Entries in healthy change (81)

Saturday
Aug132011

A fresh look at bone health

The quick answer:  The modern epidemic of osteoporosis, like coronary artery disease, is the natural result of an unnatural lifestyle—too much meat, sugar, and processed foods and too little use of the muscles. 

_______________________________________________________________________________________________

American women worry about osteoporosis.  They should worry.  There’s nothing nice about stooped-over posture, the dowager’s hump, or a life-shortening broken hip.  Osteoporosis is a big problem and in the American way, treatment has become a big business.  Unfortunately the money spent on treatment—like calcium supplements and drugs—hasn’t solved the problem.  In this post we take a fresh look at bone health and talk about prevention.  Warning:  Most of what you've been told may be wrong. 

An Old Theory Revisited

The current calcium theory of osteoporosis calls for more calcium in the diet and this has carried over into government guidance.  Americans consume more calcium than any nation, yet we are advised to take more.  Problem is that while we consume more calcium, we still have one of the highest rates of osteoporosis.  This doesn’t make sense.  There’s another theory—call it the acid/alkaline theory—that’s been around since 1968 though largely ignored, perhaps because there’s no pill to sell. 

The Lancet, published in England, is a prestigious medical journal.  Over 40 years ago it carried a revolutionary article by two Harvard researchers, Amnon Wachman and Daniel Bernstein, titled “Diet and osteoporosis.”  The article offered evidence that osteoporosis was the natural result of the modern acid-producing diet, not of too little calcium. 

Another Harvard researcher, D. Mark Hedsted in a 2001 American Journal of Clinical Nutrition commentary “Fractures, calcium, and the modern diet” (you can read it here), made these points:

  1. Questioning the guidance to eat more calcium, Hedsted asked:  “Why do populations with low-calcium diets have fewer fractures than do those with high intake?”
  2. He further observed:  “the long-standing recommendations to increase calcium intakes [though this may increase bone density] appear to have had little or no effect on the prevalence of osteoporosis or fractures in the United States.”
  3. Hedsted also noted the link between heart disease and osteoporosis—when one increases, the other follows.  This pattern is seen in country after country—what’s good for the heart is also good for the bones, and vice-versa. 

Acid/alkaline Theory

To better understand the acid/alkaline theory of osteoporosis, here are a few bone facts:

  • Bones contain calcium, but it’s only about 3 lbs. in our 25 or so lbs. of bone. 
  • Bones have other vital minerals, including phosphorous, and magnesium.
  • Bones provide structure for the body, but they’re also a reservoir for minerals that the body taps as needed.
  • For survival, the pH (a measure of acidity/alkalinity) of our blood must be controlled.  (Blood pH should be 7.4; if your pH is lower you have acidosis.)
  • If our diet causes blood pH to be too acid, the body uses first sodium, then calcium from our bones to buffer and remove the excess acid.
  • The peak rate of calcium removal (resorption) is greater than the ability of the body to add calcium (absorbtion).  This makes sense because survival depends on controlling pH.
  • Because there are limits on the ability to restore calcium to the bones (we’ll discuss the factors later), it’s important to limit removal over the long term. 
  • Some foods are alkali-producing when metabolized; others are acid-producing, which can be a problem. 
  • Basically, plant foods are alkaline while animal products (and processed foods) are acidic. 
  • It takes time, decades, but the modern diet will cause osteoporosis by dissolving bone to use the calcium for buffering excess acid.

Building strong bones:

How does the body build strong bones?  Our knowledge is incomplete, but here are some key factors:

  • Mom: The quality of your mother’s diet during pregnancy is critical, then your diet, especially during puberty (when mom was doing the cooking).  In girls, bone formation at menarche can be five-fold greater than during adulthood.  As always, much depends on Mom.
  • Mineral balance is critical.  Minerals make bones hard (a matrix of collagen makes bones flexible) but they are needed in balance.  Too much phosphorous, for example, inhibits the ability to absorb calcium (a calcium to phosphorous ratio of 2.5 to 1 is best).  One problem is processed foods, which contain fewer minerals but more added phosphorous.
  • Vitamins, especially D and K2, are needed for bone building.  There is controversy about the best way to get vitamin D (whether by sunshine, the historic method, or pills) but many experts believe we’re getting too little.  Vitamin K is found in dark greens and other vegetables; the body converts this to the needed K2. 
  • Estrogen plays a role for both men and women (yes, men produce a small amount).  The decline of estrogen after menopause is problematic for women.  Some foods stimulate estrogen production but this is not well understood.  What to do?  Until we know more, eat well and take care of your health. 
  • Want stronger bones?  Build stronger muscles!  Exercise stimulates bone growth, especially if the normal load is slightly and repetitively exceeded.  Exercise also builds muscle, which partners to strengthen bones.
  • Americans love sugar but sugar disrupts the calcium to phosphorous ratio, inhibits calcium absorption, and increases calcium resorption from bone. 
  • Chronic stress can interfere with the building of strong bones.  We’ll address stress in a future post but pick your battles carefully and create islands in time where you have peace, order, and harmony.
  • Calcium absorption is reduced by smoking, alcohol, excess caffeine and meat, and improved by eating whole grains, herbs and fruits.  All things considered, the Word of Wisdom is a remarkable recipe for good bone health. 

Summary:

Monitoring your bone health is like watching a glacier move, you need to take a long view.  There is much we don’t know and that likely won’t be known in our lifetime.  The best strategy then is to optimize bone formation and minimize the breakdown of bone to preserve blood pH.  Fortunately, the Word of Wisdom lifestyle works for both.


In the next post we'll discuss muscle-building exercises.  If you suffer from osteoporosis consult your doctor.  Be patient in adding exercises—try to avoid injury; see this as a marathon not a sprint. 

Budget Wisdom:  You don't need a fancy gym—gravity is free.  Jumping rope or climbing stairs is good for the legs.  Push-ups and pull-ups are good for the arms and shoulders.  A walker passed the house while I was working in the yard.  In conversation he said he does his age in push-ups.  I was impressed as he was in his 70s, though he looks younger.  Picking up small children counts too; as they get older you'll get stronger.  (They'll make you stop about the time they get to high school.)  The key is to incorporate into your daily life things that are harder than usual, and then do them for years and years. 

Comments:  Please share your experience with bone health.  What do your doctors recommend?  What works best for you?  What do you do to build and preserve muscle.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Sunday
Jul312011

The diet soda challenge

The quick answer:  America’s love affair with diet drinks was a big mistake.  Our recipe for better health: water, on the rocks, with a slice of lime.

____________________________________________________________________________________________

Heard of the Ornery Rule?  My invention, I confess, but it says you can count on someone finding the stuff you like the most . . . to be unhealthy.  Like sugar.  We’ve taken on America’s love for sugar—excess sugar is our single biggest health problem—with these Healthy Changes:

#1   If you consume sodas or other sugared drinks, limit yourself to one (12 oz.) serving per week. 

