Harkening back to ancient civilizations, the concept of food as medicine represents one of today’s most cutting-edge approaches to prevention and disease management. Inspired by the intricate connection of mind and body wellness, a small, special group of diets have made their way into the mainstream offering benefits far beyond short-term weight loss. Among them are DASH (Dietary Approaches to Stop Hypertension), a low-sodium diet that encourages consumption of foods rich in nutrients such as potassium and calcium and magnesium; the Mediterranean diet for heart health, emphasizing fish, fruits, and vegetables, with olive oil as the main source of fat; and combining both, the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, which shows real promise in helping its adherents preserve cognition and reduce the risk of dementia.
Launched in 2015 by researchers at Rush University Medical Center, the MIND diet encourages selecting foods from categories that include leafy greens and vegetables, legumes, fish and seafood, poultry, nuts and berries, while limiting high fat, high sugar and processed foods. Longitudinal observational studies showed the rewards of shifting to this healthier way of eating, with a 53% reduction in the risk of dementia for seniors who rigorously followed the diet, and somewhat surprisingly, a 35% risk reduction even for those who followed it only moderately well.
“This is my favorite feature,” says Jennifer Ventrelle, MS, RD, lead dietitian for the MIND Diet Intervention to Prevent Alzheimer’s Disease at Rush, “you don’t have to be perfect! It’s not necessary to eat from every preferred category to achieve your goals.”
Although it’s not intended as a reducing diet, Ventrelle says people who follow it naturally lose weight by focusing on the preferred categories of foods. “It’s too difficult for many people to consider banishing all sweets or giving up red meat forever, so we haven’t eliminated these foods but allow them with limited frequency and close attention to portion sizes,” she explains.
Additional research pointed to a host of other benefits associated with eating MINDfully for older adults: slower cognitive decline and progression of Parkinsonian signs in aging, and reduced risk of functional disability, depressive symptoms, metabolic syndrome, cardiovascular disease and all-cause mortality. “The literature continues to grow, with new studies that point to the key role diet plays in preventing cognitive decline,” says Puja Agarwal, PhD, nutritional epidemiologist and assistant professor of internal medicine at Rush.
But it is the gold-standard randomized controlled trial begun several years ago by Rush and Harvard School of Public Health that may ultimately establish a causal relationship between diet and dementia. More than 600 participants at higher risk for Alzheimer’s disease – overweight, suboptimal diets and a history of dementia in the family – were enrolled in the study designed to directly measure whether following the MIND diet versus a low-fat diet can prevent neurodegenerative ills – results are expected by the end of 2022. According to Agarwal, who is fully aware of its significance at a time when more than 6 million people in the U.S. are living with Alzheimer’s disease, a number expected to double in the coming decades. “We don’t have a cure for these diseases, so prevention strategies are essential. We’re hoping for intervention trial results for the effect of MIND diet in protecting the brain to further establish the role of diet in healthy aging.”
What a day of meals on the MIND diet might include*:
BREAKFAST Greek Yogurt Parfait: ½ cup whole grain, high fiber cereal, ½ cup berries, ½ cup low-fat Greek yogurt, 2 tbsps (raw, unsalted) walnuts, almonds or pecans.
LUNCH Whole Wheat Turkey Wrap: 1 tortilla wrap + 3-5 oz turkey breast lunchmeat or carved white meat + 1 slice reduced fat cheese + lettuce, tomato and veggies of choice.
3-Bean Salad: Mixture of kidney beans, black beans, chickpeas, red onions + 1 tbsp extra-virgin olive oil + 1 tsp balsamic vinegar + Italian seasoning mix such as oregano, parsley, basil, etc.
A seasonal bounty of fruits and vegetables is in bloom everywhere from your grocery’s fresh foods section to local farmers’ markets, and in your own backyard garden. The following is advice from experts on how to purchase summer fruits and veggies at its peak, and store them safely, until ready to enjoy.
Berries and Cherries. Look for plump, unblemished fruits with no dark spots or fuzzy white mold; raspberries, blackberries and strawberries should be fragrant. All are shiny when ripe – except for blueberries, which will have a dull matte finish. While most berries can be refrigerated for up to a week, raspberries can start fading more quickly; when that occurs, The Spruce Eats recommends freezing them for use in smoothies and other recipes. To extend their life, do not wash fruit when you unpack your groceries; wait until right before you eat them.
Corn. Choose uncut silks coming out of tightly closed, bright green husks that smell slightly grassy, advises Martha Stewart; and peel back a tad to make sure the kernels look plump and healthy. Refrigerate corn with husks on and use as soon as possible.
Cucumbers and Peppers. Look for firm, shiny vegetables without blemishes, wrinkles or soft spots. According to Have a Plant, cucumbers and peppers can be refrigerated in a plastic bag for up to one week.
