Monday, January 24, 2011

5-a-Day ‘Not Enough’ Fruits and Vegetables

New Research Finds 8-a-Day May Be Needed to Cut the Risk of Dying From Heart Disease

By Tim Locke
 
Jan. 18, 2011 -- We’re all urged to eat five servings of fruits and vegetables a day, but new research finds eight servings may be needed to cut the risk of dying from heart disease.
 
The diet and lifestyles of more than 300,000 people across eight countries in Europe found that people who ate at least eight portions of fruits and vegetables a day had a 22% lower risk of dying from heart disease than those who ate three portions a day.

Each additional portion in fruits and vegetables was linked to a 4% lower risk of death.

One portion counted as 80 grams, such as a small banana, a medium apple, or a small carrot.

Heart disease is the leading cause of death in the U.S. and around the world, accounting for more than one in every four deaths in the United States, according to the CDC.

Average Intake of Fruits and Vegetables

The average intake of fruits and vegetables in the various countries was five servings a day.

Spain, Greece, and Italy were the leaders in fruit and vegetable eating. Italian men enjoyed 7.5 portions a day, and Spanish women 6.7 portions.

Healthy eating tailed off the further north the researchers looked in Europe.

U.K. men managed 4.1 portions a day, and women 4.8 portions.

Swedish men and women were the worst, with only 3.5 and 2.9 portions a day.

The researchers say factors like cost and availability of fruit and vegetables are likely to account for differences in intake.

Data came from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study.

Every Portion Counts

Study researcher Francesca Crowe, MD, of the Cancer Epidemiology Unit at the University of Oxford in England, tells WebMD by email, “We do need to be cautious in our interpretation of these findings as participants with a higher intake of fruits and vegetables tended to be slightly healthier overall. So we are unable to say whether the association between fruits and vegetables and heart disease is causal.”

In other words, did the fruits and vegetables make people healthier, or are people who eat better also more likely to have healthier lifestyles?

Crowe says healthy eating also needs to be added to healthy lifestyle behaviors as well as other recommendations “such as not smoking, not having high blood pressure or high blood lipids [cholesterol] and being in a healthy weight range.”

Stepping up from five servings to eight servings a day might be hard, but Crowe says, “It may be a more manageable public health guideline to recommend that everyone increases their intake by one portion per day.

“This is a much more modest effect for an individual but if everyone could achieve this then at a population level the impact would be quite large.”

In a statement, Victoria Taylor, senior dietitian at the British Heart Foundation, says, “The take-home message is still that eating fruit and vegetables is healthy for your heart. We need to remember to make five portions our minimum as the more fruit and vegetables people ate the lower their risk of dying from heart disease became.”

Recent research from the British Heart Foundation and the University of Oxford suggested that 15,000 lives a year could be saved if everyone ate five servings a day.

Taylor continues: “We still don’t know exactly why we see this relationship between fruit and vegetables and heart disease. It may be something in the fruit and vegetables itself, but equally it could be something in the lifestyles of people who tend to eat more fruit and vegetables. There’s still work to be done by researchers to answer these questions.”

SOURCES:

News release, European Heart Journal.

Francesca Crowe, MD, Cancer Epidemiology Unit, University of Oxford, England.

British Heart Foundation.

NHS Choices: "Cardiovascular disease."

CDC.

Friday, January 21, 2011

The 9 Most Fattening Foods of Winter

Cold-weather favorites that can lead to winter weight gain.

By Kathleen M. Zelman, MPH, RD, LD

WebMD Weight Loss Clinic-FeatureReviewed by Louise Chang, MDControlling weight during the cold, dark days of winter is an issue for most of us. Studies show that many people gain at least a pound between November and January. And the worst part: That gain is usually permanent. Blame it on the cold weather that makes outdoor exercise less appealing, cravings for fattening comfort foods, and the seemingly endless weeks of holiday celebrating. And of course, you can hide your expanding waistline under layers of warm clothing. It's a wonder more of us don't gain more than a pound each winter!

Once you no longer have that youthful metabolism that lets you eat donuts, French fries, and fried chicken without gaining an ounce, it is time to cut down -- or even eliminate -- some of the most fattening foods, experts say. It's certainly OK to splurge on the occasional small portion of a decadent food, but most adults do better if they stay clear of the temptations.

"Keep in mind that it is easier to keep your weight stable than it is to take off the pounds" says Jayne Hurley, RD, senior nutritionist for the nonprofit watchdog group Center for Science in the Public Interest.

The foods that "talk" to us in winter tend to be hearty comforting and holiday favorites that are also often packed with artery-clogging fat, calories, and sodium.

"In summer there is an abundance of light foods, but when winter rolls around it is natural to want to beef up and yearn for richer foods," says Katherine Tallmadge, MS, RD, an American Dietetic Association spokeswoman.

And, of course, the American way is to have more than just one calorie-rich dish (witness the popularity of the holiday buffet). Studies show, the greater the variety, the more we eat.

"If there are 10 types of holiday cookies or several creamed side dishes, it only makes sense that you want to try them all," says Tallmadge, "and in the end, a wide variety encourages overeating."

Most Fattening Foods of Winter

So what are the worst winter foods, the calorie-packed culprits that we should stay away from? The truth, experts say, is that there really are no "bad" foods. A few bites of even the most fattening food can fit into your diet. But there certainly are foods that are worse for us than others. When you check out the nutritional numbers on these foods, keep in mind that most adults need fewer than 2,000 calories, 65 grams of total fat, and 20 grams of saturated fat each day.

