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.

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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

Are Raisins a Good Snack Choice?

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Raisins, like all fruits, have a variety of health benefits, but dried fruit is higher in calories per serving than fresh, so might they contribute to weight gain? A study done by the University of Connecticut helped set people's minds at ease. Men and women were assigned to consume a cup of raisins a day for six weeks and were able to successfully offset the consumption of other foods in their diets such that they experienced no significant change in weight or waist circumference. What about in kids? I explore that in the video, Are Raisins Good Snacks for Kids?.

Leave it to the California Raisin Marketing Board to dream up a study titled, "An after-school snack of raisins lowers cumulative food intake in young children." Sounds good, right? They compared raisins to potato chips and chocolate chip cookies. They gave kids raisins, grapes, chips or cookies and said they could eat as much as they wanted and surprise surprise kids ate less fruit and more junk, but I guess naming the paper "Kids Prefer Cookies" would not have garnered the same kind of sponsor approval.

This reminds me of another study they did showing that regular consumption of raisins may reduce blood sugar levels... compared to fudge cookies and Oreos. Another study showed raisins caused less of a blood sugar spike than Coca-cola and candy bars. Though you can tell it was not funded by Big Raisin by their conclusion, "whether the general public should be advised to snack on fruit rather than on candy bars requires further debate and investigation."

Comparing raisins to chips and cookies was similarly unhelpful. Luckily, a less biased study was published by researchers at the University of Toronto. Nine to eleven year old boys and girls were told to eat all the grapes or raisins they wanted 30 minutes before a meal in which they could eat all the pizza they wanted. If you just gave them the meal, no snack, they ate 837 calories worth of pizza. If you gave them all-you-can-eat grapes before the meal, they ate 128 calories of grapes, but that seemed to fill them up a bit, so they ended up eating less pizza. But because they ate the snack and the meal they ended up getting more calories over all. Still, grape calories are better than pizza calories, but when given raisins instead, they ate even more snack calories, but the raisins were evidently so satiating that they ate so much less pizza that they ate fewer calories over all.

Now I know as parents there's a concern that if our kids eat snacks it might spoil their dinner, but when the snacks are fruit and the meal is a pepperoni and three cheese pizza, the more we can ruin their appetite, the better.

Raisin marketers aren't the only one's trying game the scientific method. Check out:

How to help get our kids to eat their fruits and veggies:

More dried fruit studies (my fave is dried mango):

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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How Big Food Twists the Science

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Just like mosquitos are the vectors of spread for malaria, a landmark article published last year in one of the most prestigious medical journals, Lancet, described large food corporations as the vectors of spread for chronic disease. Unlike "infectious disease epidemics, however, these corporate disease vectors implement sophisticated campaigns to undermine public health interventions." Most mosquitoes don't have as good PR firms.

A key message was that "alcohol and ultra-processed food and drink industries use similar strategies as the tobacco industry to undermine effective public health policies and programs." What they mean by ultra-processed is things like burgers, frozen meals, chicken nuggets, fish sticks, potato chips, doughnuts and soda pop.

But how is the food industry like the tobacco industry? The "first strategy is to bias research findings." For example, Philip Morris implemented the Whitecoat project to hire doctors to publish ghost-written studies purporting to negate links between secondhand smoke and harm, publishing biased cherry-picked scientific reports to deny harm and suppress health information. In my video Food Industry-Funded Research Bias, you can see the actual industry memo describing the Whitecoat Project, designed to reverse the scientific "misconception" that secondhand smoke is harmful.

Similarly, funding from these large food corporations biases research. Studies show systematic bias from industry funding, so we get the same kind of tactics--supplying misinformation, use of supposedly conflicting evidence and hiding negative data.

The same scientists-for-hire that downplayed the risks of secondhand smoke are the same hired by the likes of the National Confectioner's Association to say candy cigarettes are A-OK as well. Of course, they declared "no conflict of interest."

