Free-Range, Cage-Free, Organic: What Do Meat and Egg Labels Mean?

Concierge Medicine, Healthy Living, Lifestyle, Nutrition

Our primary care concierge doctors in Jupiter know that these days our patients are interested in not just their own health, but also the health of the planet and the welfare of animals. So you try to shop in ways that consciously take all these factors into consideration.

But how do you know what the many bewildering grocery store labels mean? Let us help sort out some of the confusion.

Win-win Practices

According to Treehugger.com, so-called humane farming practices are no more sustainable than those of factory-farmed meats, because the animals raised for food require just as much food and water as those in concentrated animal feeding operations (CAFOs). 

On the other hand, as the Cleveland Clinic points out, many of these CAFOs use more chemicals and fertilizers that pollute both the land and water sources, so they’re not as earth-friendly as traditional farming practices.

We’ve often extolled the health advantages of plant-based diets, however, so for now we’ll just say that the fewer meats and meat products you consume, the better for the planet (and your health).

The good thing about taking animal welfare into your buying decisions, however, is that you benefit, as well.

“The alternative to factory-farm meat—grass-fed meat—is not just better for the environment and better for the animals, but better for you, too,” says the Cleveland Clinic’s Functional Medicine Director Mark Hyman.

Grass-fed meat is so nutritionally superior to factor-farmed meat, he adds, that is practically a different food.

Animals raised without antibiotics are another health plus for humans because their rampant use can lead to the development of antibiotic-resistant bacteria, making it harder to treat our own infections.

Sorting Out Labels

Unfortunately, knowing their customers are interested in more humanely raised foods, many manufacturers select labels that may tend to mislead buyers.

For example, the U.S. Department of Agriculture (USDA) does not regulate the term “pasture-raised.” “Humane” is also not an official term, so it can mean anything.

Consumer Reports (CR) says that the claim “no growth hormones” doesn’t mean the animal was not given antibiotics, or that hogs were not given a non-hormonal growth enhancer called ractopamine. On the other hand, beef labels that say “no hormones” are useful, because cattle can be raised with hormones; however, the USDA does not allow hormones to be used in poultry or pork.

In addition, labels that say “no growth-promoting antibiotics” can also be misleading, because they can still be given to “ensure animal health” or to prevent or control disease, CR says.

Likewise, “natural” simply means that meat has been minimally processed and doesn’t contain any artificial ingredients such as chemical preservatives, spices or sauces, or artificial coloring. As Insider reports, a “natural” egg is simply a real egg that came from a real hen.

Similarly, “farm fresh” means nothing: All meat and eggs come from farms, whether in bucolic outdoor settings or cramped cages on CAFOs. And “Omega-3” doesn’t tell you whether the eggs contain enough of this essential fatty acid.

What They Mean

The labels manufacturers use can be baffling, so here’s a quick guide to the most common meat and egg labels.

Meats

  • Grass-fed: This term gets a little tricky. The USDA’s definition means the meat must come from animals that have never been given grain and have access to pasture during the grazing season. According to CR, however, the USDA’s Food Safety and Inspection Service (FSIS) does not inspect these farms, and they can still be raised with antibiotics or hormones.
  • In addition, grass-fed cattle still may not have continuous access to pasture and may spend at least a part of their lives confined to a feedlot.
  • Organic: This is a more reliable term because the USDA organic seal indicates that the animal was given only organic feed, and was not given antibiotics or growth hormones. Even sick animals that were treated with antibiotics can no longer legally be labeled “organic.”
  • Pasture-raised: Again, this term can be misleading, because many meat producers will use it if their cows were only periodically allowed brief access to the outdoors.

Eggs

  • Cage-free: This means hens are not kept in cages, but that doesn’t mean they’re allowed outdoor access. In fact, they can still be raised in crowded (read: “overcrowded”) conditions indoors.
  • Free-range: This means the animals have at least some access to the outdoors, and aren’t caged, but they still may be raised primarily in crowded conditions.
  • Organic: These eggs come from hens that haven’t been fed grains grown with GMOs or synthetic pesticides. In addition, they aren’t raised in cages and must be given outdoor access. Again, though, “outdoor access” can still mean being confined in cramped conditions on tiny concrete porches.
  • Pasture-raised: Although there’s no standard definition for this term if the egg label contains either the Certified Humane or American Humane Certified pasture-raised labels, it means the hens must have access to a pasture with room for natural behaviors, such as pecking for bugs and seeds.

How to be Sure

As Vox reports, “For the grocery shopper buying animal products, the independent rating programs created by advocacy programs are the most important labels to look out for, since they actually have auditing systems built in to hold producers accountable.”

These certification labels include “GAP-Certified,” “Certified Humane,” and “Animal Welfare Approved.”

Finally, remember that what’s best for animal welfare is usually best for our health, as well.

We’re Still Consuming Too Much Salt, WHO Warns

Nutrition, Preventative Health

Our concierge primary care doctors in Jupiter often caution our patients about their salt intake, but now a new report from the World Health Organization (WHO) appears to lend new weight to that advice.

Unless governments act to restrict the salt content in our food, seven million people will die unnecessarily from diseases linked to excessive salt consumption, the WHO warned last month.

“Unhealthy diets are a leading cause of death and disease globally, and excessive sodium intake is one of the main culprits,” WHO Director-General Dr. Tedros Adhanom Ghebreysesus said in a statement.

