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SuperFoods for Any Century Steven G. Pratt, MD, FACS, ABIHM La Jolla, CA EPSE September 2011.

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Presentation on theme: "SuperFoods for Any Century Steven G. Pratt, MD, FACS, ABIHM La Jolla, CA EPSE September 2011."— Presentation transcript:

1 SuperFoods for Any Century Steven G. Pratt, MD, FACS, ABIHM La Jolla, CA EPSE September 2011

2 2004 2008 2006

3 2009



6 SuperFoods Healthy Fats SuperNutrients No Cigarettes Alcohol and health, fortune, humor & character Sleep Stress Reduction Portion Control = Weight Reduction/Control Physical Activity = burn those calories! Spirituality SuperHealth Includes

7 Load up on Fiber Inflammation the natural way High Potassium – Low sodium diet Potassium (as intake, mortality from CHD, total CVD) –0.65 (95% CI: 0.39, 1.06, P for trend=0.083) = CHD –0.73 (95% CI: 0.59, 0.92, P for trend=0.018) = CVD Sodium (as intake, mortality for total stroke, ischemic stroke, and total CVD) –1.55 (95% CI: 1.21, 2.00; P for trend<0.001) = total stroke –2.04 (95% CI: 1.41, 2.94; P for trend<0.001) = ischemic stroke –1.42 (95% CI: 1.20, 1.69; P for trend<0.001) = total CVD * Am J Clin Nutr 2008; 88:195-202 SuperHealth Includes

8 Superfoods Are… Healthy fat– carbs– protein Whole foods Timeless Delicious Readily available Discussed in peer reviewed publications –Associated with longevity –Loaded with longetivity nutrients Contain SPF (sun protective factor) nutrients Inflammation the natural way Can be eaten fresh, frozen, blended, pureed, freeze dried, cooked, micro-waved

9 Superfoods Are Part of Healthy Dietary Patterns Mediterranean cuisine (Crete) Okinawa Japanese Native American

10 Superfoods Spinach Blueberries Salmon Citrus Turkey Breast Pumpkin Broccoli Yogurt Walnuts Oats Tomato Legumes Soy Green Tea * Superfoods R x : Fourteen Foods That Will Change Your Life, 2004

11 Superfoods Apples Garlic Avocado Honey Dark chocolate Kiwi Dried fruits Onions Extra Virgin Olive Oil Pomegranates Spices * Superfoods HealthStyle: Proven Strategies for Lifelong Health, 2006

12 Supernutrients Vitamin C Lutein Vitamin D Zeaxanthin Folic Acid Lycopene Selenium Beta Carotene Glutathione Alpha Carotene Resveratrol Beta Cryptozanthin Polyphenols Fiber n-3s

13 U.S. Life Expectancy Falls Slightly in 2008: CDC American life expectancy slipped slightly in 2008 to 77.8 years, the first dip since 2004 * National Vital Statistics Reports, Dec 2010;59(2)

14 5 US Leading Causes of Death 1.Heart Disease 2.Cancer 3.Chronic Lower Respiratory Diseases (Asthma, Bronchitis, Emphysema) 4.Stroke 5.Accidents * National Vital Statistics Reports, Dec 2010;59(2)

15 Metabolic Syndrome (Met S) Constellation of –Central obesity –Dyslipidemia – BP – Triglycerides – Blood sugar 15.1% of Chinese (71 million) and similar percentage of Americans Low intensity counseling + flaxseed (30g/d) and/or walnuts (30g/d) central obesity, blood sugar, total cholesterol, & BP

16 Lower your heart disease risk by 20% Beans lower cholesterol, blood pressure, blood sugars and weight (e.g. appetite suppressant), and risk for gallbladder surgery Risk for multiple cancers Low cost Beano No Salt Added No Lard Try to eat: at least four ½ cup servings per week Superfood #1: Beans

17 Dietary fiber intake related to relative risk for disease based on estimates from prospective cohort studies DiseaseNo. of Subjects Relative Risk 95% CI Coronary heart disease158,3270.710.47-0.95 Stroke134,7870.740.63-0.86 Diabetes239,4850.810.70-0.93 Obesity115,7890.700.62-0.78

18 Superfood: Blueberries Otherwise known as brainberries Lower the risk of cardiovascular disease and cancer There is a love affair between berries and your circulatory system –Blueberries help lower blood sugar and blood pressure –Bioactives in BB, improve insulin sensitivity in obese, non-diabetic, and insulin sensitive M & Fs (*J Nutr, 2010;140:1764) The best chance to move, think like a kid as you mature Exercise associated oxidative stress May play a role in preventing obesity Berries and colon cancer Bathe each meal in berries Berries CRP #1 CAA Try to eat: 1 to 2 cups daily

