Human touch meets nutrition

I recently encountered the following statement…

“Physician and author Abraham Verghese argues that the most important innovation to come in medicine in the next 10 years is human touch.”

…and was asked to discuss it. Here’s what I said:

I spent the last five years doing a PhD in nutrition with a goal to understand how diet can prevent disease. One thing I realized during this degree is that the most efficient way to prevent disease is to nourish optimally during the first 1000 days of life—a time when breast milk is the most important source of nutrition. Unfortunately, too many women can’t breastfeed, or choose not to, or have circumstances that prevent it. What I’ve learned is that technological innovation cannot fix this problem. Even if formula companies created a powder that perfectly matched the composition of breast milk, it wouldn’t matter. That’s because the nourishment an infant receives when it breastfeeds is only partially due to the physical constituents of the milk itself. Studies have shown that skin-to-skin contact…the touch between the mother and her child is the key. Touch is what enables the mother to produce the specific antibodies for the germs her baby has been exposed to. Touch is what enables optimal development of the baby’s jaw, teeth and facial structure. And most importantly, touch stimulates greater oxytocin release in the mother which makes her more confident, improves her mood, lessens her stress, strengthens her bond with her child and increases her desire to care for her baby. Therefore, innovation in formula technologies won’t fix the health issues that stem from the earliest days of life. Because the preventative health benefits of breastfeeding are as much due to touch as they are to nutrition.

 

My 5 Tenents of Healthy Eating

Having studied nutrition for more than ten years, I’ve reached the conclusion that the gist of healthy eating can be explained by five principles…the first two are borrowed from Plato

1)Know Thyself

Ultimately, everyone’s ideal diet is different.

Thus, there’s no secret to eating-well, it depends on you…and your genes, how much you exercise, your occupation, your culture, how much stress you’re under, what you like/dislike, and so much more.

Hence, what works for someone else, may or may not work for you. So try everything, self-experimentation is vital!

Also, it’s important to know that what works for you today, may not work for you tomorrow or six months from now, or six years from now. We are constantly changing and thus our diets must also change over time.

2)Nothing in Excess

We overeat. And there are two main reasons why.

First, we overeat because we don’t eat real food. Consider real food, like raw nuts, such as almonds.

nuts

Even if you were really hungry, how many almonds could you possibly eat? Ten…maybe fifteen? After all of the laborious chewing and the consistent earthy taste you eventually stop eating.

Now, contrast that with chips…when hungry, one could easily eat an entire bag and still crave more! This is the problem. Processed food is engineered to taste too good, and that a big part of the reason why we can’t stop eating it.

The second reason we overeat is that our meals lack balance…balance is the third principle of healthy eating.

3)Balance

The most important piece of advice that I can give anyone is this…when it comes to lunch and dinner, strive to fill half your plate with vegetables, then fill approximately one-quarter with carbohydrates (like bread, rice, pasta) and one-quarter with protein (like meat, fish and beans).

This is what healthy eating looks like…

And with respect to breakfast, you can leave off the vegetables and combine carbohydrates and protein. Like this…

breakfast pic

While every single meal doesn’t have to perfectly meet these proportions, every lunch and dinner should have all three components: carbs, protein and vegetables, plus some fat (1 tablespoon of oil/butter for every two cups) alongside the vegetables to enable the absorption of the nutrients they contain.

Too often, we eat unbalanced meals consisting of only one type food, such as a dish of pasta. The problem with a carb-only meal is that it is digested too quickly, and then leaves us feeling hungry again within hours. This can easily be solved by combining different types of foods (like carbs, protein and fat). The body has to work harder to digest all of these different types of food, and by making the job harder, we feel more satisfied in the long run.