The similarities between strategies used by the tobacco, alcohol, and food and drink corporations are unsurprising in view of the flow of people, funds and activities across these industries, which also have histories of joint ownership--like Philip Morris owned both Kraft and Miller Brewing.

So what's their strategy? As a former FDA commissioner described:

"The tobacco industry's strategy was embodied in a script written by the lawyers. Every tobacco company executive in the public eye was told to learn the script backwards and forwards, no deviation was allowed. The basic premise was simple-- smoking had not been proven to cause cancer. Not proven, not proven, not proven--this would be stated insistently and repeatedly. Inject a thin wedge of doubt, create controversy, never deviate from the prepared line. It was a simple plan and it worked."

Internal industry memos make this explicit, stating "doubt is our product, since it is the best means of competing with the body of fact that exists in the mind of the general public." The internal industry memos list objective number one as "to set aside in the minds of millions the false conviction that cigarette smoking causes lung cancer and other diseases; a conviction based on fanatical assumptions, fallacious rumors, unsupported claims and the unscientific statements and conjectures of publicity-seeking opportunists... [We need] to lift the cigarette from the cancer identification as quickly as possible, and to establish--once and for all--that no scientific evidence has ever been produced, presented or submitted to prove conclusively that cigarette smoking causes cancer," similar to what's now coming out from the food industry, from the same folks that brought us smoke and candy.

This is part of a series of "political" blogs which includes my video, Collaboration with the New Vectors of Disease. Why don't I just "stick to the science"? When there are billions of dollars at stake, the body of evidence can be skewed and manipulated. Funders can determine which studies are performed, how they're performed and whether or not they get published at all. That's why I think it's important to take a broader view to account for the ways the scientific method can be perverted for profit.

Here are some examples:

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--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Original Link

Why Deep Fried Foods May Cause Cancer

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In the latest study on dietary patterns and breast cancer risk among women, healthier eating was associated with eliminating three-quarters of the odds of breast cancer, whereas less healthy eating was associated with up to nearly eight times the odds. Included in the unhealthy eating pattern was the consumption of deep-fried foods, which have previously been linked to breast cancer, pancreatic cancer, lung cancer, oral and throat cancers, esophageal cancer, and cancer of the voicebox. No deep fried foods? What's a Southern belle to do? Instead of deep fried foods, how about the traditional Southern diet, characterized by high intakes of cooked greens, beans, legumes, cabbage, sweet potatoes and cornbread, which may reduce the risk of invasive breast cancer significantly.

What about the consumption of deep-fried foods and risk of prostate cancer? Researchers at the Fred Hutchinson Cancer Research Center and the University of Washington found that eating French fries, fried chicken, fried fish, and doughnuts was associated with about a third greater odds of prostate cancer. After stratifying for tumor aggressiveness, they found slightly stronger associations with more aggressive disease, suggesting that regular intake of deep-fried foods may contribute to the progression of prostate cancer as well.

What in deep fried foods is so bad for us? Just heating oil that hot can generate potentially carcinogenic compounds, and then known carcinogens such as heterocyclic amines and polycyclic aromatic hydrocarbons form when the muscles of chickens and fish are cooked at that temperature. Deep-fried plants, on the other hand, can form acrylamide.

I did a video about acrylamide back in 2008, suggesting it's a probable human carcinogen (See Acrylamide in French Fries). Since then, studies have suggested pregnant women may want to cut back on French fries to protect the growth of their baby's body and brain. Based on a study (highlighted in my video, Cancer Risk from French Fries) feeding people a little bag of potato chips every day for a month, it now seems acrylamide may also cause inflammation as well, which could explain its purported role in cancer progression.

Acrylamide intake has been associated with endometrial cancer, ovarian cancer, lung cancer, kidney cancer, and esophageal cancer. How much cancer risk are we talking about? Taiwanese researchers examined lifetime cancer risk and French fry consumption. The researchers picked on French fries because they comprise by far the greatest percentage contribution of acrylamide to the diets of children. They estimated that, at most, one or two boys and girls out of every ten thousand would develop cancer eating French fries that they would otherwise not have developed if they hadn't eaten French fries. So it's not as bad as eating something like fried fish, or fried chicken, but how much is that saying?

