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 May 31, 2013 10:08 am

A few additional comments from the discussion on the topic from my FB page

About 12 years ago, I was sitting in the back of a health conference with the person responsible for putting the conference on. Several leading proponents of a healthy diet were on stage debating the issues similar to the ones I covered in the above linked discussion. The person I was with looked at me and asked, what I thought. I smiled and said, it is like debating how many angels can dance on the head of a pin, as that there is no evidence at all for the debate going on.

The debate is really over something else and is what I call "market differentiation" or what Dr McDougall calls "unique positioning." It is understandable to a point but it is also why, in the article above, I ended it with the quote from Dr Katz who said, anyone telling you anything different is either "misguided, selling something or both."

The reason I say this is because there is something called "effect size" which is basically a measure of the strength of the intervention or how powerful is the intervention.

Well, when it comes to the Standard American Diet (SAD), it is SO bad, literally being the most extreme version of the worse diet ever fed to humans, then moving away from it to anything healthier will provide a positive effect. This is why most diets that promote limiting any of the C.R.A.P. consumed in the typical SAD and adding in some more of the good stuff, sees a benefit. And, the more this happens, in relation to moving away from the SAD, and including some good, the better the effect size.

This is also why moving all the way over from the SAD to the plant centered, minimally processed, calorie dilute, low/no SOS diet made up of a variety of fruits, veggies, starchy veggies, roots/tubes, intact whole grains and legumes, with a few nuts and seeds, produces such a HUGE effect size. It is why we see the dramatic and almost miraculous results we do.

However, once you get all the way over here, and then want to debate the impact of one more serving of kale, or a serving of kale vs a serving of sweet potato, the true potential impact and the true potential effect size if it exists at all, is SOO very small that it is most likely non existent for most people and if it does exist, it may only exist for some remote individual who may be genetically predisposed. So, out of 10,000 people eating this way, maybe one, may benefit. Problem is, we don't know who the one is and we would have to make all 10,000 who are already eating this way, which is already far and above what is known to be of benefit, to eat the kale instead of the sweet potato &/or another serving of kale then they are already eating, to find out who the one is.

Here is another example to illustrate effect size. Say there is a new study method. Kids who are using the old study method get 77 out of 100 on a test. With the new study method, the average is now 78. We are not impressed as there is not much difference or because the "effect size" is very small. However, what if with the new method, their average is now 95? We would be very impressed as that would be a big difference and a "big effect size."

Extending that analogy to this discussion, the typical America diet is like a 50 and those on a decent WFPB diet are already at 98 or 99. Fine refinements may take us to 98.3 or 99.3 but maybe ONLY in the .01% who are genetically predisposed.

But again, why would we do that when we know we are going to get 9,999 out of 10,000 well with the largest effect size if we could just get them to eat this way. And, remember, less than 1% of the population comes even close to eating well. Look what happened above to the Japanese women in Okinawa when we got them to go from half the recommended amount of vegetables to the recommended amount.

From what I have seen, most often, those who are arguing over the benefit of eating another serving of kale instead of a sweet potato or more kale, are not even covering the basics of a healthy diet and lifestyle yet. They are just hoping that in spite of their bad or less than healthy diets, a few more servings of kale will buy them a ticket to heaven.

Last but not least, this is what has also been called by Freud, the "narcissism of small differences."

Here are two points on that...

1) From Wikipedia

http://en.wikipedia.org/wiki/Narcissism ... ite_note-6

In terms of postmodernity, consumer culture has been seen as predicated on 'the "narcissism of small differences"...to achieve a superficial sense of one's own uniqueness, an ersatz sense of otherness which is only a mask for an underlying uniformity and sameness'

2) From an article in the New Yorker about the TV show Portlandia has a line which aptly applies to this situation

“Portlandia” is an extended joke about what Freud called the narcissism of small differences: the need to distinguish oneself by minute shadings and to insist, with outsized militancy, on the importance of those shadings."

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Re: High Quality Foods

Postby JeffN » Tue Jun 25, 2013 10:53 am

I wrote this about a year ago in response to a similar question on the concept of high quality and/or super foods in this thread.

I called it, Super Foods: Buying A Ticket To Heaven

Jeff

Lets say you are 50 and care about retiring in good financial shape. However, you are not and have never been thrifty, you have little to no savings or investments, you make very little money and you barely save anything each month. Retirement calculators say worst or best case scenario, you are way, way short of what you need to retire and you have little time to make it up.

In this scenario, finding that one great investment that is going to go from like 75 to 650 ( like Apple did) may matter and save your butt. However, as we all know, the odds are finding any such stock is extremely rare and you would most likely loose money in your efforts in trying to do so and in investing in all the ones you are hoping to be that next super stock. And, to make it really work, you would have to put most all your "eggs in this one basket" which we know, never works.

However, what if you are 50 and care about retiring in good financial shape. You are very thrifty, have been saving for decades, have quite a bit in the bank in savings and an excellent and well diversified portfolio that you have been investing in for decades. Retirement calculators say worst or best case scenario, you are way way ahead of what you need and could retire early if you wanted too. You have no need to go looking for that super stock.

