Tag Archives: food

Carvings December 15th, 2025

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In the news

Another win for chocolate

            Well, not exactly. A recent study from Birmingham, England among a small group of volunteers showed that the harmful effects on blood vessels that occur during prolonged sitting can be offset by drinking cocoa. The researchers didn’t use dark chocolate, but a specially formulated cocoa drink that had a high level of flavonoids, the micronutrients that help to maintain the health and flexibility of blood vessels. In short, it was not the kind of hot chocolate mix that is so popular at this holiday time.

            Excellent sources of flavonoids include fruit, berries, nuts and tea, including green tea and herbal teas such as chamomile. These are all far superior to the sugar-laden hot chocolate mix that you’ll find at your local grocery store.

            Sitting, even for short periods – two hours in the study noted – has adverse effects on the flexibility of blood vessels and blood pressure. Decades of such inactivity inevitably lead to the kinds of cardiovascular diseases (heart attack and stroke) that are two of the three leading causes of death in Western society. Unfortunately, many occupations necessarily require long sessions at a desk. Wouldn’t it be nice to know that we can possibly offset at least a little of sedentary living’s hazards by some healthy snacking and sipping?

Lifestyle

            In the previous blog I promised to address the “I don’t have time to exercise” issue. Pardon my being blunt, if not outright crass, by pointing out that those making that argument will have plenty of time – but later – while in rehab, recovering from a heart attack or stroke, or getting around in a wheelchair while waiting for a prosthetic leg to arrive. Gross! I know, but it’s a fact.

            The most obvious lifestyle change is to substitute some TV-watching time for at least one hour of physical activity about four or five times a week. Even that relatively small input of time has been shown to significantly improve your chances of avoiding a cardiac catastrophe. And anyway, the news never changes – only the places where it’s freezing/flooding/quaking/erupting or how many people have been shot/stabbed/arrested.

            Then there are the many other ways of activating your muscles and improving your heart and lungs: stealth exercise. Take the stairs instead of the elevator – up and down. Do you find yourself driving around the parking lot to find the closest one to the entrance to the gym? The gym?!? If you park at the farthest corner of the lot you’ll get a warmup and a cooldown, you’ll never “lose” your car and your car door is less likely to get dinged. Stand up when you’re on the phone. Let your dog take you for a walk three times a day instead of twice on weekends.

            Exercise as if your life depends on it. It does!

Carvings September 1, 2025

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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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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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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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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)

Carvings December 15, 2024

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In the news

A deadly trend

          There have been several articles in the past couple of months about the rise in colon and rectal (colorectal) cancer among younger persons, even those in their thirties, actually doubling since the 90s. As a result of this trend, some medical authorities now recommend that screening for colorectal cancer should begin at the age of 45, or even earlier.

            The gold standard for the identification of colon cancer is a colonoscopy, not a trivial procedure but hardly a painful or risky one. Even the so-called “bowel prep”, which sometimes requires long sessions sitting on the commode, has become less onerous. New methods of non-invasive screening that identify blood and abnormal DNA in a stool sample are convenient and cost a fraction of that for a colonoscopy.

            I have read several media articles describing this worrisome trend, and those writers who point to diet blame junk or highly processed food. This is probably one cause but more important, I believe, is what is not in the diet: plant food. Everyone is aware that the fiber in fruits and vegetables promotes bowel activity but few understand why that matters. Simply put, when fecal material that may contain cancer-causing substances (carcinogens) stays in prolonged contact with the lining of the colon it may initiate DNA damage that leads to cancer. But there is another factor. Plant foods contain salicylates, one form of which is aspirin. The inflammation-reducing effect of aspirin/salicylates is obvious; we have used it for centuries to reduce the inflammation of infection and injury. Such inflammation promotes cancer, and it may explain why vegans are at lower risk of colorectal cancer than consumers of the Standard American Diet (SAD).

