Tag Archives: diet

Carvings March 15, 2026

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In the news

Revamping our dietary patterns

                It’s painfully clear that the Standard American Diet (SAD) is killing us by the millions and crippling us with conditions such as osteoporosis. Whatever your feelings are about the current administration, they are clearly on the right track to encourage Americans to begin eating normal food. The new food pyramid is not perfect but it’s an improvement over the old one, now with its emphasis on plant-based foods. I know, I know – I’d rather see the salmon above the steak but the latter does have an appropriately small space compared to the broccoli, carrots, and tomato. Let’s not quibble. Almost one-half of the new pyramid consists of veggies, fruit, berries and nuts.

                The place to start is breakfast, which for many persons consists of a sugary cereal. If you can’t give up breakfast cereal you can at least switch to the kind without added sugar or other processed ingredients. Eggs are fine but start cutting back on “egg helpers” such as bacon, sausage, ham, hash browns. Those are the foods that raise cholesterol, not the eggs, which are entirely innocent of that crime.

                If you need something sweet, how about one or two pieces of fruit, say half a grapefruit and a banana. Fruit juice is okay but why bother when whole fruit has less sugar, more fiber and much more satisfying “mouth feel” and is probably less expensive.

                Many Americans, especially seniors, don’t get enough protein. A morning breakfast shake that includes a scoop of powdered protein, some frozen berries, a little (!) fruit juice and some plain yogurt (more protein, as well as calcium, is tasty and filling and will get you through the morning without having to have a Danish or a donut with your coffee break.

Lifestyle

Continuing ethnoid: the salt issue

                Sodium, in the form of table salt, is a critical nutrient but taken in excess it contributes to high blood pressure. Two centuries ago it was almost the only means of preserving food and the result of a very high intake was a correspondingly high incidence of stomach cancer. In Japan, where the intake of sodium is nearly twice that in the United State – itself a higher intake than nature prefers – the incidence of stomach cancer is considerably higher than in other countries.

                In spite of the high sodium content in soy sauce and miso soup, most of the Japanese cuisine, with its emphasis on seafood and vegetables, is quite healthy. Considering that the Japanese people are the longest living on the planet, we should learn from their example. One caveat however: the youngest generation in Japan is destined to live shorter lives than its elders because of its adoption of the Western diet.

                Four items on the Chinese American menu that are particularly high in sodium are General Tso’s chicken, wonton soup, egg drop soup and vegetable stir-fry. White rice is a common staple in southern China but not in most of the country, where the folks enjoy a wide variety of vegetables that are only rarely found on Chinese restaurant menus in the United States.

 

Carvings March 1, 2026

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Our diet is our destiny

                Full credit for that statement goes to Dr. William G. Wilkoff in his column of September 10, 2025. Dr. Wilkoff points out quite clearly that “Food — not lack of exercise – fuels obesity.” That was the title of an article on National Public Radio.

                To be sure, exercise does matter. When we cut back drastically on calories it’s important to exercise regularly – meaning a minimum of four times a week, with moderate intensity, for at least one hour. The reason? When we cut back significantly on calories it’s not the fat that the body draws energy from. First, energy comes from glycogen, the carbohydrate stored in the liver and muscles. Next, the body begins to burn protein – almost entirely from muscle – as well as from stored fat. Without exercise, almost half of the pounds lost during a weight-loss regimen come from muscle.

                If you have worked out on a treadmill or stationary bike at your local gym you may have already noticed a distressing fact: roughly one hour on one of these machines burns only about 300 calories – about as many as you will get in two scoops of ice cream.

                The ideal rate of weight loss is about two pounds per week. Losing more than that leads to fatigue, cravings and irritability. Two pounds of fat is equivalent to about 7,200 calories, or about 24 hours (!) on that treadmill!! On the other hand, you can reduce your calorie intake by 7200 calories a week by eliminating a daily dessert (which average 300-500 calories per serving – see below), replacing pasta, rice, or potatoes with a fiber- and nutrient-rich vegetable like broccoli, peas, cauliflower, beans, etc., and limiting your wine intake to only one small glass (four ounces) instead of two five-ounce glasses.

