Minerals 101

The quick answer:  Most Americans are deficient in the essential minerals.  Mineral insufficiency is an underlying cause of chronic disease.  Avoid refined and highly processed foods in favor of whole foods, especially nuts, whole grains, and legumes.

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Two quotes on the importance of minerals in our dietary:

“You can trace every sickness, every disease and every ailment to a mineral deficiency.”    Dr. Linus Pauling, Nobel laureate. 

“It is not commonly realized, however, that vitamins control the body’s appropriation of minerals, and in the absence of minerals they have no function to perform.”    Dr. Charles Northern, early 20^th century researcher.

Essential Minerals

Sixteen elemental minerals are known to be essential to life.  As there are 92 naturally occurring elements, it’s possible that others will be discovered to be essential.  A diet of whole foods normally provides these needed minerals, though there are regional variations that can be important.  Iodine, for example, is deficient in the soil of the Great Lakes area and widespread deficiency was discovered during physical exams for WWI inductees.  Iodine, added to salt in 1924, was the first supplement to our food supply and though successful, established the risky idea that Man could improve upon Nature.    

Before we leave iodine, the work of a young Ohio doctor named David Marine should be remembered.  Iodine deficiency can cause an enlarged thyroid or goiter and the soil iodine deficiency around the Great Lakes led to a regional nickname: the goiter belt.  Dr. Marine had shown that iodine could resolve goiters in animals so proposed an experiment among school children in Cleveland, where he practiced. He was denied.  Undeterred, in 1916 he found a cooperative school board in Akron, which had even more schoolgirl goiters (boys get them also, but girls are more susceptible).  It would be hard to imagine such an experiment today.  Marine’s experiment was successful, dramatically reducing the number of goiters, and laid the foundation for the national iodization of salt.

A parting thought:  A generation before Dr. Marine, pure salt had replaced sea salt in the American diet.  Purifying salt removed 76 trace minerals, including iodine.  Though the soil in the goiter belt was unusually low in iodine, Dr. Marine didn’t add iodine as much as he restored it. 

The essential minerals are divided into groups by the amount stored in the body.  The seven major minerals range from around 3 lb. (calcium) down to 5 grams, including also, magnesium, sulfur, and the electrolytes, sodium, potassium, and chloride.  The minor elements (less than 5 grams) are iron, zinc, iodine, selenium, copper, manganese, fluoride, chromium, and molybdenum.  Of the minerals, four merit attention:

Calcium

Say the word “calcium” and bones or osteoporosis comes to mind.  Calcium, though critical, comprises just 3 of the 20 or so pounds of bones in our bodies, so other minerals, like phosphorous, magnesium, and manganese are also important.  In fact, the bones are the body’s mineral bank, minerals are constantly being withdrawn and deposited and like bank accounts, it’s critical to maintain a good balance. 

Good bone health, especially for women, is critical to enjoying the golden years.  Back in 1968 two American doctors theorized that the rise in osteoporosis was due to the modern diet, high in acidic processed foods and animal products, and low in alkaline fruits and vegetables.  Bone decay was due not to insufficient dietary minerals (the deposits to our bone bank), they posited, but due to excessive withdrawals of minerals like calcium to buffer our acidic diet and maintain body pH.  In next week’s post, we’ll return to the subject of bone health.

Sodium

Everyone knows we eat too much sodium, but only 6% of our intake comes from the saltshaker on the table.  The people we’ve turned our food preparation over to—processed food corporations, fast food chains, and restaurant chefs—are adding about ¾ of the salt in our diet.  You can’t blame them, salt is the cheapest flavor, easy to add, and has a long shelf life. 

In a recent post (see here) we raised a more important issue—the ratio of sodium to potassium in our diet.  These two minerals work together so a healthy balance is more important than the amount consumed of either one.  Bottom line, we need to eat less sodium and more potassium.  Potassium is found in plant foods, especially in the source of plant life: nuts, seeds, and legumes.  As noted, our sodium-potassium ratio is actually our processed food-whole food ratio.  If we cook most of our meals using whole foods, we shouldn’t have to worry about potassium or sodium. 