            Young persons are notoriously lax in their intake of fruits and vegetables. The average teenager eats less than one serving per day – a documented 0.9 servings – instead of the recommended ten, thus losing out on the myriad of nutrients such as vitamins, minerals and phytonutrients that our bodies have evolved to require.

            We can seriously slow down this cancer surge by making some simple dietary changes, educating people about the nature of the disease and promoting early screening. Is that asking too much?

Lifestyle

Pizza – the good, the bad and the ugly

            Would it surprise you to learn that I consider pizza a health food? With caveats, of course.

            First – the good. The toppings make all the difference. The crust, usually made of refined flour, is not a great source of nutrients but the (usually) most common topping is tomato sauce, sometimes with chunks of tomato as well. Cooking tomato enhances the absorption of lycopene, a carotene, and some studies have shown that it reduces the risk of cardiovascular disease and prostate cancer.

            Other nutritious toppings include bell pepper, which is rich in antioxidants, and onions, which are also rich in antioxidants and may be helpful in preventing cancer. Mushrooms are a good source of vitamin D and are known to improve immune function, possibly because of the vitamin D content and numerous phytonutrients. Olives are a Mediterranean staple for a good reason. They are rich in monounsaturated fats and vitamin E; the latter is associated with a documented reduced risk of osteoporosis. Eggplant, very much underappreciated, is rich in vitamins and antioxidants. Pineapple is a newcomer to the pizza world but it is rich in fiber. And of course, there is garlic, whose cardiovascular and anticancer benefits have been studied for decades.

            The bad: cheese (Sorry!) The amount of cheese on a single slice of American pizza would be enough for a Mediterranean family of four for a couple of days, because they use it only as a garnish, not as a main meal ingredient. You’ll find a standard serving of cheese in only two slices, with plenty of saturated fat. And if you’ve wondered why you’re so thirsty after eating pizza it’s because of the salt. A single slice of pizza contains more than 500 milligrams of sodium, so two slices (without the sausage or pepperoni) will provide you with nearly half of the recommended dietary allowance. Is it any wonder why more than half of Americans have high blood pressure?

            Pizza without cheese?? No way! But if you ask for half the usual amount of cheese, you’ll still enjoy the full flavor of America’s favorite comfort food, and if you ask for a “no cheese pizza” you’ll certainly confuse your server but you’ll still enjoy it if you add all those other veggie toppings.

            The ugly: sausage and pepperoni. These processed meat products have been classified by the World Health Organization as a Group 1 carcinogen, and strongly associated with cancer of the stomach and colon. Their high concentration of nitrites and nitrates has the European Union pushing for their reduction in food products.

            Putting pizza in perspective. As mentioned above, the toppings make all the difference. Ask for lots of the good, less of the bad, and none of the ugly.

            And here’s a bonus for readers in San Diego’s North County: Jay’s Gourmet Restaurant in Carlsbad (at the intersection of Carlsbad Village Drive and Carlsbad Boulevard), has the best pizza in town: seafood pizza loaded with fish, scallops, mussels, calamari and clams. All excellent sources of lean protein and omga-3 fatty acids. You’ll never again miss the pepperoni.

Carvings December 1, 2024

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            The outbreak of the week – what’s going on?

            Ground beef, onions, sprouts, carrots, cantaloupe, eggs – is anything safe? The short answer is “No.” Any food product can be contaminated with bacteria such as E. coli, Salmonella and Listeria – they are simply part of our environment. The good news is that we can avoid becoming ill from these organisms by taking a few simple steps.

            It’s a fact of life that most of the animals that we depend on for food are swarming with bacteria, most of which are harmless but some of which can be deadly, especially for the very young, the very old, and those with medical conditions that weaken their immune systems. Depending on the local circumstances, about 40 percent of chickens are contaminated with Salmonella bacteria; for beef it’s a similar percentage that is contaminated with E. coli. Listeria bacteria, which are especially dangerous for pregnant women and small infants, contaminate a wide variety of plant foods.

