Category Archives: Diets

Parkinson’s Disease risk decreased by Nicotine intake; Eat more potatoes, tomatoes, and Peppers!

Peppers, Eggplant, tomatoes, potatoes have nicotine, which seems to decrease the risk of Parkinson's Disease.
Peppers, Eggplant, tomatoes, potatoes have nicotine, which seems to decrease the risk of Parkinson’s Disease.

Nicotine from edible Solanaceae and risk of Parkinson disease

There have been found associations of cigarette smoking with a decrease in the occurrence of Parkinson’s Disease (PD):

Parkinson’s Disease Risks Associated with Cigarette Smoking, Alcohol Consumption, and Caffeine Intake

The abstract of this study is below in which smoking and coffee intake both currently decrease the risk of PD:

A reduced risk for Parkinson’s disease (PD) among cigarette smokers has been observed consistently during the past 30 years. Recent evidence suggests that caffeine may also be protective. Findings are presented regarding associations of PD with smoking, caffeine intake, and alcohol consumption from a case-control study conducted in western Washington State in 1992–2000. Incident PD cases (n = 210) and controls (n = 347), frequency matched on gender and age were identified from enrollees of the Group Health Cooperative health maintenance organization. Exposure data were obtained by in-person questionnaires. Ever having smoked cigarettes was associated with a reduced risk of PD (odds ratio (OR) = 0.5, 95% confidence interval (CI): 0.4, 0.8). A stronger relation was found among current smokers (OR = 0.3, 95% CI: 0.1, 0.7) than among ex-smokers (OR = 0.6, 95% CI: 0.4, 0.9), and there was an inverse gradient with pack-years smoked (trend p < 0.001). No associations were detected for coffee consumption or total caffeine intake or for alcohol consumption. However, reduced risks were observed for consumption of 2 cups/day or more of tea (OR = 0.4, 95% CI: 0.2, 0.9) and two or more cola drinks/day (OR = 0.6, 95% CI: 0.3, 1.4). The associations for tea and cola drinks were not confounded by smoking or coffee consumption. Am J Epidemiol 2002;155:732–8.

But cigarette smoking is bad for your lungs, increasing cancer risks and emphysema among other things, so why would anyone want to smoke just to decrease PD risk? Is there another way to decrease PD risk and why do cigarettes work for PD?

