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eating healthy

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Simple strategies can improve health for everyone around the table

By David Dunaief, M.D.

Dr. David Dunaief

Many of us give thanks for good health on Thanksgiving. This is especially relevant this year. While eating healthy may be furthest from our minds during the holidays, it is so important.

Instead of making Thanksgiving a holiday of regret, eating foods that cause weight gain, fatigue and that increase your risk for chronic diseases, you can reverse this trend while maintaining the traditional theme of a festive meal.

What can we do to turn Thanksgiving into a bonanza of good health? Phytochemicals (plant nutrients) called carotenoids have antioxidant and anti-inflammatory activity and are found mostly in fruits and vegetables. Carotenoids make up a family of more than 600 different substances, such as beta-carotene, alpha-carotene, lutein, zeaxanthin, lycopene and beta-cryptoxanthin (1).

Carotenoids help to prevent and potentially reverse diseases, such as breast cancer; amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease; age-related macular degeneration; and cardiovascular disease — heart disease and stroke. Foods that contain these substances are orange, yellow and red vegetables and fruits, and dark green leafy vegetables. Examples include sweet potato, acorn squash, summer squash, spaghetti squash, green beans, carrots, cooked pumpkin, spinach, kale, papayas, tangerines, tomatoes and Brussels sprouts.

Let’s look at the evidence.

Breast cancer

We know that breast cancer risk is high among U.S.-born women, where the average lifetime risk of getting breast cancer is 12.8 percent (2). In a meta-analysis (a group of eighteen prospective studies), results show that women who consumed higher levels of carotenoids, such as alpha-carotene, beta-carotene, and lutein and zeaxanthin, had significantly reduced risk of developing estrogen-negative breast cancer (3).

Lou Gehrig’s disease

ALS is a disabling and feared disease. Unfortunately, there are no effective treatments for reversing this disease. Therefore, we need to work double time in trying to prevent its occurrence. In a meta-analysis of five prestigious observational studies, including The Nurses’ Health Study and the Health Professionals Follow-Up Study, results showed that people with the greatest amount of carotenoids in their blood from foods like spinach, kale and carrots had a decreased risk of developing ALS and/or delaying the onset of the disease (4). This study involved over 1 million people with more than 1,000 who developed ALS.

Those who were in the highest carotenoid level quintile had a 25 percent reduction in risk, compared to those in the lowest quintile. According to the authors, the beneficial effects may be due to antioxidant activity and more efficient function of the power source of the cell: the mitochondrion.

Strategies for healthy holiday eating

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Despite the knowledge that healthy eating has long-term positive effects, there are obstacles to healthy eating. Two critical factors are presentation and perception.

Vegetables are often prepared in either an unappetizing way — steamed to the point of no return – or smothered in cheese, negating their benefits, but clearing our consciences.

Many consider Thanksgiving a time to indulge and not think about the repercussions. Plant-based foods like whole grains, leafy greens and fruits are relegated to side dishes or afterthoughts. Why is it so important to change our mindsets? There are significant short-term consequences of gorging ourselves.

Not surprisingly, people tend to gain weight from Thanksgiving to New Year. This is when most gain the predominant amount of weight for the entire year. However, most do not lose the weight they gain during this time (5). If you can fend off weight gain during the holidays, think of the possibilities for the rest of the year.

Also, if you are obese and sedentary, you may already have heart disease. Overeating at a single meal increases your risk of heart attack over the near term, according to the American Heart Association (6). However, with a little Thanksgiving planning, you can reap significant benefits:

Make healthy, plant-based dishes part of the main course. You don’t have to forgo signature dishes, but add to tradition by adding mouthwatering vegetable-based dishes.

Improve vegetable options. Most people don’t like grilled chicken without any seasoning. Why should vegetables be different? In my family, we season vegetables and make sauces to drizzle over them. Good resources for appealing dishes can be found at PCRM.org, DrFuhrman.com, mouthwateringvegan.com, and many other resources.

Replace refined grains. A study in the American Journal of Clinical Nutrition, showed that replacing wheat or refined grains with whole wheat and whole grains significantly reduced central fat, or fat around the belly (7). Not only did participants lose subcutaneous fat found just below the skin, but also visceral adipose tissue, the fat that lines organs and causes chronic diseases such as cancer. For even better results, consider substituting riced or mashed cauliflower for rice or potatoes.

Create a healthy environment. Instead of putting out creamy dips, cheese platters and candies as snacks, choose whole grain brown rice crackers, baby carrots, cherry tomatoes and healthy dips like hummus and salsa. Help people choose wisely.

Offer healthy dessert options. Options might include dairy-free pumpkin pudding and fruit salad.

The goal should be to increase your nutrient-dense choices and decrease your empty-calorie foods. You don’t have to be perfect, but improvements during this time period have a tremendous impact — they set the tone for the coming year and put you on a path to success. Why not turn this holiday into an opportunity to de-stress, rest, and reverse or prevent chronic disease?

References:

(1) Crit Rev Food Sci Nutr 2010;50(8):728–760. (2) SEER Cancer Statistics Review, 1975–2016, National Cancer Institute. (3) Am J Clin Nutr. 2012 Mar; 95(3): 713–725. (4) Ann Neurol 2013;73:236–245. (5) N Engl J Med 2000; 342:861-867. (6) www.heart.org. (7) Am J Clin Nutr 2010 Nov;92(5):1165-71.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

Foods that comfort the mind and body protect you from chronic diseases in the long term. Stock photo
Focusing on real ‘comfort food’ will improve your outcomes

By David Dunaief, M.D.

Dr. David Dunaief

I think it’s fair to say that our world has been radically altered by the current COVID-19 pandemic. If you are at home weathering this storm, it can feel like you are in a literal silo. 

