The Diet to Promote Health and Prevent Disease

Transcription

1 The Diet to Promote Health and Prevent Disease Warren B. Karp, Ph.D., D.M.D. Professor Emeritus Augusta University Please Note My nutrition presentations are not slide-after-slide-after-slide lectures. Today, the very best thing you can do is to FORGET about looking at a handout. Just sit back, enjoy our time together, think about the information and ask some questions. Instead of looking at a handout, let s look at each other. All the information, including what I present, today, and much more is on this website I promise you. There is one important thing you can do before our meeting begins, friend or follow me on TWITTER, FACEBOOK and PINTEREST (AskDrKarp). Why? That way, we can become lifelong learning partners. Next week or next year, if you have a question, simply TWEET, MESSAGE or me (wbkarp@gmail.com). Also, you might enjoy reading the answers to other people s questions. I have found that the best learning occurs after a presentation, not during. Regards, WBK You have to know and understand Then You have to believe and.. you have to apply and act 1

2 Today, many people live in a swamp of nutrition misinformation, in which products drive recommendations, not science. Here s the problem. 2

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4 And, along with being overweight or obese comes And, along with being overweight or obese comes Cancer Mortality Obesity Prostate Cancer Liver Cancer 4

5 What part of this is a mystery? Obesity Cancer Diabetes The maps for cv disease, hypertension, kidney disease, erectile dysfunction look like these, too. Guess what? 90% of ALL diabetes is Type 2, NIDDM PREVENTABLE Malnutrition Overnutrition Industrialized Too Much, Too Much Calories, Weight Fat, Salt Sugar, Blood Cholesterol Diseases Cardiovascular Disease Diabetes, Hypertension, Alzheimer s Cancer, Obesity, Kidney Disease Joint Disease, Impotence Undernutrition 3 rd World Too Few, Too Few Macronutrients Vitamins Minerals Diseases Scurvy Pellegra Beriberi Specific U.S. Subsets Cancer Patients ICU Patients 5

6 Malnutrition Overnutrition Signs Obesity High Blood Fat, Sugar High Blood Pressure Lab Tests LDL, HDL, TG, Blood Glucose Diet Reduce Calories, Weight Reduce Fat, Salt, Sugar, Animal Protein Increase Fiber, Whole Grains Increase Fruits, Veggies Undernutrition Signs Sore mouths, skin Anemias Lab Tests Serum Albumin Nitrogen Balance Immunity Tests Diet More Vitamins More Protein More Fat Is your idea of nutrition-related health issues? Genetic Engineering Food Additives Food Colorings Pesticides Farm-raised vs. Wild Vitamin/Mineral Def Hormones Fashionable Trends OR Heart Disease Stroke Diabetes High Blood Pressure Obesity Alzheimer s Disease Erectile Dysfunction Food Safety Shift the discussion So, here s what s real when it comes to nutrition. Heart Disease Stroke/Alzheimer s Disease Peripheral Vascular Disease Diabetes Hypertension Obesity Cancer 6

7 The very best contemporary medical advice. Brain Health = Heart Health Worried about Alzheimer s? This is not the way science works. Butter is bad. Sugar is bad. Eggs are bad. Butter is good. Natural sugar is good. Eggs are good. 7

8 Nutrition Science Evolves Starches are healthy Starches with fiber and whole grains are healthy Too much fat is unhealthy. Too much fat is unhealthy. Saturated fats raise your LDL. Unsaturated fats lower your LDL. Too much fat is unhealthy. Saturated fats raise your LDL. Unsaturated fats (olive oil, fish oil) lower your LDL. Trans fats raise your LDL and lower your HDL Cardiovascular disease is related to much more than your cholesterol, your LDL or your food. It s the way you live your LIFE Your Cardiovascular LIFE 8

9 The Diet to Promote Health and DELAY Disease THE DIET Eat less sugar and the sugar you eat should come from fruits and dairy products. Eat better quality starchs. Eat more whole grain foods. Eat more high fiber foods. Eat food, not supplements Eat less salt. Drink less alcohol; a little is ok for some. Eat less red meat. Eat more fish, especially oily fish. THE DIET Eat less smoked and charcoal-broiled foods. Eat more nuts. Avoid high doses of vitamin supplements. Don t be fat. Exercise more. Avoid moldy foods. Don t eat burnt food. Increase your amount of soy foods. Eat more variety of foods. Drink fluoridated water and eat iodized salt. Breastfeed your babies. 9