19 Blueberries Contain A synergy of multiple nutrients & phytonutrients Vitamin E Potassium Polyphenols (anthocyanins, ellagic acid, quercetin, catechins) Manganese Magnesium Iron Salicylic acid Carotenoids Fiber Folate Vitamin C Riboflavin Niacin Phytoestrogens Low calories Resveratrol

20 Resveratrol Red wine (2-5 mg/L) Purple grapes juice Cranberries Blueberries Peanut skin Mulberries

21 Resveratrol A supernutrient Activates a family of enzymes called sirtuins –SIR2 stabilizes DNA slows cellular aging Risk for Alzheimers (?) Enhances cell communication in the memory region of the brain Protects brain cells against oxidative stress, damage from diabetes, aging Diminished effect of trauma to the memory regions of the brain Risk for CVD, cancer (?)

22 Resveratrol Enhances muscle strength Fatique Mimics caloric restriction weight loss (?) Inflammation Nitric oxide makes blood vessels more flexible, BP & blood flow Normalize blood sugar levels Memory & reaction time (human study) 1150 bottles of red wine = dose of resveratrol used in animal studies Synergy with other polyphenols

23 Resveratrol Supplements MaxiVision Whole Body Formula –5 mg/4 capsules – Paradise Resveratrol –15 mg/ 1 vegetarian capsule Longevinex – Tru Nature Grape Seed & Resveratrol plus benefits of whole grape –15 mg/1 soft gel Vindure 900 – Consume with polyphenol rich foods Trans-resveratrol the most active form Dose/d 15 mg (Dr. Steve) ? 250-500 mg/d

24 Purple grapes Boysenberries Strawberries Blackberries Pomegranates Acai Bilberry Buffaloberries Huckleberries Blueberry Sidekicks Cranberries Raspberries Currants Cherries Chokeberries Gogi Lingonberry Salmon Berries


26 Superfood #3: Broccoli Superfood #3: Broccoli Risk for multiple cancers: 2 servings a day can result in 50% reduction in risk but… –+ effect in < 1 serving daily Up-regulates detox enzymes Most powerful, easiest to eat form of broccoli: broccoli sprouts (10 to 100x power of regular broccoli) Boosts the immune system, lowers the incidence of cataracts and maybe AMD, supports cardiovascular health, builds bones and fights birth defects Synergy with tomatoes to risk for prostate cancer Try to eat: ½ to 1 cup multiple times weekly

27 Broccoli Sidekicks Brussels Sprouts Cabbage Kale Turnips Cauliflower Collards Bok Choy Mustard Greens Swiss Chard


29 Superfood #4: Oats Superfood #4: Oats Whole grain consumption protects against cancer, cardiovascular disease, T2DM (our fastest-growing chronic disease) Positive associations have been reported between the consumption off refined grains and risk of multiple chronic diseases Whole grain bran fiber Atherosclerosis progression Whole grain intake is inversely and independently associated with carotid artery blood flow

30 Superfood #4: Oats Superfood #4: Oats Higher whole grain intake associated with a lower cardiovascular disease risk reduction of 25% when high, low quintiles of intake are compared Whole grain fiber (bran & germ) helps risk for obesity, cardiovascular disease, and most likely colon cancer Whole grains death from inflammatory disease Try to eat: 5 to 7 servings a day of whole grains (for example, whole wheat bread would count!) or 10-21 grams whole grain fiber

31 Oat Sidekicks Super Sidekicks –Wheat Germ –Ground Flaxseed –Oat Bran Sidekicks –Brown Rice–Buckwheat –Wheat–Bulgur Wheat –Barley–Rye –Amaranth–Quinoa –Millet– Kamut

32 Arrowhead Mills Organic Oat Bran Pancake and Waffle Mix: 75 mg sodium, 6 grams fiber per ¼ cup Bobs Red Mill Whole Ground Flaxseed Meal: 0 mg sodium, 4 grams fiber per 2 Tablespoons Breadshop Granola Crunchy Oat Bran with Almonds and Raisins: 0 mg sodium, 4 grams fiber per ½ cup Country Choice Organic Irish Style Steel Cut Oats: 0 mg sodium, 4 grams fiber per ¼ cup Familia Swiss Muesli: 0 mg sodium, 4 grams fiber per ½ cup Food for Life Sprouted Grain Ezekiel 4:9 Bread (low sodium): 0 mg sodium, 3 grams fiber per slice Low Sodium Whole Grain Foods