Here are picks from the experts for the nine winter foods most likely to pack on the pounds:

1.Macaroni and cheese. It's an all-time favorite comfort food for both kids and adults, but it can wreak havoc with your diet. A 12-ounce serving of Stouffer's macaroni and cheese has 529 calories, 25.7 grams of fat, and 10.6 grams of saturated fat. Calories can climb higher when ingredients like high-fat meats or sausage are tossed in. And some restaurants even sell deep-fried mac and cheese as an appetizer! Your best bet when eating out is simply to find another side dish. At home, "modify the recipe by using a low-fat cheese, low-fat milk, and stretch it with additional vegetables to improve the nutritional profile and still taste great," says Liz Weiss, author of The Mom's Guide to Meal Makeovers.

2.Cream-based soups, bisques and chowders. "Warm soups and chowders feel so nutritious, but if they are loaded with cream, they are also loaded with calories," says Tallmadge. Soups also tend to be high in sodium, and if you crumble salty crackers into the bowl or top with cheese, the sodium level soars even higher. A one-cup serving of Harry's Lobster Bisque (Costco) has 380 calories, 27 grams of fat, 16 grams saturated fat, and 1,240 milligrams of sodium. The New England clam chowder at Chili's, meanwhile, has 940 calories, 65 grams fat, and 34 grams of saturated fat. "Choose soups that are broth based, like vegetable or minestrone, and pair it with a salad or a whole-wheat roll," suggests Tallmadge.

3.Cream- and cheese-based casseroles, or those topped with cheese, bacon, fried onions, or buttered crackers. Who doesn't love the traditional hash brown casserole, gooey with cheese and potatoes? But brace yourself, because one serving has 568 calories, 40 grams of fat and 21 grams of saturated fat -- and this is for a side dish! Creamed, scalloped, and au gratin dishes may start out with healthy ingredients like broccoli, green beans, or potatoes. But when you add cream, butter, and canned soups and top them with cheese, bacon, and/or fried breadcrumbs, you can easily quadruple the calories. "Shave calories by substituting low-calorie mix-ins such as fat-free sour cream, low-fat cheese, or reduced-fat soups," says American Dietetic Association spokeswoman Suzanne Farrell. For a tasty, healthy side dish, try oven-roasted vegetables -- 6 ounces of oven-roasted new potatoes has just 100 calories and 4.5 grams of fat.

4.Cheesecake treats. Cheesecakes are typically loaded with artery clogging fats. In just one slice of chocolate Oreo mudslide cheesecake from the Cheesecake Factory, you get 1,050 calories, 71 grams of fat, and 34 grams of saturated fat. And don't think ordering a muffin will save you when you're craving a cream-cheese treat. Starbuck's pumpkin cream cheese muffin has 490 calories, 24 grams of fat, and 6 grams of saturated fat. Better to skip these rich desserts and satisfy your sweet tooth with a 150-calorie Skinny Cow ice cream cone -- or suck on a peppermint for a mere 20 calories.

5.Chili and stews loaded with ground beef, sausage, and/or cheese. When you make them yourself, with small portions of lean meat, lots of vegetables and beans and a sprinkle of low-fat cheese, chili and stews can be nutritious and filling. But when you order them out, beware. At Chili's, a bowl of chili with cheese will cost you 500 calories, 35 grams of fat, and 15 grams saturated fat. At Quizno's, the bread bowl chili has 760 calories, 23 grams of fat, and 7 grams saturated fat. "Stews or chili have the potential to be very hearty, high in protein, and a great meal as long as you control the high-fat ingredients such as ground meat, sausage and cheese," says Hurley. Stick to your own recipe or go to Wendy's for a cup of chili with 220 calories, 6 grams of fat, and 2.3 grams saturated fat (without cheese or crackers).

6.Pies topped with whipped cream or ice cream. These winter favorites often start with healthy ingredients, like heart-healthy nuts or antioxidant-rich fruits, but they also include high-calorie ingredients. "Rich, buttery pie crusts on the top and bottom, sweet fillings, and the customary whipped cream or ice cream topping make these pies decadent and full of calories," says Farrell. A slice of coconut cream pie at Denny's, for example, will set you back 701 calories, 32 grams of fat, and 20 grams saturated fat. Shoney's apple pie a la mode has 1,203 calories, 53 grams of fat, and 23.7 grams of saturated fat in one serving -- equivalent to the total daily calories in some weight loss plans. "Skip the crust(s), add a dollop of light whipped topping, and serve yourself only a sliver" if you want to enjoy these desserts, suggest Farrell.

7.Cookies. Enjoying one small cookie is not a problem. "Most small (about 1 -2 ounces) cookies are around 200-250 calories, which is not bad if you eat only one -- but who can stop at one?" asks Tallmadge. The CD-sized cookies you commonly find at bakeries and restaurants pack a real caloric punch. At Dunkin' Donuts, the peanut butter cup cookie (4.5 ounces) has 590 calories, 29 grams of fat, and 13 grams saturated fat. At Panera, the shortbread cookie (2.5 ounces) has 350 calories, 21 grams of fat, and 12 grams saturated fat. So split it in half, or take along a 100-calorie pack of your favorite cookie.

8.Fried side dishes -- chili cheese fries, onion rings, and plain old French fries. Sadly, the most popular vegetable in the U.S. is the French fry, which is loaded with fat, calories, and salt. Most people think nothing of adding a side of 6-ounce fries to their order at McDonald's, even though it adds an additional 570 calories, 30 grams of fat, and 6 grams saturated fat. Sharing a Chili's Awesome Blossom (1/2 portion) gives you 1,355 calories, 101 grams of fat, and 18 grams saturated fat – all before the entree. A serving of Del Taco's chili cheese fries has 670 calories, 46 grams fat, and 15 grams saturated fat, while White Castle onion rings have 750 calories, 39 grams of fat, and 6 saturated fat. "Best bet: Have a side salad with your entrée and skip the high-calorie, deep-fat fried appetizer, and look for something that is not fried and has vegetables," says Hurley. Think bruschetta or edamame.

