Breast cancer prevention strategies

When you hear health messages about cancer or any disease do you find yourself filtering it out?  If you do, this next sentence might cause you to stop reading, but please continue because there's a point I'm hoping to make. At the time of writing this, statistics say that one out of eight women will get breast cancer in their lifetime (American Cancer Society). Are you still reading? That's good, because the purpose of sharing that statistic was to illustrate that even though we frequently hear these kinds of health messages, we don't always feel connected to them. 

Perhaps you might be thinking as I did when hearing those numbers, wow, that sounds like a lot, but I'm not going to be the one.  Unfortunately, this kind of thinking often translates into inaction. Statistical health data, although sometimes shocking and troubling, may not be meaningful enough to inspire change for some of us.

If you find that you aren't motivated by statistics, you're not alone. Evidence suggests that health messages which highlight health consequences and the numbers of people who get disease aren't as effective as was once thought.

What can be more successful in motivating change in health behaviors are messages that focus on causes and solutions for disease (McKenzie).

Obviously there is no clear solution to breast cancer at this point in time. However, there is a great deal of data available that is linking lifestyle factors with increased risk.

There may be no sure way to prevent breast cancer yet. However, this doesn't mean we're powerless. Our best prevention strategy is to take steps to reduce our risk factors as much as possible. So, let's take a closer look at the modifiable risk factors.  In other words, the things we can do to lower the probability of  becoming one out of eight women who will get breast cancer.


A few Prevention Strategies

• Excercise- Enough said.
• Avoid weight gain and obesity - Exercise and healthy nutrition are the keys. According to the National Cancer Institute (NCI), a gain in body mass index (BMI) may substantially increase a women's risk for breast cancer, especially after menopause.The NCI states, " In a recent analysis, women who reported a gain in BMI of five points  or more between age 20 and postmenopausal age (ages 55-74) had nearly twice the risk of developing postmenopausal breast cancer compared to women who maintained their BMI during the same time period." You can read more about BMI in this post here.
• Eat plenty of fruits and vegetables - Preferably organic.  Organically grown produce lowers exposure to pesticides which can effect hormone levels, particularly estrogen dominance.
• Have your vitamin D levels checked -  A low level of Vitamin D is linked to increased risk for breast cancer. 
• Reduce chronic inflammation - I've blogged about this very important element of cancer prevention here, but simply put, if our immune system is preoccupied and overwhelmed responding to environmental and food stressors, it's possible that it can miss the angiogenesis of a sneaky cancer cell. 

Here's some additional information about eating "nutritarian" from Dr. Fuhrman's informative website which explains how to support our wellness with healthy nutrition. The foods we eat can either support or oppose our bodies. Experts now agree that there are even so-called power foods that do an especially good job of restoring our bodies. 

  

So, rather than tuning out messages about disease, consider the strategies that you can incorporate into your lifestyle that will help prevent illness from starting in the first place - because "an ounce of prevention is worth a pound of cure."

Sources
http://www.cancer.org/acs/groups/content/@nho/documents/document/f861009final90809pdf.pdf
McKenzie, J. An Introduction to Community Health, 5th ed.
http://www.cdc.gov/healthyweight/assessing/bmi/
NCI - http://benchmarks.cancer.gov/2010/04/gain-in-body-mass-index-increases-postmenopausal-breast-cancer-risk/
Breast Cancer.org http://www.breastcancer.org/symptoms/understand_bc/statistics
Breast Cancer.org http://www.breastcancer.org/risk/factors/low_vit_d

Wellness during a pandemic?

A pandemic doesn't bring images of good health to mind. Certainly, COVID has brought much devastation and suffering. But what if we looked at this differently? Wellness isn't just about being physically healthy. It's so much more!  We must believe that even if we're coping with the effects of an illness, COVID or any disease as contradictory as it sounds, it's still possible to be well. 

Western medicine typically defines wellness as an absence of disease. However, when people who have chronic diseases like diabetes or heart disease were asked about their sense of well being, they reflected on how their focus wasn't on the diseases or its limitations. Their sense of well being was connected to  how they were living well with the disease (1)

Research has shown that there are specific factors that aid in wellness: 

• social connectedness
• lifestyle behaviors
• stress and resilience
• emotional health
• physical health
• meaning and purpose
• sense of self
• finances
• spirituality or religiosity
• exploration and creativity

Social connectedness is at the top of the list for a reason. It's the aspect most frequently mentioned and the one that seems to carry more weight on both the positive and negative side of the wellness equation. We all know that relationships can bring both joy and sorrow, but the most important aspect of relationships for wellness was that one felt a sense of connection. After all, we humans are social beings. So, it's important in this time of "social distancing" to find ways to stay connected, whatever that may mean for you.

During this time of living with COVID, the wellness domains mentioned above can be a kind of roadmap with way points for us. 