33 Garden of Eatin Blue or Yellow Corn Taco Shells: 5 mg sodium, 1 gram fiber per 2 taco shells Julian Bakery Cinnamon Almond Raisin Bread: 75 mg sodium, 12 grams fiber per slice Kashi Go Lean Cereal: 85 mg sodium, 10 grams fiber per ¾ cup Kashi Heart to Heart: 90 mg sodium, 5 grams fiber per ¾ cup Kashi TLC Tasty Little Chewies Peanut/Peanut Butter, 90 mg sodium, 4 grams fiber per 1 bar Trail Mix, 105 mg sodium, 4 grams fiber per 1 bar 1 bar Kretschmer Toasted Wheat Germ: 0 mg sodium, 2 grams fiber per 2 tablespoons

34 Low Sodium Whole Grain Foods Post Shredded Wheat and Bran: 0 mg sodium, 8 grams fiber per 1 ¼ cup Quaker Oat Bran: 0 mg sodium, 6 grams fiber per ½ cup Ralphs Whole Wheat Rotini: 0 mg sodium, 5 grams fiber per ¾ cup Ronzoni Healthy Harvest 7 Grain Blend Pasta: 0 mg sodium, 5 grams fiber per 2 ounces Ronzoni Healthy Harvest Whole Wheat Blend Pasta: 0 mg sodium, 6 grams fiber per 2 ounces Whole Foods 365 Organic Whole Wheat Shells: 9 mg sodium, 5 grams fiber per ¾ cup Vogels Soy and Flaxseed Bread: 105 mg sodium, 5 grams fiber per slice 818-761-2892

35 Superfood #5:Oranges Superfood #5: Oranges Good source of vitamin C OJ post-meal oxidative stress Synergy with tea Highest vitamin C intake associated with lowest all cause mortality Citrus polyphenols (Flavonones) the risk of CHD death in women by 22% Enjoy the skin –Anti-inflammatory –Anti-cancer –Anti-atherogenic

36 OJ consumption DBP, acute coronary events, stroke, oxidative stress Your blood vessels love OJ! Try to eat: 1 serving daily (drink high pulp OJ) Superfood #5:Oranges Superfood #5: Oranges * Am J Clin Nutr 93:73,2011

37 Lemons White and Pink Grapefruit Kumquats Tangerines Limes Orange Sidekicks

38 Superfood #6:Pumpkin Superfood #6: Pumpkin Rich in alpha carotene and beta carotene –Longevity nutrients Helps lower the risk of various cancers (lung, colon, bladder, cervical, skin, and breast) and supplies nutrients necessary for healthy, youthful skin Inverse relationship between serum carotenoids and DM2 Try to eat: ½ cup most days

39 Pumpkin Sidekicks Carrots Butternut Squash Sweet Potatoes Orange Bell Peppers

40 Superfood #7: Wild Salmon Diets high in n-3s are conducive to CNS control of appetite The more omega-3 fish oils you eat; the lower your blood pressure and heart rate 4x weekly risk for and progression of AMD Men with the highest n-3s 66% less likely to develop colorectal cancer Studies suggest that fish consumption is associated with a lower risk for depression, violent behavior, Alzheimers disease, Attention Deficit Disorder, Atrial fibrillation, total mortality, cellular aging, acute coronary syndromes Improved bone mineral density

41 Berry polyphenols cellular EPA, DHA –Am J Clin Nutr 93:907, 2011 Try to eat: Wild salmon, halibut, sardines, etc. 2 to 4 times per week Superfood #7: Wild Salmon


43 Wild Salmon Sidekicks Canned Alaskan Salmon ( Alaskan Halibut Canned Albacore Tuna Sardines Herring Trout Sea Bass Oysters Clams For healthy heart, brain, eyesYou must eat fish!!! Monterey Bay Aquarium website

44 Superfood #8: Soy Superfood #8: Soy Helps prevent cardiovascular disease, cancer, and osteoporosis, and helps relieve menopausal and menstrual symptoms Super alternative protein; the only plant-based complete high- quality protein Lower risk for breast/prostate cancer – Risk for breast cancer recurrence Does not sex drive Avoid iodine deficiency when consuming soy The Soy – Kidney connection Important to eat soy during first 2 decades Try to eat: at least 10-15 grams of soy protein per day and divide total soy intake to two separate meals or snacks