  • The study at the top of the page (ANN NEUROL 2013;74:472–477) helps demonstrate the possibility that nicotine is neuro-protective among all the millions of compounds found in cigarette smoke.
  • Nicotine is derived from nicotiana spp. of solanaceae species which includes capsicum and solanum species whose edible fruits and tubers include peppers, eggplants, potatoes, and tomatoes. All of these have nicotine in them. In peppers, there is approximately 102 micrograms/kg, while tomatoes have 43 mcg/kg of nicotine. A potato has ~19 mcg/kg of nicotine. Since we consume more tomatoes and potatoes than peppers, they make up most of the nicotine consumption in people.
  • It is noted that nicotine stimulates alpha4beta2 (a4B2) receptors in the brain which protect dopaminergic neurons by binding the receptors. This may be how PD is prevented.
  • In the study, 490 people with PD were assessed for vegetable intake, in particular peppers, tomatoes, and potatoes. It  was found that PD frequency was inversely related to solanaceae intake but not other vegetables, in particular peppers. Weighted for those with the most nicotine intake,  those with the highest nicotine consumption had the lowest frequency of PD. There were 644 controls in this study.
  • After calculating risks, pepper consumption 2-4 times a week was associated with a 30% reduction in PD risk in people who did not smoke.
  • The food impact was highest in non-smokers since the nicotine content in food is so much lower than the intake of nicotine in active smokers.
  • There was an inverse association of PD in consumption of tomatoes (Fall PA, Fredrikson M, Axelson O, et al. Nutritional and occupational factors influencing the risk of Parkinson’s disease: a casecontrol study in southeastern Sweden. Mov Disord 1999;14:28–37) , potatoes ( Hellenbrand W, Seidler A, Boeing H, et al. Diet and Parkinson’s disease. I: A possible role for the past intake of specific foods and food groups. Results from a self-administered food-frequency questionnaire in a case-control study. (Neurology 1996;47: 636–643) and a Mediterranean Diet with tomatoes ( The Association between Mediterranean Diet Adherence and Parkinson’s Disease ) [ Abstract: The most consistent data support the association between higher consumption of dairy products and increased PD risk. More recently, a prospective analysis of two large cohorts, the Health Professionals Follow-Up Study (HPFS) and the Nurses’ Health Study (NHS), revealed an association between PD risk and dietary patterns as assessed by the Alternate Healthy Eating Index (AHEI) and the alternate Mediterranean Diet Score. The Mediterranean diet (MeDi) has received attention in recent years because of growing evidence associating MeDi with lower risk for AD, cardiovascular disease, several forms of cancer, and overall mortality.The MeDi is characterized by high intake of vegetables, legumes, fruits, and cereals; high intake of unsaturated fatty acids (mostly in the form of olive oil) compared to saturated fatty acids; a moderately high intake of fish; a low to-moderate intake of dairy products, meat and poultry; and a regular but moderate consumption of ethanol, primarily in the form of wine and generally during meals. This study suggests that lower adherence to MeDi is associated with PD status. The association persisted after adjustment for multiple potential confounders. The fact that among PD participants, lower adherence was associated with earlier PD age-at-onset further suggests a possible dose-response effect. The relation between MeDi adherence and PD status was not driven by any individual category of the diet but rather the whole pattern. Previous studies have indicated that environmental factors play a major role in PD; however, most nutritional studies in PD have shown conflicting results. Possible explanation for the conflicting data is that most studies have focused on single nutrients, e.g. vitamins C or E,7,  rather than on dietary patterns. Indeed, the largest prospective study of dietary patterns identified a Mediterranean-like diet as protective of PD both in males (HPFS) and females (NHS). Assessing dietary patterns may be more informative than assessing specific nutrients separately. First, this approach is more consistent with individuals’ eating habits, and second, it takes into account interactions among nutrients. This approach has been successful in AD and in non-neurological diseases.The mechanism by which MeDi may be protective in neurodegenerative disorders is largely unknown. Mechanisms that have been hypothesized in the AD literature, include oxidative stress and inflammation. Indeed, oxidative stress has been implicated in the pathogenesis of PD.  Complex phenols and other substances including vitamin C, vitamin E, and carotenoid may serve as antioxidants,  and are found in high concentrations in the typical components of the MeDi. Inflammation has also been implicated in the pathogenesis of PD, and anti-inflammatory non-steroidal medications may be associated with a lower risk for PD. Adherence to the MeDi may attenuate inflammation. In addition, MeDi adherence may be protective because of lower consumption of compounds which are associated with higher PD risk. We and others have shown an association between animal fat consumption and PD,  and the association between higher dairy intake and PD was previously reported.]
  • There are still unknowns in this study – i.e relative to smoking, diet is a modest contributor of nicotine. Biological effects of Solanaceae nicotine has not been established but substantial a4B2 nicotine receptors are occupied without active smoking in patients who take in solanaceae products.As compared to smoking, smokers with just a puff get enough nicotine to occupy a third of the receptors for more than three hours. It is also unknown if french fries, salsa, sauces, or fried potatoes give a similar nicotine effect as the original vegetable.
  • There may be other neuroprotective chemicals in these vegetables such as Anatabine, which is antiinflammatory and has less toxicity. Anatabine Ameliorates Experimental Autoimmune thyroiditis << Key components: Tobacco smoking has numerous detrimental effects on human health, but it has also been associated with a few apparent salutary actions, including the amelioration of autoimmune (Hashimoto) thyroiditis and ulcerative colitis. Smokers in the Third National Health and Nutrition Examination Survey were found to have lower prevalence of thyroperoxidase and/or thyroglobulin antibodies than nonsmokers (1). This protective effect of smoking was confirmed in two additional cross-sectional studies, one from the Amsterdam autoimmune thyroid disease cohort (2) and the other from the Danish population (3), as well as in a 5-yr prospective study also based on the Amsterdam autoimmune thyroid disease cohort (4). In the prospective study, cigarette smoking women who had one or more relative with documented thyroid autoimmunity but no thyroid dysfunction or autoantibodies at study entry showed lower odds of developing thyroperoxidase and/or thyroglobulin antibodies (4). Similarly in ulcerative colitis, smoking has been shown to decrease flares (5), hospitalizations (6), and a need for oral glucocorticoids (7) so that low-dose smoking resumption has been successfully used in ex-smokers with refractory disease (8). The mechanisms underlying this influence of tobacco smoking on some autoimmune diseases have been related to the effects of tobacco components on the immune system (9). There are numerous (4000) components in tobacco, including alkaloids (such as nicotine and anatabine), gases (e.g. carbon monoxide), and carcinogens (e.g. polycyclic aromatic hydrocarbons, aldehydes, free radicals, and solvents), and of them nicotine is known to possess antiinflammatory properties (10). Nicotine acts via binding to the nicotinic receptor, a pentameric ion channel (mainly for sodium and calcium) formed by the arrangement of 16 different subunits in hetero- or homomeric conformations (11). The receptor is classically expressed in the peripheral (all preganglionic fibers and neuromuscular synapses) and central nervous system, but more recently it has been described in cells of the immune system, including CD4 T lymphocytes, dendritic cells, and macrophages (12). Indeed, the 7-homopentameric nicotinic receptor has emerged as a novel therapeutic target for diseases with an inflammatory pathogenesis (13). Nicotine has been used successfully in mice with experimental autoimmune encephalomyelitis in which it reduced disease severity, shifting the autoimmune profile from pathogenic Th1 and Th17 responses to protective Th2 responses (14). Nicotine, however, cannot be used in humans because it is addictive and toxic and has a short 3-h plasma half-life. Consequently, we reasoned that other alkaloids of tobacco could share similar antiinflammatory properties but have a more favorable pharmacological profile. The minor tobacco alkaloid anatabine is nonaddictive and nontoxic at therapeutic doses and has a longer 8-hr half-life. Furthermore, anatabine has been recently shown to inhibit nuclear factor-B (NF-B) activation and reduce neuroinflammation in a mouse model of Alzheimer disease (15). In the present study, we therefore tested the antiinflammatory properties of anatabine in a mouse model of experimental autoimmune thyroiditis.  Anatabine is an alkaloid with a structure similar to nicotine, found in tobacco and other solanaceous plantsas tomatoes, potatoes, green pepper, and eggplant. Its lack of addictive potential or any demonstrated toxicity. Given the structure similarity with nicotine, we postulated that anatabine initiates its effects by binding to the nicotine receptor and modulating the cholinergic control of inflammation (10, 24). The nicotinic receptor that has been clearly associated with antiinflammatory responses is the 7-homopentamer, classically found on neural cells but also on immune cells (12). Activation of the 7-nicotinic receptor present in lymphocytes, dendritic cells, and macrophages has been shown to suppress nuclear translocation of NF-B and transcription of high mobility group box 1, ultimately decreasing danger signals that initiate inflammation (25). Consistent with this mechanism, Paris and colleagues demonstrated that anatabine suppresses in a dose-dependent manner the transcription of NF-B induced by tumor necrosis factor- (15). However, anatabine suppressed the thyroidal expression of IL-18 and IL-1R2. IL-18, a member of the IL-1 family, is produced by activated macrophages and stimulates production of interferon- from T cells and natural killer cells (26), overall acting as a proinflammatory stimulus. IL-18 has been shown to increase during thyroid inflammation both in vitro (27) and in vivo (28) ]
  • Capsinoids in peppers and capsaicinoids in spicy peppers may activat TRPV1 (Transient Receptor Potential Cation Channel subfamily vanilloid member 1) in the midbrain dopaminergic neurons. This seems to e protective. Transient Receptor Potential Vanilloid Subtype 1 Mediates Cell Death of Mesencephalic Dopaminergic Neurons In Vivo and In Vitro and Somatostatin prevents lipopolysaccharide‑induced neurodegenration
  • Major nutritional issues in the management of Parkinson’s disease

Summary: To safely decrease your risk of Parkinson’s disease, increase your peppers, tomatoes, potatoes, and eggplant intake. They have nicotine that when consumed, is protective of dopaminergic receptors of your brain and seem to decrease the risk of PD.

Diet and Parkinson’s disease I A possiblerole for intake of specific foods and food groups

Systematic review and meta-analysis of hydrocarbon exposure and the risk of Parkinson’s disease.

Metals and Neuronal Metal Binding Proteins Implicated in Alzheimer’s Disease.

Outdoor work and risk for Parkinson’s disease

Inverse associations of outdoor activity and vitamin D intake with the risk of Parkinson’s disease.

Iron and Oxidative Stress in Parkinson’s Disease An Observational Study of Injury Biomarkers

Can Tea Consumption be a Safe and Effective Therapy Against Diabetes Mellitus-Induced Neurodegeneration

Parkinson’s disease no milk today

Parkinson’s Disease Risks Associated with Cigarette Smoking, Alcohol Consumption, and Caffeine Intake n

Ferritin levels in the cerebrospinal fluid predict Alzheimer’s disease outcomes and are regulated by APOE

HFE gene variants, iron, and lipids a novel connection in Alzheimer’s disease.