#3   Cereal products must be made of whole grains, and have more grams of natural fiber than grams of sugar.

#6  Drink lots of water; make it your main drink.

#8   Buy candy a piece at a time; never bring a box or bag of candy into the home.

#12 Enjoy a healthy mix of snacks by making a daily snack plate.  (Because sugary snacks are often impulsive, this adds the virtue of premeditation to snacking.)  

#25 Don’t skip breakfast.  Start your day with a healthy breakfast rich in antioxidants with more fiber than sugar.

Non-sugar sugar?

A little history?  In the beginning there was no sugar, just natural sweeteners like honey,  By and by, someone discovered how to make sugar from cane and in the 1600s, colonies were established in the New World to meet the growing demand.  Fortunes were built on the sugar trade.  Even before the cotton plantations of the South, slaves were taken from Africa to the Caribbean to work the cane fields.  In Europe, because sugar was so precious at first, it was usually sold in drugstores (apothecaries).  As the effects of eating sugar became apparent, doctors began to warn of its dangers.

During this time there arose in France a lawyer turned food writer named Brillat-Savarin.  In 1825 he composed the first important book on food, The Physiology of Taste.  It became a classic and nearly two centuries later is still a good read.  Brillat-Savarin observes how health concerns about sugar were met with the mindless rejoinder, “sugar hurts nothing but the purse.”   A learned man even promised that, “if sugar should ever again be thirty sous a pound, I will drink nothing but eau sucree.”  He wasn’t alone, which brings us to America’s love affair with sugar alternatives.

In 1890 it was discovered that saccharine gave the taste of sugar without the calories.  Prescribed first for diabetics, it was approved for general use in 1958.  Some remember it for launching Diet Rite and then Tab, the first big diet drink.  With saccharine, it seemed, you really could have your cake and eat it too, if you didn’t mind the bitter aftertaste.  Other artificial sweeteners followed: including cyclamates (no longer approved in the US); and aspartame (NutraSweet, or Equal), the most controversial of the sweeteners.

Coca-Cola, building on the popularity of Tab, introduced Diet Coke, which used aspartame.  Launched in New York City in 1982 with a $100 million advertising campaign, Diet Coke was an immediate success and is now the #2 soft drink, after Coke.  Not to be outdone, Pepsi, Dr Pepper, and Mountain Dew brought out diet versions.  Again, as with sugar, a few doctors spoke out against the danger of artificial sugars but the temptation of both sweetness and slimness was irresistible.

Are diet drinks really healthier than sugar drinks? 

This brings us to the big question:  Are diet drinks healthier than sugary drinks?  Long story short, diet drinks really are unhealthy, but in different ways.  For example:

  • Preterm delivery risk:  A 2010 Danish study found pregnant women who consumed one diet drink daily at 38% higher risk for preterm delivery.   There was also a dose response: women who drank four per day had a 78% greater risk.  No such risk was found for sugar drinks.
  • Metabolic syndrome:  A nine-year study of 9714 people, age 45 to 64 years, reported in 2007, looked for dietary causes of metabolic syndrome (which we discussed here).  High meat intake was found to be a significant risk but the big surprise was that diet drinks increased the risk 34%. 
  • Osteoporosis: There is a longtime link between diet drinks and osteoporosis, but the exact cause remains unknown.  Is calcium leached from the bones to buffer the phosphoric acid?  Or, do soda drinkers just get less calcium from sources like milk?  We haven’t figured it out yet, but perhaps it shouldn’t surprise us that research against highly profitable products doesn’t get funded.
  • Kidney stones:  Where does the calcium lost from the bones go?  Some winds up as kidney stones.  An NIH study of kidney stones found two or more cola drinks each day double the risk for stones.  As the most popular drinks, sugar or diet, are colas, urologists will be busy treating those painful stones. The calcium in your diet isn’t the problem—a 1993 study found calcium from food protects against kidney stones. 
  • Stroke and heart attack: A U. of Miami study of 2500 Manhattan residents followed over 9 years found a 61% higher risk of vascular events (heart attack, stroke, or vascular death) for daily diet soda drinkers vs those who abstained.  Even after controlling for known risk factors, a 48% greater risk remained.   
  • Weight gain:  There’s a bag-full of studies showing diet sodas add rather than reduce weight but this shouldn’t be news.  Back in 1986 a study of 78K women ages 50-69 found nearly 2 pounds per year greater weight gain for women consuming artificial sweeteners vs. women who didn’t.  A pound or two isn’t much, but multiply it by 28 years (since Diet Coke was introduced) and you’re looking at a big gain.

The problem of weight gain for diet soda drinkers was addressed in a Yale review of prior studies.  The conclusion was that artificial sweeteners reinforce the sugar desire, without satisfying it as regular sugar does.  No surprise then that the national weight gain of recent decades parallels the growing use of artificial sweeteners—the more we eat, the more we want. Good for business, but bad for health.

There’s true irony here:  Diet drinks—despite the marketing—don’t make us slimmer, what’s worse they introduce new health risks.  We’ve been through the sugar binge, high fructose corn syrup, saccharine, and aspartame, and the bottom line seems to be that we must return to olden ways and recover our taste for flavors other than sugar, whether real or artificial. A little sugar is okay, but we've gone way past a little.

Healthy Change #31 reads much like our first Healthy Change: 


Budget Wisdom:  Americans spend about $12 billion yearly on soft drinks, I’m told.  Drinking less bottled drinks, way less, and more good old water from your tap (well, after it runs through the charcoal filter) will save you money that can be better used to buy whole foods, as well as your health.  Water on the rocks with a twist of lime—you can't beat it for value, convenience, or healthfulness.

Please comment:  This is a challenge because diet drinks are tempting, especially for moms who want something to pick them up on busy days, which can be everyday.  For this reason I’ve saved it until our 31st week—after you’ve gained strength from the dietary improvements and extra exercise.  If you’ve successfully cut back on diet sodas, please share your experience.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Monday
Jul252011

Don't Forget Fiber

The quick answer:  Over the last century, dietary sugar consumption rose as fiber intake declined.  To reduce your risk of overweight and disease, eat more natural fiber than sugar.

______________________________________________________________________________________________

The 20th Century was a dietary disaster—we’ve said it before, but repetition is a principle of learning.  The industrialization of our food is presented in the graph above that compares traditional diets (Developing Countries) to the modern Western diet. For the thoughtful person, there is much food wisdom in this chart.

