Sunday, April 30, 2017

Five “Must Haves” for the Pantry

There is solid evidence supporting the health benefits of a flexitarian diet. In short, lowering the amount of red meat in our weekly diet in exchange for more fruits and vegetables. Then in the last year we have seen the media focus on the potential benefits of decreasing our daily sugar calories, exchanging them for a few more fat calories.

If you’ve wondered if there are specific healthy foods you can ADD to your diet, here are five that should be in your pantry.

#1 - Vegetables (especially colored vegetables)

Your mom was right (again) when she told you to “eat your vegetables.” When diets have been analyzed for the ratio of meat vs. vegetables (adding points for plant based foods and subtracting points for animal products) the group with just a middle of the road score of 40 (60 equals a full vegetarian diet) experienced a 40 percent drop in mortality compared to the unlimited red meat group.  The study participants didn’t have to be full vegetarians to benefit from increasing their daily vegetable intake.

Colored vegetables provide an additional benefit. The colored pigment is incorporated into the retina itself where it helps to protect the retina from harmful uv rays. The result is a significant decrease in macular degeneration, the most common cause of blindness in the Western world.

#2 - Coffee

Although it was once speculated that coffee was a health risk, the facts are just the opposite. A 2014 analysis combined all the previously published studies assessing the health risk of coffee consumption.  It demonstrated that drinking coffee was actually associated with decreased mortality (the risk of dying for any reason). And the more cups of coffee a day, the lower the overall risk decreasing a maximum of 16 percent with four cups of coffee a day. 

There was no evidence for an increased cancer risk. In fact, a separate study actually demonstrated just the opposite, a cancer protective benefit with a 50 percent decrease in colon cancer recurrence in coffee drinkers compared with those who abstain from Seattle’s favorite brew.

#3 - Nuts

A study published in 2013 compared a group that rarely ate nuts to several others with varying nut intake. Those who ate nuts once per week had an 11 percent decrease in all-cause mortality which rose to 20 percent for those that reported eating nuts daily.  The protective benefits included reduced risks for cardiac disease, cancer, and a variety of inflammatory conditions.

Although nuts are traditionally considered highly caloric and fattening, another diet study demonstrated that a group that snacked on nuts actually lost more weight than the comparison group on a traditional low fat diet. The appetite suppressing effects of the nut oils appear to outweigh (sic) the few additional fat calories.

How many nuts? A handful, about an ounce (23 almonds, 14 walnut halves, or 21 hazelnuts) a day. And it needs to be whole nuts. Nut oils did not change the inflammatory markers in a study which compared nut oils to whole nuts.

#4 - Beans

A cross-cultural study attempting to identify specific foods associated with longer lifespans identified just one, legumes (Japanese - soy, Swedes - brown beans and peas, Mediterraneans’ - lentils, chickpeas, and white beans). There was an 8 percent reduction in overall mortality with just two tablespoons of beans a day.

The current recommendation is one-half cup a day. Canned beans are as good as dried beans. Canned beans contain significant salt so if you are on a low salt diet you should cook your own.

It is thought that the benefit of beans results from some of the poorly absorbed legume starches feeding our “good” gut bacteria in the colon. And it is the metabolic end products from the bacteria (microbiome) metabolism that are the beneficial agents.

# 5 - Flax meal

Fiber is a common component of all fruits and vegetables that helps to speed the progress of everything we eat through the digestive tract. The result is regular bowel movements which in turn decreases the time potentially cancer causing agents in our foods spend in the intestines. The result is both a notable decrease in colon cancer and as well as a blunting of the absorption of fats (which means a lower blood cholesterol) in those groups which eat high fiber diets.

In addition, phytates, the specific fiber in flax, appears to have a specific benefit in precancerous prostate changes as well as an independent benefit in the control of high blood pressure and osteoporosis.

Two tablespoons of flax meal in one-fourth cup of applesauce is an easy way to meet your daily fiber requirements without worrying about counting servings of fruits and vegetables.

So there you have it. Five foods that can easily be added to your daily diet. Start with a second cup of coffee in the morning, supplement your breakfast with a serving of a flax/applesauce mixture. Then, mid-morning, a snack of a handful of nuts to counteract the urge to snack on high sugar foods (and help keep the weight under control).  And finally, one-half cup of beans along with a colored vegetable as a side for lunch or dinner.

Wednesday, April 12, 2017

My Interests - Health, Nutrition, and Staying Fit

How did I get to be a columnist for the Beacon?  I’m told to avoid using “I” in my columns, but will ask for a pass on this column as I tell you a bit about myself and ask for your thoughts for future content.

I am a gastroenterologist (digestive, liver, and pancreas problems), now retired from The Everett Clinic in Everett. In my practice life, it was common to get patients’ observations on their diet and how it impacted their symptoms. I also fielded questions about personal nutrition changes patients could make to improve them. I was a digestive disease doctor so they naturally assumed I knew all there was to know about the food that digestive tract would need to process.

We didn’t focus much on nutrition in medical school, so I worked to expand my knowledgeable on nutrition in general. Staying on top of what was new in the field of foods and their impact on diseases and staying healthy became part of my regular reading and ongoing CME (continuing medical education).