Magnesium

The body needs magnesium to form body tissues, including building and repairing bones.  Magnesium is also part of hundreds of enzymes that regulate organs, including the heart.  Because cardiac failure is a common cause of sudden death, researchers tracked 88K women of the Nurses’ Health Study for 26 years to see if magnesium deficiency played a role.  The result was startling:  women with the highest blood level of magnesium had a 77% less risk of sudden cardiac death than those with the lowest level.  Study of the same data also showed magnesium protective of type 2 diabetes.  While the exact mechanisms aren’t proven, it seems wise to include magnesium in our diet, as one report claims 95% of Americans are deficient.

Natural sources of magnesium include nuts, legumes, and leafy greens. 

Selenium

Selenium is an important antioxidant, which may explain its success in cancer prevention.  Multiple studies have demonstrated that selenium is protective of breast, prostate, liver, and bladder cancers.  In a 1996 University of Arizona study of 1300 older persons, those given daily selenium doses had 42% less cancer, compared to those given a placebo.  And those in the selenium group who did get cancer had a 50% lower death rate than the control group.

Brazil nuts are an excellent source of selenium; other sources include seafood and plant foods grown in the western US (where soil selenium levels are higher).

Budget wisdom:  You likely saw the newspaper articles this week, that it costs the average person $380 more each year to follow the government food guidelines.  Because of the knee-jerk spin the media puts on news, these headlines followed:

•   Report: Eating Healthy is too Costly for Many Americans

•   Healthy food: A choice or a privilege of the rich?

•   Nutrition Study: Healthy Eating is Too Expensive.

•   Study:  Healthy Food Can Only Be Afforded By The Rich.

Such reporting seeks to make victims of lower-income people and falsely presumes the well-to-do are enjoying healthy home-cooked meals.  Further it ignores the American knack for creative problem solving. Sometimes it seems the media is part of the problem, rather than the solution.

A premise of this blog says the careful and organized family can eat healthy food and pay little more than those who eat processed foods and dine at fast food and similar restaurants.  In the next post we’ll discuss affordable sources of nuts.

Please comment:  How do you include minerals in your diet?  Have you tested deficient for a mineral?  Is osteoporosis a concern?  When a doctor suggested you take calcium pills, what did you do?

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.

Keeping Your Marbles

The quick answer: Hippocrates first observed that what's good for the heart is good for the brain.  Living the Healthy Changes helps to protect your brain from the twin threats of dementia and stroke.  

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Preventing dementia, including Alzheimer’s disease

We went to a funeral the other day for one of the loveliest people you could hope to know.  Her name was Nancy and she left us at a relatively young age.  Nancy was in her mid ‘60s, just entering what should have been her golden years.  But in truth, Nancy had left us some time before, for she died of Alzheimer’s disease.  Alzheimer’s, the most common form of dementia, is growing at a frightening rate.  This post is dedicated to the memory of Nancy, and the proposition that the Word of Wisdom Living lifestyle can reduce the risk of dementia, as well as stroke.

A 2005 Columbia University study found four risk factors that were highly predictive of Alzheimer’s disease (AD).  Per the study, your risk of AD is 240% greater if you have three of these four conditions:

• Smoking,
• Diabetes,
• Hypertension,
• Heart disease.

A 2010 study, also at Columbia, found a strong link between HDL cholesterol—known fondly as the “good” cholesterol, though in fact we need all the forms of cholesterol, just in the right ratio—and the risk for AD.  Those with higher HDL levels (>55 mg/dL) had 60% less risk of AD than those with lower levels.  How do we improve our level of HDL?  Here is a summary:

• Get regular aerobic exercise (more is better).
• Lose excess weight.
• If you smoke, stop.  (Is there no end to the ways tobacco harms the body?)
• Eliminate manmade trans fats (eat nothing hydrogenated).
• Eat whole foods (lower glycemic index plus more fiber and nutrients).  A diet high in sugar is a special risk for AD—those who consume the most sugar have a six-fold greater risk vs. those who eat the least.
• Eat fish (rich in the essential fat, omega-3).
• Get adequate B-complex vitamins (including niacin).

The last protective action—getting adequate B-complex vitamins—brought to mind a study of AD among Catholic nuns reported in the book, Amazing Grace.  In a prior post we discussed the link between the B vitamin folic acid and spinal cord birth defects, particularly spina bifida.