9.Creamy pot pies with pastry on the top and bottom. It looks innocent enough but when you have pastry on the bottom and top, you get a double dose of high-fat crust plus the filling. The individual Boston Market chicken pot pie has 780 calories, 47 grams of fat, and 17 grams of saturated fat. Forget the creamy pie and enjoy a roasted chicken breast and a whole-wheat roll for a fraction of the calories.

Beyond limiting the most fattening foods, here are some more general expert tips for avoiding winter weight gain:
 
Have plenty of low-sodium soups and stews that are broth- or tomato-based and contain lots of vegetables. Studies show that eating broth-based soup before a meal can fill you up and help you eat fewer calories during the meal.

Heat up your food with spices and peppers to give it more pizzazz so you won't miss the high-fat ingredients.

Use only lean meats in casseroles and other dishes. Even then, remember to keep portions reasonable.

Drink plenty of water with your meals

Include plenty of lean protein in your diet to keep you feeling full and satisfied

Replace cream in recipes with fat-free half-and-half or low-fat milk

Use 2 egg whites instead of each whole egg in recipes.

Get plenty of natural sunlight, and stay fit to keep your metabolism perking.

Keep your menus simple and reduce the number of choices to reduce the temptation to try everything, Tallmadge says.

During the holiday season, "keep your routine as normal as possible, and if you do splurge, just get right back on track so Thanksgiving dinner does not extend all the way to New Year's Day," says Hurley.

SOURCES: Katherine Tallmadge, MA, RD, author, Diet Simple: 192 Mental Tricks, Substitutions, Habits & Inspirations; spokeswoman, American Dietetic Association. Jayne Hurley, RD, senior Nutritionist, Center for Science in the Public Interest. Liz Weiss, author, The Mom's Guide to Meal Makeover. Suzanne Farrell, MS, RD, spokeswoman, American Dietetic Association. Calorieking.com web site.

Wednesday, January 19, 2011

Microbes in Our Gut Regulate Genes That Control Obesity and Inflammation

ScienceDaily (Jan. 14, 2011) — If you are looking to lose weight in the coming year, you may need help from an unexpected place: the bacteria in your gut. That's because scientists have discovered that the bacteria living in your intestines may play a far more significant role in weight loss and gastrointestinal problems than ever imagined.

In a new research report published online in The FASEB Journal, researchers show that a deficiency of Toll-like receptor 2 (Tlr2) -- used by mammals (including humans) to recognize resident microbes in the intestines -- leads to changes in gut bacteria that resemble those of lean animals and humans. This discovery builds on previous research demonstrating that a deficiency of TLR2 protects against obesity, while at the same time promoting gastrointestinal problems like excessive inflammation. It also shows that genes controlling TLR2 expression play a very important role in one's gastrointestinal health and weight management.

"Our work highlights the remarkable capacity for an orchestrated reprogramming of the intestinal inflammatory network to overcome significant genetic challenges in the mammalian bowel," said Richard Kellermayer, Ph.D., a researcher involved in the work from the Section of Pediatric Gastroenterology, Hepatology and Nutrition at Baylor College of Medicine in Houston. "The appropriate exploitation of this remarkable capacity may provide means for the prevention and optimized treatment of common metabolic (such as obesity and diabetes) and gastrointestinal disorders."

To make this discovery, Kellermayer and colleagues studied normal mice and mice deficient in TLR2 using the large intestinal lining of these mice. They compared the TLR2-deficient ones to the normal group, as well as the bacteria, the epigenome (more specifically DNA methylation, a molecular change in the DNA associated with decreased gene expression), and the gene expression of the animals. The researchers found that the absence of TLR2 leads to microbial changes in the gut that resemble lean animals and humans, as well as immunologic changes similar to those observed in ulcerative colitis.

"Every New Year, a significant percentage of us resolve ourselves to lose weight," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal, "but national statistics on obesity show that we're failing fast. This research linking gut bacteria to TLR2 expression opens entirely new doors for weight control solutions, first by cementing TLR2 as a drug target for obesity, and second by providing further evidence that managing gut bacteria may be an important and effective way to control weight. The challenge, of course, is to find a way to tip the scales just enough to keep weight under control without causing serious gastrointestinal problems."

Monday, January 17, 2011

Fighting Midlife Weight Gain

An interview with Pamela Peeke, MD

By Kathleen Doheny
 
First, you notice shopping for clothes isn't as fun or simple as it used to be. Next comes the "muffin top" spilling over the jeans. Then the scale delivers dire news: You're 10, 15, maybe 20 pounds beyond your "normal" weight.
 
Midlife weight gain is common. Many Americans gain a pound or so every year as they make their way through young adulthood, ending up fat and flabby at age 40 and beyond.

But it is not inevitable, says Pamela Peeke, MD, MPH, the author of the best-seller Fight FatAfter Forty. Peeke also serves as the chief medical correspondent for Discovery Health TV and often appears as a medical commentator on television news and talk shows.
 
Why do so many people gain weight in midlife?

Blame it on hormones in convergence with poor lifestyle choices, overeating, not exercising enough, and stress.

But hormones only account for about 2 to 5 pounds. The rest is the result of overeating, poor lifestyle choices -- such as not exercising enough -- and stress.

How can I not be one of those people who gains?

