SuperFoods for Any Century

Steven G. Pratt, MD, FACS, ABIHM

La Jolla, CA

EPSE

September 2011

2004

2008

2006

2009

• SuperFoods• Healthy Fats• SuperNutrients• No Cigarettes• Alcohol and health, fortune, humor & character• Sleep• Stress Reduction• Portion Control = Weight Reduction/Control• Physical Activity = burn those calories!• Spirituality

SuperHealth Includes

• Load up on Fiber• Inflammation the “natural” way• High Potassium – Low sodium diet• Potassium (as intake , mortality from CHD, total CVD)

– 0.65 (95% CI: 0.39, 1.06, P for trend=0.083) = CHD– 0.73 (95% CI: 0.59, 0.92, P for trend=0.018) = CVD

• Sodium (as intake , mortality for total stroke, ischemic stroke, and total CVD)– 1.55 (95% CI: 1.21, 2.00; P for trend<0.001) = total stroke– 2.04 (95% CI: 1.41, 2.94; P for trend<0.001) = ischemic

stroke– 1.42 (95% CI: 1.20, 1.69; P for trend<0.001) = total CVD

* Am J Clin Nutr 2008; 88:195-202

SuperHealth Includes

SuperfoodsAre…• Healthy fat– carbs– protein• Whole foods• Timeless• Delicious• Readily available• Discussed in peer reviewed publications

– Associated with longevity– Loaded with longetivity nutrients

• Contain SPF (sun protective factor) nutrients• Inflammation the “natural” way• Can be eaten fresh, frozen, blended, pureed, freeze dried,

cooked, micro-waved

Superfoods Are Part of Healthy Dietary Patterns

• Mediterranean cuisine (Crete)• Okinawa• Japanese• Native American

Superfoods

• Spinach • Blueberries

• Salmon • Citrus

• Turkey Breast • Pumpkin

• Broccoli • Yogurt

• Walnuts • Oats

• Tomato • Legumes

• Soy • Green Tea

* Superfoods Rx : Fourteen Foods That Will Change Your Life, 2004

Superfoods

• Apples • Garlic

• Avocado • Honey

• Dark chocolate • Kiwi

• Dried fruits • Onions

• Extra Virgin Olive Oil • Pomegranates

• Spices

* Superfoods HealthStyle: Proven Strategies for Lifelong Health, 2006

Supernutrients

• Vitamin C • Lutein

• Vitamin D • Zeaxanthin

• Folic Acid • Lycopene

• Selenium • Beta Carotene

• Glutathione • Alpha Carotene

• Resveratrol • Beta Cryptozanthin

• Polyphenols • Fiber

• n-3’s

U.S. Life Expectancy Falls Slightly in 2008: CDC

• American life expectancy slipped slightly in 2008 to 77.8 years, the first dip since 2004

* National Vital Statistics Reports, Dec 2010;59(2)

5 US Leading Causes of Death

1. Heart Disease

2. Cancer

3. Chronic Lower Respiratory Diseases (Asthma, Bronchitis, Emphysema)

4. Stroke

5. Accidents

* National Vital Statistics Reports, Dec 2010;59(2)

Metabolic Syndrome (Met S)

• Constellation of – Central obesity– Dyslipidemia– BP– Triglycerides– Blood sugar

• 15.1% of Chinese (71 million) and similar percentage of Americans

• Low intensity counseling + flaxseed (30g/d) and/or walnuts (30g/d) central obesity, blood sugar, total cholesterol, & BP

• Lower your heart disease risk by 20%

• Beans lower cholesterol, blood pressure, blood sugars and weight (e.g. appetite suppressant), and risk for gallbladder surgery

• Risk for multiple cancers

• Low cost

• “Beano”

• “No Salt Added”

• No Lard

• Try to eat:  at least four ½ cup servings per week

Superfood #1: Beans

Dietary fiber intake related to relative risk for disease

based on estimates from prospective cohort studies

Disease No. of Subjects

Relative Risk

95% CI

Coronary heart disease 158,327 0.71 0.47-0.95

Stroke 134,787 0.74 0.63-0.86

Diabetes 239,485 0.81 0.70-0.93

Obesity 115,789 0.70 0.62-0.78

Superfood: Blueberries• Otherwise known as “brainberries”• Lower the risk of cardiovascular disease and cancer• There is a love affair between berries and your circulatory system

– Blueberries help lower blood sugar and blood pressure– Bioactives in BB, improve insulin sensitivity in obese, non-diabetic, and

insulin sensitive M & F’s (*J Nutr, 2010;140:1764)

• The best chance to move, think like a kid as you “mature”• Exercise associated oxidative

stress• May play a role in preventing obesity• Berries and colon cancer• Bathe each meal in berries• Berries CRP• #1 CAA• Try to eat: 1 to 2 cups daily