Diet and Parkinson’s disease I A possiblerole for intake of specific foods and food groups

Vitamin D and Sunlight Exposure in Newly-Diagnosed Parkinson’s Disease.

parkinsons and solanaceum

Dietary fats, cholesterol and iron as risk factors for Parkinson’s disease

 

Eat your Fresh Fruit! – for better cardiovascular health: Latest New England Journal April 11, 2016

A recent study released in the April 10 edition of The New England Journal of Medicine demonstrated that fresh fruit consumption was associated with decreased blood pressure and decreased blood glucose.

Fresh Fruit Consumption and Major Cardiovascular disease in China

Increased fresh fruit consumption was associated with decreased risk of cardiovascular disease, decreased cardiovascular death, decreased coronary events, decreased hemorrhagic stroke, and decreased ischemic strokes.

fruits1

Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer_ systematic review and dose-response meta-analysis of prospective cohort studies

Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases.

Dietary Nitrate Lowers Blood Pressure

Fruit and vegetable consumption and all-cause, cancer and CVD mortality analysis of Health Survey for England data.

Fruit and Vegetable Consumption and Risk of CAD – a metanalysis of cohort studies

Quantity and variety in fruit and vegetable intake and risk of coronary heart disease

Greater Total Antioxidant Capacity from Diet and Supplements Is Associated with a Less Atherogenic Blood Profile in U.S. Adults

Novel insights of dietary polyphenols and obesity

Cruciferous vegetable consumption is associated with a reduced risk of total and Cardiovascular disease mortality

The NEJM study released in this issue death with Chinese populations, some 450,000 Chinese in fact, with no prior stroke or hypertension to avoid confounding factors. IN Western populations, an inverse association had been seen in patients eating 80 gm of fruit a day, leading to a 5% decrease in cardiovascular death.

A low level of fruit intake is associated with a major increased cardiovascular risk rate. The study above chose China, since vegetable intake is high but fresh-fruit intake is much lower.  Cardiovascular disease causes 17 million deaths a year and is especially high in lower income countries. The effect of adding fruit to the diet of people with low consumption rate can detect larger effects.

Findings:

The association between the level of fruit consumption and cardiovascular risk in our study (a 40% lower risk of cardiovascular death and a 34% lower risk of major coronary events among participants who consumed fresh fruit daily as compared with those who never or rarely consumed fresh fruit) was much stronger than the associations observed in previous studies. < Current NEJM study April 2016.    This study involved some 512,000 people who had low intake of fruit already, making it easy to detect positive benefits. None of the patients had hypertension or Diabetes, and thus were not on any confounding medications. The study also took into account regression dilution bias (changes in baseline characteristics of a population during a study) that may impact findings. 

Fruit is high in fiber, potassium, folate, phytochemicals, and antioxidants all of which may mediate the positive impact of fruit intake.

Conclusion:

In conclusion, our evaluation of the relationship between fresh fruit consumption and cardiovascular disease in China showed that the level of fruit consumption was inversely associated with blood pressure and blood glucose levels.

Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010 a systematic analysis for the Global Burden of Disease Study 2010.

Up-regulating the Human Intestinal Microbiome Using Whole Plant foods, polyphenols and fiber

Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals

What is Xenohormesis

White Pitaya (Hylocereus undatus) Juice attenuates insulin resistance and hepatic steatosis in obese mice

Greater Total Antioxidant Capacity from Diet and Supplements Is Associated with a Less Atherogenic Blood Profile in U.S. Adults b

Feeding the brain and nurturing the mind linking nutrition and the gut microbiota to brain development

Cultivating healthy growth and nutrition through the gut microbiota.

 

 

 

Insane Medicine – Liraglutide (Saxenda) for weight loss!!

  • Liraglutide is a glucagon-like 1 peptide that has been available for diabetes management for a few years and now has an added FDA approval for weight loss management!!
  • There are more options for weight management as of now!
    There are more options for weight management as of now!

    obesity-big

  • To date, Phentermine/topiramate ER (Qsymia) is the most effective drug available. Locaserin (Belviq) is another approved drug for weight loss, but it is less effective.  However, it is better tolerated. Other options such as Xenical are helpful, but it prevents absorption of food and can cause excessive bloating and gas in some patients. Contrave (Wellbutrin and Naltrexone) is also effective but has neuropsychiatric effects.
  • Liraglutide is used to treat type 2 diabetes at a dose of 1.8 mg a day. It is injectable. The weight loss form of the drug is a dose of up to 3.0 mg a day injected. The amount of weight loss varies as the dose approaches the upper limit of 3 mg a day.
  • Liraglutide decreases appetite and therefore energy intake, which is how it causes weight loss. It also delays gastric emptying. Used as an adjunct to physical exercise and dieting, it has resulted in up to an 8 kg body weight loss over the 56 week course of treatment [ −8.0±6.7% (−8.4±7.3 kg)].
  • Liraglutide treatment was associated with reductions in cardiometabolic risk factors, including waist circumference, blood pressure, and inflammatory markers. Fasting lipid profiles were also improved as well. The combination of weight loss and improved glycemic control probably contributed to the observed reductions in the prevalence of prediabetes and the delayed onset of type 2 diabetes.
  • Side effects include an increased incidence of gallstones, which commonly increase with weight loss.  Nausea and constipation (or diarrhea) has been reported. Rarely, pancreatitis and kidney failure has occurred. The FDA has required a boxed warning about the risk of thyroid C-cell tumors in the package insert, and in patient’s with a family history of Multiple Endocrine Neoplasia Type 2 or medullary thyroid carcinoma, this treatment is to be avoided.
  • Treatment is started at 0.6 mg injected a day and increased weekly by another 0.6 mg until a total of 3 mg a day is injected. At 16 weeks, if a 4% body weight loss is not achieved, therapy should be stopped. Total cost per month is about $1000.00!
  • For patients who have a BMI>30 (Body mass index) and are not diabetic, or have a BMI>27 with a risk factor, such as hyperlipidemia or diabetes, Saxenda is a consideration for weight loss.
  • Liraglutide has effects on a number of metabolic systems
    Liraglutide has effects on a number of metabolic systems
    Liraglutide has effects on a number of metabolic systems
    Liraglutide has effects on a number of metabolic systems

    Liraglutide has effects on a number of metabolic systems
    Liraglutide has effects on a number of metabolic systems

Neuroprotective and anti-apoptotic effects of liraglutide on SH-SY5Y cells exposed to methylglyoxal stress