The diet of the Western countries makes a good business—not just for the food processors that comprise Food Inc. but also for the medical establishment that treats the resulting chronic diseases.  A premise of this blog is that as we eat and live better, we will have less need of doctors, drugs, and hospitals.  We’ll still die, and perhaps from those same chronic diseases, but we’ll have more years of good health to enjoy, and less years of bad health to endure.  (A younger person diagnosed with cancer, for example, will linger longer than an older less vigorous person with the same disease.  My Father died of cancer in his 90th year, but it was just a week from diagnosis to his passing.)

Two metrics define the 20th Century damage to our dietary: the year-by-year rise of sugar consumption, and the corresponding decline in fiber intake.  The third Healthy Change established the rule that food products must be made of whole grains and contain more natural fiber than sugar.  Prior posts addressed sugar; this post is about fiber.

 

The original weight-loss marvel:

Fiber is essentially the structural material of plant cells.  Whether soluble or insoluble (it doesn’t matter which, we need both), fiber is the original weight loss marvel: it provides lasting fullness yet has zero calories.   In addition, fiber optimizes the rate of digestion, slowing the rate that starch enters the blood as glucose (thus softening the swings in blood sugar and insulin that cause type 2 diabetes and fat storage) while speeding the passage of food through the G.I. tract (which reduces the risk of colon cancer). 

Dr. Denis Burkitt

In the course of the year we highlight twelve heroes of better nutrition, including Dr. Denis Burkitt.  Dr. Burkitt served in Africa as a missionary surgeon and his keen study of disease patterns led to the ‘80s bestseller, Don’t Forget Fibre in Your Diet.  (No fiber isn’t misspelled; Burkitt was English.)  The informative graph displayed above is from his book.  Burkitt single-handedly brought the removal of fiber by the industrialization of food to the public consciousness.  From his research—he painstakingly established a large network among hospitals to monitor the incidence of diseases—Burkitt linked the disappearance of dietary fiber with modern diseases like constipation (the first sign of fiber deficiency), type 2 diabetes, heart disease, gallstones, and breast and colon cancers.

Fiber deficiency diseases:

Over the last century fiber was steadily removed from our diet by the rise of processed foods, and the chronic diseases noted above.  Another result—I’ll try to be delicate here—was increased constipation.   (Fiber deficiency isn’t the only cause; other factors include too little exercise or fluid intake, or a diet high in dairy products.)  Most people don’t realize the danger of constipation-caused straining during bowel movements:

  • Straining causes hiatal hernias, a condition where the upper portion of the stomach is forced into the chest cavity, which causes the leakage of stomach acid and heartburn.  Rather than diet reform, people take antacids (Alka-Seltzer, Milk of Magnesia, Pepto-Bismol); more recently drugs to reduce acid production (Pepcid, Tagamet, Zantac) have been heavily advertised.
  • Straining can force partially digested food into the appendix where it can lodge, become infected, and lead to appendicitis.  Appendicitis is the most common emergency surgery of the stomach.
  • Straining can cause bulges or aneurysms in the large colon and the serious disease of diverticulitis.
  • Finally, straining is associated with the painful problem of hemorrhoids, which require no explanation.

Foods rich in fiber:

The humble legume—whether pea, lentil, or bean—provides more fiber than any other food.  See here for the legumes highest in fiber.

Besides legumes, foods rich in fiber include (for details go here):

  • Whole grains (a 2011 study showed whole grains to be significantly protective of death from all causes),
  • Nuts and seeds,
  • Fruits, especially berries,
  • Vegetables, particularly root vegetables such as yams.

Budget Wisdom:

It’s well known that legumes provide the best nutrition value for your food dollar.  What’s surprising is how little shelf space markets dedicate to dried beans, the very best food value.  Selling for around a dollar per pound, you can feed the family for pennies per serving.  If you’re serious about food value, this week’s Healthy Change is a natural.

Please comment:  Share the ways you include legumes in your family’s diet.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Graph from the book Don't Forget Fiber in Your Diet by Denis Burkitt

Sunday
Jul172011

Healthy Brains

The Quick Answer: For brain health, include natural antioxidants and omega-3 DHA in your diet.
_____________________________________________________________________________

Want to keep your wits?  Dr. Keith L. Black, chairman of neurosurgery at Cedars-Sinai Hospital recommends these five ways to care for your brain:

  1. Add omega-3 and antioxidants to your diet.
  2. Get at least 30 minutes of exercise three times per week.
  3. Sleep well.
  4. Take control of your stress level.
  5. Learn something new. 

We have discussed #2, exercise, here and here; #3 & 4 (sleep and control of stress) are planned for future posts.  So lets review #1—dietary omega-3 fats and antioxidants—in this post, beginning with antioxidants.

Glucose, Oxidation, and Antioxidants

The brain never rests so it needs lots of energy.  Though just 2% of our body weight, it consumes 25% of all glucose.  It takes oxygen to burn all this fuel, so the brain also consumes 20% of your oxygen supply.  We learned in a prior post that the body uses oxygen to burn the fuel we eat but the oxidized by-products, called free radicals, can harm cells if not neutralized by antioxidants.  Some of these toxic byproducts are called “advanced glycation end-products,” known by the acryonym, AGE.  It’s a good term because AGEs are theorized to cause the aging of cells that leads to disease and death.  For this reason, a diet rich in antioxidant sources (fruits, vegetables, and whole grains) is essential to protect against free radical aging. 

The neurons of the brains are different from your other cells.  Unlike cells which are regularly replaced, we keep our neurons for life.  So a diet lacking in antioxidants will cause the accumulation of free radicals and AGEs in the brain’s neurons and the result can be dementia.  To keep your wits, eat a diet rich in antioxidants. 

The brain is 60% fat. 

Let me introduce you to Dr. Michael Crawford, who practiced medicine for a time in Africa and studied the fats found in animals.  He learned that wild animals have mostly polyunsaturated fat while domestic animals have more saturated fat.  (He consequently wrote a controversial 1968 article in the New Scientist, “Are Our Cows Killing Us?”)  Because the brain is mostly made of fat, it was inevitable that Crawford would also study the brain.  He was surprised to find that while the composition of fat varied in the bodies of animals according to diet and activity, the brain fat of animals was remarkable consistent, with the essential omega-3 DHA fat comprising 25%.  (We discussed DHA, termed the “Queen of Fats,” in a prior post.) 

You’ll recall that certain vitamins, minerals, and amino acids are essential, meaning the body can’t make them so they must be included in the food supply.  (There are over 50 of these essential nutrients—there should be a deck of playing cards featuring each, so we can learn nutrition while playing cards.)  Among the various fats, the omega-3 and omega-6 fats are essential.  Here's the problem:  We eat too much omega-6 and too little omega-3. 

