The Good Lunch

The quick answer:  School is starting.  Give the kids a healthy lunch.

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Last week we discussed how some things are unknowable—too complex for the human mind to sort out, PhD or not.  If we are humble enough to accept this, we just might be on the path to wisdom. 

The complexity of the immune system and the rise of the autoimmune diseases were presented as examples of the unknowable.  Ditto for the related and ever increasing 4-A diseases of autism, ADHD, asthma and allergy.  (A new study was presented last week as evidence that autism—the fastest rising diagnosis of the 4-A’s—is not caused by vaccinations.  Unfortunately, though they’re confident it’s not vaccinations, the cause remains unknown.)  It was also noted that the #1 killer, atherosclerotic heart disease, might be triggered by an autoimmune reaction.

Algorithms are simple rules that allow us to deal with complexity, the unknowable.  We suggested a two-part algorithm for dealing with autoimmune diseases:

1. Strengthen the immune system by living the healthiest life possible, and
2. Protect the immune system by minimizing toxic exposure.

Food Allergies

Food allergies are on the rise—they’ve doubled in the last decade—and that’s a troubling omen for the nation’s health.  If food causes an adverse immune response it’s considered an allergen.  (If the reaction doesn’t involve the immune system, you have food intolerance.)  The common food allergens form an innocuous but potentially deadly group: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.  Children in the first two years are especially vulnerable, so pediatricians guide the introduction of these foods as the immune system develops.  The reported risk of a food allergy is 6-8%, but diagnosis is crude.

But there’s an opposite view.  A 2008 study of Jewish children in England and Israel found a 10-fold greater risk of peanut allergy in England, where peanuts are avoided in the first year, vs. Israel where they are commonly consumed by the end of the first year.  A study just issued found that allergic response (measured by immunoglobulin E, or IgE, which rises quickly in the first six months of life) is lower in children with prenatal pet exposure (i.e., the mom lived around a dog or cat during pregnancy).  This leads to the hygiene theory of allergy that says living in an ultra clean environment deprives children of unknown protections, thus a higher risk for allergies.  It’s a good theory if you don’t like to dust.

Food allergies—especially peanuts, tree nuts, or shell foods—can lead to anaphylaxis, a life-threatening reaction that requires urgent medical attention and a strategy for protection from future attacks.  Know anyone that carries an EpiPen? 

There is a familial influence: If one parent has allergies there is a 48% risk for the child; if both parents are allergic the risk rises to 70%.  The elimination diet is the safest strategy for diagnosed food allergies and intolerances—simply avoid whatever makes you ill.  In the case of milk, soy, and wheat allergies this is difficult as they are used in a wide variety of processed foods—another reason to do your own cooking.  Children may grow out of food allergies—especially milk, egg, soy and wheat allergies—but adults typically don’t.

Prevention is better than treatment—this could be the motto for this blog—so the big question is how to prevent allergies.  There is evidence that breast feeding the first four months is protective of milk allergies but there’s isn’t clear evidence of protection against other allergies.  Perhaps it’s a complexity issue, but we just don't know how to prevent allergies.

Bottom line:  The prevention of allergies is another of those unknowable things—Science doesn’t yet have an answer and likely won’t in our lifetime.  But as allergies have increased with the modern lifestyle, it makes sense that protection lies in living by the olden ways, beginning with diet.  In our view, this is especially important during the years of possible conception.  

School Lunches

As school has started for some, we should talk about healthy lunches.  For the last year or so there has been a public debate about the terrible things served in school cafeterias.  Maybe you saw Jamie Oliver (the Food Revolution guy) crossing swords with the Los Angeles school board.  The menu items I read about are revolting plus there’s the knavery of schools selling pouring rights to the soda companies. 

It’s not our policy to attack Food Inc.—other critics are doing a fine job.  So we’re not going to say anything about the Kraft line of Lunchables except to invite you to go on line and read the ingredient list.  Scary.

Budget wisdom:  Here are some affordable ideas for your kid’s lunch “sack”.  Consult the kids; involve them in preparation as part of their cooking education: 

• Fruits are easy: apple, orange, banana, grapes, dates or dried mangos with nuts, there are lots of choices, you can even make a fruit cup. Fruit can also be added to the low-sugar yogurts.
• Veggies like carrot sticks, celery, or hummus with cucumbers or cherry tomatoes are all good. 
• Sandwiches are a little harder but if you use an insulated lunch box with ice packs, there are more choices:  PB&J is a classic, or try PB on banana bread.  Preserved deli meats have been sandwich favorites but limit use to once a week as suggested in this post.    The tuna fish sandwich is another favorite; add lots of chopped celery; the lettuce can keep the bread from getting soggy. 
• Try sandwich alternatives, like leftovers from favorite foods.  You can also use pita pockets with cheese, or a quesadilla. When winter comes, warm soup in a thermos is comforting.
• Sweets should be a treat, an exception, not a daily expectation.  Cookies made from healthy recipes also contain a bit of mom's love.

Please share what you to do to make an interesting but healthy lunch for the kids.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Exploring the Unknown

The quick answer:  Living more simply not only reduces your carbon footprint, it reduces your exposure to chemicals of unknowable toxicity.

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Deep Thoughts

There was once a great man of unusual humility—W. Edward Deming (1900-1993).  A PhD statistician turned quality philosopher, Deming taught the Japanese how quality principles wisely applied could raise them from the ashes of WWII to become a global manufacturing power.  This Japanese miracle was replayed in the 1980 NBC special, “If Japan Can … Why Can’t We?” which kick-started the American quality revolution.  Like many, I was a student of Dr. Deming.  Let me share one thing I learned.

Deming gave new meaning to an old word, unknowable.  The outcomes of complex systems, due to uncontrollable interactions between variables, were unknowable, he said.  We didn’t like hearing this; it contradicted our 20^th century faith in science.  We had put a man on the moon—certainly a complex undertaking—and were confident that any complex problem could be solved.  Wasn’t everything knowable, given sufficient resources? 

We’re a little humbler now, helped along by the harsh reality of the Columbia and Challenger disasters.  Armstrong and Aldrin had been fortunate in their flight; space travel was riskier than we had appreciated. 

The Good Ship Pilgrim

I took a break from writing last evening to run down to Dana Point Harbor with the beautiful wife.  The tall ship Pilgrim, a replica of the ship that inspired the book, Two Years Before The Mast, was leaving on its annual sail to the Channel Islands.  Our daughter, smitten by the romance of tall ships, was aboard as an ordinary seaman (her 10th trip).  Because the Apollo 11 moon landing had just been in my head, the beauty of this great old sailing vessel, masts and rigging rising against the darkening night, struck me with unusual force.  Volunteer sailors stood at their stations, orders were shouted, and anchoring lines were pulled in.  As the ship slowly turned to sea, the scene glimmered with all the ancient maritime traditions. 