“This report shows that most countries are yet to adopt any mandatory sodium reduction policies, leaving their people at risk of heart attack, stroke, and other health problems,” he added.

The Damage Salt Does

“Excessive sodium intake is the top risk factor for an unhealthy diet, and it is responsible for 1.8 million deaths each year,” Francesco Branca, director of the WHO’s Department of Nutrition for Health and Development, explained.

“This is really something that doesn’t cost money to anybody,” he said. “It’s a simple intervention, but it’s incredibly effective.”

Science has known for decades that too much salt is harmful.

The American Heart Association (AHA) says, “[T]he science behind sodium reduction is clear. Significant evidence links excess sodium intake with high blood pressure, which increases the risk of heart attack, stroke, and heart failure.”

“Sodium,” by the way, is not the same as salt. Salt, or sodium chloride, is a crystal-like compound that is abundant in nature. Sodium is a mineral, and one of the chemical elements found in salt. Nevertheless, most people tend to use the two words interchangeably.

“If you retain more salt in the body, it slowly puts up the blood pressure,” Graham MacGregor, a professor of cardiovascular medicine at the Queen Mary University of London, told The Washington Post.

“That raised blood pressure then causes strokes, heart attacks, or heart failure,” he explained. MacGregor was not involved in the study, but campaigns in favor of reducing salt intake.

History of Salt

Humans have used salt since ancient times, to preserve food as well as to flavor it. Cities around the world sprang up near sources of salt, according to Wikipedia.

But we’re getting too much of a good thing. The average American today consumes 55 percent more salt than in 1980, large thanks to the proliferation of processed foods.

When food began to be mass-produced, manufacturers quickly discovered that salt not only preserved their products longer and enhanced the flavor of less-flavorful foods, but also caused consumers to crave more of it.

At least one 2016 study on mice by Australian researchers appeared to identify the opioid system in the central amygdala region of the brain as the mechanism linked to our addiction to salt, the same pathway responsible for our addiction to drugs.

“It wasn’t until now known that our natural opioids working in this emotional hotspot drove salt cravings,” neuroscientist Craig Smith of the Florey and Deakin University, told the Sydney Morning Herald.

So salt begets a desire for more salt, and manufacturers are happy to comply. It’s far cheaper to add loads of salt to a product than to use more expensive herbs and spices. 

The Scoop on Salt

There’s no denying that we need a certain amount of salt to live. To maintain bodily functions, we require approximately 500 milligrams per day.

Moderate amounts of sodium also help maintain the extracellular fluid necessary for the cells’ function. Without adequate sodium, the body’s fluids would dehydrate, resulting in low blood pressure and death.

The current dietary guidelines recommend 2,300 milligrams of sodium per day. The AHA recommends even less (about 1,500 milligrams) for those at risk of heart disease. This includes adults ages 51 and older, Blacks, and those with high blood pressure, diabetes, or chronic kidney disease.

Most Americans, however, consume an average of 3,400 milligrams of sodium per day.

According to the U.S. Food and Drug Administration (FDA), sodium attracts water, and a high-sodium diet draws water into the bloodstream, thus increasing the volume of blood and subsequently your blood pressure.

Over time, high blood pressure (hypertension) injures blood pressure walls, leading to the build-up of plaque that blocks blood flow. Because hypertension causes the heart to work too hard, the high force of blood flow can harm arteries and organs throughout the body (heart, kidneys, brain, and eyes).

How to Cut Back

According to the AHA, more than 70 percent of the sodium we consume comes from packaged and restaurant foods.

“That can make it hard to control how much sodium you eat because it’s added to your food before you buy it,” the organization says.

Nevertheless, there are things you can do:

  • Compare labels, looking for the lowest amount of sodium you can find.
  • Pick fresh and frozen poultry that hasn’t been injected with a sodium solution.
  • Opt for canned vegetables labeled “no salt added” and frozen vegetables without salty sauces.
  • Drain and rinse canned beans and vegetables.
  • Cook pasta, rice, and hot cereal without salt.
  • At restaurants, ask for your dish to be made without extra salt.

One final tip: Incorporate foods with potassium like sweet potatoes, potatoes, greens, tomatoes and lower-sodium tomato sauce, white beans, kidney beans, nonfat yogurt, oranges, bananas, and cantaloupe. Potassium helps counter the effects of sodium and may help lower your blood pressure.

Zero-Calorie Sweetener Linked to Heart Attacks, Strokes

Concierge Medicine, Health Basics, Medications, Nutrition, Preventative Health

You may have heard the expression, “There ain’t no such thing as a free lunch.” It means that few things are actually free; there’s often a hidden cost to “freebies.”

Our concierge primary care doctors in Jupiter were reminded of that saying when we heard the results of a new study on the sugar substitute erythritol, popular in keto diets, which suggested it can cause an increase in strokes and heart attacks.

The Study

Researchers from the Cleveland Clinic evaluated more than 4,000 Americans and Europeans who were being evaluated for heart disease. The results, published last month in the journal Nature Medicine, showed that those with the highest blood concentration of the artificial sweetener erythritol were at an increased risk of heart attack or stroke in the following three years.