• Think about our social network and how we might connect more.
• What healthy lifestyle behaviors can we begin or bolster?
• Eating better?
• Less screen time or taking frequent breaks?
• Injecting more physical activity into our day, like walking and stretching, get outside. Just being outdoors was shown to have positive health benefits. (2)
• Adopt a laser focus on solutions and not problems. This kind of thinking is empowering and reduces the stress of feeling stuck and powerless.
• With many of us jobless as a result of the pandemic, we may feel like we've lost meaning and purpose in our lives. Strive to reframe a problem as a challenge or an opportunity. Research shows that when we do this with our negative life experiences we give them a different meaning and power. (3) We can't always control what happens to us, but we can control how we react.
• Let's be kind to ourselves and to others. We are in this together!
• Developing our spiritual health might look like: practicing mindfulness, staying in the present moment, extending forgiveness, having empathy and compassion, and perhaps having faith that a Higher Power greater than us is in control. 

Being well during a pandemic might sound like an oxymoron, but it's possible even given all the real challenges and traumas. We have to determine and define our personal meaning of wellness and go for it.  Be well!

"The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy." ~Martin Luther King, Jr.

 

References

1) Stanford Medicine - Well Now https://stanmed.stanford.edu/2016summer/well-now.html

2) Scientific Reports - Spending at least 120 minutes a week in nature is associated with good health and well being https://www.nature.com/articles/s41598-019-44097-3

3) Reframing trauma - Journal of Psychiatry https://www.fortunejournals.com/articles/preframing-trauma-the-transformative-power-of-meaning-in-life-work-and-communityp.html

Nutrient dense foods: the answer to cutting calories and curbing hunger

When it comes to maintaining or reducing body weight, the key to long term success is to choose foods with a low energy density. What is energy density in foods? The Center for Disease Control defines it as “the amount of energy or calories in a particular weight of food.” This is generally represented as the number of calories in a gram (kcal/g). This brings me to the law of thermodynamics, or energy balance equation, which I’ve discussed in a past post here.

Energy balance - Understanding this concept is important to successful weight loss, gain or maintenance.  So, here’s a brief review: if you consume more calories than you burn, you will gain weight. If you burn more calories than you consume, you will lose weight. However, a big caveat: while a calorie is a calorie, the nutrients you consume affects metabolic and hormonal secretions which may cause you to store fat instead of utilize the fat for energy, and vice versa. The types and varieties of food and beverages you ingest effect weight management, but more importantly, they are essential to your total wellness.

Understanding caloric need - Exercise is a variable that increases caloric expenditure and metabolism. In order to determine an estimation of the calories you need to consume to gain, maintain or lose weight, it's helpful to calculate your total daily energy expenditure (TDEE). You can use the calculator found here, which calculates basal metabolic rate (BMR) using the Mifflin-St Jeor equation, and then applies an activity multiplier. It's best to underestimate your acitivity level when using the calculator if you're looking to lose weight because this puts you on the conservative side of daily caloric needs. Then, if you want to calculate how many calories you should eat daily to achieve weight loss at a steady, healthy pace, you subtract 15-20% from your TDEE number. Conversely, if you're looking to gain weight, add 15-20% to the TDEE. It's not recommended that you subtract more than 25% from your TDEE calculation. You don’t want your calorie intake to drop to an unhealthy and unsustainable level.

The amount of calories you eat is important, but not the whole picture in a healthy diet. Good nutrition includes a balance in the macronutrients listed below and the way you accomplish this is in the way you combine the foods you eat in a meal. For example, rice and beans.  These two foods are considered a complete protein when eaten together. If you're a vegan. In general, try to get your total daily caloric intake from a variety of whole foods as follows: 

• Protein: 1 gram per pound of body weight
• Fat: .45 grams per pound of body weight
• Carbs: The remaining number of calories left will be filled with carbs

Nature counts the calories – Back to our discussion of low energy dense foods and how they help with weight loss.  It seems Mother Nature really does know best because “foods with a lower energy density actually provide fewer calories per gram than foods with a higher energy density (CDC).”  Also, low energy dense foods are typically more nutrient dense. Nutrient density is a measure of the nutrients provided per calorie of food, or the “ratio of the amount of a nutrient in foods to the energy provided by these same foods (Nestle).” 

So, it’s a win/win situation when you choose low energy/high nutrient dense foods because not only do they contribute fewer calories to the energy balance equation, they also provide greater nutritional value per calorie, which is especially beneficial for our health. These foods are the best of both worlds so to speak. 

Let’s look at a simple example of a higher nutrient/lower energy density food and a lower nutrient/higher energy dense food containing the same amount of calories per serving:   

	Nutrient Dense	Energy Dense
171 calories/serving	2 wedges of watermelon (approximately 1/8 of a whole watermelon)	14 ounces of Dr. Pepper
Nutritional Facts  per serving	Calories 171 Calories from Fat 7 Total Fat 0.743g Saturated Fat 0.371g Polyunsaturated Fat 0.371g Monounsaturated Fat 0.371g Cholesterol 0mg Sodium 7mg Potassium 636mg Carbohydrates 43.086g Dietary Fiber 2.229g Sugars 35.286g Protein 3.343g Vitamins & Minerals: Vitamin A 67% · Vitamin C 78% Calcium 4% · Iron 7%	Calories 175 Calories from Fat 0 Total Fat 0g Saturated Fat 0g Polyunsaturated Fat 0g Monounsaturated Fat 0g Cholesterol 0mg Sodium 70mg Potassium 0mg Carbohydrates 46.2g Dietary Fiber 0g Sugars 44.8g Protein 0g

Arguably, it might not seem equitable to compare a beverage with a food, but watermelon is 91% water by weight, so it's not too biased of a comparison. Remember, we are comparing identical calories per serving here. The numbers speak for themselves. If I’m trying to consume fewer calories in an effort to lose weight, watermelon is the better food choice by far. Where’s the Vitamin A and C in the soda? The numbers indicate a lot of sugar, no fiber or protein. The soda simply contains what are referred to as "empty calories" which provide energy, but no nutrition.  So after I drink my soda my body gets an injection of simple sugars and a blast of salt. Ironically, the salt can make me thirsty and this leads me to drink another soda later, but that's for another post!