                By losing only two pounds per week even a morbidly obese person (more than 100 pounds over standard weight for height) will be back to normal in two years or less. That will likely reduce high blood pressure, lower the risk of complications of diabetes and certainly improve self-image. 

Lifestyle

Thoughts on desserts

                From what I have observed over the years, most of us have at least one dessert a day, typically with the evening meal. There is no need to give up desserts forever – a highly unrealistic goal – but a few relatively minor changes can significantly lower one’s total weekly caloric intake.

                There are three things to consider: type, size and frequency.

                Outside of the tourist areas, European desserts often consist only of a piece of fruit – not a whole one, mind you – with a small slice of hard cheese. If it is a sugary kind it’s about the size of your thumb, gone in a mouthful, or at most, two. The desserts served in our restaurants average about 500 calories; some of our most popular establishments offer1500 calorie desserts. As an example, a slice of apple pie a la mode has 400-600 calories.

                Don’t go cold turkey on desserts if you are used to having one every day. Do without dessert just one day a week for a month, then two, then three. At the end of three months that’s 1500 calories a week, or two pounds a month. Right on target for a healthier lifestyle!

Carvings February 15, 2026

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Is it an ethnic cuisine – or ethnoid?

                What would life be like in America without ethnic foods – Italian, Chinese, Japanese, Greek, Vietnamese, etc.? I only wish that more cultures were represented – Russian, for example, or German or Chilean. I’m sure that you can find these lesser-known venues in our larger cities, but they are uncommon elsewhere.

                On the other hand, many of our favorite restaurants serve what I call ethnoid, not ethnic foods. (-oid from the Greek, meaning similar) Catering to American tastes, they are usually  sweeter, saltier, more meat-laden and huge.

                This week I’ll discuss Italian food – specifically, the true Mediterranean diet. You won’t find it at your local pizza parlor. Outside of the tourist hotspots in the home country, Italian pizza is quite simple: a thin crust, a layer of tomato sauce and a smidgin of cheese. The amount of cheese that we find on a single slice of American pizza would suffice for about two days for a family of four in rural Italy. It is a garnish, not a major part of the entrée. Only occasionally does it come with pepperoni or sausage. 

The True Mediterranean diet consists mostly of vegetables. There is no significant beef industry in the 21 countries that touch upon the shores of the Mediterranean Sea, largely because it is so expensive both in terms of money and in environmental resources. Goats and young sheep are much less costly for both. Until a few decades ago they had no refrigeration either, which is why cheese, not milk, is the major dairy product. Fish and other products of the sea are major suppliers of protein.

Consider a favorite menu at the Olive Garden – A Tour of Italy: 1500-1800 calories,93 grams of saturated fat and 3,210 milligrams of sodium. And that doesn’t count the breadsticks, the wine or the dessert. The Olive Garden does have a number of very healthy items and if you like it – and I do – be sure to read the fine print on the menu.

The True Mediterranean Diet is a favorite of healthcare advocates. Scores of scientific articles attest to its cardiovascular and anticancer benefits. And of course, it includes a glass of red wine.

Carvings January 15, 2026

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Finally – a more sensible Food Pyramid.

            First comes a symbolic leap – the pyramid is inverted. That’s an attention-getter! But less symbolic and more practical is the array of foods across the top. Broccoli, carrots –not quite everyone’s favorites but carrying important nutrients, including carotene and zeaxanthin for healthy vision. The steak could hardly have been relegated to a position down the pyramid considering Americans’ unquenchable taste for red meat (and the clout of the beef industry). The accompanying saturated fat, once condemned as a major cause of coronary artery disease, has been rehabilitated. In my opinion, its hazards cannot be ignored, but having beef, lamb or pork a couple of times a week is not likely to shorten one’s life. There are many other foods that will.