45 Soy Sidekicks (Forms of Soy) Tofu Soymilk Soy Nuts Edamame Tempeh Miso Soy Yogurt

46 Superfood: Spinach and Other Leafy Greens Superfood: Spinach and Other Leafy Greens People who eat them have risk for –Diabetes –Stroke –Colon cancer –Cataracts –Macular degeneration –Bone loss –Maturity related sarcopenia –Memory loss Try to eat: 1 cup steamed or 2 cups raw, dark, leafy greens most days

47 Spinach Contains A synergy of multiple nutrients & phytonutrients B vitamins (thiamine, riboflavin, B 6, folate) Lutein / zeaxanthinAlpha lipoic acid Beta-caroteneVitamins C & E Plant-derived omega-3 fatty acids Minerals (calcium, iron, magnesium, manganese, and zinc GlutathionePolyphenols PotassiumBetaine Nitrites/Nitrates * Is also low in calories

48 Spinach Sidekicks Kale Collards Swiss Chard Mustard Greens Turnip Greens Bok Choy Romaine Lettuce Orange Bell Peppers

49 The cheapest, easiest, no-calorie way to improve your diet and live longer Risk for cataracts, hypertension (dose response) Inverse relationship between green tea intake and risk for DM2 Initial studies suggest may help to control weight by increasing energy expenditure (a fat burner) The administration of GTCs with caffeine is associated with statistically significant in BMI, body weight, WC –Clinical significance modest at best * Am J Clin Nutr 2010;91:73 Try to drink: >1 cup green, black,oolong, white, Rooibus (herbal) tea daily – dont forget the lemon Ideal 4 cups/d & squeeze the tea bag dry then rub the bag on your facial skin Superfood: Tea Superfood: Tea

50 Superfood #10: Tea Superfood #10: Tea Not just women: Men who drink tea may reduce their risk of heart attack by 44% with just one cup daily Green Tea Benefit in Women –31% risk of dying from CVD –62% risk of dying from stroke –23% risk of dying from any cause Green Tea Benefit in Men –22% risk of dying from CVD –42% risk of dying from stroke –12% risk of dying from any cause Green tea consumption s risk for breast cancer Green tea and cataracts, AMD Risk for diabetes

51 My Favorite Tea 3-4 oz hot water Steep 2 green tea bags 3-4 minutes Squeeze tea bags dry Add 1-2 tsp dark honey Add 3-4 ounces Silk Vanilla or plain Soy Milk (or Costco Vanilla Soy Milk) Enjoy!

52 What About Coffee? The #1 antioxidant source in the American diet –Has a favorable effect on some markers of subclinical inflammation – Oxidative stress –A beneficial effect on HDL-C (filtered) – Coffee consumption risk for DM2 3-4 c/d risk 25% compared to 2 cups or less/d Decaf also works – Risk for endometrial cancer –Watch your sugar and milk – use Splenda, Stevia, honey & soymilk or 1% low-fat organic milk –Avoid dairy substitutes?? –1 cup/d may risk of stroke by 30%

53 Coffee contains compounds that are effective in helping to lower body fat Coffee bean indigestible mannooligosaccharides (MOS) play a role in total body volume –MOS = prebiotic properties –MOS total body fat What About Coffee? * J Nutr 140:1943,2010

54 Coffee – Tea – Brain Tumors Etiology of brain tumors (adult gLioma) poorly understood –Ionizing radiation –Genetic predisposition –? EMF (e.g. cell phones) U.S. study reported a 40% risk between combined coffee & tea intake and gLioma ( 5 vs. 0-1 c/d) ( * Cancer Epid Biomark Prev 2010;19:39 ) –In same study caffeine risk in M > F European study reported a 34% risk for those consuming 100 mL coffee & tea per day compared with those consuming < 100mL/d ( *Am J Clin Nutr 2010;92:1145 )

55 Superfood #11: Tomatoes Lower the likelihood of cancer, can play a role in preventing cataracts, age-related macular degeneration, and cardiovascular disease A natural blood thinner, as are kiwi & purple grape juice/red wine The lycopene in tomatoes actually acts like an internal sun block = SPF Nutrients Try to eat: 1 serving of canned tomatoes per day and multiple servings per week of fresh tomatoes. Pizza can be a health food if you modify it slightly: more sauce; less cheese plus whole grain crust

56 Tomato Sidekicks Red Watermelon Pink Grapefruit Japanese Persimmons Red-fleshed Papaya Strawberry Guava

57 Superfood #12: Turkey A perfect example of a twenty-first century "healthy" protein source, extremely low in fat, and provides multiple nutrients which help build a strong immune system Try to eat: 3 to 4 servings per week (3 - 4 ounces)