On the other hand, the 2 wedges of watermelon provide 67% of the daily requirement of Vitamin A and 78% of Vitamin C.  That’s some good stuff! Plus, the 2.3 grams of fiber in the watermelon will help me feel fuller for a longer period of time than the soda, which has 0 grams of fiber. I might even feel full after eating 1 wedge of watermelon. Therefore, I can eat less of this food and decrease my calorie intake while keeping my hunger satisfied for longer than I could with a soft drink. This brings me to my next point, which can be pivotal to weight loss success.

Eat more to lose weight? – Really?! Usually losing weight is equated with starving oneself and eating minuscule portion sizes, right? However, foods with a low energy/high nutrient density typically contain fewer calories per serving than the same amount of a high energy/low nutrient density food and they provide more vitamins, minerals and also phytochemicals. You can read more about phytochemicals and their amazing health benefits here. 

Now, let’s look at another example comparing the nutritional information for servings of an nutrient dense food with a calorie dense food, but of differing calorie content:

	Nutrient Dense Food	Energy Dense Food
Food choice	Kale	French Fries
Calories per serving	1 cup chopped 33 calories	1 medium serving (117 g) 365 calories
Nutritional facts per serving	Total Fat 0.6 g     Saturated fat 0.1 g            Polyunsaturated fat .2 g               Monounsaturated fat 0 g               Cholesterol 0 mg               Sodium 25 mg     Potassium 329 mg             Total Carbohydrate 6 g    Protein 2.9 g  Vitamin A 133% Vitamin C 134% Calcium 10%       Iron 5% Vitamin D 0%       Vitamin B-6 10% Vitamin B-12 0%                Magnesium 7%	Total Fat 17 g      Saturated fat 2.7 g            Polyunsaturated fat 6 g    Monounsaturated fat 7 g               Trans fat 0.1 g     Cholesterol 0 mg               Sodium 246 mg   Potassium 677 mg             Total Carbohydrate 48 g  Dietary fiber 4.4 g             Sugar 0.4 g           Protein 4 g           Vitamin A 0% Vitamin C 9% Calcium 2%          Iron 5% Vitamin D 0%       Vitamin B-6 20% Vitamin B-12 0%                Magnesium 10%

Once again, the data doesn’t lie. As the above comparison shows, I would have to eat a whopping 11 cups of chopped kale to equal the amount of calories I would consume in a medium serving of fries! If I’m trying to lose weight, the good news is that I can eat more kale while consuming far fewer calories than I would if I were to eat the French fries. This means I will feel fuller for a longer period of time. I’m also fueling my body with less unhealthy fats and far more nutritional value. Like I said before, it’s a win/win. 

Move over vegetarian, I'm a nutritarian -  So are you ready to transition to a nutritarian diet which is eating more low-energy/nutrient dense foods? If you said yes, congratulations! You're making a good choice for your health. Are you unsure how to decide which foods to choose? A good starting point to help you in your search to find the most nutrient dense foods is to check out the ANDI guide. ANDI stands for aggregate nutrient density index and was developed by Dr. Joel Furhman.

This is from Dr. Furhman's site: "Adequate consumption of micronutrients – vitamins, minerals, and many other phytochemicals – without overeating on calories, is the key to achieving excellent health. Micronutrients fuel proper functioning of the immune system and enable the detoxification and cellular repair mechanisms that protect us from chronic diseases. A nutritarian is someone whose food choices reflect a high ratio of micronutrients per calorie and a high level of micronutrient variety."

With this in mind, the ANDI guide categorizes whole foods and then scores them on a scale from 1 to 1000 based on an extensive range of micronutrients, including vitamins, minerals, phytochemicals and antioxidant capacities. In addition, Dr. Furhman's original ANDI guide has been updated to reflect a more accurate picture of each food's nutritional qualitywhich now considers certain beneficial phytochemicals, such as angiogenesis inhibitors (i.e. cancer prevention, read more here), organosulfides (found in onion, garlic and cruciferous veggies), isothiocyanates (organosulfur compounds found in cruciferous veggies and are among the most effective cancer-prevention agents known), and aromatase inhibitors (suppress the synthesis of estrogen and thought to aid in the prevention of breast cancer).