So....

Someone who is overweight &/or obese, unhealthy, sedentary and eats a junk food diet is like the first scenario. As their intake of fruits, veggies, intact whole grains, beans etc & most nutrients is low, to them, finding that one superfood and eating it is their " hope" & their "ticket to heaven" that they will be "saved" & live & long & healthy life. It's like the poor person with no money spending what little they do have on a lottery ticket each week. While true, we will hear of the one or two who did win and had their lives changed, the reality is most will spend what little they have each week and never win. And, if they had instead saved and invested that money each week, they would have been in much better shape.

However, to someone who is following a healthy lifestyle and healthy plant based diet is like the second scenario. What difference does it make to them which new super food is being marketed? They have eliminated all the risk factors they can, are doing everything right in regard to diet and lifestyle, and already far surpass the rec'd intake for all fruits, veggies, intact whole grains and legumes and all nutrients and already limit or eliminated added salt, sugar fats/oils, etc . Will a few more vegetables or a vegetable with a few more nutrients really matter?

Does someone with a well balanced and diversified portfolio need to find the next Apple stock to make it?

Which scenario above should we be teaching & following? :)

Now, some of you may be thinking, "yes, but I got into this later in life and have not been well for a long time, couldn't I benefit more from finding some high quality or super food?"

While it may sound plausible, the reality is that most all of our studies have been done on people in the exact situation described. They are not done on younger, healthier subject but older subjects who are not well and have not taken care of themselves. After all, who else comes to us for help? And, the reality is, these older people who have not taken care of themselves over the course of their life and who are not well, all get better and many if not most all are able to fully recover and reverse their diseases just by applying the same principles as outlined above in the second scenario.

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Re: High Quality Foods

Postby JeffN » Tue Jun 25, 2013 10:57 am

One more on these individual super foods (i.e. kale, broccoli, mushrooms). I think this puts it all in perspective, especially why the "super food" of the day approach is misguided.

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http://ajcn.nutrition.org/content/97/1/ ... tract?etoc

Is everything we eat associated with cancer? A systematic cookbook review. Am J Clin Nutr January 2013 vol. 97 no. 1 127-134

Abstract

Background: Nutritional epidemiology is a highly prolific field. Debates on associations of nutrients with disease risk are common in the literature and attract attention in public media.

Objective: We aimed to examine the conclusions, statistical significance, and reproducibility in the literature on associations between specific foods and cancer risk.

Design: We selected 50 common ingredients from random recipes in a cookbook. PubMed queries identified recent studies that evaluated the relation of each ingredient to cancer risk. Information regarding author conclusions and relevant effect estimates were extracted. When >10 articles were found, we focused on the 10 most recent articles.

Results: Forty ingredients (80%) had articles reporting on their cancer risk. Of 264 single-study assessments, 191 (72%) concluded that the tested food was associated with an increased (n = 103) or a decreased (n = 88) risk; 75% of the risk estimates had weak (0.05 > P ≥ 0.001) or no statistical (P > 0.05) significance. Statistically significant results were more likely than nonsignificant findings to be published in the study abstract than in only the full text (P < 0.0001). Meta-analyses (n = 36) presented more conservative results; only 13 (26%) reported an increased (n = 4) or a decreased (n = 9) risk (6 had more than weak statistical support). The median RRs (IQRs) for studies that concluded an increased or a decreased risk were 2.20 (1.60, 3.44) and 0.52 (0.39, 0.66), respectively. The RRs from the meta-analyses were on average null (median: 0.96; IQR: 0.85, 1.10).

Conclusions: Associations with cancer risk or benefits have been claimed for most food ingredients. Many single studies highlight implausibly large effects, even though evidence is weak. Effect sizes shrink in meta-analyses.



This editorial was also published in the same journal in response to this article and am going to highlight a few key parts of it.


Nutritional epidemiology in practice: learning from data or promulgating beliefs?
Am J Clin Nutr 2013;97:5–6

The world can be a scary place. Bad things sometimes happen to us and our loved ones, and few things are scarier than cancer. When we are facing frightening things, a sense of controllability can ease our fears (1). But experience and empirical evidence tell us that things are often more seemingly random and less pre-dictable and controllable than we commonly think (2). Before Benjamin Franklin’s scientific investigation of lightning and invention of the lightning rod, lightning was a terrifying, seemingly random and uncontrollable, and often deadly occurrence. People sought explanations and control: they found those explanations in divine provenance and perceived control in the ringing of church bells. Unfortunately, ringing church bells does not actually dissuade lightning and often led to the deaths of bell ringers who ascended the bell towers in the midst of storms (3).

...

White hat bias, confirmation bias, and publication bias can lead to self-deception (8, 9). White hat bias, defined by Cope and Allison as ‘‘bias leading to distortion of research-based information in the service of what may be per ceived as ‘righteous ends’,’’ may be a factor in the overstatement of research findings (8). In addition, overstatement of results can be influenced by confirmation bias, in which the overstated results match preconceived views and hypotheses, leading to acceptance of the results even if the results are weak or nonsignificant (9). When results are null, publishing can be difficult and can lead to publication bias in which significant findings are more likely to be published, further distorting our view of what is known (9). When results are presented in a biased manner, the distorted results are disseminated to the public through lay media (10).