Later I wondered, “What can a tall ship and a moon landing teach us about the immune system?”  Science, I concluded, explores the unknown, but Tradition is a safe harbor.  In truth, because of the complexity of the immune system, we don’t really know how to optimize, or even measure, its function.  For our generation, this is unknowable.  We can only trust the tradition that what’s good for the body . . . is also good for the immune system. 

A Toxic Environment

In addition to the autoimmune diseases discussed in the last post, there is another epidemic that science is powerless to prevent.  The related 4-A diseases of autism, ADHD, asthma and allergy collectively affect millions of American children.  Though there is a genetic factor, these are largely diseases of a poisoned environment.  Environment includes the food we eat, the toxins we’re daily exposed to, and our daily stresses. 

Since WWII there has been a poorly regulated explosion of new chemicals, some benign and some toxic.  The Western nations, especially the Europeans, have lately become more careful, but the meteoric rise of manufacturing in China and other less cautious Asian countries will continue to pollute the planet.  We’ve opened a Pandora’s box and no part of our planet is safe.  For example, 1998 studies of Artic polar bears revealed most of the toxins found in man.  

We deal with the unknowable here.  The cumulative effect of long-term exposure to these chemicals, some of which interact synergistically cannot be known with certainty, but the rise of the 4-A conditions noted above, as well as the 80 or so autoimmune diseases, says there is an effect.  Given that we’ve opened Pandora’s Box and must live with the consequences, how do we minimize the damage?  A wise strategy for protecting the immune system from polluting toxins should have two components:

1. Optimize health (the subject of our blog), and
2. Minimize toxic exposure (the subject of this post).

Minimizing Exposure

Some years, well, decades, ago we lived in La Canada, located in the hills above Pasadena next to a national forest.  I liked living near a forest and had been accepted into a well-known search-and-rescue group.  There was one problem—the smog that daily rolled into the hills.  Other than eye irritation, there wasn’t a proven health hazard from the smog so people weren’t too concerned.  But our children were young and we were unwilling to expose them to a smoggy childhood on the chance no long-term health problem would be discovered.  When my employer relocated to Orange County, we gave up the hills to live near the beach.  Because the prevailing breeze is from the ocean, the air is fresh.

This still makes sense—if there is even a small health risk from exposure that will be long-term, avoidance is the best policy.  So how do we minimize pollutant exposure?  If you’ve been following this blog, you likely don’t smoke and are trying to follow the Healthy Changes, and that all helps.  It helps a lot.

Here are ten sensible ways to reduce toxin exposure without actually wearing a Save the Planet T-shirt:

1. Question everything that is disposable in your home.  Because of the role of chemicals in manufacturing, using less stuff can equate to less toxins in the home.  The weight of the garbage hauled away each week can be a measure of your progress.  Recycling is nice, but using less is best.  Remember (excepting junk mail), you probably spent good money for all that stuff in the trashcan. 
2. Choose glass and ceramic dishes and containers.  Challenge the use of flexible plastics in the kitchen (the degree of flexibility is a rough measure of toxic additives, like BPA and phthalates).  For long-term storage, it’s hard to beat those old Mason jars.  Don't use plastic containers in the microwave, as heat speeds up chemical absorption.
3. You know those plastic water bottles we’ve all been carrying around the last ten years?  We can do without; no one lives that far from a drinking fountain. 
4. Condiments, etc.—look in the fridge door and see how much store-bought stuff is now in plastic containers, some squeezable, just sitting there soaking up the chemicals from the plastic.  I just did: we had 12 glass containers and 12 plastic—time to move back to glass. 
5. Use stainless steel pans and Pyrex baking dishes; try to replace the aluminum and Teflon-coated stuff.  I always thought Teflon was inert; it isn’t.
6. Simplify the use of household cleansers.  The average home has several dozen different cleaners, many in spray cans.  These are strong chemicals and the guys making this stuff have no conscience—they get a lot of business by introducing more specialized products that promise to save labor, like those Scrubbing Bubbles that watch you shower.  How many cleansers and polishes do you actually need?
7. Don’t like bugs?  Pest control companies like to make frequent visits and anything that kills bugs isn’t going to be great for you.  Can you get by with fewer visits?
8. Here’s a crazy issue—flame-retardants in children’s pajamas (go here for a hilarious discussion by some common-sense moms), foam baby products (see here), and all of our mattresses.  In 2007 (2005 in California) the Feds upgraded the requirements for flame-retardants, exposing 300 million Americans to toxic chemicals for the unsubstantiated benefit of reducing a few deaths in fires.  Because the government is doing this, they don’t have to prove safety, nor are the manufacturers required to tell you what’s in your stuff.  Want a toxin-free mattress?  You can get one with a prescription from your doctor.
9. Eat small fish, like sardines, light tuna (not albacore), or salmon.  You’ll get less mercury and all the other toxins in the ocean food chain.   (Eating less meat, the main source of consumed toxins, was covered by Healthy Change #20.)
10.  I saved this one for last.  Cosmetics contain a lot of chemicals and the industry isn’t adequately regulated.  I don’t know a good solution here, except to use as little as you can and try to load up when you’re in Europe, as they’re more careful.  Maybe you don’t have to paint your nails (where did all those nail salons come from, anyway?) or use those dark hair dyes. (There are guys that like grey hair, though they’re mostly over 100. :-)

Please comment:  What are you doing to reduce your toxic chemical exposure (without looking too crazy)?

The Immune System

The Quick Answer:  Autoimmune diseases are difficult to diagnose and even harder to treat.  Protect your immune system through a wholesome diet.

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During the time this blog has grown to its current form, our photographer, and daughter, had a competing, even more creative engagement—growing a baby.  In the early, dark hours of the morning our phone rang . . . her time was come and they were off to the hospital.   The arrival of a new baby brings to mind Wordsworth’s timeless phrase, “. . . trailing clouds of glory do we come from God, who is our home.”  Now I hear a shriek from my beautiful wife . . . on her phone, sent by the proud father . . . the first picture of a new grandchild. 

The newborn is a good segue to this week’s subject: the care and feeding of our immune system.  It’s unfair, but women are three times more likely than men to suffer a disease of the immune system.  These autoimmune diseases are onerous conditions, difficult to diagnose and resistant to cure.  Like many topics in nutrition, the process is unknown.  A possible cause, researchers speculate, is the women’s role in the creation of life.  Immune systems are designed to reject all that is foreign, but for nine months a woman’s must relax and permit the growth of a tumor whose DNA is 50% foreign.  This additional burden—essential to the preservation of our species—may underlie women’s greater vulnerability. 