The researchers examined the subjects’ blood platelets—the type of blood cell that sticks together to form blood clots—and found those with the highest level of erythritol showed increased platelet activity, thereby encouraging the greater formation of clots. Clots in the bloodstream have the potential to cause heart attacks or strokes when they block the normal flow of blood.

The researchers also injected mice with erythritol and found that clots formed more quickly after an injury than those who had been injected with saline.

Finally, they took blood samples from subjects who had consumed an erythritol-sweetened drink and found levels of the sweetener remained high for two days.

“Every way we looked at it, it kept showing the same signal,” Stanley Hazen, a cardiologist at the Cleveland Clinic, who also directs the Cleveland Clinic’s Center for Microbiome and Human Health, told The New York Times.

“People are trying to do something healthy for themselves but inadvertently may be doing harm,” he told the paper.

About Erythritol

Erythritol is a sugar alcohol like xylitol and sorbitol and is found naturally in many fruits, vegetables, and fermented foods. It is also manufactured artificially for use in food products.

It has become more popular than earlier types of artificial sweeteners because it has no lingering aftertaste, doesn’t spike blood sugar, and doesn’t cause the laxative effect common with other such additives.

USA Today reports that it is added to many processed foods and beverages and is commonly found in products aimed at those on the keto diet because it does not affect blood glucose. It is also an ingredient in the sweetener Truvia.

“Erythritol looks like sugar, it tastes like sugar, and you can bake with it,” Hazen told CNN.

“It’s become the sweetheart of the food industry, an extremely popular additive to keto and other low-carb products and foods marketed to people with diabetes,” he added.

The U.S. Food and Drug Administration (FDA) lists erythritol as generally recognized as safe or GRAS. Therefore, it is not required to be listed on a product’s ingredient list, according to Hazen. The label might simply say, “artificially sweetened with natural products,” or “zero sugar.”

Other Research

Robert Rankin, executive director of the Calorie Control Council, an association representing the low- and reduced-calorie food and beverage industry, told USA Today that the people in the study were at higher risk for cardiovascular disease (CVD), so the results shouldn’t be applied to the general population.

“The results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe,” he said.

But other studies have raised the question about the safety of erythritol.

For example, Karsten Hiller, a biochemist, and specialist in human metabolism at the Braunschweig Institute of Technology in Germany published a paper in 2017 showing that Cornell University freshmen whose blood contained high levels of erythritol gained more weight than students with low levels, the USA Today reported. Which kind of defeats the purpose of using an artificial sweetener.

“Science needs to take a deeper dive into erythritol and in a hurry, because this substance is widely available right now,” Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health, a hospital in Denver, told CNN. Freeman was not involved in Hazen’s research.

Hazen agreed.

“I normally don’t get up on a pedestal and sound the alarm,” he told CNN.

“But this is something that I think we need to be looking at carefully,” he added.

Eating Healthier

Artificial sweeteners in general have been called into question by numerous studies. For example, a 2020 study by a group of Yale researchers found that those who used the artificial sweetener sucralose (found in the brand names Splenda, Zerocal, and others) can result in high blood sugar levels in the blood. The Washington Post reports that sucralose is found in thousands of consumer-packaged goods such as baked goods, yogurt, canned soups, condiments, and syrups.

Another study at the Weizmann Institute of Science last year looked at what happened to subjects who consumed aspartame, saccharine, stevia, or sucralose in amounts well below the FDA’s daily allowances. The researchers found that these sweeteners caused changes in both the function and composition of the participants’ gut microbiomes, the communities of bacteria, viruses, and fungi that live in the intestines, The Post reported.

There’s no question that artificial sweeteners are hard to avoid these days. And we keep trying to have our sugar without paying the price.

But for the sake of your long-term health, we recommend sticking as closely as possible to fresh, natural, unprocessed foods and beverages.

Live Longer with Blue Zone Foods

Environment, Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health, Uncategorized

Of all the diet trends available today, one our primary care concierge doctors in Jupiter can highly recommend is the Blue Zone way of eating: fresh, healthy, unprocessed food, from as close to its source as possible, in meals shared with family and friends.

The term “Blue Zone” was coined nearly 20 years ago by journalist and researcher Dan Buettner in a 2005 National Geographic cover story titled, “Secrets of Living Longer.”

His team of anthropologists, demographers, and scientists had traveled the world to find the world’s longest-living people, and to discover the secrets to their longevity.

Buettner’s team found five seemingly disparate places where the people live exceptionally long, healthy lives: on average, around 100. (The term “blue zone” came from the blue circles the researchers drew on a map during their quest.)

The five places are:

Okinawa, Japan
the Nicoyan Peninsula in Costa Rica
the Seventh Day Adventists in Loma Linda, California
Sardinia, Italy
Ikaria, Greece

More than Diet

Of course, healthy eating is key to a healthy body, but the Blue Zone residents had more than good food on their side. Genetics, as always, plays a big role in how long anyone will live no matter where they are.

Other factors the team found the Blue Zones had in common were:

Natural movement: no marathons or gym visits, just long walks, hiking, gardening, etc.
Hara Hachi Bu: an Okinawan term for eating until they’re about 80 percent full
Plant slant: a preference for plant foods over meat
Grapes of Life: one to two servings of red wine daily (except for the Seventh Day Adventists, who eschew alcohol)
Plan de Vida: or “why I wake up in the morning,” i.e., a sense of purpose
Downshift: controlling stress, a sense of serenity
Belong: participation in a spiritual community
Loved ones first: making family a priority
Close tribe: social connectedness

Blue Zone Meals

The Blue Zone diet, which Buettner details in his latest book, “The Blue Zones American Kitchen: 100 Recipes to Live to 100,” is a cornerstone of the Blue Zone program, and closely resembles the Mediterranean diet, but with even less emphasis on fish and meat.

