COOKING FOODS, ESPECIALLY MEAT, AT HIGH TEMPERATURES INCREASES RISK OF ALZHEIMER’S & DIABETES

Cooking foods at high temperatures, especially meats and other proteins, alters their composition creating harmful substances that are combinations of sugars and proteins and other large molecules called advanced glycation end products (AGE).  AGE's are naturally produced in the body but when foods rich in AGE's are consumed, the body cannot effectively process them and they can build up over time.  Recent studies add to a growing body of evidence linking greater intake of AGE's with higher levels of chronic systemic inflammation and higher rates of diseases linked with inflammation including heart disease, diabetes, and Alzheimer's.  

In one recent study researchers analyzed food intake records from large studies in the U.S. and France.  From this data, researchers estimated the average AGE content of different diets.  They found a strong link between higher intakes of AGE's and rates of Alzheimer's.  Researchers previously have linked AGEs with Alzheimer’s, and have suggested that these compounds could be one possible cause of the accumulation of amyloid plaques in the brain associated with the disease.

Another recent series of studies found a direct relationship between AGE consumption and insulin resistance.  Insulin resistance, the hallmark metabolic problem that precedes the development of full-blown type 2 diabetes, occurs when the body's cells fail to respond to insulin causing blood sugar to remain elevated.  Researchers randomized diabetes patients to follow either a carb-controlled diabetes diet, that was either high in AGE's or low in AGE's.  Interestingly, researchers found that insulin resistance significantly improved in those on the low-AGE diet but not in those on the high AGE diet.  

What to do:  Aim to reduce your intake of AGE's. AGEs are particularly high in animal-derived foods, especially fatty cuts of red meat,that are cooked at high temperatures.  They are also present in anything that has been charred  or browned such as burnt toast or roasted nuts as well as food items that have been aged such as hard cheeses.   Instead of meats opt for leaner protein sources such as seafood, skinless chicken, lowfat dairy, eggs, and beans.  Instead of high heat cooking methods such as frying, roasting, broiling, and grilling use moist heat methods such as boiling, steaming, poaching, and microwaving.  When grilling, you can reduce the production of AGE's by pre-cooking in the microwave and finishing foods on the grill.  Marinating foods in an acid such as lemon also helps to reduce AGE formation during the cooking process.

Sources:

Perrone L, Grant WB, et al. Observational and ecological studies of dietary advanced glycation end products in national diets and Alzheimer’s disease incidence and prevalence.  Journal of Alzheimer’s Disease. February 2015; 45(3).  DOI:10.3233/JAD-140720

Mark AB, Poulsen MW, et al.  Consumption of a diet low in advanced glycation end products for 4 weeks improves insulin sensitivity in overweight women.  Diabetes Care. January 2014; 37:1 88-95.  DOI:10.2337/dc13-0842.

Uribarri J, Woodruff S, et al. Advanced glycation end products in foods and a practical guide to their reduction in the diet. Journal of the American Dietetic Association. June 2010;110:911-916.  DOI:  10.1016/j.jada.2010.03.018

Adapted from articles available at:

http://www.todaysdietitian.com/newarchives/030314p10.shtml

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704564/

http://www.cevk.com/high-temperature-cooking-may-increase-alzheimers-risk-2/

http://www.foodnavigator.com/Science/Crusty-AGE-rich-foods-may-raise-risk-of-heart-disease

http://www.sciencedaily.com/releases/2015/02/150203094144.htm

LOWER BLOOD PRESSURE WITH THE DASH EATING PLAN

Recently, the Dietary Approaches to Stop Hypertension or DASH diet was named the the best overall diet by U.S. News & World Report for the fifth year in a row.  Why does the DASH plan deserve top ratings? The DASH diet, developed by the National Heart, Lung, and Blood Institute (NHLBI), is a lifelong approach to healthy eating that is designed to help treat or prevent high blood pressure. 

Benefits of the DASH Plan

Research has demonstrated those who follow the plan can see reductions in their systolic pressure (the pressure in the arteries when the heart beats) by as much as 7-12 mmHg and diastolic pressure (the pressure in the arteries when the heart is at rest) by 3-6 mmHg.  These changes significantly improve heart and cardiovascular health outcomes. Research also indicates that following the DASH diet reduces risk of osteoporosis, some cancers, kidney disease, obesity, and diabetes. 

Components of the DASH Plan

DASH emphasizes intake of vegetables, fruits, and fat-free/low-fat dairy products and includes healthy amounts of whole grains, fish, poultry, beans, seeds, nuts, and vegetable oils while limiting salt, sweets, sugary beverages, and red meats.  Nutritionally, this means DASH is low in sodium and unhealthy saturated fats while being rich in fiber, protein, and the blood pressure-friendly minerals potassium, calcium, and magnesium.