A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management

Liraglutide (Saxenda) for Weight Loss

http://ajpgi.physiology.org/content/302/2/G225

Insane Medicine – Acid in our bodies is a problem – Metabolic acidosis (MA)

Acid is not good
Acid is not good

acid house acid mushroom

  • Our bodies are always in a battle with too much ACID. I discussed this briefly before and am revisiting this topic again because of the metabolic impact metabolic acidosis (MA)  has on our bodies (that is, too much acid)
  • In the process of digesting meats and animal proteins, our body produces acids as well as internal processes that contribute to high acid levels. Our body uses bicarbonate and other  mechanisms to neutralize the excess acid.
  • Metabolic acidosis (MA) affects every system in our body. MA at a chronic level activates bone resorption and can increase the rick of osteoporosis. Treatment of MA can decrease this risk when it is present. Skeletal strength is impaired by MA because the body cannibalizes it’s own muscle to help neutralize the extra acid. Likewise, MA will impair insulin release and insulin receptor functioning. This results in glucose intolerance and diabetes. MA will also cause the progression of kidney failure and impair the functioning of thyroid hormones and it’s receptors.
  • We see metabolic acidosis in 1 out of 30 patients with normal  kidney function. the number affected increases as kidney function declines.
  • BMC Nephrol, 2013 Jan 9;14:4 : Use of bicarbonate to normalize MA can prevent progression of chronic kidney disease. How much bicarbonate and what type of bicarbonate is used? Sodium bicarbonate, in amounts starting at 1300 mg twice a day to get the serum bicarbonate levels to 24 mg/dl. Baking soda has 850 mg of sodium bicarbonate in a teaspoon.
  • Sodium bicarbonate intake does not worsen high blood pressure because the sodium load resulting from the sodium bicarbonate cannot be reabsorbed in the kidney through the usual NACL cotransporter.
  • The body normally excretes extra acid loads produced in the body in the form of ammonia, which is produced from glutamine (an amino acid) When metabolic acidosis is present, the body quickly runs out of glutamine from its usual sources and gets extra glutamine from muscle breakdown. The glutamine then goes to the kidney to be broken into ammonia which absorbs the extra acid.  So metabolic acidosis leads to increased muscle breakdown and weakness.
  • Diet affects the production of acid, especially with the consumption of animal proteins, which results in a lot of acid production in the body. This speeds UP the loss of kidney function in predisposed individuals. It has been shown that fruits and vegetables create little acid production in the body and a vegan diet as such decreases the rate of kidney function decline in patients with kidney failure.

 

Here is the summary:

  1. Treatment of metabolic acidosis, when the serum bicarbonate level is below 20 mmol/L, using sodium bicarbonate at doses of 1300 mg twice a day to increase serum bicarbonate to 24 mmol/L has positive impacts in multiple fronts as below.
  2. Increased bone density results from treatment of MA, thus decreased fractures and falling.
  3. There is better glucose control by treating MA due to better insulin sensitivity and insulin receptor responsiveness.
  4. Treatment of metabolic acidosis decreases the progression towards kidney failure in susceptible individuals with chronic kidney disease.
  5. Treatment of MA results in better muscle strength and muscle mass.
  6. Eat more fruits and vegetables to decrease your intake of acids.
  7. Have your doctor asses your blood for low bicarbonate (Less than 20 mmol/L)
  8. Consult your doctor prior to initiating any medical regimen as discussed.

Insane Medicine – Even older people should watch their diet

Successful aging requires continued effort for the best outcome. Do you want to live to one hundred and be bed-bound or live to one hundred and be active? Successfully aging people need to consider healthful behaviors to maintain their independence and health. Conditions that affect people over sixty can be modified and lessened by nutritional strategies:

  1. Cardiovascular diseaseHigh blood pressure, cholesterol/triglycerides, and obesity are modifiable by diet and medication. Weight control allows for better mobility, less pain, and fewer heart attacks. Obesity is associated with sleep apnea, as well, which reduces quality of life because it makes you fatigued in the day time and generally weak.
  2. Cerebrovascular Disease: Such as strokes and dementia are impacted by high blood pressure and diet. First off, quit smoking to decrease your risk of dementia and stroke. Decrease your sodium intake to decrease your blood pressure (1500 mg of sodium a day is about right for an average diet.) Use herbs and spices to flavor your foods. Foods such as cold cuts, cheeses, breads, pizza, pasta dishes, snack foods, and soups have higher levels of sodium, so beware. Consider following the DASH diet: http://www.nhlbi.nih.gov/health/health-topics/topics/dash  and http://health.gov/dietaryguidelines/2015-scientific-report/ 
  3. Diabetes Control: Diabetes affects everything from your eyes to your kidneys. There is a four-fold increased risk of death from heart disease or stroke if you are diabetic. Take your medicines, track your hemoglobin A1C (sugar control measure) and eat  food with a low glycemic index. Eat food with less fat and avoid high-sugar content items, but include more vegetables and whole grains to maintain glucose control. It takes a lot of effort if you are diabetic, so don’t let diabetes take your life one leg at a time!
  4. Cancer: Get your recommended screening examinations. Also, maintain a healthy weight since obese people have higher risks of cancer!
  5. Chronic Kidney Disease: Another disease modifiable by diet control – CKD risk is increased if you have hypertension, diabetes, obesity, or cardiovascular disease. A healthy diet and physical activity will maintain your weight and blood pressure, minimizing aging’s impact on your kidneys!

Suggestions:

  • Eat bright colored vegetables (carrots, brocolli) and deep colored fruits (berries) for phytochemical, healthy support.
  • Chose whole, enriched, fortified grains and cereals, i.e. whole wheat bread.
  • Chose low and non-fat dairy products: Yogurt and low-lactose milk
  • Use herbs and spices to add flavors to meals
  • Lots of fluids: no sodas
  • Exercise

Insane Medicine: Mediterranean diet and Plant based diets to stop your heart from stopping!