...

The implications of Schoenfeld and Ioannidis’ analysis may be
important for nutritional epidemiology even more broadly. Numerous food ingredients are thought to have medicinal properties that are not sufficiently supported by current knowledge—for example, coffee ‘‘curing’’ diabetes (11). These distortions can also be used to demonize foods, as shown by the longstanding presumption that dietary cholesterol in eggs contributes to heart disease (12). Causative relations between various foods and diseases likely do exist, but the evidence for many relations is weak, although conclusions about these relations are stated with the certainty one would expect only from the most strongly supported evidence.

...

However, none of these debiasing solutions address the fundamental human need to perceive control over feared events. Although scientists may have ulterior motives for looking for nutrient-disease associations, the public is always the final audience. It is therefore imperative that we spend less time repeating weak correlations and invest the resources to vigorously investigate nutrient-cancer and other disease associations with stronger methodology, so that we give the public lightning rods instead of sending them up the bell tower.
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Re: High Quality Foods

Postby JeffN » Fri Jun 28, 2013 8:00 am

This just came out and reinforces all the above.

Over 71,000 participants were followed for 13 years. Those who never consumed Fruits/Veggies (FV) lived 3 yrs. shorter & had a 53% higher mortality rate than those who consumed 5 servings FV/d. Those who never consumed fruit lived 19 mo shorter than those who ate 1 fruit/d. Those who consumed 3 vegetables/d lived 32 mo longer than those who never consumed vegetables.

Fruit & vegetable consumption & all-cause mortality: a dose-response analysis. Am J Clin Nutr August 2013 ajcn.056119

http://ajcn.nutrition.org/content/early ... hort?rss=1

However, was more better?

According to this study...

"We found that daily consumption of FV was associated with substantially longer survival and lower rate of overall mortality. The shape of the association was nonlinear. Level of consumptions <5 servings/d were associated with progressively shorter survival, with a 3-y shorter survival and a 53% higher mortality rate for those who did not consume FV. Compared with a FV consumption of 5 servings/d, higher levels of consumption were not associated with longer survival or a decreased rate of mortality. Benefits from eating fruit was observed at a consumption of merely 1 serving/d, whereas vegetable consumption was associated with a progressively longer survival up to 3 servings/d."

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Re: High Quality Foods

Postby JeffN » Fri Jul 05, 2013 7:00 am

The study below on DHA came out this past week and I was discussing it during the week with several of the leading MD's in the plant based world and received the following response from Dr Campbell, who has agreed to allow me to reprint his comments here, exactly as he wrote them, for everyone to see.

The points he makes below apply equally not only to this study (and others) on DHA (and fish oil), but also to similar studies on broccoli, kale, mushrooms, onions, tea, etc.

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The Study...

************
Docosahexaenoic Acid Supplementation, Vascular Function and Risk Factors for Cardiovascular Disease: A Randomized Controlled Trial in Young Adults. J Am Heart Assoc. 2013;2:e000283. Originally published July 1, 2013.
http://jaha.ahajournals.org/content/2/4/e000283.full
http://jaha.ahajournals.org/content/2/4 ... l.pdf+html

Abstract

Background A high consumption of omega-3 long-chain polyunsaturated fatty acids, and particularly docosahexaenoic acid (DHA), has been suggested to reduce the risk of cardiovascular disease (CVD). However, while DHA supplementation may have benefits for secondary prevention, few studies have investigated the role of DHA in the primary prevention of CVD. Here, we tested the hypothesis that DHA supplementation improves endothelial function and risk factors for CVD.

Methods and Results Healthy volunteers (n=328), aged 18 to 37 years, were randomly assigned to 1.6 g DHA/day (from a microalgae source) together with 2.4 g/day carrier oil (index group) or to 4.0 g/day olive oil (control) (both given in eight 500-mg capsules/day for 16 weeks). Flow-mediated endothelium-dependent vasodilation (FMD) of the brachial artery (primary outcome) was measured before and after the intervention (n=268) using high-resolution vascular ultrasound. FMD was the same in both groups at randomization (mean, SD; 0.27, 0.1 mm), but postintervention was higher in the control group (0.29, 0.1 mm) compared with the DHA-supplemented group (0.26, 0.1 mm; mean difference -0.03 mm; 95% CI -0.005 to -0.06 mm; P=0.02). Of other outcomes, only triglyceride (mean difference -28%, 95% CI -40% to -15%; P<0.0001) and very low-density lipoprotein concentrations were significant lower in DHA-supplemented individuals compared with controls.

Conclusions DHA supplementation did not improve endothelial function in healthy, young adults. Nevertheless, lower triglyceride concentrations with DHA supplementation was consistent with previous reports and could have benefits for the prevention of CVD.

************************

Dr Campbell's response...

Jeff,

Thanks for sharing.