What’s not there: processed meats, refined flour and all forms of sugar. There is overwhelming evidence that overindulgence in the latter two is mainly responsible for the current epidemics of obesity and type two diabetes and the former is associated with cancer. Food pyramids of the past placed junk foods, sweets and sugary drinks at the top, suggesting that they could be part of a healthy diet. They cannot. It is my fervent hope that as a follow-on to the revision of these dietary guidelines there will soon be legislation that will gradually eliminate them from the food scene.

Almost hidden between a carton of milk and a can of green beans is a flask of oil. Is it olive oil or a cooking oil – presumably an omega-6 variety? Both are healthy but the Standard American Diet (SAD) contains too little of the former and too much of the latter. On the other hand, sources of omega-3 fats are represented by the salmon and shrimp. So is tuna, in that little blue can between the egg – no longer a cause of elevated cholesterol – and the avocado, perhaps the healthiest item in the entire pyramid.

Whole grains are at the bottom. Strictly speaking they are not unhealthy, but we should be aware that humans evolved without them.  The old pyramid displayed not only bread, but a large sack of white flour, white rice and a pretzel. They are gone.

There is much, much more to the guidelines than I have mentioned here. I commend the creators of the new version for their willingness to finally tackle the core problem of the nation’s declining health.

The full report, which is an easy read, can be found on Google: dietary guidelines 2026. Go to the realfood.gov link.

Lifestyle

Stop falling!                                              

            A major cause of falls, even in middle age, is the loss of muscle that is the curse of the affluent, technically advanced lifestyle. Without labor-saving devices and powered vehicles, your grandparents, from childhood through their later years, had no choice but to use muscle power to get anything done. It was a blessing, not a curse. With few exceptions, today’s Medicare recipients began losing muscle mass in their mid-twenties at the rate of nearly one percent per year. If muscles mass diminishes by a third to a half, the body sees no need to maintain as much bone mass to support it, so bones become less dense and more fragile.

            There are other factors that increase the risk of falls. As we get older our alcohol tolerance decreases as our muscle mass diminishes and we are often on the verge of dehydration; there is less body water in which to dilute the alcohol. Most seniors take one or more prescription drugs, some of which lead to drowsiness or dizziness, and some of these medications are potentiated by alcohol.

            As old age creeps up on us slowly we need to make some changes in order to avoid falls. It may be time to get rid of scatter rugs. Have a non-skid mat in the tub or shower. Put night lights in the hallways and bedroom. Wear slippers, not socks, when you take off your shoes.  

            A broken hip might not be life-threatening but a cracked skull certainly is.

Carvings January 1, 2026

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Happy New Year!

In the news

Is a pill the answer?

                The new year is going to see a surge in the oral forms of Ozempic and similar drugs for control of type 2 diabetes and for weight loss. The injectable forms of GLP-1, in spite of their inconvenience compared to oral medications, have been very popular because they are effective and they have relatively few serious side effects.

                The availability of a new class of drugs for the control of type 2 diabetes is welcome. That disease, which is entirely lifestyle related with very few exceptions, is a threat to the financial stability of the healthcare system. If the CDC projection is correct, more than half the U.S. population will be burdened with this disease by 2050 and the cost will reach over one trillion dollars per year.

                What are the practical aspects of the new pills in regard to weight loss? Some studies show a weight reduction of 10-15 percent; the best that I have seen in one trial was 27 pounds. That degree of fat loss does matter. It lowers the risk of coronary artery disease, stroke and the complications of type 2 diabetes.  That’s not the end of the story. A 250-pound person who loses 27 or 30 pound is still obese. They have lowered their risk but they have not eliminated it. The benefits are not permanent. Approximately two-thirds of users will regain their weight within only one year after stopping medication.

                There is nothing easy about trying to lose weight. The new pill has not changed that.

                The hardest “pill” for Americans to swallow is a change in lifestyle. Prescription drugs will help along the way, but only a reduction in caloric intake will eventually eliminate a decades-old accumulation of fat. Nor is exercise the answer. To exercise without cutting food intake is folly. However, it is extremely important to exercise regularly when on a calorie-reduction diet in order to prevent the loss of muscle mass that would otherwise result.

