broccoli rabe, carrots, fennel, figs, garlic, ginger, honey, licorice, mustard, nutmeg, pine nuts, raspberries, strawberries, truffles, vanilla, and wine.
In Part II of Food and Creative Love: Eating for Fertility and I will provide a few recipes to boost your fertility while tickling your taste buds! This blog entry has been so fun to research I may just develop a workshop from it!
Keep it Fresh!
Tuesday, March 23, 2010
Sourcing bias is a notorious problem with meta-analyses (i.e., the choice of studies to use in a meta-analysis). Another problem is that you cannot tell what the studies sourced controlled for. Consider a study that compares health markers for smokers and non-smokers, where the smokers eat more saturated fat than the non-smokers. This study may confuse the effect of smoking with that of saturated fat consumption. To be reliable, the study must analyze the effect of saturated fat consumption, controlling for smoking habits.
There are other statistical issues to be considered in meta-analyses. For example, some of the sourced studies may take nonlinear relationships into consideration and others not. In multivariate analysis studies, nonlinearity may lead to significantly different results from those obtained through more conventional linear analyses.
Finally, reaching misleading results with sound statistical analyses is not that hard. As my age went from 1 to 20 years, my weight was strongly correlated with the price of gasoline. Yet, neither my weight caused the price of gasoline, nor the other way around. When you look at an individual study, not a meta-analysis, you can at least try to identify the possible sources of bias and mistakes.
Having said that, a solid refutation of the main argument in the article can be made from many angles. Here is a simple refutation based on what I would call the “HDL cholesterol angle”, with links to posts and various refereed publications:
- Increasing HDL cholesterol levels, especially beyond 60 mg/dl, dramatically decreases the risk of heart disease; and this is an almost universal effect in humans. This reduction in risk occurs even for people who suffer from diabetes and familial hypercholesterolemia. The latter is a genetic condition that is associated with very elevated LDL cholesterol and that is rare, typically afflicting 1 in 500 people in its heterozygous (and most common) form.
- Increasing consumption of saturated fats (present in: lard, fatty meat, coconut oil) and dietary cholesterol (from: fish, organ meats, eggs), while decreasing consumption of refined carbohydrates (e.g., pasta, white bread) and sugars (e.g., table sugar, high fructose corn syrup), significantly increases HDL cholesterol for the vast majority of people. Neither omega-6 nor omega-3 polyunsaturated fats lead to the same results. Omega-3 fats do reduce triglycerides, and increase HDL somewhat, but their effect on HDL pales in comparison with that of saturated fats. Excessive consumption of omega-6 fats is associated with chronic inflammation and related health problems.
- With the exception of cases involving familial hypercholesterolemia, there is no conclusive evidence that LDL cholesterol levels are associated with heart disease. Two widely used online calculators of risk of heart disease, based on the Framingham Heart Study and the Reynold Risk Score, do not even ask for LDL cholesterol levels to estimate risk. And that is not because they calculate LDL cholesterol based on other figures; they do not ask for VLDL cholesterol or triglycerides either.
After reading the BBC article again, it is clear that they are re-stating, in general terms, Rudolph Virchow’s mid-1800s lipid hypothesis. And they do so as if it was big news!
These findings provide evidence that consuming PUFA in place of SFA reduces CHD events in RCTs [how do you like the acronyms?]. This suggests that rather than trying to lower PUFA consumption, a shift toward greater population PUFA consumption in place of SFA would significantly reduce rates of CHD.Looking at the studies they included in their analysis (and at those they excluded), it looks like they did a very nice job cherry picking. For example:
- They included the Finnish Mental Hospital trial, which is a terrible trial for a number of reasons. It wasn't randomized, appropriately controlled or even semi-blinded*. Thus, it doesn't fit the authors' stated inclusion criteria, but they included it in their analysis anyway**. Besides, the magnitude of the result has never been replicated by better trials, not even close.
- They included two trials that changed more than just the proportion of SFA to PUFA. For example, the Oslo Diet-heart trial replaced animal fat with seed oils, but also increased fruit, nut, vegetable and fish intake, while reducing trans fat margarine intake! The STARS trial increased both omega-6 and omega-3, reduced processed food intake, and increased fruit and vegetable intake! These obviously aren't controlled trials isolating the issue of dietary fat substitution. If you subtract the four inappropriate trials from their analysis, which is half the studies they analyzed, the result disappears. Those four just happened to show the largest reduction in heart attack mortality...
- They excluded the Rose et al. corn oil trial and the Sydney Diet-heart trial. Both found a large increase in total mortality from replacing animal fat with seed oils, and the Rose trial found a large increase in heart attack deaths (the Sydney trial didn't report CHD deaths, but Dr. Mozaffarian et al. stated in their paper that they contacted authors to obtain unpublished results. Why didn't they contact the authors of this study?).
So basically, even if the authors' conclusion were correct, you overhaul your whole diet and replace natural foods with bland unnatural foods, and...? You reduce your 10-year risk of having a heart attack from 10 percent to 9 percent. Without affecting your overall risk of dying! The paper states that the interventions didn't affect overall mortality at all. That's what they're talking about here. Sign me up!