58 Turkey Sidekicks Skinless Chicken Breast Turkey Glutathione Connection Boost you Glutathione with high cysteine protein sources Turkey breast Chicken breast Nonfat yogurt Soy

59 90% of the phenols found in the skin (slight bitterness) Gamma tocopherol > alpha tocopherol Energy-dense powerhouse of anti-oxidants, anti-inflammatory phytonutrients, minerals, healthy fat, protein Platelet activation –Wild salmon (n-3s) –Kiwi, Tomato, Berries, Grapes Only 5.5% of all adults (19-50) consume tree nuts of any kind Nuts can play an important role in helping to prevent obesity A handful a day can cut your risk of a cardiovascular event by as much as 15-51% Protective against metabolic syndrome, DM2, prostate and breast cancer Promotes bone health Superfood: Walnuts

60 Endothelial cells love walnuts Two tablespoons of peanut butter 5 times/week cuts risk of type II diabetes by 20% Along with tea, the easiest way to improve your heath A great snack food Risk/progression of AMD Melatonin C-Reactive protein & TNF-a (inflammatory molecules) Try to eat: a handful (7-14 walnut halves) of nuts, five times a week * Skip the salt and added oils

61 Walnut Sidekicks Almonds Pistachios Sesame Seeds Peanuts Pumpkin and Sunflower Seeds Macadamia Nuts Pecans Hazelnuts Cashews

62 Nuts and Omegas Grams/oz Almonds0 Peanuts0 Pecans0.28 Pistachios0.07 Walnuts2.6


64 Superfood #14: Yogurt Superfood #14: Yogurt Non-fat and organic when possible Great source of digestible protein; double the protein of milk Promotes strong bones and a healthy heart, great source of calcium Helps lower blood pressure (Dash diet) Look for active cultures, prebiotics (e.g. Inulin) Immune system booster Try to eat: 2 cups daily

65 Yogurt Sidekicks Kefir Stoneyfield Farm yogurt / fruit smoothie Dan Active Immunity Probiotic Soy yogurt Sustenex (BC 30)

66 Prebiotic a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and activity of one or a limited number of bacteria in the colon that have the potential to improve host health


68 Fertilizer for colon bacteria Inulin-type fructans found in leeks, onion, garlic, asparagus, Jerusalem artichoke, chicory Prebiotic Superfoods include tea, blueberries, honey Absorption of calcium, magnesium Found in breast milk Prebiotic

69 Probiotic a living microorganism which upon ingestion in certain numbers, exert health benefits beyond inherent general nutrition

70 Benefits of Probiotics Inhibit colon cancer Help control dental caries Constipation Obesity Infectious diarrhea in infants, children Travelers diarrhea H.Pylori

71 Benefits of Probiotics Anti-allergic Atopic disease/eczema Vaginal yeast/bacterial infections Altering intestinal microflora (bacteria) Immune system booster (G.I. GALT) and body- wide lung, nose, skin, URO-genital tract Inactivation of toxins and detox of host and food components in the gut

72 Benefits of Probiotics Anti-inflammatory Anti-hypertensive Found in breast milk Probiotics, immunity, exercise Daily intake for optimum results IBS/IBD


74 Superfood #15: Dark Chocolate In a cohort of 470 elderly men, cocoa intake inversely associated with –Blood pressure –15 year cardiovascular and all-cause mortality Inflammation A natural blood thinner HDL-C Caffeine not an issue Photoprotection of the skin – Skin sensitivity to sunlight (25%) –Protects DNA from oxidation – Inflammation in skin – Cutaneous blood flow (100%) –Improves skin texture – Skin hydration

75 Dark chocolate and sex – your brain may not know the difference Many risk for AD At least in females, blood flow to parts of brain, associated with cognition Mortality in women When buying dark chocolate, purchase brands with at least 70% cocoa solids The BP med with NO side effects, but use portion control! A prebiotic food Excess dark chocolate without adequate bone nutrients may increase your risk for osteoporosis!? Dark Chocolate

76 Dr. Steves Hot Chocolate 3-4 Tbsp 100% ground organic cocoa beans 6-8 oz Soy milk (warm) 1-2 tsp dark honey Only known side effect = better health


78 Superfood: Apples The fiber (pectin power) & the whole apple – TC, LDL-C – triglycerides Peel power Risk for asthma, pulmonary function Risk for lung cancer, ? Breast and colon cancer Apple consumption seems to lower risk for DM2 –Polyphenols help regulate blood sugar Inhibit enzymes that break down low glycemic carbs to simple sugars Glucose absorption from GI tract Stimulates uptake of blood glucose into cells