Immune System Facts

• As wondrous as our bodies are, the immune system is even more amazing.  It’s a distributed organ, divided between the spleen, bone marrow, lymph system, leukocytes (white blood cells), G.I. tract, even our skin and heaven knows what else. 
• The immune system is essentially a second brain, capable of remembering among many thousands of foreign microbes which pose a threat, and how to disarm them.
• Because our mouth—through eating and breathing—is the portal for nearly all that is foreign, 80% of our immune capability resides in the gut.  The much smaller foreign bacteria in our gut outnumber the cells of our body.  Though outnumbered, the immune system keeps a watchful eye over these microbial visitors, both benign and toxic, and maintains control, with few exceptions.
• Everyone has cancer all the time, we’re told, but our immune system with rare exception detects and eliminates these cancerous cells in the early stages.  When there is a breakdown, a cancer may begin to grow.  There’s an important lesson here:  If we took better care of our immune system, these failures could be even more rare.
• It’s morbid, but the power of the autoimmune system to protect against hostile microbes can be appreciated by considering death.  When animals (or humans) die, the autoimmune system ceases its work.  Within hours and days, the body is first attacked then devoured by invading bacteria previously held at bay by the immune system. 

Immune System Mistakes

Sometimes the immune system goes haywire and attacks the cells it’s supposed to defend.  We call this autoimmune disease; type 1 diabetes, rheumatoid arthritis, and celiac disease are examples of this “friendly” fire.  The revelation of the last decades is that any organ can be mistakenly attacked—80 such diseases have been identified to date.  In fact, more Americans suffer from autoimmune conditions than heart disease.  Worse, atherosclerosis, the beginning of heart disease, appears to have an autoimmune origin.

The workings of the immune system are incredibly complex and cannot be told in this brief post.  But three factors should be considered in the rise of these diseases:

1. The post-WWII explosion of chemicals, some benign but many not, which was poorly regulated in the beginning and has now poisoned our planet.
2. The 20^th century decline in the wholesomeness of diet, particularly insufficiency of vitamins, minerals and other nutrients due to food refining, plus the addition of chemicals for various purposes.
3. The theory that autoimmune disease is triggered by infection.  If proven, the infection theory raises another question:  What has changed, are infectious agents more potent, or is our immune system weaker?

Foods for the Immune System

We can do little about exposure to infections, and pollutants will be around the rest of our lives.  (Regarding pollutants, the next post will discuss ways to minimize exposure, including safer cookware.)  The one thing we can optimize, in the view of this blog, is the ability of our body to overcome the harm done by pollutants and infections. 

We offer a new theory here:  The industrial revolution has brought many problems but perhaps it has also brought compensating benefits: 

1. Modern nations are less subject to devastating famine;
2. We enjoy a greater variety of foods; and
3. The seasons of foods have been extended. 

Perhaps a merciful God, through the bounteous supply, greater variety, and extended seasons of whole foods, has provided a pollution antidote.  Of course, to benefit we must avoid factory goods and cook with real food.

The following nutrients are important to immune system health:

• The antioxidant vitamins—A (carotenoids), C, and E.
• The essential minerals, zinc, selenium, and magnesium.
• Omega-3 fatty acids, especially if omega-6 is reduced and oxidized or trans fats avoided.
• Other antioxidants, like the bioflavonoids, known by their yellow, orange, red, and blue colors.

Though each of the nutrients above can be taken in pill form, they are naturally available by eating fruits and vegetables.  By taking them in the natural form, you also get accompanying phytonutrients that are believed to play essential supporting roles.

The Challenge

Prior Healthy Changes have covered the nutrients noted above.  The challenge is to regularly include them in our diet.  It’s not hard to include tasty fruits and nuts in our diet.  But we do find it difficult to regularly include the recommended daily servings of vegetables and legumes.  It’s much like juggling balls, as balls—think Healthy Changes—get added it’s harder to keep them all in the air.  This leads us to this week’s Healthy Change:

Readers have made prior requests that we post some weekly menus.  We’ll do this, from time to time, a few for each season of the year, guided by the three pillars of science, tradition, and scripture.  We hesitate to do this every week, first because people vary in their needs and there is not a single answer, and second, because the perfect menu remains a mystery.

Please comment on what works best for you in menu writing. 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Bones and Muscles

The quick answer:  Machines and servants are beguiling, but for healthy bones, get up and do your own work.

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Dealing With Doctors

A while back the beautiful wife had her annual ob/gyn exam.  She came back upset; scolded for not taking calcium supplements or vitamin D pills.  “They’re proven to work,” the doctor snapped, “you’re foolish not to take them.”  I hesitate to criticize doctors; they’re among the smartest and best educated of our society and in a career gain much experience.  Still, I wondered. 

“Why vitamin D pills,” I asked, “did he test your serum vitamin D level and find it lacking?”  In fact, my wife has never been tested; few people have.  This one-size-fits-all form of medical advice is cost-efficient but of questionable value.  “Shouldn’t the doctor determine your level, then have a discussion about the merits of vitamin D from the sun, vs. taking pills” I queried. 

“And what about calcium pills?  Does he have test data that you lack calcium?  If so, couldn’t he provide information about the research on getting calcium—and all the accompanying minerals and nutrients—from whole foods vs taking pills? Don’t vegetables have a place?”  For the beautiful wife, it’s all very confusing.

In the last post Harvard researcher D. Mark Hedsted was quoted: “The long-standing recommendations to increase calcium intakes [though this may increase bone density] appear to have had little or no effect on the prevalence of osteoporosis or fractures in the United States.”  The issue here is about the importance of bone density vs bone strength—taking calcium can add a little density but if the fracture rates don’t improve, those denser bones aren’t any stronger.

Building Bone

Bone strength is about more than calcium and vitamin D pills:

• Various minerals—including phosphorous and magnesium in addition to calcium, all found in natural foods—must be in balance for optimum bone health. A balanced diet of whole foods will do this.
• Acid/alkaline balance—the diet that is high in natural plant foods and low in animal products and processed foods will be less acidic and thus require less calcium to be pulled from the bones to buffer and remove the excess acid. 
• Endocrine system—if you have concerns about osteoporosis, a thorough physical exam may be in order.  I know this sounds like TV drug advertising, which I hate, but ask your doctor.  In my experience, doctors prefer doing preventive work like exams over reacting to crises.  Bone health requires a well-working endocrine system (adrenal glands, pancreas, thyroid, parathyroid, etc.).
• Muscle-bone balance—because muscles are anchored to bones, strong muscles make for strong bones and vice versa.  The relationship is mutually beneficial.  To strengthen bones, think about how to use and build your muscles.

Building Muscle

Guys will sometimes go on a muscle-building program; girls too.  There’s a cost: the gym membership, workout clothes, a trainer, and time from a busy life.  There’s risk too: like long-lasting injuries from unusual straining.  I’ve done this; it was fun.  I felt better and looked a bit buffer, but it wasn’t sustainable.  The excitement wore off and I sustained an injury—lateral epicondylitis, or tennis elbow, from the weights. 