Similarly, too often we eat unbalanced meals that leave out a food group, like carbohydrates, a classic dieter’s tactic. This is equally troublesome because many different signals need to be sent from our digestive system to our brain in order to feel full. These different signals are stimulated by different foods…so while some are released after the ingestion of carbs, others are stimulated by fat and protein. Thus, if you leave out a particular food group, certain signals never get sent and the brain keeps telling the body it’s hungry. Furthermore, leaving out carbs is one of the worst things you can do, because the satiety signals that are stimulated by carbohydrates amplify the signals stimulated by protein and fat. So the bottom line is, you won’t feel full unless you’ve got carbohydrates, protein and fat in each meal meal.

4)Structure

When you eat can be as important as what you eat. Ideally you should strive to maintain a consistent meal pattern throughout the day. Whether it’s three meals a day, or three meals plus two snacks, figure out what works for you and stick with it because one of the root causes of overeating is meal-skipping, which always leads to uncontrollable eating later on.

5)Make treats, treats

It’s perfectly okay to indulge yourself every once and a while, just don’t make a habit of it.

That’s it. That’s the gist of what you need to know. Too often we get caught up in the details, but in fact, eating-well is about the big picture. In order to be healthy, remember:

  • You’re the only one who can figure out what your ideal diet is
  • Create a meal schedule that works for you and stick to it
  • Balance your meals
  • Avoid overeating by eating real food instead of processed foods
  • Treat yourself, sometimes

The foundation of a healthy diet is that simple.

VEGGIES + FAT = BETTER TOGETHER…a lesson in how to absorb the most nutrients from your vegetables

Did you know that when you eat raw carrots you only absorb 1-3% of the beta-carotene they contain?1

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That’s right, eating vegetables, raw—with no dressing, no dip, or no oil—is the surest way to miss-out on some of the most important nutrients nature has to offer.

The best evidence of this comes from a study published in the American Journal of Clinical Nutrition in 2004. In the experiment, they fed subjects three different salads and measured the amount of carotenoids (a specific class of nutrients, explained below) they absorbed.

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The catch is…the first salad contained fat-free dressing, the second contained reduced-fat dressing, and the third contained full-fat dressing.

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What did they find?

When people ate salad with full-fat dressing they absorbed FORTY-TIMES more beta-carotene compared to when they ate salad with fat-free dressing!

The morale of the story is, without fat, you simply can’t absorb certain nutrients!

So what are carotenoids anyway?

Carotenoids are antioxidant superstars that can improve cognition in older adults,2 stave off age-related macular degeneration,3 help prevent heart disease,4 and reduce risk for lung, stomach, colorectal, prostate and liver cancer.5

Chemically, they look like this…

beta-carotene

…and they’re what give plants their colour. Hence, they can be found in vegetables that are red, orange or yellow…

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…and they’re also abundant in dark leafy greens.

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But fat is not the only way to maximize absorption…

Lycopene, a type of carotenoid found in tomatoes, is the perfect example of this. Lycopene came into the limelight in the early 2000s when it was linked with decreased risk for cancer. But the catch is you can’t reap the benefits of lycopene by simply eating raw tomatoes.

This is precisely why Bolognese sauce—a meat-based tomato sauce that originated in Bologna, Italy, and is the Sunday dinner staple in my home…no bias here—is a masterpiece of both culinary and nutritional merit.

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Bolognese sauce exploits the tomato and maximizes your ability to absorb the lycopene it contains. Consider this:

  • By crushing tomato, lycopene absorption is increased6
  • By cooking tomato, lycopene absorption is increased even more(note: cooking usually produces a three-fold increase in absorbability)8
  • And by adding meat, you’re also adding fat; hence lycopene absorption is increased even more

Thus, everything about Bolognese sauce maximizes our absorption of the lycopene it contains, making it a delicious vehicle for maximum nutrient absorption.

Speaking of dishes that are both culinary and nutritional masterpieces, the Cobb salad is another perfect example…

In case anyone’s not familiar, the classic Cobb salad combines leafy greens with tomato, chives, avocado, cheese, chicken breast and its star ingredient…a boiled egg!

A study published in 2015 in the American Journal of Clinical Nutrition showcased the genius of the Cobb salad by demonstrating that co-consuming cooked eggs with salad increases carotenoid absorption three to eight fold.

