Nutrition HEALTH AND WELLNESS THROUGH NUTRITION "Let your food be your medicine, and let your medicine be your food." Hippocrates. OUR PHILOSOPHY ABOUT FOOD AND NUTRITION AT NATURE'S HEALTHCARE At Nature's Healthcare, we believe that one's nutritional status has a major impact on health and wellness, perhaps more so than any other single factor except maybe lifestyle. Everyday, we participate in three activities that allow chemicals to come into our bodies: that would be in the air we breathe, the water we drink, and the food we eat. We put trust in our elected officials and utility companies to see that our air and water are as pure and safe as possible, and we would not allow them to knowingly pollute our air or water or to allow them to become unsafe. As a society, however, we have not given the same level of concern to our food, as we have turned over the responsibility of preparing our food to someone else, and in so doing we have given up control over what goes into our food. We have become farther and farther removed from the process of food preparation, and we have allowed chemicals, preservatives, dyes, coloring agents, and flavor enhancers to be added to food, when we would never consider adding them ourselves. We have also given up control over the fat and sugar content of our food, resulting in the epidemic of obesity we now face. Other conditions seem to be on the rise as well, such as asthma which is felt to be possibly related to food allergens; a number of cancers, possibly linked to chemicals in our food; degenerative diseases such as osteoarthritis, which is associated with diets high in animal protein; and cardiovascular disease and stroke, our nation's #1 cause of death which is associated directly with the amount of dietary fat we consume. The good news is that we can reclaim control of the preparation of our food, and make informed decisions regarding its' content. We can eliminate those things from our food that are just not needed when we prepare our food ourselves, and which have absolutely no beneficial effect on our health and are likely harmful. We have solid scientific proof regarding the effects our dietary choices can have on our health, allowing us to make choices that can improve our overall health and well being, or to choose a dietary plan aimed at treating a specific medical problem. The following nutritional advice can be followed safely by anyone, except for those with specific metabolic deficiencies. And following this advice will result in improved health as outlined below. If we are seeing you for a specific problem, we might be emphasizing specific parts of this advice that might be especially helpful for you. Or, we may modify this advice or add to it, depending on the problem. EAT A PLANT-BASED, PREDOMINANTLY VEGETARIAN DIET Would it help you to believe in a predominantly vegetarian diet if we told you it was endorsed by the following agencies: The National Institutes of Health (NIH), the National Academy of Science, the National Cancer Institute (NCI), the U. S. Department of Agriculture, The National Research Council, The U.S. Department of Health and Human Services, the American Heart Association, and the American Cancer Society. No? Well, what if we told you that the dietary guidelines that follow could either lower your risk of developing or lessen the difficulty you are having with the following problems: Cardiovascular Disease. Stroke. Many types of Cancer. Inflammatory conditions such as Rheumatoid Arthritis. Autoimmune conditions such as Lupus and Multiple Sclerosis. Allergic conditions such as Asthma, Eczema, and Atopic Dermatitis. Degenerative conditions such as Rheumatoid Arthritis. Some behavioral and emotional problems such as depression, PMS, and ADHD. Now that you are convinced that such dietary choices would benefit you, how is this accomplished? THE FOOD GUIDE PYRAMID: In 1992, the USDA introduced the Food Guide Pyramid as a way of selecting our foods such that we achieve a nearly vegetarian diet. A copy of the pyramid is attached, with explanations regarding servings and calories. The emphasis in the pyramid is on increasing our consumption of fruits, vegetables, and grains, and minimizing our consumption of fats and sweets. Accomplishing this requires that we assume control of purchasing our food fresh, from a supermarket, and that we follow through with the preparation of that fresh food. This allows little room for prepared or processed food due to the higher fat and sugar content of such foods. The health benefits of the Pyramid are accomplished in the following ways: An increase in dietary fiber- This results in a lowering of serum cholesterol and triglyceride, improved bowel function and a lower risk of colon cancer. A decrease in the consumption of saturated fat and an increase in the consumption of essential fatty acids- This results in a reduced risk of cardiovascular disease and stroke. Saturated fat is found primarily in animal sources, the consumption of which is limited in the pyramid, and is substituted with unsaturated