Grapes. Choose firm, plump grapes with green healthy stems. They can last up to two weeks when refrigerated. Or try an easy frozen treat: Place on a baking sheet; freeze until firm, and enjoy. Store leftovers in a freezer-safe bag for up to 12 months.
Lettuces. Eliminate those with wilted or broken leaves. Lettuce can be stored for up to four days when refrigerated; darker lettuces tend to last longer than pale, tender varieties. Wash all lettuces just before using.
Melons. Select watermelons without flat sides or dents, and choose ones with a heavy weight for optimal juiciness. Cantaloupe and honeydew melons are best when they have a pale yellow rind and flowery smell at the stem. Harvest to Table recommends storing whole ripe melons in the refrigerator for up to a week to avoid spoiling; cut melons will keep for up to three days.
Plums, Nectarines, Peaches. Opt for vibrant colors, a firm feel, and beautifully fragrant aroma for nectarines and peaches. Store unripe plums, nectarines and peaches in a paper bag until ripe. When ripe, peaches and nectarines can be stored at room temperature for use within a few days; plums can be kept fresh for up to five days in the refrigerator.
Tomatoes. Pick vividly colored, medium-firm tomatoes with smooth, shiny skin. To preserve the freshness and natural flavor of unripe tomatoes, Master Class recommends storing them on a countertop away from direct sunlight. They will last a week on countertops and up to two weeks if stored in the refrigerator.
Zucchini and Summer Squash. Look for smooth-skinned, small to medium size vegetables. Eating Well advises storing zucchini in the crisper drawer of your refrigerator, in either a plastic or paper bag with one end open to ensure good ventilation.
Eating Your Fruits and Veggies May Help Reduce the Risk of Chronic Disease
Fill your plate with a vibrant, colorful array of fruits and vegetables for a naturally delicious way to meet your daily requirement of vitamins, minerals and nutrients. Plant foods contain thousands of natural compounds called phytonutrients, which may have anti-inflammatory benefits that can help reduce the risk of chronic diseases. Every color has a contribution to make – aim for a few different ones each day, and enjoy the entire spectrum.
Red and pink:
These fruits and vegetables are an abundant source of the carotenoid lycopene, which may help balance free radical activity in the body, offering protection against prostate cancer and heart and lung disease. Additional picks: red onions, persimmons and raspberries.
beets
cherries
cranberries
pink grapefruit
pomegranates
radicchio
red radishes
red apples
red grapes
red peppers
red potatoes
rhubarbs
strawberries
tomatoes
watermelons
Orange and yellow:
Enjoy an extra boost of beta cryptoxanthin, which supports intracellular communication and may help prevent heart disease. Orange and yellow fruits and vegetables also contain vitamin C and carotenoids, including beta-carotene, which is associated with promoting healthy vision and cell growth. Additional picks: pomelos, turmeric root and star fruit.
acorn squash
butternut squash
apricots
cantaloupes
carrots
corn
grapefruit
lemons
mangoes
nectarines
oranges
orange peppers
papayas
peaches
pineapples
pumpkins
summer squash
sweet potatoes
tangerines
yams
yellow apples
yellow peppers
yellow squash
Green:
These are some of the healthiest fruits and vegetables, rich in chemicals like sulforaphane, isothiocyanates and indoles, which may inhibit the action of carcinogens. Dark green and leafy vegetables have the highest concentration of both antioxidants and fiber. They’re also packed with potassium, lutein, isothiocyanates, isoflavones and vitamin K, which can be important for vision, bone and blood health. Greens like kale have as much calcium as milk. Additional picks: Swiss chard, arugula, zucchini, edamame, alfalfa sprouts and green herbs (mint, rosemary, sage, thyme and basil).
artichokes
asparagus
avocados
bok choy
broccoli
Brussels sprouts
celery
collard greens
cucumbers
green beans
green cabbage
green grapes
green onions
green peppers
kale
kiwis
leeks
limes
mustard greens
okra
pears
peas
romaine lettuce
snow peas
spinach
sugar snap peas
watercress
zucchini
Blue and purple:
Anthocyanins – powerful antioxidants that may help delay cellular aging, block the formation of blood clots and boost urinary tract health – abound in these fruits and veggies. Additional picks: beetroot, radishes and purple cabbage.
blackberries
blueberries
black currants
dates
eggplants
grapes
plums
prunes
purple figs
raisins
White:
These foods may not be as brightly hued as the others, but they shine with valuable phytonutrients. These include the potentially anti-tumor properties of allicin and quercetin, found in garlic and onions; the healthy compound sulforaphane in the cruciferous cauliflower; and immune-supporting selenium in mushrooms. Additional picks: leeks, white beans (cannellini, navy beans, lima beans, soybeans), lychees, white peaches and daikon radish.
