Have you wondered if you’d miss anything if you skipped over all the articles in the news about healthy foods? You would do just fine! In fact, there is no one correct diet for everyone. Despite various recommendations on low fat, low carbs, all day fasts, and whatever, the bottom line is that eating a variety of foods is probably the kindest thing you can do for yourself. The only nutrition plan that will work well for you is one that makes you feel healthy and that you’ll actually want to follow. Foods affect people in different ways. My patients with diabetes who monitor their blood sugars have taught me that foods that cause a substantial rise in blood sugar for some don’t affect the sugar much for others.
If we look at the nutrition recommendations for the American Diabetic Association and American Heart Association, there is major overlap. They both emphasize intake of vegetables, fruits (although limited in diabetes), whole grains, some low-fat dairy products and a variety of additional protein sources including poultry, fish and legumes, with limited sweets and red meat. Legumes include a variety of foods. By definition, they are plants that have seed pods that split along both sides when ripe — e.g. beans, lentils, peanuts, peas and soybeans.
The Mediterranean style diet comes out fulfilling these criteria for heart health. As we’ve mentioned in other articles on Lady Docs, the Mediterranean diet is no one particular regimen. It includes many fruits and vegetables, whole grains, and legumes with a reliance on olive oil and nuts to provide heart-healthy fats. Other foods rich in healthy omega-3 fatty acids are fatty fish, especially salmon and mackerel, flaxseed (but not the oil), and canola oil. Protein sources can include fish, poultry and dairy products with little red meat. This contrasts with what is familiar as a ‘western’ diet which typically includes red meat, processed meat, high-fat dairy products and sweets.
A Mediterranean diet has been shown to decrease the risk of heart attacks, stroke, and death rates from heart ailments and for all causes combined. Studies have also shown improved outcomes in patients who have already had a first heart attack when they then adhere to a Mediterranean style diet. A recent study showed that it delayed for two years the need for diabetic medications. So it’s never too late to adopt a plant-based diet to influence your future health.
It is difficult to prove cause and effect in dietary studies because there are so many variables, and adherence to a diet over years is hard to prove, but just to complete the list, a Mediterranean diet has also been associated with a decreased risk for cancer, Parkinson’s and Alzheimer’s. Particular benefit has been noted with cruciferous veggies (broccoli, cabbage cauliflower and Brussel sprouts), green leafy vegetables, citrus fruits and Vitamin C-rich fruits and vegetables. Since fiber has also been associated with a decreased risk in heart disease, diabetes and death, it has been questioned whether the increased fiber in the Mediterranean diet is responsible for the health benefits attributed to it.
In a review of many studies involving 900,000 people, the beneficial impact of fiber is even more substantial from veggies and cereals than from fruit, and even more helpful in smokers and heavy drinkers than in the general population. In all of these cases, it’s not clear which components provide the protective effect for the heart, or if the benefit accrues from other healthy habits that are more common in those who choose a higher fiber diet – do they exercise more, stress less, sleep better, maintain a healthier weight, etc. The reduction in cancer is controversial, although it now seems that tomato-based products have been associated with a lower risk of prostate cancer and fiber may decrease the risk of colon cancer.
The recommended amount of fiber is 25 grams/day for women and 38 grams for men, with at least half being from whole grains. Fiber is the part of plants that can’t be digested by our enzymes. Brown rice and other whole grains such as oatmeal have higher fiber content than white rice and white bread. ‘Refined grains’ such as white rice or sweetened cereals, are milled, which removes fiber, iron and B vitamins to give the food a finer texture and improve shelf life. They may be called ‘enriched’ if the iron and B are added back, but the fiber is usually not.
We can’t conclude a discussion about nutrition and heart disease without mentioning red meat. Higher red meat consumption has been associated with increased heart disease. It is felt that the high saturated fat content is to blame. Whether one of the protein components, carnitine, plays a role is in question now. This is a naturally occurring product of an amino acid that is present in all cells, including those in red meat. It is also advertised as an over-the-counter supplement that can aid in weight loss, exercise performance, treatment of male infertility, graceful aging and general sense of well-being. None of these has been proven. Scientists are exploring whether excess carnitine in the gut from eating red meat allows bacteria to produce more of a chemical, TMAO, which can in turn cause increased atherosclerosis. This line of thought requires more research, but in the meantime, taking carnitine supplements for the unproven benefits mentioned above seems like something that should be avoided.
People often associate following a particular ‘diet’ with aiming for weight loss. Regarding the plant-based – but not vegetarian – diet that has been described above, good health is the objective. By virtue of using many low calorie foods, changing emphasis from processed foods to these foods is likely to be associated with weight loss. Weight loss of more than 5-10% of initial body weight, which can be as little as 10-20 pounds or so, leads to a reduced risk for diabetes and can affect cholesterol and blood pressure, which are risk factors for heart disease. In some cases, patients may be able to reduce the use of medications for these issues.
The important take-away is that what you eat is likely to impact your longterm health – and you do NOT need to follow each little detail of new studies. You just need a basic roadmap – lots of vegetables, fruits, whole grains, plus healthy oils and lean protein. Our hope is that this knowledge and some of the healthy recipes on this site will make it easier to adopt a beneficial nutrition plan – and allow you to enjoy becoming a healthier you.
Check out a new fall recipe for a carrot and parsnip purée, rich in fiber and vitamin A and C as well as our other recipes. Coming soon — info about carbs, fats and protein as well as how fiber fits into these categories.
For now, you can look into the content of foods and a method to track your activity on www.supertracker.usda.gov.
For more healthy recipes try http://www.canyonranch.com/your-health/food-nutrition/cooking-recipes
Happy Thanksgiving 2014 to you and your families!
Estruch, R. et al, NEJM 2013; 368:1279-90
Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies.
AUKim Y, Je Y SOAm J Epidemiol. 2014 Sep;180(6):565-73. Epub 2014 Aug 20.