Cha-cha-cha-chia!

Remember those plant pets popular in the 90s?  Turns out that the plant is much more useful than for just watching spouts grow into the shape of an animal. Chia seeds have become somewhat of a health craze lately and for good reasons.  This is one health fad that hopefully does not fade.

The tiny seeds of the chia plant are LOADED with anti-inflammatory nutrients.  Below are just some of the reasons you may want to think about incorporating chia seeds into your diet.

First look at the nutrition label info: 1 Tbsp of chia seeds: ~Fat: 1.8g (0.2 g saturated fat) ~Carbs: 2.6g      ~Fiber: 2.2 g (all carbs come from fiber which essentially makes gives this a net carb count of zero) ~Protein: 1g Very good source of: calcium, iron, phosphorus, manganese, magnesium, copper, zinc  1.       Omega-3 fatty acids. Chia are full of these protective fats. In fact, they have about 2x more omega-3s than walnuts (oz for oz). Walnuts are one of the main plant sources of these essential nutrients.  Omega-3s help protect the arteries, heart and brain from damage due to chronic inflammation (i.e. the inflammation that is generated by eating a typical American diet). There is also much evidence that they decrease the severity of autoimmune diseases and depression. These fats have been shown to decrease triglycerides and increase HDL (good) cholesterol. Flax seeds, too, are a source of omega-3s, but these seeds must be ground up prior to ingestion for the body to access and absorb the fats.  Chia seed omega-3s are more bioavailable so you can add them whole to any product and still absorb the beneficial nutrients. 2.       Fiber.  Oz for oz, chia have about 3x more fiber than oatmeal and about 33% more fiber than flax seeds.  I’ve given my speal about fiber before, but basically consuming more fiber is extremely beneficial in the prevention and management of almost ANY chronic (and some acute gastrointestinal) medical problems.  EAT MORE FIBER! 3.       Calcium. Again, oz for oz, these seeds have 5x more calcium than whole milk! If you’re trying to cut back on dairy for any reason, here is a great way to get calcium. One serving (considered 5 Tbsp) of chia gives you 20% of your daily calcium needs.  Plus, you can avoid the cholesterol, hormones and acidic animal proteins that all tag along with the calcium in milk.  As far as the uses of chia, the possibilities are almost endless. When put in liquid and allowed to sit (~15-30min) the seeds expand dramatically, which adds bulk to many foods without adding many calories. Try putting chia in smoothies or soups.  I enjoy a bit in oatmeal (adding the chia and letting it sit makes for a GIANT bowl of oatmeal).  You can use it just like you would flax seeds, putting it in baked products or using the seeds to add texture variety to yogurt or salads. One neat thing to try with chia (or flax) is using it in place of an egg. 1 chia egg = 1 tbsp ground chia + 3 tbsp water This combo mimics the binding characteristic that eggs are typically used for in baking recipes. You can find chia in bulk sections of some grocery stores or in the health food section. The Dole company has just come out with 9.5oz containers of ground and whole chia, which store well.

Move to Washington, become a Granola (not really, just an oat lover)

I am currently obsessed with oatmeal (baked oatmeal to be exact)!  I’ve always enjoyed oatmeal but the 5x5 packs of flavored instant Quaker oatmeal just don’t do it for me anymore.  Nonetheless, I am still upset that the cookie dough flavors were discontinued (90s kids would remember these)!

I’ve been on a huge oatmeal kick lately so I started reading about the benefits of oatmeal. Many of these benefits I have known for a while and I feel many of you will have heard of some of these benefits. However, I learned quite a bit about just how health promoting the tiny whole grains can be! 

1.       Lowers cholesterol

Oatmeal is a good source of soluble, or fermentable, fiber. Soluble, means that this fiber is soluble in water; it makes a gel like substance when mixed with liquids. Because of this, it can soak up not only cholesterol that is ingested with food, but it also binds up bile acids which are compounds needed for digestion of fats. Normally, bile acids are recycled in the body but when they are bound up and eliminated with the fiber the body must make new bile acids – from cholesterol. The body is forced to pull cholesterol from its stores to break it down to make new bile acids.  This process can be continuous with cholesterol constantly being broken down and eliminated in the form of bile acids. This type of fiber is also fermented (why it’s also called fermentable fiber) by gut bacteria into short chain fatty acids (SCFA). SCFA have beneficial properties in and of themselves. One SCFA, propionate, is a competitive inhibitor of the enzyme HMG-CoA reductase, the all-important enzyme needed for cholesterol synthesis! This is the same enzyme that all statins (Lipitor, etc) target in order to lower cholesterol. Yep, soluble fibers can be natural statins!  For every 1g of oat bran fiber consumed daily, you can lower your risk for heart disease by about 3%. This is significant since just a single ½ cup serving of oats has 4 grams of fiber (2 soluble and 2 insoluble).

2.       Promotes regularity

The insoluble fiber in oats promotes bowel health via various mechanisms. Mainly, the fiber adds bulk to stool since it can’t be digest and absorbed. Additionally, the fiber soaks up water to make stool heavier and softer.  The fiber from oats is also considered a PRE-biotic. Prebiotics are what PRO-biotics (good bacteria) consume in order to proliferate. I’m sure you’ve all seen the various commercials touting various dairy products that are high in probiotics and that probiotics promote bowel health. Well, oats (and other fiber) only help the probiotics do their job, rooting out disease causing bacteria and encouraging regular bowel movements (this may be too much for some but just FYI – the majority of stool weight comes from bacteria; the more good bacteria you can grow, the larger and more frequent your stools).