Amazing Grace found a similar protection for folic acid against AD.  It’s most interesting to learn how vitamins that are protective at birth also protect our brain at the end of our lives.

There was also a link between AD and homocysteine, a normal chemical which can be harmfully high when folic acid and other B vitamins are deficient.  In the post on heart disease, elevated homocysteine was an important risk factor.  In fact, if you look over the lifestyle habits that protect from heart disease, you find the same constellation that is protective of dementia.  Because tradition is one of the three sources of wisdom for this blog, we should now honor the ancient physician Hippocrates who said: 

“Food that is good for the heart is likely to be good for the brain.”

A Personal Story

May I tell a story?  In 1991 I took a position with a new medical device company called Target Therapeutics.  With the help of leading doctors, this company founded a new field of medicine called interventional neuroradiology.  Basically we provided doctors with miniature catheters and other tools to treat structural brain disorders by working from inside the blood vessels.  (This was much less invasive than surgery by cracking open the cranium.)  At first we provided catheters for diagnosis but our fame came from an innovative treatment for treating aneurysms.  Yet all the time our big goal—a task still unfulfilled—was better treatment of strokes. 

My work here brought an unexpected moment of closure.  When I was just three years old—this is the short version of the story—I fell out of a moving car and suffered a brain injury that might have proved fatal.  The concussion caused a slow-developing hemorrhage that put increasing pressure on my brain.  As the clot grew over weeks, I became less active, sleeping more and more.  Because the progress was slow, the doctor involved was not concerned.  My parents were frightened, however, and through a serendipitous chain of events my Mom got into the office of a neurosurgeon in San Francisco.  This was during the early years of neurosurgery but the doctor immediately saw the problem and arranged a life-saving surgery not available where I lived.  (Yes, that's me in the picture above, wearing a protective cap during recuperation.)  Years later, while working at Target Therapeutics and observing the use of our products I visited that same hospital where my life had been saved as a child.  I think it was this moment of closure that sparked a continuing interest in promoting brain health.  For this reason, I call your attention to stroke prevention and treatment.

Treating Stroke

Stroke is the 3^rd leading cause of death in the US, causing 160,000 deaths each year.  Because breast cancer has been so well advertised we should note that more women die of stroke than breast cancer.  In fact, strokes are much more easily avoided—up to 80% of strokes are preventable.  It’s a tragedy that our society is not more effective at preventing, or quickly treating, strokes. 

Most strokes are ischemic, meaning a clot blocks an artery in the brain, cutting off the flow of blood and life-giving oxygen to brain cells.  A minority of strokes is hemorrhagic, meaning a blood vessel bursts, usually due to an aneurysm, and leaks into the brain cells.  Avoiding high blood pressure is the first protection against stroke. 

It’s important to remember that when a stroke occurs, it takes 4-8 hours for brain cells to die—a much longer treatment window than in heart attacks.  Therefore, recognizing the signs of a stroke and quickly getting to a major hospital—one with a certified stroke center and interventional neuroradiologists trained in methods of treatment—is essential to survival.  I repeat: essential! (If you don't know the best hospital, get to the biggest one and inquire.)

Borrowing from the success our society had in alerting people to the signs of heart attacks, it’s helpful to see strokes as brain attacks, and be aware of the signs.  Because the brain is separated into two halves, stroke symptoms usually affects one side of the body.  As a public service, the American Stroke Association posts these stroke signs to watch for:

• Sudden numbness or weakness of the face, arm, or leg, especially on one side,
• Sudden confusion, trouble speaking or understanding,
• Sudden difficulty speaking,
• Sudden trouble seeing in one or both eyes,
• Sudden trouble walking, dizziness, loss of balance or coordination,
• Sudden, severe headache, with no apparent cause. 

If someone you know shows these symptoms, respond quickly. 

One other  fact about strokes—strokes can be “tiny”, and these are called “transient ischemic attacks” or TIAs.  With TIAs the above symptoms may pass, but there can be loss of brain cells and the accumulation of TIAs is one cause of dementia.  It’s equally important to see a doctor about TIAs because treatment can prevent a more devastating stroke, as well as progressive dementia.