Because the omega-3 fats have a short shelf life once processed, they have been gradually removed from packaged foods.  The removal of omega-3 fats from the American diet in order to improve storage was discussed in a prior post, “The Worst Food Mistake of The Last Century?”  Dr. Crawford makes omninous comments about the shrinkage of brain mass since humans stopped eating wild meat, which is much higher in DHA than modern feedlot meat. 

There are three main omega-3 fats—known by the acronyms ALA, EPA, and DHA.  We get ALA from plants—all the green stuff we eat.  The irony of ALA is though it’s deficient in the American diet, it’s the most abundant fat on the planet.  There is true irony in this:  The richest nation misses out on the most vital fat because it's too "common."  To address omega-3 deficiency we had the Healthy Change of eating a green salad daily.  The green smoothie is another source.  

The body can process ALA into EPA, and then DHA but at a limited rate.  So for best health, we need to also eat some DHA to protect the brain, eyes, and nerves.   (DHA, ahem, plays an important role in fertility also.)  Here are dietary sources of DHA omega-3: 

  • Cold water fish (wild or even farmed salmon, tuna, trout, sardines, shrimp, oysters, and crab),
  • Eggs (especially if chickens are free range, or algae is added to the diet),
  • Meat (particularly liver, which no one eats anymore) from pastured ruminants (cows, sheep, etc.), 
  • The omega-3 fish oil capsules.

A prior Healthy Change, as noted, encouraged eating omega-3 fats daily.  This week’s change is more specific:  Be sure to also get some DHA omega-3 most days.  We try to eat fish twice a week (a tuna sandwich counts), or take a fish oil pill for each missed serving.  Maybe one of our smart readers will invent a sandwich with sardines (because of their small size they’re the safest for mercury).  We also buy the omega-3 eggs. 


Budget Wisdom
:  For the parents of newborns, there is no better value than mother’s milk.  Breast milk is high in the omega-3 DHA needed for brain development.  Dr. Crawford’s understanding of the critical nature of DHA led to a 30-year crusade to get it included in baby formula.  Finally, in 2002, DHA was approved for addition in the US, but is still not required.  As a result, for years formula-fed babies received insufficient omega-3 and studies have shown lower IQs and poorer vision as a result. 

Please comment:  For a generation we were incorrectly taught that animal fat was unhealthy, that saturated fat and dietary cholesterol caused heart disease.  Worse, man-made vegetable oils high in omega-6 and trans fats but deficient in omega-3 (due to processing and hydrogenation) were wrongly touted as heart healthy.  Today the healthiness of traditional fats, especially the omega-3s, is being rediscovered.  Please comment and share how this cycle of erroneous teaching has affected you and your family’s health, and what you are doing today to enjoy healthy fats, especially the omega-3s.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Monday
Jul112011

Healthy Hearts

The quick answer:  Better to learn how to care for your heart then have the doctors “repair” it.  See the seven steps below.

_____________________________________________________________________________________________

The motto of this blog, that we all "eat smarter, look better, and live longer" requires us to squarely face the greatest threat to longevity: the chronic diseases.

Chronic disease is a natural and preventable consequence of the mismatch between our biology and the modern lifestyle, especially our diet.  The good news is that while we can’t change our biology, we can change lifestyle.  “Chronic” suggests that symptoms develop slowly over years, even decades.  Dental cavities are an early warning of a diet gone awry.  Our sugary intake leads to other symptoms: high insulin levels, inflammation, insulin resistance, atherosclerosis, high blood pressure, and metabolic syndrome (discussed here). The end result may be an autoimmune disease, cancer, diabetes, or heart disease, this week's topic.

What Causes Heart Disease?

If there were a single cause for heart disease, we would have fixed it by now.  Sadly, a generation of time was wasted on the now-discredited “saturated fat-dietary cholesterol theory.”  The simplest answer is that heart disease has multiple causes, including the following lifestyle factors:

•  Smoking is a significant risk factor.

•  Excessive sugar intake leading to elevated insulin and triglyceride levels is an important cause.  See Gary Taubes’ book, Good Calories, Bad Calories. 

•  Chronic infection is a risk as shown by the link heart disease and gingivitis.

•  Central obesity (fat around the liver and other internal organs) is a special risk, even in people of relatively normal weight.

•  The Stress Theory posits that cortisol, the stress hormone, contributes to heart disease during chronic stress.

•  Lack of exercise is a significant risk; a 1996 study found that even 15 minutes a day reduced risk by almost half.

•  High homocysteine level, a result of vitamin B deficiency, is also a risk factor.  For more on homocysteine, see the N.Y. Times article, “The Fall and Rise of Kilmer McCully.”

•  Trans fats, from hydrogenated vegetable oils, are another cause.

Heart Disease Treatments

The intent of this blog is to provide fresh insight into the power of diet to prevent disease, and not to repeat what you’ve already heard.  You likely know that heart disease is the #1 killer of women as well as men, that women display different warning signs, and that women are slower to seek emergency help.  For more on women and heart disease, go here.   

Though the incidence remains high, deaths from coronary heart disease (CHD) have declined since 1980.  Reasons include better emergency and secondary care, more attention to high blood pressure, and the cutback in smoking.  The result is that people are living longer with heart disease and treatment has become an enormous business for drug and device companies, doctors, and hospitals.  Good business doesn't mean good medicine; the following therapies are getting a second look:

• The campaign against dietary cholesterol has not had a significant benefit, and Dr. Uffe Ravnskov, MD, PhD, questions the evidence for cholesterol-lowering drugs, in books like Fat and Cholesterol are GOOD for You.

•  The survival benefit of coronary artery replacement, is now questioned.  See also, Is Heart Surgery Worth It?

•  The use of catheterization to expand or stent coronary arteries, except to reduce persistent angina, may not be the best treatment. 

 

Preventing Heart Disease

Pioneering doctors have demonstrated that lifestyle improvement, including diet, and appropriate pharmaceutical support may be the best way to treat heart disease.  Dr. Caldwell Esselstyn of the prestigious Cleveland Clinic was among the first to demonstrate that lives could be saved through diet and other changes.  His book Prevent and Reverse Heart Disease, tells the remarkable survival story of 17 patients who followed his protocol.  On the West Coast, Dr. Dean Ornish has a similar program and also a book.  Other doctors have followed these pioneers.  If you Google “preventive cardiology” you get a million hits, a sign of progress.

Here is a short list of preventive measures against heart disease:

1. Develop a muscular lifestyle.  Forget laborsaving devices.  Walk everywhere you can.  Care for your own yard.  Exercise at least 30 minutes most days.

2. If you smoke, stop.

3. Eat a healthy diet of vegetables, whole grains, fruit, nuts, fish, dairy, eggs, and a little meat.  Avoid highly processed foods, especially trans fats.  Keep intake of added sugar below the AHA level.

