What Do All the Blue Zones Have in Common?

Do Flexitarians Live Longer.jpg

What accounts for the benefits of a Mediterranean-style diet? An anatomy of health effects was published, and the single most important component was the high consumption of plant foods. In contrast, fish and seafood consumption, the only animal foods promoted in the Mediterranean diet, did not seem to help.

If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan and lowering heart disease and cancer mortality, they all share only four things in common: more fruit, more vegetables, more whole grains and more nuts and beans. They are all built on a common core of a diet rich in plant foods, whereas opposite food patterns, rich in animal foods and poor in plant-based foods (in other words, the Western diet), is associated with higher risks. So we need to optimize the food environment to support whole grains, vegetables, fruit and plant-based proteins.

That's one of the things all the so-called Blue Zones have in common: the longest living populations have not only social support and engagement and daily exercise, but nutritionally they all center their diets around plant foods, reserving meat mostly for special occasions. In fact, the population with perhaps the highest life-expectancy in the world, the California Adventist vegetarians, doesn't eat any meat at all.

So if the primary benefits of the Mediterranean diet are due to all the whole plant foods, what if you went back to the famous PREDIMED study and created a "provegetarian" scoring system? We know vegetarians live longer, but because a pure vegetarian diet might not easily be embraced by many individuals, maybe it would be easier to swallow if we just tell people more plant-based foods and less animal-based foods. But would just moving along the spectrum towards more plants actually enable people to live longer? Researchers thought of this food pattern as a "gentle approach" to vegetarianism, figuring that if it improved survival it would be an easily understandable message for health promotion: more plant foods, less animal foods.

On this scoring system, you get points for eating fruit, vegetables, nuts, grains, beans, olive oil and potatoes, but get docked points for any animal fats, eggs, fish, dairy or any type of meat or meat products. Of course that means you get a higher score the more potato chips and French fries you eat. That's why I prefer the term "whole-food, plant-based diet" since it's defined by what you eat, not by what you don't eat. When I taught at Cornell I had "vegan" students who apparently were trying to live off French fries and beer; vegan does not necessarily mean health-promoting.

But did the provegetarian scoring system work? Regardless of healthy versus unhealthy, if you give points to people for any kind of plant food, processed or not, and detract points for any kind of animal product consumption, people with higher scores live longer. The maximum provegetarian score is 60, but even just scoring 40 or more was associated with a 40 percent drop in mortality. In fact, there were so few deaths in the highest category of adherence to the provegetarian diet, they had to merge the two upper categories for their analysis. This is evidence that simple advice to increase the consumption of plant-derived foods with reductions in the consumption of foods from animal sources confers a survival advantage. You can view the graph in my video Do Flexitarians Live Longer?

The researchers conclude, "this modest change is realistic, affordable, and achievable because a sizable proportion of their population was already eating that way. So one can get significant survival benefit without a radical shift to the exclusive consumption of plant foods, a more gradual and gentle approach which is more easily translatable into public policy." A 41 percent drop in mortality rates in the United States would mean saving the lives of hundreds of thousands of Americans every year.

Here are some of my previous videos on the Mediterranean diet:

I've done a few videos on the health of so-called semi-vegetarians or flexitarians ("flexible" vegetarians). See how they rate in:

The Provegetarian Score reminds me of the animal to vegetable protein ratio in Prostate Cancer Survival: The A/V Ratio. My favorite dietary quality index is the one in Calculate Your Healthy Eating Score. How do you rate? Even the healthiest among us may be able to continue to push the envelope.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link

What Do All the Blue Zones Have in Common?

Do Flexitarians Live Longer.jpg

What accounts for the benefits of a Mediterranean-style diet? An anatomy of health effects was published, and the single most important component was the high consumption of plant foods. In contrast, fish and seafood consumption, the only animal foods promoted in the Mediterranean diet, did not seem to help.

If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan and lowering heart disease and cancer mortality, they all share only four things in common: more fruit, more vegetables, more whole grains and more nuts and beans. They are all built on a common core of a diet rich in plant foods, whereas opposite food patterns, rich in animal foods and poor in plant-based foods (in other words, the Western diet), is associated with higher risks. So we need to optimize the food environment to support whole grains, vegetables, fruit and plant-based proteins.