“The five pillars of every longevity diet, including the Blue Zones, are whole grains, vegetables in season, tubers, nuts, and beans. In fact, I argue the cornerstone of a longevity diet is beans,” he told CNN.

Legumes, in fact, are key, he told The Washington Post. They are rich in fiber, which is key to improving cholesterol and blood sugar levels.

“Figure out how to get a cup of beans into your diet every day,” he told the paper. “Just one cup gives you half of all the daily fiber you need.”

What Not to Eat

And even though the Mediterranean diet includes a certain amount of meat and fish, Blue Zone diets contain little, if any.

“People in Blue Zones don’t eat nearly as much fish as the Mediterranean diet prescribes, only three times a week and only three ounces,” he told CNN. “Meat is eaten only five times a month. There’s no cow’s milk in any Blue Zone.”

Instead, people eat goat and sheep’s milk cheeses such as feta and pecorino, he said.

In addition, “no more than three eggs are consumed per week,” he told NBC’s Today show.

“The Blue Zone eating pattern is 98 percent plant-based foods—whole food-based and high carbohydrate,” Buettner told CNN.

“But only complex carbs, not the simple carbs like salty snacks and candy bars and soda pop. You say carbohydrates and people are horrified, but the healthiest foods in our food system are complex carbohydrates,” he added.

Time and Place Count, too

In keeping with the other factors that affect longevity, sharing meals—especially with family—is another component. While our busy schedules might not often permit this, Buettner says it’s worth doing as often as possible.

“Families that eat together tend to each much more nutritiously, they eat slower, and there’s good research that children have fewer issues with disordered eating if they’re eating socially,” he told The Post.

And it turns out the recent trend toward intermittent fasting appears to have some validity. Buettner reports that people in Blue Zones tend to eat earlier in the day.

Okinawans, for instance, traditionally eat a big breakfast and a moderate lunch.

“They don’t even have dinner,” he told the paper.

And the Seventh Day Adventists in Loma Linda would eat a big breakfast at 10 a.m. and a moderate lunch at 4 p.m. “And then they’re done for the day,” he said.

Small Moves

Of course, there’s more to the Blue Zone lifestyle than just food, as we mentioned earlier. Three of the five Blue Zones are isolated, which forces tight social connections and a lot of walking.

“Walking is one of the best forms of exercise and you can do it without thinking about it,” Buettner told Today, suggesting that people think about adopting a dog as a strategy to encourage regular walks.

“We’re all looking for magic dietary pills or serums or supplements, but you see none of that in the Blue Zones,” he said. “It’s mostly small things driven by the right environment,” he said.

That includes social connections.

“We’re genetically hardwired to crave social interaction, and when you don’t have it, there’s a level of subconscious stress that grates away at you,” he added.

Here’s to Your Heart Health

, , , Disease, Health Basics, Healthy Living, Nutrition, Preventative Health

In recognition of American Heart Month in February, our primary care concierge doctors in Jupiter thought we’d share some facts with you about your heart, and what you can do to keep it healthy.

Surprising Heart Facts

First, from the Cleveland Clinic, here are a few interesting things you may not know about your heart.

Your heart is about the size of your two hands clasped together.
It beats 100,000 times a day.
The beating sound is the clap of valve leaflets opening and closing.
A woman’s average heartbeat is faster than a man’s by almost eight beats a minute.
Every cell in your body gets blood from your heart, except for your corneas.
The heart pumps blood through 60,000 miles of blood vessels.
A normal heart pumps approximately four tablespoons of blood with each beat.
Each minute, your heart pumps 1.5 gallons of blood.
Your heart has its own electrical supply and will continue to beat when separated from your body.
Heart cancer is very rare because heart cells stop dividing early in life.

About Heart Disease

Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the U.S. About 697,000 people in the U.S. died from heart disease in 2020 (the most recent figures available). And every year about 805,000 people in the U.S. have a heart attack; over 600,000 of those are first heart attacks.

According to the Centers for Disease Control and Prevention (CDC), the term “heart disease” refers to several types of heart conditions.

The most common type of heart disease in the U.S. is coronary artery disease (CAD), which affects blood flow to the heart. Decreased blood flow can cause a heart attack. In 2020, about 20 percent of deaths from CAD occurred in adults below the age of 65, known as an “early cardiac event.”

Common Symptoms of Heart Disease Include:

Heart attack: chest pain or discomfort, upper back or neck pain, pain in the jaw or throat, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, a cold sweat, and shortness of breath
Arrhythmia: fluttering feelings in the chest (palpitations)
Heart failure: shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins

The Cleveland Clinic’s Dr. Curtis Rimmerman, a cardiologist, emphasizes that symptoms of a heart attack can vary widely, but adds that the discomfort is usually unrelenting, typically lasting five minutes or more.

“Regardless of where the pain is, people typically can’t find a position that relieves the pain,” he says. “Nor do they find relief by taking a drink of water, popping antacids or taking deep breaths.”