The ANDI guide can be a useful tool in your determining healthy food choices, but it isn't the holy grail. I like what Dr. Furham says and I believe his suggestion is the best advice when it comes to choosing foods.  He says: “…nutrient density scoring is not the only factor that determines health benefits… if we ate only foods with a high nutrient density score, our diets would be too low in fat. For that reason we have to pick some foods with lower nutrient density scores.” Also, he notes that if thin individuals or those who are very active ate only foods with the highest nutrient density, they would become so full from fiber that it's likely they would be unable to meet their caloric needs. Remember my kale example above? One can only eat so much fiber. Balance and variety are key to consuming the greatest number and variety of micronutrients.

You may already know that kale is a better food choice than French fries, so if you operate on the simple premise that your diet should emphasize fruits, vegetables, and whole grains and not prepackaged, processed or fast food, you probably don’t need the ANDI guide to tell you where to get the most nutritional bang for your buck. However, if you’re uncertain as to whether or not you’re making the best food choices for your health, the ANDI rankings are a good starting point. 

I really like Dr. Weil's anti-inflammatory "diet" approach and I have incorporated some of his wisdom into my lifestyle as well. I've blogged about the health benefits of reducing the risk for chronic inflammation in an earlier post. Look for more on that in a future post.  In the meantime, I'll leave you with this food for thought:

Sources:

• CDC Low energy dense foods and weight management - http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_energy_density.pdf
• Nutrient Density, Clemson Cooperative Extension - http://www.clemson.edu/extension/hgic/food/nutrition/nutrition/dietary_guide/hgic4062.html
• Food and Nutrition, Nutrient Density - http://www.nestle.com/asset-library/Documents/Library/Documents/Nutrition_Health_Wellness/Food-and-Nutrition-Issue09-Nutrient-Density-Jan2008.pdf
• Sports Science Exchange, Energy Balance and Weight Reduction - http://www.uni.edu/dolgener/UG_Sport_Nutrition/Articles/Energy_Balance.pdf
• Simple Science Fitness, Energy balance and law of thermodynamics -http://simplesciencefitness.com/ 
• Whole Foods Market uses ANDI guide - http://www.wholefoodsmarket.com/healthy-eating/andi-guide
• Nutrient Rich, ANDI Guide - http://www.nutrientrich.com/1/aggregate-nutrient-density-index-andi-score.html

Resistance training: a fountain of youth!

Let's face it. From the moment we're born our bodies begin to age. However, for most of us healthy folks the reality of aging doesn't have to mean a major decline in the quality of our lives. Why? Read on my curious aging friends. The clock is ticking...

You may be familiar with the expression "use it or lose it." Well, this couldn't be more true when it comes to aging and the decline of muscle. In case you're thinking that this only applies to really old people, think again. According to Dr. Mark Peterson from the University of Michigan Physical Activity and Exercise Intervention Research Laboratory,

"normally, adults who are sedentary beyond age 50 can expect muscle loss of up to 0.4 pounds a year. That only worsens as people age. But even earlier in adulthood - the thirties, forties and fifties - you can begin to see declines, if you don't engage in any strengthening activities."

 Other research shows that,

"after age 40, people typically lose 8 percent or more of their muscle mass each decade, a process that accelerates significantly after age 70. Less muscle mass generally means less strength, mobility and among the elderly, independence. It also has been linked with premature mortality." (1)

I'd venture to say that most of us want our "golden" years to be, well, golden.  In other words, it would be ideal if quality and quantity of life marched along at the same pace.  However, for many people, an increase in quantity of life comes with a relatively rapid decline in quality of life.

Until fairly recently, muscle atrophy was thought to be a natural part of aging and that this decline was inevitable and, more importantly, irreversible. However, research has repeatedly shown the opposite to be true! In one 2007 ground breaking study of resistance exercise and how it reverses aging in human skeletal muscle done by S. Melov, et. al. it was demonstrated that muscle decline is reversible with weight training and the changes occur at the gene level! This is exciting because it proves that performing resistance training really does offer us a fountain of youth so to speak.

What does all this mean for us in a practical sense? Call me Captain Obvious, but I'll state it none the less - first and foremost, we have to perform resistance training! Some of you might be saying, okay, already, I've got the message. Resistance training is important, but what should I be doing in my resistance training program?  Good question!

I had the pleasure of attending a workshop given by Mark Roozen, who was the strength coach for the Cleveland Browns.  The information he presented focused on the importance of training movements patterns, before focusing on individual muscle strength. You might be wondering what constitutes a movement pattern. Humans have 7 primary movement patterns that we learn and refine over the course of our lives. These are:

1. Gait - walking, running, sprinting
2. Squatting
3. Lunging
4. Pulling
5. Pushing
6. Pressing
7. Twisting

Now, it may surprise you as it did me to learn that even elite athletes like the pro football players Mark works with may have to return to the basics.  Mastery of these movement patterns is critical to the prevention of injury, and to the ability to train to full potential.  This applies to all of us - from weekend warriors to elite athletes and everywhere in between.

Training movement patterns is a more efficient way to train the body than isolation training because it mimics the way our bodies perform in our activities of daily living.  Ultimately this is what healthy aging is all about - training our bodies to be efficient in performing activities of daily living.