That's one of the things all the so-called Blue Zones have in common: the longest living populations have not only social support and engagement and daily exercise, but nutritionally they all center their diets around plant foods, reserving meat mostly for special occasions. In fact, the population with perhaps the highest life-expectancy in the world, the California Adventist vegetarians, doesn't eat any meat at all.

So if the primary benefits of the Mediterranean diet are due to all the whole plant foods, what if you went back to the famous PREDIMED study and created a "provegetarian" scoring system? We know vegetarians live longer, but because a pure vegetarian diet might not easily be embraced by many individuals, maybe it would be easier to swallow if we just tell people more plant-based foods and less animal-based foods. But would just moving along the spectrum towards more plants actually enable people to live longer? Researchers thought of this food pattern as a "gentle approach" to vegetarianism, figuring that if it improved survival it would be an easily understandable message for health promotion: more plant foods, less animal foods.

On this scoring system, you get points for eating fruit, vegetables, nuts, grains, beans, olive oil and potatoes, but get docked points for any animal fats, eggs, fish, dairy or any type of meat or meat products. Of course that means you get a higher score the more potato chips and French fries you eat. That's why I prefer the term "whole-food, plant-based diet" since it's defined by what you eat, not by what you don't eat. When I taught at Cornell I had "vegan" students who apparently were trying to live off French fries and beer; vegan does not necessarily mean health-promoting.

But did the provegetarian scoring system work? Regardless of healthy versus unhealthy, if you give points to people for any kind of plant food, processed or not, and detract points for any kind of animal product consumption, people with higher scores live longer. The maximum provegetarian score is 60, but even just scoring 40 or more was associated with a 40 percent drop in mortality. In fact, there were so few deaths in the highest category of adherence to the provegetarian diet, they had to merge the two upper categories for their analysis. This is evidence that simple advice to increase the consumption of plant-derived foods with reductions in the consumption of foods from animal sources confers a survival advantage. You can view the graph in my video Do Flexitarians Live Longer?

The researchers conclude, "this modest change is realistic, affordable, and achievable because a sizable proportion of their population was already eating that way. So one can get significant survival benefit without a radical shift to the exclusive consumption of plant foods, a more gradual and gentle approach which is more easily translatable into public policy." A 41 percent drop in mortality rates in the United States would mean saving the lives of hundreds of thousands of Americans every year.

Here are some of my previous videos on the Mediterranean diet:

I've done a few videos on the health of so-called semi-vegetarians or flexitarians ("flexible" vegetarians). See how they rate in:

The Provegetarian Score reminds me of the animal to vegetable protein ratio in Prostate Cancer Survival: The A/V Ratio. My favorite dietary quality index is the one in Calculate Your Healthy Eating Score. How do you rate? Even the healthiest among us may be able to continue to push the envelope.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link

Does Caramel Color Cause Cancer?

NF-Nov13 Does Caramel Color Cause Cancer?.jpg

Used as a coloring agent in products ranging from colas and beer to gravies and soy sauce, caramel coloring may be the world's most widely consumed food coloring. It helps grocery stores sell more than a billion servings of food and beverages a day. Unfortunately, the manufacturing of certain artificial caramel colorings can lead to the formation of carcinogens such as 4-methylimidazole, which causes cancer in mice but not rats (or at least, not male rats). However, it is unclear whether humans are more like mice or rats in terms of their response to the carcinogen.

To be safe, California officially listed it as a carcinogen and started requiring warning labels on soft drinks containing more than 29 micrograms per serving. The soft drink industry was unsuccessful in opposing the action, so they were forced to reduce carcinogen levels in their products--but only in California. Buy Coke anywhere else, and it may have up to five times the limit (See Is Caramel Color Carcinogenic?).

There's another class of additives that the soda industry uses to make its soda brown (see Phosphate Additives in Meat Purge and Cola). There are other harmful additives in soda as well (Is Sodium Benzoate Harmful? and Diet Soda and Preterm Birth).

Similarly the junk food industry uses titanium dioxide to whiten processed foods (Titanium Dioxide & Inflammatory Bowel Disease).