That means it’s time to call 911, he adds.

Increasing Risk

Unfortunately, about one in every five heart attacks are “silent”—that is, the damage is done, but the person is not aware of it.

That’s why it’s important to know your risk factors and what you can do about them.

About half of all Americans (47 percent) have at least one of the three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

In addition, several other medical conditions and lifestyle choices also put people at a higher risk for heart disease, the CDC reports, including:

diabetes
overweight and obesity
unhealthy diet
physical inactivity
excessive alcohol use

In addition, a 2021 study published in the journal Heart found that those who used illicit substances, including amphetamines, cocaine, and cannabis, were far more likely to experience an early cardiac event than those who didn’t.

And another study, published in the Journal of the American Heart Association (AHA) in 2020, found that the chances of developing cardiovascular disease (CVD) were 19 times higher in women who consumed one or more sugary drinks a day. This included everything from fruit juices to soft drinks (not diet) to coffee with sugar.

Lowering Risk

Some risk factors cannot be controlled, such as age or family history of heart disease, but you can take steps to lower your risk by changing the factors you can control.

Have your blood pressure, cholesterol, and triglycerides checked regularly.
Ask us whether you should be tested for diabetes.
Quit smoking.
Limit the alcohol you consume to one drink a day.
Learn how to manage stress levels by finding healthy ways to cope with stressful events.

In addition, there are two other ways that have been shown to dramatically reduce your risk for heart disease.

The first is exercise. According to the Cleveland Clinic, regular moderate-intensity exercise for at least 150 minutes is the single most important—and free—key to heart health.

The second is diet, specifically a plant-based diet. This doesn’t necessarily mean going totally vegetarian, just making plant foods vs. animal foods the main component of your diet.

“I’ve seen people whose diabetes, angina, or blood pressure goes into remission [on a plant-based diet],” Andrew Freeman, a cardiologist and the co-founder of the Nutrition and Lifestyle Work Group at the American College of Cardiology, told The Washington Post.

“I’ve seen autoimmune diseases go away when you cut inflammation,” he said. “The best way to do that is with a plant-based diet, and people get better.”

Doctor’s Best Diets for the New Year

, , , , Health Basics, Healthy Living, Holiday Safety, Lifestyle, Motivation, Nutrition

At the beginning of every new year, it’s customary to make resolutions to improve our lives in some way. Usually near the top of the list of New Year’s resolutions the goal of losing weight. Our primary care concierge doctors in Jupiter certainly applaud that one, because obesity negatively impacts our health in so many areas, from the possibility of type 2 diabetes to heart disease. 

But there are other reasons to adhere to a particular type of diet, which don’t necessarily relate to weight loss. Diet in this sense means a way of eating, whether it’s cultural or just for overall health.

Forbes 2023 Rankings

Forbes Health recently consulted a team of seven nutrition experts to rate 19 diets considering a range of factors, from weight loss to heart health. 

Which one is best for you depends on your reason for trying a new diet. Of the 19 diets reviewed, these made the top 10:

  • Best for overall health: Mediterranean diet, emphasizing fresh fruits, olive oil, nuts, and fish
  • Best non-meat diet: vegetarian, which generally doesn’t allow meat, poultry, or fish
  • Best for heart health: dietary approaches to stop hypertension (DASH) diet, which focuses on fruits, vegetables, whole grains, lean proteins, and low-fat dairy
  • Best commercial diet: Weight Watchers (now known as WW), emphasizing lower calories, with coaching and group support
  • Best commercial diet runner-up: Noom, an app that ranks food according to calories, with coaching and group support
  • Best non-meat diet runner-up: vegan, which allows no animal products of any kind
  • Best diet for flexibility: pescatarian, a type of vegetarianism that also allows fish and other seafood
  • Best diet for holistic health: Ornish diet, low-fat emphasis allowing no meat, fish, or poultry
  • Best diet for a brain boost: MIND diet, a combination of the Mediterranean and DASH diets
  • Best diet for a nutrient boost: Nordic diet, consisting primarily of fish, berries, and winter vegetables, with a small amount of meat and sweets allowed

Other Views

The annual US News listing of best diets includes most of the above diets, in addition to Jenny Craig, Dr. Weil’s anti-inflammatory diet, the Mayo Clinic diet, volumetrics, the nutritarian diet, the South Beach diet, and the Plantstrong diet.

Everyone, it seems, has an opinion on what makes a great diet.

For instance, Dr. Michael Greger told NBC’s TODAY that the worst diet is what he terms the CRAP diet: “calorie-rich and processed foods” that make health problems worse and weight loss impossible.

Instead, he recommends consuming a whole-food, plant-based diet, which is naturally high in fiber and low in calorie density and allows people to eat as much as they want—no calorie counting or portion control needed.

“It’s a diet that minimizes the intake of meat, eggs, dairy, and processed junk, and maximizes the intake of fruits, vegetables, legumes like beans, whole grains, nuts and seeds, mushrooms—basically, real food that grows out of the ground. Those are our healthiest choices,” he told TODAY.

“The strategy is to improve the quality of food rather than restricting the quantity of food,” he added, “so it doesn’t leave you hungry. That’s a diet you can stick with. You get a boost of energy, better digestion, better sleep.”