Preventing Stroke

We should follow Hippocrates’ advice; the following protect both the heart and the brain:  Manage your blood pressure, avoid the use of tobacco and alcohol, eat a healthy diet, get plenty of exercise, avoid or control diabetes, and watch out for TIAs.  One more thing (I hope this isn't too much information): be aware that the heart problem of atrial fibrillation can increase your stroke risk by 500%!  For more information, visit the website of the National Stroke Association.  

Please comment:  We’re not used to thinking of the brain when we discuss diet and other lifestyle improvements.  Have the posts this week helped you to know how to hang on to your marbles?

What Builds Bones?

The Quick Answer:  Calcium (essential for bone health) deficiency is a problem for adolescent girls, menopausal women, and older men.  There is growing evidence that getting calcium from whole foods works better than taking it in pill form.  The foods in this picture provide 700 mg.

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In 1939 Dr. Weston Price published a remarkable book, Nutrition and Physical Degeneration.  Price studied 13 indigenous civilizations from his expeditions, comparing dental decay in people eating traditional diets to their cousins who had moved to the cities and adopted the modern diet.   He concluded that it was possible to prevent dental cavities (or caries) through diet, and that prevention was better than repair.  His work was ignored, and the business model for modern dentistry was built on repair rather than prevention.  This is a repeating story in nutrition: repair, in our culture, makes a better business than prevention (which requires that so un-American behavior—self-restraint).

I intended to share more about Dr. Price until I discovered that May was National Osteoporosis Awareness & Prevention Month—I almost missed it.  Osteoporosis is a lot like dental cavities—repair makes a better business than prevention.  Here are a few facts:

•  Half of women over fifty will break a bone because of declining bone density; worse, there is the risk of “dowager’s hump.” 

•  For men the risk of age-related bone fracture is one in four. 

•  Risk factors for osteoporosis include: insufficient dietary calcium, vitamin D deficiency, excessive intake of protein, sodium, and caffeine, and lack of exercise.  (Smoking and heavy alcohol intake are causes also, but if you’re reading this blog you don’t likely have those problems.)

My beautiful wife was upset recently because the doctor gave her a stern lecture for not taking calcium and vitamin D pills.  I was puzzled because the doctor had not tested her to see if there was a deficiency, or made a diagnosis of bone loss.  He claimed the benefit was well proven; I thought it would be wise to see the proof.  My wife is caught between her doctor’s faith in pills, and our faith in wholesome food. 

This week the prestigious British Medical Journal reported on a major long-term study that addressed this question; the article was titled “Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study.”  (An online digital version is available here.) 

The study tracked diet, supplements, and bone fractures in 61,400 postmenopausal Swedish women for nineteen years, starting after they turned fifty.  This is the most complete study of diet and bone health to date and the article made these surprising statements:

•  There is currently a wide range of daily calcium recommendations: The UK calls for 700 mg; Scandinavia, 800 mg; the U.S., 1200 mg; and 1300 mg in Australia and New Zealand.  (These values include dietary calcium and any taken in pill form.  Because no one knows how much calcium they get in their diet, these targets are not very helpful.)

•  Reviews of prior studies have found little or no benefit to taking calcium in pill form.  Eating calcium as part of a healthy diet seems to be best but the optimum amount had not been determined.

•  The study concluded that the optimum dietary intake of calcium for postmenopausal women was 700 mg daily.  Taking less resulted in more hip fractures; taking more also caused an increase in hip fractures, though at a reduced rate.  At lower levels of calcium intake, vitamin D intake was especially helpful.

•  Taking calcium in pill form as a supplement did NOT show a benefit.

Based on this major study, we should:

1. Eat more foods rich in calcium.  This is critical for adolescent girls, menopausal women, and older men.  The most recent data (NHANES 2002-6) showed older women averaging about 560 mg of calcium daily from food sources; men were getting a little more, about 650.  Because we already get 51% of our calcium from milk and dairy, getting more from plant sources seems wise as there are other reasons to eat more dark green vegetables, legumes, nuts and seeds. (Plant-sourced calcium also increases estrogen activity in women, and reduces the risk of kidney stones.)

2.  Discuss with your doctor the wisdom of taking calcium in pill form; he should be aware of other health considerations.  Getting sufficient calcium is a bigger challenge if you avoid milk or dairy.  (All this is a tough topic for doctors as they have been guided to push calcium supplements.)

