High Quality Foods

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Re: High Quality Foods

Postby JeffN » Fri Jul 24, 2015 6:52 am

In regard to the recent issue of whether or not leafy greens like kale, carry high levels of heavy metals, I touched on this in the rice and arsenic discussion. In that discussion, several members asked if the issue of rice in arsenic is a good reason to eat less rice (and other grains) and eat more vegetables.

Well, this quote is from John M. Duxbury, PhD, a professor of soil science and international agriculture at Cornell University in Ithaca, N.Y and responds to that question. What he says is true not only for Arsenic but for other heavy metals too.

“All plants pick up arsenic. Concentrations in leaves of plants are much higher than in grains of plants. Thus, leafy vegetables can contain higher levels of arsenic than rice, especially when they are grown on arsenic-contaminated soils. But because we eat a much lower volume of leafy greens compared to other kinds of foods, arsenic intake from this source is also low."

Now, this may be true for most Americans who barely eat any vegetables or greens (leaves). But what about us, who probably surpass the amount of vegetables most American eat in a week, each day (or meal).

Now what? :)

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Re: High Quality Foods

Postby JeffN » Mon Aug 10, 2015 9:20 am

Fruit and vegetable intake and risk of hip fracture: a cohort study of Swedish men and women.
J Bone Miner Res. 2015 Jun;30(6):976-84.
doi: 10.1002/jbmr.2384.

Abstract
Dietary guidelines recommend a daily intake of 5 servings of fruits and vegetables. Whether such intakes are associated with a lower risk of hip fracture is at present unclear. The aim of the present study was to investigate the dose-response association between habitual fruit and vegetable intake and hip fracture in a cohort study based on 40,644 men from the Cohort of Swedish Men (COSM) and 34,947 women from the Swedish Mammography Cohort (SMC) (total n = 75,591), free from cardiovascular disease and cancer, who answered lifestyle questionnaires in 1997 (age 45 to 83 years). Intake of fruits and vegetables (servings/day) was assessed by food frequency questionnaire and incident hip fractures were retrieved from the Swedish Patient Register (1998 to 2010). The mean follow-up time was 14.2 years. One-third of the participants reported an intake of fruits and vegetables of >5 servings/day, one-third reported >3 to ≤5 servings/day, 28% reported >1 to ≤3 servings/day, and 6% reported ≤1 serving/day. During 1,037,645 person-years we observed 3644 hip fractures (2266 or 62% in women). The dose-response association was found to be strongly nonlinear (p < 0.001). Men and women with zero consumption had 88% higher rate of hip fracture compared with those consuming 5 servings/day; adjusted hazard ratio (HR) was 1.88 (95% CI, 1.53 to 2.32). The rate was gradually lower with higher intakes; adjusted HR for 1 versus 5 servings/day was 1.35 (95% CI, 1.21 to 1.58). However, more than 5 servings/day did not confer additionally lower HRs (adjusted HR for 8 versus 5 servings/day was 0.96; 95% CI, 0.90 to 1.03). Similar results were observed when men and women were analyzed separately. We conclude that there is a dose-response association between fruit and vegetable intake and hip fracture such that an intake below the recommended five servings/day confers higher rates of hip fracture. Intakes above this recommendation do not seem to further lower the risk.
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Re: High Quality Foods

Postby JeffN » Tue Feb 16, 2016 3:08 pm

I thought Dr Lisle did a great job responding to this topic in this interview around ~52:50 to ~60:00

http://youtu.be/Gc3XfIOxTLU

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Re: High Quality Foods

Postby JeffN » Fri Dec 22, 2017 2:47 pm

The benefit was seen in just ~1.3 serving of green leafy veggies a day


Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study.
Morris MC, Wang Y, Barnes LL, Bennett DA, Dawson-Hughes B, Booth SL.
Neurology. 2017 Dec 20. pii: 10.1212/WNL.0000000000004815. d
oi: 10.1212/WNL.0000000000004815. [Epub ahead of print]
PMID: 29263222

http://n.neurology.org/content/early/20 ... 0000004815

Abstract

OBJECTIVE:
To increase understanding of the biological mechanisms underlying the association, we investigated the individual relations to cognitive decline of the primary nutrients and bioactives in green leafy vegetables, including vitamin K (phylloquinone), lutein, β-carotene, nitrate, folate, kaempferol, and α-tocopherol.

METHODS:
This was a prospective study of 960 participants of the Memory and Aging Project, ages 58-99 years, who completed a food frequency questionnaire and had ≥2 cognitive assessments over a mean 4.7 years.

