Tag Archives: food

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)

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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In the news

            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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In the news

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.