Friday, April 15, 2016

Smoothie Science and Beet and Ginger Smoothie

M and I recently had the pleasure of a Buenos Aires visit from Dr. Michelle McMacken and her husband. You can see her BYOL posts here and here.

Naturally, we talked about a lot of different vegany (an excellent term coined by her husband) issues – but don’t worry, we balanced all this with a healthy amount of futbol chatter as well!

One afternoon, Dr. McMacken mentioned that she warns her patients against smoothies (even whole food smoothies). To be fair, she is not alone in this stance: Registered Dietitian Jeff Novick, Dr. C Esselstyn, and all of the Engine 2 folks are also against consuming liquid calories.

She explained that smoothies are a bit of a trap for most of her patients who are seeking to lose weight, because they are often very calorie dense. And because those calories are liquid, people often consume more calories than they would if they were eating the same foods.

Fair point.

However, there are some reasons why I think incorporating smoothies into your diet can be a positive thing.

First, for anyone who is a picky veggie eater, whole-food smoothies can be a great way to sneak in lots of good and healthy veggies into your diet. In fact, Mayo Clinic recommends this for picky children. I recently encouraged a college friend who is trying to change his diet to be more plant-forward to try this tactic as well. Maybe it’s not optimal, but it has helped him to lose a significant amount of weight compared to the SAD diet he was eating (no real contest, I know).

There is also some evidence that certain nutrients become more available to our bodies when the cells are disrupted, ie: pulverizing or blending foods. Now for a long time I thought this was just a marketing exploit of Vitamix and Blendtec, but it turns out, there is some evidence to back it up.

A few studies compared particle size and bioavailability and digestion. They found that many nutrients become more bioavailable when the cells of a nutrient are broken. This is one argument for chewing your food well. But the studies also show that no matter how well we chew, we can never masticate as well as a blender, which can break the foods down to a cellular level. These studies showed that the bioavailability of these foods than became greatly improved, particularly B-carotenoids in carrots, and folate from leafy greens.

Furthermore, back to Dr. McMacken’s point, there is some research that suggests that simply slowing down while consuming liquid calories (soups or smoothies) can significantly help our bodies regulate the amount we are consuming, and the thicker that slowly-drank smoothie is, the longer the person will feel satiated.

Smoothies can also be helpful when you are short on time, or if you are going to a place where you know you will not eat well. Slowly drinking a whole food vegetable-based smoothie before going out can help you get some health boosting veggies in.

Overall, I do agree with Dr. McMacken. Smoothies are an occasional tool and shouldn’t be relied upon. They also may not your best choice for weight-loss.

But that said, I do see a place for mostly (green) vegetable smoothies with some added fruit in a healthy diet. I would recommend avoiding all-fruit smoothies, as well as smoothies with added sugars or juices as this fundamentally changes the discussion.

Beet and Ginger Smoothie

Keeping all of this in mind, today I’m going to share a delicious beet smoothie which I think even Dr. McMacken would love (actually, I’m almost positive she would!) The recipe is mostly credited to M, although I was her taste tester for several versions of this… Please hold your applause.

Not only is this smoothie comparatively low-calorie and veggie-filled, but it also turns out a beautiful rich Malbec red color (come on, I am in Buenos Aires!) and is filled with health promoting nitrates making it an excellent way to start the day or a pre-workout drink.

Beet and Ginger Smoothie:
Serves 2

1 medium-sized red beet – cubbed
½ large cucumber
6-7 large Kale Leaves
10-15 red grapes
2 tbsp chia seeds
2 tbsp lemon juice
1 tbsp maca powder (optional)
1/2” piece of peeled ginger
1 ½ cup of water

Wash and chop all of the ingredients, and place them into your blender.*

Add the chia, maca, and lemon juice along with the water and ice.

Blend until smooth and enjoy

*If you are not using a high-powered blender like the two brands mentioned above, try cutting the veggies into smaller pieces to make it easier for your blender.

Castenmiller, J., C.J. van de Poll, et. al. “Bioavailability of folate from processed spinach in humans. Effect of food matrix and interaction with carotenoids.” Annuals of Nutrition and Metabolism. 44(4) 2000.
de Graaf, C. “Why Liquid Energy results in overconsumption,” Procedings of Nutrition Society, May 70 (2) 2011.