Blueberries Contain

• A synergy of multiple nutrients & phytonutrients

• Vitamin E• Potassium

• Polyphenols (anthocyanins, ellagic acid,quercetin, catechins)

• Manganese• Magnesium• Iron

• Salicylic acid• Carotenoids• Fiber• Folate• Vitamin C

• Riboflavin• Niacin• Phytoestrogens• Low calories• Resveratrol

Resveratrol

• Red wine (2-5 mg/L)• Purple grapes juice• Cranberries• Blueberries• Peanut skin• Mulberries

Resveratrol• A supernutrient• Activates a family of enzymes called sirtuins

– SIR2 stabilizes DNA slows cellular aging• Risk for Alzheimer’s (?)• Enhances cell communication in the “memory” region of

the brain• Protects brain cells against oxidative stress, damage from

diabetes, aging• Diminished effect of trauma to the memory regions of the

brain• Risk for CVD, cancer (?)

Resveratrol• Enhances muscle strength• Fatique• Mimics caloric restriction weight loss (?)• Inflammation• Nitric oxide makes blood vessels more flexible, BP &

blood flow• Normalize blood sugar levels• Memory & reaction time (human study)• 1150 bottles of red wine = dose of resveratrol used in

animal studies• Synergy with other polyphenols

Resveratrol Supplements

• MaxiVision Whole Body Formula– 5 mg/4 capsules– www.medop.com

• Paradise Resveratrol– 15 mg/ 1 vegetarian capsule

• Longevinex– www.longevinex.com

• Tru Nature Grape Seed & Resveratrol plus benefits of whole grape– 15 mg/1 soft gel

• Vindure 900– www.vinomis.com

• Consume with polyphenol rich foods• Trans-resveratrol the most active form• Dose/d 15 mg (Dr. Steve) ? 250-500 mg/d

• Purple grapes

• Boysenberries

• Strawberries

• Blackberries

• Pomegranates

• Acai

• Bilberry

• Buffaloberries

• Huckleberries

Blueberry Sidekicks

• Cranberries

• Raspberries

• Currants

• Cherries

• Chokeberries

• Gogi

• Lingonberry

• Salmon Berries

Superfood #3: Broccoli

• Risk for multiple cancers: 2 servings a day can result in 50% reduction in risk but…

– + effect in < 1 serving daily

• Up-regulates “detox” enzymes

• Most powerful, easiest to eat form of broccoli: broccoli sprouts (10 to 100x power of regular broccoli)

• Boosts the immune system, lowers the incidence of cataracts and maybe AMD, supports cardiovascular health, builds bones and fights birth defects

• Synergy with tomatoes to risk for prostate cancer

• Try to eat: ½ to 1 cup multipletimes weekly

Broccoli Sidekicks

• Brussels Sprouts

• Cabbage

• Kale

• Turnips

• Cauliflower

• Collards

• Bok Choy

• Mustard Greens

• Swiss Chard

  Superfood #4: Oats

• Whole grain consumption protects against cancer, cardiovascular disease, T2DM (our fastest-growing chronic disease)

• Positive associations have been reported between the consumption off refined grains and risk of multiple chronic diseases

• Whole grain bran fiber Atherosclerosis progression

• Whole grain intake is inversely and independently associated with carotid artery blood flow

  Superfood #4: Oats

• Higher whole grain intake associated with a lower cardiovascular disease risk reduction of 25% when high, low quintiles of intake are compared

• Whole grain fiber (bran & germ) helps risk for obesity, cardiovascular disease, and most likely colon cancer

• Whole grains death from inflammatory disease

• Try to eat: 5 to 7 servings a day of whole grains (for example, whole wheat bread would count!)or 10-21 grams whole grain fiber

Oat Sidekicks

Super Sidekicks– Wheat Germ– Ground Flaxseed– Oat Bran

Sidekicks

– Brown Rice – Buckwheat

– Wheat – Bulgur Wheat

– Barley – Rye

– Amaranth – Quinoa

– Millet – Kamut

• Arrowhead Mills Organic Oat Bran Pancake and Waffle Mix: 75 mg sodium, 6 grams fiber per ¼ cupwww.arrowheadmills.com

• Bob’s Red Mill Whole Ground Flaxseed Meal: 0 mg sodium, 4 grams fiber per 2 Tablespoonswww.bobsredmill.com

• Breadshop Granola Crunchy Oat Bran with Almonds and Raisins: 0 mg sodium, 4 grams fiber per ½ cup

• Country Choice Organic Irish Style Steel Cut Oats: 0 mg sodium, 4 grams fiber per ¼ cupwww.countrychoiceorganic.com

• Familia Swiss Muesli: 0 mg sodium, 4 grams fiber per ½ cup www.bio-familia.com

• Food for Life Sprouted Grain Ezekiel 4:9 Bread (low sodium): 0 mg sodium, 3 grams fiber per slice