The keys are three: mind, mouth, muscle.

Use your mind to control stress. If you walk around and everything is stressful, you have a problem. You may respond to stress by making poorer lifestyle choices, such as not eating healthfully and not exercising enough.

Look at your nutrition -- in terms of quality, quantity, and frequency of eating. You should eat often.

Quality is all about eating whole foods, fruits, and vegetables, whole grains, lean protein.

Processed foods are bad. Anything that comes in a family-size bag, turn in the opposite direction and run.

Quantity is where a lot of people fall. The majority are baffled by what a serving size should look like. When eating out, and in doubt, eat half of it or less.

Be accountable for calories. You need a general idea of how many calories you need. An average woman, not an athlete, in her 40s or 50s, needs about 1,500 to 1,600 calories a day, on average, if she is exercising. A middle-aged man, average height and not an athlete but exercising, needs about 1,800 to 2,000.

Muscle, of course, refers to the need to exercise and, of course, to weight train.

Should my goal weight increase when I hit midlife?

A better goal than focusing on scale weight is to keep track of body fat. The goals should be to decrease body fat and optimize bone strength.

For a man, a body fat percentage of 18% to 25% is not bad for 40-plus. For women 40-plus, 22% to 27% is not bad.

To get that body fat percentage, you need to have excellent fitness to maintain a good muscle base.

Also, a man should have a waist circumference below 40 inches and a woman below 35 inches.

I'm 40-plus, eating right, and exercising but not losing weight. Why do I have midlife weight gain?

If you have tailored your portion sizes to ones that are appropriate, look at the frequency of your eating. Eat every three or four hours. But not too late at night. The later you eat, the lighter you eat is a good rule.

Eat a balance of lean protein, fats, and carbs. Make the fat good fat, not palm oil or hydrogenated oil, but high-quality good fats [such as those in nuts]. The protein should be lean -- a turkey burger or a veggie burger.

Most people have been doing the same exercise routine for years, and your body acclimates. Fat cells at 40 are reticent to give it up. Mix up the exercise routine. Exercise at least five times a week, and I mean cardio.

Add intensity. Add some level of weight training, and challenge yourself with the weights. [Getting professional instruction is advised if you're a novice.] Weight train two or three times a week.

Building muscle gives you that metabolic edge, since muscle mass burns more calories than fat.

Does HRT cause midlife weight gain, is that the culprit?

You can't blame the low doses of HRT in use today for midlife weight gain, at least not for any more than a few pounds. You do get a little more bloated on it, but it does not cause body fat accumulation. Overeating, not exercising, and stress do.

What's up with this belly? I never ever had one before.

I call it the menopot. On a man, it's the manopot.

Excess body fat occurring in the lower abdomen is associated with aging, after 40. This excess body fat in the normal range is usually only 2 to 5 pounds. And you do get a little pooch.

How can I lose this belly?

You minimize it by following the mind-mouth-muscle concepts.

But it's probably unrealistic to expect a stomach as flat as your 20-something stomach.

Can I boost my metabolism?

Absolutely. You can optimize your metabolism throughout life relative to your age by maintaining the highest level of training you can, within the limits and constraints of your life.

If you lose muscle mass [by not exercising], obviously your metabolism is going to drop.

Of course strength or weight training is crucial.

What workout or workouts are best for midlife people?

Creative cardio. Burn 400 to 500 calories a day in cardio. On the elliptical, for instance, you can burn about 400 calories in about 35 minutes. Cross train as much as you can. Burn the 400 to 500 calories all at once or accrue it.

And don't forget the weight training.

What's your weakness? What's the hardest part, for you, of staying on track and fighting flab after 40?

Because of long days and all my commitments, getting enough sleep. I remind myself: the poorer your sleep, the wider your girth.

Eating dinner not too late. Sometimes I am on a plane or a train, I don't have the control I want over how late I eat. In general, do not eat dinner past 8:30. I like to eat right about 7.

SOURCE:

Pamela Peeke, MD, MPH; author of Fight Fat After Forty.

Reviewed on November 25, 2008

Wednesday, January 12, 2011

Aging Well: Eating Right for Longevity

Is your diet the key to longevity? Find out why eating right just may mean aging right, too.

By Elizabeth M. Ward, MS, RD
 
Aging: everyone does it, yet some people seem relatively unaffected by getting older. Could good nutrition be the key to a healthier, longer life?
 
Does Aging Equal Illness?

"Aging is often associated with the development of one or more chronic diseases, but it doesn't have to be that way," says Jeffrey Blumberg, PhD, professor at the Friedman School of Nutrition Science and Policy at Tufts University.
 
It's not always just a matter of time before you have a heart attack or stroke, get type 2 diabetes or cancer, break a hip because of osteoporosis, or develop Alzheimer's, even though these conditions are often associated with aging, Blumberg says.

Your risk for disease and disability increases with inadequate physical activity, genetic susceptibility, and poor diet.

Aging: Defy It With Diet

So what's the best eating plan for preventing, delay, or minimizing the conditions associated with aging, including inflamed joints, flagging memory, and failing eyesight?

"The most beneficial diets rely heavily on fresh vegetables, fruits, and legumes -- foods that are naturally lower in calories and packed with nutrients," says Bradley Willcox, MD, MPH, co-author of The Okinawa Diet Plan and professor of geriatrics at the University of Hawaii.

Experts suspect the antioxidant compounds found in produce, legumes, and whole grains are largely responsible for holding back the march of time.

Antioxidants, such as vitamins C and E, and other compounds, including polyphenols and anthocyanins, battle free radicals -- unstable forms of oxygen that damage cell function. Free radicals form from normal metabolism. Your body also produces them in response to strong ultraviolet rays from the sun; air pollution; smoking; and secondhand smoke.