10 THE DIET Overall, eat less fat Eat less saturated fat Eat less trans fatty acids Substitute with monounsaturated fat, polyunsaturated fat THE DIET Enjoy what you are eating and stop being such a food phobic and bore about your diet! IN A NUTSHELL Eat a varied plant-based diet with moderate amounts of fat, sugar, and salt and exercise every day. 10

11 Macronutrients Caloric Distributions/Total Amount Total Fat 25-35% Total Calories Saturated Fat no more than 5-6% Monounsaturated Fat Up to 15-20% Polyunsaturated Fat Up to 10% Carbohydrates 50-60% Sugars no more than 5-10% Starches 50% Total Fiber gms/day, not more than 35 Soluble Fiber gm/day Protein Up to 15%, mostly as vegetable protein. All Dietary Guidelines AGREE 11

12 Nutrition and Cancer Precautionary Principle: Evidence is substantial, but not conclusive. Dairy Products/Calcium Limiting or avoiding dairy products may reduce the risk of prostate cancer The effect of dairy products on increasing prostate cancer risk seems to be due to both the calcium in dairy and the insulin-like growth factor (IGF-I) in dairy. Pros: Decreasing whole milk lowers cv risk; decreasing dairy decreases lactose intolerance symptoms. Cons: May be associated with decreased bone density, increased risk of colorectal cancer, decreased Vitamin D levels. Dairy Products/Calcium Drinking two glasses of milk each day increases risk of prostate cancer by 60 percent. Calcium supplements appear to have the same effect as milk intake. Men who supplement with more than 400 milligrams of calcium per day increase risk for fatal prostate cancer by 51 percent. Obtain calcium through green leafy vegetables, legumes, other non-dairy sources. 12

13 Alcohol One drink/week increases the risk of larynx, pharynx and mouth cancers by 24 percent. Two - three glasses/week raise the risk of developing colorectal cancer by 21 percent. The alcohol, not additives, appears to be the cause of cancer. Wine, beer, and spirits all demonstrate this increased cancer risk. Alcohol Pros: Decreasing alcohol decreases abuse problems; cirrohsis, pancreatitis, pregnancy complications, obesity, accidents, suicide. Cons: Moderate alcohol (1 drink/day women; 2 drinks/day men) associated with reduced cardiovascular and Alzheimer s risk. Red Meat/Processed Meat Avoid red and processed meats to reduce the risk of cancers of the colon and rectum. Each 50-gram daily serving of processed meat (i.e., two slices of bacon or one sausage link) increases risk of colorectal cancer by 21 percent. Each 120- gram daily serving of red meat (equivalent to a small steak) increases risk of colorectal cancer by 28 percent. 13

14 Red Meat/Processed Meat Pros: May also reduce the risk of diabetes, hypertension, stroke and cardiovascular disease. Cons: Red meat is a good source of protein, iron and zinc. These can also be found in a varied plant-based diet. Relationship of Cancer to Animal Protein With respect to cancer, the major problem with animal protein is the amount of total fat and the way the protein is cooked. By cooking meat at high temperatures (grilling, broiling), you create carcinogens in the food. Plants are generally cooked at lower temperatures under less extreme cooking conditions. Smoked and Charcoal-broiled Foods It is prudent to minimize these. 14

15 What do you usually see on a grill? The fact is that, although it is healthier to eat the veggies, BOTH meat and veggies, if they are burnt and smoked, are not all that healthy. Don t grill so often. Grilled/Fried/Broiled Meats May increase the risk of such cancers as colon, rectum, breast, pancreas and kidney. Heterocyclic amines (HCAs) are associated with cancer of the colon and rectum. HCAs form from creatine and amino acids in cooked skeletal muscle, increasing with higher cooking times and higher temperatures. HCAs can disrupt DNA synthesis. Cook meat at lower temperatures and shorter times. Grilled/Fried/Broiled Meats Pros: Reduces saturated fat and cholesterol, reducing cardiovascular risk. Cons: No cons associated with cooking meat at lower temperatures; cook meat thoroughly; don t eat raw meat. 15