Below is a table detailing the contents of the DASH diet at 1200 calories, 1600 calories, and 2000 calories.  Everyone has different calorie needs but if you are looking to lose weight the 1200 calorie menu is a good starting place for women and the 1600 calorie level for men.  It may look complicated but going DASH is easy.  Include generous portions of veggies at 2 meals daily, fruit for a snack and dessert, and include a lowfat dairy source at every meal and your basically there.  Detailed information on the DASH plan is available online at: http://www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf.  There you will find menu plans at different calorie levels and for different cuisines including Hispanic, Asian, and Southern. 

The DASH diet was developed when guidelines recommended limiting sodium to 2300 mg, roughly equivalent to 1 teaspoon of salt.  Currently, the average American consumes 2-3 times this amount. It is now recognized that there are additional blood pressure benefits to lowering sodium intake to less than 1500 mg (~2/3 of a teaspoon of salt). Even if you do not add salt at home, you are probably eating too much sodium.  Approximately 75% of our sodium intake is derived from salt added by manufacturers to food products long before they appear on our tables.  Preparing foods from home and avoiding pre-made products is the most effective way to reduce your sodium intake.

DASH Eating Plan Overview
Food Group	Daily Servings				Notes	Significance of Each Food Group to the DASH Eating Pattern
	2000 calorie	1600 calorie		1200 calorie
Grains	8 oz	6 oz		3 oz	-Opt for whole grain or whole wheat options. -Examples include whole wheat bread and rolls, whole wheat pasta, whole grain cereals, oatmeal, brown rice, barley, quinoa, & buckwheat.	-Major sources of energy & fiber -Brans are great sources of magnesium
	1 oz = 1 slice bread, 1/2 cup cooked grains or cereal, or 1/3 cup pasta
Veget-ables	2-3 cups	2 cups		2 cups	-Potassium is lost in cooking water so when cooking opt for steaming instead of boiling or consider drinking the cooking water. -Some vegetables especially rich in potassium include dark leafy greens, potatoes, tomato, beets, squash, broccoli, romaine, & Brussels sprouts.	-Rich sources of fiber, potassium, magnesium -Dark leafy greens rich in calcium & potassium
Fruits	2-2.5 cups	2 cups		1.5-2 cups	-Dark purple fruits such as cranberry, blueberry, pomegranate, cherries, and acai appear especially helpful. -Choose fresh or frozen over canned or dried which often have added sugar. -Standouts for potassium include kiwi, banana, orange, guava, and melons.	-Important sources of potassium, magnesium, & fiber
Fat-free/ low-fat milk and dairy	3 serving	2-3  serving		2-3  serving	-Dairy is naturally high in unhealthy saturated fat so opt for the low or nonfat options.  Use cheese sparingly as it is high in sodium as well as saturated fat. -Consider some of the less common options such as lowfat/nonfat cottage cheese, nonfat ricotta, and lowfat/nonfat plain kefir. -Lactose intolerant persons can take lactase pills, choose lactose-free products (e.g. Lactaid), opt for products naturally low in lactose (e.g. hard cheeses, yogurt), or use fortified substitutes such as unsweetened soy milk.	-Major sources of calcium, potassium, and protein
	Ex: -1 cup milk or yogurt -1.5 oz cheese
Poultry, fish, & other lean protein	7 oz	5 oz		5 oz	-Select only lean cuts of meat; trim away visible fats; remove skin from poultry. -Choose fish and chicken most of the time. -Mostly avoid processed meats as they appear to be especially bad for heart health and are high in sodium. -1 oz of tofu or 1/2 cup of beans can substitute for 1 oz of animal protein.	-Rich sources of protein & magnesium -Many fish are also high in potassium -Fatty fish such as salmon & tuna are good sources of essential omega-3 fatty acids
Nuts, seeds, & beans	4-5  serving  per  week	3-4   serving  per  week		3-4 serving per week	-All types of raw, unsalted nuts are excellent options. -While it is important to be mindful of portions do not shy away from nuts as there is strong evidence of  their heart health benefits. -Try Beano or similar products if you find beans uncomfortably gassy.  Slowly increasing your intake of beans helps to minimize gas symptoms. -Use beans on salads, as spreads and dips, and in soups as well as many other ways.	-Rich sources of energy, magnesium, potassium, protein, & fiber
	Ex: -1/3 cup nuts/seeds -2 Tbsp peanut butter -1/2 cup beans
Oil	3-4 tsp		2-3 tsp	2 tsp	-Choose healthy plant-based oil such as olive as well as fat-rich fish.  -Avoid unhealthy saturated fats (as well as salt) in butter and margarine.	-The DASH study had 27% of calories as fat
Sweets and added sugars	4 or less per week		2 or less per week	1 or less per week	-Note that the allowed portions and serving sizes of sweets here are very limited compared to the average American diet which includes 19 teaspoons of sugar daily. -Try to use the blood pressure-friendly fruits and lowfat dairy products as sources of sweets.	-Studies reveal that high sugar diets increase blood pressure independently of their impact on bodyweight.