The buildup of free radicals contributes to the aging process and to the development of a number of age-related diseases such as cancer, heart disease, and inflammatory conditions, including osteoarthritis. What's worse, aging increases free radical production. That means your diet should be healthier than ever with the passage of time.

The question, of course, is how do we do that?

Anti-Aging Nutrition

Antioxidants generate a lot of buzz when it comes to longevity, but aging well takes more. You must optimize a myriad of beneficial nutrients, including protein, calcium, and vitamin D, and minimize detrimental dietary components including saturated and trans fats.

While none of these foods is the "Fountain of Youth," including them on a regular basis as part of a balanced diet can reduce the toll time takes on your body.

Nuts

Nuts are cholesterol-free protein sources, and are worthy substitutes for fatty meats. Research published in the American Journal of Clinical Nutrition found that in a group of nearly 35,000 women, those who ate foods rich in vitamin E, including nuts, lowered their risk of having a stroke.

Top picks:
 
Almonds for their high vitamin E levels; pecans, for their antioxidants; and walnuts, for omega-3s.

Tips:

Top breakfast cereals, yogurt, salads, and cooked vegetables with an ounce of chopped nuts.

Snack on an ounce of whole almonds (about 24) for almost half the vitamin E you need for the day.

Enjoy a nut butter sandwich on whole-grain bread.

Concoct a smoothie by blending a medium frozen banana, 1/2 cup plain fat-free yogurt, 1/4 cup chopped walnuts, and 2 teaspoons sugar (optional).

Fish

According to the American Heart Association, fish harbors omega-3 fats that reduce the risk of plaque buildup in your arteries; decrease blood triglyceride (fat) levels; help lower blood pressure; and lessen the odds of sudden death. Fish is a wise protein choice because of its relatively low saturated fat and cholesterol content.

Top picks:

Salmon, sardines, and canned tuna are among the fish with the highest levels of omega-3 fatty acids.

Tips:

Have at least two fish meals a week instead of fatty meats.

Add canned light tuna or canned salmon to salads instead of chicken or cheese.

Olive Oil

Olive oil is rich in heart-healthy monounsaturated fats and beneficial plant compounds. It's also free of the trans fats found in some margarines and other processed foods, and that's a good thing. A study published in the journal Neurology found that among healthy people 65 and older, the higher the saturated and trans fat intake, the greater the cognitive decline during a six-year period.

Top pick:

The extra virgin variety. A recent report in the Annals of Internal Medicine found extra-virgin olive oil more beneficial than other types for increasing the high-density lipoprotein levels (HDL or good cholesterol) in men.

Extra-virgin olive oil also offers beneficial levels of oleocanthal, a compound that mimics the effects of anti-inflammatory medications including aspirin and ibuprofen.

Tips:

It's good for you, but don't go overboard; olive oil is caloric. Limit total oil consumption to 7 teaspoons daily (assuming all of the added fat you use is from olive oil) on a 2,000-calorie diet; 5 for a 1,600-calorie plan.

Make salad dressing with one part olive oil and three parts balsamic vinegar.

Choose olive oil instead of butter or margarine.

Lightly coat chopped broccoli, sweet or white potato, or carrots with olive oil and roast on a baking sheet at 400 degrees until done.

Fruits and Vegetables

Produce provides fiber, vitamins, and minerals, as well as hundreds of anti-aging phytonutrients. When it comes to age-defying properties, some produce is better than others, according to the United States Department of Agriculture's tests for antioxidant activity.

Still, any fruit and vegetable is better than none. People who take in the most produce -- upwards of 10 servings a day -- have higher levels of antioxidants in their bloodstream, which probably translates to better aging. Produce-lovers also have stronger bones, thanks to the magnesium and potassium that fruits and vegetables supply (dark greens are also rich in vitamin K, necessary to bolster bones).

Top picks:
 
Fruit: Blueberries, cranberries, blackberries, raspberries, strawberries, apples, and cherries.

Vegetables: Kale, spinach, broccoli, artichokes, avocado, asparagus, cauliflower, sweet potato, carrots, pumpkin, and onions.

Tips:

Include berries at least once daily on top of breakfast cereals, in smoothies or salads, or snack on them as is.

Add dried cranberries or cherries to cooked whole grains.

Make a quick guacamole by mixing a ripe avocado and large, diced tomato with 1 tablespoon each of olive oil, fresh chopped cilantro leaves, and finely chopped onions.

Prepare a pumpkin smoothie with 1 cup canned pumpkin, 1/2 cup low-fat milk, and ground cinnamon and sugar to taste. Heat the remainder of the can as a side dish. Add chopped frozen kale or spinach to soups and pasta dishes.

Legumes

Legumes are packed with complex carbohydrates and fiber to ensure steadier blood glucose and insulin levels, and they provide a cholesterol-free source of protein. Legumes are also packed with antioxidants.

Top picks:

From black beans to soy beans, they're all good for you.

Tips:

Add beans to soups, salad, egg and pasta dishes

Puree cooked beans (includes canned) and add to soups or stews

Snack on bean dips and fresh vegetables or whole grain crackers

Munch roasted soy nuts or thawed edamame (green soy beans)

Substitute firm tofu for meat in vegetable stir-fry dishes

Whole Grains

Whole grains retain more of their natural nutrients, particularly age-defying vitamin E, fiber, and B vitamins, than refined varieties. They are also a wealth of antioxidant compounds.

Top picks:

Quinoa, millet, barley, oatmeal, whole-wheat pasta, cracked wheat, wild rice.