* Autopsies were not conducted in a blinded manner. Physicians knew which hospital the cadavers came from, because autopsies were done on-site. There is some confusion about this point because the second paper states that physicians interpreted the autopsy reports in a blinded manner. But that doesn't make it blinded, since the autopsies weren't blinded. The patients were also not blinded, so the study overall was highly susceptible to bias.
** They refer to it as "cluster randomized". I don't know if that term accurately applies to the Finnish trial or not. The investigators definitely didn't randomize the individual patients: whichever hospital a person was being treated in, that's the food he/she ate. There were only two hospitals, so "cluster randomization" in this case would just refer to deciding which hospital got the intervention first. Can this accurately be called randomized?
Monday, March 22, 2010
The article states that:
The company also set two goals for the next 10 years: to cut the average added sugar per serving by 25 percent and saturated fat per serving by 15 percent, in addition to adding more whole grains, fruits, vegetables and low-fat dairy into its array of products.While it is nice to see more of a focus on sugar than on saturated fat, I would have preferred to see something like this:
The company also set two goals for the next 5 years: to cut the average added sugar per serving by 95 percent and increase saturated fat per serving by 50 percent, in addition to adding more vegetables and full-fat dairy into its array of products.What would happen? Well, Indra Nooyi is a very smart CEO, and the company has many competent people. They know that they would probably lose enough customers to go out of business … or become the Apple of their industry.
The bottom line is that, if you want to improve your health, you should generally avoid any food or liquid that is highly industrialized.
Maybe PepsiCo should add unprocessed coconut water to their portfolio of drinks.
Saturday, March 20, 2010
With genetics, even if you spent thousands to decode your genome (genetic map), we simply do not know enough about genetics to say that if someone has a certain genetic makeup, they will develop diseases. A number of years ago, we paid for BRAC1 and BRAC2 testing (http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA) which are known as cancer genes. The thought is that if you had these genes, you are most likely to get breast or ovarian cancers will enter the minds of many women who are diagnosed. Some women are so afraid of the cancer after being diagnosed, they have their breasts removed preventative, even though nothing is wrong simply based on fear. The question we should all ask ourselves is that if we find out we have a gene and it is suspected to be potentially harmful, will it be and if so, what will trigger the problem? The problem is that we do not understand genes or these processes well enough to use this information constructively and our fears will create many unneeded treatments and procedures that can be worse than the gene itself?
What do you think? I invite your opinions. Check us out at www.backfixer1.com
NAFLD is an excessive accumulation of fat in the liver that impairs its function and can lead to severe liver inflammation (NASH), and in a small percentage of people, liver cancer. An estimated 20-30% of people in industrial nations suffer from NAFLD, a shockingly high prevalence (1).
I previously posted on dietary factors I believe are involved in NAFLD. In rodents, feeding a large amount of sugar or industrial seed oils (corn oil, etc.) promotes NAFLD, whereas fats such as butter and coconut oil do not (2). In human infants, enteric feeding with industrial seed oils causes severe liver damage, whereas the same amount of fat from fish oil doesn't, and can even reverse the damage done by seed oils (3).
So basically, I think sugar and industrial oils are major contributors to NAFLD, and if you look at diet trends in the US over the last 40 years, they're consistent with the idea. Industrial oils are harmful due (at least in part) to their high omega-6 content, which is problematic partially because it disturbs normal omega-3 metabolism. A potential solution to fatty liver is to reduce sugar, replace industrial oils with natural fats, and ensure a regular source of omega-3. I've posted two anecdotes of people rapidly healing their fatty livers using diet changes* (4, 5).
I recently came across a study that examined the diet of Canadian children with NAFLD (6). The children had a high sugar intake, a typical (i.e., high) omega-6 intake, and a low omega-3 intake. The authors claimed that the children also had a high saturated fat intake, but at 10.5% of calories, they were almost eating to the American Heart Association's "Step I" diet recommendations**. Busted! Total fat intake was also low.
High sugar consumption was associated with a larger waist circumference, insulin resistance, lower adiponectin and elevated markers of inflammation. High omega-6 intake was associated with markers of inflammation. Low omega-3 intake was associated with insulin resistance and elevated liver enzymes. Saturated fat intake presumably had no relation to any of these markers, since they didn't mention it in the text.
These children with NAFLD, who were all insulin resistant and mostly obese, had diets high in omega-6, high in sugar, and low in omega-3. This is consistent with the idea that these three factors, which have all been moving in the wrong direction in the last 40 years, contribute to NAFLD.
* Fatty liver was assessed by liver enzymes, admittedly not a perfect test. However, elevated liver enzymes do correlate fairly well with NAFLD.
** Steps I and II were replaced by new diet advice in 2000. The AHA now recommends keeping saturated fat below 7% of calories. Stock up on those skinless chicken breasts! Make sure there isn't any residual fat sticking to the meat, it might kill you. I do have to give the AHA credit however, because their new recommendations focus mostly on eating real food rather than avoiding saturated fat and cholesterol.
An easy way to do this is with garlic soup. I pulled this recipe off the NY Times (http://events.nytimes.com/recipes/7022/1999/09/01/Garlic-Soup/recipe.html).
Adapted from Jean-Georges Vongerichten