INACTIVITY TWICE AS DEADLY AS OBESITY

A new analysis has concluded that a sedentary lifestyle is two times more likely than obesity to lead to early death.  And, that adding even a very moderate amount of activity such as a 20-minute brisk walk each day helps to reduce the risk of premature death by as much as 30%.  The analysis revealed regardless of whether a person is at a healthy weight or obese, going from inactive to active substantially reduces the risk of premature death.

To measure the link between physical inactivity and premature death, and its interaction with obesity, researchers analyzed data from 334,161 men and women across Europe participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Participants were tracked for 12 years during which their weight, waist circumference, and level of physical activity were recorded.  Over that  period there were more than 21,000 deaths.  Twice as many of the deaths were attributed to inactivity than to extra weight.

Why is exercise so linked to longevity?  Aerobic exercise exerts a potent effect on one's overall health.  It has been shown to strengthen the cardiovascular system, support the body's immune system, boost mental function, mood & energy, bolster the musculoskeletal system, and reduce the risk of most chronic diseases including heart and vascular disease, cancer and diabetes.

What to do:  This study points out that regardless of weight, even modest amounts of daily activity can make a big difference to our longevity.  And this is a good thing because, often levels of activity are easier to change than bodyweight.  So, get moving anyway you can.  Healthy exercise need not be high impact.  Swimming, stationary bicycling, elliptical, brisk walking, and seated aerobics are all excellent activity options that spare the knees.

Adapted from articles available at:

http://consumer.healthday.com/senior-citizen-information-31/misc-death-and-dying-news-172/lack-of-exercise-more-deadly-than-obesity-study-suggests-695505.html

http://www.medicalnewstoday.com/articles/288042.php

http://www.sciencedaily.com/releases/2015/01/150114143118.htm

Source: 

Ekelund U, Ward HA, Norat T et al.  Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC). American Journal of Clinical Nutrition.  First published January 14, 2015. DOI: 10.3945/ajcn.114.100065

A DAILY CUP OF BLUEBERRIES REDUCES BLOOD PRESSURE

Here's one more reason to top that morning cereal with blueberries.  A new trial has found  daily consumption of blueberries helps to reduce blood pressure and arterial stiffness.  Researchers conducted a randomized controlled trial of 40 postmenopausal women ages 45-65 with high blood pressure. Half ate 22 grams of freeze-dried blueberry powder, equivalent to a cup of blueberries, daily for eight weeks. The other half consumed an identical-looking and tasting placebo.

At the end of the eight weeks, participants receiving the blueberry powder had an average 7 mmHg (5.1%) decrease in systolic blood pressure (the top number in the blood pressure reading which measures the pressure in the arteries when the heart beats) and a 5 mmHg (6.3%) reduction in diastolic blood pressure (the bottom number that measures the pressure in the arteries between heartbeats).  Levels of nitric oxide, known to be involved in relaxing and widening blood vessels, increased 68% in the blueberry eaters. There were no significant changes in blood pressure in the placebo group.

What to do:  Include more blueberries and other dark purple fruits and vegetables in your diet.  Beets, cherries, pomegranates, cranberries, grapes, acai, and others have been found to have positive effects on blood pressure and heart health.  Blueberries have long been championed for their high antioxidant potential and anti-inflammatory properties. They’re only 80 calories a cup and are high in fiber, vitamin C, and manganese.   Put fresh, frozen, or dried blueberries in hot and cold cereals, smoothies, and yogurt, or have them as a stand alone snack. 

Adapted from articles available at:

http://www.nutraingredients.com/Research/Blueberries-could-lower-blood-pressure-RCT-data

http://well.blogs.nytimes.com/2015/01/14/blueberries-may-lower-blood-pressure/?_r=0

http://www.sciencedaily.com/releases/2015/01/150108113525.htm

Source:

Johnson SA, Figueroa A, et al. Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre­ and stage 1­hypertension: A randomized, double­blind, placebo­controlled clinical trial.  Journal of the Academy of Nutrition and Dietetics. 2015.   Published online ahead of print, DOI:10.1016/j.jand.2014.11.001

BPA IN CANS & PLASTIC BOTTLES INCREASES BLOOD PRESSURE

A new study has found that ingestion of beverages kept in cans lined with bisphenol A, BPA, raises blood pressure.  BPA is widely found in plastic bottles, plastic packaging, receipt paper, and the linings of food and beverage cans. Previous studies have linked chronic BPA exposure with increased rates of heart disease, diabetes, thyroid dysfunction, and cancer.  This new study reveals that BPA exposure is not only a problem over the long-term, but that blood pressure increases within hours of ingesting products kept in BPA-lined cans. 

