A recent large study assessed the correlation between food intake and cardiovascular disease and deaths in the Middle East, South America, Africa, or south Asia. A link was brought to light between increased fruit, vegetable, and legume consumption with a lower risk of cardiovascular and total mortality. Maximum benefits could be derived for total mortality at three to four servings of any of these components per day (equivalent to 12 to 17 ounces per day) .

This study evaluated 135,335 individuals aged 35 to 70 years without cardiovascular disease. Enrollees were selected from 613 communities in 18 low-income, middle-income, and high-income countries in seven geographical regions: North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. Their diet involved country-specific food frequency questionnaires at baseline. The data contained demographic factors, socioeconomic status (education, income, and employment), lifestyle (smoking, physical activity, and alcohol intake), health history and medication use, and family history of cardiovascular disease.

The main outcomes were cardiovascular diseases of all types, cardiovascular mortality, non-cardiovascular mortality, and total mortality. They assessed the correlations between fruit, vegetable, and legume consumption with risk of cardiovascular disease events and mortality.

The study covered 10 years beginning in 2003, and was concluded at the end of March, 2017. Combined mean fruit, vegetable and legume intake averaged 3.9 servings per day. During a median 7.4 years of follow-up, the following events were reported: 4784 major cardiovascular disease events, 1649 cardiovascular deaths, and 5796 total deaths.

Higher total fruit, vegetable, and legume intake displayed an inverse correlation with major cardiovascular diseases and total mortality in the models adjusted for age, sex, and random effects. The overall hazard ratio for total mortality was lowest for three to four servings per day compared with the groups taking substantially less.  Interestingly, there was no additional decrease in hazards with higher consumption.

Fruit intake was related to lower risk of cardiovascular, non-cardiovascular, and total mortality.

Legume intake was also inversely linked with non-cardiovascular death and total mortality.

For vegetables, raw vegetable intake strongly correlated with a lower risk of total mortality.  In contrast, cooked vegetable intake exhibited a modest benefit against mortality. 


This study adds further support for what we have recommending for many years. In general, dietary patterns in the U.S. have been trending in this direction, but for many, obesity seems to be nullifying much potential benefit. I was a bit surprised by the suggestion that raw vegetables might be better than their raw counterparts, but any firm conclusions will await further study.

Although the study did not detail the causes for reductions of non-cardiovascular mortality, from what we already know, it is likely that various cancers were likely prevented as well.






How can you keep snacking from derailing your healthy eating program, not to mention weight control? Try these tips.

Don’t skip meals. Skipping meals may seem like a good way to cut calories, but in fact this just makes you so hungry later in the day that you’re vulnerable to devouring mega-portions of snack food in order to supply your body with easily digested sugars.

Keep junk food out of the house. There’s a lot of truth to the old joke about the “see-food diet” — you see food and you eat it. The opposite is also true. If you don’t have junk food lying around, the sight of it won’t tempt you, so don’t even bring it home. After all, you can’t eat what isn’t there. Or, if someone in your household tends to have chips or other unhealthful snacks, put them out of sight.

Snack mindfully. Have you ever watched a show on television with a bag of chips or pint of ice cream in hand, only to find that it was all gone before you knew it? This type of mindless eating can pack on a lot of unwanted calories. The solution is simple. Try not to snack while doing something else like surfing the Web, watching TV, or working at your desk. Instead, stop what you’re doing for a few minutes and pay attention to your snack. Savoring a piece of fine chocolate can be more satisfying than gobbling down a whole chocolate bar.

Remember, you can take it with you. Think ahead and carry a small bag of healthful snacks in your purse or the glove compartment of your car. If you have a healthy snack handy — preferably, one you really like — you won’t turn in desperation to the calorie-laden cookies at the coffee counter or the candy. My preference is a wide variety of nuts—peanuts, pistachios, etc. It’s best to consume them in their salt-free form. Popcorn is also a viable option, but again without salt or other high caloric additives. Additional ideas are provided in a previous post:

Zero in on hunger. Before you snack, ask yourself, “Am I truly hungry?” Many of us mistake emotions, such as stress and fatigue, for hunger. If the answer is yes (your stomach feels hollow, your head is achy), make sure you’re not confusing hunger with thirst. Drink an 8-ounce glass of water, then wait 10 to 15 minutes. If you’re still hungry, have a healthful snack.

