- Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC
- Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.
Wednesday, August 26, 2015
A large new observational study has linked frequent consumption of spicy foods to greater longevity and reduced rates of heart disease and cancer. For the 7-year study, researchers tracked the dietary intake and health outcomes of more than 485,000 people ages 30-79, living in China. The researchers collected information on participants' dietary habits including how often they ate spicy food, red meat, alcohol, and vegetables and then tracked participants disease and mortality. The study found that, compared to people who had spicy food less than once per week, people who ate spicy foods 1-2 days per week had a 10% reduced risk of overall mortality and those who had spicy food 3 or more times per week had a 14% reduced risk of all cause mortality. Spice eaters' better longevity appeared to stem specifically from lower rates of cancer, heart disease, diabetes, and respiratory diseases.
Though cause-and-effect cannot be proven in an observational study, there is significant evidence that many spices have potent anti-inflammatory and anti-oxidant effects that can help to reduce chronic disease risk. In the region where this study took place, the primary source of spice is chili peppers (cayenne). Those who consumed fresh chili peppers appeared to have a slightly lower rate of mortality than those who consumed chili's from dried sources. Capsaicin is believed to be the primary compound responsible for both the medicinal properties of cayenne and its spicy taste. The hotter the pepper, the more capsaicin it contains.
What to do: Herbs and spices contain a wide variety of antioxidants, minerals and vitamins, and help maximize the nutrient density of your meals. Every time you flavor your meals with herbs or spices you are literally "upgrading" your food without adding a single calorie, so go for plenty plenty of herbs and spices in your foods. Besides cayenne, some of the spices and herbs with the highest concentrations of beneficial phytonutrients include ginger, rosemary, turmeric, cinnamon, cloves, and sage. You can add these not only to your cooking but also tea, coffee, yogurt, cereal, oatmeal, salad dressings, sauces and condiments. Extra spices and herbs are also a great way to liven up prepared foods such as frozen meals, canned soups, and other ready-to-eat items.
Lv J, Qi L, Yu C et al. Consumption of spicy foods and total and cause specific mortality: population based cohort study. BMJ. 2015; 351:h3942. DOI:10.1136/bmj.h3942
Adapted from articles available at:
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 8:48 AM
Saturday, August 22, 2015
Most of us are eating way too much sugar. The sweet stuff -- which also goes by names like fruit juice concentrate, fructose, honey and syrup -- is found in 74% of packaged foods in our supermarkets. Besides all the drinks and treats that are loaded with sugar, "savory" foods like sauces, pickles, condiments, peanut butter, salad dressing, frozen meals, bread, crackers, and chips often contain significant amounts of added sweeteners. The average American now consumes 22-28 teaspoons of added sugars a day -- mostly high-fructose corn syrup and ordinary table sugar. That adds up to 350-440 empty calories.
Research is increasingly finding that our high sugar consumption not only fuels weight gain, but also directly contributes to our risk of chronic diseases like heart disease and diabetes. Here's the lowdown on some of the consequences of a high sugar diet.
Weight Gain & Obesity
Intake of excessive sugar consistently results in weight gain. Sugary drinks, loaded with calories and devoid of nutrients, are quickly digested so that they do little to satiate hunger. A 2014 review of 68 different studies found the more sugar intake increases, the more weight increases. Fortunately, the converse is also true. Want to lose weight? Cutting sugar intake is a very effective place to start.
There is also evidence that high sugar intake alters hunger-related hormones, increasing appetite. Leptin is a hormone released in response to food intake. It is instrumental in the system that signals your brain you have had enough to eat. High sugar directly stimulate higher than normal levels of leptin, which actually reduces the body's sensitivity to the hormone, leading to chronic over consumption. Although excess weight itself also contributes to leptin resistance, experimental studies find that when excess sugar is removed from the diet, leptin resistance improves.
High Blood Pressure
Hypertension is usually associated with salty foods, not desserts — but eating lots of added sugar has also been linked to high blood pressure. In one study following 4,528 adults without a history of hypertension, consuming 74 or more grams of sugar each day (about 20oz. of soda) was strongly associated with an elevated risk of high blood pressure, independent of weight status. It is widely know that blood pressure increases after a salty meal but it also responds to sugar intake. For example, a recent experimental study found that drinking 60 grams of fructose elicited a spike in blood pressure two hours later.