Tips:

Wrap sandwiches in whole-wheat tortillas instead of white

Choose whole-grain cereal for breakfast and snacks

Try wild or brown rice or whole-wheat pasta

Add leftover cooked whole grains to soups

Low-Fat Dairy

Dairy foods are excellent sources of bone-strengthening calcium. They also supply protein that bolsters bones and muscle, and is needed for peak immune function.

Top picks:

Milk, either 1% low-fat or fat-free. Milk is fortified with vitamin D, necessary for calcium absorption. Adequate levels of vitamin D may reduce prostate, colon, and breast cancer.

Tips:

Sip café au lait or cappuccino made from decaffeinated coffee and fat-free milk

Make mashed potatoes with fat-free evaporated milk

Enjoy a smoothie made with milk, berries, and crushed ice

Indulge a chocolate craving with fat-free chocolate milk

Fight Fat, Live Longer?

It's not only what you eat when it comes to stalling the aging process. Calories count, too.

"Being overweight stresses your heart, blood vessels, and joints, accelerating age-related diseases," says Willcox.

Excess body fat also plays a role in the development of dementia, certain cancers, and eye diseases, including cataracts and age-related macular degeneration.

Cutting a few hundred calories a day from your regular eating plan may be all it takes to make it into your 80s or 90s in relatively good health.

That's what Willcox and his colleagues found when they related eating habits to death rates among 2,000 nonsmoking men. In his study, the men who consumed an average of 1,900 calories per day -- about 15% below the average for the entire group -- were less likely to die over the 36-year study period.
 
Nobody knows exactly how a lower calorie diet works to lengthen life. Perhaps the secret lies in a slower metabolism that comes with eating less food. A reduced metabolic rate means your body produces fewer free radicals.

Calorie reduction plans also lower the body's core temperature and insulin levels, two indicators of longevity. A recent study in the Journal of the American Medical Association found that overweight people who cut their daily calorie intake by up to 25% were more likely to have a lower core body temperature and normal fasting levels of insulin in their blood.

Aging: We're all doing it. Perhaps combining a diet rich in "anti-aging" foods with fewer calories overall may help us do it better -- and live longer.

SOURCES: Jeffrey Blumberg, PhD, professor, Friedman School of Nutrition Science and Policy at Tufts University. Bradley J. Willcox, MD, clinician-scientist, Pacific Health Research Institute, University of Hawaii. United States Department of Agriculture. American Heart Association. Yochum, L. American Journal of Clinical Nutrition, August 2000; vol 72: pp 476-438. Morris, M. Neurology, 2004; vol 62: pp 1573-1579. Covas, M-I. Annals of Internal Medicine, September 2005; vol 145: pp 333-341. Beauchamp, G. Nature, Sept. 1, 2005; vol 437: pp 45-46. Willcox, B. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2004; vol 59: pp B789-B795. Heilbronn, L. The Journal of the American Medical Association, 2006; vol 295: pp 1539-1548. Garland, C.F. American Journal of Public Health, February 2006; vol 96: pp 252-261.

Monday, January 10, 2011

RA and Your Diet

How to eat to avoid joint inflammation, increase bone and heart health, and feel better all over.

By Camille Peri
 
How much can what you eat help -- or hurt -- your rheumatoid arthritis (RA)? For decades, researchers have looked into whether there is a link between food and RA. For almost as long, various diets and supplements have claimed to relieve swollen joints and morning stiffness -- or even falsely "cure" RA and "end joint pain forever."
 
Though many diet claims that promise relief from pain are unproven, they can lure and confuse even the savviest women with RA. Kathy Lubbers, who has had rheumatoid arthritis for more than 20 years and is a CEO at a communications firm, sums up why it's easy to fall for false claims: "When I was in excruciating pain, I'd try anything," she says.

If you have RA, there's no question that a good diet is vitally important. But which diet? And why? Here's the latest on how to eat for your health with RA -- and enjoy every bite.

RA and Nutrition: What to Consider

To figure out what's the best diet for you, it helps to keep in mind some of the nutritional challenges you have with RA. If painful fingers or wrists make it tough to chop vegetables and cook healthy meals, you may be more likely to grab a burger from the drive-thru. If your medications give you an upset stomach or make you feel like you don't want to eat, you may wind up skipping meals. If you routinely have an upset stomach or no appetite, you may also be missing important nutrients.

Sometimes your medications, while they may provide relief from RA pain, can bring other nutritional challenges. Taking corticosteroids (like prednisone) may cause your body to get rid of too much potassium. Methotrexate can lower your folic acid levels.

It's common for women with RA to not get enough vitamin D and calcium. It's especially important that you get enough of those nutrients because having RA -- and taking certain treatments for it -- raises your risk of osteoporosis.

Do Some Foods Cause Joint Inflammation?

Should you cross some foods off your list? Although no scientific studies have found any definitive link between food and RA, some people with RA say that eating certain foods makes their RA worse. For Kathy Lubbers, it's white sugar and cheese. For author M.E.A McNeil, an organic farmer and beekeeper in San Anselmo, Calif., it's foods with chemical additives. For other people with rheumatoid arthritis, it may be vegetables in the nightshade family, such as eggplant and tomatoes.

"Some patients say that certain types of food seem to make their RA worse," says Tracey Robinson, MD, a rheumatologist in Redwood City, Calif., and clinical professor of medicine at the University of California, San Francisco. "It may be highly processed foods with a lot of chemicals, foods that are very fatty, red meat, or milk products. It tends to be very individual."