                The holidays are a lousy time to cut back on calories, but the holidays are over. Consider just throwing away all the goodies that were foisted upon you by loving friends and relatives. (A confession: I will not throw away my daughter’s fruit cake! Everything else goes.)

Carvings, December 1, 2025

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In the news

I hope that I’m preaching to the choir

        As you know from recent blog posts, the influenza vaccine, though it does not always prevent the flu, is important because it decreases the severity of an infection, likely avoiding hospitalization. You may also recall that an episode of influenza significantly increases the risk of a heart attack or stroke, while the vaccine has just the opposite effect. Another point to emphasize: influenza weakens the immune system, which is the reason why deaths from the flu are almost always due to secondary infection, not viral infection.

                Infectious disease experts warn that this year’s flu season will probably be more severe than most because the current strain is more potent. This is already evident in Australia and the UK. That makes getting the vaccine especially important this winter.

Lifestyle

What hardly anyone knows about exercise.

                The title of this blog might seem somewhat pretentious but the evidence is all around us. Surveys over the years are pretty consistent: about eighty percent of Americans simply do not engage in any form of exercise. An interesting coincidence: eighty present of Americans are overweight or obese. Are they the same eighty percent. Ya think?

                The human body has evolved to require several hours a day of moderately intense physical activity. Before the Industrial Age there was no way around it. Getting to or from anywhere required walking. (Lest you think that riding horseback didn’t require physical activity, be assured that a ride of any distance is a pretty good workout.) Craftsmen used only hand tools; the most mundane household chore required lifting, carrying, chopping, etc..

                Moderately intense physical activity has two major effects: it burns calories and it opens dormant blood vessels. If we use up all the calories we take in there aren’t any left to be turned into fat. That’s obvious but what is not so obvious is that those fat stores are factories (fattories?) for churning out inflammatory chemicals that are the drivers of coronary heart disease, ischemic stroke, type 2 diabetes, cancer and osteoporosis. Another interesting coincidence: none of those conditions exist in pre-industrial societies – not one, except for some cancers!

                When your heart pumps vigorously in the course of intense physical activity, every blood vessel in the body, even those that are “resting”, opens up to accommodate the flow. That ensures that every cell receives oxygen and nutrients and gets rid of accumulated waste products. The ebb and flow of blood also keeps those blood vessels flexible so that they can handle the sudden stress of the kind that might precipitate a heart attack or stroke. 

                Twenty-five percent of the blood that exits the left side of the heart goes to the head, nearly all of it to the brain. Simply put, well-fed brain cells last longer.

                The excuse that I hear most often is “I don’t have time”. I’ll address that issue in the next post.

Carvings September 1, 2025

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In the news

Omega-3s and Alzheimer’s Disease

            Omega-3 fats are critical nutrients for every cell in the body, especially those in the brain and eyes. The main natural sources, fish and leafy green vegetables, are lacking in the diets of most people. Now there’s another reason to ensure that you get what you need. A study of more than 800 Alzheimer’s Disease (AD) patients in the UK revealed that women with AD had fewer omega 3s and more saturated fat in their blood than normal individuals. The authors caution that “this still warrants further research” a CYA phrase that seems to be included in so many scientific publications, but it is consistent with hundreds of peer-reviewed articles that show how important omega-3 fats are. A study that I included in my lecture on avoiding dementia about two decades ago revealed that patients with AD had less omega-3 fats in brain tissue than normal persons.

          Alzheimer’s Disease is enormously complex, beginning with the fact that there are several types of this disorder, that at least one form is strongly hereditary, and that not a single drug has been shown to significantly reverse it or to stop it. All the more reason to do what we can with proper nutrition and lifestyle (see the article below) to slow it down.

Lifestyle

What do knitting and playing the piano have in common?