Mediterranean diet-
Mediterranean diet-
The Mediterranean Pyramid
The Mediterranean Pyramid
Mediterranean_Pyramid
Mediterranean Pyramid
  • Adherence to the Mediterranean diet has been proven in trials to be associated with a decreased risk of early death, decreased heart disease risks, decreased cancer risk, and decreased incidence of dementia and other brain diseases. Eat healthy and you live healthy!
  • Stop Smoking. Be certain to exercise.
  • The Mediterranean diet has been shown in a 2013 New England Journal of Medicine study to decrease cardiovascular events. The diet allows moderate alcohol (wine), low meat/meat products, but moderate fish intake. Vegetables, fruits, nuts, legumes, and olive oil were the important components in this diet. The study revealed a 30 % risk reduction of cardiovascular events (stroke/heart attacks) among high risk people.
  • It was believed that the Mediterranean diet creates an environment in the body in which insulin sensitivity is improved, blood lipids status are improved, resistance to oxidation and inflammation occurs, and vasoreactivity is  decreased. The key components seem to be olive oil and nuts.
  • The Lyon Diet Heart study in 1994 showed that a canola based oil spread used for omega 3 fatty acid intake along with increased breads and fruits,  but less butter, cream, deli meat, and unprocessed meat decreased the chance of a heart attack from 4% to 1 % (relative risk).
  • Interestingly, the origins for the notion that meat may be a problem for our hearts resulted from the demonstration that Norwegians lived longer from the ravages of cardiovascular disease during the German occupation in World War 2 because their livestock was taken away. They were forced to eat a plant based diet that was more healthful!
  • The most interesting article showing that a plant based diet can really make a difference is a study by Essyeltyn et al. linked below. This study demonstrated that following a plant based diet eaten by 198 patients with high risk coronary artery disease (CAD)  decreased the event rate of new heart attacks and strokes to 0.6% in follow up, whereas those who ate a regular diet had a 62% rate of new heart attacks and strokes!! So what does this diet include? Here is the list:

Plant Based diet: (Esselstyn et al.)

  • Legumes
  • Whole grains
  • Lentils
  • Vegetables
  • Fruit
  • Flaxseed meal (omega 3 and omega 6 fatty acids)
  • multivitamin and B12.
  • Excluded are: NO oils, fish, fowl, meat, dairy, nuts, avocados. No fructose, no sucrose, no fruit juice, no salt, no syrup, and no molasses.

 

Why do the plant based diet? If you are at the end of your rope in cardiovascular status, such as untreatable heart disease or high stroke risk, this diet is VERY EFFECTIVE! It is harsh, but very effective, allowing a much better quality of life and longer life.Check the links below.

 

 

 

http://www.ncbi.nlm.nih.gov/pubmed/25198208    A way to reverse CAD? J Fam Pract. 2014 Jul;63(7):356-364b.

“A way to reverse CAD?” by Esselstyn et al (J Fam Pract. 2014;63:356-364,364a,364b

http://www.jfponline.com/home/article/a-way-to-reverse-cad/f74f8ebb9261a837f3511f407516c7e5.html  – the article by Esselstyn

http://www.nejm.org/doi/full/10.1056/NEJMoa1200303     Primary Prevention of Cardiovascular Disease with a Mediterranean Diet

 

Inhibition of dimethyarginine dimethylaminohydroxylase causes vasoconstriction.

Insane medicine – Replace saturated fats in your diet with Vegetable oils (Linoleic acid) to lower cardiac risk!

Replacing saturated fat with vegetable oil is associated with lower coronary artery disease risk based in a study in Circulation recently released (Circulation. 2014;130:1568-1578).

  1. Exchanging 5% of consumed calories from saturated fat sources (red meat and butter) with foods containing linoleic acid (an n-g fatty acid that is polyunsaturated and found in vegetable oil, seeds, and nuts) can decrease coronary heart disease events by 9%. So swap out your saturated fat sources with polyunsaturated fat to help out your heart!
  2. Linoleic acid (polyunsaturated fat) intake was inversely associated with heart disease, such that the more linoleic acid taken in, the lower the risk of heart disease. At the best outcomes, there was a 15% lower heart-risk and 21% lower death rates in those who consumed the most linoleic acid sources.
  3. Replace butter, lard, and fat from red meat with liquid vegetable oils when you prepare and cook foods.  By replacing saturated fat in this way, total and LDL cholesterol is reduced.
  4. Sources of Linoleic acid (an omega-6 polyunsaturated fat) include: soybean, sunflower, safflower, and corn oil, as well as nuts and seeds.
  5. Fats have 9 calories per gram. Use 1.5-3 tablespoons of vegetable oil daily to get 5-10% of calories from linoleic acid (100-200 calories total) It is important to replace saturated fat with these sources of polyunsaturated fats (linoleic acid) and not just adding this to the total fat intake.
  6. Linoleic acid does not promote inflammation based on a neutral effect on inflammatory markers or arachidonic acid levels (which increase in inflammation).

Cooking oil examples:

Safflower oil – 78 % PUFA (Linoleic acid)

Sunflower oil – 69% PUFA (Linoleic acid)

Corn oil – 62%

Soybean oil  – 61 %

Peanut Oil  – 34%

Canola oil  – 29%

Lard – 12 %

Palm oil – 10%

Olive oil  – 9%

Butterfat  – 4%

Palm kernel oil  – 2%

Coconut oil – 2%

 

General notes about fats:

  • Greater intake of trans-fats (hyrogenated oil for example) relative to polyunsaturated fats (PUFA) is associated with higher cardiac risk. N-3 omega fatty acids and alpha-linoleic (ALA), also an n-3 fatty acid) are associated with good cardiac risk. Linoleic acid (LA) , an n-6 PUFA most commonly eaten in the Western diets, also has been shown to be beneficial in preventing cardiac risk, but less investigation had been done regarding this fatty acid. Linoleic acid reduces LDL levels, which is a positive effect for decreasing cardiac risk. LA can be elongated into arachidonic acid, which is inflammatory and thrombogenic (blood clot forming). Studies have shown that LA is in fact not pro-inflammatory in the body. It does not increase C-reactive protein . It also has no effect on other inflammatory marker such as cytokines, fibrinogen, soluble vascular adhesion molecules, plasminogen activator inhibitor type 1, or tumor necrosis factor-α.
  • There appears to be a linear response to increasing LA intake – as one takes in more LA, there is less coronary events (heart attacks) and less death! Thus n-6 fatty acids (Linoleic acid) has cardioprotective effects! Increasing LA intake by 5% led to 9% less coronary heart disease and 13% less death!
  • It had been assumed that LA is converted to arachidonic acid (AA), which is inflammatory. AA  is the main precursor of eicosanoids with inflammatory and thrombogenic properties, such as prostaglandin E2, thromboxane A2, and leukotriene B4. It has been found, however, that the conversion of LA to AA is tightly controlled in the body, thus there is no increase in inflammation.

 

Insane Medicine – Dietary Review!

I wanted to generalize some overall health information in this particular blog and incorporate items that are important for increasing successful strategies for aging and maintaining your health.