Dietary Calcium

What does 700 mg of calcium from natural foods look like?  The picture above tells the story, but here are the details:

•  Breakfast of Post Grape Nuts and milk (1/2 cup each): 165 mg.

•  Morning snack of cheese (1/2 oz.) and whole wheat cracker: 100 mg.

•  Lunch of canned tuna on whole wheat store bread (wheat isn't a significant sourse of calcium; the bread shown is calcium fortified):  87 mg.

•  Afternoon snack of yogurt (2 oz.): 100 mg.

•  Dinner of spinach salad and a bean dish: 212 mg.

•  Evening snack of walnuts, Brazil nuts or sunflower seeds: 30-40 mg.

We’ll come back to bone health in a future post—it’s a complex subject that scientists are still unraveling.  Three parting thoughts:

1. Remember that besides dietary calcium, exercise, adequate vitamin D, and avoidance of excessive salt and caffeine are also important to bone health.

2. Strong bones go hand-in-hand with strong muscles.  Both peak in our youth; the key to health is to slow the decline.

3. Exercise builds muscles and most muscles are attached at each end to a bone.  So besides improving your appearance, exercising your muscles also strengthen your bones.

Please comment on your approach to calcium sufficiency, or your experience protecting bone strength.

Dental cavities: Preventable and curable?

The Quick Answer:  If you or a family member gets one cavity in three years, it’s not just an unnecessary expense that will lead to future pain and expense; it’s also a wake-up call to take preventative action.  Buy more fluoride?  No!  Eat less sugar (and more whole foods, including green salads).

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Here’s a fresh look at a common childhood disease: dental cavities (or caries).  The chronic diseases—type 2 diabetes, heart disease, cancer, autoimmune diseases, etc.—may take decades to develop, but cavities, which have a shared cause, can develop in baby teeth.  There’s a saving grace in the baby tooth cavity—if taken seriously, it’s an early warning that preventive change is needed to save the permanent teeth that follow.  Dental caries are highly preventable and curable, if caught early, by diet reform.

Dental cavity questions:

•  How big a problem is dental decay?   Cavities is the single most common chronic childhood disease (over 50% of children 5-9 years have at least one cavity; 78% of 17-year-olds do.  (How do 22% reach 17 with none?)

•  What causes cavities?  Sugar, mainly.  Bacteria that live in the plaque on your teeth use sugar to produce acid that can demineralize tooth enamel.  The body can repair this through remineralization but only if the plaque isn’t too acidic.

•  Can cavities be prevented?  Technically, yes, but you must move beyond the advice of the old dental establishment and the government.  If you Google “dental cavities, prevention” you will get official guidance on brushing & flossing, fluoridation, dental sealants, and regular visits to your dentists.  This is all good, it’s certainly a good business and does reduce decay, but history shows it won’t prevent or cure cavities.  Surprisingly, diet—the major factor—gets little mention.

•  So, can people actually prevent and even cure cavities?  Pretty much, but there are issues of family history, including genetics, and the fact that you’re starting well after your teeth were formed.

•  Is preventing and curing cavities a recent discovery?   No.  Important discoveries were made way back in the 1920s and 1930s and then forgotten.  So we should remember two pioneering women:  Dr. May Mellanby, and Mrs. Weston Price.

Dr. May Wellanby was the wife of Dr. Edward Wellanby who solved the problem of rickets (like caries, a bone disease) and contributed to the discovery of vitamin D.  His wife, a brilliant scientist in her own right, studied the epidemic of dental caries using dogs and then humans.  She found diet combinations that drastically reduced cavity formation and actually healed smaller cavities.  May Wellanby published her discoveries in 1924 (credit to Stephan Guyenet for this summary):

•  A diet with adequate minerals, particularly calcium and phosphorous (the ratio is important), is critical;

•  The diet must also include the fat-soluble vitamins, especially vitamin D which is also obtained from sunlight;

•  Dr. May Wellanby recommended a varied diet of whole foods, including dairy, and cautioned against excessive sugar and [refined] grain intake.

Mrs. Weston Price didn’t leave a record of her work; her contribution was to assist her husband during the ‘30s on expeditions around the world to the most primitive indigenous people they could find.  Their mission was to study the dental health of indigenous people who had not yet adopted the Western diet of refined foods, and compare them to their cousins who had moved to the city and converted to the modern diet.  Weston published his findings in the 1939 book Nutrition and Physical Degeneration:

•  Price found that for the same indigenous population, dental cavities were 35 times higher (that’s 3400% more) on the modern refined, sugary, diet, than on the traditional diet. 