This report is part of a broken record, like squeezing water out of an old wash rag lying in the desert.

A few observations:

1. The omega-3 DHA and EPA fatty acids possess anti-inflammatory activities among other 'favorable' health effects. But these benefits have been shown only in highly focused out-of-context studies.

2. However, in human studies, evidence for these 'benefits' is quite variable, inconsistent and generally mixed at best.

3. To my knowledge, virtually all of apparent benefits have been obtained for people consuming pro-inflammatory Western type diets typically high in omega-6 fatty acids, fat, protein and refined carbohydrates. The ratio of omega 6:omega 3 in these diets may be as high as 30:1 or more, thus creating a very high pro-inflammatory environment.

4. When the 6:3 ratio is so high, it is reasonable that this is when the supplementary anti-inflammatory omega-3 effect might be seen.

5. The ideal ratio of omega 6:omega 3 is about 2:1 that is typical for a low fat, whole food, plant-based (WFPB) diet (10-12% fat). I know of no evidence that omega-3 supplementation has any beneficial effects for the WFPB dietary lifestyle.

6. For subjects on a pro-inflammatory Western diet, a massive meta-analysis of 89 cohort and randomized clinical trials published 7 years ago(1) concluded that " long chain and shorter chain omega-3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer." Indeed, increased risk for cancer (although only of borderline statistical significance) "could not be excluded".

7. In a similar pro-inflammatory 'Western diet' prospective cohort study of nearly 3 million person-years of follow-up published in 2009(2), a highly significant (p<0.001) increasing trend in type 2 diabetes risk was observed with increasing omega-3 supplementation. Even individuals consuming omega-3 rich fish 5 or more times per week showed a highly significant increased risk of type 2 diabetes (p<0.001) when compared with individuals consuming fish less than one time per month.

My conclusion:

Why is so much effort and money still being spent to find, if possible, health benefits for omega-3 fat supplementation? Even more to the point, these efforts mostly concern out-of-context investigations of individual biomarkers of early disease risk where results are variable and inconsistent.

Why are these massive summaries of findings (along with more recent summaries) being ignored? Is it because lots of money is being made by selling these supplements?

http://www.drfuhrman.com/shop/supplements.aspx#DHA

http://krilloil.mercola.com/krill-oil.html

Why is it that people who promote and sell these products also have a tendency to say that a WFPB diet may have important nutrient deficiencies or that it is difficult to follow? Are these sentiments linked?

It is my opinion that people who do this are participating in a serious public health scam and are able to do so because of their unquestioning faith in reductionist science. It is time that these fraudulent practices are challenged.

Colin

T. Colin Campbell
Jacob Schurman Professor Emeritus
of Nutritional Biochemistry
Cornell University

Refs

1. Hooper L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore JJ, Worthington HV, Durrington PN, Higgins JPT, Capps NE, et al: Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer:systematic review. Brit Med Journ 2006, 332:752-760.

2. Kaushik SV, Mozaffarian D, Spiegelman D, Manson JE, Willett W: Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus. Am J Clin Nutr 2009, 90:613-620.

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Re: High Quality Foods

Postby JeffN » Sat Aug 17, 2013 8:43 am

JeffN wrote: Earlier this week, the NY Times featured an article saying that the produce available in the supermarkets today was inferior and to get all the benefits, we had to eat "wild" plants

http://www.nytimes.com/2013/05/26/opini ... =all&_r=1&

"The message to eat more of our current vegetables and fruits is not enough – we must also select the “right” varieties, including blue corn, arugula (pictured) and wild foods like dandelion greens, for best health."

Today, the American Institute of Cancer Research (mentioned earlier in this thread), which has authored the largest and most comprehensive report on cancer and diet ever, responded.

http://blog.aicr.org/2013/05/29/nutriti ... eating-it/

Quoting...

"I love seeing the heirloom purple carrots, blue potatoes and dark red apples in farmer’s markets and even in some grocery stores. And it’s a dietitian’s dream to see people eating a wide variety of deep and colorful fruits and vegetables.

But right now, most Americans are not eating even the minimum recommended amounts of any kinds of veggies and fruits – a total of about 3-4 cups per day. A 2009 report from the CDC shows that barely one-third of U.S. adults consumed fruit two or more times per day and only about one in four reported eating at least three servings of vegetables per day.

And the evidence is clear: eating plenty of those basic supermarket varieties of vegetables and fruits and other plant foods like grains and legumes link to reduced risk for many cancers, according to AICR’s expert report and its updates. These plant foods also help people get to and stay a healthy weight, and excess body fat is a cause of seven different cancers."


This response is inline with my earlier comments in this thread about how much it takes to meet and easily surpass the recommended amounts shown to be beneficial if someone is following the guidelines and principles recommended here. It is also directly inline with my article on "Super Foods."

http://www.jeffnovick.com/RD/Newsletter ... Foods.html

In Health
Jeff

PS: Of course, be careful, because the next food trend we will see, is all these wild varieties turned into junk food and grocery stores and health food stores will be featuring fried wild blue corn chips. :)




There was a recent discussion on FB in response to the above authors book/article. Specifically about how our current variety of store-bought bananas were inferior and we needed to seek out exotic and wild varieties of bananas.