So how do we incorporate these movement patterns into our resistance training workouts? Consider the following:

• Movement planes and the axes in which movements take place 

  

  Image from http://kintasticscleanandjerkproject.weebly.com/uploads/1/7/1/4/17146288/7514150_orig.jpg

• incorporate the 7 movement patterns
• Ex: Squats, Lunges, Cleans, Deadlifts, Bench and Military Presses 
• If you're over age 50 and/or previously sedentary consider starting a resistance training program that uses your body weight. For example you can start with simple squats like chair squats and lunges (knees permitting), etc. NOTE: exercises may be challenging for those new to resistance training. Start slow and with the basics. This means performing stationary exercises in one plane and then progressing to movements that incorporate more weight and multi-planes.  Always consult your physician before beginning any exercise program.

The next post will go into more specifics about particular functional resistance training exercises. For now suffice to say, just start training because the evidence is clear. Resistance training really can be the fountain of youth! Adding functional resistance training exercises is an excellent way to increase the strength, agility and stability needed to perform activities of daily living and to maintain or improve our quality of life as we age.

Still not convinced? Check out this excellent article by Dr. Wayne Wescott found here, which details the many health benefits gained through resistance training.

(1) Source: Reynolds, Gretchen. “Aging Well Through Exercise,” The New York Times.

Weight loss success: nutrient dense foods cut calories and control hunger

When it comes to maintaining or reducing body weight, the key to long term success is to choose foods with a low energy density. What is energy density in foods? The Center for Disease Control defines it as “the amount of energy or calories in a particular weight of food.” This is generally represented as the number of calories in a gram (kcal/g). This brings me to the law of thermodynamics, or energy balance equation, which I’ve discussed in a past post here.

Energy balance - Understanding this concept is important to successful weight loss, gain or maintenance.  So, here’s a brief review: if you consume more calories than you burn, you will gain weight. If you burn more calories than you consume, you will lose weight. However, a big caveat: while a calorie is a calorie, the nutrients you consume affects metabolic and hormonal secretions which may cause you to store fat instead of utilize the fat for energy, and vice versa. The types and varieties of food and beverages you ingest effect weight management, but more importantly, they are essential to your total wellness.

Understanding caloric need - Exercise is a variable that increases caloric expenditure and metabolism. In order to determine an estimation of the calories you need to consume to gain, maintain or lose weight, it's helpful to calculate your total daily energy expenditure (TDEE). You can use the calculator found here, which calculates basal metabolic rate (BMR) using the Mifflin-St Jeor equation, and then applies an activity multiplier. It's best to underestimate your acitivity level when using the calculator if you're looking to lose weight because this puts you on the conservative side of daily caloric needs. Then, if you want to calculate how many calories you should eat daily to achieve weight loss at a steady, healthy pace, you subtract 15-20% from your TDEE number. Conversely, if you're looking to gain weight, add 15-20% to the TDEE. It's not recommended that you subtract more than 25% from your TDEE calculation. You don’t want your calorie intake to drop to an unhealthy and unsustainable level.

The amount of calories you eat is important, but not the whole picture in a healthy diet. Good nutrition includes a balance in the macronutrients listed below and the way you accomplish this is in the way you combine the foods you eat in a meal. For example, rice and beans.  These two foods are considered a complete protein when eaten together. If you're a vegan. In general, try to get your total daily caloric intake from a variety of whole foods as follows: 

• Protein: 1 gram per pound of body weight
• Fat: .45 grams per pound of body weight
• Carbs: The remaining number of calories left will be filled with carbs

Nature counts the calories – Back to our discussion of low energy dense foods and how they help with weight loss.  It seems Mother Nature really does know best because “foods with a lower energy density actually provide fewer calories per gram than foods with a higher energy density (CDC).”  Also, low energy dense foods are typically more nutrient dense. Nutrient density is a measure of the nutrients provided per calorie of food, or the “ratio of the amount of a nutrient in foods to the energy provided by these same foods (Nestle).”

So, it’s a win/win situation when you choose low energy/high nutrient dense foods because not only do they contribute fewer calories to the energy balance equation, they also provide greater nutritional value per calorie, which is especially beneficial for our health. These foods are the best of both worlds so to speak. 

Let’s look at a simple example of a higher nutrient/lower energy density food and a lower nutrient/higher energy dense food containing the same amount of calories per serving:   

	Nutrient Dense	Energy Dense
171 calories/serving	2 wedges of watermelon (approximately 1/8 of a whole watermelon)	14 ounces of Dr. Pepper
Nutritional Facts per serving	Calories 171 Calories from Fat 7 Total Fat 0.743g Saturated Fat 0.371g Polyunsaturated Fat 0.371g Monounsaturated Fat 0.371g Cholesterol 0mg Sodium 7mg Potassium 636mg Carbohydrates 43.086g Dietary Fiber 2.229g Sugars 35.286g Protein 3.343g Vitamins & Minerals: Vitamin A 67% · Vitamin C 78% Calcium 4% · Iron 7%	Calories 175 Calories from Fat 0 Total Fat 0g Saturated Fat 0g Polyunsaturated Fat 0g Monounsaturated Fat 0g Cholesterol 0mg Sodium 70mg Potassium 0mg Carbohydrates 46.2g Dietary Fiber 0g Sugars 44.8g Protein 0g

Arguably, it might not seem equitable to compare a beverage with a food, but watermelon is 91% water by weight, so it's not too biased of a comparison. Remember, we are comparing identical calories per serving here. The numbers speak for themselves. If I’m trying to consume fewer calories in an effort to lose weight, watermelon is the better food choice by far. Where’s the Vitamin A and C in the soda? The numbers indicate a lot of sugar, no fiber or protein. The soda simply contains what are referred to as "empty calories" which provide energy, but no nutrition.  So after I drink my soda my body gets an injection of simple sugars and a blast of salt. Ironically, the salt can make me thirsty and this leads me to drink another soda later, but that's for another post!