3.       Boosts immune system

Beta-glucan, one type of soluble fiber in oats, has been shown to increase killing activity and cytokine production (chemical messengers) of neutrophils and macrophages (two innate white blood cells that fight infections).

4.       Protects against or helps manage diabetes

As the fiber in oats creates a viscous mix when it mixes with liquids in the small intestine, it slows down digestion and absorption of nutrients. This helps curb the rate at which sugar is absorbed into the blood stream. The spikes in both glucose and insulin that occur after meals are attenuated and made more predictable by this slower process. High fiber diets have been shown to decrease fasting glucose levels by 10% or more. This means lower average blood sugars for diabetics.  Moreover, consuming a high fiber diet from whole grains (and fruits and veggies) has been shown to lower the risk of even developing diabetes in the first place.  

5.       Anti-inflammatory effects

Just like any other plant, oats contain antioxidants. One special class is called avenanthramides.  Avenanthramides are thought to be the compound that provides the anti-itch, anti-inflammatory effect when oatmeal is used on skin irritations. Likewise, this phytochemical can quench free radicals that can harm HDL (good) cholesterol and cause inflammation in blood vessels. Keeping HDL levels high protects against heart disease.  

6.       Protects against cancer

Oats help protect against colon cancer and most hormone related cancers (breast, prostate, endometrial).  In regards to colon cancer oats provide the fiber that decreases transit time of the gut, ensuring that toxins have as little time as possible to interact with the gut wall and cause cancerous changes. The soluble fiber also binds up toxins like a sponge so they don’t even have the chance of instigating harm. Finally, one of the SCFA produced from soluble fiber by gut bacteria, butyrate, is very nourishing for colon cells and actually causes cells with cancerous changes to undergo programmed cell death.

In regards to hormone related cancers, oats reduce risk by the same way they reduce cholesterol. They simply bind up and cause elimination of hormones in the gut, effectively lowering the ‘food supply’ for cancerous cells that rely on hormones to grow.

7.       Promotes weight loss

Oatmeal can aid in weight loss in many ways. First, the viscous solution and slowed gut motility produced in the small intestine when oats are ingested keeps fat and carbohydrate molecules in contact with satiety receptors for longer periods of time. Essentially, you feel full longer. The modulatory effect on blood glucose also ensures that you don’t have any crashes where you feel so hungry you could eat a dozen cookies – and you do.  Finally, the oats also soak up fat and other nutrients in the gut, thereby lowering total calorie absorption. Eat 2,000 calories, but only absorb 1,800!  It’s simple, no calorie-counting weight loss!

So my advice is to add oats to your diet. You don’t have to eat oatmeal to do it.  Here are other ways:

1.       Try oat flour in place of all-purpose or whole wheat flour. You can simple grind whole oats in a food processor to make your own oat flour to use in pancakes, waffles, pastries, cookies or other baked goods.

2.       Add whole oats to almost any baked goods recipe, especially cookies (besides cookies, you may have to experiment to get the right consistency or ratio)

3.       For meat eaters, put oats into beef patties when making burgers or into meatloaf (soaks up fat, cholesterol and carcinogens in the meat and adds volume so you use less meat for the same size patty/loaf)

4.       Buy or make granola

5.       Make smoothies thicker by adding a Tbsp or two of instant oats

But since I am currently obsessed with baked oatmeal here are some of my favorite recipes:

Single servings:

Banana bread baked oatmeal for one:

http://www.healthyfoodforliving.com/?page_id=30012?recipe_id=6019233

Buttermilk chocolate chip pancake oatmeal for one:

http://www.healthyfoodforliving.com/?page_id=30012?recipe_id=6023228

*In these recipes I use a ‘flax egg’ (1 tbsp ground flax seed + 3 tbsp water) for the egg or I use an extra ½ banana for the egg. For the buttermilk I made my own by placing ½ tbsp vinegar (could use lemon juice) in the measuring cup before measuring enough soymilk to fill it the rest of the way. Let the mixture sit for a few minutes before you use it so the acid can make the milk ‘buttermilk.’ If you don’t want it vegan than you can just make the recipes as they are.

**The healthyfoodforliving website has multiple other flavors for single serving baked oatmeal. I just haven’t had a chance to try them all yet!

For 2+ people:

Strawberry, banana, chocolate chip baked oatmeal

http://www.inspiredtaste.net/9928/baked-oatmeal-with-strawberries-banana-and-chocolate-recipe/

Mex-Asian fusion

After completing a few posts on more academic aspects of nutrition and health I want to do one that is more practical.  One of my goals for this blog is to show you all how easy it is to really gain multiple health benefits from the food you eat.  Putting just a little time and thought into food preparation can lead to yummy and nutrient rich meals.  Here is a recent example of a dish I really kind of threw together on a whim, but after it was done I realized it was a nutrient powerhouse!