Low Sodium Whole Grain Foods

Low Sodium Whole Grain Foods

• Garden of Eatin’ Blue or Yellow Corn Taco Shells: 5 mg sodium, 1 gram fiber per 2 taco shellswww.gardenofeatin.com

• Julian Bakery Cinnamon Almond Raisin Bread: 75 mg sodium, 12 grams fiber per slicewww.julianbakery.com

• Kashi Go Lean Cereal: 85 mg sodium, 10 grams fiber per ¾ cup

• Kashi Heart to Heart: 90 mg sodium, 5 grams fiber per ¾ cup

• Kashi TLC Tasty Little ChewiesPeanut/Peanut Butter, 90 mg sodium, 4 grams fiber per 1 barTrail Mix, 105 mg sodium, 4 grams fiber per 1 bar 1 bar

www.kashi.com

• Kretschmer Toasted Wheat Germ: 0 mg sodium, 2 grams fiber per 2 tablespoonswww.kretschmer.com

Low Sodium Whole Grain Foods

• Post Shredded Wheat and Bran: 0 mg sodium, 8 grams fiber per 1 ¼ cup www.kraftfoods.com

• Quaker Oat Bran: 0 mg sodium, 6 grams fiber per ½ cup

• Ralph’s Whole Wheat Rotini: 0 mg sodium, 5 grams fiber per ¾ cup

• Ronzoni Healthy Harvest 7 Grain Blend Pasta: 0 mg sodium, 5 grams fiber per 2 ounces

• Ronzoni Healthy Harvest Whole Wheat Blend Pasta: 0 mg sodium, 6 grams fiber per 2 ounceswww.ronzonihealthyharvest.com

• Whole Foods 365 Organic Whole Wheat Shells: 9 mg sodium, 5 grams fiber per ¾ cup

• Vogel’s Soy and Flaxseed Bread: 105 mg sodium, 5 grams fiber per slice 818-761-2892

  Superfood #5: Oranges

• Good source of vitamin C• OJ post-meal oxidative stress• Synergy with tea• Highest vitamin C intake associated with lowest all cause

mortality • Citrus polyphenols (Flavonones) the risk of CHD death in

women by 22%• Enjoy the skin

– Anti-inflammatory– Anti-cancer– Anti-atherogenic

• OJ consumption DBP, acute coronary events, stroke, oxidative stress

• Your blood vessels love OJ!• Try to eat: 1 serving daily

(drink high pulp OJ)

  Superfood #5: Oranges

* Am J Clin Nutr 93:73,2011

• Lemons• White and Pink Grapefruit• Kumquats• Tangerines• Limes

Orange Sidekicks

  Superfood #6: Pumpkin

• Rich in alpha carotene and beta carotene

– “Longevity nutrients”

• Helps lower the risk of various cancers (lung, colon, bladder, cervical, skin, and breast) and supplies nutrients necessary for healthy, youthful skin

• Inverse relationship between serum carotenoids and DM2

• Try to eat: ½ cup most days

Pumpkin Sidekicks

• Carrots• Butternut Squash• Sweet Potatoes• Orange Bell Peppers

Superfood #7: Wild Salmon• Diets high in n-3’s are conducive to CNS control of appetite

• The more omega-3 fish oils you eat; the lower your blood pressure and heart rate

• 4x weekly risk for and progression of AMD

• Men with the highest n-3’s 66% lesslikely to develop colorectal cancer

• Studies suggest that fish consumption is associated with a lower risk for depression, violent behavior, Alzheimer’s disease, Attention Deficit Disorder, Atrial fibrillation, total mortality, cellular aging, acute coronary syndromes

• Improved bone mineral density

• Berry polyphenols cellular EPA, DHA– Am J Clin Nutr 93:907, 2011

• Try to eat: Wild salmon, halibut,sardines, etc.  2 to 4 times per week

Superfood #7: Wild Salmon

Wild Salmon Sidekicks

• Canned Alaskan Salmon (www.vitalchoices.com)• Alaskan Halibut• Canned Albacore Tuna• Sardines• Herring• Trout• Sea Bass• Oysters• Clams

For healthy heart, brain, eyes—You must eat fish!!!