Skip the Gimmicks

His approach is simple. And in contrast, notice what kinds of diets don’t show up on any of these lists.

The hugely popular keto diet is one example. Studies show that 80 percent of those who try it struggle to stick with it. Why, when it often results in huge and rapid amounts of weight loss?

Because it not only can it cause numerous side effects—body aches, headaches, light-headedness, nausea, fatigue and lethargy, constipation, and brain fog—but because everyone else is eating garlic bread and mashed potatoes (not cauliflower) with gravy and pasta. 

Because, in short, the keto diet is restrictive. It has a long list of very tasty foods that either aren’t allowed or are allowed only in small portions after a certain time.

“When you are on the keto diet, you drastically cut your carbs to only 20 per day. That’s less than one apple!” nutritionist Lisa Drayer, a CNN contributor, told the network.

Bottom Line

Above all, research shows that the most successful diet is the one that you yourself designed because it gives you a sense of control, rather than being at the mercy of a set of restrictive rules.

“You have to have joy and pleasure in food,” Stanford University professor of medicine Christopher Gardner told The Washington Post. He has conducted numerous randomized trials to test the success rate of various diets and found they are essentially the same.

“They agree more than they disagree,” he said. Instead, he counsels, “Limit added sugars and refined grains, and eat more non-starchy vegetables. [I]f you do those two things, you get 90 percent of the benefits.” 

If you enjoy what you eat, you’ll have a much better chance of sticking with it for the rest of your life, he added.

Study Finds Another Possible Benefit from Intermittent Fasting

Healthy Living, Nutrition

Diet fads come and go, especially on today’s social media. Our primary care concierge doctors in Jupiter cringe whenever a new weight loss gimmick surfaces, because nearly all of them are unsupported by science, and—while they may achieve temporary weight loss—are nutritionally unsound.

One atypical approach to eating that seems to be generally accepted in the medical literature is the technique of intermittent fasting (IF). This is an eating pattern that includes hours or days of no or minimal food consumption without deprivation of essential nutrients.

The first approach, known as 16:8, is the most popular, which involves fasting for 16 hours a day and consuming all your meals within an eight-hour period.

Other popular types of Intermittent Fasting involve either fasting on alternate days, or 5:2 fasting, which involves eating normally five days a week and fasting for two non-consecutive days a week, consuming 500-600 calories on fasting days.

Benefits of Intermittent Fasting

Evidence from decades of animal and human research suggests wide-ranging health benefits from IF, according to a 2020 review of the research published in the New England Journal of Medicine (NEJM).

Researchers found that “eating in a six-hour period and fasting for 18 hours can trigger a metabolic switch from glucose-based to ketone-based energy, with increased stress resistance, increased longevity, and a decreased incidence of diseases, including cancer and obesity.”

And researchers at Johns Hopkins Medicine also found numerous health benefits that result from Intermittent Fasting:

-improved working memory and verbal memory
-improved blood pressure and resting heart rates, as well as other heart-related measurements
-reduced tissue damage during and after surgery
-loss of fat while maintaining muscle mass

In addition, the Mayo Clinic reports: “Some research suggests that intermittent fasting may be more beneficial than other diets for reducing inflammation and improving conditions associated with inflammation, such as Alzheimer’s disease, arthritis, asthma, multiple sclerosis, [and] stroke.”

And the American Heart Association recently reported in its journal Heart that “[r]egular fasting is associated with lower rates of heart failure and a longer life span, according to two new studies.”

Latest Finding

Finally, a new study published this month in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism showed that after an IF diet intervention, patients achieved complete diabetes remission, defined as an HbA1c (average blood sugar) level of less than 6.5 percent at least one year after stopping diabetes medication.

In this small study of 36 participants, researchers at Hunan Agricultural University in Changsha, China, placed participants who had type 2 diabetes from one year to 11 years on the more restrictive IF plan of five fasting days followed by 10 days of reintroducing everyday food items such as wheat, barley, rice, rye, and oats. Subjects ranged between 38 and 72 years of age and were using anti-diabetic drugs and/or insulin injections.

Known as the Chinese Medical Nutrition Therapy (CMNT) diet, the approach resulted in 47.2 percent of participants achieving diabetes remission, compared with 2.8 percent in the control group.

The study showed that “type 2 diabetes is not necessarily a permanent, lifelong disease,” Dongbo Liu, the study’s corresponding author and a professor at the University, said in a news release.

Dr. Robert Gabbay, chief scientific and medical officer for the American Diabetes Association (ADA), told UPI he found the study’s findings encouraging.

“This study, though small, adds to the emerging literature on the potential benefits of intermittent fasting for the diabetes community,” he told the news organization.

Some Caution Warranted

If you plan to follow an IF diet, we strongly suggest that you check with us first, because this type of eating plan isn’t for everyone.

For example, one small 2020 study published in the journal JAMA Internal Medicine found that those following the 16:8 IF diet over 12 weeks lost little weight but most of what they did lose was “lean mass” which includes muscle tissue, possibly because they were consuming less protein.

And Harvard Health Publishing notes several other potential side effects from IF:

  1. Depending on the length of the fasting period, you may experience headaches, lethargy, crankiness, or constipation.
  2. It may cause you to overeat “because your appetite hormones and hunger center in your brain go into overdrive when you are deprived of food.”
  3. It may be dangerous if you’re taking certain medications, including anti-diabetes drugs and medications for blood pressure or heart disease.