16 Soy Eating soy foods (edamame, tofu), not supplements, during adolescence can reduce the risk of breast cancer as well as the risk of recurrence and mortality for women who already have breast cancer. Pros: Using soy as a protein source may reduce the risk of cardiovascular disease. Cons: Too much soy may increase cancer; stay away from supplements. Fruits/Veggies Cruciferous vegetables (kale, cabbage, broccoli, cauliflower) may reduce the risk of colorectal cancer by 18 percent and reduce the risk of lung and stomach cancer. Women who consume the highest quantities of any kind of fruit or vegetable reduce breast cancer risk by 11 percent. Tomato products, garlic (not garlic pills) and onions have been shown to reduce risk of gastric cancer. Fruits/Veggies Pros: Increased fruits/veggies associated with reduced chronic diseases, such as cardiovascular disease, hypertension and type 2 diabetes. Cons: No disadvantages associated with increased intake. 16

17 And, two more Avoid high doses of vitamin supplements. Breastfeed Decreases risk of both occurrence and recurrence Diet Against Stroke and Hypertension THE DASH DIET Grains and grain 7 8 servings Vegetables 4 5 servings Fruits 4 5 servings Nuts, seeds, 4 5 servings per week Dry beans 2 Tbsp or 1/2 oz seeds The DASH Diet USDA Dietary Guidelines in Overview Balancing calories to manage weight Foods and food components to reduce Na+, saturated fat, trans fat, sugar Foods and nutrients to increase Fruits, veggies, beans, whole grains, skim dairy, seafood Building healthy eating patterns Notice the order of the guidelines. 17

18 The American Heart Association Diet Nutrient Recommended Intake Saturated fat Less than 5-6% of total calories Polyunsaturated fat Up to 10% of total calories Monounsaturated fat Up to 20% of total calories Total fat 25 35% of total calories Carbohydrate 50 60% of total calories The American Heart Association Diet-cont d Fiber Protein Total calories grams per day Approximately 15% of total calories Balance energy intake and expenditure to maintain desirable body weight/ prevent weight gain What about the new cardiovascular risk reduction guidelines? Is your cholesterol number still important? Yes, but it is put into the framework of risk reduction with reference to your entire lifestyle, not just your LDL or HDL. It s the way you live your life that reduces cardiovascular risk, not just your blood cholesterol values. Current Cardiovascular Risk Reduction Guidelines 18

19 Do Vitamins Promote Health or Delay Disease? 19

20 Vitamins and Minerals There are no recommendations from any major health organization for a normal, healthy population to routinely take a specific vitamin or mineral or a multivitamin/mineral supplements, especially ones which contain more than 100% the RDA for that vitamin or mineral. There are sub-populations which might benefit. Examples are: Women of childbearing age, specifically for folic acid (CDC, March of Dimes recommendations) Children who are not getting enough Ca++ and Vitamin D For undernourished individuals. For people who have specific diseases or are critically ill. For postmenopausal women not getting enough calcium and Vitamin D. 20

21 Vitamins and Cancer Most recommendations for cancerpreventing diets stress staying away from excessive vitamin consumption. I am not talking about meeting RDA s. I am talking about taking megadoses of vitamins in the misguided attempt to prevent or cure or treat cancer. Are you ahead of the science? Don t be. Step back and make sure the science is ahead of you Since cancer cells are very metabolically-active, did it ever occur to you that antioxidants, like some vitamins, may make them healthier and more potent by preferentially protecting them? Some Evidenced-Based Nutrition Websites (public access site to Medline)

22 About the Speaker Warren B. Karp, Ph.D., D.M.D. is Professor Emeritus of Pediatrics, Biochemistry and Molecular Biology, Oral Biology and Oral Diagnosis at Augusta University, in Augusta, GA. He has a Ph.D. in nutritional biochemistry from The Ohio State University and a Doctorate in Dental Medicine from Augusta University. He is an elected member of The American Institute of Nutrition (Federation of Societies of Experimental Biology) and is past president of the Georgia Nutrition Council. He has served as Director of the Nutrition Consult Service at the College of Dental Medicine for over twenty years, and has served as Vice Chair of the Board of Health in Augusta (Columbia County). 22