I was trying to decide what to make for dinner the other night and had some edamame (soybeans) I needed to use. However, I didn't really feel like an Asian themed meal.  My favorite ethnic food is Mexican food and as I looked through the fridge I saw some tomatoes, onion, and green pepper.  I had some corn in the cupboard, too, so I decided to make a soybean corn Mexican salad (a twist on a traditional black bean and corn salad).  I'm not good at writing down recipes but here is roughly what I put in it:

1 large roma tomato, seeded and chopped
1/2 green pepper, chopped
1/2 cup white onion, chopped
1 can corn (no salt added)
1 cup shelled edamame
~ 2 Tbsp finely chopped cilantro

For the dressing I drizzled about 1/2 Tbsp olive oil and 1-2 Tbsp lime juice over all the ingredients.  Then, I sprinkled on garlic powder (I would like to of used real, minced garlic, but didn't have any on hand), chili powder, cumin and salt and pepper. I didn't measure these at all, I just added a bit of each until it looked and tasted good to me.

Now, let's look at how much nutrition this simple salad provides:

Tomato
Tomatoes are high in vitamin C and are full of phytochemicals some of which include: polyphenols, carotenoids, beta-carotene (vitamin A precursor and antioxidant), flavonoids and lycopene
~Lycopene has been studied for quite some time for its role in prostate cancer. Higher lycopene consumption has been linked with both lower risk of developing this cancer and with decreased growth of cancer that has already been detected. Lycopene is thought to have these effects because it interacts with DNA to promote production of a gene that codes for anti-cancer enzymes. It likely has protective effects for other types of cancers, as well.

Green pepper
Green peppers are also high in vitamin C and beta-carotene. They are good sources of folate, which is needed for proper DNA synthesis, and of potassium.  Higher potassium intake is correlated with lower blood pressure.

White onion
Two types of phytochemics are found in onions: anthocyanins, which impart a red/purple color and flavanols such as quercetin responsible for the yellow skins. These and other compounds from onion have been reported to have a range of health benefits which include anti-cancer properties, blood thinning activity, anti-asthmatic and antibiotic effects.  Moderate onion consumption (about 3-4 one-half cup servings/week) has been found to lower the risk for various types of cancer.

Corn
This may be a surprise to many of you but corn is actually not a vegetable!  It is a grain. But, don't think that grain = carb = bad for you. Corn is a WHOLE grain. Whole grains are some of the best sources of nutrients including various B vitamins, folate, and multiple antioxidants including beta-carotene, leutin (needed for good vision). Moreover, whole grains are good sources of protein and fiber and in corn's case it has about 5 grams/cup of each! 
I can't stress how important fiber is in the diet. Most people only associate fiber with digestive health but it's benefits go way beyond that. Fiber acts like a sponge in the gut, soaking up excess fats, cholesterol and even excess hormones. It also binds to toxins and chemicals in foods, causing them to be eliminated from the body. Hundreds of research studies have attributed increased fiber intake to lower risk of: heart disease, colon cancer, breast cancer, diabetes, diverticulosis, high blood pressure, high cholesterol and obestiy.
I actually feel so strongly about the importance of fiber that I recommend that you try to get almost 2x the level fiber suggested by the USDA (U.S. Dept of Agriculture). They suggest about 25 grams/day, while the average American takes in only 14-16 grams/day!  The majority of studies out there that show significant reduction in disease risk with high fiber intakes typically have participants takin in well over 30 grams/day.  You may first think that there is no way that you can get close to 50 grams, but it is very possible, if you take out foods that are void of fiber (ahem......animal based products) and replace them with fruits, vegetables and whole grains!  However, if you attempt to do this, go slowly with adding more fiber so your digestive system has time to adapt.  Adding too much fiber too quickly will result in gas and loose stools as your body does not have the proper gut bacteria to deal with larger amounts of fiber. Over time however, the 'good' bacteria will grow and be able to accomodate large volumes of fiber.

Edamame
Like other soy products, edamame is a great source of plant-based protein. Being a plant, it is also a good source of fiber.  The the main health benefits of soy come from two phytochemicals in the class of isoflavanoids: genistein and diadzein.  These compounds have gotten a bad rap in the past due to the fact that their chemical structure is similar to estrogen and due to this they have weak binding abilities at estrogen receptors.  However, this is not a bad thing, it's actually really positive. Because they bind so weakly to the receptor they don't necessarily activate it and cause all the effects that natural estrogen does.  When one of these compounds is bound to the estrogen receptor, the real hormone can't bind (they compete for binding) and therefore the receptor is not actvated. This is the typical situation in hormone responsive tissues such as breast and uterine tissue which actually lends protective benefits to these tissues. However, the estrogen receptor is arranged differently in other tissues, like bones, and in this case the soy can activate the receptor and cause estrogenic effects which in bones means less bone loss.  In effect, soy is pretty much an selective estrogen receptor modulator (SERM), much like the drugs tamoxifen and raloxifene. 

Soy consumption has been correlated with decrease heart disease risk via reduction in cholesterol levels. Additionally, soy can help alleviate menopausal symptoms and prevent bone loss/osteoporosis due to is selective estrogenic effects on various tissues.  Finally, regular soy consumption may reduce risk for breast, prostate and endometrial cancers.