Gyms are okay but to be long-lasting, exercise should be integral to your daily life—there’s plenty that can be done around the house, with the family.  With the caution to proceed carefully and consult your doctor about health limitations, here are some suggestions:

1. Reject the trend to servancy—having things done for you.  It strokes the ego, but do you really need a car with automatic door closers?  Simplify your life and take satisfaction in doing things yourself.
2. Do your own yard work and housework.  The hard times in Mexico are bad for our bones—immigrants will work hard for little money to do the chores that once built our muscles.  Do your own yardwork, using old-fashioned manual tools, like a push-mower.  Forget the noisy leaf blower—find a rake or push broom and enjoy the peace.  If you have children, think how you can involve them.  It’s fun to do yard work, to be outside connected with nature. 
3. Besides yard work, there’s the joy of house cleaning.  Isn’t there?  Make a schedule of work and give it 30 minutes daily; work to up tempo music to improve your efficiency and effort.
4. Walk.  The beautiful wife is out each morning with her friends; they walk and gab, never run out of things to say.  Lunchtime walks are good, at home or at work, because you also get a little sunshine.
5. Get a bicycle.  Walking is good, but cycling gives a more intense workout and you get to see more country.  Alternate between both in your workouts.  For daily errands, consciously double the distance you’ll travel without starting the car.  (I wear a helmet and stay off busy roads.)
6. Add these tools to your home: a speed bag (the leather ball with a swivel used by boxers); a pull-up bar, and a jump rope.  The repetitive jumping is a safe and effective way to strengthen bone, plus it’s a super aerobic workout.  You won’t last very long at the start, but you’ll improve with time.  Same way with the speed bag.  With a few months of practice the clatter will be music to your ears and a good way to work off your aggression.
7. In the car, use the time at stoplights to exercise.  You can get a good upper body workout by compressing or tensioning the steering wheel, or just keep a hand exerciser handy.  Depending on your commute, you can spend a lot of time at stoplights.  (No working out when driving.)
8. Stairs are a great work out; forget the elevator.  If stairs aren’t in your daily routine, find a local hill or high school stadium steps to add to your workout.
9. Cooking is work, there’s no way around it.  But it’s also exercise.  So besides the nutrition benefit of home cooking, enjoy the effort too.
10. Dance.  Rediscover the joy of dance exercise.  At the church we attend, there were a group of widows in their 90s who would sit together.  What was the secret to their longevity?  Maybe that they had all been dancers in their youth.

Please comment on how you include exercise in your daily routine. 

A fresh look at bone health

The quick answer:  The modern epidemic of osteoporosis, like coronary artery disease, is the natural result of an unnatural lifestyle—too much meat, sugar, and processed foods and too little use of the muscles. 

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American women worry about osteoporosis.  They should worry.  There’s nothing nice about stooped-over posture, the dowager’s hump, or a life-shortening broken hip.  Osteoporosis is a big problem and in the American way, treatment has become a big business.  Unfortunately the money spent on treatment—like calcium supplements and drugs—hasn’t solved the problem.  In this post we take a fresh look at bone health and talk about prevention.  Warning:  Most of what you've been told may be wrong. 

An Old Theory Revisited

The current calcium theory of osteoporosis calls for more calcium in the diet and this has carried over into government guidance.  Americans consume more calcium than any nation, yet we are advised to take more.  Problem is that while we consume more calcium, we still have one of the highest rates of osteoporosis.  This doesn’t make sense.  There’s another theory—call it the acid/alkaline theory—that’s been around since 1968 though largely ignored, perhaps because there’s no pill to sell. 

The Lancet, published in England, is a prestigious medical journal.  Over 40 years ago it carried a revolutionary article by two Harvard researchers, Amnon Wachman and Daniel Bernstein, titled “Diet and osteoporosis.”  The article offered evidence that osteoporosis was the natural result of the modern acid-producing diet, not of too little calcium. 

Another Harvard researcher, D. Mark Hedsted in a 2001 American Journal of Clinical Nutrition commentary “Fractures, calcium, and the modern diet” (you can read it here), made these points:

1. Questioning the guidance to eat more calcium, Hedsted asked:  “Why do populations with low-calcium diets have fewer fractures than do those with high intake?”
2. He further observed:  “the long-standing recommendations to increase calcium intakes [though this may increase bone density] appear to have had little or no effect on the prevalence of osteoporosis or fractures in the United States.”
3. Hedsted also noted the link between heart disease and osteoporosis—when one increases, the other follows.  This pattern is seen in country after country—what’s good for the heart is also good for the bones, and vice-versa. 

Acid/alkaline Theory

To better understand the acid/alkaline theory of osteoporosis, here are a few bone facts:

• Bones contain calcium, but it’s only about 3 lbs. in our 25 or so lbs. of bone. 
• Bones have other vital minerals, including phosphorous, and magnesium.
• Bones provide structure for the body, but they’re also a reservoir for minerals that the body taps as needed.
• For survival, the pH (a measure of acidity/alkalinity) of our blood must be controlled.  (Blood pH should be 7.4; if your pH is lower you have acidosis.)
• If our diet causes blood pH to be too acid, the body uses first sodium, then calcium from our bones to buffer and remove the excess acid.
• The peak rate of calcium removal (resorption) is greater than the ability of the body to add calcium (absorbtion).  This makes sense because survival depends on controlling pH.
• Because there are limits on the ability to restore calcium to the bones (we’ll discuss the factors later), it’s important to limit removal over the long term. 
• Some foods are alkali-producing when metabolized; others are acid-producing, which can be a problem. 
• Basically, plant foods are alkaline while animal products (and processed foods) are acidic. 
• It takes time, decades, but the modern diet will cause osteoporosis by dissolving bone to use the calcium for buffering excess acid.

Building strong bones:

How does the body build strong bones?  Our knowledge is incomplete, but here are some key factors:

• Mom: The quality of your mother’s diet during pregnancy is critical, then your diet, especially during puberty (when mom was doing the cooking).  In girls, bone formation at menarche can be five-fold greater than during adulthood.  As always, much depends on Mom.
• Mineral balance is critical.  Minerals make bones hard (a matrix of collagen makes bones flexible) but they are needed in balance.  Too much phosphorous, for example, inhibits the ability to absorb calcium (a calcium to phosphorous ratio of 2.5 to 1 is best).  One problem is processed foods, which contain fewer minerals but more added phosphorous.
• Vitamins, especially D and K2, are needed for bone building.  There is controversy about the best way to get vitamin D (whether by sunshine, the historic method, or pills) but many experts believe we’re getting too little.  Vitamin K is found in dark greens and other vegetables; the body converts this to the needed K2. 
• Estrogen plays a role for both men and women (yes, men produce a small amount).  The decline of estrogen after menopause is problematic for women.  Some foods stimulate estrogen production but this is not well understood.  What to do?  Until we know more, eat well and take care of your health. 
• Want stronger bones?  Build stronger muscles!  Exercise stimulates bone growth, especially if the normal load is slightly and repetitively exceeded.  Exercise also builds muscle, which partners to strengthen bones.
• Americans love sugar but sugar disrupts the calcium to phosphorous ratio, inhibits calcium absorption, and increases calcium resorption from bone. 
• Chronic stress can interfere with the building of strong bones.  We’ll address stress in a future post but pick your battles carefully and create islands in time where you have peace, order, and harmony.
• Calcium absorption is reduced by smoking, alcohol, excess caffeine and meat, and improved by eating whole grains, herbs and fruits.  All things considered, the Word of Wisdom is a remarkable recipe for good bone health. 