Know your cravings. If you want a snack, but you’re not hungry, attack cravings from a psychological level. Ask yourself how you’re feeling. Lonely? Bored? Stressed? Then, ask yourself the bigger question: Will food fix this problem? The answer is always no. Eating a cookie, for example, won’t address a problem at work that you’re worried about. Go for a walk around the block, do a few stretches, put on some music, or choose another simple activity that might distract you or boost your mood. Then if you still want the food, fine. Ask yourself what food you really want. Then eat only a small amount, and make it good. If you’re craving chocolate, for example, eat one small square and savor it. It’s important that you snack on what you’re craving rather than deny the craving. Eating around a craving may only cause you to eat more because the craving isn’t satisfied.

Hopefully, these tips might make life a bit more pleasant and free of that undesirable excess weight!



Eating more red meat is associated with an increased risk of dying from eight common diseases including cancer, diabetes and heart disease, as well as “all other causes” of death, according to a U.S. study.

Researchers examined data on almost 537,000 adults aged 50 to 71 and found the people who consumed the most red meat had 26 percent higher odds than those who ate the least of dying from a variety of causes.

But people who ate the most white meat, including poultry and fish, were 25 percent less likely to die of all causes during the study period than people who consumed the least, researchers report recently in The BMJ (British Medical Journal).

“Our findings confirm previous reports on the associations between red meat and premature death, and it is also large enough to show similar associations across nine different causes of death,” said lead study author Arash Etemadi of the National Cancer Institute, adding further,”We also found that for the same total meat intake, people who reported a diet with a higher proportion of white meat had lower premature mortality rates”.

For the study, researchers followed the health and eating habits of people from six U.S. states and two metropolitan areas over about 16 years. They analyzed survey data on total meat intake as well as consumption of processed and unprocessed red meat and white meat. Red meat included beef, lamb and pork, while white meat included chicken, turkey and fish.

Then, researchers sorted people into five groups from lowest to highest intake of red and white meat to see how this influenced their odds of death during the study period.

They evaluated deaths from nine conditions, including cancer, heart diseases, stroke and cerebrovascular disease, respiratory diseases, diabetes, infections, Alzheimer’s disease, kidney disease and chronic liver disease, as well as all other causes. Overall, 128,524 people died, with cancer, heart disease, respiratory disease and stroke as the leading causes of death. Only Alzheimer’s disease risk was not linked to red meat consumption.

Certain ingredients in red meat, including nitrates and iron (from blood), may help to explain why it’s linked to higher mortality rates for the other causes of death, the authors argue.

The highest intake of iron was associated with 15 percent higher odds of premature death than the lowest intake, the study found.

The study wasn’t a controlled experiment designed to prove how the amount or type of certain meats might directly influence mortality.

Other limitations include the reliance on survey participants to accurately recall and report on their eating habits and the lack of data on any changes in people’s diets over time, the authors note.

Even so, the findings should reinforce the need for many adults to cut back on meat consumption, said Dr. John Potter of the Center for Public Health Research at Massey University in Wellington, New Zealand.

Potter stated further that “Processed meat can produce cancer–causing chemicals, while saturated fats in meats can increase the risk of cardiovascular disease”. He also added that “Choosing organic meat may not change the risk of premature death, and mortality is higher with higher meat intake for every major cause of death except Alzheimer’s.”

“The really key issue in all this is that the current level of meat consumption, in most of the developed world and increasingly in low– and middle–income countries, is unprecedented in human history,” Potter said. “We need to reduce meat consumption back to about one–tenth of our current level.”

As I have stated in a previous communications, one should try to limit this type of meat consumption to no more than twice weekly. Throw the rest to the sharks!



Cholesterol         According to the American Heart Association, 102.2 million Americans age 20 and older (almost 50 percent of American adults) have elevated blood cholesterol levels, a key risk factor for heart disease. Lifestyle changes such as improving diet, losing weight and increasing exercise are often effective. Various medications, such as the”statin” drugs and niacin, may be used to lower cholesterol, but various supplements may also be helpful as well, lowering low-density lipoprotein (LDL or “bad cholesterol”), sometimes raising high-density lipoprotein (HDL or “good cholesterol”), and improving the LDL/HDL ratio. Some supplements may also reduce triglycerides, which pose additional, although lower, risks.
As I have indicated previously, dietary changes that are useful in controlling cholesterol levels are spelled out in the following posts:
After changing one’s diet, however additional measures are often needed, which can be considered before resorting to drugs. Supplement ingredients that have been used to reduce cholesterol include sterols and sterol esters (produced in the normal refinement of vegetable oils, or alternatively as a byproduct of papermaking from the oil of pinewood pulp), stanols and stanol esters (substances closely related to sterols that are derived from the same sources), red yeast rice (a yeast grown on rice), garlic, fish oil, and soy protein. Soluble fiber such as oats in the diet as well as moderate intake of alcohol can also improve cholesterol levels. :
The evidence supporting the various cholesterol-lowering supplements varies. The best evidence is for sterols, stanols and their esters, soy protein and high dose-niacin (sold as a supplement as well as a prescription drug). These are sometimes associated with certain risks, which should be understood. ..
This review will be limited to the stanols and sterols, which constitute groups of agents that are inexpensive and possess a good safety profile. It should be noted, however, that while sterols and stanols can lower cholesterol and likely cardiovascular disease risk, no study thus far has shown a direct risk reduction by this means..