In response, Jeff Nelson, posted this excellent rebuttal...

Jeff Nelson wrote: "Absolutely nothing wrong as far as I'm concerned with people knowing all fruits and veggies aren't created equal. I am not trying to bash or rain on any parades!

I'm just saying that kale is wonderful, but iceberg isn't junk food, and to prove the point it was served daily at Pritikin and everyone who went through that program got well.

There is, I think, a trap in the plant-based world, which is the idea that "more is better." If a nutrient is good for you, more or even a whole lot more must be better. But is that true?

Remember that the foundation for why we all appreciate today how healthy a plant-based diet can be are the programs like Pritikin, PCRM, McDougall, Ornish, Esselstyn, Kempner, Morrison and so forth, which published a lot of studies. And all of these programs used conventional produce that people got at regular old supermarkets. Not one of the programs focused on super foods, or super varieties of foods. None of them advised eating wild foods for health reasons. In fact, they all served normal Cavendish bananas regularly, and still do. And the people in those programs and in those studies, they completely reversed hypertension, metabolic syndrome, CVD, diabetes, etc. etc. -- even those who went into their programs seriously ill.

In terms of iceberg lettuce, Jeff Novick did a great job exploding the common myth about the nutritional value and worthiness of iceberg lettuce, that iceberg is to be avoided. No, iceberg is actually very good stuff, read his full piece at:

http://www.jeffnovick.com/RD/Articles/E ... nsity.html

And remember that Dr. Esselstyn says one of the benefits of plant foods in regard to CVD is their nitrate content, which helps increase nitric oxide, and is a very significant benefit of eating this way.

Well, according to this review study/report

http://www.efsa.europa.eu/en/scdocs/doc/689.pdf

the average nitrate level in curly kale was 537 mg/kg -- but iceberg lettuce was 875 mg/kg, leaving kale in the dust!

So just in terms of proper perspective and relative importance, I personally think Jo Robinson's reporting on the "most nutritious" bananas is interesting, but for people trying to be healthy and live life, it's apparent to me that whether someone eats a Cavendish or a "more nutritious" banana, it's not going to have any meaningful difference, at least none that can be shown. So to me it's important since not everyone is as sophisticated as experts like you, to remind people that this is just a theoretical, possible benefit that is being discussed, but not any actual proven benefit.

Now if we wanted to show there were a benefit to super-foods and "wild foods," and we wanted to show it was true, we'd need to take at least 100 people who are on the SAD and are sick, put half of them on, let's say, Esselstyn or Pritikin diets, and the other half on the same Essy or Pritikin diet except the second group has to use only "wild" bananas or kale or special super-nutritious foods, or whatever "high quality" choices someone has written a book about and show this group does better.

Of course this has never been done, and won't be, but the odds of there being any difference between the Essy group eating his diet, and one which substitutes the "super-food" version of the same diet is about .01% at best, I would venture. And even then it's probably a benefit only in people with some sort of genetic predisposition in some way.

The more people think they have to buy fancy supplements or eat special breeds of bananas or only the "most nutritious" berries or whatever, you run the risk of making people say, "Oh, this is a bummer because I like to eat bananas on my oatmeal" or "You just ruined bananas for me!" as people on this string did say. Now they maybe were kidding, but some people may see your post and think, "Wow, you mean it's not enough to eat a healthy plant-based diet out of my supermarket like Pritikin, McDougall, Ornish, Esselstyn and the rest did to get results? You mean I have to now start spending time looking for special bananas in order to be totally healthy?" And I think we can agree the answer is No, you don't. Not at all. There is no research showing eating wild bananas will improve your health or extend your life over eating a Cavendish.

This looks like an interesting book and interesting information, but you can reverse your heart disease and live a long time using iceberg lettuce and regular old bananas. That's been solidly proven in the literature. If you're traveling or busy, you don't have to trouble yourself to get special hard-to-find or expensive super-foods. And you can eat basic old sweet potatoes as the foundation of your diet, like the long-lived Okinawans have done and many still do, and research shows you are maximizing your health and chances of living a long time.



I agree 100% and could not have said it better.

Thanks Jeff.

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Re: High Quality Foods

Postby JeffN » Wed Aug 21, 2013 7:49 am

In response to this thread, I received the following in a private message.

I have often thought about why people fail with a veg diet, which the casual observer will attribute to lack of meat and dairy.

I think it is two things:

1. Junk food- just because it's vegan doesn't mean it's healthy. Junk food is junk food, whether or not dead animals were involved.

OR

2. Micro managing micro nutrients- Becoming obsessed with super foods doesn't help either and can be very fatiguing.

They are opposite ends of a spectrum, but they are traps that I have fallen into.

I have taught for years, so I know that the fundamentals are fundamental because they must be repeated over, and over, and over ...

Thank you so much for your patient persistence in teaching what matters most!


Thanks!