            Thorough cooking provides the best defense against contaminated chicken, beef or shellfish. As much as you might enjoy steak tartare or raw oysters, those foods carry some risk. So do bean sprouts, which are often served raw on salads or sandwiches. If you serve bean sprouts at home, make sure that they’re fresh, keep them refrigerated and cook them thoroughly.

            All fruits should be washed thoroughly as soon as you bring them home from the market or fruit stand. I always use soap and ignore the questionable advice of some nutritionists who warn us about the chemicals in soap. Bah! Just be sure that you rinse them thoroughly. Be particularly assiduous about cantaloupe – that rough skin makes it hard to remove bad bacteria. The knife with which you cut melons or other fruit can carry bacteria into it.

            Buying pre-cut fruit is not a great idea. Aside from the possibility that the preparers might not follow good hygiene practices, if it has been sitting in the cooler for several hours that allows bacteria to grow and gather in greater numbers. The “convenience” isn’t worth the risk.

            About 45 million Americans become ill from contaminated food each year. You can avoid being one of them.

Lifestyle

            What to do about leg cramps?

            Almost everyone gets leg cramps, usually in the calf. They have a myriad of causes and there is no simple way to prevent them or to provide immediate relief, but there are some things to consider.

            If you get leg cramps frequently, several times a month, or if muscles in other parts of the body cramp up, that’s an indication for a thorough medical exam. If there is local swelling, or the pain is persistent, don’t delay. I have consistently recommended that everyone should have a thorough physical exam and basic blood tests every year, especially after the age of 40, because conditions such as high blood pressure, kidney disease and diabetes show no symptoms until significant damage has occurred.

Dehydration is a common but subtle condition, especially among seniors, and it may be the cause of leg cramps. Be sure to have at least one glass of water between dinner and bedtime. (Yes, I know – that probably means at least one visit to the bathroom at night but it’s a small price to pay.)

As soon as you feel a cramp starting, get up immediately, stretch the calf by leaning forward flat-footed or by pulling your toes toward you, or by massaging the calf. Sometimes chewing on one or two Tums tablets will relieve the cramp almost immediately, so have a bottle of Tums handy if that seems to have worked for you. Standing on a cold tile floor may also help; sometimes walking around provides relief.

A variety of vitamin and mineral inadequacies have been blamed for leg cramps but there is no nutrient that seems to work consistently. The Standard American Diet (SAD!) is so poor that even the American Medical Association advocates a multivitamin/multimineral supplement for everyone. Whole grains, fruits and vegetables, especially leafy greens, should be part of everyone’s daily diet.

If you have had good results with anything that I have not mentioned here, feel free to share your experience with me at drphilg@cox.net.

Carvings October 1, 2024

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In the News

The flu season begins today

          Today marks the official start of the influenza season and this post is a reminder that it should be a top priority for everyone, especially those of us who are old enough to be on Medicare.

From a prior post: The influenza vaccines that have been developed over the last half-century are far from perfect, but to quote an old saw: “The perfect is the enemy of the good.” Some vaccines have low efficiency, perhaps about 25 percent, but some are much better and it will take a few months before we know how effective the latest version is. As I have noted numerous times over the past several decades, the flu vaccine might not keep you from getting that disease but the evidence has been consistent that it will keep you out of the hospital, and from dying. Remember that influenza weakens the immune system, which is why nearly all influenza-related deaths are not due to the virus itself but to secondary bacterial invaders, many of which are now resistant to almost all antibiotics. The problem of antibiotic-resistant bacteria continues to worsen and many of these are circulating in hospitals.

           Another benefit: a nine-year study involving more than four million adults showed that the influenza vaccine reduced the incidence of all forms of stroke by about 25 percent. Previous research indicated that there is a similar reduction in heart attacks in vaccinees. Conversely, there is a significantly greater risk of heart attack and stroke following natural influenza virus infection.

            As of this week there is almost no influenza activity in the U.S., but you should plan on getting the vaccine no later than the end of October. It remains effective for about six months, which will take you through the end of the flu season in the Spring.