The average consumption of soy isoflavones in the U.S. is < 1 mg/day while the average consumption in Japan is between 25-100 mg/day.   If you wish to encorporate more soy into your diet, try edamame. Steamed and salted, they taste good eaten right out of the shell or you can add them to your favorite dishes as the protein source (i.e. instead of shrimp/chicken/beef in stir-fries or pasta dishes).  Packages of edamame in the shell or deshelled can be found in the freezer section of most grocery stores. Tofu is an excellent source of soy and can also easily be added/substituted in many recipes. Soy milk is always a good option, too, and it comes in various flavors!  Try the vanilla flavor in smoothies or in baked goods.  Kids will love the chocolate flavor.  Most, if not all, coffee shops carry soy milk.  Try a soy latte and I bet you may be nicely surprised by the nice nuttiness and creaminess the soy provides for the drink.

Cilantro
This is a tough little plant. Some of the alcohols in its cells have been found to be anti-viral and anti-bacterial.  Because of this, cilantro has been found to be a prevention measure for food borne illnesses, such as salmonella.  Other compounds in cilantro are anti-oxidants and anti-inflammatory molecules.  Additionally, many polyphenols (guardians of the epi-genome) are found in this herb.  Finally, probably through its anti-oxidant properties, cilantro may help lower LDL (bad) cholestrol.

Olive oil
Olive oil is high in monounsaturated fatty acids (MUFAs) which are anti-inflammatory in nature (aka the good fats). Olive oil is full of phenolic compounds (types of antioxidants) that quench DNA damaging free radicals. Diets high in olive oil have been correlated with lower blood pressure and lower 'bad' cholesterol. To gain these benefits, olive oil (virgin or extra virgin) should be used in place of butter or other animal fats. Animal fats (butter, dairy fat, saturated fats in meats) are pro-inflammatory and may lead to the creation of free radicals.

Olive oil is a mainstay in the Mediterranean diet, the diet I referenced in one of my first posts. This diet pattern, eaten by populations native to the Meditarranean area, has been extensively correlated with lowering risks for almost all types of chronic disease including cancer (breast and colon in particular), cardiovascular disease and autoimmune diseases.

Lime juice
Like all citrus fruits, limes are great sources of vitamin C, a potent antioxidant.  It's antioxidant properties lend protection to blood vessels from free radicals that may damage the vessle and induce plaque formation.  The antioxidant also lowers inflammation, making it useful for managing the symptoms of arthritis and other inflammatory conditions. Limes also have various phytochemicals which have been found to inhibit some types of cancer cells by altering the cell cycle (when cells decide to multiply or die) and which are very antimicrobial.  Infact, the addition of lime juice to foods has been used to protect against cholera in endemic areas.  Lime juice also directly modulates the activities of monocytes, one of the immune cells in the body.

Cumin
Cumin is widely used in traditional Ayurvedic medicine for dyspepsia and diarrhea as it has an antispasmotic effect on the gut.  It is also antimicrobial, notably against H. pylori, the bacteria thought to be the causal agent of many stomach and duodenal ulcers. This spice has also been shown to reduce the risk of stomach and colon cancers due to phytochemicals that modulate the metabolism of carcinogens. Finally, cumin may also increse insulin sensitivity and may be a hypoglycemic agent, aiding in glucose control in individuals who have type 2 diabetes or who are pre-diabetic.

Chili powder (chili pepper)
There are many varieties of chili peppers, all of which contain capsaicin, a natural pain reliever. However, most of the research on pain relief has focus on topical preparations in the treatment of arthritis. Dried chili pepper also contains capsaicin though and some studies have found this compound to be protective against laboratory induced tumorigenesis.  Additionally, chili peppers are good sources of vitamin A, another strong antioxidant and anti-inflammatory dietary component.

Garlic
Garlic has many beneficial properties (fresh garlic provides more benefits than powdered, but powdered is still better than none). Those little bulbs contain calcium, iron, zinc, potassium, selenium, and vitamins A, B1, B2, B6 and C.  Further, garlic has been found to be antibacterial and antiviral.  It also contains over 80 protective phytochemicals, some of which have been found to help normalize blood cholesterol, thin the blood and protect against plaque build-up in arteries. One specific phytochemical, S-allylcysteine, has been found to inhibit cancer cell growth and cause apoptosis (cell death) of prostate, breast, oral and non-small cell lung cancers!

As you can see, it is pretty easy to put together a delicious, disease fighting meal.  A whole foods (meaning non-packaged), plant based diet is the best way you can improve, maintain and/or promote your future health!  It is worth mentioning that many research studies have suggested that trying to gain the benefits of certain phytochemicals and antioxidants by taking supplements does not necessarily provide the same effect and my even be harmful to health.  It is the consumption of these whole, natural foods, with compounds that we have not even discovered yet, and the way they synergistically interact with other nutrients that provides superior benefit from anything concocted in a laboratory.

Happy whole foods eating!


P.S. This is my last post as a medical student!  I am moving out to Seattle soon for further medical training and hope to be able to make more fresh dishes from the abundance of options out there. I hope to bring you more posts like this in the future!

Got milk? You shouldn't have

It was requested, so I have decided to write about THE topic which really inspired me to become passionate about the direct link between food and disease. I've always been interested in nutrition in general, but during grad school I took a vegetarian nutrition course which changed my life and I hope that by passing on some of this information you, too, can make some lifestyle changes for better long term health.