Scientific studies have shown that a dose of 800 mg or more of free sterols per day is required to produce effective reductions in cholesterol, usually around 10%. According to Consumer’s Lab, most of the supplements contain their claimed amounts of sterols other than Pure Encapsulations CholestePure, which. at the dose of one capsule, would provide only 450 mg of free sterols.
• Enzymatic Therapy Cholesterol Shield also includes pantethine, which may cause a modest decrease in total cholesterol, LDL, and triglycerides. In addition, HDL will rise at a dose of 300 mg 3 to 4 times a day
• Source Naturals Cholesterol Rescue includes Sytrinol™ (300 mg per day) which, may also modestly lower cholesterol.
             Phytosterols at Lowest Cost
Comparing the cost to obtain an equivalent amount of free sterols (800 mg), the lowest cost is from Nature Made CholestOff, amounting to 33 cents, while the cost for the same amount of ingredient from other products ranges from about 40 to 60 cents. CholestOff Plus is also supported by a successful clinical trial.

List of Phytosterols: This following presents a compilation of effective products (capsule or tablet form): CholestaCare, Cholesterol Shield, CholestOff, CholestePure, Shaklee Cholesterol Reduction Complex CholestePure, and Source Naturals Cholesterol Rescue.

Butter-like spreads: Plasma total- and LDL-cholesterol concentrations are reduced by margarines enriched with free plant sterols. Results are effective at an intake of 1.5gm or more of plant sterols per day, but they have little apparent effect on HDL-cholesterol or triacylglyceride concentrations. One prime example of this group is Benecol, which is provided in the form of a spread, but it is also produced in a yogurt drink, cream cheese spread, and Dobrogea Benecol Rye Bread. Another spread that has between 0.85 to 1.3 grams of sterol esters per serving is Smart Balance HeartRite Light. Just 2-4 servings of this spread per day also can fulfill your daily recommended dose of phytosterols. In order to consume enough amounts of these spreads, try adding them to such foods as steamed broccoli and oatmeal.

Conclusion: Whether you have cardiovascular disease or are presently normal, consider including the strategies above in your diet, especially make use of the spreads on your bread or in your cooking.




During the past 25 years dietary supplements have rocketed in popularity in the U.S.A., reaching over $25 billion yearly in sales. Contributing to a misguided air of authenticity, they are offered in drugstores, supermarkets, and health-food stores. But what do we actually know about these products in terms of both safety and efficacy? In a  2013 Consumer Reports survey, 55% of respondents thought the government required supplement makers to include warnings about potential dangers and side effects on their products. They don’t, meaning that safety issues are often ignored!

   So let’s run down a list of highly popular supplements, and the pros and cons for each:

Multivitamins: Many people believe they can promote general health and ward off serious conditions such as cardiovascular diseases and cancer. But the facts don’t support these contentions. Clinical trials repeatedly fail to show benefit of multivitamin supplements to healthy people. But even worse, they can, under certain circumstances, be risky: Both vitamin A and calcium can be dangerous if taken in excess, especially when added to a normal diet. Adult males and females should not ingest a daily total of over 3,000 mg. of vitamin A. Total daily calcium intake should not exceed 2,500 mg. So check to see how much you are getting in your regular diet and avoid supplements that cause the totals to exceed these levels.

Vitamin E: Originally touted to prevent cardiovascular disease, later studies have totally debunked this premise. More recently, supplements of vitamin E were suggested in the hope of preventing prostate cancer, but actual study pointed in the opposite direction: This vitamin actually increased prostate-caner risk in men age 50 and older.

B vitamins: Often thought to promote healthy metabolism and energy, the evidence refutes this contention in most circumstances. A normal diet contains an excess of B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (Pyridoxine), B12 (cobalamin), and folic acid. Unless your diet is deficient (see below), then supplementation is a waste of money. Vegetarians, and people (especially the elderly) having difficultly with absorbing B12, may benefit from supplementation of this vitamin. Moreover, women who are or may become pregnant should consider supplementation with folic acid, 0.8 mg daily. The oral form of supplemental folic acid is usually absorbed better than that found naturally in food. One caveat, however, is that high doses of folic acid can mask B12 deficiency that can lead to serious physical problems.