Summary:

Monitoring your bone health is like watching a glacier move, you need to take a long view.  There is much we don’t know and that likely won’t be known in our lifetime.  The best strategy then is to optimize bone formation and minimize the breakdown of bone to preserve blood pH.  Fortunately, the Word of Wisdom lifestyle works for both.

In the next post we'll discuss muscle-building exercises.  If you suffer from osteoporosis consult your doctor.  Be patient in adding exercises—try to avoid injury; see this as a marathon not a sprint. 

Budget Wisdom:  You don't need a fancy gym—gravity is free.  Jumping rope or climbing stairs is good for the legs.  Push-ups and pull-ups are good for the arms and shoulders.  A walker passed the house while I was working in the yard.  In conversation he said he does his age in push-ups.  I was impressed as he was in his 70s, though he looks younger.  Picking up small children counts too; as they get older you'll get stronger.  (They'll make you stop about the time they get to high school.)  The key is to incorporate into your daily life things that are harder than usual, and then do them for years and years. 

Comments:  Please share your experience with bone health.  What do your doctors recommend?  What works best for you?  What do you do to build and preserve muscle.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Nuts to you!

The quick answer:  Many have overlooked the healthiness of nuts.  Make nuts a regular part of your diet; eat a serving most days.

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A charming Victorian farmhouse high in the Rocky Mountains of Utah is just one of the good things my Beautiful Wife brought to our family.  (There are also those six slightly-above-average children and a pack of way-above-average grandchildren.)  The farmhouse is located in a small town settled mostly by Swiss emigrants in the 1860s.  Though the family farms have mostly disappeared, the traditions linger and influence all who come here.  I know this; the customs of this town have given me a deeper reverence for the wisdom of tradition.  We’ve been graciously welcomed here, considering that we’re from California, probably because a good part of the town is some kind of cousin to the Beautiful Wife.

There’s always some project to do when we come here, like painting.  This trip the trim around the 2^nd story roof wanted paint so I needed some scaffolding—which brought me to two local men of character, Steve and Gary.  Gary has the scaffolding and Steve has a trailer to haul it to the house.  I got to know, and respect, them during the restoration of the home.   The other day, standing around a pick-up truck, a place where guys here are prone to visit, they began to reminisce about times past. 

Their most vivid memories were about harvesting hay—farm boys work a bunch, but being strong enough to heft hay bales seemed to be the work that signaled a boy’s passage to manhood.  The conversation turned to the long-ago death of a friend, killed in a farming accident.  Gary, who was there, recalled the boy was going to take a certain pretty girl from the next village to see the fireworks that night.   There was a moment of silent remembering; working through the genealogy I realized that the boy who died too soon and his lovely date were cousins of my wife. 

We returned later for a missing item and found Gary in his garden, his arms full of squash.  In the way of those who farm, he insisted I take some zucchini, which led to a story about a visitor to the area.  The visitor was impressed that his host never locked his car and even left the keys inside.  But on Sunday, when they went to church, the windows were rolled up tight and the doors locked.  Later he asked about the need for such security at church.  “Oh, you have to,” the host explained, “while you’re in meeting, they’ll slip their extra zucchini into your car!”  When we got back to the house I left the zucchini in Steve’s truck but he returned it later with a grin.  We had it for dinner, steamed, with a cheese sauce.  As I ate, I pondered how people who garden seem extra healthy.

Healthy Nuts (and Seeds)

Now some past posts come together.  As we reduce the animal protein in our diet in favor of plant protein (discussed here, but 1/3 animal, 2/3 plant), we also reduce the saturated fats in favor of their less-saturated cousins.  I like beef, and pork; now that I’ve figured out that sheep are the last meat to be pasture-fed I’m taking a liking to lamb also.  But there’s a new dietary:  Less meat but more fish, legumes, and nuts.  You can even save a little money, as well as your health.  I like the crunchy chew of nuts, it’s probably a guy thing, and am happy to eat less meat in exchange for more nuts.

Many are unaware of the health benefits of nuts so here are a few highlights:

• Nuts are rich in antioxidants (discussed here), including vitamin E and selenium.  In the prior post, we talked about the importance of selenium in protecting you from cancer. 
• Besides antioxidants, you also get omega-3 fats, which lower LDL (or “bad”) cholesterol.  (Foods rich in omega-3 are typically high in protective antioxidants.)
• Studies show the risk of heart disease death is significantly lower (around 40% less, depending on the study) for people who eat a serving of nuts most days.
• Nuts fight inflammation.  A 2005 study found those who eat the most nuts to have the lowest level of inflammation markers.  For almonds, the anti-inflammatory effect is as strong as the statin drugs, without all the nasty side effects.   (Inflammation was discussed here.)
• Nuts are a good source of fiber, and minerals, including potassium and magnesium, important to bone health.
• The risk of type 2 diabetes is reduced through replacing meat with nuts according to recent study discussed in the N.Y. Times.  See the article here.
• Nuts are a great non-sugary snack, one that won’t cause you to gain weight.  Though dense in calories (and nutrients), studies show a significant advantage in weight loss for nut eaters.  (Though the nuts are high in calorie-dense fats, they are also very filling so there’s no calorie penalty.)
• Seeds—like flax, pumpkin, or sunflower seeds—offer the best nutrition value pound-for-pound.

Budget Wisdom

You can save by buying nuts in bulk.  The grocery stores offer nuts in small packages (2-1/4 oz.) at high prices.  For example, at the local supermarket almonds were $18/lb in the small package (and $9/lb. in the 6 oz. package); pecans were $24.81/lb; walnuts were $16.20.  Prices as high as these are offensive.  The same nuts can be bought at the health store in any quantity from bulk bins for $3.59 for almonds, and $9.62 for walnuts (pecans weren’t available at the store visited).  If you can use a 2- or 3-lb. bag, Costco offers almonds at $3.26/lb; pecans at 7.50/lb; and walnuts at $7.00/lb.  For the best value and taste: buy in bulk and refrigerate your nuts in a sealed container.

Do the supermarkets realize how long the train has been gone?  The policy of the grocery stores is to seek the best price rather than offer best nutrition.  Worse, they add unneeded processing (sugar coated peanuts?).  It’s a bankrupt strategy; they are missing the train.