Monterey Bay Aquarium website www.mbayaq.org

  Superfood #8: Soy• Helps prevent cardiovascular disease, cancer, and osteoporosis,

and helps relieve menopausal and menstrual symptoms

• Super alternative protein; the only plant-based complete high-quality protein

• Lower risk for breast/prostate cancer– Risk for breast cancer recurrence

• Does not “sex drive”

• Avoid iodine deficiency when consuming soy

• The Soy – Kidney connection

• Important to eat soy during first2 decades

• Try to eat: at least 10-15 grams of soy protein per day and divide total soy intake to two separate meals or snacks

Soy Sidekicks (Forms of Soy)

• Tofu• Soymilk• Soy Nuts• Edamame• Tempeh• Miso• Soy Yogurt

  Superfood: Spinach and Other Leafy Greens

• People who eat them have risk for – Diabetes– Stroke– Colon cancer– Cataracts– Macular degeneration– Bone loss– Maturity related sarcopenia– Memory loss

• Try to eat: 1 cup steamed or 2 cups raw, dark, leafy greens most days

Spinach Contains

• A synergy of multiplenutrients & phytonutrients

• B vitamins (thiamine, riboflavin, B6, folate)

• Lutein / zeaxanthin • Alpha lipoic acid

• Beta-carotene • Vitamins C & E

• Plant-derived omega-3 fatty acids

• Minerals (calcium, iron, magnesium, manganese, and zinc

• Glutathione • Polyphenols

• Potassium • Betaine

• Nitrites/Nitrates

* Is also low in calories

Spinach Sidekicks

• Kale• Collards• Swiss Chard• Mustard Greens• Turnip Greens• Bok Choy• Romaine Lettuce• Orange Bell Peppers

• The cheapest, easiest, no-calorie way to improve your diet and live longer

• Risk for cataracts, hypertension (dose response)

• Inverse relationship between green tea intakeand risk for DM2

• Initial studies suggest may help to control weight by increasing energy expenditure (a “fat burner”)

• “The administration of GTC’s with caffeine is associated with statistically significant in BMI, body weight, WC”

– Clinical significance modest at best

* Am J Clin Nutr 2010;91:73

• Try to drink: >1 cup green, black,oolong, white,Rooibus (herbal) tea daily – don’t forget the lemon

• Ideal 4 cups/d & “squeeze” the tea bag “dry” then rub the bag on your facial skin

  Superfood: Tea

  Superfood #10: Tea • Not just women: Men who drink tea may reduce their risk of heart

attack by 44% with just one cup daily

• Green Tea Benefit in Women– 31% risk of dying from CVD

– 62% risk of dying from stroke

– 23% risk of dying from any cause

• Green Tea Benefit in Men– 22% risk of dying from CVD

– 42% risk of dying from stroke

– 12% risk of dying from any cause

• Green tea consumption ’s risk for breast cancer

• Green tea and cataracts, AMD

• Risk for diabetes

My Favorite Tea

• 3-4 oz hot water• Steep 2 green tea bags 3-4 minutes• Squeeze tea bags “dry”• Add 1-2 tsp dark honey• Add 3-4 ounces Silk Vanilla or plain Soy Milk (or Costco

Vanilla Soy Milk)• Enjoy!

What About Coffee?

• The #1 antioxidant source in the American diet– Has a favorable effect on some markers of subclinical

inflammation– Oxidative stress– A beneficial effect on HDL-C (filtered)– Coffee consumption risk for DM2

• 3-4 c/d risk 25% compared to 2 cups or less/d• Decaf also “works”

– Risk for endometrial cancer– Watch your sugar and milk – use Splenda, Stevia, honey &

soymilk or 1% low-fat organic milk– Avoid dairy substitutes??– 1 cup/d may risk of stroke by 30%

• Coffee contains compounds that are effective in helping to lower body fat

• Coffee bean indigestible mannooligosaccharides (MOS) play a role in “total body volume”– MOS = prebiotic properties– MOS total body fat

What About Coffee?

* J Nutr 140:1943,2010

Coffee – Tea – Brain Tumors

• Etiology of brain tumors (adult gLioma) poorly understood– Ionizing radiation– Genetic predisposition– ? EMF (e.g. cell phones)

• U.S. study reported a 40% risk between combined coffee & tea intake and gLioma ( 5 vs. 0-1 c/d) (* Cancer Epid

Biomark Prev 2010;19:39)– In same study caffeine risk in M > F

• European study reported a 34% risk for those consuming 100 mL coffee & tea per day compared with those consuming < 100mL/d (*Am J Clin Nutr 2010;92:1145)

Superfood #11: Tomatoes

• Lower the likelihood of cancer, can play a role in preventing cataracts, age-related macular degeneration, and cardiovascular disease

• A “natural blood thinner,” as are kiwi & purple grape juice/red wine

• The lycopene in tomatoes actually acts like an internal sun block = SPF Nutrients

• Try to eat: 1 serving of canned tomatoes per day and multiple servings per week of fresh tomatoes. Pizza can be a health food if you modify it slightly: more sauce; lesscheese plus whole grain crust

Tomato Sidekicks

• Red Watermelon• Pink Grapefruit• Japanese Persimmons• Red-fleshed Papaya• Strawberry Guava

Superfood #12: Turkey

• A perfect example of a twenty-first century "healthy" protein source, extremely low in fat, and provides multiple nutrients which help build a strong immune system