79 Superfood: Apples Risk for cardiovascular disease (13-22% in one female cohort) CRP Weight control –Eat an apple 15 min. pre-meal & it caloric intake of meal 15% An apple a day keeps the doctor away Sidekicks: pears, bananas

80 Superfood #18: Spices Serum glucose, triglycerides, LDL-C, and TC Smell cinnamon for brain boost Cinnamon Culinary herbs and spices have the highest antioxidant content of all foods Potent anti-inflammatory action ½ tsp cloves > ½ cup blueberries or cranberries Synergy of multiple spices

81 Superfood #18: Spices Black Pepper Enhances the bioavailability of polyphenols Anti-inflammatory properties Rosemary Detox with Rosemary Cooking with Rosemary decreases cancer-causing Heterosyclic Amines (HCAs)

82 Superfood #18: Spices Turmeric The yellow spice that makes curry Antioxidant Anti-inflammatory Inflammatory markers Natural aspirin effect via salicyclic acid Anti-cancer Blocks a wide array of cancer promoting mechanisms India = average consumption about 1 gram/d 8 grams/d safe A true SuperSpice

83 What About Salt? From the Japan Public Health Center based Prospective Study –Higher consumption of salted fish roe associated with risk of cancer –Higher consumption of cooking and table salt associated with risk of CVD SPICE IT UP!!! * Am J Clin Nutr 2010:456-64

84 Superfood #19: Extra Virgin Olive Oil Oxidative stress including oxidation of LDL-C Blood pressure, TC, LDL-C Risk for colon, breast cancer Sidekicks: canola oil 1 tablespoon most days High smoke point (410 ) ** Best to cook with temperatures < 350 Store in cool, dark place Consume within 10-12 weeks once opened or store in fridge where it lasts about year

85 Smoke Point / Cooking Oil Safflower450 F / 230 C Hi Oleic Sunflower450 F / 230 C Avocado520 F / 271 C Ghee400-500 F / 204-260 C Extra Virgin Olive Oil250 F / 121 C **

86 Superfood #20: Garlic Synergy of 100 nutrients Blood pressure A natural blood thinner Triglycerides, LDC-C HDL-C May colorectal, gastric and prostate cancer Antibiotic Sidekicks: scallions, shallots, leeks, onions Use to taste multiple times per week

87 Superfood #21: Onions Risk of heart disease 20% Risk for cancers of brain, esophagus, lung, stomach Potent anti-inflammatory –Quercetin mimics resveratrol Sidekicks: garlic, scallions, shallots, leeks, chives For maximum health benefits cut and let sit for approximately 10 minutes Phytonutrient content purple > yellow > white Eat multiple times per week

88 Superfood #22: Honey A lot more than sugar serum antioxidants Wound healer Buckwheat honey the best Prebiotic function Sidekicks: none 1-2 teaspoons multiple times per week

89 Sugar and Your Health U.S. the largest consumer of sugars and caloric sweeteners = WORLD CHAMPS! Americans consume 22.2 tsp/d Sugar releases opiates/dopamine ? addictive Sweet safe, bitter poison Sugar does not cause diabetes Scant scientific evidence that sugar causes hyperactivity Sugar insulin which can accelerate the growth of cancer cells Lower blood pressure by sugar sweetened drinks

90 Sugar on the Label Corn syrupInvert sugar High fructose corn syrupCane sugar * HoneyDextrose * Maple syrupSucrose * Fruit juice concentratesMaltodextrin * Malt syrupGlucose * MolassesFructose Sorghum * Antioxidants

91 Sugar and Your Health 10% of calories/d from added sugar vs. < 5% – HDL-C (25% 3 fold risk) – Triglycerides – Weight & waistline (multi-factorial) AHA = maximum 100 cal/d (6 tsps) added sugar (F) and 150 cal/d (M) –A 12 oz Coke has 10 tsps * JAMA 2010;303:1490

92 Sugar and Your Health Bulk up on whole food sugars Soda and sweetened beverages Processed foods Check food labels Look for all-fruit spreads Dark honey & molasses Splenda

93 Antioxidant Content of Alternatives to Refined Sugar * Estimated average per capita consumption of added sugars in America is 130g/d * Substituting alternative sweeteners could antioxidant intake an average of 2.6 mmoL/d –Similar to the amount found in a serving of berries or nuts * J Am Diet Assoc. 2009;109:64-71 SourceSizeFrap mean mmoL/100g Blackstrap molasses1 Tbsp5.513 *** Date sugar1 oz (28.35g)4.586 *** Barley malt syrup1 Tbsp2.121 *** Brown rice malt syrup1 Tbsp0.717 Dark brown sugar1 Tbsp0.689 Maple syrup1 Tbsp0.454 Raw cane sugar1 Tbsp0.327 Golden blossom honey1 Tbsp0.193 Agave nector1 Tbsp0.034 Refined sugar1 Tbsp0.017 Corn syrup1 Tbsp0.008

