Great Science on What We Should Eat

In recent years, medical researchers have recognized some common denominators in chronic degenerative diseases:  insulin resistance, long-term inflammation, high blood pressure, and cholesterol imbalance (to name a few).  In fact, several of these factors have been grouped together to form metabolic syndrome, a constellation of symptoms including at least 3 of the following 5 conditions:

• Fasting blood sugar (glucose) ≥100 mg/dL
• Blood pressure ≥130/85 mm Hg
• Triglycerides ≥150 mg/dL
• HDL-C ("good cholesterol") < 40 mg/dL in men or < 50 mg/dL in women
• Waist circumference ≥40 inches in men or ≥35 inches in women

I often talk to patients about dietary factors to reduce these risk factors, mainly focused on low glycemic index foods -- healthy foods that stabilize blood sugar and insulin levels throughout the day.  In a recent study (1), researchers used a dietary intervention for overweight middle-aged adults that significantly improved many of these markers for cardiometabolic risk.  Key components of the diet included the following:

• Antioxidant-rich fruits and veggies
• Omega-3 fatty acids (from fish oil)
• A focus on low glycemic index meals
• Viscous dietary fiber and plant sterols/stanols
• Whole grains, soybeans, and almonds
• Probiotic bacteria supplement

Sound familiar?  If you've been through FirstLine Therapy with me, this sounds an awful lot like that diet plan.  Most of these factors are available through sensible consumption of whole foods.  Some are more easily obtained through supplements (probiotic bacteria) or medical food meal replacements (viscous fiber, plant sterols/stanols).  And the results for good adherence to this diet?

• Total cholesterol decreased by 26%
• LDL ("bad cholesterol") decreased by 34%
• hs-CRP (a marker of systemic inflammation) decreased by 29%
• Systolic blood pressure dropped by 8%

Once again, science is showing that a common-sense, supplemented Mediterranean diet is as good as pharmaceuticals for improving cardiometabolic health -- without the side effects.

1.  Juscelino Tovar; Anne Nilsson; Maria Johansson; Rickard Ekesbo; Ann-Margreth Åberg; Ulla Johansson; Inger Björck.  A Diet Based on Multiple Functional Concepts Improves Cardiometabolic Risk Parameters in Healthy Subjects.  Nutr Metab. 2012;9(29).  Accessed August 29, 2012 at http://www.medscape.com/viewarticle/766177

Transitions

It's that time of year.

Yes, the weather is still blazing summer heat (though we've finally been getting a break now and then!), but we hit a transition in the last couple of weeks.  Somewhere in there, we reached the point where it's still dark outside when my 5:30am alarm goes off.  There's about a three-month period -- six weeks on either side of the summer solstice -- when I get to awake to glorious dawn light.  It's a natural part of our physiology:  It's much easier to get up and get started on the day that way, than to feel like my alarm is going off in nighttime darkness.

So this is my reminder that we're starting on the back half of the year, approaching autumn, sliding gradually toward the winter solstice, the days becoming shorter and shorter.  We're even getting back into the school year routine.

As we approach this transition, it's a good time to reflect on our health habits.

• I get energized in the early morning darkness with a contrast shower (most important as the weather gets cooler).  
• Take an inventory of your eating habits:  Did you take advantage of the abundant fresh fruits of summer, or use the hot weather as an excuse to indulge in too much ice cream, barbecue, and diet soda?  Reorient your thinking to the rich fall harvest of healthy veggies and lean meats.  
• As the days get shorter, it's also a time to think about getting your blood levels of vitamin D tested, since low levels of this "sunshine vitamin" have been associated with cardiovascular disease, autoimmune disease, seasonal affective disorder, and polycystic ovarian syndrome, to name a few.  
• And if the summer led to relaxation of your exercise routine, time to get back into some physical activity, since it's so critical to your health.

Even as we still enjoy the summer warmth, start thinking ahead to make the rest of the year vibrantly healthy.

Time to Go Gluten-Free?

I recently wrote an article about the growing popularity of gluten-free (GF) diets, and some healthy ideas for GF snacking.  A recent study (1) found that celiac disease, a genetic intolerance to wheat gluten, is much more prevalent in the United States than previously thought -- about two million Americans have celiac disease, and most don't know it.

My previous article goes into more detail about the difference between celiac disease, and the less severe (and also less well-defined) condition called gluten intolerance.  The authors of the current study found that many people who follow a gluten-free diet (GFD) do not have actual celiac disease.  According to a report about this study on Medscape,

...the authors emphasize that embarking on a GFD without first confirming the diagnosis of CD is not a good idea.

“Symptomatic improvement of gastrointestinal symptoms after gluten withdrawal is considered a poor predictor of a CD diagnosis,” the authors note. "Self-treatment with a GFD is not recommended and should be discouraged.”

 Okay -- read that last paragraph again.  They're saying that feeling better is not a good reason to avoid gluten.  You must have celiac disease in order to follow a GF diet.  Huh?  Now there is conventional medical thinking at its finest:  You can't have the medicine unless you have a specific disease.  In this case, the medicine is a GF diet.  There is absolutely no reason to keep eating gluten if you feel better while avoiding it!

Just remember one caveat:  If you decide to experiment with a GF diet, maintain healthy, balanced food choices.  Don't just substitute our gluten-saturated Standard American Diet (S.A.D.) with gluten-free versions of junk food.  A lot of foods marketed as GF are highly processed.  Stick with the whole foods approach, and kick your health into high gear.

1.  The Prevalence of Celiac Disease in the United States.  Am J Gastroenterol advance online publication 31 July 2012; doi: 10.1038/ajg.2012.219