•  Traditional diets were not only protective against cavities; they also resulted in well-formed dental arches in newborns.   Their cousins born in the city had the crowded malformed dental arches that delight the orthodontist.

•  Price visited tribal people all over the world who lived in varied climates and ate different diets.  What they had in common was an evolved food tradition based on natural foods and game at hand that sustained health. 

Preventive Dentistry:

Here we have a familiar story:  science has discovered a great deal about how caries develop, but we must turn to food traditions to learn how we can prevent them.  When scientists studied dental plaque—the coating on your teeth—they found a surprisingly complex community of bacteria that they gave a new name: biofilm.  Many of the bacteria in biofilm produce acid and when there is too much acid (the pH has to drop below 5.5) tooth enamel is demineralized, or eaten away.  When the pH is above 5.5 (less acidic) enamel can be remineralized, or repaired if given a healthy diet.  Your saliva is key to a healthy acid level.

The biofilm is constantly bathed in saliva.  Saliva, 98% water and sometimes called the blood supply for the mouth, is a rich broth that can buffer excess acid; it contains minerals, proteins, antibacterial agents, and enzymes needed for digestion of food.  The mouth produces about a liter of saliva each day, so drinking adequate water is as important as a healthy diet.  Prescription drugs present a special problem; there are around 3000 medications that have the side effect of “dry mouth,” which accelerates the formation of caries and gum disease.  If this warning is on the package insert of a drug you take, consult your dentist.

I had a phone interview with Dr. Cliff Sorensen, who practices preventive dentistry in Ogden, Utah.  I had read about Dr. Sorensen’s work so gave him a call, thinking that because he had once dated both my future Beautiful Wife and one of my charming sisters, he would talk with me.  We had a great conversation about saliva, biofilm, acid-producing bacteria, caries, and the difficulty of getting people to change self-destructive habits.  Dr. Sorensen gave up drill-and-fill dentistry, at considerable personal expense, when he became convinced that, for most, dental caries was preventable and curable.  As explained, he provides a cariogenic assessment and based on the outcome, provides guidance and support as appropriate.  (I like that word, cariogenic, meaning cavity or carie-producing.)

Dr. Sorensen doesn’t give nutrition advice, except to eat a healthy low-sugar diet.  I am not aware of any dentist who does; as you know, the subject is complex and the science incomplete.  But the guidance of science, tradition, and scripture combined can give us the best possible answer and that is the goal of this blog.  For example:

•  Cariogenic foods begin with sugar, but include refined and processed foods too.  Growth of the caries epidemic has paralleled our growing sugar appetite.  So sugary drinks and snack foods are a problem.  Research suggests eating less than 33-44 pounds of sugar a year will protect against dental caries.  This can be accomplished with the three sugar Healthy Changes (found here, here, and here), based on meeting the AHA’s maximum intake of six (women) to nine (larger men) daily teaspoons, which is about the proposed 33-44 pound maximum. 

•  Protective (non-cariogenic) dietary includes a variety of whole foods including dairy, plus adequate vitamin D (discussed here) as suggested by Dr. May Wellanby nearly 80 years ago.  Calcium and phosphorous are important minerals for bone health.  It's well-advertised that milk and dairy supply calcium; it's less well-known that plants are an essential source.  An important plant source is the leafy green vegetables used in salads.

Comment:  Share your favorite salad recipes, or your experience preventing cavities. 

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.

what if there isn't a cure?

One of the things I admire most about women is the way you rush to support a friend (or a stranger, even) in distress.  Take breast cancer.  I’m moved when I see a picture of a woman who has lost her hair to chemotherapy surrounded by friends who have shaved their heads in support.  I think you would do anything for your sisters.  You walk, run, and ride bikes in the race for the cure. 

But what if there isn’t a cure? 

The portrait above was taken in the heroic style popular after World War II.  It’s a most American picture.  You see a young couple holding their children, framed against the sky in a way that makes them seem a little bigger than life, bravely striding into a promising future.  The Quonset hut (a low-cost portable building left over from the war) is their home.  Who are they?  I remember them as Uncle Glen and Aunt Adele; they’ve been gone a long time.