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Re: High Quality Foods

Postby JeffN » Sat Mar 01, 2014 10:26 am

Those of you who have heard me lecture, have often hears me say in the Calorie Density and/or Lighten Up lecture, while showing this picture of the current average intake of Americans..

Image

... when you understand that the typical diet consumed today is **so** bad, possibly being the worst diet ever consumed by humans in recorded history, then you understand that you can look at a group of those eating this diet and take *any* one healthy (or healthier) food (or food with some healthier aspects to it), and look at those who eat more of it compared to those who eat less of it (or none of it) and almost always see a difference. But that does not make it into a health food, let alone a super food.

I said the same thing in this thread, here...

viewtopic.php?f=22&t=40295&p=413947#p413947

If you take a group of people who do not meet the 5 Healthy Lifestyle Characteristics and are eating an unhealthy diet most likely low in many nutrients, and you give them a few servings a week of a healthy food fairly rich in nutrients, they will do better. No Doubt! And, we will see this impact regardless of whether it is a few more servings of kale, broccoli, blueberries, acai berries, walnuts, brown rice, etc etc. That is because this food will have a positive impact on their poor diet. And, that is why we see this in the news all the time about broccoli, kale, cauliflower, carrots, walnuts, etc etc etc.

But, that means absolutely nothing at all to anyone already consuming a diet that consists predominately of a variety of unrefined, minimally processed plant foods rich in fruits and vegetables. Where is there any evidence at all that adding another few servings a week of kale, blueberries, or walnuts to such a diet, has any effect?

There is none because it doesn't exist. The only evidence is when it is added to a poor(er) diet.

Truth is, using the above approach of adding several servings a week of a fruit or vegetables to a poor(er) diet, all and any fruits and veggies could be shown to be super foods. If they tracked broccoli intake, they would find it increases lifespan by X%, carrots extend life by X%, and so on and so on.


Today, another article came out proving this concept..

Move Over Walnuts, Kale, Goji Berrries, Sweet Potatoes, Purple Cabbage, etc., & Make Room For The Next Super Food: Carrots!

Dietary carrot consumption and the risk of prostate cancer.
Xu X, Cheng Y, Li S, Zhu Y, Xu X, Zheng X, Mao Q, Xie L.
Eur J Nutr. 2014 Feb 12. [Epub ahead of print]
PMID:24519559

http://www.ncbi.nlm.nih.gov/pubmed/24519559

"Carrot intake might be inversely associated with prostate cancer risk."

I wonder if carrots will become the new chocolate!

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Re: High Quality Foods

Postby JeffN » Thu Jul 31, 2014 3:36 pm

How much is enough?

Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies.
Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W, Hu FB.
BMJ. 2014 Jul 29;349:g4490. doi: 10.1136/bmj.g4490.
PMID: 25073782
http://www.bmj.com/content/349/bmj.g4490.long
http://www.bmj.com/content/bmj/349/bmj.g4490.full.pdf

Abstract

OBJECTIVE:

To examine and quantify the potential dose-response relation between fruit and vegetable consumption and risk of all cause, cardiovascular, and cancer mortality.

DATA SOURCES:

Medline, Embase, and the Cochrane library searched up to 30 August 2013 without language restrictions. Reference lists of retrieved articles.

STUDY SELECTION:

Prospective cohort studies that reported risk estimates for all cause, cardiovascular, and cancer mortality by levels of fruit and vegetable consumption.

DATA SYNTHESIS:

Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals and to incorporate variation between studies. The linear and non-linear dose-response relations were evaluated with data from categories of fruit and vegetable consumption in each study.

RESULTS:

Sixteen prospective cohort studies were eligible in this meta-analysis. During follow-up periods ranging from 4.6 to 26 years there were 56 423 deaths (11 512 from cardiovascular disease and 16 817 from cancer) among 833 234 participants. Higher consumption of fruit and vegetables was significantly associated with a lower risk of all cause mortality. Pooled hazard ratios of all cause mortality were 0.95 (95% confidence interval 0.92 to 0.98) for an increment of one serving a day of fruit and vegetables (P=0.001), 0.94 (0.90 to 0.98) for fruit (P=0.002), and 0.95 (0.92 to 0.99) for vegetables (P=0.006). There was a threshold around five servings of fruit and vegetables a day, after which the risk of all cause mortality did not reduce further. A significant inverse association was observed for cardiovascular mortality (hazard ratio for each additional serving a day of fruit and vegetables 0.96, 95% confidence interval 0.92 to 0.99), while higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality.

CONCLUSIONS:

This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality.
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Re: High Quality Foods

Postby JeffN » Fri Aug 01, 2014 12:42 am

Fruit intake decreases risk of incident type 2 diabetes: an updated meta-analysis.
Li S, Miao S, Huang Y, Liu Z, Tian H, Yin X, Tang W, Steffen LM, Xi B.
Endocrine. 2014 Jul 30. [Epub ahead of print]
PMID: 25074631

Abstract

Association between fruit intake and risk of type 2 diabetes is inconsistent.

In this study, we performed a meta-analysis of all prospective cohort studies to clarify the association between fruit intake and risk of type 2 diabetes.