fat and essential fatty acids found in seeds, legumes (nuts and soy), and grains. An increase in the consumption of antioxidants and phytochemicals such as flavonoids and carotenoids- This results in a reduced risk of several cancers, a reduced risk of cardiovascular disease and stroke, and possibly a slowing down of the aging process. Flavonoids can be found in the red and purple pigmented fruits and vegetables such as: Tomatoes, red cabbage, red onions, berries, and plums. Carotenoids can be found in the yellow and orange fruits and vegetables such as: carrots, apricots, yams, mangoes, and squash, as well as in green leafy vegetables and in legumes, seeds and grains. You will see recommendations regarding supplementation with beta-carotene, but evidence shows that naturally acquired carotenes are more effective than those taken as a supplement. A decrease in the consumption of animal protein- Diets high in animal protein have been linked to inflammatory conditions such as rheumatoid arthritis, autoimmune conditions such as lupus and MS, and degenerative conditions such as osteoarthritis. A reduced intake in the consumption of refined sugar- these are the so-called "simple sugars." Consumption of simple sugars is associated with high insulin levels, which are linked to higher rates of cardiovascular disease and stroke, and which may effect certain mood and behavioral disorders. These five areas are addressed separately below. AN INCREASE IN DIETARY FIBER Fiber refers to the indigestible and non-absorbable components of our food. It consists primarily of the walls of the cells of our fruits and vegetables, composed primarily of cellulose. The consumption of high amounts of fiber is associated with a lowering of serum cholesterol, and is believed to lower the risk of colon cancer and possibly breast cancer. It also improves bowel function and lessens the development of the diverticular diseases in the colon, diverticulitis and diverticulosis. Fiber also contributes to satiety, which is the sensation of fullness. As such, it can contribute in this way to calorie restriction and weight management. The ability of dietary fiber to lower cholesterol has been strongly proven in multiple studies of oat bran and oatmeal. This effect seems to be stronger in people with high serum cholesterol compared to people with normal cholesterol who show little change in cholesterol from dietary fiber. Consumption of the equivalent of 3 gm of soluble oat fiber will lower total cholesterol by 8-23%. The importance of this is that each 1% drop in total cholesterol result in a 2% decrease in the risk of developing heart disease. 3 gm of fiber is provided by approximately one bowl of oat bran cereal or oat meal. The target for dietary fiber consumption is 35gm of fiber per day. Examples of fiber content are as follows: 1 medium apple- 3.5 gm 1 medium banana-2.4 gm 1 medium orange- 2.6 gm 1 medium tomato- 1.5 gm ½ cup celery- 1.1 gm 1 cup broccoli- 4.4 gm 1 cup carrots- 4.6 gm ½ cup baked beans- 8.8 gm ½ cup navy beans 6 gm ½ cup white rice- 0.2 gm ½ cup brown rice-1.0 gm ½ cup all bran- 8.5 gm ½ cup grape nuts- 2.8 gm 1 ¼ cup corn flakes 0.6 gm DIETARY FAT In a perfect vegetarian world, we would consume no animal fat at all. The American Heart Association and the American Cancer Society have established guidelines that recommend limiting the intake of fat such that the calories from fat make-up no more than 30% of total calories. As well, by limiting the intake of animal fat in favor of fat from seeds, legumes, nuts, and seeds, the type of fat consumed changes from saturated fat to polyunsaturated fat, which lowers the risk of heart disease and stroke. The amount of fat consumed from animal protein should be limited to 4-6 ounces per day, and should consist primarily of fish, skinless poultry, or lean lean lean cuts of beef. SATURATED FAT VS. UNSATURATED FAT: The gist of saturated vs. unsaturated fat is as follows. The term saturation refers to the number of hydrogen atoms attached to the carbon atoms in the fat molecule. That is, a saturated fat has the most hydrogen atoms possible attached to the carbon atoms, but that's not important. What is important is that this chemical property determines which fats will cause deposits in the arterial walls of the heart, or will lead to inflammatory reactions in our joints, or will affect the deterioration and function of our cells and lead to cancer. Saturated fat is obtained primarily from animal sources, and is solid at room temperature. Unsaturated fat is obtained primarily from vegetable sources, and is liquid at room temperature. Saturated fat causes heart disease, stroke, cancers, inflammatory conditions, skin conditions, and a variety of other disorders. Unsaturated fat is associated with a lower risk of these conditions, and can even cause improvements in the symptoms associated with them. So, how does this effect the choices I make in my selection of food? Where can my fat come from? THE WORST CHOICES: High intake of saturated fat from animal sources such as beef. High