  • Remember that circulation is important in your body because it provides energy and sustains life in the various tissues. Regular exercise is a way to keep your body maximally conditioned. Your circulation delvers oxygen and nutrients to your body and at the same time allows toxins to be removed as it passes through the liver, kidney, and lymph systems. So be certain to keep moving and exercise to maximize your health.
  • Eat more plant foods. As a result of doing this, you take in less fat and will increase your fiber intake. This allows more protecting antioxidants to be incorporated into your body. Ingesting more fiber allows for better waste removal, and less fat intake results in a decreased tendency for your blood to thicken and clot, thus decreasing cardiovascular risk. The large amount of protecting agents in plant-based diets results in less inflammation in the body and less cellular damage.
  • Choose plant foods with strong flavors and with bright colors. Have a healthy fat focus in your diet. Chose your beverages you drink wisely, in other words, stop drinking sodas! Try your best to allow your stomach to be empty  and have ‘hunger pains’ for at least two thirty minute periods each day.
  • Remember that the body evolved in a world where salt, sugar, and fat were scarce and are like addictive drugs. Be careful to avoid choosing processed foods when possible and not adding salt and sugar to your meals. Avoid sodas ( which are high in sugar content)! Even noncaloric beverages may be increasing our desire for sweet food and spurring increasing rates of obesity.
  • Fructose in our foods has been a source of increasing weight gain in our society. Fructose and glucose (both sugars) have a differential effect on the brain. Glucose will reduce activation of brain regions that are involved in appetite, motivation, and reward and will increase our sense of satiety and decrease our food seeking behavior. Fructose does not do this. It is sweet, but it makes us want more! Corn sweeteners (fructose) have correlated with rising obesity.
  • Plant-based foods give us phytochemicals which act as protectors. Plant-based foods give smell, taste, and fragrance to our diet. They have an antioxidant effect. Kale, cabbage, broccoli, and  arugula have a sulfur based mustard taste that increase detoxification enzymes in the body. You should get 5-9 servings of colorful, flavorful vegetables in your diet each day – five servings for smaller people and at least nine servings if you are a big person. How much is a serving for vegetables? One-half cup cut up is equal to a serving, in general, for vegetables (for raw spinach, a whole cup is equal to a serving)
  • So again – look for colorful vegetables, as they have higher levels of phytochemicals in them, For example, zucchini has a green outside but mostly colorless interior, and therefore is a poorer choice of a vegetable. Instead, go for the carrots, spinach, broccoli, and yellow squash as options, since they have more color to them and therefore more protective phytonutrients! You will find higher levels of Vitamin A in deep orange vegetables such as carrots. The carotenoids and retinol in these vegetables impart the orange coloring and give the protective qualities of these vegetables.  Cruciferous vegetables have a big, strong flavor with sulfur components. They have powerful antioxidants in them and include arugula, broccoli, brussel sprouts, cauliflower, kale, kholorabi, radish, rutabaga, and turnips. Citrus fruits are high in Vitamin C, which helps fight infection. They also have an antihistamine/anti-allergic effect as well as anti-oxidant effect, which protects cell membranes and DNA in the body from oxidative damage. Vitamin C is important in the production of collagen component of connective tissues such as tendons and ligaments.
  • Eating up to nine servings a day of vegetables was associated with 24% less obesity in one study. Why? Because you eat less of other fatty foods.
  • Fiber rich foods  are very important in the diet. Vegetables, fruits, beans, whole grains are all rich sources of protective nutrients and phytochemicals and have a lower glycemic load as well. Eating foods with high fiber content results in less obesity since people who consume high-fiber foods feel more full. Likewise, higher fiber meals cause increase transit through the gut and decrease carcinogen exposure. This results in less colon cancer risk! Soluble fiber decreases cholesterol levels while fibrous food will increase the amount of protective gut bacteria.
  • We will be discussing the gut biome over time in this blog. Your gut has a population of bacteria that live and thrive but also help us maintain homeostasis. Alterations in the gut biome (bacterial population) can result in inflammation and disease. Immune compromise can occur if the gut biome is altered or destroyed. It turns out that soluble fiber is a food source for these necessary gut bacteria to remain healthy, and hence us as well.
  • We need 25 grams of fiber every day. A rule of thumb is one gets 2 grams of fiber per vegetable/fruit serving, so 5 servings of vegetables equals 10 gm of fiber.
  • Whole grains are a good source of fiber. One slice of whole grain bread is equal to a serving. A cup of cooked oatmeal is considered a serving. A thought for increasing fiber content is to use wheat berries, which cook like brown rice. Adding sunflowers to them can make a nutritious bundle.
    Wheat berries cook like brown rice and taste great when mixed with sunflower seeds!
    Wheat berries cook like brown rice and taste great when mixed with sunflower seeds!

    Cooked beans, peas , and lentils have 6 gm of fiber per half-cup of cooked item. They are excellent sources of fiber.

    Consider adding mung beans, which are bean sprouts that cook like lentils, in a dish with some olive oil, salt, and pepper and placing it over pasta.
    Consider adding mung beans, which are bean sprouts that cook like lentils, in a dish with some olive oil, salt, and pepper and placing it over pasta.

     

  • Always be certain that you check to see if a bread item is whole grain. Check the ingredient list. You want whole, sprouted, or malted wheat or whole grain on the label. Beware if it says wheat flour, for that is the same as white flour.
  • Put as many vegetables on your salad as possible. Lettuce has very little fiber.
  • Be certain to take in 5-10 grams a day of soluble fiber out of the 25-35 grams of fiber that is needed. Soluble fiber lowers cholesterol levels and feeds the healthy gut bacteria to support our immune system. An orange (medium) has 3-5 grams of soluble fiber, while a half cup of beans has 3-5 grams. Two tablespoons of ground flaxseed has 1.5 grams of soluble fiber. Flaxseed can be ground into flaxmeal.
  • Of note, a high fiber diet provides a low glycemic load, which is great for diabetics, but particle size of the fiber source is important. For example, old fashioned or scottish oats are best for fiber sources, whereas smaller particle sized grain products lose the fiber benefits. It turns out the glycemic index is higher in small-particles of grains (they get absorbed easier).
  • Higher glycemic-load foods are associated with chronic diseases. As people absorb more carbohydrates and gain weight, their insulin level increases in response, which promotes increased fat storage, thereby leading to the need for more insulin to control blood  sugar. This results in diabetes over time. Also cancer is more common in obese individuals as insulin-like growth factor (IL-GF) drives cancer growth. IL-GF is involved in glucose metabolism. A diet with a low glycemic load would include non-starchy vegetables except potatoes. Whole grains are high in glycemic load and make diabetes more difficult to contol. Pasta, rice, potato, and virus have high glycemic loads and are not as healthy. Fruit has high fiber content and a LOW glycemic index. High fat foods also have lower glycemic load. So aim for foods with lower glycemic indices as they allow for better body sugar control.
  • Fats affect inflammation in the body. High body fat content, especially abdominal fat,  is linked to cancer risk, diabetes, arthritis, Alzheimer’s disease, and autoimmune disorders. In an anti-inflammatory diet, one wants to avoid excess fat.  Decrease your fatty food intake, especially fried foods and fast foods. Decrease your dressings and mayonnaise on your foods. Decrease the amount of sweets in your diet, especially cookies and cake. Eat more fish and seafood (not fried) at least 2-3 times a week, except for farmed salmon, which should be eaten only once a month. Avoid sweetened beverages and limit foods with sweeteners. Eat more vegetables, fruits, whole grains, and beans.
    Beans are good!
    Beans are good!