• Try to eat: 3 to 4 servings per week (3 - 4 ounces)

Turkey Sidekicks• Skinless Chicken Breast

Turkey Glutathione Connection

• Boost you Glutathione with high cysteine protein sources• Turkey breast• Chicken breast• Nonfat yogurt• Soy

• 90% of the phenols found in the skin (slight bitterness)• Gamma tocopherol > alpha tocopherol• Energy-dense powerhouse of anti-oxidants, anti-inflammatory

phytonutrients, minerals, healthy fat, protein• Platelet activation

– Wild salmon (n-3’s)– Kiwi, Tomato, Berries, Grapes

• Only 5.5% of all adults (19-50) consume tree nuts of any kind• Nuts can play an important role in helping to prevent obesity• A handful a day can cut your risk of

a cardiovascular event by as much as 15-51%• Protective against metabolic syndrome, DM2,

prostate and breast cancer• Promotes bone health

Superfood: Walnuts

Superfood: Walnuts• Endothelial cells love walnuts• Two tablespoons of peanut butter 5 times/week cuts risk

of type II diabetes by 20%• Along with tea, the easiest way

to improve your heath• A great snack food• Risk/progression of AMD• Melatonin • C-Reactive protein & TNF-a (inflammatory molecules)• Try to eat: a handful (7-14 walnut halves) of nuts, five

times a week

* Skip the salt and added oils

Walnut Sidekicks

• Almonds• Pistachios• Sesame Seeds• Peanuts• Pumpkin and Sunflower Seeds• Macadamia Nuts• Pecans• Hazelnuts• Cashews

Nuts and Omega’s

Grams/oz

Almonds 0

Peanuts 0

Pecans 0.28

Pistachios 0.07

Walnuts 2.6

  Superfood #14: Yogurt

• Non-fat and organic when possible• Great source of digestible protein; double the protein of

milk• Promotes strong bones and a healthy heart, great source

of calcium• Helps lower blood pressure (Dash diet)• Look for active cultures, prebiotics (e.g. Inulin)• Immune system booster• Try to eat: 2 cups daily

Yogurt Sidekicks

• Kefir• Stoneyfield Farm yogurt / fruit smoothie• Dan Active Immunity Probiotic• Soy yogurt• Sustenex (BC 30)

Prebiotic

“a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and

activity of one or a limited number of bacteria in the colon that have the potential to improve host health”

• “Fertilizer” for colon bacteria• Inulin-type fructans found in leeks, onion, garlic,

asparagus, Jerusalem artichoke, chicory• Prebiotic Superfoods include tea, blueberries, honey• Absorption of calcium, magnesium• Found in breast milk

Prebiotic

Probiotic

“a living microorganism which upon ingestion in certain numbers, exert health benefits beyond

inherent general nutrition”

Benefits of Probiotics

• Inhibit colon cancer• Help control dental caries• Constipation• Obesity• Infectious diarrhea in infants, children• Traveler’s diarrhea• H.Pylori

Benefits of Probiotics

• Anti-allergic• Atopic disease/eczema• Vaginal yeast/bacterial infections• Altering intestinal microflora (bacteria)• Immune system booster (G.I. GALT) and body-widelung,

nose, skin, URO-genital tract• Inactivation of toxins and detox of host and food

components in the gut

Benefits of Probiotics

• Anti-inflammatory• Anti-hypertensive• Found in breast milk• Probiotics, immunity, exercise• Daily intake for optimum results• IBS/IBD

Superfood #15: Dark Chocolate

• In a cohort of 470 elderly men, cocoa intake inversely associated with– Blood pressure– 15 year cardiovascular and all-cause mortality

• Inflammation• A “natural” blood thinner• HDL-C• Caffeine not an issue• Photoprotection of the skin

– Skin sensitivity to sunlight (25%)– Protects DNA from oxidation– Inflammation in skin– Cutaneous blood flow (100%)– Improves skin texture– Skin hydration

• Dark chocolate and sex – your brain may not know the difference

• Many risk for AD• At least in females, blood flow to parts of brain, associated

with cognition• Mortality in women• When buying dark chocolate, purchase brands with at least

70% cocoa solids• The BP med with NO side effects, but use portion control!• A prebiotic food• Excess dark chocolate without adequate “bone nutrients”

may increase your risk for osteoporosis!?