Glen was a war hero in my mind, a Marine who fought in the terrible WWII battle for Okinawa.  Adele was an unusually intelligent woman; her home was always extra nice.  She likely planted and cared for the sweet peas in the corner of the picture.  The children are my cousins Linda and Vicki; later there was a son, Rick. 

And the future they were striding into?  It was brief—each died in their early thirties.  Glen in an accident; Adele of breast cancer, an unusual case, given her youth.  Perhaps the sudden loss of her husband was a factor.  As a young boy I was a spectator to the tragedy of their deaths.  Their orphaned children, Linda, Vicki and Rick, were taken into our home, so I was also witness to how hard it is for young children to lose their parents. 

This childhood memory is my only qualification to write about breast cancer; maybe it’s enough.  So I repeat the question, “What if there isn’t a cure?”  In a caring way, I sometimes ask women, “What should you do to prevent breast cancer?”  The most frequent response is to get regular mammograms.  Then I point out that a mammogram is for when you already have cancer and repeat the question.  Most women are unsure; a few know a preventative measure or two.  But that’s about it. 

So in memory of my Aunt Adele, and with the hope of not adding to the burden of the breast cancer survivors in our audience, I offer ten steps to reduce a woman’s risk to breast cancer.  This is not my work; it is based on a 2007 meta-study done by experts working for the American Institute for Cancer Research.  I have added guidance from work by other scientists.  With time this list should get better, but it’s the best I could find. (If you've been following our weekly Healthy Changes since January, you'll see that you are already doing many of these steps.)

1. Avoid alcohol.  If you choose to drink, limit alcohol to one drink per day. (It’s presumed you are avoiding tobacco.)

2. Stay lean.  As lean as possible within the healthy weight range.  (Elevated body fat is a risk factor after the teen years.)

3. Be physically active.  Every day, for at least 30 minutes. 

4. Have children early (in your adult years) and as often as you choose.  Breast-feed infants at least six months.

5. Limit sugar to the AHA daily guideline of 6 tsp. for women and 9 for men.  Avoid sugary drinks and limit consumption of candy as well as sugary breakfast cereals and bread products.  Less is better.

6. Limit intake of red meats and dairy; avoid all processed meats. 

7. Eat a varied diet rich in fruits, vegetables, whole grains and legumes.  (These foods are an excellent source of protective antioxidants including vitamins A and C.)

8. Eat food, not pills (unless prescribed by your doctor).  Avoid the use of multivitamin pills, or supplements to reduce cancer risk.  (See AJCN March 24, 2010, “Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women”.)  Hormone replacement therapy is also a risk factor for breast cancer.

9. Maintain a healthy level of vitamin D with moderate sunshine where possible.

10. Eat healthy fats.  Avoid all trans fats (noted by the word hydrogenated in the ingredient list).  Eat natural fats like olive oil and butter in moderation and minimize vegetable oil products.  (Limiting food with vegetable oils like chips, will improve the important ratio of omega-6 to omega-3 fats as well as reduce salt intake.)

The AICR recommends that cancer survivors—after receiving treatment—also follow their preventative steps.  Readers are invited to share their experience or any other guidance on how to prevent breast cancer.

The Skinny on Overweight

I’m moved by the genuineness of our readers.  A bit overweight?  Well, it’s right out there in your comments.  Summer is coming—school will be out in about 100 days and swimming suit season follows.  Thinking about dieting?  Forget it.  Diets are temporary and Word of Wisdom Living is about permanent, healthful change.  Fortunately, a healthy lifestyle usually leads to a healthy body.  I say usually because we’re all different, but eating right is the place to start.   

A heavy guilt trip has been put on the overweight and obese in our society.  This is counterproductive; it just doesn’t work, as evidenced by the continuing national weight gain.  So lets do something smarter.  The common wisdom says weight gain occurs because we eat too much and move too little—excess calories become excess fat.  So, shame on the overweight?  Maybe not.   