The researchers found that when study participants drank soy milk from glass bottles their urinary BPA levels remained low. But, within two hours of drinking soy milk from a can, their levels of BPA were 16 times greater.  As their BPA levels rose so did their blood pressure with systolic readings increasing by an average of 5 mm Hg.  To put this rise in perspective, every 20 millimeter increase in systolic blood pressure doubles cardiovascular disease risk. The researchers chose soy milk as the beverage in the study because it does not have any properties that are known to increase blood pressure, and, unlike soda, fruit juice,  tomato juice and other acidic products which are known to promote BPA leaching, soy  milk is neutral.

While a single instance of increased blood pressure is unlikely to be harmful, the findings suggest that for people who drink from multiple cans or plastic bottles every day, the repeated exposure over time could contribute to hypertension.  BPA is an endocrine disrupter that can mimic the actions of estrogen.  BPA is known to block certain estrogen receptors that are thought to be responsible for repairing blood vessels and controlling blood pressure. The chemical may also affect blood pressure indirectly by disrupting thyroid hormone.

What to do:  Because of growing concerns about BPA, some packaged products now carry “BPA free” claims on their labels. However, these products often contain chemically similar alternatives – like bisphenol S that also leach chemicals with estrogenic activity.  To minimize exposure avoid #3, #6, #7 plastics and aluminum cans as much as possible.  Products that are liquid and/or acidic cause more chemical leaching.  Look for products packaged in glass bottles instead.  Avoid freezing, microwaving, or machine dishwashing plastics as these processes degrade the plastic allowing more BPA to leach into your foods.  Store foods in glass or stainless steel containers. 

Adapted from articles available at:

http://newsroom.heart.org/news/cans-lined-with-bisphenol-a-may-increase-blood-pressure?preview=0aef

http://well.blogs.nytimes.com/2014/12/08/bpa-in-cans-and-plastic-bottles-linked-to-quick-rise-in-blood-pressure/?ref=health&_r=0

Source:

Bae S, Hong Y-C. Exposure to Bisphenol A from drinking canned beverage increases blood pressure: Randomized crossover trial. Hypertension.  2014; DOI: 10.1161/HYPERTENSIONAHA.114.04261

VITAMIN D SUPPLEMENTATION DECREASES LUNG DISEASE FLARE-UPS

A new trial has found that when vitamin D deficient patients with chronic obstructive pulmonary disease (COPD) are supplemented with the vitamin, rates of respiratory flare-ups decrease by 40%.  

Chronic bronchitis and emphysema are two types of COPD. These conditions are characterized by coughing, excess mucus, shortness of breath, wheezing, fatigue, and tightness in chest but when a flare-up strikes these symptoms become so severe that individuals often require hospitalization.

This randomized controlled trial included 240 patients with COPD. For one year, half of the patients received 120,000 IU of vitamin D every 2 months (equivalent to taking 2000 IU daily) while the other half received a placebo. The risk, severity and duration of flare-ups was then compared between the two groups.  The supplemented group experienced a 40% reduction in flare-ups.  

How vitamin D reduced COPD flare-ups is not entirely understood.  Because adequate levels of vitamin D appear to be important in immune function, researchers had speculated that supplementation would decrease rates of upper respiratory tract infections, but, instead, they found that the supplemented patients and controls did not differ in their rate of respiratory infections.  Instead, it appears that the anti-inflammatory properties of vitamin D are what mediates the reduction in COPD flare-ups.  Interestingly, while it is not believed that vitamin D supplementation can prevent COPD, patients with chronic lung diseases such as asthma, cystic fibrosis, COPD, and interstitial pneumonia appear to be at increased risk for vitamin D deficiency.

What to do:  Increasingly, it is being recognized that vitamin D plays an important role not only in bone health but also immune, endocrine, and pulmonary function.  Blood tests can reliably check vitamin D levels.  If deficient, patients are often prescribed a prescription dose.  Vitamin D is naturally produced when the skin is exposed to the sun but having darker skin, excess weight, and/or older age decreases the body’s ability to produce vitamin D.  Salmon, sardines (and other fish in which the bones are eaten), and cod liver oil are some of the few foods that contain significant amounts of vitamin D.  Milk and many other products are now fortified.  When taking a supplement choose the Vitamin D₃ form.  Discuss with your provider what level of supplementation is appropriate.