Dark Chocolate

Dr. Steve’s Hot Chocolate

• 3-4 Tbsp 100% ground organic cocoa beans• 6-8 oz Soy milk (warm)• 1-2 tsp dark honey

Only known side effect = better health

Superfood: Apples

• The fiber (pectin power) & the whole apple– TC, LDL-C– triglycerides

• “Peel power”• Risk for asthma, pulmonary function• Risk for lung cancer, ? Breast and colon cancer• Apple consumption seems to lower risk for DM2

– Polyphenols help regulate blood sugar• Inhibit enzymes that break down low glycemic carbs to simple

sugars• Glucose absorption from GI tract• Stimulates uptake of blood glucose into cells

Superfood: Apples

• Risk for cardiovascular disease (13-22% in one female cohort)

• CRP• Weight control

– Eat an apple 15 min. pre-meal & it caloric intake of meal 15%

• “An apple a day keeps the doctor away”• Sidekicks: pears, bananas

Superfood #18: Spices

• Serum glucose, triglycerides, LDL-C, and TC• Smell cinnamon for brain boost

Cinnamon

• Culinary herbs and spices have the highest antioxidant content of all foods

• Potent anti-inflammatory action• ½ tsp cloves > ½ cup blueberries or cranberries• Synergy of multiple spices

Superfood #18: Spices

Black Pepper• Enhances the bioavailability of polyphenols• Anti-inflammatory properties

Rosemary• Detox with Rosemary

• Cooking with Rosemary decreases cancer-causing Heterosyclic Amines (HCAs)

Superfood #18: Spices

Turmeric• The yellow spice that makes curry• Antioxidant• Anti-inflammatory

• Inflammatory markers• Natural aspirin effect via salicyclic acid

• Anti-cancer• Blocks a wide array of cancer promoting mechanisms

• India = average consumption about 1 gram/d• 8 grams/d “safe”

• A true SuperSpice

What About Salt?

• From the Japan Public Health Center based Prospective Study– Higher consumption of salted fish roe associated with risk

of cancer– Higher consumption of cooking and table salt associated

with risk of CVD

SPICE IT UP!!!

* Am J Clin Nutr 2010:456-64

Superfood #19: Extra Virgin Olive Oil

• Oxidative stress including oxidation of LDL-C• Blood pressure, TC, LDL-C• Risk for colon, breast cancer• Sidekicks: canola oil• 1 tablespoon most days• High smoke point (410) **• Best to cook with temperatures < 350• Store in cool, dark place• Consume within 10-12 weeks once opened or store in

fridge where it lasts about year

Smoke Point / Cooking Oil

Safflower 450 F / 230 C

Hi Oleic Sunflower 450 F / 230 C

Avocado 520 F / 271 C

Ghee 400-500 F / 204-260 C

Extra Virgin Olive Oil 250 F / 121 C **

Superfood #20: Garlic

• Synergy of 100 nutrients• Blood pressure• A “natural” blood thinner• Triglycerides, LDC-C• HDL-C• May colorectal, gastric and prostate cancer• Antibiotic• Sidekicks: scallions, shallots, leeks, onions• Use “to taste” multiple times per week

Superfood #21: Onions

• Risk of heart disease 20%• Risk for cancers of brain, esophagus, lung, stomach• Potent anti-inflammatory

– Quercetin “mimics” resveratrol• Sidekicks: garlic, scallions, shallots, leeks, chives• For maximum health benefits cut and let sit for

approximately 10 minutes• Phytonutrient content purple > yellow > white• Eat multiple times per week

Superfood #22: Honey

• A lot more than “sugar”• serum antioxidants• Wound healer• Buckwheat honey the “best”• Prebiotic function• Sidekicks: none• 1-2 teaspoons multiple times per week

Sugar and Your Health

• U.S. the largest consumer of sugars and caloric sweeteners = WORLD CHAMPS!

• Americans consume 22.2 tsp/d• Sugar releases opiates/dopamine ? “addictive”• Sweet “safe”, bitter “poison”• Sugar does not cause diabetes• Scant scientific evidence that sugar causes hyperactivity• Sugar insulin which can accelerate the growth of cancer

cells• Lower blood pressure by sugar sweetened drinks

“Sugar on the Label”

Corn syrup Invert sugar

High fructose corn syrup Cane sugar

* Honey Dextrose

* Maple syrup Sucrose

* Fruit juice concentrates Maltodextrin

* Malt syrup Glucose

* Molasses Fructose

Sorghum

* Antioxidants

Sugar and Your Health

• 10% of calories/d from added sugar vs. < 5%– HDL-C (25% 3 fold risk)– Triglycerides– Weight & waistline (multi-factorial)

• AHA = maximum 100 cal/d (6 tsps) added sugar (F) and 150 cal/d (M)– A 12 oz Coke has 10 tsps

* JAMA 2010;303:1490

Sugar and Your Health

• Bulk up on whole food sugars• Soda and sweetened beverages• Processed foods• Check food labels• Look for all-fruit spreads• Dark honey & molasses• Splenda

Antioxidant Content of Alternatives to Refined Sugar

* Estimated average per capita consumption of added sugars in America is 130g/d* Substituting alternative sweeteners could antioxidant intake an average of 2.6 mmoL/d