The level of cancer risk in both boys and girls associated with French fries depends on how long and hot they're fried. In Europe, the food industry swore that they'd self-regulate and control fry times to decrease acrylamide levels, but we've yet to see any subsequent change in acrylamide levels in French fries.

Researchers continue to urge that the cooking temperature should be as low as possible and the cooking time should be as short as possible, "while still maintaining a tasty quality" of course. We wouldn't want to reduce cancer risk too much--they might not taste as good!

Blanching the potatoes first reduces acrylamide formation, but potato chip companies complain that, not only would it muck with the flavor, but it would reduce the nutritional properties by leaching away some of the vitamin C. But if we're relying on potato chips to get our vitamin C, acrylamide is probably the least of our worries.

More on heterocyclic amines:

There are some things we can do to counteract the effects of these carcinogens, though:

I touch on polycyclic aromatic hydrocarbons in Meat Fumes: Dietary Secondhand Smoke and Is Liquid Smoke Flavoring Carcinogenic?
Certain fats may play a role in breast cancer survival as well: Breast Cancer Survival, Butterfat, and Chicken and Breast Cancer Survival and Trans Fat.

-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: Kim Love / Flickr

Original Link

Should Carrageenan Be Avoided?

 

 

 

 

 

 

 

 

Should Carrageenan Be Avoided?

Six hundred years ago, people living along the coast of Carragheen County Ireland started using a red algae, which came to be known as Irish moss, to make a jellied dessert. This moss is now the source of carrageenan, a fat substitute (perhaps most famously used in the failed McLean Deluxe) and a food additive used as a thickener in dairy and nondairy products.

In 2008 I raised a concern about carrageenan. We had known for decades that it had harmful effects on laboratory animals, but in 2008 the first study on human cells to “suggest that carrageenan exposure may have a role in development of human intestinal pathology” was conducted. This was all five years ago, though. What’s the update? (See Is Carrageenan Safe?)

After the activation of inflammatory pathways was demonstrated in actual human colon tissue samples, Europe pulled it from infant formula, concerned that infants might be getting too much at such a vulnerable age. The latest suggests carrageenan consumption could possibly lead to a leaky gut by disrupting the integrity of the tight junctions that form around the cells lining our intestine—the barrier between our bloodstream and the outside world. This was just an in vitro study, though, done in a Petri dish. We still don’t know what effects, if any, occur in whole human beings. Some researchers advise consumers to select food products without carrageenan, accusing the FDA of “ignoring [its] harmful potential.”

Personally, after having reviewed the available evidence, I continue to view carrageenan the way I view acrylamide, another potential, but unproven hazard. Acrylamide is a chemical formed by cooking carbohydrates at high temperatures. So should we avoid eating such foods, like the EPA suggests? Well, “Food safety concerns must also be considered [in the context of dietary] consequences.” Where’s it found the most? Foods that are already unhealthy.

So sure, we can use our concern about the probable carcinogen,acrylamide as yet another reason to avoid potato chips and French fries, but until we know more I wouldn’t cut out healthful foods like whole grain bread. (For more on Acrylamide, see my video Acrylamide in French Fries).

Similarly, I’d use potential concerns about carrageenan as additional motivation to avoid unhealthy foods like cream cheese, but I wouldn’t cut out healthful foods until we know more. I would, however, suggest that those with inflammatory bowel syndrome or other gastrointestinal problems try cutting out carrageenan at least temporarily to see if symptoms improve.

Titanium dioxide is another additive used in nondairy substitutes. See Titanium Dioxide & Inflammatory Bowel Disease for the latest on its safety.

Other videos on food additives include:

-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.

Image credit: cafemama / Flickr

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