Adapted from articles available at:

http://www.sciencedaily.com/releases/2014/12/141202082539.htm

https://www.vitamindcouncil.org/health-conditions/chronic-obstructive-pulmonary-disease/#

Sources:

Martineau AR, James WY, Hooper RL et al.. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. The Lancet Respiratory Medicine, 2014; DOI: 10.1016/S2213-2600(14)70255-3

Gilbert CR, Arum SM, Smith CM. Vitamin D deficiency and chronic lung disease. Canadian Respiratory Journal : Journal of the Canadian Thoracic Society 2009;16(3):75-80.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706673/

TART CHERRIES REDUCE URIC ACID AND INFLAMMATION ASSOCIATED WITH GOUT & AID IN SLEEP

Tart cherries, the red cherries commonly used in cherry pie, are one of the fruits highest in anti-oxidant plant compounds known as anthocyanins.  Two recent studies add to a growing body of evidence on the joint health benefits of regular tart cherry consumption.    In the studies researchers found tart cherries caused changes in how the body processes uric acid -- a substance that is elevated in those suffering from gout.  They also found that sour cherry juice reduces c-reactive protein, a biomarker of systemic inflammation.  

In the studies, healthy participants consumed tart cherry juice concentrate equivalent to 45 or 90 tart cherries.   Researchers collected blood and urine samples from the participants immediately before and at numerous intervals for up to 48 hours after the tart cherry juice was consumed.  They found that after consumption of the juice, participants’ blood levels of uric acid significantly decreased and urinary excretion of uric acid increased and that these changes persisted for more than 12 hours.  They also found that c-reactive protein levels significantly declined after consumption.

In addition to joint health benefits, tart cherries appear to help with sleep.  They are one the richest natural sources of melatonin, a hormone that helps regulate the sleep-wake cycle.  A study from April of this year, found that seniors  who drank 8 oz. of tart cherry juice in the morning and at night were able to sleep more than an hour longer each night compared to those taking a placebo.

What to do:  Studies on the cherries thus far have been relatively small but results are encouraging.  Doses and preparations used in studies have varied.  Be mindful that any of the cherry preparations add calories and natural sugars to your diet.   If you are up for giving the cherries a go, try having an 8oz glass of the juice, 2 Tablespoons of sour cherry juice concentrate, or 1-1.5 cups of sour cherries  twice daily.  Also, though perhaps not quite as packed with anthrocyanins as tart cherries, diets rich in all kinds of cherries (not just sour cherry), blueberries, and cranberries appear to be helpful in reducing gout flare-ups and increasing the body’s anti-oxidant defenses.

Sources:

Bell PG, Gaze DC, Davison GW, George TW, Scotter MJ, Howatson G. Montmorency tart cherry (Prunus cerasus L.) concentrate lowers uric acid, independent of plasma cyanidin-3-O-glucosiderutinoside. Journal of Functional Foods. 2014; 11: 82-90.  DOI: 10.1016/j.jff.2014.09.004

Bell PG, Walshe IH, Davison GW, Stevenson E, Howatson G. Montmorency cherries reduce the oxidative stress and inflammatory responses to repeated days high-intensity stochastic cycling. Nutrients. 2014;6:829-843.  DOI:10.3390/nu6020829

Seymour EM, Warber SM, Kirakosyan A, Noon KR, Gillespie B, Uhley VE, Wunder J, Urcuyo DE, Kaufman PB, Bolling SF. Anthocyanin pharmacokinetics and dose-dependent plasma antioxidant pharmacodynamics following whole tart cherry intake in human adults. Journal of Functional Foods. Sept. 2014; Available online ahead of print.  DOI: 10.1016/j.jff.2014.08.007

Liu AG, Tipton RC, Pan W, Finley JW, Prudente A, Karki N, Losso JN, Greenway FL.  Tart cherry juice increases sleep time in older adults with insomnia. Experimental Biology. 2014. San Diego, CA. April 28, 2014.  http://www.fasebj.org/content/28/1_Supplement/830.9

Adapted from articles available at:

http://www.medicalnewstoday.com/releases/283390.php

http://www.prnewswire.com/news-releases/study-tart-cherry-juice-increases-sleep-time-in-adults-with-insomnia-257037251.html

http://www.medicaldaily.com/tart-cherry-juice-found-cut-levels-uric-acid-and-inflammation-biomarker-blood-306112