– Similar to the amount found in a serving of berries or nuts

* J Am Diet Assoc. 2009;109:64-71

Source Size Frap mean mmoL/100g

Blackstrap molasses 1 Tbsp 5.513 ***

Date sugar 1 oz (28.35g) 4.586 ***

Barley malt syrup 1 Tbsp 2.121 ***

Brown rice malt syrup 1 Tbsp 0.717

Dark brown sugar 1 Tbsp 0.689

Maple syrup 1 Tbsp 0.454

Raw cane sugar 1 Tbsp 0.327

Golden blossom honey 1 Tbsp 0.193

Agave nector 1 Tbsp 0.034

Refined sugar 1 Tbsp 0.017

Corn syrup 1 Tbsp 0.008

Superfood #23: Kiwi

• Triglycerides and platelet hyperactivity (up to 18%)• A “non-fat” source of vitamin E• Rich in vitamin C• A fruit source of lutein• Very low caloric/nutrient score• A “natural” blood thinner• Sidekicks: pineapple, guava• Eat multiple times weekly

Superfood #24: Pomegranates

• ¼ cup LDL-C oxidation• Blood pressure• 100% juice best• Growth rate of prostate cancer • May play a role in preventing skin, lung, colon and breast

cancer• May atherosclerosis• Dermal collagen• Sidekick: plums• 4-8 oz of 100% juice multiple times weekly & unlimited

seeds

• Berries (beware of added sugar)• Figs• Apricots• Raisins• Prunes (dried plums)• Apples• Cherries / Tart Cherries• All are calorie rich / nutrient rich

Superfood #25: Dried Fruits

What About Restaurant Foods?

• Data from the Black Women’s Health Study– Hamburgers, fried chicken, fried fish and Chinese food

associated with risk for DM2

* Am J Clin Nutr 2010;465-471

ORAC Score

Fruit ORAC Score

Dried Tart Cherries 6,800

Acai fruit 5,754

Blueberry 2,400

Frozen Tart Cherries 2,100

Strawberry 1,540

Raspberry 1,220

Per 100 grams (3.5 ounces):

* Need 3,000 to 5,000 ORAC units of antioxidants a day to reach the level of antioxidant capacity in the blood associated with various health benefits.

Tart Cherries

• Pain of gout, arthritis• Inhibit COX-1 and COX-2• Triglycerides, TC, FBS/insulin, HDL-C• Protect brain cells against oxidative stress• Contain melatonin

When to Go Organic

• 12 most contaminated F&V = 14 pesticides/d: peaches, apples, sweet bell peppers, celery, nectarines, strawberries, cherries, lettuce, imported grapes, pears, spinach, sweet potatoes = go organic, seasonal

• “Clean” produce = <2 pesticides/d: onion, avocado, frozen sweet corn, pineapples, mango, frozen sweet peas, asparagus, kiwi, bananas, cabbage, broccoli, eggplant

* Nutr Today 2009;44(1):38-42

Stress

• Stressor + your negative perception = stress• Stress is your response to a situation• A stress response needs your permission to occur• So…

– Listen to nature’s symphony– Let the wind be you massage therapy– Get your fanny moving its not for sitting – Perceive yourself as a winner– Green tea lowers stress hormone (Cortisol)– Teach Play Inspire

Walking is man’s best medicine--Hippocrates

Those who think they have not time for bodily exercise will sooner or later have to find time for illness.

--Edward Stanley, the Earl of Derby, 1873

I have 2 doctors, my left leg and my right.--G.M. Trevelyan

Walk and be happy, Walk and be healthy.--Charles Dickens

GOAL

“Died of old age, mind sharp, hearing intact, heart strong, and still saw like a hawk”

Avoiding the “Big Six”

Steven G. Pratt, MD, FACS, ABHM

La Jolla, CA

EPSE

September 2011

Top 22 Tips for Preventing (or Living With) Cardiovascular Disease—Heart Attack and

Stroke—the Superhealth Way

1. No cigarettes or exposure to second-hand smoke

2. Become an environmentalist

3. Get 7-8 hours sleep per night

4. Watch your weight and waistline

5. Burn those calories

6. DASH you way to lower blood pressure

7. Eat your vegetables and fruits

8. Be a Carotenoid King or Queen

9. Take an antioxidant “bath” with every meal

10. Raise your intake of potassium; lower intake of sodium

11. Love those nuts and seeds

12. Love those healthy fats13. Eat like an Alaskan Brown Bear14. Drink tea, 4 cups per day15. “Thin” your blood naturally16. Bring on the “B”s17. Consume 10-15 grams of whole food soy protein/d18. You can’t beat whole grains19. Control your blood sugar20. Add 2-4 tablespoons per day of Bob’s Red Mill Whole Ground

Flaxseed Meal, oat bran, wheat germ21. Supplement your health with fish oil22. Indulge in dark chocolate