L. Lemmens, S., Van Buggenhout, A.M. Van Loey, et. al. “Particle size reduction leading to cell wall rupture is more important for the B-carotene bioaccessibility of raw compared to processed carrots.” Journal of Argriculture and Food Chemistry. Dec. 22,58 (24) 2010.

Ibrugger, S., M. Kristensen et. al. “Flaxseed dietary fiber supplements for suppression of appetite and food intake” Appetite April, 58 (2) 2012.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Friday, April 1, 2016

The vegetarian cancer gene and Turmeric golden tofu

Okay, so if you have the internet, chances are you saw an article that has been all over the place which claims that a population of vegetarians in India are more prone to cancer than their meat eating counter parts. Now the story goes something like this:

A group of Indian vegetarians have a specific gene that alters the digestion of plant fats to produce arachidonic acid, and this acid can then be a risk factor in both heart disease and prostate cancer. The article also claims that generations of vegetarian eating caused this gene to be expressed this way.

Based off this, the reporter says that a vegetarian diet may change your genes and make you more susceptible to heart disease and canc… wow that is such a ridiculous statement it is not even worth typing.  The author also says that vegetarians suffer colorectal cancer as much as 40 times more than meat eaters. (Ugh)

It is apparently easy to publish absolute rubbish. I now understand why Dr. Garth Davis hates nutrition reporters and nutrition bloggers so much…

First lets simply address the fact that the study is looking at genomes not diets.

Next up, the idea that just because they are a predominantly vegetarian population, doesn't mean they are healthy eaters. Diets from this area are typically heavy in added oils and butters or ghee, dairy and on top of this, the dishes also often included fried foods. If the issue was diet related, chances are it has more to do with these items than with the consumption of fresh fruits and vegetables.

The claim that meat eaters have less colorectal cancer is also outrageously ridiculous. The author bases this claim off one study, which was later found to be incorrect when the data was revisited. Furthermore, not only have I previously outlined how TMAO is formed after consuming meat and dairy which increases the risk of heart disease, but the links between meat consumption and cancer are so strong that according to an article reviewed by Dr. Greger of the meat industry is studying the possibility of adding ingredients to meat which may help reduce the inherent cancer risks of consuming it.

Perhaps most ironic part of all this is that chicken and eggs are the two greatest sources of arachidonic acid according to the Institute of Medicines’ Dietary Reference Intakes list.

Finally, if you actually look at the study rather than the health reporters take on the study, it suggests that the massive doses of Omega-6 found in oils are most-likely the biggest part of the problem for the people with this particular genotype, but of course, we already knew oil isn’t healthy…   As Dr. Tom Brenna, one of the authors of the study said, “to say it is a vegetarian gene is quite a stretch…”


Turmeric Gold Tofu

Okay so if you are still worried about having some bizarre gene that could increase your risk of cancer, here is a great dish that can offer some comfort. We know that turmeric has several antioxidants that can offer some buffering protection, so give this deliciously golden tofu a try. 

Since we are heading into fall here in BA, we served the tofu with massaged kale, spaghetti squash (seeds which we brought from the US and planted at her families farm) and cardamom spiced rice. However, this tofu would also be fantastic on a large dark-green salad or even as a sandwich.

Let me know what you all think.

Turmeric Gold Tofu

1 package Firm Tofu – Cubed
2 tablespoons Apple Cider Vinegar
1 tablespoon Dijon mustard
2/3 tablespoon turmeric
1 teaspoon soy sauce
1 teaspoon cumin
1 teaspoon garlic powder
½ teaspoon black pepper

Put all of the spices together along with the mustard, the vinegar, and the soy sauce and mix well. Once well mixed, pour on top of the tofu and toss until the tofu is evenly coated.

Now put the tofu and all of the remaining dressing into a pan over medium-low heat and cover. Let cook for about 5-8 minutes and then stir the tofu. The sauce should start to simmer. Repeat this until the tofu is golden brown - roughly 15 minutes - and then serve hot or cold.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Wednesday, March 9, 2016

Quick tips to help improve your workday

Recently two friends from the US came to visit M and I. While we were exploring a different state, I received an offer to participate in a posting with on easy goals to make an average work day healthier. I was asked to contribute three “hacks” as they called them, and in return they created this neat little graphic check list for me to share on BYOL.