On the other hand, the 2 wedges of watermelon provide 67% of the daily requirement of Vitamin A and 78% of Vitamin C.  That’s some good stuff! Plus, the 2.3 grams of fiber in the watermelon will help me feel fuller for a longer period of time than the soda, which has 0 grams of fiber. I might even feel full after eating 1 wedge of watermelon. Therefore, I can eat less of this food and decrease my calorie intake while keeping my hunger satisfied for longer than I could with a soft drink. This brings me to my next point, which can be pivotal to weight loss success.

Eat more to lose weight? – Really?! Usually losing weight is equated with starving oneself and eating minuscule portion sizes, right? However, foods with a low energy/high nutrient density typically contain fewer calories per serving than the same amount of a high energy/low nutrient density food and they provide more vitamins, minerals and also phytochemicals. You can read more about phytochemicals and their amazing health benefits here. 

Now, let’s look at another example comparing the nutritional information for servings of an nutrient dense food with a calorie dense food, but of differing calorie content:

	Nutrient Dense Food	Energy Dense Food
Food choice	Kale	French Fries
Calories per serving	1 cup chopped 33 calories	1 medium serving (117 g) 365 calories
Nutritional facts per serving	Total Fat 0.6 g    Saturated fat 0.1 g           Polyunsaturated fat .2 g               Monounsaturated fat 0 g              Cholesterol 0 mg              Sodium 25 mg    Potassium 329 mg            Total Carbohydrate 6 g   Protein 2.9 g Vitamin A 133% Vitamin C 134% Calcium 10%      Iron 5% Vitamin D 0%      Vitamin B-6 10% Vitamin B-12 0%               Magnesium 7%	Total Fat 17 g     Saturated fat 2.7 g           Polyunsaturated fat 6 g   Monounsaturated fat 7 g              Trans fat 0.1 g    Cholesterol 0 mg              Sodium 246 mg  Potassium 677 mg            Total Carbohydrate 48 g Dietary fiber 4.4 g            Sugar 0.4 g          Protein 4 g          Vitamin A 0% Vitamin C 9% Calcium 2%         Iron 5% Vitamin D 0%      Vitamin B-6 20% Vitamin B-12 0%               Magnesium 10%

Once again, the data doesn’t lie. As the above comparison shows, I would have to eat a whopping 11 cups of chopped kale to equal the amount of calories I would consume in a medium serving of fries! If I’m trying to lose weight, the good news is that I can eat more kale while consuming far fewer calories than I would if I were to eat the French fries. This means I will feel fuller for a longer period of time. I’m also fueling my body with less unhealthy fats and far more nutritional value. Like I said before, it’s a win/win.

Move over vegetarian, I'm a nutritarian -  So are you ready to transition to a nutritarian diet which is eating more low-energy/nutrient dense foods? If you said yes, congratulations! You're making a good choice for your health. Are you unsure how to decide which foods to choose? A good starting point to help you in your search to find the most nutrient dense foods is to check out the ANDI guide. ANDI stands for aggregate nutrient density index and was developed by Dr. Joel Furhman.

This is from Dr. Furhman's site: "Adequate consumption of micronutrients – vitamins, minerals, and many other phytochemicals – without overeating on calories, is the key to achieving excellent health. Micronutrients fuel proper functioning of the immune system and enable the detoxification and cellular repair mechanisms that protect us from chronic diseases. A nutritarian is someone whose food choices reflect a high ratio of micronutrients per calorie and a high level of micronutrient variety."

With this in mind, the ANDI guide categorizes whole foods and then scores them on a scale from 1 to 1000 based on an extensive range of micronutrients, including vitamins, minerals, phytochemicals and antioxidant capacities. In addition, Dr. Furhman's original ANDI guide has been updated to reflect a more accurate picture of each food's nutritional qualitywhich now considers certain beneficial phytochemicals, such as angiogenesis inhibitors (i.e. cancer prevention, read more here), organosulfides (found in onion, garlic and cruciferous veggies), isothiocyanates (organosulfur compounds found in cruciferous veggies and are among the most effective cancer-prevention agents known), and aromatase inhibitors (suppress the synthesis of estrogen and thought to aid in the prevention of breast cancer).

The ANDI guide can be a useful tool in your determining healthy food choices, but it isn't the holy grail. I like what Dr. Furham says and I believe his suggestion is the best advice when it comes to choosing foods.  He says: “…nutrient density scoring is not the only factor that determines health benefits… if we ate only foods with a high nutrient density score, our diets would be too low in fat. For that reason we have to pick some foods with lower nutrient density scores.” Also, he notes that if thin individuals or those who are very active ate only foods with the highest nutrient density, they would become so full from fiber that it's likely they would be unable to meet their caloric needs. Remember my kale example above? One can only eat so much fiber. Balance and variety are key to consuming the greatest number and variety of micronutrients.

