Nutrition – One of The 7 Keys to Healthy Aging

“If We Could Give Every Individual The Right Amount Of Nourishment And Exercise – Not Too Much And Not Too Little – We Would Have Found The Safest Way To Health,” Hippocrates.

 Two thousand four hundred years ago and it is still the best advice.

Your agenda is health and longevity. This means most of us have to modify our lifestyles. That is the goal. If lifestyles are changed to include appropriate eating patterns and appropriate food intake along with exercise, better sleep, no tobacco and less stress, then health and wellness will follow and persist. This means many fewer chronic illnesses and a longer lifespan. But it is very important to modify lifestyles for the long term, not just a few weeks or months.

A good place to begin is with nutrition and for that a good starting point is to understand and follow the Mediterranean Diet. It consists of extensive fresh vegetables and fruit each day plus regular servings of nuts, seeds and beans along with whole grains such as whole wheat, oats and brown rice, olive oil and fish with a topping of wine but limited meat and very little added sugar. This is widely considered to be a sound, healthy diet. As a general rule it is food prepared “from scratch” in the kitchen, not processed food from the manufacturers nor prepared foods from the corner deli or fast food place.

There are some specifics that should be noted.

Cover your plate with two thirds vegetables and only one third with meat or fish. Make the veggies the major part of the meal. Fresh and local when possible and organic whenever available. Fix them simply such as steaming, stir frying or baking. Fresh vegetables need little seasonings although some herbs are both flavorful and healthy additions. Dark greens should be a frequent part of the meal – spinach, kale, collards, dandelion greens, arugula and Swiss chard are good examples. Spinach, arugula and dandelion make a wonderful salad; toss it with olive oil and balsamic vinegar and perhaps top it with a few slivers of carrot plus some cucumber slices and cherry tomatoes. Consider steaming or stir frying the others.

Fruits are important. Eat a wide variety of types and colors, preferably local and fresh although frozen is fine. Avoid canned fruits as they invariably have added sugar. Berries like strawberries, blueberries, blackberries, raspberries and cherries are high in polyphenols that are valuable for many metabolic processes and especially good for the brain.

Whole grains means just that and not refined white flour as found in most breads, packaged foods such as most cereals, pasta, cakes, pies, cookies, and yes even pizza. Refined white flour has essentially no nutritional value so it is essential to avoid all of these, with perhaps a rare treat or two. It follows that trips to the fast food outlet are verboten. Fats are fine in moderation and indeed are essential. Get them from olive oil, avocados, nuts and seeds and from fin fish. Avoid trans fats. Keep omega 6 fatty acids to a minimum; they are found in many commercially baked goods.

It is critical to avoid sugar. This is difficult since we have been trained to desire sweet tastes and sugar of various types is added to many packaged foods, sodas, yogurts and of course ice cream. The limit per day is 25 grams for women and 37 grams for men. To put this in perspective, a can of soda has the full complement of sugar for a man and is well over that for a woman. One more reason to avoid fast foods. When you buy cheese avoid ones with food colors; real cheese has natural color. Yogurt is very healthy but most brands add fruit, flavoring and a lot of sugar. Look to also see that the cultures are “live;” many are not and essentially all flavored yogurts and those with sugar added have no live cultures.

Fish are high in omega 3 fatty acids – the good fats. You need them and can’t create them in your body so it must come from your foods. Most beef comes from animals that have been placed in small pens for months and fed a diet of grains like corn and soybeans so as to fatten them up. But this fat is mostly omega 6 fatty acids which is pro inflammatory. Unfortunately, the USDA labels the fattest beef as “prime.” Beef from cattle that have been grazed their entire life have minimal omega 6s and do have omega 3 fatty acids but the amount pales compared that found in salmon, mackerel or sardines. Another important point – find meats that do not have additives, either on the range, the feed lots or added after butchering. Antibiotics, growth hormone, nitrites and other additives are likely adverse to your gut health.

Chickens are usually raised in buildings so that they never see the light of day before slaughter but do have antibiotics in their feed and may be stimulated with hormones to grow larger. Look instead for poultry from farms that use no additives and let the chickens fun free. And with all meats avoid these that have added liquid “to retain moisture.” Get real chicken and real beef, lamb or pork, additive free and pasture grazed.

Buying organic vegetables and fruits and grass-fed meats are more expensive for sure. But the health benefits outweigh the costs.

Is there anything that you can eat? Yes, dark chocolate, preferably 85% cocoa or more. It is inherently healthy. So is coffee. It is not only OK but healthy to have alcohol in moderation.