A mounting body of evidence indicates the odds of dying from heart disease appear to rise in tandem with the percentage of sugar in the diet—and that holds true regardless of a person’s age, sex, physical activity level, and weight status. For example, a large 15-year long observational study recently found participants who took in 20-25% of their daily calories as sugar were more than twice as likely to die from heart disease as those whose diets included less than 10% added sugar, and participants
Insulin Resistance & Diabetes
Intake of excess sugar increases the body's demand for insulin, a hormone that signals the cells to use digested sugars for fuel. Chronically elevated insulin levels produce insulin resistance in the body's cells -- the cells fail to take up sugar in the blood, leaving blood sugar levels elevated. Insulin resistance necessitates excessive insulin production and high levels of insulin predisposes nutrients to be stored as fat, especially in the abdominal region. If unchecked, insulin resistance progresses into pre-diabetes and then diabetes. A recent review of previous research involving a total of 310,819 participants found that consistent intake of sugar throughout the day (i.e. the duration of sugar exposure) and average amount of sugar ingested (the dose) correspond closely with diabetes rates.
Fatty Liver & Liver Failure
Most sweeteners are made up of two kinds of molecular sugars, fructose and glucose. Fructose must be metabolized first by the liver. Large intakes of fructose increases deposition of detrimental fat in the liver (and other organs) that can result in nonalcoholic fatty liver disease. The incidence of fatty liver is strongly linked to rates of sugary drink consumption. Fatty liver can progress to full-on liver failure in some individuals, especially in those with additional risk factors for liver failure.
Gout is a type of arthritis that is triggered by high levels of uric acid in the blood. Classic dietary sources of uric acid include high purine foods such as meat, shellfish, and beer but fructose metabolism also increases uric acid production. A recent study tracking thousands of men for over a decade found a strong relationship between sugar consumption and rates of gout.
Trust your dentist on this one: sugar is the "arch criminal" behind cavities. Tooth decay occurs when the bacteria that line the teeth feed on simple sugars, creating acid that destroys enamel. The consequences of dental health go beyond the mouth. Chronic dental inflammation adversely effects heart health.
How Much Added Sugar Is Too Much?
As the evidence of sugar's ill health effects has mounted, the dietary recommendations on sugar consumption have become more stringent. The American Heart Association and the World Health Organization currently recommend that no more than 5% of daily calories come from added sweeteners. This means cutting back intake to 100-150 calories (i.e. 6½ to 9½ teaspoons --the amount of sugar in 8-12 oz. of soda ). The average American gets 18% of their calories from added sweeteners, well in excess of the 5% limit. But, a few diet tweaks can help you quickly reduce your sugar intake, knock down your disease risk, and improve your weight status. Here's what to do:
Nix sweetened beverages: More than one-third of the added sugar in Americans’ diets come from sugary beverages like soda, energy drinks, sports drinks, sweet tea, lemonade, and fruit punch. Just one 12-ounce can of regular soda contains about 10 teaspoons of sugar which means that a single soda exceeds the recommended limit. Replace sweetened drinks and juice which is concentrated with natural sugars with water or seltzer. Liven up good, old-fashioned H2O with healthy, flavorful add-ins like lemon, lime, fresh mint, strawberries, cucumber, herbal tea sachets, or a splash of juice. When you need something sweet opt for diet drinks or diet flavoring packets (such as Crystal Light). While artificial sweeteners do have some negative health effects -- they appear to increase our cravings for sweets and slightly stimulate insulin production -- recent research reviews have found they have no clear links to chronic disease risk.
Identify hidden sources of sugar: Added sugar hides in dozens of foods you might not suspect. You can look at the Nutrition Facts label to see how many grams of sugar are in the specified serving size, though the label does not distinguish between natural sugars and added sugars. Still, if it is not a product with an obvious source of natural sugars such as fruits, milk, or plain yogurt, you can assume the grams of sugar are from added sources. Divide the grams of sugar by four to learn how many teaspoons of sugar is in a serving. Also, you can scope out added sugar by reading the ingredient lists. Brown sugar, corn syrup, maltose, fructose, dextrose, molasses, agave, brown rice syrup, cane syrup, evaporated cane juice, fruit juice concentrate, date crystals, coconut crystals, and maple syrup are all forms of added sugars. Ingredients are listed in descending order by weight, so if sugar is near the top that is a red flag the product is high in sugar.