4. Avoid protracted stress.  Pick your battles wisely.

5. Get plenty of sleep.

6. Have fun—smell the roses, laugh a lot, enjoy friends and family.

7. Get regular physicals but take ownership of your health in partnership with your doctor.  Keep a health log with regular checks of waist circumference, blood pressure, and fasting blood glucose, etc.  

You could add, “maintain a trim waist,” to the list, but this should naturally result from following the seven lifestyle steps.


Budget wisdom: 
I have always thought it wasteful to pay for both an exercise club and a gardener.  Cancel the gym membership and buy a hand mower, or plant a garden.  Rediscover the pleasure of long walks.  Without endangering your safety, save a little gas by riding a bike.  (Read about four women who rode across the US to promote preventive cardiology here.)  Try grinding wheat by hand, it’s a good workout (though it does take time).  Wash your own car, and your neighbor’s too.  Take up swimming.  Give your spouse a backrub, and a little loving.  It’s all good—the best things in life really are free.

Please comment:  How is life made more enjoyable by using your muscles?

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Tuesday
Jul052011

Dodging Diabetes

The Quick Answer:  The shopping list is the perfect place to manage snacking—if a snack is in the house you'll likely eat it; if it isn’t you won’t. ____________________________________________________________________

Have a great 4th of July?  (Clearly I did: I’m a bit late with this post.)  Independence Day is a good time to reflect on the American spirit, the unique virtues as well as the defects that influence how we live, eat, and die.  We are the world’s true pioneers.  No other country is so innovative.  We invented democracy (with a little help from the ancient Greeks), for goodness sake.  And we invented processed foods, soda pop, fast foods, and diet drinks.  We love change.  What other nation would so recklessly experiment with food innovations—like getting half our calories from sugar and other refined carbs—of unknown consequence?   

Books on Diabetes

I like to collect old books on nutrition, not because they’re old, but because they offer lost dietary wisdom.  Here, for example, is the English biochemist R. H. A. Plimmer in his 1925 book, Food, Health, and Vitamins:

The Americans, with their love of candy, are the largest sugar eaters in the world.  Incidentally, cancer and diabetes, two scourges of civilization, have increased proportionately to the sugar consumption.”   (Bold face added.)

We should have listened to Dr. Plimmer.  I have another book, not as old but just as revolutionary, by John Yudkin, with this long but descriptive title:  Sweet and Dangerous, The new facts about the sugar you eat as a cause of heart disease, diabetes, and other killers.  (First published in England as Pure, White and Deadly.)  Yudkin was the first to speak clearly about the dangers of our growing love for sugar.  People value these books: A used copy of Sweet and Dangerous is offered today at $100 while a copy of Pure, White and Deadly requires $199. 

Of course you can get the information updated at a lower cost with Nancy Appleton’s book, Suicide by Sugar: A Startling Look at Our #1 National Addiction.  Scary titles.

What Causes Diabetes?

Diabetes comprises a disease family that includes type 1, type 2 and gestational diabetes.  Type 1 diabetes, perhaps 5% of all cases, is an autoimmune disease of children that destroys insulin-producing cells in the pancreas.  The cause is unknown but a near-normal lifespan is now possible through improved medical technology.  

Type 2—the subject of this post—is an increasingly common consequence of the modern lifestyle.  How common?  Twenty-six million Americans have Type 2 diabetes, a chronic disease that leads to other diseases, such as heart disease, stroke, and cancer.  Seventy-nine million of us are prediabetic and at risk for full-blown diabetes.  These days, diabetes is a growth industry. 

So what causes type-2 diabetes?  This will drive you crazy but despite all the research, scientists don’t know for sure.  We think of diabetes as the sugar disease but it’s more complicated.  Not everyone who eats a lot of sugar gets diabetes.  There are other factors, including diet, family history, overweight, and lack of exercise.

The best book I’ve read on sugar and disease is Gary Taubes’ Good Calories, Bad Calories; Challenging the Conventional Wisdom on Diet, Weight Control, and Disease.  My conclusion after reading Taubes:  The best way to avoid the risk of overweight and diabetes is to bring sugar intake below the American Heart Association recommendation (6 tsp daily for women, 9 tsp for men), eat a whole foods diet, and exercise at least three hours weekly.  The Healthy Changes of the last six months build a foundation for doing this.

Where do we get most of our dietary sugar?  Sugary drinks (addressed here) and snacks!

Healthy Snacking

We talked about snacking in a prior post and implemented the Healthy Change of using a snack plate.  (Confession:  I sometimes forget and need to remind myself to do this.) 

Four principles for healthy snacking:

1. Commercial snacks are usually the unhealthiest food in the store and the worst value for your money.  Remember: money spent on unhealthy snacks is a vote for that company to succeed.

2. Watch for “boredom” snacking and substitute other forms of variety, like a walk, a chapter from a favorite book, calling a friend, or, ahem, checking your favorite nutrition blog. 

3. The key to healthy snacking is to eat a good (low G.I., whole food) breakfast.  Our worst snacking habits arise from stimulant-craving due to skipped breakfasts. (The danger of coffee, I suspect, is less about the coffee and more about habitually skipping a nutritious breakfast.) 

4. If your waist size is greater than your goal, eat a healthy breakfast and don’t snack after 8:00 pm. 

We’ll talk more about healthy snacks and proven waist-reducing habits in the next post, but just to remind, snacks can be organized in these groups:

•  Veggies

•  Fruits

•  Nuts and seeds (including popcorn)

•  Cheeses and yogurt

•  Leftovers

•  Home-made snacks (like crackers or cookies from healthy recipes).

Which brings us to the healthy change of the week:

If we don’t have unhealthy snacks in the home (or office), we won’t eat them.  If we have healthy snacks available, it’s likely we will eat them.  Pretty simple.  Got a nasty snack you can’t resist?  Buy just one serving, once a week.  The experience of many is that as you eat better, you’ll also snack better. 

Budget Wisdom:  As an experiment, wander the grocery store snack aisles and look at the cost per ounce.  Then compare to the cost of fruits and vegetables or other healthy snack ingredients.  With the exception of certain nuts and seeds, which I love, you save by buying healthy snacks.

Please comment:  Share your favorite healthy snacks.  We’ll collect your favorites into the next post.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Sunday
Jun262011

Protecting Your Guy

The quick answer: Remember how good the big hunk looked on your wedding day?  To keep your guy around as long as possible, replace the sugar and most of the meat in his diet with cruciferous vegetables and a few Brazil nuts.  Wives who cook control three of the five factors linked to prostate cancer in men. 