intake of saturated fat from butter. The use of oils such as corn oil, safflower oil, and soy. Eventhough these are composed of polyunsaturated fats, they are unstable when exposed to heat and light and form toxic derivatives called lipid peroxides. The use of Margarine and Shortenings due to their content of "Trans" fatty acids (see separate description below). High intake of cholesterol. THE BEST CHOICES: Follow the Food Guide Pyramid. See Pyramid Guidelines. Vegetables: 3-5 servings per day. Fruits: 2-4 servings per day. Breads, Grains, Cereals, Pastas, and Rice: 6-11 servings per day. Milk, Yogurt, and Cheeses: 2-3 servings per day. Meat, Poultry, Fish, Eggs, Beans, and Nuts: 2-3 servings per day: Limit animal protein (and its fat content) to 4-6 ounces per day, coming mostly from lean beef, fish, and skinless poultry. Oils: Choose Olive Oil and Canola Oil. Avoid Margarine: See section on "Trans" Fat. Use Butter instead of Margarine, but in limited amounts ("Sparingly" according to the pyramid.) Limit calories from fat to 30% of total calories, with only 10% of that coming from saturated fat. Calories from fat should preferably come from fruits, veggies, nuts, and beans rather than from animal sources. This favors polyunsaturated and monounsaturated fat over saturated fat. Limit cholesterol intake to 300 mg per day. Only foods of animal origin contain cholesterol. "TRANS" FAT: The FDA recently changed the labeling requirements for food, now requiring that labels contain not only the amount of fat contained in food, but also the amount of what is called "trans" fat, short for trans-fatty acids. This change is prompted by the recognition that trans fat poses some health risks. Understanding trans fat requires a brief chemistry lesson. Certain chemicals, such as fats, can occur in two similar but geometrically different forms called isomers. Isomers are basically the same chemical, but appear "backward" as if you held them in front of a mirror. These two backward shapes are the isomers, and are given the names "cis' and "trans." We have told you that the preferred fats are the unsaturated fats, and the fats to be avoided are the saturated fats ("sat fat"), and that sat fat is generally solid at room temperature and unsaturated fat is generally liquid at room temperature. The problem occurs in the preparation of margarine and shortening, where normally liquid unsaturated oils, in the "cis" configuration, are partially hydrogenated to make them solid,, whereby they become more saturated and are now in the "trans" configuration. Having said that, why are "trans" fat-containing margarines and shortenings a problem? The problem is that even though margarine contains mainly unsaturated fat, it has been changed to the trans configuration, which behaves as if it were saturated, raising the risk of heart disease, etc. Trans fat raises LDL (so-called "bad" cholesterol) and lowers HDL ("good" cholesterol). Trans fat also interferes with the metabolism of essential fatty acids (see that section) which serve many functions, such as the formation of healthy cell membranes and the production of prostaglandins. Alterations in essential fatty acid metabolism have been linked to an increased risk of certain cancers including breast cancer. It is for this reason that the labeling change to include trans fat was made and why our advice at Nature's Healthcare is to avoid trans fat, so much so that we now believe it is wiser and healthier to use butter sparingly than margarine liberally, and shortening never. ANTIOXIDANTS Normal cellular metabolism produces substances called "Free Radicals." If left unchecked, free radicals are capable of producing cellular damage, and they are felt to be involved in the development of certain cancers, of cardiovascular disease, and in the cellular destruction that accompanies aging. The compounds that keep free radicals in check are called "Antioxidants." Consumption of antioxidants has been shown to reduce the risk of cardiovascular disease and cancer, and may slow the aging process. The major antioxidants are: Vitamin C. Vitamin E. Carotenoids, mainly beta-carotene. Selenium. Flavonoids. Antioxidant supplementation is more effective when taken as a group rather than selecting a specific antioxidant to be taken alone and the best way to obtain antioxidants is felt to be from a combination of supplementation along with a diet high in antioxidant-containing foods. For a more detailed explanation of the role of antioxidants in health and wellness, see our separate outline on this subject. In short, the following general guidelines can be given as a means to achieve better health and to reduce the risk of developing cardiovascular disease, cancer, certain inflammatory conditions, and to possibly slow the aging process. No supplement, including antioxidants, can be a substitute for a healthy and balanced lifestyle. Certain conditions and lifestyle issues, such as smoking and certain inflammatory conditions, increase the oxidative stress experienced by the body, and supplementation