94 Superfood #23: Kiwi Triglycerides and platelet hyperactivity (up to 18%) A non-fat source of vitamin E Rich in vitamin C A fruit source of lutein Very low caloric/nutrient score A natural blood thinner Sidekicks: pineapple, guava Eat multiple times weekly


96 Superfood #24: Pomegranates ¼ cup LDL-C oxidation Blood pressure 100% juice best Growth rate of prostate cancer May play a role in preventing skin, lung, colon and breast cancer May atherosclerosis Dermal collagen Sidekick: plums 4-8 oz of 100% juice multiple times weekly & unlimited seeds

97 Berries (beware of added sugar) Figs Apricots Raisins Prunes (dried plums) Apples Cherries / Tart Cherries All are calorie rich / nutrient rich Superfood #25: Dried Fruits


99 What About Restaurant Foods? Data from the Black Womens Health Study –Hamburgers, fried chicken, fried fish and Chinese food associated with risk for DM2 * Am J Clin Nutr 2010;465-471

100 ORAC Score FruitORAC Score Dried Tart Cherries6,800 Acai fruit5,754 Blueberry2,400 Frozen Tart Cherries2,100 Strawberry1,540 Raspberry1,220 Per 100 grams (3.5 ounces): * Need 3,000 to 5,000 ORAC units of antioxidants a day to reach the level of antioxidant capacity in the blood associated with various health benefits.

101 Tart Cherries Pain of gout, arthritis Inhibit COX-1 and COX-2 Triglycerides, TC, FBS/insulin, HDL-C Protect brain cells against oxidative stress Contain melatonin

102 When to Go Organic 12 most contaminated F&V = 14 pesticides/d: peaches, apples, sweet bell peppers, celery, nectarines, strawberries, cherries, lettuce, imported grapes, pears, spinach, sweet potatoes = go organic, seasonal Clean produce = <2 pesticides/d: onion, avocado, frozen sweet corn, pineapples, mango, frozen sweet peas, asparagus, kiwi, bananas, cabbage, broccoli, eggplant * Nutr Today 2009;44(1):38-42

103 Stress Stressor + your negative perception = stress Stress is your response to a situation A stress response needs your permission to occur So… –Listen to natures symphony –Let the wind be you massage therapy –Get your fanny moving its not for sitting –Perceive yourself as a winner –Green tea lowers stress hormone (Cortisol) –Teach Play Inspire


105 Walking is mans best medicine --Hippocrates Those who think they have not time for bodily exercise will sooner or later have to find time for illness. --Edward Stanley, the Earl of Derby, 1873 I have 2 doctors, my left leg and my right. --G.M. Trevelyan Walk and be happy, Walk and be healthy. --Charles Dickens

106 GOAL Died of old age, mind sharp, hearing intact, heart strong, and still saw like a hawk

107 Avoiding the Big Six Steven G. Pratt, MD, FACS, ABHM La Jolla, CA EPSE September 2011

108 Top 22 Tips for Preventing (or Living With) Cardiovascular DiseaseHeart Attack and Strokethe Superhealth Way 1.No cigarettes or exposure to second-hand smoke 2.Become an environmentalist 3.Get 7-8 hours sleep per night 4.Watch your weight and waistline 5.Burn those calories 6.DASH you way to lower blood pressure 7.Eat your vegetables and fruits 8.Be a Carotenoid King or Queen 9.Take an antioxidant bath with every meal 10.Raise your intake of potassium; lower intake of sodium 11.Love those nuts and seeds

109 12.Love those healthy fats 13.Eat like an Alaskan Brown Bear 14.Drink tea, 4 cups per day 15.Thin your blood naturally 16.Bring on the Bs 17.Consume 10-15 grams of whole food soy protein/d 18.You cant beat whole grains 19.Control your blood sugar 20.Add 2-4 tablespoons per day of Bobs Red Mill Whole Ground Flaxseed Meal, oat bran, wheat germ 21.Supplement your health with fish oil 22.Indulge in dark chocolate Top 22 Tips for Preventing (or Living With) Cardiovascular DiseaseHeart Attack and Strokethe Superhealth Way

