Diet & Nutrition

An Ounce Of Prevention Really Is Worth A Pound Of Cure

The Impact Of Diet On Disease

The relationship between diet and disease has long been of interest to epidemiologists but only in relatively recent times to other health care professionals and members of the public. One of the first and most significant findings was the protective effect against cancer afforded by a diet rich in fruits and vegetables. Interestingly, this has now been expanded to include heart disease, stroke, cataract, age-related macular degeneration, Alzheimer disease and other chronic degenerative diseases. Research into the molecular basis of chronic degenerative diseases suggests a common mechanism we term free radical damage. Oxygen free radicals produced during normal metabolism attack cellular components such as proteins, lipids and DNA.

Damage to different tissues at different sites results in different chronic degenerative diseases. Fortunately, Nature has provided us with the perfect antidote to free radicals – the anti-oxidants. These can be divided into the antioxidant enzymes, “those we make”, and the antioxidant nutrients, “those we take”. Fruits and vegetables are our principle dietary source of antioxidants. The protective benefits they provide may simply derive from the numerous antioxidants (and minerals and other phytochemicals) they contain. According to Dr Bruce Ames, “Not getting enough fruits and vegetables every day is like standing next to an unguarded X-ray machine.”

There is accumulating evidence that isolated vitamin supplements are ineffective in preventing chronic degenerative diseases. The reason for this is not fully understood. However, it is likely that complex interactions between large numbers of the thousands of micronutrients present in fruits and vegetables are necessary to neutralize free radicals in different cellular systems. Some systems seem to favour specific antioxidants such as lutein, an important antioxidant in the retina, and lycopene, an equally important antioxidant in the prostate.

The red pigment in tomatoes, lycopene, also appears to reduce the risk of other cancers including those of breast, ovary, lung, stomach, colon, mouth, esophagus and cervix as well as lowering the risk of heart attack (Heart & Stroke Foundation, 2002). Additional benefits of lycopene may include an improvement in the symptoms of asthma among adults and children and cognitive function in elderly nuns. Perhaps we should all be taking lycopene supplements& or perhaps not. Using a rat model for prostate cancer, researchers found significantly fewer deaths among rats fed tomato powder than those fed lycopene beadlets. It would seem that consumption of tomato, but not lycopene in isolation, inhibited prostate carcinogenesis suggesting that tomato products contain compounds in addition to lycopene that modify carcinogenesis.

Understanding Disease At The Molecular Level

Over the past 25 years, we have seen enormous advances in our understanding of the causes of chronic degenerative diseases such as cancer, heart disease, stroke, diabetes, Alzheimer Disease, arthritis and macular degeneration (to name but a few). This wealth of recent knowledge has opened up many new treatment possibilities but has also allowed each and every one of us to make informed decisions as to how lifestyle and dietary changes can significantly reduce our risk of chronic degenerative disease.

We have learned that the nutrition from fruits and vegetables, just as our parents and grandparents told us, is a key factor in living a long and healthy life. In fact, Health Authorities in most developed countries strongly recommend that we all eat 7-10 servings of fresh, preferably raw, fruits and vegetables every day. Sadly, most people are not listening. In practice, the vast majority of us do not even come close to this nutritional requirement.

Over the past 50 years, our diets, and particularly those of our children, have deteriorated drastically. Our increased consumption of ‘convenient’, ‘low-cost’, processed foods, fast foods and soft drinks (at the expense of natural whole foods) is largely to blame. Even with ‘rationing’ and the deprivations of war, Europeans were more healthy in the 1940s than they are today.

In an attempt to compensate for the lack of fresh fruits and vegetables in our diet, many of us have turned to daily multi-vitamin, mineral and even herbal supplements. Unfortunately, results that appeared so promising in the early days, have largely been discredited by larger, more recent studies. At present, there is very little good evidence that isolated or fragmented vitamin, mineral or antioxidant supplements can significantly reduce our risk of developing chronic degenerative disease.