RESULTS:
In a linear mixed model adjusted for age, sex, education, participation in cognitive activities, physical activities, smoking, and seafood and alcohol consumption, consumption of green leafy vegetables was associated with slower cognitive decline; the decline rate for those in the highest quintile of intake (median 1.3 servings/d) was slower by β = 0.05 standardized units (p = 0.0001) or the equivalent of being 11 years younger in age. Higher intakes of each of the nutrients and bioactives except β-carotene were individually associated with slower cognitive decline. In the adjusted models, the rates for the highest vs the lowest quintiles of intake were β = 0.02, p = 0.002 for phylloquinone; β = 0.04, p = 0.002 for lutein; β = 0.05, p < 0.001 for folate; β = 0.03, p = 0.02 for α-tocopherol; β = 0.04, p = 0.002 for nitrate; β = 0.04, p = 0.003 for kaempferol; and β = 0.02, p = 0.08 for β-carotene.

CONCLUSIONS:
Consumption of approximately 1 serving per day of green leafy vegetables and foods rich in phylloquinone, lutein, nitrate, folate, α-tocopherol, and kaempferol may help to slow cognitive decline with aging.
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Re: High Quality Foods

Postby JeffN » Sun Apr 22, 2018 12:40 pm

The cut-off was <2 vs >3 servings per day.

Also.. ““Potatoes, roasted or fried, including hot chips” was not included in total intake of vegetables because hot chips are not recommended as part of a healthy diet.33 “Potatoes cooked without fat” were included.”

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Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women.
J Am Heart Assoc. 2018 Apr 4;7(8). pii: e008391. doi: 10.1161/JAHA.117.008391.
PMID: 29618474 Free Article
http://jaha.ahajournals.org/content/7/8/e008391

Abstract

BACKGROUND:
Dietary patterns rich in fruits and vegetables are considered to reduce atherosclerotic disease presentation and are reported to be inversely associated with subclinical measures of atherosclerosis, such as carotid artery intima-media thickness (IMT) and plaque. However, the effect of vegetable intake alone, and relationships to specific types of vegetables containing different phytochemical profiles, is important. The aim of this study was to investigate the associations of total vegetable intake and specific vegetables grouped according to phytochemical constituents with common carotid artery IMT (CCA-IMT) and carotid plaque severity in a cohort of older adult women (aged ≥70 years).

METHODS AND RESULTS:
Total vegetable intake was calculated at baseline (1998) using a validated food frequency questionnaire. Vegetable types included cruciferous, allium, yellow/orange/red, leafy green, and legumes. In 2001, CCA-IMT (n=954) and carotid focal plaque (n=968) were assessed using high-resolution B-mode carotid ultrasonography. Mean (SD) total vegetable intake was 199.9 (78.0) g/d. Women consuming ≥3 servings of vegetables each day had ≈4.6% to 5.0% lower mean CCA-IMT (P=0.014) and maximum CCA-IMT (P=0.004) compared with participants consuming <2 servings of vegetables. For each 10 g/d higher in cruciferous vegetable intake, there was an associated 0.006 mm (0.8%) lower mean CCA-IMT (P<0.01) and 0.007 mm (0.8%) lower maximum CCA-IMT (P<0.01). Other vegetable types were not associated with CCA-IMT (P>0.05). No associations were observed between vegetables and plaque severity (P>0.05).

CONCLUSIONS:
Increasing vegetables in the diet with a focus on consuming cruciferous vegetables may have benefits for the prevention of subclinical atherosclerosis in older adult women.
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Re: High Quality Foods

Postby JeffN » Sat Sep 29, 2018 11:59 am

It doesnt take much. In this study, the high intake was 2.9 cups, which by today’s measure is about 3 servings.


Prospective Analysis of Vegetable Amount and Variety on the Risk of All-Cause and Cause-Specific Mortality among US Adults, 1999⁻2011.
Conrad Z, Thomson J, Jahns L.
Nutrients. 2018 Sep 27;10(10). pii: E1377. doi: 10.3390/nu10101377.
PMID: 30261669
https://www.mdpi.com/2072-6643/10/10/1377/htm

Abstract
The Dietary Guidelines for Americans 2015⁻2020 (DGA) provides recommendations for consuming a specific amount and variety of vegetables, but no studies have assessed the relationship between DGA-recommended vegetable variety and risk of mortality. We prospectively assessed the relationship between vegetable amount and variety and the risk of mortality using nationally-representative survey data (n = 29,133). Hazard ratios were estimated using survey-weighted, multivariate, Cox-proportional hazards models. Mean follow-up time was 6.5 years (12.8 years maximum). Total deaths from all causes were 2861, which included 829 deaths from cardiometabolic disease (556 coronary heart disease, 170 stroke, and 103 diabetes). Compared to individuals who reported consuming the greatest amount of vegetables daily, those with the least intake had a 78% greater risk of mortality from all causes (HR: 1.78, 95% CI: 1.29⁻2.47), a 68% greater risk of death from cardiovascular disease (1.68, 1.08⁻2.62), and an 80% greater risk of death from coronary heart disease (1.80, 1.09⁻2.08). No relationships were observed between vegetable variety and risk of all-cause or cause-specific mortality. Greater vegetable amount, but not variety, was associated with a reduced risk of mortality from all causes, cardiovascular disease, and coronary heart disease. Additional large-scale longitudinal studies with repeated measures of dietary exposure are needed.
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Re: High Quality Foods

Postby JeffN » Sat Sep 29, 2018 2:51 pm

And, another one...