_________________________________________________________________________________________________

Could I tell a story?  Early in the last century an engineer turned doctor developed a safe process for making intravenous solutions (IVs) and founded a company called Don Baxter Laboratories.  Don Baxter is forgotten now but his IVs became central to medical treatment—it’s rare to see a hospitalized person today who is not hooked up to a number of IVs.  I worked for Don Baxter’s company (later known as McGaw Laboratories) for many years and our products included solutions used in a surgical procedure called TURP.  TURP stands for transurethral resection of the prostate, the standard treatment for men with urination and other problems due to an enlarged prostate. 

The urologists we met were interesting: they were regular guys and if their standing in the pecking order of doctors was humble, they were good at home repairs and tended to have a workshop in the garage.  In 1988 the status of urologists began to rise—a test for detection of prostate cancer (the PSA test) was introduced and a great hope arose that earlier treatment would reduce mortality of the #2 men’s cancer (after lung cancer).  So urologists rose from mere plumbers for men to healers of cancer, or so we thought.

There was a basis for our faith in the early detection of prostate cancer.  In 1943 Dr. George Papanicolaou published a paper of historical importance, “Diagnosis of Uterine Cancer by the Vaginal Smear”.  Basically, he invented the Pap smear screening test, which detected pre-cancerous cells of the cervix and allowed early preventative treatment.  If you look at the graph in our recent post on cancer, you can see the dramatic decline in uterine cancer since WWII, thanks to this good doctor.

So when the PSA test was introduced in 1988, it was presumed a similar triumph over prostate cancer would be achieved.  Men who tested positive were given the standard cancer treatments—slash, poison, burn (surgery, chemotherapy, radiation).  The side effects were dreadful but the benefit women received from the Pap test was not matched for men with the PSA test.  (Two recent studies, ERSPC done in Europe and PLCO done in the US, showed no detectable benefit, or a benefit small enough to not offset the risk, for treatment indicated by PSA testing.  The use of this test remains a topic of debate.)  So prostate cancer seems much like breast cancer (discussed here): the best protection is prevention through lifestyle reform. 

The chart above shows 75 years of cancer incidence for men.  Prostate cancer (PC) is second only to lung cancer, and it’s interesting they have declined in tandem (a delayed benefit of the decline in smoking).  The exact cause of any cancer is unproven but studies have linked these risk factors to prostate cancer:

1. Tobacco:  The more you smoke the greater the risk; overall smokers have 40% greater risk and the risk is doubled for those with >40 pack-years.   (A pack-year is one pack a day, done for one year, etc.)

2. Sugar:  Sugar drives insulin and higher insulin levels are linked to PC risk as well as overweight.  Overweight is a separate risk factor for PC.  A 2008 study showed a 300% greater PC death risk for men with both high insulin (measured by C-peptide) and overweight.  Avoid sugary drinks, refined carbs, and eat a low G.I. diet. 

3. Meat:  Eat meat sparingly; men who eat 5 or more servings weekly have 150% greater risk than those consuming 1 serving.  Conversely, dairy products, especially from pastured cows, contain vitamin K2, which is protective of PC.

4. Vegetables:  Veggies—particularly cruciferous vegetables such as broccoli, cauliflower, and cabbage—are protective against the most deadly PCs.  Include them in your diet most days.  Vegetables, whole grains, and especially Brazil nuts also provide selenium, which is protective of PC.  Eat a few Brazil nuts weekly.

5. Exercise, in the sun:  Men who got three or more hours of vigorous exercise weekly had a 61% lower risk of dying from prostate cancer.  Vitamin D also reduces risk, so consider running on the sunny side of the street.

Budget Wisdom:  Compare the cost of cruciferous vegetables to meat and you’ll find a real savings.  These veggies are also protective of women’s cancers.  An interesting fact:  A generation ago Americans spent about 15% of their income on food and 10% on medical care.  Today the numbers are reversed but you can save by spending wisely on food now and less on medical care, down the road.

Please Comment:  Share your best ideas and recipes for including cruciferous vegetables in the family diet.  In the next post we’ll feature a recipe for coleslaw. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Chart found here

Monday
Jun202011

The War We Lost

The Quick Answer:  Despite the billions spent in search of a cure for cancer, history keeps reminding that prevention through a healthy lifestyle is the wiser approach. 

______________________________________________________________________________________________

Cancer: The War We Lost

The picture of President Kennedy is a little faded—I took it in 1963 when he visited Costa Rica.  (He seemed so polished and elegant, bigger than life itself.)  Kennedy had launched our race to the moon just two years before, and Apollo 11’s successful landing in 1969 was a national confidence builder.  For years after when difficult projects were discussed, you would hear the phrase, “Well, we got to the moon didn’t we?” 

So you can’t blame President Nixon, in a moment of hubris, for declaring war on cancer in 1971, with the goal to find a cure by 1976.  A five-year cure seemed reasonable; after all we had discovered penicillin and other miracle drugs that could cure the killer diseases of the prior century, hadn’t we?  (It was also a moment of historical forgetfulness, for a single agent has NEVER cured a major disease.  Public health improvements—piped water, sewer systems, safer food—had brought the infectious diseases into decline before the arrival of penicillin.)  Never the less, an army of scientists was gathered and truckloads of money duly delivered.  What have we learned after 40 years and a few hundred billions of dollars?  That cancer is far more complex that anyone imagined, that there may not even be a cure for most cancers, and that a better goal would have been the prevention of cancer.  Considering the lives needlessly lost and the resources wasted, it was a terribly expensive lesson.

Last week we introduced the subject of chronic disease and the early phases—chronic inflammation, and metabolic syndrome.  Evidence suggests the chronic diseases have common causes, shared risk factors, which derive from the modern way of eating and living.  We’ll next look at the diseases: cancer in this post, then prostate cancer (breast cancer was discussed here), heart disease, diabetes, and so on.  Rather than repeat what you’ve already heard, we’ll look at these diseases in a new way, and from the viewpoint of prevention rather than treatment.  (Prevention is surely a unique view; of the billions spent on cancer research, less than half of one percent is spent on the benefits of nutrition.) 

Cancer is an ancient disease, perhaps the oldest.  Yet, though once rare, it has become terribly common.  The incidence rose steadily in the last century until it became the #2 killer in 1926.  Now, half of men and one-third of women will get cancer in their lifetime.  Some think of cancer as a modern disease because it’s growth is aggressive, self-absorbed, out-of-control, and ultimately self-destructive.  What could be more modern?

Here is a fascinating graph.  It shows 75 years of cancer incidence among women.  The graph for men is similar (just replace breast/ovarian cancers with prostate cancer) with the exception of lung cancer.  Men smoked more and earlier so had over twice the rate of lung cancer.  On the other hand they begin stopping sooner so are first to show reduction.  The most interesting curve is the steady decline of stomach cancer.  At the start of the last century it was the #1 cancer but safer foods (thanks to the FDA) plus the arrival of refrigeration (thus safer and less preserved foods) drove it down.  The decline in breast cancer in the last decade is due to stopping hormone replacement therapy—a practice not adequately tested before widespread advocacy by doctors.