You are eating not just for yourself but also for the bacteria in your intestines – the gut microbiota (microbiome.) The 100 trillion of them need nourishment so that they can help maintain your immune system, your intestinal lining cells and so that they can produce various nutrients that your cells in various organs use for energy. Their “food” is the fiber that your intestinal enzymes cannot digest but which the bacteria love. The best sources are in vegetables and fruits. Consume inadequate fiber and the “good” bacteria are starved. If meanwhile, you eat sugar, refined white flour or too much alcohol, you will be feeding the “bad” bacteria with detrimental results. That, of course, is a common combination in the standard American diet but it leads to increased intestinal permeability (“leaky gut”), local and systemic inflammation, passage of toxins into the bloodstream and the induction of a variety of complex chronic illnesses. So, treat those bacteria well. The foods like veggies with their high fiber content that benefit the gut microbiota are called prebiotics. Foods that include bacteria and yeasts that are known to be healthy are called probiotics and are found in many foods like live culture yogurts, live culture Kefir, non-pasteurized sauerkraut, kim chi and other fermented foods. Have some regularly.

To recapitulate – aggressively avoid added sugars; eat lots of veggies of a wide range of colors including dark green leafies; include only whole grains and not too much. You need good fats as found in olive oil, nuts and seed, and lots of fish. Dairy, eggs and poultry are best if it comes from grass fed animals. Same for beef, pork and lamb in limited quantities. Include some wine and plenty of water. Be sure to include plenty of fiber foods and probiotic foods as well. Local, fresh and organic are preferable.

This combination will keep you healthy and keep your intestinal bacteria happy as well. When they are happy, you will be healthier

A final word comes again from Hippocrates; “All disease begins in the gut.” 

Still the best advice only now we begin to understand just why he was correct.

Next post – Keep moving!

Gluten - It's Not Just The Bread - 2

There are three (possibly more) illnesses caused by gluten - celiac disease, gluten allergy and gluten sensitivity.

There are no medicines or pills to take. Whether it is celiac disease, allergy or gluten sensitivity, the only effective approach is to totally avoid gluten. This is relatively easy to do at home but it can be more complex eating out. Gluten is obviously in products made from wheat flour like bread, pasta, pizza, pretzels, pies and cakes. At home it means getting rid of the obvious - white or whole wheat flour, pancake mix, cake and cookie mixes and many cereals like Wheaties. More difficult to recognize are pantry items that have gluten lurking in them that might surprise you. Cheerios and Corn Flakes include wheat flour. Soy sauce usually is made of both soy and wheat although wheat-free soy sauce is available.  Worcestershire sauce is a problematic item; some brands are gluten-free while others are not. Malt vinegar is made from barley and so is not gluten-free; white vinegar may be not be gluten free whereas balsamic and apple cider vinegar are usually safe. Beer is brewed from wheat and barley. Hard liquors are often made from wheat but are distilled and so are generally gluten free.  Seasonings can be a complex problem; some seasonings may use wheat to stabilize the spice or herbs in it.

Basically, it is a process of reading the labels carefully. Food package labeling has improved immensely in recent years and can be a real blessing in the grocery store. The ingredients label must note if it contains wheat.
If you follow the basic very healthy Mediterranean style diet you can reasonably easily remain gluten free. The Mediterranean diet is fundamentally one based on a fresh vegetables, simply cooked, multiple fruits, legumes such as beans and lentils and modest size quantities of meat, poultry or fish plus olive oil along with nuts and seeds and wine in moderation.
It's easy to prepare food from scratch but in our society we don't tend to do that anymore. Most foods come processed and pre-packaged; often those forms are adulterated with substances that include gluten. That's why the label reading is very important. But far better to start with fresh ingredients from the produce, meat and fish sections and prepare them in a way that doesn’t use gluten.
Eating in a restaurant is more of a challenge. There you're not in control of the ingredients used. As for everyone, ordering meals based on fresh prepared vegetables and fruits along with high quality meats, poultry and fish is best. Then the question is whether the chef used any added gluten-containing ingredient such as in the seasoning or marinade. Gravies are often thickened with flour as are many soups.  Eggs of course are gluten-free so you might expect that an omelet will be gluten-free even if you add veggies such as spinach, tomatoes and perhaps some cheese. But it may not be. Why? It's because some of the commercial prepackaged omelet mixes include a bit of pancake batter to make the omelet a bit smoother and fluffier. Something you would probably never guess. But if you are gluten sensitive, your GI tract will figure it out a short while later with disturbing symptoms.