“Conventional dietary guidance has emphasized the importance of eating a wide range of fruits and vegetables.

"You've been told to eat vegetables and fruits of every different color. Variety is the cornerstone of dietary advice, right? Wrong!" said Dr. Vogel, a cardiologist at the University of Colorado, Denver.

He cited a prospective study of the independent roles of quantity and variety in vegetable and fruit consumption in association with incident coronary heart disease in 71,141 women and 42,135 men participating in the Nurses' Health Study and the Health Professionals Follow-Up Study. During follow-up there were 2,582 documented cases of CHD in women and 3,607 in men. In a multivariate analysis, subjects in the highest quintile of daily fruit and vegetable consumption had a 17% lower risk of CHD. The absolute quantity of fruit and vegetable in take, but not the variety, was associated with a significantly lower risk of CHD.

Quantity and variety in fruit and vegetable intake and risk of coronary heart disease.
Am J Clin Nutr. 2013 Dec;98(6):1514-23. doi: 10.3945/ajcn.113.066381. Epub 2013 Oct 2.

Abstract

BACKGROUND:
Dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety.

OBJECTIVE:
We prospectively examined the independent roles of quantity and variety in fruit and vegetable intake in relation to incident coronary heart disease (CHD).

DESIGN:
We prospectively followed 71,141 women from the Nurses' Health Study (1984-2008) and 42,135 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. Variety was defined as the number of unique fruit and vegetables consumed at least once per week. Potatoes, legumes, and fruit juices were not included in our definition of fruit and vegetables.

RESULTS:
During follow-up, we documented 2582 CHD cases in women and 3607 cases in men. In multivariable analyses, after adjustment for dietary and nondietary covariates, those in the highest quintile of fruit and vegetable intake had a 17% lower risk (95% CI: 9%, 24%) of CHD. A higher consumption of citrus fruit, green leafy vegetables, and β-carotene- and vitamin C-rich fruit and vegetables was associated with a lower CHD risk. Conversely, quantity-adjusted variety was not associated with CHD.

CONCLUSIONS:
Our data suggest that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD. Nevertheless, consumption of specific fruit and vegetable subgroups was associated with a lower CHD risk.


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Re: High Quality Foods

Postby JeffN » Sun Sep 30, 2018 11:51 am

JeffN wrote:
Quantity and variety in fruit and vegetable intake and risk of coronary heart disease.
Am J Clin Nutr. 2013 Dec;98(6):1514-23. doi: 10.3945/ajcn.113.066381. Epub 2013 Oct 2.

Abstract

BACKGROUND:
Dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety.

OBJECTIVE:
We prospectively examined the independent roles of quantity and variety in fruit and vegetable intake in relation to incident coronary heart disease (CHD).

DESIGN:
We prospectively followed 71,141 women from the Nurses' Health Study (1984-2008) and 42,135 men from the Health Professionals Follow-Up Study (1986-2008) who were free of diabetes, cardiovascular diseases, and cancer at baseline. Diet was assessed by using a validated questionnaire and updated every 4 y. Variety was defined as the number of unique fruit and vegetables consumed at least once per week. Potatoes, legumes, and fruit juices were not included in our definition of fruit and vegetables.

RESULTS:
During follow-up, we documented 2582 CHD cases in women and 3607 cases in men. In multivariable analyses, after adjustment for dietary and nondietary covariates, those in the highest quintile of fruit and vegetable intake had a 17% lower risk (95% CI: 9%, 24%) of CHD. A higher consumption of citrus fruit, green leafy vegetables, and β-carotene- and vitamin C-rich fruit and vegetables was associated with a lower CHD risk. Conversely, quantity-adjusted variety was not associated with CHD.

CONCLUSIONS:
Our data suggest that absolute quantity, rather than variety, in fruit and vegetable intake is associated with a significantly lower risk of CHD. Nevertheless, consumption of specific fruit and vegetable subgroups was associated with a lower CHD risk.



As you can see in this chart, the benefit seemed to level off at about 4-5 servings of fruits and veggies a day. A little more was a little better (diminishing returns) but the biggest benefit (In relative risk) was going from <3 to 3-4 (.08) and from going from 3-4 to 4-5 (another .08). Going from <3 to 4-5 got you a drop of .16. Going from 4-5 to >8 only added another .04 reduction in RR.

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