You may already know that kale is a better food choice than French fries, so if you operate on the simple premise that your diet should emphasize fruits, vegetables, and whole grains and not prepackaged, processed or fast food, you probably don’t need the ANDI guide to tell you where to get the most nutritional bang for your buck. However, if you’re uncertain as to whether or not you’re making the best food choices for your health, the ANDI rankings are a good starting point. 

I really like Dr. Weil's anti-inflammatory "diet" approach and I have incorporated some of his wisdom into my lifestyle as well. I've blogged about the health benefits of reducing the risk for chronic inflammation in an earlier post. Look for more on that in a future post.  In the meantime, I'll leave you with this food for thought:

Sources:

• CDC Low energy dense foods and weight management - http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_energy_density.pdf
• Nutrient Density, Clemson Cooperative Extension - http://www.clemson.edu/extension/hgic/food/nutrition/nutrition/dietary_guide/hgic4062.html
• Food and Nutrition, Nutrient Density - http://www.nestle.com/asset-library/Documents/Library/Documents/Nutrition_Health_Wellness/Food-and-Nutrition-Issue09-Nutrient-Density-Jan2008.pdf
• Sports Science Exchange, Energy Balance and Weight Reduction - http://www.uni.edu/dolgener/UG_Sport_Nutrition/Articles/Energy_Balance.pdf
• Simple Science Fitness, Energy balance and law of thermodynamics -http://simplesciencefitness.com/ 
• Whole Foods Market uses ANDI guide - http://www.wholefoodsmarket.com/healthy-eating/andi-guide
• Nutrient Rich, ANDI Guide - http://www.nutrientrich.com/1/aggregate-nutrient-density-index-andi-score.html

Should we avoid GMO's? I listen to my gut.

Istockphoto/Eraxion - via Scientific American

There's an English language idiom that's used to encourage someone to trust their instincts or intuition. It's "go with your gut." This expression is often used figuratively, but  I've come to think of it in a more literal sense. When it comes to my health, I am finally learning to listen to my gut and give it the credence it deserves. How about you? Is your gut trying to tell you something?

What's in your gut? -  Although the word gut sounds short and simple, the system it describes is actually very complex and is also absolutely critical to our survival. In fact, the gut is so important that it has its own "brain" - the enteric nervous system (ENS) (3). The gut, or gastrointestinal (GI) system includes the stomach, large intestine and colon, among other things. The major events of digestion and food absorption occur in the small intestine, which is covered in tiny little projections called villi that aid in the absorption of nutrients from the foods we eat (3). Problems can occur when these villi and the gut lining become compromised (3).

Wellness and the gut - When it comes to diagnosing disease, it seems wisdom dictates the symptoms are related to the location where they are present. For example, my Mom had eczema when she was a child. Since the rash was on her skin, the doctors called this a skin disorder. Thankfully, Western medicine has progressed since then and recognizes that there is more to the picture. The diagnosis of disease is now taking a more holistic approach, recognizing that the body is an integrated system and a symptom in one location could actually stem from something occurring in another location.  Applying this understanding to my Mom's eczema, doctors now see a link between eczema and the immune system, even though the symptoms appear on the skin (1). So, clearly this isn't just a skin disorder.

What's all this have to do with the gut? Well, experts are making connections between our gut health and a variety of diseases outside of the GI system itself. I imagine Hippocrates (460-377 BC), who is often referred to as the father of western medicine and is quoted as saying, "all disease begins in the gut" would be amused by modern medicine's reluctant acceptance of his ancient wisdom! (2)

GE foods  - Let's take a moment to discuss the nomenclatures used to describe these

foods. The terms genetically modified (GM) foods, genetically modified organisms (GMOs),  genetically engineered (GE) foods, and bio-engineered foods, all describe products that have had "foreign genes (genes from other plants or animals) inserted into their genetic codes" (5) "creating  combinations of plant, animal, bacterial and viral genes that cannot occur in nature or in traditional crossbreeding" (4).

from USDA Economic Research Service

I'm not eating GE foods, am I? - You may be surprised by just  how much of the food in US grocery stores comes from GE crops. I know I was! In the US there are 4 commonly grown GE crops: corn, soy, canola and cotton.  The USDA’s Economic Research Service estimates that 90 percent of the corn grown in the United States is genetically modified (7) (at time post was written). So, if you're eating corn that was not organically grown you are eating GMO's. Maybe you're careful to not eat GE corn. Good! However, if you eat animals that eat feed that contains GE corn, you are consuming GMO's. Maybe you don't eat meat or GE corn? Well, if you are eating processed foods (which usually contain high fructose corn syrup) you are consuming GMO's. In fact, about 70 percent of processed food in US supermarkets contains GE ingredients, according to the Center for Food Safety (8).