The meat industry has also used potentially toxic additives for cosmetic purposes such as arsenic-containing drugs (Arsenic in Chicken) and phosphate additives in chicken to make poultry pink. Carbon monoxide is used to keep red meat red, and acanthoxanthins keep salmon pink (Artificial Coloring in Fish).

It's amazing the risks the food industry will take to alter appearances (Artificial Food Colors and ADHD).

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Volker2342 / Flickr

Original Link

Breast Cancer & Alcohol: How Much is Safe?

 

 

 

 

 

 

 

 

Breast Cancer & Alcohol: How Much is Safe?

Nearly 5,000 breast cancer deaths a year may be attributable to just light drinking (up to one drink a day).

The International Agency for Research on Cancer, the World Health Organization body tasked with collating the totality of evidence as to whether or not something causes cancer, has now concluded that alcoholic beverages—all alcoholic beverages—are to be considered carcinogenic to humans.View image

There has been convincing evidence that alcohol consumption increases the risk of breast cancer, but most of the data were derived from studies that focused on the effect of moderate or high alcohol intakes, while little was known about light alcohol drinking (up to 1 drink/day). A recent meta-analysis of studies that compared light drinkers to non-drinkers found a moderate but significant association with breast cancer, based on the results of more than 100 studies.

The researchers estimate that about 5,000 breast cancer deaths a year are attributable to light drinking, meaning nearly 5,000 women that died of breast cancer maybe wouldn’t have if they had stayed away from alcohol completely, leading to an editorial in the medical journal Breast that concluded “women who consume alcohol chronically have an increased risk for breast cancer that is dose dependent but without threshold.” No threshold means there’s apparently no level of alcohol consumption that doesn’t raise breast cancer risk at least a little. Any level of alcohol consumption appears to increase the risk of developing an alcohol-related cancer. For example, the Harvard Nurses’ Study found that even consumption of less than a single drink per day may be associated with a modest increase in risk.

Most recent research has focused on acetaldehyde, the first and most toxic alcohol metabolite, as the primary cancer-causing agent. The bacteria in our mouths appear to oxidize alcohol into this acetaldehyde carcinogen, which we then swallow. So even a single sip of alcohol may be harmful. A new study found that just holding a teaspoon of hard liquor in our mouth for 5 seconds results in carcinogenic concentrations of acetaldehyde—even if we don’t swallow. The exposure continues for at least 10 min after spitting it out.

No surprise then alcohol-containing mouthwash can offer a carcinogenic spike as well. Researchers conclude: “All in all, there is a rather low margin of safety in the use of alcohol-containing mouthwash. Typical use will reach the concentration range above which adverse effects are to be expected. Until the establishment of a more solid scientific basis for a threshold level of acetaldehyde in saliva, prudent public health policy would recommend generally refraining from using alcohol in such products.”

So why isn’t the same recommendation made for alcoholic beverages? Well, as the Harvard paper concludes, “individuals will need to weigh the risks of light to moderate alcohol use on breast cancer development against the benefits for heart disease prevention to make the best personal choice regarding alcohol consumption.” They’re talking about the famous J shaped curve (watch my 4-min video Breast Cancer and Alcohol: How Much is Safe? to check it out). While smoking is bad and more smoking is worse, and in general exercising is good and more exercise is better, for alcohol there appears to be a beneficial effect of small doses. A six-pack a day raises overall mortality, but so does teetotalling.

The #1 killer of women isn’t breast cancer, but heart disease, and a drink a day reduces the risk of heart disease. Why just reduce the risk of heart disease, though, when you may nearly eliminate the risk of heart disease with a healthy enough diet? See, for example, my video Eliminating the #1 Cause of Death. A plant-based diet that excludes certain plant-based (alcoholic) beverages may therefore be the best for overall longevity.

For more on this topic, please see my follow-up video Breast Cancer Risk: Red Wine vs. White Wine. I’ve also previously addressed the pros and cons in Alcohol Risks vs. Benefits.

The other mouthwash video I refer to in the above video is Don’t Use Antiseptic Mouthwash, part of a video series on improving athletic performance with nitrate-containing vegetables (if interested, start here: Doping With Beet Juice).

How else might one reduce breast cancer risk? Please feel free to check out:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Images thanks to ondrej.lipar / Flickr

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