Lifestyle

Vitamin C deficiency versus inadequacy

            If your car runs out of gas (deficiency) it stops. If you fill the tank with poor quality gas it will sputter and barely make it up a steep grade (inadequacy). A publication in the journal Nutrients revealed that the same concept applies to vitamin C.

            Scurvy is a debilitating and often fatal disease caused by an absolute deficiency of vitamin C and was the scourge of seafarers until a British naval physician convinced the admiralty to provision its ships with fruit, especially citrus (hence “limeys”, a term describing British sailors). The Nutrients article notes that persons with inadequate levels of vitamin C are 2.3 times more likely to suffer from coronary artery disease than those with normal levels.

            During the recent pandemic it was noted that severe, sometimes fatal infections were associated with “vitamin C deficiency”. (Note: even researchers misuse the term “deficiency” when they really mean “inadequacy”, as embarrassingly noted in the article.)

            Vitamin C is a critical nutrient that helps to control inflammation, which is a driver not only of heart disease, but also of cancer, stroke and osteoporosis, among other maladies. Further, it is necessary for the proper maintenance of connective tissue, the element that literally holds our cells and tissues together. When it fails the result is bleeding in the gums and other tissues, tooth loss, neurologic disorders, weakness and death – the hallmarks of scurvy.

            It’s well-known that organized medicine, with a few exceptions, claims that vitamin supplementation is foolish. Yet a report from the University of Colorado points to the occurrence of frank scurvy among children, most of whom have poor eating habits. Those researchers also observe that the nutrient value of today’s mega-farmed plant foods is considerably lower in vitamins, minerals and protein than those grown 75 years ago.

The lesson: vitamin deficiencies are not common but vitamin inadequacies are. Even the American Medical Association, in a pair of landmark publications in 2002, (Journal of the American Medical Association June 19, 2002, Vol. 287, No. 23, P. 3127) urged that everyone should take a multivitamin/multimineral every day, a position completely opposite that of earlier recommendations and sadly still espoused by some physicians today.

Carvings June 1, 2024

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More confusing research

          The last thirty years or so have seen a surge in publications touting the benefits of omega-3 fats in preventing heart disease and stroke. There have been a few studies that claim no benefit, but almost none have stated that these nutrients can be detrimental to heart health. A recent study from the UK reported that persons with poor heart health did receive benefits from omega-3s but previously healthy persons had a small (6 percent) risk of developing atrial fibrillation, a heart attack, heart failure or stroke.

          Even though this was a large study involving more than 400,000 people, it was observational and did not show direct causation. The authors noted that a limitation of the study was the lack of information regarding the dose and type of fish oil consumed. Takers of fish oil were significantly more likely to be elderly, which could be a factor in more of them developing atrial fibrillation.

          Although healthy persons taking fish oil supplements were more likely to develop heart disease, they were less likely to die than non-takers. The authors’ discussion did not take into consideration other benefits of omega-3 fats, including the lowering of inflammation, reduction in blood pressure, improvement in immune function and a lower risk of sudden cardiac arrest. A circuitous benefit of omega-3 fats is their role in preventing osteoporosis. A fall in an elderly person that results in a fracture leads indirectly to death, especially when that fracture involves the hip or the skull, for very different reasons.

          In an associated commentary, a nutritionist stated that she still recommends an intake of 500 milligrams of omega-3 fats per day, from fish, fish oil or a combination of the two.

And so we come to sardines!

          Sardines are one of the most beneficial foods on the planet, but I can already hear you say “Ugh! Not for me!” From my lecture experience I am well aware that Americans are about evenly split between sardine lovers and sardine haters. An Internet search will come up with nearly 100 recipes for sardine dishes, although I will admit that “sardine pie” did not excite me.

          Because sardines are so low on the food chain there is virtually no risk of mercury contamination that is a challenge in large fish such as tuna. A single four-ounce serving provides more than the recommended amount of omega-3s mentioned above, a fourth of your calcium requirements and as much iron as a hamburger. Canned sardines are convenient, can be stored almost forever and are a whole lot cheaper than beef or larger fish.