This is not because the vitamin C, for example, in an orange is “superior” to or of any “better quality” than the vitamin C in a multi-vitamin tablet. But rather because the vitamin C in an orange is accompanied by literally thousands of additional vitamins, minerals, antioxidants and phytonutrients which are essential for vitamin C to act effectively. What we are talking about here is a balanced diet at the molecular level.

Over 15,000 Studies Published On Oxidative Stress

Imagine yourself as a battlefield. There’s a war going on every second of every day between the forces of good ” the antioxidants ” and the forces of evil – the free radicals. Sadly, for most of us for most of the time, the free radicals are winning. Researchers have a name for this sorry state of affairs: they call it OXIDATIVE STRESS. They have even devised a whole battery of laboratory tests to measure it. Oxidative stress has been found at increased levels in virtually every chronic degenerative disease we have looked for it. We have found it in tumors, in the blood streams of heart and stroke patients, in the brains of victims of Alzheimer and Parkinson disease, in the lungs of asthmatics and in the joints of those crippled by arthritis and rheumatism.

Chronic Fatigue Syndrome And Fibromyalgia

Let me give you an example of how our understanding of the role oxidative stress plays has influenced our approach to the management of chronic fatigue syndrome (CFS) and fibromyalgia (FM). CFS describes a group of symptoms that includes, among others, extreme and persistent weakness and exhaustion. Both mental and/or physical fatigue may be present often accompanied by numerous non-specific symptoms involving various body systems. Young, white females are most commonly affected. The cause of CFS remains unknown and early beliefs that a virus is involved have largely been discredited. There is no evidence that the condition is in any way contagious.

FM, previously called fibromyositis, is a poorly understood disorder characterized by generalized fatigue and pain in various muscles, tendons and ligaments. Symptoms may be persistent or recur in episodes lasting a few days at a time. Women age 20-50 are most commonly affected. FM is most likely present when the patient reports tenderness in at least 11 out of 18 characteristically painful sites. Like CFS, a diagnosis of FM is often made by the exclusion of other conditions since no specific clinical or laboratory tests are yet available.

Over the past few years several researchers have demonstrated an association between oxidative stress and both of these conditions. Compared with normal subjects, patients with CFS and FM had higher blood levels of well-established indicators of oxidative stress such as malondialdehyde and pentosidine whose formation is closely associated with oxidative stress. There was also more oxidative damage to DNA and lipids in their muscles. It follows that increasing antioxidant intake may have a role in the management of CFS and help to reduce muscle symptoms.

Scandinavian researchers have recently described patients with FM who switched to a strict uncooked vegan diet (fruits, vegetables, berries, nuts, germinated seeds and sprouts) rich in naturally-occurring antioxidants and other phytochemicals. Compared with a control group of FM patients who continued with their usual (omnivorous) diet, those consuming the vegan diet showed significant improvements in joint pain and stiffness as well as in their quality of sleep and perception of general health. In an earlier study, whole food nutritional supplements resulted in a “remarkable” reduction in initial symptom severity with continued improvement in patients with FM and CFS.

Green Leafy Vegetables And Eye Disease

Several studies have suggested that a diet rich in green leafy vegetables (preferably not boiled to extinction) may significantly reduce our risk of macular degeneration and cataract. Isolated and fragmented vitamin supplements have been less successful in this regard. Stuart Richer, Chief of Optometry, DVA Medical Center in Chicago has reported that dietary modification with a lutein-rich food can even reverse some of the damaging effects of Age-Related Macular Degeneration.

Alzheimer Disease: Food For Thought

Alzheimer Disease is a cruel fate robbing those affected of both physical and mental faculties often at the end of a long and fruitful life. Sadly, for some, much earlier. In the United States, 40 new cases are diagnosed every hour In Canada, 1 in 50 (age 65-74), 1 in 9 (age 75-84) and 1 in 3 (age 85+) people are affected. The precise cause is largely unknown although recent studies strongly suggest a link to lipid peroxidation, the result of free radical damage to fats. Several hundred studies have already been published on the role of oxidative stress and Alzheimer Disease.