We buy walnuts from a small grower in northern California after the Fall harvest.  When I first met him I wanted to buy a bag full of walnuts in the shell and use them through the year as needed.  The grower laughed, “You mean, keep them in your garage?”  That was what I had planned, actually.  He explained that the fats would oxidize and turn rancid during the year; you have to shell the nuts and freeze or refrigerate them (just like fresh-ground wheat).  The grower, who also supplies restaurants, had a cold room to protect his nuts.  The fresh walnuts I bought had great taste and color (blond, whereas the older, unrefrigerated walnuts in the stores turn a darker brown as they age), and only cost $5/lb. if I shelled them. 

I like nuts with dried fruit.  Throw in some oats and you have the Swiss breakfast, muesli.  Nuts are important to granola also.  And the snack plate is a good place to set out your daily serving.

You likely noticed we didn't have a picture for this post.  Reason is my talented photographer, who donates her time to the cause, has mentioned the two words I have been fearing:  "Maternity leave."  So we're going to have to be more creative for a while.

Please comment on how you buy and use nuts, or your favorite nuts. 

Minerals 101

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

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Two quotes on the importance of minerals in our dietary:

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

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

Essential Minerals

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

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

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

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

Calcium

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

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

Sodium

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

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

Magnesium

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

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

Selenium

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

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

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

•   Report: Eating Healthy is too Costly for Many Americans

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

•   Nutrition Study: Healthy Eating is Too Expensive.

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

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

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

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

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Sugar and Addiction

The quick answer:  The objective in eating less sugar is not to replace sugar with sugar-like substitutes, but simply to eat less sugar.  The split pea soup recipe attached delivers wonderful sugar-free flavor.

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Addiction

What’s addiction but the inability to resist harmful behavior.  Though known through out history, the rapid spread of addictive behavior is a phenomenon of our time.  The growing variety of addictions suggests a fundamental human vulnerability triggered by the modern diet and way of living.  Though some people are more vulnerable than others, with repeated exposure anyone is susceptible. 

Food addictions, as we have seen, make a good business for the suppliers.  The success of Coca-Cola, which originally contained cocaine, and of other caffeinated and sugary drinks is testimony to this.  These and other sugary foods are mildly addictive to most, but some find them highly addictive.  A central challenge of healthy eating and living is to live free of addictions. 

Occasionally we hear the refrain, “moderation in all things.”  This is actually a way of saying everything is okay, and we know that isn’t so.  Some things, like tobacco, or trans fats, should be avoided completely.  Other things—like sugar or sugar substitutes—should be minimized.  It would be wiser to say, “moderation in all good things.”

The reader comments to the last post suggest that even diet sodas are addictive and one reader asked for ideas on how to quit.  Serious addiction requires professional help and programs exist to provide such assistance, but here are a few suggestions for the mildly addicted:

1. Make your home a safe place:  If something desirable is in your home, it will be eaten.  So keep your addictions out of the home.  Healthy Change #8, for example, said to “buy candy a piece at a time; never bring a box or bag of candy into the home.”  So if you’re unable to resist soda drinks, just buy one when you do your weekly shopping.  And get a hacksaw and cut the drink holders out of your car.  Ha ha.  
2. Seek friends who don’t share your addiction.  A recent book, Connected: The Surprising Power of Our Social Networks, followed the behavior of people who stopped smoking, a difficult addiction.  Those who were successful gravitated to social groups who didn’t smoke.  Try inviting your friends to quit unhealthy practices with you; the best outcome is when friends improve together.
3. Eat a healthy diet.  Poor nutrition is addictive nutrition—some researchers, for example, describe sugar as “the mother of all addictions.”  The science is not complete but there is evidence of the depressive effect of sugar on neuro-transmitters like serotonin, which leads to addictive behavior to compensate.  The sugar substitutes may also have this effect.
4. Remember you’re being watched.  There is scripture about the sins of the fathers passing to the sons, and their sons.   If you want to protect your children, work very hard at eating well and avoiding addictive behavior.  The generation X’ers who embraced street drugs grew up in a culture where adults abused prescription drugs.
5. Replace your addiction with something better.  Take a walk when you’re tempted to reach for a diet drink.  Water always tastes better after a walk.

Stevia

Readers have asked about stevia as a replacement for artificial sweeteners.  I think the question misses the point—to improve our diet the safest approach is to reduce all sweeteners, not just our sugar intake.  There is no research, to my knowledge, that shows a total health benefit from replacing sugar with any chemical that has the same sweetening effect.  To improve health and longevity, we need to de-sweeten the modern diet and return to traditional flavors.

Look at the history:  A new chemical or product is regularly discovered and marketed to replace one found addictive or unhealthy.  Since sugar was shown to be unhealthy in the amount being consumed, we have seen a series of potently sweet new chemicals being introduced, from saccharine to cyclamate, to sucralose, to aspartame to the most potent yet, neotame (acesulfame potassium).  Short-term, these products are probably safe to use.  The long-term safety remains unknown and may never be known due to the needle-in-the-haystack difficulty of proving what makes us ill among the thousands of foods we eat. 

Stevia is a traditional sweetener in Latin America and is now used around the world, especially in Asia.  China—not generally considered a safe source for processed foods—is a significant exporter of stevia sweeteners.  The leaves, once used intact, are now chemically processed to isolate several of the sweetening molecules.  Two, stevioside and rebaudioside A are marketed in different forms.  Rebaudioside A was approved for the FDA’s GRAS (generally regarded as safe) list in 2009, which simplifies its addition to food products.  Coca-Cola and Cargill developed a stevia product called Truvia, and Pepsi-Co developed PureVia.  The use of these products will grow and we eat at our risk.

We have used stevia products in our home but have stopped.  My beautiful wife didn’t care for the after taste and I decided I just didn’t know enough about how they are manufactured. 

Please comment:  Reducing sugar intake to the AHA guidelines of 6 tsp daily for women and 9 tsp for men is about a 75% reduction for the average American.  The goal is to de-sweeten our diet, not just to replace sugar with non-sugar sweeteners.  Please share your experience with eating less sugar (whatever the form). 