Although no diet can cure RA, research has shown some evidence of a link between certain foods and inflammation. For example, eating a lot of saturated fats (such as bacon, steak, and butter) can increase the chemicals in the body that are responsible for inflammation, pain, and swelling in the joints. Even so, many people with RA don't have any food problems.
 
Even McNeil and Lubbers say that they aren't sure if their "trigger" foods are really guilty of causing inflammation or whether it just seems that way.

"It's difficult to draw a conclusion about virtually anything that you do because the disease waxes and wanes so much," says McNeil.

Getting Rid of Problem Foods

If you think certain foods are making your RA worse, try eliminating them from your diet. The only real way to tell if the foods are at fault is to add them back in, slowly and one at a time, to see if your RA flares when you start eating a particular food again. For example, McNeil says she found that she feels better when she doesn't eat commercially produced red meat.

Eliminating foods from your diet is generally safe as long as you don't cut out whole food groups, say medical experts. But it can be hard to stick with an elimination diet. If you want to try it, your doctor or a registered dietitian can help you.

Robinson says she doesn't give blanket diet recommendations to her patients with RA. "But if a person finds that eliminating certain foods seems helpful, I encourage them to try it as long as they still maintain good nutrition, calcium intake, and vitamins," she says.

The Mediterranean Diet

One diet that is showing some promise for people with RA is also one of the tastiest. The Mediterranean diet is loaded with fruits and vegetables and includes healthy non-saturated fats (like olive oil and canola oil), nuts, whole grains, herbs and spices (instead of salt and butter), and heart-healthy fish (instead of red meat).

Eating fish such as salmon, sardines, and tuna may double your benefit. They help protect against heart disease, which is a risk when you have RA. And the omega-3 fatty acids they contain, in addition to being heart healthy, also help fight inflammation. If that isn't enough, the Mediterranean diet can also help you maintain a proper weight, which takes pressure off your joints.

"The best data we have is that a diet high in omega-3 fatty acids and antioxidants is good for RA," says Nathan Wei, MD, clinical director of the Arthritis and Osteoporosis Center of Maryland. "The Mediterranean diet is high in both, and it's also good for people who want to be careful about weight gain. Of course, it's also important to couple the diet with exercise."

Supplements and RA
 
Herbal remedies and dietary supplements are often touted to relieve RA pain. And some may indeed help. But keep in mind that no herb or supplements can "cure" RA, and there's no evidence that they can actually stop the disease from progressing, as certain prescription medications (called disease-modifying anti-rheumatic drugs, or DMARDs) can.

Supplements are not regulated by the FDA, so it's hard to know exactly what's in them. And they can react with prescription or over-the-counter (OTC) drugs. Always talk to your doctor about what supplements may be helpful -- or harmful -- for you.

Here are some that may help:

Fish oil. Scientific studies of fish oil or other omega-3 fatty acid supplements show promise in treating RA symptoms such as painful joints and morning stiffness, according to the National Institutes of Health's National Center for Complementary and Alternative Medicine (NCCAM). People with RA who take fish oil may sometimes be able to cut back on other pain medications, like nonsteroidal anti-inflammatory drugs (NSAIDs). Fish oil supplements may also help lower your risk of heart disease. Keep in mind that fish oil can cause stomach upset and some types of fish oils increase the risk of bleeding, especially if you also take blood-thinning medication.

The Arthritis Foundation suggests 2.6 grams of fish oil twice a day for people who are interested in supplementing their diet. It may take weeks, or even a few months, for you to tell if it's working.

Vitamins and Minerals. If you have RA, you may want to take a good multivitamin that also contains minerals. Ask your doctor about whether you need to take calcium and vitamin D supplements. "Vitamin D deficiency is a huge concern in general, and especially for women with RA because they have more bone health issues," says Robinson. "They're more susceptible to osteoporosis even without adding in factors like steroid use, and many people are on steroids, which is also a negative for bone health." Check with your doctor about how much vitamin D and calcium you need.

Selenium and vitamin E supplements may decrease damage to the joints, easing swelling and pain. People who take methotrexate may also need to take a folic acid supplement.

Turmeric and ginger. There is some evidence that turmeric may help to relieve joint inflammation. Ginger supplements may also reduce joint pain and stiffness in people with RA. However, both may increase the risk of bleeding, especially if you take blood-thinning medication, and should not be used if you have gallstones.

RA and Diet: The Bottom Line

McNeil says she feels best following a Mediterranean diet. For Lubbers, a basic balanced diet seems to work well.

"I also eat smaller portions more often to keep my blood sugar level even-keeled," Lubbers says. "When it's not, it's another opportunity for a bad physical response. And I feel better when I eat lighter -- more soy and vegetables, and less bread and meat."

Both women say they shifted to a healthier diet not so much to tame specific symptoms but as part of an overall plan to improve their health with rheumatoid arthritis. "When you have a chronic condition," says Lubbers, "you want to have every positive thing you can on your side."

SOURCES:
 
Johns Hopkins: "Nutrition and Rheumatoid Arthritis," "Complementary and Alternative Medicine for Patients with Rheumatoid Arthritis."

Arthritis Foundation: "Diet and Your Arthritis," "Alternative Therapies Overview."

Tracey Robinson, MD, rheumatologist, SOAR Medical Group, San Francisco; assistant clinical professor of rheumatology, University of California, San Francisco.

Mayo Clinic: "Rheumatoid arthritis diet: Do certain foods worsen symptoms?" "Mediterranean diet: Choose this heart-healthy diet option."

American Family Physician: "Omega-3 Fatty Acids."

Nathan Wei, MD, FACP, FACR, fellow of the American College of Rheumatology; clinical director of the Arthritis and Osteoporosis Center of Maryland, Frederick.