is no substitute for smoking cessation or the appropriate treatment of inflammation. Antioxidants should be obtained from a combination of dietary and supplemental sources. And individual antioxidant supplements should be avoided in favor of combination or multiple antioxidants. Dietary Sources of Antioxidants: Carotenoids and Vitamin A can be found in: Green leafy vegetables. Yellow and orange vegetables and fruits such as carrots, mangoes, squash, apricots, and yams. Legumes, grains, and seeds. ANIMAL PROTEIN Consumption of animal protein has been linked to a variety of disorders, including heart disease, osteoporosis, kidney disease, and a variety of degenerative disorders including osteoarthritis. It can be difficult to separate the effects of the animal protein from the effects of the animal fat, as they are consumed together. It is quite possible that each plays a separate role, a sort of dietary double whammy. It does appear that the source of the protein is more important than the amount of protein. Vegetarians who consume an equal amount of protein as do omnivores but from vegetarian sources have a lower risk of the conditions listed above. Patients with Rheumatoid Arthritis improve when placed on a vegetarian diet. Animal protein is a source of arachadonic acid, which is a precursor in the synthesis of what are called Series II prostaglandins. Prostaglandins are substances produced by the body and serve a number of functions. The Series II prostaglandins are felt to be inflammatory, and they are known to increase the adhesiveness of platelets, which are involved in the evolution of heart attacks and strokes. The advice on animal protein is to consume as little as possible. The American Heart Association and a number of other advisory panels set a limit on animal protein consumption at 4-6 ounces per day, with that coming from lean beef, skinless poultry, and fish. There is no limit set on the consumption of cold water fish such as salmon, herring, mackerel, albacore tuna, and halibut, as these fish are rich in omega 3 fatty acids. SUGAR CONSUMPTION Sugars are carbohydrates, and carbohydrates are sugars. That is, all carbohydrates are ultimately broken down by the body to yield sugars, which then serve as a source of energy in the form of calories. There are a number of different terms used to describe sugars and carbohydrates, such as simple sugars, refined sugar, complex carbohydrates, etc. Complex carbohydrates are also called starches. The distinction lies in the degree to which they must be metabolized in order to yield calories. Simple and refined sugars yield calories quickly with little metabolic breakdown, and complex carbohydrates yield calories more slowly through a more lengthy metabolic process. Sugars and carbohydrates directly effect blood sugar levels, which then effects blood insulin levels. High levels of insulin have been linked to heart disease and stroke. Thus, dietary intake of sugar can have a direct impact on our risk for these serious medical problems. Sugar intake also has an impact on the following: Our risk of cardiovascular disease, heart disease and stroke, by its effect on insulin levels. Tooth decay: the more often we consume sugars, and the longer the time between eating sugars and brushing, the greater the risk of tooth decay and cavities. Hyperactivity and Mood Disorder: Diets high in sugar do not cause hyperactivity, but they may have a role in its severity. Sugar consumption also seems to influence mood swings in PMS, anxiety, depression, and ADD/ADHD, so much so that minimizing sugar intake is advised as part of the overall treatment plan for these conditions. Weight Control and Obesity: Sugar provides calories, a lot of calories, but little nutritional value. As such, nutrients must be obtained from other sources, which also contain calories. This makes sugar a sitting duck in weight control, as minimizing sugar consumption can eliminate calories without sacrificing nutrition content. Sugar substitutes: Sugar substitutes such as aspartame and sorbitol can provide suitable taste with no calories. However, the mere presence of a sugar substitute does not necessarily mean a low calorie food. Reading labels is still required to determine calorie content. Where will I find sugars: Read labels. Minimize consumption of anything that shows the following on the label, which will generally indicate that sugar has been added: sucrose, glucose, maltose, lactose, fructose, or corn syrup. sugars are also found in high amounts in the following foods: candies, cookies, cakes, doughnuts (most bakery goods), jellies, syrups. So, what guidelines do I follow to reduce my sugar intake? Read labels. Look for the "sugar words." Avoid/minimize prepared and processed foods. Avoid/minimize the foods listed above as being high in sugar Restrict calories from sugar as follows: for 1600 calories per day, allow 6 tsp of sugar. for 1800 calories per day, allow 12 tsp of sugar. for 2200 calories per day, allow 18 tsp of sugar.

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