Recipe:  Split Pea with Ham Bone

In the post on legumes I promised to share our recipe for split pea soup.  It’s a traditional dish good for several meals, full of flavor without resorting to sugar.  We started with the Cooks Illustrated recipe, which follows the traditional ingredients for legume soups but took too long.  Split pea soups are a thrifty dish for using ham bones left over from a Sunday dinner.  We cooked this twice, once with a ham bone from the freezer, the second time using cooked ham hock/shoulder from the store.  Because the amount of bone will vary, we wrote the recipe per pound of bone:

Ingredients

1# ham bone with a little meat attached, or a ham hock/shoulder

4-6 cups water, or enough to cover ham bone

1-2 bay leaves

1 cup split peas, rinsed

½ tsp thyme, dried

1 T EVOO

1 medium onion, chopped

1 carrot, chopped

1 celery stalk, chopped

1 T butter

1 garlic clove, minced (optional)

1 new potato, cubed (optional)

Tabasco sauce (optional)

Directions

1. Place the bones with meat in a suitable pot with bay leaves.  Bring to boil and simmer 2-1/2 hours.
2. Remove the bone from the pot and set aside to cool.  Add split peas and thyme to the pot.  Return to boil and simmer 45 minutes until peas are soft.  (Steps #3 and 4 can be done during the 45 minutes.)
3. While the peas are simmering, add olive oil to a frying pan and sauté carrots, celery, and onion about ten minutes, until soft and moisture is evaporated.  Clear a little space in the pan and add butter and optional garlic, then stir into the vegetable mixture. 
4. Remove the meat from the cooled bone(s) and chop into small pieces.
5. Place the vegetable mixture, cubed potato, and meat in the pot of split peas.  Add salt and pepper to taste.  Simmer for 20 minutes.  Add optional Tabasco sauce to taste and serve after cooling.  (During step #5 a green salad can be prepared and served with bread.) 

Note:  Not counting the 2-1/2 hours of step #1, this meal can be prepared in a little over an hour.  Cook it on a day when you have extra time and you’ll have enough leftovers for several more meals.  A 3# ham bone made enough to freeze a quart and provide two dinners and a lunch for two people. 

The diet soda challenge

The quick answer:  America’s love affair with diet drinks was a big mistake.  Our recipe for better health: water, on the rocks, with a slice of lime.

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Heard of the Ornery Rule?  My invention, I confess, but it says you can count on someone finding the stuff you like the most . . . to be unhealthy.  Like sugar.  We’ve taken on America’s love for sugar—excess sugar is our single biggest health problem—with these Healthy Changes:

#1   If you consume sodas or other sugared drinks, limit yourself to one (12 oz.) serving per week. 

#3   Cereal products must be made of whole grains, and have more grams of natural fiber than grams of sugar.

#6  Drink lots of water; make it your main drink.

#8   Buy candy a piece at a time; never bring a box or bag of candy into the home.

#12 Enjoy a healthy mix of snacks by making a daily snack plate.  (Because sugary snacks are often impulsive, this adds the virtue of premeditation to snacking.)  

#25 Don’t skip breakfast.  Start your day with a healthy breakfast rich in antioxidants with more fiber than sugar.

Non-sugar sugar?

A little history?  In the beginning there was no sugar, just natural sweeteners like honey,  By and by, someone discovered how to make sugar from cane and in the 1600s, colonies were established in the New World to meet the growing demand.  Fortunes were built on the sugar trade.  Even before the cotton plantations of the South, slaves were taken from Africa to the Caribbean to work the cane fields.  In Europe, because sugar was so precious at first, it was usually sold in drugstores (apothecaries).  As the effects of eating sugar became apparent, doctors began to warn of its dangers.

During this time there arose in France a lawyer turned food writer named Brillat-Savarin.  In 1825 he composed the first important book on food, The Physiology of Taste.  It became a classic and nearly two centuries later is still a good read.  Brillat-Savarin observes how health concerns about sugar were met with the mindless rejoinder, “sugar hurts nothing but the purse.”   A learned man even promised that, “if sugar should ever again be thirty sous a pound, I will drink nothing but eau sucree.”  He wasn’t alone, which brings us to America’s love affair with sugar alternatives.

In 1890 it was discovered that saccharine gave the taste of sugar without the calories.  Prescribed first for diabetics, it was approved for general use in 1958.  Some remember it for launching Diet Rite and then Tab, the first big diet drink.  With saccharine, it seemed, you really could have your cake and eat it too, if you didn’t mind the bitter aftertaste.  Other artificial sweeteners followed: including cyclamates (no longer approved in the US); and aspartame (NutraSweet, or Equal), the most controversial of the sweeteners.

Coca-Cola, building on the popularity of Tab, introduced Diet Coke, which used aspartame.  Launched in New York City in 1982 with a $100 million advertising campaign, Diet Coke was an immediate success and is now the #2 soft drink, after Coke.  Not to be outdone, Pepsi, Dr Pepper, and Mountain Dew brought out diet versions.  Again, as with sugar, a few doctors spoke out against the danger of artificial sugars but the temptation of both sweetness and slimness was irresistible.

Are diet drinks really healthier than sugar drinks? 

This brings us to the big question:  Are diet drinks healthier than sugary drinks?  Long story short, diet drinks really are unhealthy, but in different ways.  For example:

• Preterm delivery risk:  A 2010 Danish study found pregnant women who consumed one diet drink daily at 38% higher risk for preterm delivery.   There was also a dose response: women who drank four per day had a 78% greater risk.  No such risk was found for sugar drinks.
• Metabolic syndrome:  A nine-year study of 9714 people, age 45 to 64 years, reported in 2007, looked for dietary causes of metabolic syndrome (which we discussed here).  High meat intake was found to be a significant risk but the big surprise was that diet drinks increased the risk 34%. 
• Osteoporosis: There is a longtime link between diet drinks and osteoporosis, but the exact cause remains unknown.  Is calcium leached from the bones to buffer the phosphoric acid?  Or, do soda drinkers just get less calcium from sources like milk?  We haven’t figured it out yet, but perhaps it shouldn’t surprise us that research against highly profitable products doesn’t get funded.
• Kidney stones:  Where does the calcium lost from the bones go?  Some winds up as kidney stones.  An NIH study of kidney stones found two or more cola drinks each day double the risk for stones.  As the most popular drinks, sugar or diet, are colas, urologists will be busy treating those painful stones. The calcium in your diet isn’t the problem—a 1993 study found calcium from food protects against kidney stones. 
• Stroke and heart attack: A U. of Miami study of 2500 Manhattan residents followed over 9 years found a 61% higher risk of vascular events (heart attack, stroke, or vascular death) for daily diet soda drinkers vs those who abstained.  Even after controlling for known risk factors, a 48% greater risk remained.   
• Weight gain:  There’s a bag-full of studies showing diet sodas add rather than reduce weight but this shouldn’t be news.  Back in 1986 a study of 78K women ages 50-69 found nearly 2 pounds per year greater weight gain for women consuming artificial sweeteners vs. women who didn’t.  A pound or two isn’t much, but multiply it by 28 years (since Diet Coke was introduced) and you’re looking at a big gain.

The problem of weight gain for diet soda drinkers was addressed in a Yale review of prior studies.  The conclusion was that artificial sweeteners reinforce the sugar desire, without satisfying it as regular sugar does.  No surprise then that the national weight gain of recent decades parallels the growing use of artificial sweeteners—the more we eat, the more we want. Good for business, but bad for health.

There’s true irony here:  Diet drinks—despite the marketing—don’t make us slimmer, what’s worse they introduce new health risks.  We’ve been through the sugar binge, high fructose corn syrup, saccharine, and aspartame, and the bottom line seems to be that we must return to olden ways and recover our taste for flavors other than sugar, whether real or artificial. A little sugar is okay, but we've gone way past a little.