W of W Living suggests a different theory:

This theory removes self-starvation—but not a little self-discipline—from the cure for overweight.  The hunger impulse is too strong to ignore for long, so we need a better strategy.  Here’s a new plan, based on the sugar-insulin theory of weight control: Simply eat a reasonable amount of healthy food and you’re on your way to a good weight.  Real food is rich in nutrients and filling fiber, but low in calories.  And don’t forget to exercise, get plenty of sleep, enjoy a little sunshine, and deal with whatever stress is making you snack.

Lest you credit me with too much genius, I must acknowledge the sugar-insulin theory has been around for a while.  Unfortunately, society tends to solutions that place guilt rather than enlighten—so the worn-out “eat less, move more” mantra persists in the media.  We’ll deal more thoroughly with being overweight in a later post, but here are a couple of suggestions from the Word of Wisdom on eating:

1. Lower your blood sugar and insulin levels by avoiding factory food.  Factory food is high in refined carbs (the white stuff—sugar, flour, white rice, plus HFCS) that raise your blood sugar and insulin levels.  Insulin moves the excess blood sugar into our fat cells and keeps it there.  If you don’t significantly reduce the refined carbs in your diet your waistline will keep growing.

2. Farm food has a low glycemic index (G.I.)—a measure of its ability to spike your blood sugar level.  A diet with a low G.I. lowers your insulin level and results in smaller fat cells.  Smaller fat cells mean a smaller waistline.  So enjoy some fruit and nuts along with lots of vegetables, whole grains, legumes, with a little meat and dairy.

3. If you buy factory food you’ll eat it.  So avoid the center aisles in the grocery store that offer sugary drinks, cookies, candy, chips, and bakery goods.  (Ever noticed that the baked goods in stores don't even taste that good?  If you're really craving apple pie, make your own!)

4. Life is to be enjoyed, but get your guilty pleasures in the smallest possible dose.  I like See’s candy, but I follow Healthy Change #8.  If I see a store in the mall I get my favorite piece.  But we don’t bring boxes or bags of candy into the house.  Sad experience has taught that if it’s in the house it’ll get eaten.

5. Besides sugary drinks, avoid diet drinks too.  They’re less healthy than water for a number of reasons, but there is another problem:  Studies show that diet drinks DO NOT result in you eating less sugar.  In fact, they seem to reinforce the infantile desire for sugar so you get extra sugar in other forms (more to come on this topic).  Per Healthy Change #6, drink lots of water.

Lifestyle change works best if your friends join in, so pass the word.  And please share your weight loss experience by adding a comment, so we can learn together. 

a new conversation

To be honest, my health goal is quite modest.  I accept dying; my goal is to hold off the grim reaper until I’m done living.  There is, ahem, one other goal:  to look good, even in death. 

I’m not counting on modern medicine to save me (nor does this blog take the place of doctors, who we sometimes need).  In truth, the killers who stalk us—heart disease, cancer, stroke, and so on—are mostly incurable.  So here is an idea that has been largely ignored:  prevention!   Prevention is about lifestyle, mostly diet, but also work and rest (more about these later).  We all know we should eat better but there is a mountain of confusion about what to eat.  And old habits resist change.  Saying is easy; doing is hard.

In the last century there was a great respect for science.  Perhaps it was a misplaced trust because on subjects like eggs, or butter vs. margarine, the advice kept changing.  To be blunt, science has over-promised and under-delivered.  Important questions, like what to eat, still remain a puzzle.

So this blog offers an integrated approach we can use today:  Combine incomplete science with knowledge from two venerable but neglected sources—tradition and scripture.  Taken together, these three offer our best chance.  In later postings we will dig into tradition and scripture.  And we will share ideas on good-for-you food.  As you will appreciate, this is a profoundly American approach.

So let the discussion begin.  I will write twice a week, raise topics and offer ideas.  You, the reader, can improve them with your comments.  Together we will learn.  If we learn well, I will publish it in a book. Question for today:  Please share your biggest questions about health and nutrition.

One other request, share this with a friend.  In the beginning we said changing one’s diet is hard.  It is hard, but we are more likely to succeed if joined by our friends.

Note:  This is a nonprofit blog; there will be no ads and nothing is for sale.  Though an avid student of nutrition, I am neither doctor nor scientist and don’t pretend to be.  In fact, that is my credential: I’m a private person studying a public puzzle: how to live.  In my search I have read over a hundred books, plus many, many articles and studies.  Whatever I have been able to learn, I freely offer for your consideration and comment.