The topic: milk.  When I first starting learning about the less than desirable qualities of milk (and all dairy products made from milk) I was a bit skeptical. We have all been told ever since we can remember that milk is good for us. I specifically remember, as a child, being made to sit at the dinner table until I finished my glass of milk. Where will you get calcium? We all need milk to grow up big and strong right? WRONG. As I have read about and seen and heard first hand, this is a controversial subject. Many of you may be skeptical I like first was, but try to keep an open mind and if you're so inclined, do some research yourself.  There is an abundance of evidence that strongly suggests that dairy, may in fact, be one of the worst components of the American diet.

Before I get deeper into this I need to put out a disclaimer: I am a hypocrite - I do eat dairy.  Not everyday and not in large quantities, but I do enjoy a slice of pizza every now and then or a bowl (pretty large) of ice cream.  For awhile I was good at avoiding all dairy but it's hard!  However, I am going to try again, starting today!

The first thought I'd like you to ponder is this: Humans (Western societies in particular) are the only species on this planet that consumes milk beyond infancy.  Moreover, we chose to consume cow milk, which is a complex, bioactive substance produced with a nutrient profile for the growth and development of a baby bovine, who will gain, on average, 1.5-2.0 pounds per day and should reach over 500 pounds when full grown.  Do we really need the same nutrition designed for a heifer?  Would it not be more suitable and 'natural' to consume ape milk, the species we consider most close to us on a molecular level?

While not very publically revealed or even publically accessible, much research has been conducted on the role of milk in various diseases. Below is a very brief synopsis of the findings that I know about (keep in mind that there is much more research out there that I hope to read):

~ Through multiple research studies, the main protein in milk, casein, has shown to be a potent instigator of cancer initiation (sets the stage) and promotion (increases tumor growth).  What's more is that the level of protein in the diet has been shown to directly correlate with tumor growth.  Dr. Thomas C Campbell, former head of the biochemistry department at Cornell University, has shown through various studies that the level of casein consumption can literally control the growth of cancer cells.  Provide protein (in the form of casein) to cells exposed to a carcinogen, at 20% of daily calorie needs, and 100% of subjects (mice) develop cancer.  However, provide the protein at 5% of daily calorie needs and ZERO subjects develop cancer (with the same carcinogen exposure).   A ratio of 100:0 is RARELY seen in science.  Further, when Dr. Campbell lowered the protein level in the mice who had cancer, from 20% to 5% of daily calorie needs, the tumors stopped growing!  When given back the 20% protein, the tumors began to grow again.  Tumor growth was turned on and off, like a light switch, by one change - the amount of protein in the diet.  But, what about plant protein? When these experiments were repeated, with wheat protein (gluten) and soy protein, tumors showed no growth at any level of protein in the diet.  One argument that has been thrown at this research is that many things are possible carcinogens, when given in high enough quantities (you may be familiar with the artificial sweetener debate).  But, in this research, protein was provided at levels NORMALLY consumed by humans.  The average U.S. adult consumes ~16% of calories from protein, and many individuals consume a lot more than that! This isn't laboratory data that is isolated from the real world. Rather it mirrors the real world!

Molecular studies conducted on how casein affects cancer revealed multiple different mechanisms by which this dietary component wreaks havoc on cells.  When the protein is provided at higher levels:
1. More carcinogens enter cells
2. Cells multiply faster
3. Enzymes that naturally detoxify carcinogens showed reduced activity
4. More carcinogen-DNA damage sites were formed (damaging DNA = potential cancer initiation)

Dr. Campbell went on to conduct one of the most comprehensive human nutrition studies and found that his lab findings of protein consumption and cancer were highly consistent with human protein consumption and cancer.  That is - humans who eat more animal based products have higher rates of almost all types of chronic disease. Some have tried to argue that it is the fat in these products that is the culprit. However, there is much evidence that just cutting out animal fat (drinking skim milk, eating low fat white meat) does not lead to lower cancer rates.  I wish I could put the graphs in this post but I can't figure out how, but data from countries around the globe provides convincing evidence that total fat intake does not necessarily correlate with cancer incidence.  What the evidence does indicate is that there is a direct, strong correlation between animal fat intake and cancer (breast specifically), but no correlation at all between plant fat (even saturated fat) and cancer.  Could it not be the fat in the animal products, but the protein instead?  If fat is the bad guy, then taking fat out of the diet should decrease cancer rates. However, Americans are eating more 'low-fat' and 'reduced-fat' products now, in this age of processed foods, and even though the death rate of many cancers has leveled off or even declined (likely due to better detection and treatment methods), the incidence of most cancers has not.

~ Like I mentioned in a previous post (McAcne), milk is full of hormones which are intended to aid in the growth of a baby cow.  Regarding human consumption, one of the most important hormones to consider is insulin and its family of insulin-like growth factors (IGF).  These hormones are necessary for proper growth, development and homeostasis of multiple organ systems.  Due to their roles in growth and development, IGFs are potent stimulators of cell proliferation and inhibitors of cell apoptosis (programmed cell death).  Hormones are signaling molecules that cross cell membranes and deliver their message to a cell's nucleus, the house of DNA. Milk contains active IGF-1 and IGF-2.  When you drink milk you are ingesting hormones that can directly interact with your cells' epitome, altering genetic activity.  These disturbances in DNA activity have wide and long-ranging results.  From in the womb up until old age, the excess IGFs ingested from dairy products exert negative effects on human health.  Just a few ways too much IGFs and their signaling system contribute to less than optimal health are shown in the two figures below.