Relevant studies were identified by searches of the PubMed and Embase databases up to November 2013.

The summary relative risks of association were obtained using a fixed- or random-effects model. A total of nine prospective studies (403,259 participants, including 27,940 with incident type 2 diabetes) from seven publications were included in the meta-analysis of fruit intake and risk of type 2 diabetes. We found that individuals in the highest category of fruit intake had a reduced risk of type 2 diabetes (relative risk 0.92, 95 % confidence interval 0.86-0.97, p = 0.003) compared to those in the lowest category, with moderate evidence of between-study heterogeneity (I 2 = 37.6 %, p = 0.12). There was an evident non-linear association of fruit intake with type 2 diabetes (P for nonlinearity <0.001). A non-linear threshold of 200 g/day of fruit intake was identified and the risk of type 2 diabetes reduced by about 13% at this cut-off.

Our findings are consistent with diet recommendations to consume about 200 g/day of fruits to prevent type 2 diabetes.


NOTE: 200 grams is approximately 2.5 servings

http://www.who.int/dietphysicalactivity ... t.pdf?ua=1
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Re: High Quality Foods

Postby JeffN » Wed Aug 27, 2014 8:47 pm

Tomatoes, Fruits, Vegetables & Prostate Cancer.

Adherence to dietary and lifestyle recommendations and prostate cancer risk in the Prostate Testing for Cancer and Treatment (ProtecT) trial. Vanessa Er, J. Athene Lane, Richard M. Martin, et al. Cancer Epidemiol Biomarkers Prev Published OnlineFirst July 13, 2014.

http://cebp.aacrjournals.org/content/ea ... 2.full.pdf

Abstract
Background: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) published eight recommendations for cancer prevention but they are not targeted at prostate cancer prevention. We investigated whether adherence to the WCRF/AICR recommendations and a prostate cancer dietary index are associated with prostate cancer risk.

Methods: We conducted a nested case-control study of 1,806 PSA-detected prostate cancer cases and 12,005 controls in the ProtecT trial. We developed a prostate cancer dietary index by incorporating three dietary factors most strongly associated with prostate cancer. Scores were computed to quantify adherence to the WCRF/AICR recommendations and the prostate cancer dietary index separately.

Results: The prostate cancer dietary index score was associated with decreased risk of prostate cancer (OR per 1 score increment: 0.91, 95% CI: 0.84, 0.99; p-trend=0.04) but the WCRF/AICR index score was not (OR: 0.99, 95% CI: 0.94, 1.05; p-trend=0.82). There was no heterogeneity in association by prostate cancer stage (p=0.46) or grade (p=0.86). Greater adherence to recommendations to increase plant foods (OR per 0.25 index score increment: 0.94; 95% CI: 0.89, 0.99; p-trend=0.02) and tomato products (OR adherence vs. non-adherence: 0.82; 95% CI: 0.70, 0.97; p=0.02) were inversely associated with overall prostate cancer risk.

Conclusions: Adherence to the prostate cancer-specific dietary recommendations was associated with decreased risk of prostate cancer. High intake of plant foods and tomato products in particular may help protect against prostate cancer.


Also...

Tomatoes 'cut risk of prostate cancer by 20%': It takes 10 portions a week - but even baked beans count
By Sophie Borland for the Daily Mail
Published: 09:28 est, 27 august 2014
Updated: 17:30 est, 27 august 2014

http://www.dailymail.co.uk/health/artic ... er-20.html

"They found that those who ate at least ten portions of tomatoes a week were 18 per cent less likely to develop prostate cancer compared to those who had none, or very few.”

(This is per week)

"‘We also found men who ate more fruits and vegetables had a reduced risk of prostate cancer. The risk reduction figure for men who ate five or more portions of fruit or vegetables, compared to those who ate less than two and a half portions, was 24 per cent.’

(This is be per day)

Tomatoes or fruits and vegetables?

"However, experts said there was not enough evidence for conclusive proof that tomatoes protected against prostate cancer. Dr Iain Frame, of Prostate Cancer UK said: ‘Studies like these are notoriously difficult to interpret and should be done so with extreme caution. ‘It is difficult to separate the effects of one type of food from another, and we still don’t have nearly enough evidence to make concrete recommendations on which specific foods men should eat to reduce their risk of prostate cancer."

‘What we do know is that men shouldn’t rely too heavily on one type of food, such as tomatoes. ‘A healthy, balanced diet with plenty of fresh fruit and vegetables together with regular exercise is by far the best option.’


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Re: High Quality Foods

Postby JeffN » Thu Aug 28, 2014 12:11 pm

Thanks to VegMommy for posting this in the Lounge as it is excellent and really makes the point

Super Foods, Super Fooled, or Super Marketing?

http://youtu.be/fPGnBkH3fBg

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Re: High Quality Foods

Postby JeffN » Wed Apr 08, 2015 10:39 am

I hesitate to post this as it is unpublished and based on a presentation at a medical conference, but it does contain some interesting points in relation to this topic..