Vitamin K:Believed to promote healthy blood clotting and protein synthesis and prevent cancer. The reality: Leafy greens and other vegetables provide more than enough to satisfy the body’s need for this vitamin. Moreover, the normal bacteria that inhabit the bowel synthesize vitamin K and can make up any possible shortfall. There is no evidence that supplemental doses can prevent cancer. But there is a downside risk: Too much vitamin K can make the anticoagulant (blood thinning) drug warfarin (CoumadinR) less effective, a serious potential danger.

Fish Oil:  This supplement is widely used with the intent to prevent and/or treat cardiovascular diseases. Although the evidence indicates that two or more servings of fish weekly is capable to reducing heart attacks and strokes, linking fish oil supplements to these diseases is less clear. Some evidence suggests that they may help, but the better choice is in the dietary consumption of the fish itself.

Calcium: An important mineral constituent of the body, calcium is often taken with the intent of building healthy bone, thus preventing osteoporosis and fractures. But the evidence does not support such claims. Even with supplemental consumption of over 1,000 milligrams daily, calcium has not been shown to prevent fractures in either premenopausal or postmenopausal women. Among the possible risks of high calcium intake, some studies suggest that it may increase the risk of heart disease.

Vitamin C: For many years high doses of this vitamin have been used for preventing and treating colds, heart disease, and cancer. Despite numerous studies, however, the actual evidence fails on all these counts.  Although generally safe, a possible risk of high doses of supplemental vitamin C can lead to unhealthy buildup of iron in body tissues and organs, posing a risk to the occasional individual suffering from iron storage disease (hemochromatosis).

Vitamin D: This vitamin is important in bone and muscle health, nervous and immune system function, cell growth and reproduction, and moderating inflammation. Although controversial, its administration is alleged to ameliorate certain types of heart disease, hypertension (high blood pressure), diabetes, and possibly multiple sclerosis. Some research suggests it may prevent colon cancer, and—although controversial—other cancers as well. It’s also associated with a reduced rate of depression in older people, and greater immunity against some infections. So far, however, few controlled prospective trials have investigated the potential benefits of vitamin D supplementation in preventing any of these problems.

      Normally we obtain vitamin D through sun exposure and dietary intake. It is manufactured by the body, but the process requires exposure to ultraviolet light. Given the widespread use of sunscreen, however, to prevent skin cancer, up to 36 % of Americans are low on this vitamin. Food sources for this vitamin are limited, although some products such as milk are fortified. Natural sources include fatty fish such as catfish, salmon, mackerel, sardines and tuna; eggs; beef liver; and cod liver oil. Your doctor can perform a blood test to determine whether you are deficient of this vitamin. If you are found to be deficient, instead of risking sun exposure, dietary modification and/or supplemental vitamin D should be considered.  

     The latest US recommendations for the minimum daily requirement of vitamin D, or cholecalciferol—vitamin D3, the preferred formare 600 IU (international units) for those under 70, and 800 IU for those older. These quantities appear to retard bone loss. Persons infrequently exposed to the sun, especially the elderly, and postmenopausal women may need 800–1000 IU daily. From a review of available information, I conclude that people who get at least 700 IU of vitamin D daily and take calcium supplements have denser bones, have better muscle strength, and are likely to suffer fewer falls and fractures than those who don’t. The only caution is to avoid exceeding the government’s safe daily upper limit of 2,000 IU.

Glucosamine/Chondroitin:  This supplement is widely used in the effort to help repair cartilage and relieve suffering from degenerative joint disease (osteoarthritis).  After many conflicting studies, however, a recent, more definite large study showed that glucosamine was unable to relieve knee pain or cartilage loss in people with osteoarthritis. Although generally safe, this product would pose some risk to some people with shellfish allergies.


      Unless there is compelling evidence of efficacy—which is seldom the case—all supplements should be avoided. Three especially egregious products linked to serious dangers are the following: 1)  Kava, which is taken to relieve stress and anxiety, is capable of producing serious liver disease, 2) Yohimbe (yohimbine hydrochroride), used to treat erectile dysfunction, is risky because the impure ingredient present in over-the counter preparations, can cause unpredictable effects on blood pressure, rapid heart rate, and other problems,.and 3) Aconite, touted to relieve inflammation and joint pain, can cause nausea, vomiting, low blood pressure, respiratory system paralysis, heart-rhythm disorders, and even death.

                          IS ANYTHING WORTH TAKING?