When answering questions from my patients, I needed to provide the information in a way they could easily understand.  A brief explanation of the physiology helped them to understand the reasons a specific recommendation was being made, and understanding the connection would made it more likely that they would follow through. This reinforced my interest in effective patient education, and by extension a personal approach that crossed over into providing clear answers to other questions on medicine and physiology.
My interest in nutrition and education worked its way into my personal life as well. I was not an athlete in high school, in fact I hated PE. I ran my first mile when I was 30 and have stayed active running and bicycling. I started biking with a group of friends in the late 1980s and, being competitive, they would regularly turn to me with questions on nutrition and its impact on their performance.

Although there are now many books on nutrition and sports performance, there were none in the late 1980s. So I took my research of the literature, my advice to them, added in my interest in education and physiology, and wrote a short book on the subject of nutrition and bicycling performance - Bicycling Fuel.
In the 90s, I became interested in the Internet and decided to move my thoughts on nutrition and performance to a website.  As bikers’ (and other athletes’) interest in nutrition is really about their interest in improving their personal performance, I expanded the website content to include the physiology of exercise in general and training tips. That website Cycling Performance Tips ( continues to be my personal hobby.
Now that I am retired, a new set of questions have surfaced. Staying healthy. Staying active. Staying engaged in life. A friend is writing a book on the topic so we talk about it a lot. As I see it, it just an extension of the same questions I have been asked over the last 40 years.

When I was approached to in a column for The Beacon, it seemed a natural fit with my interest in education. My only question was “what topics”? So, this is where I make a public appeal. Please comment on past topics, on what areas you’d like me to explore in more detail and, of course, other ideas for the future. I’ve set up an email for you to contact me:

Send thoughts and questions my way. Nutrition, digestive problems, biking, and exercise physiology. I’ll do my best to avoid politics.

Monday, April 3, 2017

Where does exercise fit in a personal commitment to stay healthy?

Regular exercise can be so much more than just a way to control your weight. The truth is that everyone will benefit from regular exercise. Maybe you are fortunate enough to have an active day job and will get most of your weekly exercise there. But even if you are, it is likely that a little extra exercise time every week will yield big benefits as you age.
Here are four proven benefits of regular exercise:

Benefit #1 - Improved longevity
There is no question that those who exercise regularly live longer, more active lives than their sedentary peers. Numerous studies have proven the connection between an active lifestyle and living longer. This health benefit is independent of the weight loss effect experienced by those who exercise regularly. Best of all, the benefits are not age independent. That means a regular exercise routine can enhance life for people who do not start a routine until they are well into their 60’s and 70’s.
You not only will you live more years, but they will be healthier years. Regular exercisers miss fewer days of work, have a lower overall cancer rate, experience fewer heart attacks and suffer from fewer chronic diseases such as diabetes.

Benefit #2 - Improved strength and muscle health
Just living longer is not the only benefit of regular exercise.  You will also be able to continue those activities you enjoy for more of those days of your longer life.
As we get older, all of us gradually lose muscle cells. If the muscle is stressed (forced to lifting weight) the remaining muscle cells increase in size which then compensates for this inevitable loss of cells. Maintaining your strength means you can stay involved in your regular activities.
In addition, stronger muscles improve your balance which in turn decreases the risk of falling, and the flexibility that comes with regular exercise decreases the chances of a muscle pull or strain if a fall might occur.
Although it is impossible to stop the inevitable aging process, we can certainly slow it down with a regular exercise routine.
How much stress is needed to maintain strength? Three times a week of focused weight training will do the job, as will changing your daily routine to add activities which will make the muscles work a little harder - such as regularly taking the stairs (up as well as down) or adding hills to your daily walk.

Benefit #3 - Improved heart health
Those individuals who stay active have a lower chance of dying from a heart attack or from a blocked blood vessel (exercise stimulates the growth of  additional “collateral” arteries in the heart), regular exercise improves the fitness of the heart muscle cells which means you can exercise longer and harder before you tire out. And the fitness benefit requires as little as a dozen 20 second bouts of vigorous exercise three times a week. There have been many articles on High Intensity Training (HIT) lately if you want to find out more.

Benefit #4 - Brain health
Finally, we have the benefits of exercise on the brain. A recent study looked directly at brain cell development in exercised lab animals confirming an increase in the number of new brain cells with exercise. This supports the known fact that regular exercisers experience a slower rate of decrease in memory and mental function as they get older. And in the animal study, the longer the duration of the regular exercise routines, the more new cells were found.
How much exercise do you need to take advantage of the various health benefits of exercise? If you walk the equivalent of an hour a day, you decrease your chance of dying by almost 40 percent. And if you add 20 to 30 minutes per week of vigorous exercise (getting your heart rate up to 80 percent of your personal maximum heart rate or enough to break a sweat), you get an extra few percentage points benefit as a bonus.
Changing a long-standing routine is a challenge, whether it is moving to a healthier routine, a lower salt or lower sugar diet or regular exercise. Even though it is difficult, the benefits of adequate weekly exercise are clear. You will live longer while maintaining the ability to stay involved in life - both mentally and physically.
After all, isn’t that what life is all about??