As you can see you can greatly reduce your risk of multiple chronic diseases by taking dairy out of your diet. What about calcium you ask? Well that will be another post at some point but just know for now that you can still get enough calcium from plant products. Soy milk and almond milk are great substitutes. Calcium is actually found at some level in almost all whole, plant foods.  Some good sources are nuts (especially almonds), beans, leafy greens and broccoli (see table below). If you're a tofu fan, it, too, is a good source of calcium.  Moreover, individuals who do not consume animal products likely need LESS calcium than those do chose to eat meats and dairy. This is because animal proteins alter the pH of the blood, making it more acidic, and the body's best buffer to neutralize the extra acid -- calcium! Calcium is pulled from bones to be used in the blood as a buffer and then is subsequently excreted in the urine.  Those who eat animal products loose more calcium in urine and therefore need to take in more calcium from food.  But, the details about all this can be saved for another post about bone health.

If you want to do more reading yourself about this controversial subject I will point you to two sources:

The China Study by T Colin Campbell (lots of science but written for the general public)

Melnik BC. Milk - The promoter of chronic Western diseases. Med Hypotheses (2009) doi: 10.1016./jmehy.2009.01.008  (lots of scientific explanations)

Polyphenols = polyprevention

The Nerdy Science
I, along with many of my friends, will tell you that I am a nerd.  I get excited over really weird things.  A lot of the things I get excited about revolve around science.  The latest thing I've been intrigued by are polyphenols.  Polyphenols are a class of phytochemicals (plant chemical) characterized by multiple benzenoid rings attached to hyroxyl (OH) groups (see picture on right, green tea phenol). These compounds are only found in plants and are intended to help protect plants from photosynthetic (sun) damage and protect against reactive oxygen species (hyperactive particles that damage DNA). 

Here is where epigenetics comes in!  (This may get a bit technical for some, I apologize).  DNA can be modified via three different mechanisms: methylation (attachment of a methyl group, -CH3), histone modification (histones are proteins that DNA is wrapped around), and post-transcriptional gene modification by microRNAs. These processes affect gene product stability, DNA folding and complete nuclear organization of gene material.  Although polyphenols affect each of these processes I want to focus on  DNA methylation.  When specific segments of DNA have too many methyl groups attached, the gene product of that DNA is 'silenced.' Conversely, when these regions have very few methyl groups attached they are active and produce gene products. It is now believed that hypermethylation (silencing) of tumor suppressor genes is one of the leading causes of tumor initiation and progression.  In other words, it's a lack of signal from silenced DNA that tends to lead to cancer - not a new signal from active DNA.  Think of the methyl groups as dumbbells - the more that are attached to the DNA, the more the DNA is weighed down and not able to replicate normally.

How do polyphenols fit in to all of this? Polyphenols actually directly inhibit the enzyme that attaches methyl groups to DNA. Therefore, they block gene silencing by keeping the DNA free from the dumbbells! They allow active tumor suppressor gens to keep being made (more tumor suppressor gene activity = more natural cancer defense).

The Lesson for Everyday Life
Polyphenols are essential for human health.  With your new knowledge of the science behind polyphenols I'm sure you won't be surprised to learn that there is much evidence that suggests that populations with high pholyphenol intake have lower rates of all types of cancer.  Now there are over 8,000 dietary polyphenols! Remember polyphenols are only found in plants (spices included).  Listed below are just a few that have been found to help keep DNA free of methyl groups.

 Various polyphenols from these and additional fruits, vegetables and spices have been found to inhibit the growth of MANY types of cancer cells in vitro (in lab conditions) including: breast, colon, prostate, cervical, lung, esophageal, skin, uterine, leukemia and lymphoma.

Keep in mind that drinks made from plants count too. Tea, coffee, soy milk and wine are actually great sources of polyphenols!


So, what little steps can you do add these protective compounds into your diet:

1. Add spices to foods.  Instead of going for the salt shaker, try novel spices on your veggies. Sprinkle garlic powder, paprika, curry powder, dill or cumin on steamed veggies.  One of my favorite things to do is to add a dash of cinnamon to my morning coffee. It gives it a different flavor and I'm getting the benefits of cinnamon (cinnamon also helps stabilize blood sugars). 

2. Try to get the recommended number of servings of fruits and vegetables (newer recommendations are up to 9 servings!). Divide your plate in half, whether it be breakfast, lunch or dinner, and make sure that 1/2 of the plate is made up of fruits and/or vegetables. These foods also help keep you full longer because of their higher fiber content and increased water content compared to meats and carbohydrates. Now don't be overwhelmed by the number of servings. Serving size is what matters. One commercially harvested apple bought at a regular grocery store is large enough to be 2 servings. Only 1 cup of spinach or lettuce, a palmful, is a serving.  You only need to have 4-5 spears of steamed broccoli to count as a serving.  You really can get at least 5 servings/day by just eating a large piece of fruit and a medium-sized salad. Challenge yourself to try a new vegetable or fruit you have never had before at least once a month!