But let’s back up for a second to talk about eggs, because they’re one of those foods that makes a nutrition geek like me sit back in awe of the amazing synergistic nutrient combinations found in nature.

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Remember how I said earlier that carotenoids are what give vegetables their colour? Well, carotenoids are also what make egg yolks orange/yellowish. As a result, egg yolk is one of the most easily absorbable sources of carotenoids because they contain carotenoids in combination with the fat necessary for absorption. And it doesn’t end there; yolks don’t contain just any-old kind of fat. In fact, they contain a special type of phospholipid that has been shown to specifically enhance carotenoid absorption.9, 10 Therefore, this is an example of how some nutrients are just meant to be together and how nature can be the best clue to finding these synergistic combinations.

And then there’s avocado…

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Avocado is another food that contains carotenoids in combination with the ideal kind of fat to aid absorption. Furthermore, one study showed that adding a cup of avocado to salsa resulted in 4.4 times greater lycopene absorption and 2.4 times greater beta-carotene absorption.11 Hence, avocado with salsa—a staple of Mexican cuisine—is not just a flavor match made in heaven, but also a nutritionally wise pairing. Not to mention, the avocado in Cobb salad is another nod to that genius combination of ingredients.

But how much fat is needed to maximize absorption?

Presently, there’s no definitive answer. But after browsing the literature, it seems a 1:2 ratio…

ONE tablespoon of oil (or any kind of fat such as salad dressing, butter, etc.) for every TWO cups of vegetables

…is a good rule of thumb.

Keep in mind, we don’t always eat vegetables in isolation, and in the context of a meal, there’s probably going to be fat coming from elsewhere, in which case, you could potentially add less without compromising absorption.

Meanwhile, in the “egg study” they compared the effect of 3 eggs versus 1.5 eggs on absorption of carotenoids from approximately 3 cups of salad. They found with more eggs, more nutrients were absorbed. But in the context of a cobb salad, when you factor in the fat coming from the bacon, avocado and chicken, the standard one egg-per-salad is probably good enough.

In Conclusion…

I have to admit, I wrote this blog, because I was formerly guilty of eating raw vegetables solo…who among us has not eaten a salad, sans dressing, in an effort to lose weight?

Hopefully, this post will help you dip that carrot guiltlessly, and add a little more olive oil to your salad, because at the end of the day, health is about balance, and vegetables were meant to be consumed with fat!

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References:

  1. Hedren E, Diaz V, and Svanberg U. Estimation of carotenoid accessibility from carrots determined by an in vitro digestion method. Eur J Clin Nutr, 2002. 56(5):425-30.
  2. Johnson EV, R; Mohn, E; Haddock, J; Rasmussen, H; Scott, T;. Avocado consumption increases neural lutein and improves cognitive function. The FASED Journal, 2015. 29(1 Supp. 3.28).
  3. Piermarocchi S, Saviano S, Parisi V, Tedeschi M, Panozzo G, Scarpa G, et al. Carotenoids in Age-related Maculopathy Italian Study (CARMIS): two-year results of a randomized study. Eur J Ophthalmol, 2012. 22(2):216-25.
  4. Liu S, Lee IM, Ajani U, Cole SR, Buring JE, and Manson JE. Intake of vegetables rich in carotenoids and risk of coronary heart disease in men: The Physicians’ Health Study. Int J Epidemiol, 2001. 30(1):130-5.
  5. Ito Y, Suzuki K, Ishii J, Hishida H, Tamakoshi A, Hamajima N, et al. A population-based follow-up study on mortality from cancer or cardiovascular disease and serum carotenoids, retinol and tocopherols in Japanese inhabitants. Asian Pac J Cancer Prev, 2006. 7(4):533-46.
  6. Brown MJ, Ferruzzi MG, Nguyen ML, Cooper DA, Eldridge AL, Schwartz SJ, et al. Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. Am J Clin Nutr, 2004. 80(2):396-403.
  7. Dewanto V, Wu X, Adom KK, and Liu RH. Thermal processing enhances the nutritional value of tomatoes by increasing total antioxidant activity. J Agric Food Chem, 2002. 50(10):3010-4.
  8. Priyadarshani AM. A Review on Factors Influencing Bioaccessibility and Bioefficacy of Carotenoids. Crit Rev Food Sci Nutr, 2015:0.
  9. Baskaran V, Sugawara T, and Nagao A. Phospholipids affect the intestinal absorption of carotenoids in mice. Lipids, 2003. 38(7):705-11.
  10. Lakshminarayana R, Raju M, Keshava Prakash MN, and Baskaran V. Phospholipid, oleic acid micelles and dietary olive oil influence the lutein absorption and activity of antioxidant enzymes in rats. Lipids, 2009. 44(9):799-806.
  11. Unlu NZ, Bohn T, Clinton SK, and Schwartz SJ. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. J Nutr, 2005. 135(3):431-6.