Now I want to be clear, there was no money exchanged. I was not paid nor had to pay to participate. While I have made many purchases from over the years when I  lived in New York, I am not partnered with them nor do I receive any bonus or incentives to post for them. As such I feel in clear conscious about sharing these quick little and cheap tips.

Having lived and worked in different office settings around New York, I know how demanding and stressful a typical day can be. As such, here are just a few suggestions that can help improve your work day and remove some temptations from your office environment .

1. Taking a walk after lunch

This has long been one of my favorite tips for office workers, as using part of your lunch break to take a walk can do wonders for your physical and mental health. Walking after a meal has been shown to help aid in digestion, lower blood sugar, bring down your triglycerides, and it burns some excess calories. Perhaps the best thing is you only need to walk for about 10-15 minutes to start achieving these results. It also helps get you out of the office for a few minutes, when you return you’ll often be more productive having refreshed your mind.

2. Swap the candy jar with a bowl of fruit:

One of the most challenging parts about working in an office is you tend to be surrounded by unhealthy options, particularly in the form of candy jars. These become comparable to a safari watering hole where people congregate throughout the afternoon. However, what could be at play is the fact that after an entire morning of stress and decision-making, we start to exhaust our mental capabilities. This is similar to endurance athletes and as such, taking in a healthy source of glucose in the form of fruit can help satisfy that sweet craving by supplying all the sugars your brain needs in a healthy way.

3. Water over soda – staying hydrated

This one will probably seem quite obvious, but it relates more to the one above than many might assume. The sweetness of soda makes it especially enticing as the daily fatigue of the day starts to set in; however even diet sodas have been found to lead to weight gain, as they stimulate our hunger sense and cause us to eat more. Soda also has a limited ability to hydrate our body which is why sometimes after drinking it, you remain thirsty.

On the other hand, water is calorie-free and hydrating. It helps prevent bad breath, and can even refresh our brain energy.

M wanted me to also suggest that it's an excellent idea to buy your own small carton of plant-based milks like almond or soy, and keep it at work if you are a coffee or tea drinker, so you will always have an option.  

So go ahead and try these simple and cheap suggestions and see if it helps make your day at the office a little more tolerable. I’m willing to bet it is.

Also while I never like to endorse specific products or companies, I will share that has a great selection of assorted nuts and dried fruits that can make eating and snacking at the office easier. (although do remember that it is not a plant-based company, so be sure to always read the ingredients.) For more tips and to see their products, check out their Healthy Snacks for Work page.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Monday, February 15, 2016

Treating the disease of kings with diet

Gout has long been termed the “disease of kings” because hundreds of years ago in Europe, it was the royalty who were primarily impacted by the disease.

I’ve personally seen how gout can impact not just a person’s life but also all of those around them. I have a family member who suffers from it and have seen how he has struggled with the disease for years, much to the dismay of his wife and children. My grandfather also had it, and I remember when I was young how some days he was essentially bed-restricted from the pain.

Now neither my grandfather nor any other family members are royalty (despite how we may sometimes act). But as it turns out, it’s has nothing to do with royalty, but more often than not is commonly found in overweight and obese people who consume rich foods and drink alcohol. Historically only the very wealthy could afford to eat such foods with such frequency which is why the disease has the reputation it does, but today nearly everyone has access to these debilitating foods, and as such, gout now affects nearly 1-2% of the American population at some point in their lives, and as high as 5% of men over the age of 65. This makes it the most common inflammatory arthritis in men and older women.

For some time we’ve know that foods high in purines tend to trigger and set off gout. Purines are a compound found naturally in certain foods that form uric acid. Gout accrues when that uric acid crystalizes in our joint fluid, causing a very painful form of inflammation. As such, when a person suffers from gout they are told to avoid foods that contain a high level of purines.

Seafood and organ meats are among the highest purine-containing foods (chicken and other meats are high on that list as well). However beans are also surprisingly high on that list of foods with purine.

However a study published in the Annals of the Rheumatic Diseases found that the risk for a gout attack increased five times with the consumption of animal protein when compared to those consuming plant-protein.

So then why are beans always excluded from a gout-prescribed diet? Well Brenda Davis, R.D. figured it out. Most lists of purine containing foods, display the amount of purines found in 100 grams of a food. Now 100 grams of beans is roughly half a dry cup, which when cooked is closer to 1.5 cups. The average serving size for a portion of beans is 1/2 cooked cup.