110 Causal Association Between Diet and Coronary Heart Disease Strong Cohort Data OnlySupported by RCTs Mediterranean dietYes High-quality diet Vegetables Nuts Trans-fatty acids Glycemic index or load Prudent diet Western diet Monounsaturated fatty acids * Arch Intern Med, 2009;169(7):659-669

111 Causal Association Between Diet and Coronary Heart Disease Moderate Cohort Data OnlySupported by RCTs FishNo Marine ω-3 fatty acidsYes Dietary folate Supplementary folateRCT data only Whole grains Dietary vitamin E Dietary beta carotene Supplementary beta caroteneRCT data only Dietary vitamin C Alcohol, light/moderate consumption Alcohol, heavy consumption Fruits Fiber * Arch Intern Med, 2009;169(7):659-669

112 Causal Association Between Diet and Coronary Heart Disease Weak Cohort Data OnlySupported by RCTs Supplementary vitamin EYes Supplementary ascorbic acidYes Total fatYes Saturated fatty acids Polyunsaturated fatty acidsYes ω-3 fatty acids, totalNo Meat Eggs Milk * Arch Intern Med, 2009;169(7):659-669

113 Top 13 Tips for Breast Cancer Prevention 1.Have a mammogram and clinical breast exam every year starting at age 40 2.Control weight before, during and after pregnancy 3.Avoid alcohol if family or personal history of breast cancer; limit to 3 drinks per week if no history 4.Choose healthy fat 5.Watch your weight and waistline 6.Be physically active and burn those calories 7.Love those cruciferous veggies 8.Aim for 1200-6000 IU/d vitamin D 3, including supplements, diet and 10-20 minutes sun exposure 3-4 days per week 25 (OH)D Aim for 60-80 ng/mL 9.Enjoy 10-15 grams soy protein and 2-4 tablespoons flaxseed meal most days 10.Be a fiber consuming machine and a carotenoid queen 11.Healthy environment = Breast Cancer Free you 12.Breast feed 6-12 mos/child 13.Average 7-8 hrs sleep/night

114 Breast Cancer and Your Environment It has been difficult to prove a direct cause and effect >216 chemicals mammary gland tumors in animal studies 73 chemicals identified in consumer products are potential mammary carcinogens, 35 are in air pollutants, and 29 are produced at > 1 million pounds in the U.S. The 3 bad boys –Polychlorinated byphenols (PCBs) –Polyaromatic hydrocarbons (PAHs) –Organic solvents and dioxin

115 Top 14 Tips for Prostate Cancer Prevention or Control 1.Be physically active 2.Drink four or more cups of tea a day 3.Consume 22mg of lycopene from food most, if not all, days 4.Add 2-3 tablespoons of ground flaxseed meal to your daily diet 5.Consume healthy fats and a lower intake of saturated fats 6.Love those cruciferous veggies 7.Limit calcium intake from milk products and increase vitamin D3 to 1200-6000 IUs per day 8.Consume legumes most days 9.Take a well-balanced, up-to-date supplement 10.Have more fun in bed 11.Watch your waistline and your weight 12.Beware of processed meat 13.Look for lean, free range beef (when you have it ) 14.Average 7-8 hrs sleep/night

116 Top 11 Tips for Colorectal Cancer Prevention 1.Have a colonscopy 2.Be physically active 3.Stay away from red meat and processed meat 4.Have no more than 3 alcoholic drinks per week for women, 6-7 for men 5.Watch your weight and your waist 6.Consume foods containing dietary fiber, and nonfat milk, nonfat yogurt, calcium and garlic 7.Dont smoke 8.Discuss your family history with your doctor 9.Get your vitamin D 10.Watch your insulin levels 11.Average 7-8 hrs sleep/night

117 Top 13 Tips for Lung Cancer Prevention 1.Dont smoke 2.Stop smoking 3.Avoid secondhand smoke 4.If you smoke, know the dangerous combinations of: a.cigarettes + beta-carotene supplements + alcohol b.cigarettes + beta-carotene supplements + asbestos 5.Limit alcoholic drinks to 3 for women, 6-7 for men 6.Avoid carcinogens at work 7.Eat plenty of fruits 8.Be physically active 9.Eat apples 10.Decrease exposure to arsenic in drinking water: use reverse osmosis device or bottled water 11.Houseplants to detox your home/office air 12.Your lungs love carotenoids and omega-3s 13.Average 7-8 hrs sleep/night

118 Note that physical activity (PA), sleep, Superfoods are in Every List

119 GOAL Died of old age, mind sharp, hearing intact, heart strong, and still saw like a hawk

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