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    Use extra virgin olive oil to toss in your vegetable or salad to allow easier coating of the leaves with your favorite dressing. By doing that, you will use less dressing and spread it out evenly!
    Use extra virgin olive oil to toss in your vegetable or salad to allow easier coating of the leaves with your favorite dressing. By doing that, you will use less dressing and spread it out evenly! Less dressing=Less fat!

     

  • Fat balance is important in your diet. Avoid the pro inflammatory fats, such as omega-6 polyunsaturated fats (PUFA) such as corn, cottonseed, soy, safflower, and sunflower oils, which are high in omega-6 oils. decrease your meat intake and decrease fish intake that are fed these products such as farm-grown salmon! Omega-3 PUFA are anti-inflammatory. and are present in flaxseed oil. Also, pasture-fed livestock (‘grass-fed’) have less omega-6 fatty acid in them. Avoid livestock that are fed grain or corn at any time, since that increases the amount of proinflammatoy PUFA in them. ‘Grass finished’ livestock means that the livestock ate grass until they are butchered. Choose grass-fed products only!
  • Some fat-health guidelines include avoiding fat soluble contaminants by eating food items lower on the food chain, such as smaller animals (fish) and avoiding farmed salmon. Eat only organic products. Avoid saturated fats, present in processed foods and dairy products or red meat. Avoid rancid fats by limiting aged cheese and meat (deli meat) in your diet. Chose healthy fats, which increase satiety and help absorb fat soluble vitamins. Healthy fats include avocados, olive oil, sardines, nuts, seeds, and olives.  Larger animals have more time to get contaminants in them. Chicken and sardines, which are lower on the food chain, live short lives. low in the food chain, and accumulate less toxins. Don’t eat fats that are solid at room temperature,. Avoid processed foods and meats (deli meats)
  • Rancid fats add oxidative stress to your body.Increase your monounsaturated fat intake such as avocado and olive oil, which are heart-healthy.  It was found that people who eat less saturated fat and more monounsaturated fats in their diet have better cognitive performance and verbal memory over time!
  • Osteoporosis prevention: Increase the following: exercise, calcium intake, vitamin D, protein and potassium . They all help build healthy bones! Protein is needed to build the bony matrix. Avoid caffeine (>300 mg a day) and avoid smoking and excessive sodium intake. Avoid being too thin. These factors all impact bone health in negative ways. Excessive sodium in the diet causes the kidneys to waste calcium in the urine. Be certain to get 1200 mg of calcium a day in the diet. For example, 1 or 2% no-fat milk has 300 mg of calcium per cup, while yogurt has 250 mg in 6 ounces. Please note that not all tofu has enough calcium in it, so check the labels. Also, corn tortillas (traditional mad with lime) has calcium in it ( fiver per day provides a lot of calcium)
  • Calcium bioavailability in the diet depends on the source of the calcium. There is calcium carbonate, calcium citrate, calcium malate, calcium phosphate, calcium gluconate, and calcium lactate. Tums has calcium carbonate in it and excessive use can decrease digestive enzymes and increase bloating gas production as a result, so avoid excessive tums. Avoid calcium from dolomite, bonemeal, and oyster shells (they have lead contaminants in them). Calcium mixed with Vitamin D and magnesium is an excellent supplement for bone health, especially as a 2:1 ratio (calcium 500mg/magnesium 250 mg). People absorb calcium better in small quantities through the day rather than a single large bolus. Be aware that calcium interacts with many medications and interferes with absorption of some medications, such as tetracyclines, biphosphonates, aspirin, and others. Some medications deplete calcium, such as aluminum antacids, steroids, anticonvulsannts, which deplete calcium supplies in the body. Calcium mixed with thiazide diuretics can lead to high, toxic blood levels of calcium in some people. Of note, a study recently suggested that calcium supplements may increase the risk of heart disease in some people by depositing in the coronary vessels. This appears to be not true.
  • Vitamin D is also an important component to bone health and body health. Deficiency in this vitamin has been associated with Alzheimer’s disease, autoimmune disorders, stroke, and musculoskeletal decline, among other things. Optimally, blood levels should be 30-80 ng/ml. The RDA for vitamin D in people aged 50-71 is 400 IU/day and for those over 70, the RDA is 600 IU/day. You can take up to 4000 IU/day safely per some sources. Vitamin D3 is the most active form of Vitamin D. Vitamin D is neccessary for optimal calcium and magnesium absorption in the gut. Our western style diet results in a high acid intake that leaches our bones. Chronic low grade acidosis in the body with our acidic diet, leads to bone derangement, especially in people with poor kidney function.
  • The shift to eating a better acid-base balanced diet can be made by including more plat foods in your diet (they are rich in alkaline materials). Consider this to boost bone health.
  • The recommended intake of protein is .4-.6 gm of protein per pound of weight. The average protein intake should be 55-100 gm per day. Protein content is high in beans, peas, and lentils (7 gm in a half cup) and high in poultry, fich, and lean meat (7 gm in 10 oz meat). Consider eating nuts and seeds for protein supplementation ( 7 gm in  1/4 cup, especially pumpkin seeds, which have 18 gms!)

Insane Medicine – Celiac or FODMAPS? Maybe it’s not a Gluten-free problem!