If you study this chart in light of the failed war on cancer you might arrive at three conclusions:

1.     Despite a mammoth effort, cancer has not been cured.  (Though several minor cancers like childhood leukemia are now treatable, overall mortality has been reduced by only 5%.)

2.     Lifestyle changes, not curative drugs, have reduced a few common cancers. Changes included safer foods/refrigeration (stomach cancer), stopping smoking (lung and related cancers), and HRT cessation (breast cancer).

3.     Our best chance of avoiding the remaining cancers would be to stop hoping for a cure and seriously strive for a healthier lifestyle.

What to do?

We should first acknowledge how living the prohibitions of the Word of Wisdom has protected Mormons.  Tobacco has been associated with 400K deaths annually in the US and alcohol has been linked with 90K deaths.  People—regardless of faith—who neither smoked nor drank alcohol were spared.  We should note that the prohibited hot drinks (coffee and tea) have no deaths associated with them but their popularity drove increased consumption of sugar, which is linked to the rise of cancer.  (It was the availability of affordable sugar that popularized these otherwise bitter drinks.)

The next step is to follow the prescriptions of the Word of Wisdom and return to a natural diet of whole foods, with a little meat if desired.  Note the 10 steps in the prior post on breast cancer, based on work by the American Institute for Cancer Research.  In previous posts we:

•   Recommended cereal products be made of whole grains and contain more grams of natural fiber than sugar (see here),

•   Shared the recipe for our breakfast compote (here), and

•   Visited the cereal aisle of the local grocery and recommended healthier packaged cereals (here).

Recently I interviewed a group of teens before an early morning class, asking what they had eaten for breakfast.  These were good kids but they were not starting their day with a healthy breakfast.  Mostly they were grabbing whatever was available as they rushed through the kitchen on the way out the door.  So we need more attention on, and a little more time for, breakfast:

Budget Wisdom:  In the next post we’ll share a recipe for homemade granola that is less costly and tastier than the purchased products.  A reminder—if you buy oranges and squeeze your own juice, it’s about 1/3 cheaper and way more tastier than the store-bought stuff. 

Please comment on the healthy breakfasts that work for your family. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Chart found here.

Monday
Jun132011

The Chemical Fire Within

Short Answer: There is a chemical fire that burns within us all, managed by our immune system.  If our lifestyle forces it to burn without rest, chronic disease will eventually result.  You have been warned!
______________________________________________________________________________________________

Saturday morning I worked on this post, seeking a simple explanation for a complex and dangerous healthy problem common to the modern lifestyle—chronic inflammation.  Inflammation is the chemical firestorm driven by our immune system to respond to various threats and to heal injury.  When we mistreat our body the immune system must work without rest, and the resulting chronic inflammation sets the stage for the chronic diseases that will surely follow: metabolic syndrome (more on this in the next post), autoimmune diseases (a special risk for women of childbearing age), diabetes, heart disease, and cancer.  By the end of the morning I had made little progress on the post, which I had started the day before.

After lunch I went down to the beach to greet some guests, a pediatrician and his family.  There was a benefit at the beach for a big group of kids with type 1 diabetes.   As the kids walked by, our guest pointed out the patches and catheters for their insulin pumps.  I wanted to applaud the kids—T1D is a tragic autoimmune disease that strikes without warning, but from what I could see the kids were handling it well.  After they passed our conversation turned to nutrition and the protection of health.  I soaked up some rays—vitamin D protects against inflammation.  The 124 steps to get down to the beach are part of my exercise regime, another protection from inflammation.

In the evening we were guests of dear friends at a concert.  Orange County has a beautiful concert hall with superb acoustics, and an excellent symphonic orchestra.  The program included Gershwin’s Rhapsody in Blue, and a Rachmaninoff symphony.  It was very soothing; I held my beautiful wife’s hand and was grateful for the friendship of our hosts.  I’m no expert on classical music, but the excellence demonstrated by the orchestra planted the idea that I should reach higher in writing this blog.  It’s a worthy and meaningful goal.

Before the concert we dined at a new restaurant called the True Food Kitchen.  The menu—based on Dr. Weil’s anti-inflammatory diet—offers “simple, fresh, pure ingredients”, including vegetables, whole grains, and protein.  Anti-inflammatory diet?  I had struggled to write about it yet here it was in front of me and it tasted great.  I had the chicken chop salad.  The waitress did give me a copy of Weil’s Anti-inflammatory Food Pyramid; you can see it here.

People are becoming aware of inflammation and how it rages within us for years before the symptoms of chronic disease present.  How can you tell if chronic inflammation is a problem?  There are several tests; one increasingly used is the high sensitivity C Reactive Protein (hsCRP) test.  I had it done in a physical exam a couple of years ago and had an average score; not bad but not super good either. 

How do we reduce chronic inflammation?  Unwittingly, while struggling to write this post, the most important steps had found their way into my Saturday activities.  Healthy Changes have also taught them, with more to come.  In fact, the Healthy Changes constitute a handbook for avoiding chronic inflammation and protecting your health.  Here is a list of ten steps to reduce chronic inflammation (with links to those already presented):

1.     Reduce your sugar to below the AHA recommendation by cutting  back on sugary sodas,  avoiding sugary breakfasts, and slashing sugary snacks.

2.     Replace trans fats  and vegetable oils with traditional fats.

3.     Eat whole grains, especially fresh-ground.

4.     Eat anti-oxidant and nutrient rich fruits and vegetables.

5.     Be sparing in meat, eating more plant than animal protein. 

6.     Enjoy midday sunshine for vitamin D (but don’t get pink).

7.     Get regular exercise.

8.     Stress has a purpose, but don’t let the stress of life and work overwhelm you.  Organize your days enough to provide order, reduce chaos, and complete the tasks that make life meaningful.  The best guide to stress reduction?  The answer to this modern problem is in the Bible—take a fresh look at the Sermon On The Mount.

9.     Get adequate sleep, eight to nine hours daily, in the dark.

10.    Seek activities that build bonds with friends and loved ones, including dining together.

Budget wisdom:  The non-inflammatory lifestyle is the most affordable.  The person of modest means, who lives a simple but orderly life, enjoys friends and family, finds purpose within their faith, and takes their food as nature provided, has more chance of avoiding chronic inflammation than any billionaire surrounded by his possessions and served by his retinue.

Please comment on the lifestyle and diet choices that help you find harmony and health in daily living.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Tuesday
Jun072011

Fast Food Taste Tour

The Short Answer:  The fast food companies won’t get serious about healthy food unless they believe they’re going the way of the dinosaurs.  Only buy healthy fast food.