How to Intermittent Fast Safely

Registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Hospital, recommends easing into an IF plan to help your body adjust more easily.

“Slowly reduce the time window for eating, over a period of several months,” she advises.

She recommends you should also:

Continue your medication regimen as recommended by your doctor.
Stay hydrated with calorie-free beverages, such as water and black coffee.
Choose a modified fasting plan approved by your doctor if you need to take the medication with food.

Also, if you’re thinking, “If some fasting is good, more will be even better,” don’t. Longer periods without food can encourage your body to store more fat because it slips into starvation mode.

Finally, eating normally during the off-fast portion of the day or week doesn’t mean binging on junk food. Whether fasting or not, your body needs healthy, nutritious food to maintain health and a normal weight.

How and Why to Steer Clear of Ultra-Processed Foods

, , Health Basics, Healthy Living, Lifestyle, Nutrition

Our concierge primary care doctors in Jupiter often suggest you consume healthy foods and avoid processed and ultra-processed foods. In the real world, of course, we know how difficult that is to do.

The question is, why? Why have ultra-processed foods come to dominate 60 percent of the American diet?

Ultra-processed foods are quick and convenient, for one thing, and for another, there’s no denying that, for the most part, these foods taste good. From frozen dinners, cookies, and cakes, to fast-food burgers and chicken, fried foods, deli meats, and sodas, many of us not only can’t quit them, but we also don’t want to.

And we convince ourselves that processed foods aren’t really all that bad for us. On that last point, we have to disagree. The one thing we know for sure is that processed and ultra-processed foods can trigger numerous health concerns.

What the Studies Say

For example, one study of more than 22,000 adults published this year in the journal BMJ found that subjects who consumed more ultra-processed foods had a 19 percent higher likelihood of early death and a 32 percent higher risk of dying from heart disease than those who ate fewer ultra-processed foods.

Another 2019 study published in BMJ followed more than 100,000 adults in France for five years. They found that those who ate the most processed foods were 23 percent more likely to experience a heart condition or stroke than those who consumed the lowest amounts.

A third study, also published in BMJ, tracked 20,000 Spanish adults over 20 years. Those who ate the most processed foods were 62 percent more likely to die during the study period than those who ate the lowest.

Other studies have linked processed and ultra-processed foods to a higher risk for colon cancer, type 2 diabetes, obesity, and heart disease.

How are Foods Classified?

Researchers classify foods into roughly three categories:

“Unprocessed or minimally processed” foods include fruits, vegetables, milk, eggs, legumes, meats, poultry, fish and seafood, yogurt, white rice and pasta, and natural juices (some classification systems divide these into two categories).

“Processed” foods include cheeses, bread, beer, wine, ham, and bacon.

“Ultra-processed” foods include potato chips, pizza, cookies, chorizo, sausages, mayonnaise, chocolates and candies, and artificially sweetened beverages.

They also created a separate category called “processed ingredients,” which includes salt, sugar, honey, olive oil, butter, and lard.

What’s Wrong with Processing?

The big mystery is why foods that are so convenient and taste so good are so bad for us. The problem seems to come from the processing itself, which changes foods from their natural state.

These tend to be high in poor-quality fats, additional sugar, salt, and chemical preservatives, and low in vitamins and fiber. The common factor can be summed up in the phrase “convenience foods”; that is, foods that are quick and easy to prepare at home or grab at a drive-through.

Some researchers believe that changing foods from their natural state leads to inflammation throughout the body, which puts us at risk for a host of diseases.

“Some of the foods that have been associated with an increased risk for chronic diseases such as type 2 diabetes and heart disease are also associated with excess inflammation,” Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health, told Harvard Health Publishing.

“It’s not surprising, since inflammation is an important underlying mechanism for the development of these diseases,” he said.

How to Break the Addiction

Asking you to give up all these delicious foods might seem as if we’re condemning you to a life of bland, tasteless meals. But that’s because Big Food has spent billions of dollars getting you addicted to all its additives.

In addition, these ultra-processed foods leave our bodies so depleted of nutrients that we keep eating more and more to try to make up the shortfall, not unlike Star Trek’s famous tribbles, which “starved to death in a storage compartment full of grain.”

The fact is, humans have been eating non- or minimally processed food for millennia. When your taste buds reacclimate themselves to the real thing, you’ll be surprised how sweet a carrot can be, or how a locally grown tomato is bursting with tangy flavor.

Finally, when you begin eating better, you’ll likely begin sleeping better, looking younger, have more energy, and many of the aches and pains you thought you’d just have to live with may begin to decrease or disappear altogether.

Take it Easy

All this will make you want to keep on this new path, and eventually, you’ll lose your taste for processed and ultra-processed foods. When you’ve been eating lower- or no-salt foods for a while, for example, then dip into a package of potato chips, you’ll think the contents are half potatoes and half salt.

The key is to withdraw from these addictive substances gradually. Substitute french fries for sweet potato chips you’ve baked yourself, for instance, or swap out soda for water occasionally.

Shop the store’s perimeter as much as possible, where they keep the fruits and vegetables and fresh meat and seafood.

If you must visit a fast-food restaurant, opt for salads or baked chicken sandwiches if they offer them.