This means that most lists of high-purine foods are measuring triple the recommended serving size for beans. Imagine if we tripled the serving size of chicken? Most beans fall in the moderate range, and have a purine count of  20-75 mg per serving. 

Diets typically suggest avoiding the highest purine foods which have over 200 mg purines per serving or more (these are typically seafoods and organ meats), greatly reducing foods that contain 100 mg purines per serving (this is where white fish, pork, steak and chicken all fall) and eating no more than one portion  per day of moderate foods, or those that have between 50-100 mg per serving (hello beans!). 

The authors of the above study also cited other studies which found that long-term, habitual consumption of purine-rich vegetables was not associated with an increased risk of gout. That means eating beans may not be a bad thing, even for those suffering with gout.

I would be remiss if I didn’t mention that a different study from the EPIC-Oxford group found that vegans actually had the highest levels of blood uric acid compared to vegetarians, fish eaters, and meat eaters, but the authors did not look specifically at gout, and even still they found that the vegans had the lowest scores for other risk markers of gout, including Body Mass Index. They attributed the high level of uric acid to consumption of soy protein, and a lack of dairy, which may have some benefits for uric acid - although it could have many other serious health risks (see: here, here, here, here, here).

At first this paper seems contradictory from what we normally know. However, this is in fact, one of those papers where they actually over adjust, skewing the end result. They adjusted for BMI, which is the problem. It's problematic because we know that meat consumption leads to weight gain (In fact, according to one EPIC study, chicken is the biggest offender!) Weight gain tends to go hand and hand with higher levels of uric acid, which is why overweight and obese people have much higher incidence rates of gout, so when they adjust the studies statistics, they take the majority of meat eaters out, in favor for the minority whose bodies seem more adapt at processing heavy animal products. Also exercise was not added into the equation, and it remains possible that some of the patients included in the study switched to a vegetarian or vegan diet after they first got gout.

Finally, there may be one fruit that seems uniquely helpful when dealing with this painful disease. The same research team that published on animals vs plants proteins, uric acid, and gout incidence, published a second paper that same year which found that cherries seem to be a particularly protective when trying to control gout. But unlike the EPIC-OXFORD research, this one specifically examined patients suffering from gout.

They studied 633 individuals who were suffering from gout, and found they had a 35% decreased occurrence rate of gout when consuming just 1/2 cup of cherries per day - they did not change anything else (including any medications they were taking) - but simply ate cherries. The other fruits they tested did not have the same benefits.

When patients who were taking medications to help control their attacks added cherries, the researchers saw even greater benefits, reducing attack occurrences by 75% compared to an untreated control. 

Another paper found that fresh, frozen, and even cherry juice all worked well. As little as 1 tablespoon of concentrated cherry juice per day could decrease the flare ups. The cherry juice decreased flare up occurrences by as much as 50%, and nearly 50% of all the patients in the study were able to stop taking their medication for the crippling disease. 

So if you suffer from the disease of kings, you may be able to greatly reduce or completely stop your flare ups by simply making some small changes in your diet, namely minimizing or eliminating alcohol and meats, while increasing your consumption of fruits and veggies (potentially beans as well) and especially by adding cherries (in almost any form - although I haven't been able to track down a study showing the benefits of cherry pies yet!). While all the studies recommended more research be done on treating gout with diet, the only know side effects of eating cherries or even adopting a plant-based diet is better health. 

Schlesinger, N. et al. “Previously reported prior studies of cherry juice concentrate for gout flare prophylaxis: comment on the article by Zhang et. al” Journal of Arthritis 2013 April. 

Schmidt, J et al. “Serum Uric Acid Concentrations in Meat Eaters, Fish Eaters, Vegetarians and Vegans: A Cross-Sectional Analysis in the EPIC-Oxford Cohort.” PLoS ONE 8(2): e56339.

Vergnaud, A.C. et. al. “Meat consumption and prospective weight change in participants of the EPIC-PANACEA study” American Journal of Clinical Nutrition. 2010 August 92 (2).

Zhang, Yuging et al. “Cherry consumption and decreased risk of recurrent gout attacks” Journal of Arthritis 2012 64 (12).

Zhang, Yuging et al. “Purine-rich foods intake and recurrent gout attacks” Annuals of Rheumatic Diseases Sept. 2012, 71 (9).

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.