Inspired by a belief that our diets can be redefined to integrate both healthier eating and environmental responsibility, Menus of Change encourages a meaningful “flip” in the emphasis on animal proteins and highly processed carbohydrates to an emphasis on highly appealing alternatives.
The Protein Flip, introduced in 2016, laid the groundwork for the Menus of Change health- oriented methodology, stating, “Higher intake of red meat, irrespective of its total fat content, increases risk of heart disease, stroke and diabetes when compared to poultry, fish, eggs, nuts, or legumes.”
The Menus of Change solution was to challenge chefs in every setting to place meat, poultry and seafood in a supporting role or as a side and make vegetables and plant proteins the stars – for example, burger blends composed of primarily mushrooms, other vegetables, grains or legumes; surf and turf reimagined as seafood with bountiful vegetables and only a bite or two of meat; use of tapas, mezze and other plant-forward small plate replacements for entrees. The public response was immensely gratifying, spurring further innovation and the mainstreaming of vegan options, such as lentil, barley and black bean burgers or wild rice polenta burgers made with mushrooms, carrots and leeks.
Building on their successful work with proteins, the collaborative is now developing a complementary program centered on advancing carbohydrate quality on the American plate. “From fluffy pancakes to soft hamburger buns, refined, fast-metabolizing carbohydrates are still found in many a diet and are contributing to the rise in diet-linked chronic conditions such as
diabetes and heart disease,” according to a recent Menus of Change summit panel discussion headed by Sarah Schutzberger, RD, CSO (certified in oncology nutrition). “In large part because of our food choices, scientists project that 75 percent of chronic diseases are attributable to diet and lifestyle.”
A substantial emphasis on whole, minimally processed carbohydrates can help change the trajectory, beginning with these flips described by the panel:
Take on the Three Pleasures challenge: Create a delicious dessert using dark chocolate, nuts, and fresh-cut or dried fruit. “Instead of forcing a choice between a whole slice of cheesecake with a single strawberry as garnish or a plain bowl of berries, enjoy a dessert made from a healthy market basket that includes dark chocolate, fruit, whole grains, nuts and yogurt,” advised Greg Drescher, Culinary Institute of America.
Look to world food cultures for inspiration:
Mediterranean region: “This type of cooking features a healthy fat versus a low fat approach to diet, with olive oil as the foundation of flavor,” said Drescher. Try tabouli, made of cracked bulgur wheat, chopped parsley and olive oil, or a salad made with hydrated, whole-grain barley rusks, topped with chopped tomatoes and fresh feta cheese and tossed with olive oil. Also important: improve the health profile of pasta by using a whole-grain type and cooking al dente to make it a source of slower-releasing carbohydrates.
France: The niçoise salad suggests ways to include potatoes in limited amounts by pairing with green beans and other vegetables, hard-boiled egg, and a light vinaigrette for a slow-metabolizing lunch.
Asia and India: Try a salad featuring soba noodles made from buckwheat flour; a Buddha bowl with foundational ingredients that include legumes, fresh vegetables and plant proteins, paired with small amounts of salmon or roasted tofu; and whole-grain flatbreads.
It’s long been the case that provocative headlines, unexpected findings and misinformation travel far faster than conventional wisdom, especially in the internet age. Even respected medical journals like the Annals of Internal Medicinecan become caught in a crossfire of disagreement, as occurred last year when a controversial nutritional study by the NutriRECSConsortium concluded that three servings of red and/or processed meat weekly resulted in a very small increased risk of cancer or heart disease.
NutriRECS further suggested that the evidence surrounding potential harm from regular consumption of red meat was weak, and therefore people needn’t abstain from eating it for health reasons.
So misleading was the journal’s press release headline, “New guidelines: No need to reduce red or processed meat consumption for good health”, that the entire study was offered as a cautionary tale at the most recent Menus of Change conference, an influential initiative on plant-forward eating from the Harvard T.H. Chan School of Public Health and the CulinaryInstitute of America.
A panel headed by Walter Willett, MD, professor and past chairman of the department of nutrition at the Harvard School of Public Health, dissected why a message that flew in the face of decades of research and established guidelines from the American Heart Association and the World Cancer Research Fund, made its way into the mainstream.
According to Dr. Willett, the major flaw was the authors’ decision to disregard numerous studies done over the years regarding red meat and health as “weak evidence” because they weren’t based solely on randomized clinical trials. While these are the gold standard of scientific research, the reality for nutrition studies can be different.
“There are no double-blinded, placebo-controlled trials of red meat and its links to cardiovascular disease or cancer,” explained Dr. Willett. “It’s not really possible to get this kind of study because people won’t stay on specific diets for years to track and compare.”