My Search for the Perfect Probiotic

Since Ancient Rome they’ve been prescribed for upset stomach, and today they’re clinically proven to treat numerous digestive issues. They can prevent allergies in infants, and have even been linked with decreased risk for anxiety and depression…wondering what I’m talking about? PROBIOTICS, of course!

The truth is, I’ve been thinking a lot about probiotics lately. And embarrassingly, it’s because I rarely eat them. Hence, I resolved to learn more about probiotics and incorporate them into my life…here’s what happened…

First, because of…let’s just call it my restricted dairy intake…I got excited about the idea of drinking Kombucha tea. Kombucha tea is an ancient beverage that has become somewhat of a health fad these days. Initially, I thought I could buy Kombucha tea at my local specialty tea store. And while they do sell Kombucha tea leaves, this isn’t the real deal, as it’s impossible for dry tea leaves to contain probiotics, because outside of a cool environment, probiotics die. While there are some “spore” varieties that will supposedly hatch after being heated, I couldn’t find any of those on stores shelves.

As for making Kombucha tea from scratch…it would definitely be a “dairy-less” way to get probiotics, however, without being able to verify which strains are in the starter culture, I wasn’t too eager to invest my time. Plus, I read too many case reports of people getting sick from “suspicious” starter culture. Hence, I decided to keep searching for another probiotic food choice.

There’s always yogurt, of course. But after some reading I realized that nearly all of the “big name” commercial probiotic yogurt brands only contain one or two specific strains, and none of them carried the strains that seemed to me to be the most beneficial, namely L. casei and L. rhamnosus.

Then I came across Kefir.

Kefir

Kefir has been called the “champagne of probiotic milk beverages” and has been around since ancient times. Kefir is fermented milk, so it’s basically just like yogurt except it’s a little more “liquedy”.  But more importantly, unlike many probiotics yogurts, Kefir contains ten different strains of probiotics, including the two I was looking for!

So I bought it! And I tried it! I didn’t notice any immediate changes in how I felt, but coincidentally after I started drinking it someone told me that I looked different and specifically asked me if I had changed my probiotics routine! It was quite a shocking coincidence!

But then I sat down with a friend of mine, Richard You-Wu, an MD-PhD candidate who specializes in gastrointestinal health. He set me straight on some probiotic facts that initially changed how I felt about them.

First, while I thought that more strains meant more benefits, Richard said, “it’s not as simple as saying that more is better or diversity is better.” As a matter of fact, he explained that some probiotics can antagonize others, meaning mediocre probiotic strains may out-compete healthier probiotic strains. So with a mixed bag, there’s no guarantee that you’ll get a sufficient quantity of the kind you’re looking for.

The other thing that sold me on Kefir is that each half cup contain two billion probiotics, which is often the amount used in scientific studies. Interestingly, Richard explained that we don’t know enough about dosage. He even commented that no one even knows why we use the current dosages we use; they were just randomly picked at some point.