Top 22 Tips for Preventing (or Living With) Cardiovascular Disease—Heart Attack and

Stroke—the Superhealth Way

Causal Association Between Diet and Coronary Heart Disease

StrongCohort Data Only Supported by RCTs

“Mediterranean” diet Yes

High-quality diet

Vegetables

Nuts

Trans-fatty acids

Glycemic index or load

“Prudent” diet

“Western” diet

Monounsaturated fatty acids

* Arch Intern Med, 2009;169(7):659-669

Causal Association Between Diet and Coronary Heart Disease

Moderate Cohort Data Only Supported by RCTs

Fish No

Marine ω-3 fatty acids Yes

Dietary folate

Supplementary folate RCT data only

Whole grains

Dietary vitamin E

Dietary beta carotene

Supplementary beta carotene RCT data only

Dietary vitamin C

Alcohol, light/moderate consumption

Alcohol, heavy consumption

Fruits

Fiber * Arch Intern Med, 2009;169(7):659-669

Causal Association Between Diet and Coronary Heart Disease

WeakCohort Data Only Supported by RCTs

Supplementary vitamin E Yes

Supplementary ascorbic acid Yes

Total fat Yes

Saturated fatty acids

Polyunsaturated fatty acids Yes

ω-3 fatty acids, total No

Meat

Eggs

Milk

* Arch Intern Med, 2009;169(7):659-669

Top 13 Tips for Breast Cancer Prevention

1. Have a mammogram and clinical breast exam every year starting at age 40

2. Control weight before, during and after pregnancy 3. Avoid alcohol if family or personal history of breast cancer; limit to 3

drinks per week if no history4. Choose healthy fat5. Watch your weight and waistline6. Be physically active and burn those calories7. Love those cruciferous veggies

8. Aim for 1200-6000 IU/d vitamin D3, including supplements, diet and 10-20 minutes sun exposure 3-4 days per week 25 (OH)D Aim for 60-80 ng/mL

9. Enjoy 10-15 grams soy protein and 2-4 tablespoons flaxseed meal most days

10. Be a fiber consuming “machine” and a carotenoid queen11. Healthy environment = Breast Cancer Free you12. Breast feed 6-12 mos/child13. Average 7-8 hrs sleep/night

Breast Cancer and Your Environment

• It has been difficult to prove a direct cause and effect• >216 chemicals mammary gland tumors in animal studies• 73 chemicals identified in consumer products are potential

mammary carcinogens, 35 are in air pollutants, and 29 are produced at > 1 million pounds in the U.S.

• The 3 “bad boys”– Polychlorinated byphenols (PCB’s)– Polyaromatic hydrocarbons (PAH’s)– Organic solvents and dioxin

Top 14 Tips for Prostate Cancer Prevention or Control

1. Be physically active2. Drink four or more cups of tea a day3. Consume 22mg of lycopene from food most, if not all, days4. Add 2-3 tablespoons of ground flaxseed meal to your daily

diet5. Consume healthy fats and a lower intake of saturated fats6. Love those cruciferous veggies7. Limit calcium intake from milk products and increase vitamin

D3 to 1200-6000 IUs per day8. Consume legumes most days9. Take a well-balanced, up-to-date supplement10. Have more fun in bed11. Watch your waistline and your weight12. Beware of “processed” meat13. Look for lean, free range beef (when you have it )14. Average 7-8 hrs sleep/night

Top 11 Tips for Colorectal Cancer Prevention

1. Have a colonscopy

2. Be physically active

3. Stay away from red meat and processed meat

4. Have no more than 3 alcoholic drinks per week for women, 6-7 for men

5. Watch your weight and your waist

6. Consume foods containing dietary fiber, and nonfat milk, nonfat yogurt, calcium and garlic

7. Don’t smoke

8. Discuss your family history with your doctor

9. Get your vitamin D

10. Watch your insulin levels

11. Average 7-8 hrs sleep/night

Top 13 Tips for Lung Cancer Prevention

1. Don’t smoke2. Stop smoking3. Avoid secondhand smoke4. If you smoke, know the dangerous combinations of:

a. cigarettes + beta-carotene supplements + alcohol b. cigarettes + beta-carotene supplements + asbestos

5. Limit alcoholic drinks to 3 for women, 6-7 for men6. Avoid carcinogens at work7. Eat plenty of fruits8. Be physically active9. Eat apples10. Decrease exposure to arsenic in drinking water: use reverse

osmosis device or bottled water11. Houseplants to “detox” your home/office air12. Your lungs love carotenoids and omega-3’s13. Average 7-8 hrs sleep/night

Note that physical activity (PA), sleep, Superfoods are in

“Every List”

GOAL

“Died of old age, mind sharp, hearing intact, heart strong, and still saw like a hawk”