Even a restaurant meal free of gluten might have been prepared next to a gluten containing meal leading to cross contamination.  So it is critical that the restaurant know your requirements and be prepared to assist.

The food industry has jumped on the gluten free bandwagon in a major way. They see market potential. It is now a multi-billion dollar per year market and growing. Why so much? Many people have started to go gluten free even though they are not sensitive nor have celiac disease. They believe that they do or will feel better by avoiding gluten. Of course this means that there are more and more gluten free products on the grocery shelves now for those that must be gluten free. Unfortunately, the food manufacturers that have produced so much gluten free food are not necessarily manufacturing healthy foods. A food product may be gluten free but processed to contain high levels of salt, fat and sugar – hardly healthy. Once again, read the label, this time for the calorie count, the fat content, the added salt and sugar.
Here is the bottom line. For a sizable portion of the population, gluten is a toxic substance. Celiac disease is very serious. Gluten allergy although uncommon can be devastating. Gluten sensitivity, while not life threatening, can be very life altering in a most negative way. Unfortunately because the symptoms of celiac or sensitivity are not necessarily GI related, the diagnosis is often elusive. For those with gluten-related disease the only treatment is preventative – completely avoid gluten. 

What should you do? If you are gluten sensitive, then you need to avoid gluten. If you have celiac disease this is especially important, indeed critical. If you are gluten sensitive you'll be most uncomfortable if you eat anything containing gluten.  The degree of discomfort and the length of the discomfort will probably depend upon how much you eat at any given time. So the key is to avoid it. But before you try to diagnose and treat yourself, talk to your doctor; that is essential. Your problem may or may not be gluten; it’s too important to leave to chance.

Gluten - It's Not Just The Bread - 1

Gluten is a mixture of proteins found in wheat, rye, barley, spelt, kamut and a few other grains. Gluten which means glue in Latin is the substance that gives bread its texture and elasticity. It's what gives bread that sticky pull which is so nice when you break a good French baguette; it's what gives a muffin its spongy characteristic and it helps form those little cells in warm bread that soaks up butter.
Gluten is not found in rice, corn, quinoa, amaranth or tiff. Despite its name, buckwheat does not contain gluten. Oats are gluten free but often raised near wheat or processed in mills that also grind wheat so they can be and often are cross contaminated.

There are three (possibly more) illnesses caused by gluten - celiac disease, gluten allergy and gluten sensitivity. Celiac disease is a serious life-modifying and often life-threatening disease. It is an autoimmune disease meaning that gluten sets up a reaction in a predisposed individual such that the body attacks its own cells. Not only can it cause gastrointestinal damage leading to malabsorption but it can lead to problems in multiple other organs in the body. Previously rather uncommon with no more than one person in 300 having the disease, today about 1% of Americans have celiac disease and the incidence appears to be rising still. It occurs in people who have a genetic predisposition, these being about one third of the population. But within that group of predisposed individuals, only some will develop celiac disease for reasons that remain unclear.
Gluten allergy is uncommon, affecting less than 1% of the population. It's an allergy similar to how some people develop G.I. symptoms from, say, shellfish. Usually the reaction comes on quickly after eating, can be quite severe often with abdominal pain, nausea, vomiting and diarrhea. The reaction stops once the offending allergen (gluten) has passed out of the body.
Gluten sensitivity (or gluten intolerance) affects perhaps 10% and possibly more of the population. It ranges from rather mild to quite severe. The most common symptom is abdominal discomfort ("bellyache," nausea, bloating) in two thirds of affected individuals. The next most common symptoms do not relate to the GI tract – eczema, “foggy mind,” headache and fatigue, all occurring in about a third of individuals. One third develop diarrhea when they eat gluten. Other less common symptoms are depression (20%), anemia (20%), numbness in hands or feet (20%), acid reflux and joint pains in about 10%.  The severity of the symptoms seems to depend upon how much gluten is ingested at one time. The more one eats, the worse the symptoms. For some people the symptoms dissipate within just a few hours but, for others, problems such as diarrhea, reflux or even abdominal discomfort can persist for days or even weeks.

In a continuing care retirement community of about 2000 residents where I live, Charlestown probably has about 20 with celiac disease, a few with gluten allergy and 200 or so with gluten intolerance/sensitivity. Many will not be aware of the connection between their symptoms and gluten ingestion. The diagnosis is often missed by physicians because the symptoms can be vague. Many problems cause abdominal discomfort and many of the symptoms of gluten associated disease are not related to the GI tract, such as headaches or rash.

There are no medicines or pills to take. Whether it is celiac disease, allergy or gluten sensitivity, the only effective approach is to totally avoid gluten.