    In general, normal diets contain more that enough to preclude the need for supplementation. If one has a demonstrated deficiency of any, then, upon the advice of a physician, supplementation may be justified. As noted above in the case of vitamin B12, folic acid, and Vitamin D, supplementation can be useful.





    Most of us are aware that red meat—when taken in excess—is not a very healthy choice. But what constitutes an excess of this food, and how bad is it? So, let’s take a closer look at these issues:

    First, red meat may shorten your life! In 2012 scientists at the Harvard School of Public Health evaluated results from more than 120,000 subjects in two studies and found that, after a period of 28 years, those who ate the most red meat (two or more servings per day) had a 30% higher risk of dying than those who ate only about 1/2 serving or less per day. They concluded that 8% of deaths in women and almost 10% in men could be prevented if people consumed less than half a serving of red meat per day. In their study, a single serving was roughly 3 oz. of cooked steak, hamburger, and pork chop, but only 1 oz of sausage, ham, or other processed meat, and 1/2 oz. of bacon. These results fell in line with earlier studies involving half a million people. From this I would conclude that you don’t need to stop eating such meat entirely, but curtailing your intake to about once a week can eliminate most of the risk.

   Second, red meat is not “heart or brain healthy.” This means that the arteriosclerotic process resulting from consumption of this meat can lead to heart attacks and strokes, both resulting from closure of arteries supplying blood to the heart and brain. So even if you survive, you may impair the function of your heart or brain, and with it, your life style can go out the window! The reason: Red meat is a major source of saturated fat in the average diet. This latter fat raises bad (LDL) cholesterol levels and contributes to hardening of the arteries (arteriosclerosis). But other compounds in this meat may contribute to these bad effects. These latter substances include nitrite, salt, iron from blood, and also potentially harmful compounds that are created when meats are cooked at high temperatures. Another possible culprit in meat is carnitine, a substance that may, on its own, enhance arteriosclerosis by promoting bacterial growth in the bowel that produces excessive TMAO (trimethylamine-N-exide). This latter substance is capable of producing accelerated heart disease in animals, and higher levels are found in individuals suffering from overt heart disease. These early observations are speculative and require further study for definite conclusions.

   Another threat red meat poses is a greater risk of developing type 2 diabetes, a condition further enhancing the risks of  arteriosclerosis and other bad outcomes.  Several studies have linked processed red meats to an elevated rate of this disorder, and this may also extend to unprocessed red meats as well. One example: Harvard researchers tracked more than 200,000 people for up to 28 years and found that the risk of diabetes increased by 32% for every two ounces of processed meat—and by 12% for every three ounces of unprocessed meat eaten per day. Numerous possible explanations have been advanced explain this relationship, but the meaning is clear for each person’s eating habits. 

    Third, there is a relationship between red meat and cancer. The American Cancer Society has weighed in on this issue with the following statement: “Limit consumption of processed meat and red meat. To reduce your cancer risk, eat no more than 18 oz. per week of red meats such as beef, pork and lamb, and avoid processed meat such as ham, bacon, salami, hot dogs, and sausage.” After careful analysis, they found that the risk of colon and rectal cancer rises by about 20% for every serving red or processed meat consumed daily, with additional suggestive evidence that the risk may extend to other cancers such as pancreas, prostate, or esophagus. How red meat could produce cancers is unknown, but there are two possible pathways: 1) N-nitroso compounds—capable of producing cancers in experimental animals—are created by the nitrites used to color and preserve processed meats like bacon, sausage, and lunch meats. But even unprocessed red meat seems to increase levels of these compounds, possibly through the effect of iron attached to the blood contained in red meat (as opposed to white meat).  2) When meats are cooked to well done at high temperatures, heterocyclic amines and polycyclic aromatic hydrocarbons are formed, and these compounds are carcinogenic, at least in animals. This latter danger can be reduced by cooking to less well done at lower temperatures, a measure that applies to all types of meat—red or white.

     Finally, excessive consumption of red meat is environmentally unfriendly. About two-thirds of corn and soybean production in the U.S.A. goes for animal feed rather than for humans. Since it requires about 5-8 lbs of feed to produce one lb of beef or pork, this inefficiency results in excessive use of water and fossil fuels which in turn jeopardizes our environment at a time when the world can ill-afford this burden.  Moreover, methane, a potent greenhouse gas, is produced by cattle and has 23 times the heat trapping capacity of carbon dioxide. Adding further to this burden, in order to accommodate increasing farmland to feed animals, forests must be cleared, again causing us to lose a valuable means to clear carbon dioxide from our atmosphere.

     So I can simply conclude that those cattle appearing repetitively on TV are passing along the correct advice—”Eat Mor Chikin”! (and Fish, too!)