Eating green leafy vegetables keeps mental abilities sharp
March 30, 2015

http://www.sciencedaily.com/releases/20 ... 112227.htm

Summary:
Something as easy as adding more spinach, kale, collards and mustard greens to your diet could help slow cognitive decline, according to new research. The study also examined the nutrients responsible for the effect, linking vitamin K consumption to slower cognitive decline for the first time.

From the article...

"The researchers tracked the diets and cognitive abilities of more than 950 older adults for an average of five years and saw a significant decrease in the rate of cognitive decline for study participants who consumed greater amounts of green leafy vegetables. People who ate one to two servings per day had the cognitive ability of a person 11 years younger than those who consumed none."

"When the researchers examined individual nutrients linked with slowing cognitive decline, they found that vitamin K, lutein, folate and beta-carotene were most likely helping to keep the brain healthy."

"Our study provides evidence that eating green leafy vegetables and other foods rich in vitamin K, lutein and beta-carotene can help to keep the brain healthy to preserve functioning.

"In addition to green leafy vegetables, other good sources of vitamin K, lutein, folate and beta-carotene include brightly colored fruits and vegetables."


Federation of American Societies for Experimental Biology (FASEB). "Eating green leafy vegetables keeps mental abilities sharp." ScienceDaily. ScienceDaily, 30 March 2015.

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Re: High Quality Foods

Postby JeffN » Tue Jun 23, 2015 12:34 pm

Fruit intake and cardiovascular disease mortality in the UK Women's Cohort Study. Lai HT, et al. Eur J Epidemiol. 2015..Jun 16. [Epub ahead of print]

Abstract

In observational studies, fruit intake is associated with a reduced risk of cardiovascular disease (CVD), though fruit type has been less frequently explored. The aim of the current study was to explore the association between total fruit and fruit subgroup intake according to polyphenol content and CVD mortality in the UK Women's Cohort Study. Total fruit intake (g/day) derived from a 217-item food frequency questionnaire was obtained from 30,458 women (aged 35-69 years) at baseline from 1995-1998. Fruit intakes were sub-categorised according to similarities in polyphenol profile from Phenol Explorer, including berries, citrus, drupes, pomes and tropical fruits. Mortality events were derived from the NHS Central Register. During the mean follow-up period of 16.7 years, 286 fatal CVD deaths [138 coronary heart disease (CHD), 148 stroke] were observed. Survival analysis was conducted using participants free from history of CVD at baseline. Total fruit intake was associated with lower risk of CVD and CHD mortality, with a 6-7 % reduction in risk for each 80 g/day portion consumed (99 % CI 0.89, 1.00 and 0.85, 1.01 respectively). Concerning particular fruit types, the direction of the associations tended to be inverse, but point estimates and tests for trend were not generally statistically significant. However, women in the highest intake group of grapes and citrus experienced a significant reduction in risk of CVD and stroke respectively compared with non-consumers [HR 0.56 (99 % CI 0.32, 0.98) and 0.34 (0.14, 0.82) respectively]. These findings support promoted guidelines encouraging fruit consumption for health in women, but do not provide strong evidence to suggest that fruit type is as important.

PMID 26076918 [PubMed - as supplied by publisher]
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Re: High Quality Foods

Postby JeffN » Sun Jul 05, 2015 11:56 am

Many international and national health organizations recommend a minimum of 400 grams of fruit and vegetables a day. This is based on the same recommendation of a minimum of 5 servings a day of fruits and vegetables (2 of fruit and 3 of vegetables) at about 80 grams per serving.

This study found the lowest risk in those consuming 800 grams per day. This is 4 servings of fruit and 6 of vegetables. Some recommendations include starchy vegetables and some don't. Even if we leave out the starchy vegetables, that is just 150 calories of veggies per day and 240 calories of fruit (based on average calories per serving).

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Fruit and Vegetable Consumption and Risk of Cardiovascular Disease: a Meta-analysis of Prospective Cohort Studies.
Zhan J, Liu YJ, Cai LB, Xu FR, Xie T, He QQ.
Crit Rev Food Sci Nutr. 2015 Jun 26:0. [Epub ahead of print]
PMID:26114864

Abstract
A meta-analysis of prospective cohort studies was conducted to examine the relation between fruit and vegetables (FV) consumption and the risk of cardiovascular disease (CVD). We searched PubMed and EMBASE up to June 2014 for relevant studies. Pooled relative risks (RRs) were calculated and dose-response relationship was assessed. Thirty-eight studies, consisting of 47 independent cohorts, were eligible in this meta-analysis. There were 1,498,909 participants (44,013 CVD events) with a median follow-up of 10.5 years. The pooled RR (95% confidence interval) of CVD for the highest versus lowest category was 0.83 (0.79-0.86) for FV consumption, 0.84 (0.79-0.88) for fruit consumption, and 0.87 (0.83-0.91) for vegetable consumption, respectively. Dose-response analysis showed that those eating 800 g per day of FV consumption had the lowest risk of CVD. Our results indicate that increased FV intake is inversely associated with the risk of CVD. This meta-analysis provides strong support for the current recommendations to consume a high amount of FV to reduce CVD risk.
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