3. Choose green tea (unsweetened preferably) or coffee as your morning beverage.

4. Try soy!  Edemame (soy beans that look like snap peas in their pod) and soy milk are great substitutes for meat and cow milk, respectively. I love vanilla soy milk in coffee and cereal!


Keep in mind that many other things in your environment can affect DNA function and that the research on how food compounds directly affect DNA is still in it's infancy.  However, like I mentioned earlier we do know that populations that consume the highest amounts of fruits, vegetables (and other nutrient dense foods like whole grains and legumes) do have some of the lowest cancer rates.  While there is still much to learn, there is little risk in incorporating polyphenol rich foods into your everyday diet!

McAcne?

I am currently completing a dermatology rotation (last month of school  - ever!) and am constantly reminded of how much I still do not know. I recently learned about an interesting diagnosis: iododerma.  I initially had many thoughts about this diagnosis and it's relation to diet, but those kind of fizzled out with my research.  However, I thought I would take the opportunity to talk about a similar, very common diagnosis that is DEFINITELY affected by diet - acne.

Iododerma is part of a larger set of diagnoses termed halogenodermas. If you can remember way back to high school chemistry, the halogens (specific chemical elements of the periodic table) include iodide, bromide and fluoride.  Halogenodermas are skin eruptions that result from halogen containing drugs or substances.  On the face, inflammatory acne like lesions are seen while on the rest of the body large, red, raised papules are observed.

The connection to diet here is that, dating back to the 1920's, the American salt supply has been fortified with iodine. The rationale with this intervention was to reduce the incidence of goiter (thyroid disease). The fortification did its job as iodine related goiter is rarely, if ever, seen today. However, the current problem is that Americans are consuming too much salt. The recommended daily salt (sodium) intake for an average, healthy individual is 2,300mg. However, the mean intake of the average American ranges from 3,400 - 5,000mg. I found good news though - the foods typically highest in salt content (processed foods and fast food) usually contain non-iodized salt.  (However, read food labels because some companies do use still use iodinized salt and the Burger King chain does use this form in its food preparation.)  One would have to over-salt all meals with table salt for quite a while to develop the blood level of iodine to induce iododerma (eat > 20,000mg iodized salt per day).

So, what I thought was going to be a sure bet - high salt intake from processed/fast foods leads to increased skin problems - seems to not be the case at all. In fact, compared to 30 yrs ago the average consumption of iodine has fallen by about 50%.  There are now some authorities that believe that iodine deficiency could become a societal problem again due to the fact that so many individuals get their sodium fix from non-iodized sources.  Obviously Americans do not need to consume additional salt, just additional iodine.  My advice: cut back on the processed foods and lightly season fresh vegetable / pasta / fish dishes with iodized table salt.

While fast food may not lead to less than optimal skin via iodine, there are multiple other ingredients found in these foods and other staples in the American diet that likely DO increase the development and severity of acne.  There has been debate for decades about diet and acne but there is strong evidence that environment plays a large role as multiple non-Western cultures have been found to be completely free of this skin problem.  I bet most of you have heard about chocolate or carbonated beverages worsening acne. While these suggestions have been brushed aside as 'myths' by those in the dermatology field, there are underlying truths to these claims.

The development of a pimple is a process composed of 3-4 steps:
1. Keratinocyte (skin cell) proliferation
2. Androgen (male hormone) mediated sebum (oil) production
3. Inflammation
4. In some people: colonization of the skin with the bacterium Propionibacterium acnes

Steps 1-3 can all greatly be affected by diet. First, skin cell proliferation is induced by insulin and insulin-like growth factor (IGF-1), which are two pro-growth hormones. Androgens are male hormones that, among other things, bind to and activate oil glands. Androgen production is also increased by insulin and IGF-1.  Further, insulin and IGF-1 decrease the liver's synthesis of the protein that binds up androgens in the blood, resulting in higher blood levels of these male hormones and increased oil production. Insulin and IGF-1 also directly bind to oil glands and induce oil production. Finally, inflammation plays a large role in the severity of acne. The inflammatory process is why the pimples get red, swollen and painful.

What can be done to limit each of these processes?

1. Limit the amount and duration of insulin in the blood. Insulin is produced to help sugar (carbs) get into cells. More insulin is produced when more sugar is consumed.  There is tons of data that suggest that diets low in processed carbohydrates (white bread, white rice, crackers, cake, etc) improve acne. This means eating more whole grains and fresh fruits and vegetables. Not only are these items low in simple sugars, they are also high in fiber, which not only reduces overall insulin levels but also binds up and eliminates hormones in the intestine. Diets high in fiber, >30g/d, have been associated with improved acne. 

Exercise, even moderate activity such as walking, also lowers blood insulin levels. Try to get at least 30 min of moderate activity each day. This doesn't have to be all at once either. Your muscles, which use the insulin in your blood, will be just as happy with short bursts.  Three 10 min walks will lower insulin!