Researchers from Rotterdam and Chicago recently reported that fruits and vegetables rich in vitamins C and E, carotenes and bioflavonoids reduced the risk of Alzheimer Disease by between 40% and 70%. Predictably, isolated vitamin C and E supplements had no apparent effect on the risk of developing Alzheimer Disease.

Homocysteine: The Black Sheep Of The Amino Acid Family

Most of the 20 or so amino acids circulating in your blood stream are healthy building blocks for new proteins. Homocysteine is a notable exception. It is a toxic amino acid generally considered to be a clear indicator of our old enemy oxidative stress. A high level of homocysteine in the blood is an independent risk factor for arterial disease and heart attack and may also elevate the risk of cancer and other chronic degenerative diseases including the aforementioned Alzheimer Disease.

Lowering your homocysteine level may be the single most effective step that you can take in reducing your risk of developing a degenerative disease or dying prematurely from any cause. At the risk of repeating myself, the best way to lower your homocysteine levels is to reduce oxidative stress. And the best way to reduce oxidative stress is to increase your consumption of fruits and vegetables& fresh, ripe and, for the most part, raw.

Fruits And Vegetables: Nature’s Synergy

In nature, vitamins and minerals are never isolated. They are always provided in whole foods in combination with all of the other nutrients found there, working together in ways science is only beginning to understand. In her book, Biochemistry of Foods and Supplements, Judith DeCava expresses this perfectly: “To isolate or separate a vitamin, mineral, amino acid or other component and call it a nutrient is just as impractical as isolating a steering wheel, battery or carburettor and calling it an automobile. It won’t work without the other parts.”

There are thousands of phytonutrients in every food we eat. Each one we study is proving to play an important role in human health and vitality. Without them, we lay the foundation for a weak immune system and chronic degenerative disease. A traditional vitamin and mineral supplement cannot begin to scratch the surface of this vast array of nutrition.

According to Dr Andrew Weil in his book, Eating Well For Optimum Health, “You will find little or nothing about these phytochemicals in conventional nutrition textbooks and courses, but scientific papers about them are proliferating so rapidly that nutritionists will have to take note.”

Moreover, taking large quantities of specific vitamins and minerals is of questionable benefit to begin with. Supplements should be judged not by how much of a given nutrient they contain, but by how much is actually absorbed by the body. Our bodies only absorb small amounts of nutrients at any single moment, not the huge amounts contained in most synthetic supplements.

Ambulances And Fences

Over the past hundred years, which actually covers most of the history of modern medicine, we have largely focused our attention on the treatment of disease rather than on its prevention. This is understandable in that the care of the sick has always been and always will be the central medical task. Dennis Burkitt, an Irish Surgeon, with a wonderful sense of humor, put it perfectly. If people are falling over the edge of a dangerous cliff, we can do one of two things& erect a fence at the top or put ambulances at the bottom. Unfortunately, we seem to spend most of our time positioning the ambulances and very little erecting fences.

Had he been alive today, Dennis would probably have been horrified at the increase in chronic degenerative diseases over the past 50 years. He would have been surprised at our singular failure to treat most of these conditions any more successfully than he was able to half a century ago. But above all, he would have been grievously disappointed at the appearance of diseases of the elderly and middle-aged, including Type 2 Diabetes, arthritis and cardiovascular disease, in younger and younger adults and even in children.

Dr. Michael J. Hardy

Dr Hardy has served as Associate Professor in a Medical School and as Chief of Chemical Pathology and Acting Head of The Department of Laboratory Medicine in a Teaching Hospital. He has contributed over 30 original publications to the medical literature including such presitigious international publications as The British Medical Journal, The Journal of Obstetrics and Gynaecology, The British Journal of Obstetrics and Gynaecology, The Scandinavian Journal of Clinical and Laboratory Investigation, Hemoglobin, Annals of Clinical Biochemistry, The Journal of Pediatrics and The Journal of Clinical Endocrinology and Metabolism.

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