Healthy Change #31 reads much like our first Healthy Change: 

Budget Wisdom:  Americans spend about $12 billion yearly on soft drinks, I’m told.  Drinking less bottled drinks, way less, and more good old water from your tap (well, after it runs through the charcoal filter) will save you money that can be better used to buy whole foods, as well as your health.  Water on the rocks with a twist of lime—you can't beat it for value, convenience, or healthfulness.

Please comment:  This is a challenge because diet drinks are tempting, especially for moms who want something to pick them up on busy days, which can be everyday.  For this reason I’ve saved it until our 31^st week—after you’ve gained strength from the dietary improvements and extra exercise.  If you’ve successfully cut back on diet sodas, please share your experience.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

The Benevolent Bean

The quick answer: Legumes are underutilized value champions, offering protein, fiber, and a host of nutrients.  Enjoy them most days, in a soup, stew, casserole, or just sprinkled on a salad.

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The Healthy Change for this week advises eating legumes most days.  Before I introduce a book on the subject, let’s look at the twisted trail of the author Ancel Keys, a scientist who shaped the American view of heart disease.  Keys, more than any other person, sold the misguided mantra known as the Lipid Theory of Heart Disease, which posited that coronary heart disease (CHD) could be prevented by eating a low-fat diet, particularly a diet low in saturated fat and cholesterol.  

This conclusion was based on his Seven Countries Study but it was later suspected he chose countries that supported his preconceived notion that dietary fat was the culprit.  In retrospect, choosing different countries would have given a different answer.   Due to Keys’ persistent efforts—he’s often portrayed as an academic bully—the focus of CHD research turned to cholesterol.  It helped that a cheap test for blood cholesterol had been developed—today most everyone knows their cholesterol number and many believe that lowering cholesterol is good for their health.  It’s a curiosity of medicine that the available test can shape the treatment of disease, and cholesterol-lowering drugs grew into an enormously profitable business, though more and more their use is being questioned.

Keys later retired to a charming fishing village on the Italian coast where he became a proponent of the Mediterranean diet which, due to the consumption of olive oil and fish, is low in saturated fats.  He even wrote a book on the diet that became a best seller.  Unfortunately, the cholesterol adventure wasted 50 years in the war against CHD.  Why did I tell this story of science gone awry? Because it reminds that science is often wrong, and we are wise to consider other venerable sources of knowledge, including tradition and scripture.  We’ll invoke all three in this post.

Scripture

Do you remember the food experiment of Daniel and his three friends in the Old Testament?  It may have been the first use of classic experimental design.  Taken captive to Babylon for training, Daniel and his friends were offered the rich food and drinks served at the king’s table.  Daniel demurred, proposing a 10-day experiment wherein he and his friends would eat the simple food known as pulse, and drink only water.  Pulse is a traditional dish of cooked edible seeds, usually leguminous, such as lentils, chickpeas, and, perhaps, foods grown from those seeds.  This plant-based diet was successful as Daniel and friends were later found to look better and test wiser than those eating the king’s fare. Daniel was wise beyond his years.

Wisdom sometimes fails.  Do you remember Esau selling his birthright to brother Jacob for a “mess of pottage”?  It’s another legume story—the dish was likely lentils, plus some bread.

Tradition

The good Lord, it seems, looks after the poor.  In much of the world, the humble legumes on which Daniel excelled are the affordable fare.  The prosperous can get their protein from animal sources, but by tradition the poor must eat the plants at hand—which are actually healthier.  In the post on protein, it was suggested we get 2/3 of our protein from plants, and just 1/3 from animal sources, which is roughly the reverse of how we currently eat.  Have you considered how this protein is also the source of plant life—legumes, whole grains, seeds and nuts?

In our home, the beautiful wife's most recent dinner was a pot of split peas cooked with a ham bone from the freezer.  (Recipe to follow.)  There is a traditional method for cooking legumes:  To the legumes you add three savory vegetables (onions, carrots, and celery) and then three spices (parsley, thyme, and bay leaf) plus salt, pepper, and perhaps a little garlic, then a few bones or a bit of meat (often from the humble pig).  Legumes vary by region, there are thousands of varieties, but most dishes follow this formula.  In Provence, cassoulet is a traditional dish of white beans with savory meats, vegetables and spices, topped with a breaded crust. 

People are different and for some, certain beans bring the bane of flatulence.  To give this post a high tone, we simply refer you to this blog for information.  There is an OTC pill that provides the enzyme to prevent this problem that some may distain as it has a lowbrow name: Beano.

Science

We return now to the errant scientist Ancel Keys and his book on legumes.  Titled The Benevolent Bean, it was first published in 1967 but is now out of print.  It’s a charming introduction to legumes and full of recipes.  Unlike most vegetables, beans are rich in protein.  Keys suggests we double the 7-8 pounds (dry weight) we consume each year, which aligns with this week’s Healthy Change and the USDA's 2010 Dietary Guidelines for Americans.  (The USDA sometimes has the right answer.)

Legumes are not complete proteins (meaning they don’t contain all 8 or 9 essential amino acids) but combining beans with another food group completes the protein profile.  For example, beans are eaten with corn tortillas in Latin American, or with pasta in Italy (pasta e fagioli), or as tofu and rice in Asia.  Besides nutrients and fiber, there’s another benefit to dried beans—shelf life; they’ll last years if properly stored. 

Redemption is found in unusual places.  It’s easy to dislike Ancel Keys because of his dominating role in the cholesterol debacle that badly delayed the battle against heart disease.  Yet I found the book The Benevolent Bean, quite charming.  What made the difference?  The great scientist wrote the book with his wife, Margaret, and the help of their daughters and that, I think, made all the difference.  It's another reminder that the women who cook should be involved in our nation's food decisions.

Budget Wisdom

The two keys to healthier eating also offer the best value.  The keys: 1) eat whole foods, and 2) do your own cooking.  In the last century, older women passing away took their knowledge of cookery with them—their children, seduced by modernity, weren’t interested in olden ways.  Taken in totality, this is a great loss to our planet.  If we find it difficult to cook nutritious meals of whole foods, the answer is to reclaim this lost wisdom.  Perhaps the book clubs, so popular with young mothers, can be expanded to cooking clubs. I saw a program last night where women got together to visit and assemble food dishes for the week. 

A reader referred me to a charming book The Pleasures of Cooking for One by Judith Jones.  Jones was the editor that recovered The Dairy of Anne Frank from the reject pile, and edited all the works of Julia Child and James Beard, and many others.  Though her style of cooking is a little fancy for most, I admired her reverence for the kitchen art, and her determination to carry on making memorable meals after the death of her husband.  In this regard, Judith Jones is a beckoning light upon a hill. 

Please comment

How can we recover the art and discipline of cooking nutritious meals that fit the family budget?