2. Limit dairy. Many of you may not know that dairy contains testosterone precursors, androstenedione and dehydroepiandrosterone-sulfate.  Additionally, dairy, skim milk in particular, is loaded with IGF-1. Still, for reasons beyond the scope of this blog, dairy causes an increase in insulin release far exceeding other types of foods. Finally, the animal proteins and fats in dairy are pro-inflammatory. The fats in dairy cause the body to produce prostaglandins (signaling molecules) that only potentiate inflammation and causes recruitment of inflammatory cells to damaged areas (pimples). As you can see dairy contributes to acne by muliple mechanisms.

3. Alter the types of fat you are consuming.  Omega-3 and omega-6 fatty acids (FA) compete for metabolism into signaling molecules that direct 1,000s of reactions in the body. Omega-3 FA are turned into anti-inflammatory molecules while omega-6 FA are turned into pro-inflammatory molecules.  Omega-3 fatty acids are found mainly in fish (fish oil) and their precursors are found in walnuts, flax and some green veggies.  Omega-6 FA are found in most oils, the oils used to fry, bake and cook most of the foods in our diets.  Animal proteins and animal fat are very inflammatory and contribute to the omega-6 profile of inflammatory signaling molecules.  For those who care, you can see the cascade below and the eicosanoids produced from each food product:

 There is actually evidence that those who consume moderate amounts of omega-3 FA, like 2 servings of fish per week, are less likely to have acne lesions.  Further, omega-3 FA may decrease IFG-1 which would halt the steps 1 & 2. 


An anti-acne diet consists of:

Few simple carbs: white bread, white rice, cookies, cake, pie

Very little dairy: cow milk, ice cream, yogurt  (soy / almond milk and other products are great substitutes)

Very little amounts of animal protein (besides fish): red meat, poultry, pork

More high fiber foods: whole wheat products, oats, beans, vegetables, seeds, high fiber breakfast cereals

More omega 3 FA: salmon, herring, shrimp, cod, ground flax seed.
Ground flax seed can be put into oatmeal, smoothies, baked products and can be used as a thickner in any recipe.  If you don't like fish you can take fish, try fish oil supplements. The trick with the supplements is to make sure you are getting 1g of EPA+DHA oil/day (which is also cardioprotective). Look at the back of the bottle to make sure there is at least 1g per serving. Some people complain of fishy tasting burps taking these pills, but stored in the freezer this side effect seems to disappear.

P.S. I am not suggesting taking up wine drinking but there is evidence that the resveratrol phytochemical in wine is an anti-oxidant that actually helps improve acne! 

All these ingredients are found in the Mediterranean diet, the diet pattern found in populations that border the Mediterranean Sea.  This diet has proven to be helpful in almost all inflammatory conditions and also promotes cardiovascular health and protect against multiple forms of cancer.  So, even if acne is your main concern now when you are young by adopting this diet profile you will be able to protect yourself from various more serious diseases in the future!

Happy eating for happy skin!

‘‘Let food be your medicine and let your medicine be food"

The title of this post is one of my favorite quotes. Hippocrates, the father of medicine, stated this back when little, if any, scientific evidence existed on the link between diet and health. I want to use this quote to help explain the title of my blog and provide background information for future postings.

People eat for many reasons: to satisfy a primal need, when they are happy, when they are sad, etc. But, how many of you eat to turn on or turn off your DNA? That's right, whether you carefully chose every ingredient you put in your mouth or don't give a second thought to what's filling your belly, the food you ingest today will have a profound impact on thousands of aspects of your health, both immediately and in the distant future. We know this because of a newer field of research called epigenomics.

Since this about food I will use this analogy: your epigenome is like a thin layer of icing on your DNA cake. Epigenomics is the study of this icing. The epigenome is made up of various chemical compounds that tell your DNA what, where and when to make a genetic product. It holds the switch to turn various genes on and off. Here's the exciting part - while you can't change your DNA, the epigenome is consistently changing from influences inside your body's cells (the environment), from choices you make! While there is still much research to be done, some evidence suggests that you, by your daily choices, can turn off various 'bad' genes that promote the development of cancer, autoimmune diseases and many other chronic diseases and turn on 'good' genes that protect against these conditions.

Now, for more specifics. The chemical compounds that make up the epigenome come from various sources including natural things, like nutrients from food, or from synthetic things like medications, tobacoo byproducts or pesticides.  This means that what you put in your mouth intimately interacts with your DNA, manipulating it and flipping the 'on' and 'off' switches of your genes. I don't know about you, but I would rather have my DNA bathing in an anti-inflammatory, anti-oxidant glaze rather than being slathered in a fatty, toxic film. What's more intriguing is that we know that these epigenetic changes to DNA can be passed down through generations.  What you eat today could impact your grandchildren's health! 

So, what can you do to make a happy epigenome that stays busy flipping off all the 'bad' genes?  Let food be your medicine!  Of course there are other improtant things like avoiding tobacco and exercising (exercise has also been shown to positively modify the epigenome!), but since we all need to eat to live changing our eating habits is a sure way that we can have some control over our DNA and our health destiny!

Future posts will provide some specific examples how various foods impact your DNA and promote or prevent various health conditions. 

For specific recipes that will make your epigenome happy I want to direct you to my friend's blog: http://munchkieandme.blogspot.com/. She is a nurse and a mommy who is devoted to making healthy meals for her family. We both share the same views on nutrition and I would recommend all her recipes. They will all feed your genes right!