The result was elimination of influential studies and meta-analyses clearly pointing to increased risk of disease for meat eaters. This included a pivotal 2015 Harvard School of Public Health study of more than 121,000 individuals followed for an average of 26 years that showed every daily serving of processed meat was associated with a 13% higher risk of death from all causes; processed red meat increased the risk to 20%. A 2019 meta-analysis in the Annals itself showed that reducing processed red meat by three servings per week decreased the incidence of diabetes by 22%; lowered mortality from cardiovascular disease by 10% and from cancer by 7%; and decreased overall mortality by 7%.
“These statistics alone could have been the basis for a blockbuster drug,” asserted Dr. Willett.
Additionally, as came to light after the study was published, the authors’ ties to food industry groups were not accurately disclosed. In January, the journal issued a correction detailing those connections, but the panel’s experts were concerned that the damage had been done, and the study’s misleading headlines had negatively affected public acceptance of traditional nutritional guidance.
“The global consensus remains unchanged: largely replacing red meat with plant protein sources and (optionally) modest amounts of fish, poultry and dairy foods will reduce the risk of coronary heart disease, diabetes and premature death,” said Dr. Willett.
Beyond the Burger: What’s Next in Plant-Based Alternatives
Also featured at Menus of Change was a look at the growing American appetite for alternative proteins. The trend, kick-started by the popularity of plant-based burgers, intensified during the pandemic as consumers sought what they perceived as healthier foods produced in safer, sterile environments. Note: plant-based items are not always nutritionally sound, so please check the labels carefully when these products become available.
Coming soon:
Plant-based ground meat, sausages, deli slices, chicken tenders, even cookie dough
Plant based seafood, including tuna, crab cakes, fish burgers, eel and shrimp
Egg substitutes and oat-based dairy products
Lamb substitutes using organic compounds to replicate the earthy taste
Cell-based seafood and cultured meats grown from the cells of fish and animals
“Plant proteins are becoming the growth story of the decade, on the cusp of replacing fish and seafood as the fourth-most-popular protein in America.”
As football coaches and nutritionists know, the best offense is a good defense. In the fight against COVID-19, the promise of boosting the immune system with specific ‘superfoods’ is an enticing one. However, registered dietitian Linda Gigliotti, who is a fellow of the Academy of Nutrition and Dietetics and has been in practice for more than three decades, cautions that the concept is somewhat misleading. Here is what you should consider regarding superfoods and your immune system.
Balance Leads to Immune System Harmony
She explains, “We may wish there were specific foods that could make us less susceptible to illness by building up our immune system, but it doesn’t work that way. The immune system is not a single entity, and requires harmony and balance between its different components to function well.”
According to experts, although the body continually generates immune cells, with extra ones dying off in a process called apoptosis, scientists don’t yet know how many cells are needed for optimal functioning of the immune system or what the best mix of cells may be. A better approach, according to Gigliotti, is using a mix of foods that are the building blocks of a nutritionally balanced diet (e.g., the Mediterranean diet) to support or protect the immune system, not boost it.
Foods to Support & Protect the Immune System
“There’s no one ‘superfood’ or category that should be singled out to the exclusion of others,” says Gigliotti. “The typical American diet can certainly benefit from more of an emphasis on fruits and vegetables, but eat the whole rainbow of colors – red peppers, yellow corn, orange carrots, green broccoli, brown mushrooms. Chickpeas, often touted as a superfood, are excellent, but so are other legumes, such as kidney and pinto beans. Be sure to include a variety of probiotic-rich and fiber-packed foods to promote healthy gut bacteria, which also enhances your ability to maintain health and resist disease.”
Immune System of Older Adults
For older adults the picture may be a little hazier, due to “micronutrient malnutrition,” a deficiency in essential vitamins and trace minerals obtained from the diet, which is frequently seen in seniors even in affluent countries. According to Harvard Health, some lab studies have linked deficiencies in zinc; selenium; iron; folic acid; and vitamins A, B, C and D to an altered immune response in animals.
Can Vitamin Megadoses boost your Immune System?
However, it’s important to know that megadoses of vitamins and minerals are not recommended as a preventive measure for anyone. For example, studies over the years show that vitamin C supplements do not appear to lessen the possibility of getting a cold, although they may help recover from one faster and lessen the symptoms. Taking extra-large doses is not advised, because vitamin C is water soluble and excess amounts aren’t stored in the body, but excreted. The optimal way to naturally absorb vitamin C and other vitamins is by eating a variety of fruits and vegetables. If you are concerned that you may not be getting sufficient micronutrients in your diet, you may want to consider a multi-vitamin.
Flu Season and your Immune System
How can you best support your immune system as the new flu season waits in the wings? Focus on healthy lifestyle habits, advises Gigliotti, including a balanced diet rich in fruits, vegetables, high-protein foods and whole grains; adequate sleep; regular exercise; no smoking or vaping; and managing anxiety.
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