            Neuroscientists have known for decades that mind-engaging activities can stimulate the formation and connectivity of brain cells, thus developing a “cognitive reserve” that delays the progression of age-related brain shrinkage and Alzheimer’s Disease. Two new studies reveal why activities such as knitting and playing the piano are particularly valuable. They both require the use of two hands, advance planning and fine motor movement. (Note that similar activities such as woodworking, painting and model building are similarly beneficial.) The result of the aforementioned nerve cell connectivity is improved memory, better motor skills and a reduction in stress. Specifically, a study of seniors engaged in piano playing showed improvement in areas of the brain that are associated with memory and language. Brain-associated hormones also showed improvement in the knitters. The stress hormone cortisol was reduced while serotonin and dopamine – the latter associated with Parkinson’s Disease – were increased.

          It’s important to emphasize that you can build a cognitive reserve at any age, and the benefits of these activities have been observed even in persons who are already showing symptoms of dementia or Parkinson’s Disease.

          The adage “It’s never too late” takes on new meaning.

Carvings July 15, 2025

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In the news

U.S. children’s health going downhill

            A very significant paper was published this month in JAMA, the Journal of the American Medical Association. It is the loudest wake-up call that I have heard yet, warning us of a deadly trend: American children from birth to age 19 years are nearly twice as likely to die as a cohort from 18 other high-income nations. Nearly half (!) – 45.7 percent — have a chronic health condition such as autism, sleep apnea, behavioral disorders and depression, among others. Nearly 21 percent of children are obese. (The figure was 5.2 percent in 1974.) The type 2 diabetes epidemic among children shows no slowing trend.

            It’s frightening to think what this scenario will be like two or three generations from now, knowing that the several causes of these conditions are unlikely to be reversed without severe, draconian regulations that no politician dares to propose. The multiple causes have been staring us in the face for decades but there is no national will to eliminate them.

            A major cause of the decline in our children’s health is the lack of outdoor exercise. Kid power is no longer needed for bicycles, skateboards or scooters. Team sports are over-organized, so that the kids expend minimal energy. A study of PE classes in schools revealed that the students were actually moving for only ten minutes out of an allotted hour.

            Processed foods high in salt and sugar have replaced vegetables. More than half of children are deficient in omega-3 fats that are crucial for brain development and function.

            The recent decision to remove artificial dyes from candy and other forms of junk food will have only a minuscule effect on children’s health. It is junk food, not just its coloring, that should disappear from grocery shelves. That is unlikely and so is the prospect that the nation’s children’s health issues will be reversed in this generation. The only hope is that individuals and their families will follow a healthy lifestyle.

Carvings May 1, 2025

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In the news

Your brain on eggs. What does it mean for Alzheimer’s Disease?

            Alzheimer’s Disease (AD) has become a severe burden in the U.S., both financially and emotionally. Six million Americans already suffer from the condition and it is projected to more than double by 2050. It is not only because our population is aging. In my opinion, our diet plays a major role in the development of this debilitating disease. 

            Caveat: this blog addresses only a single nutrient. Many other factors, nutritional, inflammatory, toxicological and social are part of the picture. However, the one discussed here is entirely under our control.

            According to the Framingham Study, a research program that was instituted more than 75 years ago by Harvard Medical School and that carries a stellar reputation in tracking the dietary and lifestyle habits of generations of participants, a low intake of dietary choline is associated with an increased risk of dementia, including Alzheimer’s Disease. It is one of many recent studies that have noted that inverse association. Further, it is becoming evident that the current DRI (Dietary Reference Intake) for choline “may not be optimal for proper brain health and cognition”. (Ref.: Velaquez R et al., Choline as a prevention for Alzheimer’s Disease, Aging 2020 Vol. 12, No 3, p. 2026-270).

            In July 2024 the Rush Memory and Aging Project, involving more than 1,000 subjects, reported that a modest intake of two eggs per week was associated with a decreased risk of Alzheimer’s Disease, and at autopsy, AD patients with a higher egg intake showed fewer changes in the brain than are typical of that disease.