GM Foods and our gut health - Before we talk about our gut health, we need to look at one genetic modification in particular occurring in certain US crops, that is the insertion of a short sequence of genes from Bacillus thuringiensis (Bt) into plants like corn and potatoes for example. Bt "is a Gram-positive, [naturally occurring] soil-dwelling bacterium" and is now "commonly used as a biological pesticide." (10)  You can read more about it at the University of California - San Diego's webpage here, but here's the shorter explanation:

Image from UCSD 

"Bt has to be eaten [by the insect] to cause mortality. The Bt toxin dissolve in the high pH insect gut and become active. The toxins then attack the gut cells of the insect, punching holes in the lining. The Bt spores spill out of the gut and germinate in the insect causing death within a couple days." Organic farmers have used Bt topically as a pesticide for years. Splicing the Bt genes into a plant is a relatively new occurrence.

What does Bt have to do with our gut health? There is compelling evidence from a study done in the early part of last year that indicates consuming GE foods containing Bt toxin has a detrimental effect on humans. For the first time, researchers have found Bt toxin in the blood stream of people. The doctors who did the study wondered why this would be the case if the Bt toxin were being destroyed in the human stomach during digestion as was originally believed. They argue in their research that "modified Bt toxins are not inert on nontarget human cells and that they can present combined side effects with other residues of pesticides specific to GM plants." (9)

Not too surprisingly, this French study was criticized and attempts were made to discredit it. However, a new study released this year from the University of Brazil reinforces the concerns highlighted by the earlier research and raises disturbing new issues of potential toxic affects to our blood. You can read the details here. (11)

This subject is too lengthy to discuss in one post, so I will wrap this up for now and conclude next time with a discussion of what the recent research reveals about how consuming GE foods impacts our gut and overall health.  In the meantime, consider this quote from another Greek power thinker named Aristotle - "Intuition is the source of scientific knowledge." What do you think? Are you going with your gut? 

UPDATE: The Research paper referenced above has been retracted by the Journal Food and Chemical Toxicology. The following is a segment of their statement.  You can read it in it's entirety here:

"The journal Food and Chemical Toxicology retracts the article “Long term toxicity of a Roundup herbicide and a Roundup-tolerant genetically modified maize,” which was published in this journal in November 2012. This retraction comes after a thorough and time-consuming analysis of the published article and the data it reports, along with an investigation into the peer-review behind the article. The Editor in-Chief deferred making any public statements regarding this article until this investigation was complete, and the authors were notified of the findings."

In what sounds like a low budget film title, this has come to be known as the Seralini affair. I will leave the determination of whether or not this study was faulty to minds much more scientific than mine. I will say that my gut reaction is to remain skeptical regarding the safety of eating GMO's.  No one really knows the long term effects. The biggest study being conducted is occurring in real time among the general population who consume GMO's. Profit and greed seem to trump health and safety these days. Given the power of the chemical industry in America it doesn't surprise me.  I'll leave you with these facts:

"The U.S. Chemical Industry - The chemicals industry is one of the United States’ largest manufacturing industries, serving both a sizable domestic market and an expanding global market. It is also one of the top exporting sectors of U.S. manufacturing. Accounting for 15 percent of global chemical shipments, the United States is a world leader in chemicals production and exports. The industry’s more than 10,000 firms produce more than 70,000 products. In 2012, the U.S. chemicals industry had sales of $769.4 billion and directly employed more than 784,000 workers, with additional indirect employment by industry suppliers of more than 2.7 million. With investment of $57 billion in research and development in 2012, and strong enforcement of intellectual property rights, one-fifth of all patents granted in the United States are chemistry-related." (Select USA)

Sources -
1) Nature Immunology, Cutaneous immunosurveillance and regulation of inflammation by group 2 innate lymphoid cells, Ben Roediger, et.al., http://www.nature.com/ni/journal/vaop/ncurrent/full/ni.2584.html
National Institutes of Health, Medline Plus - http://www.nlm.nih.gov/medlineplus/ency/article/002432.htm
2) Hippocrates - Wikipedia from http://en.wikipedia.org/wiki/Hippocrates
3) Understanding Nutrition, Ellie Whitney, 11th edition, Thomson, 2008
4) GE foods and health - http://www.actionbioscience.org/biotech/pusztai.html
5) GMOs -  http://www.nongmoproject.org/learn-more/what-is-gmo/
6) University of Maryland Medical Center - http://www.umm.edu/ency/article/002432.htm
7) USDA Economic Research - http://www.ers.usda.gov/
8) Center for Food Safety - http://www.centerforfoodsafety.org/issues/311/ge-foods/non-gmo-shoppers-guide-325/1846/tips-for-avoiding-gmos
9) Cytotoxicity on human cells of Cry1Ab and Cry1Ac Bt insecticidal toxins alone or with a glyphosate-based herbicide - http://www.sciencedirect.com/science/article/pii/S0278691512005637
10) Bt - http://en.wikipedia.org/wiki/Bt_toxin
11) Hematotoxicity of Bacillus thuringiensis as Spore-crystal Strains Cry1Aa,
Cry1Ab, Cry1Ac or Cry2Aa in Swiss Albino Mice - http://gmoevidence.com/wp-content/uploads/2013/05/JHTD-1-104.pdf
12) Serafini affair - http://en.wikipedia.org/wiki/S%C3%A9ralini_affair
13) Select USA - US Chemical Industry - http://selectusa.commerce.gov/industry-snapshots/chemical-industry-united-states