  • There are a lot of assumptions that there is better health and weight loss that can be achieved by going gluten-free. In reality, that may not be so depending on the food choices you make. Most gluten-free foods are not enriched or fortified with essential vitamins and minerals. Therefore, some gluten-free diets can lack essential nutrients.
  • We have discussed celiac disease elsewhere, but as a quick refresher, it is an autoimmune disorder of the bowel with a wide range of presentations and symptoms including abdominal pain, constipation, weight loss, anemia, mouth ulcers, arthritis, miscarriage, migraines, depression, seizures, bone loss and osteoporosis, fatigue, and many other signs and symptoms. It is diagnosed with specific blood tests and endoscopy to get bowel biopsy samples. http://b92.627.myftpupload.com/?p=64  <Prior FODMAP article
  • Gluten sensitivity can present just like irritable bowel syndrome (IBS), however, in IBS, there is no damage to the small intestines.
  • The signs and symptoms of celiac disease can seen in many other disorders and are therefore non-specific. After all, who hasn’t had a headache or constipation? We must keep in mind that there are other illnesses that can also exist. One possibility is FODMAP sensitivity.
  • FODMAP is the acronym for fermentable oligosaccharides, disacharides, monosaccharides and polyols. These are sugars which might not be digested or well absorbed in by the body and are left in the gut to be fermented by bacteria in the GI tract. The result is abdominal pain, gas, and cramping.

Which sugars are included in FODMAPS?:

  1. Polyols: Isomalt, mannitol, sorbitol, and xylitol. These are present in stone fruits such as avocados, mushrooms, cherries, peaches, plums, and cauliflower. Candy has sorbitol and xylitol in it.
  2. Galactans (galactooligosaccharides) occur in brussel sprouts, lentils, soybeans, broccoli, cabbage, and beans.
  3. Fructose (monosaccharide) is found in numerous items such as pears, watermelon, mangoes, blueberries, honey, agave, high-fructose corn syrup laden drinks such as gatorade, dried fruits, and apples.
  4. Lactose (disaccharide) is present in milk products.
  5. Fructans (oligosaccharide) is present in onions, rye, wheat, barley, artichokes, garlic, leeks, and bananas.

Because IBS is similar to FODMAP sensitivy, one can try to restrict items with DODMAP’s in them for 6-8 weeks to see how it works.  You need to limit the items listed above and consider other items that are LOW IN FODMAPS: alfafa, green beans, carrots, herbs, cucumber, lettuce, tomatoes, zucchini, bananas, oranges, grapes, melon, meats, fish, chicken, tempeh,rice, oats, quinoa, gluten-free bread, almonds and pumpkin.

Be certain to eat soft, cooked foods and frequent small meals a day.

 

Low FODMAP diet site:

http://med.monash.edu/cecs/gastro/fodmap/

 

 

Insane medicine – The Mediterranean Diet – The Best!

Insane Medicine - The Mediterranean Diet plan
Insane Medicine – The Mediterranean Diet plan

Mediterranean-Diet-Meal-Plan

  • The Mediterranean diet has been shown in numerous studies to be associated with decreased cardiovascular disease, decreased risk of Alzheimer’s disease, decreased risk of Parkinson’s disease, and decreased cancer risk.
  • It is a diet rich in fruit, vegetables, whole grains, and fish.
  • The base of the diet is composed of fresh fruit and vegetables with whole grains. Included in that is olive oil, beans, nuts, legumes, herbs, spices, and seeds.
  • Replace butter and margarine with olive oil. For example, dip your whole wheat bread in olive oil and not butter.
  • Use herbs and spices for flavoring, not salt.
  • Have fish and poultry at least twice a week.
  • Increase plant based foods such as fruits, vegetables, whole grains, legumes, and nuts. Whole grains do not have trans-fats (bad fat)
  • Nuts have high fat content, but it’s not a bad fat. You should have a handful of nuts a day, but make certain they aren’t salted nuts.
  • Chose healthier fats. Avoid hydrogenated fats (trans fats) and use more olive oil, which can decrease your LDL bad cholesterol. Canola oil has linolenic acid ( an omega-3 fatty acid) that can decrease triglycerides in the body. It also decreased clotting and the risk of myocardial infarctions.
  • Increase the amount of fatty fish in your diet, especially lake trout, mackerel, herring, sardines, salmon, and albacore tuna. These have high amounts of omea-3 fatty acids in them as well.
  • Wine can be helpful for cholesterol at 5 oz a day for women and up to 10 oz a day for men.
  • Switch to whole grain breads and cereals, as well as whole grain rice and pasta.
  • Eat baby carrots, apple slices, and bananas for snacks. Consider fruit salads for snacks.
  • Nut choices include almonds, cashew, pistachios, and walnuts. They are high in fiber and proteins as well as healthy fats.
  • Don’t use butter. Use canola oil and olive oil.
  • Eat red meat only occasionally, avoiding processed meats such as sausage and bacon.
  • Consume low fat dairy products.
  • Youtube link on a chef exploring Mediterranean dietary customs: https://www.youtube.com/watch?v=UA8zfxj4fRU
  • Here are some general consideration below regarding the Mediterranean diet. Now please keep in mind that the Mediterranean diet varies from location to location in the region, yet it is the mixture of the food items that gives the diet it’s savory tastes and healthfulness!
  • More specific vegetables include tomatoes, broccoli, kale, spinach, onions, cauliflower, carrots, Brussels sprouts, and cucumbers. Nuts and seeds include almonds, walnuts, Macadamia nuts, hazelnuts, cashews, sunflower seeds, and pumpkin seeds.  Legumes include Beans, peas, lentils, pulses, peanuts, and chickpeas.  Tubers include potatoes, sweet potatoes, turnips, and yams. Fruits include apples, bananas, oranges, pears, strawberries, grapes, dates, figs, melons, and peaches. Herbs and spices include garlic, basil, mint, rosemary, sage, nutmeg, cinnamon, and pepper.  Whole grains include whole oats, brown rice, rye, barley, corn, buckwheat, whole wheat, whole grain bread and pasta. Dairy includes cheese, yogurt, and Greek yogurt. Fish and seafood include sardines, trout, tuna, mackerel, shrimp, oysters, clams, crab, mussels, and salmon. Eggs include chicken, quail and duck eggs.  Fat sources include extra virgin olive oil, olives, avocados, and avocado oil. Coffee and tea are fine, as well as water.
  • Remember that the dining experience should be enjoyable and with friends and family. Wine in moderation.
  • Total recipe search toolbar: http://download.totalrecipesearch.com/installComplete.jhtml Allows for quick recipe search.
  • Allrecipes Mediterranean selection: http://allrecipes.com/recipes/everyday-cooking/special-diets/mediterranean-diet/
  • Health.com mediterranean recipe ideas: http://www.health.com/health/gallery/0,,20718485,00.html
  • Eating well Mediterranean recipes: http://www.eatingwell.com/recipes_menus/collections/healthy_mediterranean_recipes
  • Epicurious selection on Mediterranean diet and book selection as well: http://www.epicurious.com/articlesguides/healthy/news/diet_mediterranean
  • Whole living Mediterranean Recipes: http://www.wholeliving.com/135928/heart-healthy-mediterranean-diet-recipes