            Although choline is present in many common foods, especially poultry, fish, red meat, eggs, liver, cruciferous vegetables (such as broccoli, kale, Brussels sprouts, etc.), nuts and seeds, the Standard American Diet (S.A.D.) is lacking in almost all of these foods except for red meat. Taking a vitamin supplement won’t help; among several whose labels I examined, none lists choline in the list of ingredients. A solution appears to be the Mediterranean Diet, which includes the best sources of choline and many other nutrients.

            Eggs to the rescue! As noted in recent posts, eggs are among the healthiest foods and contain a generous amount of choline. Cholesterol is a non-issue. Eating two or three eggs every day will not raise your blood cholesterol by a single milligram, unless you eat them with “egg helpers” such as bacon, sausage, ham, hash browns, etc., all of which contain saturated fat, the real cholesterol-drivers. Eggs are excellent sources of protein and vitamins A, B complex, D and E, and several important but lesser-known nutrients.

            The recommendation of the month: Include a veggie omelet in your meal plan at least twice a week. Frozen mixed vegetables make it really easy. Be sure to add a tablespoon of olive oil to the mix. And leave those egg-helpers on the supermarket shelf!

Carvings April 17, 2025

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In the news

Synergistic supplements

            I have long argued that a high dose of a single supplement – vitamin, mineral or other – is not a solution to any health problem. Most if not all nutrients interact with each other like the instruments in a symphony orchestra and taking a large amount of any nutrient causes imbalance which can be harmful. On the other hand, we must ensure that our diet includes optimal amounts of vitamins, minerals and other nutrients.

            Omega-3 fatty acids are absolutely essential for virtually every cell in the body. They are vital for normal development and function of the heart, brain, eye and skeleton. Numerous studies link omega-3 deficiency with behavior disorders, schizophrenia, bipolar disorder and attention deficit disorder, and other neuropsychiatric problems.

            Vitamin D also has numerous roles, especially in maintaining a vigorous immune system. The deficiency of this vitamin in childhood results in rickets, a softening of the bones, often accompanied by serious brain damage. It is one of the many nutrients that are essential in preventing osteoporosis in older persons.

            Both of these nutrients are lacking in most Americans. An astonishing 95 percent of children and more than 65 percent of adults have an inadequate dietary intake of omega-3s. More than half of adolescents and adults have inadequate levels of vitamin D, especially in the northern latitudes. These two nutrients together act in the synthesis of serotonin, a brain chemical that regulates executive function and social behavior.

            Psychiatric disorders in our young population have reached levels that threaten to overwhelm our healthcare system. Children’s hospitals throughout the country find themselves unable to cope with what is clearly an epidemic. Nutrition alone will not stem the tide but it clearly is one factor that is within our ability to improve. Perhaps we should start with some strategy to get our kids to bolster their diet with these synergistic supplements. 

Lifestyle

            We are about to see an assault on highly processed foods, which now account for 60 to 90 (!) percent of the Standard American Diet (SAD – a perfect acronym) There is more to this picture than the addition of dozens of chemicals that make non-nutritious foods so attractive and addictive. In the course of altering the basic ingredients, the manufacture of these products results in the loss of important vitamins, minerals and fiber. Sometimes these are added back in, of course. That may not be enough, as reported in data from the UK’s National Health Service, showing a surge in hospital admissions due to vitamin deficiencies.

            All three leading causes of death, heart disease, cancer and type 2 diabetes, are unequivocally associated with (a) a high intake of highly processed foods and (b) the lack of whole foods, such as whole grains, legumes, fruits and vegetables. Highly processed foods include our favorite processed meats: cold cuts, hot dogs, bacon and sausage. We might add a warning from a 2009 article in the British Journal of Psychiatry: Persons who ate whole foods had a 26% lower risk of depression; those who ate processed food had a 58% higher risk. (Akbaraly TN et al., Dietary pattern and depressive symptoms in middle age, Br J Psychiatry 2009 Nov;195(5):408-13)