For the most part, sweeteners are similar in their calorie content and their effect on blood sugar, so the most important thing is to limit them, regardless of type. Still sweeteners with more glucose such as dextrose and corn syrup (not high-fructose corn syrup which is a little over 1/2 fructose) have less of an effect on insulin resistance, fatty liver, and high tryglycerides than those high in fructose such as agave, apple juice concentrate, and fructose.
Eat outside the box: Most of our sugar intake comes from packaged and restaurant foods, so, to avoid added sugars, cook from scratch or buy plain foods and, if desired, sweeten them just enough for your needs. Adding in fiber rich fruit is a great way to sweeten your food choices while still avoiding sugar isolates. Sometimes foods do not need more sugar but just more flavor. Utilize vanilla and other extracts, orange zest, unsweetened cocao powder, cinnamon, ginger, cardamom and other spices to enhance the flavor of your foods.
Trade sweetened foods for naturally sweet fruit: Instead of concentrated sweeteners, sweeten up your foods with fruits and root vegetables. Unlike concentrated sugars, fruits and vegetables are packed with heart healthy fiber, vitamins, minerals, and anti-inflammatory phytonutrients. For example, in place of strawberry jam on PB&J's, try sliced bananas, pureed sweet potato, unsweetened apple sauce, or warmed up frozen fruit. Just one level tablespoon of jam packs 50 calories and is typically made with three sweeteners: high fructose corn syrup, corn syrup, and sugar while a half cup of frozen strawberries, warmed up on the stovetop and seasoned with a little cinnamon, contains less than 25 calories plus many beneficial nutrients. Fruit—whether it’s fresh, baked, grilled, or pureed—makes a great replacement for sugar in lots of dishes, from cookies to coleslaw. Do not worry about overdosing on fructose, and sugar generally, from whole fruits. However fruit juices and juice concentrates, are significant sources of sugar that should be avoided as much as possible. Unsweetened dried and canned fruits are also reasonable options but go with fresh or frozen most of the time.
Think protein and fat: Moderating carbohydrates in the diet, especially quickly digested carbohydrates such as white flour, white rice, potatoes, and high sugar products can help to curb sugar cravings. Refined carbohydrates and sugar cause the blood sugar to rise rapidly, stimulating a large insulin release that then causes blood sugar to plummet. To minimize this rapid rise and fall, control your carbohydrate portions, and pair carbohydrates with protein, healthy fats, and fiber. These can slow down the release of blood sugar in your body and keep you full for longer. This is especially important at breakfast, so, for example, add minced raisins and nuts to your unsweetened oatmeal or pair your toast with an egg or unsweetened peanut butter rather than jam. Including healthy fats (fats do not raise blood sugar) such as nuts, seeds, avocado, and plant oils is especially helpful in curbing sugar cravings.
Decrease gradually: Humans are hard-wired to love sugar. Sugar intake stimulates the release of hormones in the brain that help us feel pleasure and serenity. When you cut sugar out of your diet, you may find yourself in sugar withdrawal. Try cutting back slowly. For instance, if you normally put two sugars in your coffee, try one for a time. For your cereal and yogurt, mix half a serving of sweetened versions with unsweetened ones, and eventually move on to just using fresh fruits in plain yogurt or unsweetened cereals. When you get sugar cravings, fight back. Opt for a naturally sweet fruit or vegetable. Sometimes we craves sweets when we are actually hungry, thirsty, or tired. Try satisfying these needs in healthy ways and the sweets craving may go away. Or, if it is a pick-me-up you are after, try doing something else you enjoy such as listening to music, going for a walk, or playing a game on your phone.
Limit sugary treats to 1-2 times per week: Pick a day or two a week to have the sugary treat you love most. This will help you be deliberate about your choices and bypass many of those incidental treats we encounter - on the street, in the workplace, or in front of the TV. Just knowing that you have a pre-planned treat to look forward to can help you avoid a good deal of sugar intake. When you do have a treat, slowly savor each bite to maximize your satisfaction.
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 11:40 AM