After hearing about all of the uncertainty surrounding the science of probiotics, I started to feel less thrilled about the whole idea of “health enhancing bacteria”. But when I asked Richard about the coolest thing he’s ever learned about probiotics, I was reassured of the miraculous ability of these microorganisms. Deep down inside me, my gut instinct (no pun intended) tells me they really do belong in our diets. And while we presently don’t have all the details sorted out, I think it’s hard to deny that they have some serious potential to heal people. Here’s what Richard told me…

“The coolest thing I’ve learned about probiotics, goes back to my second year when I was 19 and I was working in a research lab…I was looking at how the gut moves, (called) peristalsis… (which is) a wave motion that moves food down your gut. I had a sick animal (in whom) peristalsis did not happen, there was no movement and no stool passing down, which would result in harm for the animal. But I noticed that when I put a certain strain of probiotics inside their intestine, after about 5-10 minutes, I saw a full recovery of movement in the gut. It regained its function and you could see movement. Just one type of bacteria was able to do that! That was the first time that I saw how something as small as a probiotic could cause an organ to regain its function.”

I don’t know about you, but after hearing this, I think the future of probiotics looks bright!

RFF#100 – Your ethnicity may be a clue to your ideal diet

Nutrigenomics—the science that combines nutrition and genetics—is revolutionizing the traditional “one size fits all” approach to nutrition recommendations. Scientists are now discovering the gene variants that cause people to respond differently to the same nutrient. A closer look at omega 3 and 6 fatty acids offers a unique view of how nutrition, in combination with genes, dictates health.

By now, everyone has heard that omega 3s are good for your brain. However, omega 3 is a generic name for a family of fats. Docosahexaenoic acid (DHA), a specific type of omega 3 found in fish, krill and algae, is what your brain is made from. While humans have the ability to convert the type of omega 3 in walnuts and seeds into DHA, new research has shown that the degree to which these omega 3s are converted is dictated by your genes.

The scientist behind this discovery is Dr. Floyd Chilton, a full professor of Physiology and Pharmacology at Wake Forest University in North Carolina. In his research, Dr. Chilton has shown that 83% of African Americans are high converters (meaning they can readily convert ALA to DHA), in contrast to only 42% of European Americans. This makes perfect sense when you consider the geography of these regions. In the landlocked countries of Africa, people don’t have access to seafood, hence, they rely on nuts and seeds for their omega 3s. Meanwhile, Europeans don’t require the ability to convert DHA from these other sources, because they tend to get a rich supply from seafood. Biologically speaking, all of this works well, until people migrate and abandon their ancestral diets.

Presently in North America, “we almost have an omega 3 deficiency syndrome,” according to Dr. Chilton. Therefore, you’d think that it’s advantageous to be a high converter. Unfortunately, it’s not that simple. The ability to convert more omega 3s means you also have the ability to convert more omega 6s. This is problematic as Dr. Chilton explained “we have 40 years of studies showing that (omega 6s are) converted to a set of highly proinflammatory mediators… (and) their biochemistry suggests that they can impact inflammation in a potentially negative way.” Therefore, these genetic differences may partially contribute to disparities in health among different ethnic groups.

When asked about what led to this discovery, Dr. Chilton explained “one of the things that really got my attention is the inconsistency of the clinical trials, (this) led me to think that there must be something that we’re missing.” While some studies showed that omega 3s had great benefits, others showed no effect. Part of the reason for this is heterogeneity in the study populations, “when you mix everyone together, it becomes very difficult to make sense of it all.”

In conclusion, this story illustrates one of the great challenges in nutrition. Everyone is genetically different and thus, everyone’s ideal diet is different. As long as we continue conducting trials on genetically heterogeneous populations, it’s likely that we’ll continue seeing anomalies that create confusion and uncertainty. It’s the dawn of a new era in nutrition. Your optimal diet is likely a product of your genes, and while you may have not yet had yourself genotyped, your ethnicity may be a clue to guide you in the right direction.

Special thank you to Dr. Chilton for sharing his expertise. For more information on omega 3s and inflammation, please check out Dr. Chilton’s website www.genesmart.com which offers a wealth of resources.