So naturally, we need to find things that make us feel “better.” Many of us reach for food to help comfort us. Guess which food item has had the largest sales increase in the U.S. from 2019. Here is a hint: it’s not broccoli. It’s frozen cookie dough, where sales are up 454 percent (1). 

But there is a difference between food that comforts just the mind and food that comforts both the mind and the body. What is the difference? Let’s look at two recent examples from my clinical practice. 

Food that comforts the mind and body 

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First, let’s look at the results of a 71-year-old male who stopped eating out during COVID-19, like so many of us. Apparently, for this patient, eating out meant indiscretions with his diet. While at home, there was less temptation to stray from his dietary intentions. The results speak for themselves. 

In a month, his nutrient level improved, measured using serum beta carotene levels. His inflammation, measured by c-reactive protein (CRP), was reduced 40 percent. What is the importance of inflammation? It is the potential basis for many of the chronic diseases that are rampant in the U.S. (2). His kidney function increased by about 14 percent with an increase in his glomerular filtration rate (GFR), which helps remove waste from the kidney, from 51 to 58. This patient, who suffers from gout, also found his uric acid dropped. Finally, and most importantly, his symptoms improved, and he garnered more energy. He described himself as enjoying food more.

I am not suggesting you don’t order out, but do it wisely. Diametrically opposed is our second example. 

Food that comforts the mind only

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This 72-year-old female decided to embrace ultra-processed foods, adding cookies, cakes and sour-dough breads to her diet. Her kidney function decreased by more than 15 percent, with the GFR shifting from 88 to 63. Her inflammation, measured by CRP, went up by 75 percent. Her LDL, “bad cholesterol,” increased by more than 20 percent. Her allergy symptoms worsened. She described herself as more sluggish and, to boot, she gained five pounds.

What makes these examples even more interesting is that both patients are deemed in the high-risk category for getting severe COVID-19 and being hospitalized. COVID-19 is associated with elevated CRP, which may increase the risk for more lung lesions and the risk of severe disease (3).

What is the moral of the story? Use this time to focus on foods that comfort both the mind and the body. Make food work for you and against the common enemies of COVID-19 and chronic diseases that are putting people at higher risk for viruses.

What about exercise? 

Just because we are cooped up indoors most of the time does not mean we can’t exercise. Time and again, exercise benefits have been shown. Yet, we are sitting more and, with social distancing, we have less incentive to go outside or opportunities to socialize, go to the gym or do many of our usual activities.

However, not to fret. There was a recent small study with eight volunteers equally split between men and women. Results showed that four-minute intervals of exercise throughout the day that interrupted continuous sitting led to a substantial improvement in triglycerides and metabolized more fat after high-fat meals the next day, compared to continuous sitting for eight hours uninterrupted and then eating a high fat meal the next day (4).  

The participants used a stationary bike, exercising intensely for four seconds and then resting for 45 seconds, repeating the sequence five times in a row. They completed this four-minute sequence once an hour for eight hours. Their daily intense exercise totaled 160 seconds. This bodes well for very short bursts of exercise rather than sitting for long periods without movement.

Not everyone has a stationary bike, but you can do jumping jacks, run in place, or even dance vigorously to your favorite tunes once an hour.

Ventilator vs. Incentive Spirometer

As I’m sure you’ve been reading, some with severe COVID-19 require ventilators. Unfortunately, the statistics with ventilators are dismal. According to a recent study of 5700 COVID-19 patients in the New York region, 88.1 percent of patients died (5). Hospitals are trying alternate approaches while using oxygen masks not ventilators, such as proning (turning patients on their stomach instead of lying on their backs in bed) and having them sit up in a chair in order to help with oxygenation in the lungs in those who have low oxygen saturation.

However, the ultimate exercise for the lung and the ability to improve oxygenation is an incentive spirometer. This device expands your lungs as you inhale. The more you do it, the better your lung functioning. One study, which I mentioned in previous articles on lung function, involved inhaling a total of 50 breaths a day which in two increments (6). 

The brand of spirometer used was a Teleflex Triflo II. This costs less than five dollars online at medicalvitality.com

What about incentive spirometer in sick patients? There was a small study with patients who had COPD exacerbations (7). Those who were given an incentive spirometer plus medical treatment saw a significant increase in the blood gases over a two-month period. Also, the quality of life improved for those using the incentive spirometer. 

Remember, one of the factors that may be a sign that someone is at high risk for severe COVID-19 is very low oxygen saturation. If you can improve oxygen saturation with incentive spirometer that is readily available, how can you pass this up? 

While it is tempting to gorge yourself with food that comforts the mind, DON’T! Foods that comfort the mind and the body protect you not only in the short term, but also the longer term from the consequences of chronic diseases.

Therefore, focus on DGLV (dark green leafy vegetables) that raise beta-carotene, which in turn lowers CRP. This can be achieved with diet by increasing consumption of beta-carotene-rich fruits and vegetables while limiting consumption of beta-carotene-poor ultra-processed and fatty foods. Interestingly, it is much easier right now to get DGLVs than it is to get certain ultra-processed foods. Add in exercise and an incentive spirometer and you will comfort your body plus your mind.

References:

(1) CNBC.com April 23,2020. (2) Front Immunol. 2018; 9: 1302. (3) Med Mal Infect. 2020 Mar 31;S0399-077X(20)30086-X. (4) Medicine & Science in Sports & Exercise. Online April 17, 2020. (5) JAMA. 2020 Apr 22;e206775. (6) Ann Rehabil Med. Jun 2015;39(3):360-365. (7) Respirology. 2005 Jun;10(3):349-53. 

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.