Finally, don’t agonize over everything you eat. Stress is bad for you, too. Simply prefer fresh food over processed as often as possible.

belly fat

From Fat Belly to Flat Belly: 3 Effective Ways to Slim Down

Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health

You think you’re doing all the right things: exercising, eating healthy, and keeping your weight in check. So why do you look down and see that bulge hanging over your belt line?

Our concierge primary care doctors in Jupiter can’t promise that the following tips will give you a washboard abdomen, but we do know that you can at least reduce the problem area if you know what causes it and, therefore, how to combat it.

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vit d

Vitamin D: Is It the ‘Cure-All’ Vitamin?

Health Basics, Healthy Living, Lifestyle, Medications, Nutrition, Preventative Health

Studies surrounding vitamin D can be conflicting, often leading to confusion on the part of our patients. So our concierge primary care doctors in Jupiter thought we’d take a look at some of the newest findings about this essential vitamin.

Dueling Conclusions

As an example of how different researchers can draw opposite conclusions even from the same study, one doctor recently wrote in The Washington Post that a study she led “found no statistically significant reduction in cardiovascular disease or cancer” in a nationwide randomized trial of 26,000 adults over five years.

Furthermore, she wrote, “My colleagues and I have conducted further studies from VITAL [the study’s title] showing that vitamin D supplements do not decrease the risk of cognitive decline, depression, macular degeneration, atrial fibrillation or several other health conditions. The most recent report showed no reduction in the rate of bone fractures—once the vitamin’s most commonly touted benefit.”

She concluded that the vast majority of Americans are already getting all the vitamin D they need from brief sun exposure and a normal diet.

“Is it necessary for you to spend money on the supplement? For most healthy adults, the answer is no,” JoAnn Manson wrote in The Post.

However, this same researcher told the Harvard Gazette in January of this year that the VITAL study showed subjects who took vitamin D, or vitamin D and omega-3 fatty acids, had a significantly lower rate of autoimmune diseases such as rheumatoid arthritis and psoriasis than those who took a placebo.

“Given the benefits of vitamin D and omega-3s for reducing inflammation, we were particularly in whether they could protect against autoimmune diseases,” she said.

More Confusion

So maybe the vitamin has some value after all, at least for some.

Yet in 2018, another study published in the National Institutes of Health’s (NIH) National Library of Medicine looked at the prevalence of vitamin D deficiency in the U.S. population. In the introduction, the study’s authors wrote that, “Since foods containing natural vitamin D are rare, the primary source of the compound remains . . . exposure to ultraviolet rays in sunlight.”

It went on to assert that “subclinical vitamin D deficiency . . . plays a role in downstream clinical consequences, including cardiovascular disease, cancer, diabetes, osteoporosis, and fractures.”

Why the frequent discrepancy among various studies? One 2020 clinical study published in the journal BMJ sought to answer that question. 

“Our analysis of pooled raw data from each of the 10,933 trial participants allowed us to address the question of why vitamin D ‘worked’ in some trials, but not in others,” Adrian Martineau, a professor at Queen Mary University of London (QMUL) and a lead researcher on the study, wrote in a release.

Those who have the lowest levels of vitamin D in their blood seem to show the largest benefit, he said, along with those who took it daily or weekly, as opposed to intermittently.

The Last Word?

A fact sheet on vitamin D produced by the NIH’s Office of Dietary Supplements (ODS) updated last month summarized numerous studies, including the VITAL study.

For each of the most common health claims connected to vitamin D it reached the following conclusions:

Bone health – All adults should consume recommended amounts of vitamin D and calcium from foods and supplements.

Cancer – Taken together, studies to date do not indicate that vitamin D with or without calcium supplementation reduces the incidence of cancer, but adequate or higher levels might reduce cancer mortality rates.

Cardiovascular disease (CVD) – Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low levels as measured in their blood.

Depression – Overall, clinical trials did not find that vitamin D supplements helped prevent or treat depressive symptoms or mild depression, especially in middle-aged to older adults who were not taking antidepressants.

Type 2 diabetes – Clinical trials provide little support for the benefits of vitamin D supplementation for glucose homeostasis.

Weight loss – Overall, the available research suggests that consuming higher amounts of vitamin D or taking vitamin D supplements does not promote weight loss.

And although the COVID-19 pandemic sparked hope that vitamin D could help prevent or reduce the severity of the illness, two new clinical studies released this month found that it didn’t help with the coronavirus or any other type of respiratory virus.

Vitamin D Overdose?

According to the NIH, the recommended daily allowances for vitamin D are:

  • 0-12 months: 10 mcg (400 IU)
  • 1-70 years: 15 mcg (600 IU)
  • >70 years: 20 mcg (800 IU)

And while many people who supplement with vitamin D take much higher doses than that, too much can be dangerous. Vitamin D is a fat-soluble vitamin, which means it tends to be stored in the body’s fat and can lead to accidental overdoses. 

The upper limit of safety appears to be 100 mcg (4,000 IU) daily.

Those who take more than that could experience side effects from supplementing with vitamin D, including nausea and vomiting, constipation, weakness, and kidney damage, among others.

Overall, most studies seem to show that supplementing with vitamin D doesn’t have much effect on various conditions. On the other hand, moderate doses from a reputable manufacturer are generally considered safe. So if you think you could benefit from vitamin D supplements, the decision is up to you.

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