_______________________________________________________________________________________________

Kicking the Fast Food Companies

There’s no sport in kicking the fast food companies around—that’s been done in works like Fast Food Nation, and Supersize Me.  The ways that fast food can harm health seem unlimited—did you see the recent scare about perfluorinated compounds (PFCs) used to make fast food wrappings grease resistant?  Turns out the PFCs—a possible cause of infertility, thyroid disease, and cancer—are getting into the food.  Ouch! 

We should pause to honor an English woman little known in the US—Helen Steel.  In the ‘80s, as part of an activist group in London, Helen was handing out leaflets that accused McDonald’s of sins including 1) the exploitation of children, 2) inhumane treatment of animals, and 3) endangerment of workers and customer’s health.  McDonald’s decided to make an example by first infiltrating the group and then threatening the members with a libel lawsuit if they didn’t apologize and desist.  Intimidated by the overwhelming power of McDonald’s, most apologized and shut up.  But Helen dug in her heels:

 “It really stuck in my throat to apologize for something that didn’t deserve an apology, and I just thought, ‘Well, I’m going to fight this case come what may...” 

Helen had no resources and just one ally in the beginning, but serving as her own attorney she learned enough law to fight a ten-year court battle that became a public relations nightmare for McDonald’s, produced a book (McLibel: Burger Culture on Trial) plus a documentary, and gave new meaning to the term, “asymmetric warfare”.  Incidentally, the judge found in favor of Helen on the three sins listed above.  (Note to McDonald’s:  Resist the urge to use your corporate muscle to bully poor, single women with names like “Steel”.)

The Darkness of the World

The premise of this blog is that we can discover the best possible diet by using our common sense to integrate three venerable oracles: science, (food) tradition and scripture.  Because the media is unaware or at least unfamiliar with scripture—in contrast to most Americans—it seemed important the wisdom found therein be included.  Though our audience includes people of varied persuasions—some churchgoers, others not—none have protested our use of scripture. 

So perhaps you will allow me to share a thought that came while sitting in church.  I had been thinking about fast food, wanting to bring deeper insight to a food reviled by most, but consumed by many.  At the close of the service we sang a lovely song, Abide With Me; ’Tis Eventide, written by a Presbyterian minister in the 1800s.  The closing verse invokes a feeling we all have in our search for enlightenment:

“The darkness of the world I fear, would in my home abide . . .”

So what was my great thought?  It was to not add to the mountain of criticism already flung at the fast food companies, rather to shine a little light.  Because of their size, these companies have the power to do good also.  McDonald’s became the world’s biggest buyer of apples when they added fresh fruit to their menu.  My beautiful wife suggested that we go taste the healthful foods offered by these companies.  It was the last thought I might have had, but I was intrigued and we set out on a tasting tour.  There were a few requirements: we wanted food that was low in calorie density (one calorie per gram was our goal); more fresh produce than meat; not deep fat fried or even fried; and breads must be whole grain, with more fiber than sugar. 

Fast Food Tasting Tour

We started at the chain with the most outlets: Subway.  The guys running Subway must be smart because they beat the rest of the industry to the health movement with Jared, the guy who lost hundreds of pounds eating Subway sandwiches and exercising, the focus on food with less than six grams of fat, and the addition of whole-grain breads.  Is their food really healthier?  Maybe not; their meats are mostly processed and they have a wall-to-wall display of Frito-Lay chips.  But there is the tuna sub, which we ordered on whole-wheat bread with cucumbers, green peppers, onions, spinach, tomatoes, banana peppers, and vinaigrette dressing.  It was pretty healthy and tasted good.  My only complaint was the amount of mayonnaise mixed with the tuna (a 50:50 mix per the attendant).  Subway offers salads also, but they didn’t look appealing.  The shop was clean and well managed.

Our next stop was Taco Bell, the outlet with the cheapest prices.  You can buy your food fresco style now, which replaces cheese with fresh tomato salsa.  We had the Chicken Fiesta Taco Salad, fresco style.  It didn’t look that good, the tortilla shell was tasteless, and the greens were just iceberg lettuce.  I’ve eaten plenty of their tacos in the past, but I fear Taco Bell is falling behind.

I’ve never been a fan of Wendy’s square hamburger patty but we got a surprise:  Wendy’s does salad better than anyone else.  We had the Apple Pecan Chicken Salad, and it was an attractive, tasty dish.  The greens were mixed, the Pomegranate Vinaigrette dressing and toasted pecans were delicious.  The restaurant was clean and attractive; I’d come just for the salads.

Carl’s Jr. has changed; I thought it was a hamburger outlet (remember the Famous Star, or the Double Western Bacon Cheeseburger?) but the menu we saw was mainly Mexican food:  burritos, enchiladas, taco salad, etc.  Carl’s hasn’t gotten serious about healthier foods.  We ordered the Cranberry, Apple, Walnut Grilled Chicken Salad, I think, it was okay, but the cranberries and walnuts were missing.  Did I get the order wrong, or were they cutting costs?  I don’t know but it wasn’t in the class of Wendy’s salads.  On the other hand, the YouTube Charbroiled Turkey Burger advertisement featuring Miss Turkey shows they understand their audience. 

Our last stop was McDonald’s, the favorite fast food of kids, thanks to Ronald.  McDonald’s has a line of salads plus the Fruit and Walnut Salad, a snack.  We were full of salad so tried the Chipotle BBQ Snack Wrap.  It was good but of marginal healthiness (white flour tortilla, too much chicken, too few greens).  On further thought, it was like all their food:  too many calories, not enough wholesome stuff.  We tried a new drink, a strawberry-lemonade freeze.  It was beautiful to see, but sickly sweet with synthetic flavors that left a chemical aftertaste.  Mark Bittman reported a similar outcome earlier this year when they added oatmeal, titled the “bowl full of wholesome”, to their menu.  McDonald’s has the resources to really make a difference in the world but lacks the will to promote anything not sickly sweet.

We skipped KFC because I couldn’t find anything on their website that looked good.  I have enjoyed their cole slaw and baked beans in the past but both have too much added sugar, 17 or 18 grams, about 4-1/2 tsp per serving. 

A word about the people that work in the fast food outlets:  they’re good kids, they work hard for very little money and most smile when they talk to you.  Their life is hard but they don’t complain—I came away with a greater respect for them.

I had planned to make the Healthy Change for fast food similar to sugary drinks—to limit it to once a week or less.  Unfortunately, I doubt the fast food companies will make serious changes unless they sense a real chance they’re headed the way of the dinosaurs.   Here's one way to make the darkness of the world go away:

Please comment and share experience finding healthy food away from home. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Page 1 ... 4 5 6 7 8 ... 9 Next 10 Entries »