Arthritis Today: "Supplement Guide: Fish Oil, Turmeric, Ginger."

Kathy Lubbers, Key Biscayne, Fla.

M.E.A. McNeil, San Anselmo, Calif.; author, The First Year: Rheumatoid Arthritis: An Essential Guide for the Newly Diagnosed (De Capo, 2005).

Reviewed on January 15, 2010

Imagination Tricks the Brain Into Eating Less

Researchers Say That Repeatedly Imagining Eating a Food May Help You Eat Less of It

By Bill Hendrick
 
Dec. 9, 2010 -- Simply imagining eating a certain food may help you eat less of it, new research indicates.
 
The finding challenges the assumption that thinking about a favorite food makes you crave it more and likely to eat more of it when it’s available.
 
In a series of experiments involving dozens of volunteers at Carnegie Mellon University, researchers found that people who repeatedly imagined eating a certain food, such as a cube of cheese or an M&M candy, subsequently ate less of it than they otherwise would have.
 
Suppressing Thoughts About a Desired Food Not a Good Strategy
 
“These findings suggest that trying to suppress one’s thoughts of desired foods in order to curb cravings for those foods is a fundamentally flawed strategy,” says Carey Morewedge, PhD, of Carnegie Mellon and author of the study.
 
“We think these findings will help develop future interventions to reduce cravings for things such as unhealthy food, drugs, and cigarettes; and hope they will help us learn how to help people make healthier food choices,” Morewedge says in a news release.
 
In one of Morewedge’s experiments, a group that imagined putting three quarters into a laundry machine and then imagined eating 30 M&Ms one at a time ate significantly fewer of the candies when given a bowl of M&Ms afterward, compared to a group that imagined putting 33 coins into a laundry machine and a third group that imagined inserting 30 quarters into a laundry machine and then imagined eating three M&Ms.
 
In other experiments, people were asked to imagine themselves eating cheese or another food, or doing something else completely different, like repeatedly putting coins into a laundry machine.
 
In each case where the group repetitively imagined eating a food, the researchers detected a gradual reduction in motivation to obtain food and a decrease in its subsequent intake, a process they called habituation. The research points to the conclusion that repetitive mental imagery has a different effect than picturing a single mental image, according to the study.
 
The study is published in the journal Science.
 
SOURCES:
 
News release, Carnegie Mellon University.
 
Morewedge, C. Science, Dec. 10, 2010;vol 330: pp 1530-1533.

Thursday, January 6, 2011

Women's Weight Tied to Healthy Aging

Study Shows the More Weight Gained From Ages 18 to 50, the Lower the Odds of Being Healthy at 70

By Miranda Hitti
 
Sept. 29, 2009 -- For women, the odds of being healthy at age 70 are best for those who don't gain a lot of weight between ages 18 and 50 and who aren't obese at 50.
 
That news appears in the "Online First" edition of BMJ.

But millions of middle-aged women are overweight and obese, and they can't go back in time to change that. Researcher Qi Sun, MD, of the nutrition department at the Harvard School of Public Health, doesn't want those women to give up on the possibility of healthy aging.

"The key message from our paper is that to enjoy a healthy yet long life, women need to maintain a healthy body weight throughout adulthood," Sun tells WebMD in an email. "Meanwhile, I believe it is never too late to take initiatives to lose weight (in a safe and healthy way) to maximize the probability to achieve healthy survival," Sun writes.

Sun points out that being physically active, at any weight, is a healthy habit.

"The bottom line is women who are already age 50, no matter what [their] current weight is, can still benefit from physical activity to increase their odds of having wonderful health at later life," Sun writes. "Of course, the best way to maximize the probability of healthy survival is to maintain at least moderate levels of physical activity AND a healthy body weight throughout adulthood."

Tracking Healthy Survivors

Sun's study focuses on "healthy survivors." That's the term Sun and colleagues coined for women they studied who lived to age 70 without any of the following:

Cancer (except nonmelanoma skin cancer)

Diabetes

Heart attack

Coronary artery bypass

Congestive heart failure

Stroke

Kidney failure

Chronic obstructive pulmonary disease (COPD)

Parkinson's disease

Multiple sclerosis

Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease)

Major impairment of mental skills

Major limitation of physical function

Mental health that's less than good (based on scores from a mental health survey)

Data came from a long-term health study of 121,700 female U.S. nurses.

The women answered questions about their height, weight, health, and lifestyle every two years for decades, starting in 1976, when they were 30-55 years old.

About 17,000 women were still alive, with enough data for Sun's team to study, at age 70.

Only 10% of those women qualified as healthy survivors.

Weight and Healthy Aging

Women who were obese at age 50 were 79% less likely than women with a normal BMI at that age to be healthy survivors.

What had happened to the women's weight between age 18 and 50 mattered most.

Women who were overweight (but not necessarily obese) at age 18, and who gained at least 10 kilograms (about 22 pounds) by age 50, had the worst odds of becoming a healthy survivor. Only 18% of those women became healthy survivors.

The more weight the women gained between the ages of 18 and 50, the less likely they were to become healthy survivors.

The study doesn't prove that the women's weight affected their survival. Observational studies, like this one, don't prove cause and effect. And it's possible that the nurses in the study don't represent all women.

However, the results held when the researchers adjusted for these factors: women's age upon enrolling in the study; level of education; marital status; husband's level of education; hormone use after menopause; smoking; various diet patterns; family history of heart disease, diabetes, or cancer; and physical activity.

SOURCES:

Sun, Q. BMJ, Sept. 30, 2009; "Online First" edition.

Qi Sun, MD, department of nutrition, Harvard School of Public Health.