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 MATTERS
OF THE HEART
Dozens of Ways to Improve Cardiac Health
February is aptly called American Heart Month, and with Valentine's Day fast
approaching, we wanted to devote this issue of the Dole Nutrition News to
helping you protect your heart -- not from Cupid's arrows, but from
cardiovascular disease. We will cover dietary, exercise and lifestyle factors
that will help keep your heart in the pink.
Superfoods for Heart Health: Best bets include berries, fish, soy, bananas and
oatmeal.
Heart Healthy Guide: As part of our Health and Wellness brochure series, we're
featuring a Healthy Heart pamphlet that can be downloaded that will tell you which
fruits and vegetables provide the key nutrients you need to maintain
healthy blood pressure, reduce "bad" cholesterol (and prevent its oxidation)
and lower levels of homocysteine (an amino acid, which at high levels can lead
to artery blockage).
Women and Heart Disease: More women die of heart disease every year than of
Alzheimer's, breast cancer and diabetes combined -- but only 13% of women
consider heart disease their most serious health risk.
Brewing Threat: You may remember that excessive coffee consumption can raise
your risk of bladder cancer. But Dutch researchers have also found that four or
more cups of joe a day could elevate blood levels of homocysteine, thus
increasing your risk of heart disease. Switching to tea will not only improve
your breath, it may lower blood pressure, boost immune function, fight
cancer-causing free radicals and reduce inflammation, which is being
increasingly recognized as a unique cardiac risk marker (to learn more, read
on).
DON'T
BE SO INFLAMMATORY
Elevated C-Reactive Protein Best Predictor of Heart Disease
Inflamed passion might be a good thing on Valentine's Day -- but chronic
inflammation could put your heart out of commission for good. Inflammation is
measured by blood levels of C-reactive protein (CRP) -- a risk marker that's
gaining recognition as one of the most accurate predictors of future
cardiovascular disease, as accurate (if not more) a diagnostic as your
cholesterol count.
What is inflammation?
Inflammation is an immune response to infection or injury. Externally we
recognize inflammation as redness, increased temperature and swelling -- and in
proper proportion it serves as part of the cycle of healing. The symptoms are
evidence of immune cell activity working to break down injured and dying
tissues so that new, healthy ones can replace them.
But certain factors can force this delicate balance out of whack, leading --
literally -- to inflammatory overkill that over time can come to damage
otherwise healthy tissues. Well-established cardiac risk factors such as
obesity, smoking, hypertension and chronic periodontal disease all increase
inflammation and CRP protein levels in the body. As we've explained in past
issues, adipose tissue functions as a virtual organ, spewing out hormones and
compounds (including CRP) that raise disease risk, which is one reason why
weight takes such a toll on the heart.
But my cholesterol is fine?
Nearly 27% of Americans are thought to have elevated (greater than 2.2 mg/L)
levels of CRP, while nearly 7% may have levels higher than 10 mg/L. What's
more, research indicates that up to 35 million Americans have a total
cholesterol score within normal range but above-average levels of
inflammation.
What does elevated CRP mean?
Normal CRP levels range from less than 1.0 mg up to 3.0 mg per liter of blood.
According to the American Heart Association (AHA) and the Centers for Disease
Control and Prevention (CDC), those with CRP levels greater than 3.0 mg/L have
two times the relative risk for cardiovascular diseases.
The Women's Health Study, which involved 39,876 healthy, post-menopausal women,
found that those with the highest levels of CRP had five times the risk of
developing cardiovascular disease and seven times the risk of having a heart
attack compared with subjects with the lowest levels. This is key: CRP
levels predicted risk even in women who appeared to have no other pertinent
risk factors.
A Henry Ford Heart and Vascular Institute study published in the July 2003
issue of Circulation: Journal of the American Heart Association,
analyzed data for the 5,417 men and women ages 65 or older who participated in
the Cardiovascular Health Study and found that those subjects in the highest
quartile of CRP levels were 60% more likely to have a stroke, compared to those
with the lowest CRP levels.
Elevated CRP levels may even affect your eye health. Harvard Medical School
researchers found that C-reactive protein levels were significantly higher
among people with advanced age-related macular degeneration (AMD) than those
with no AMD. Whether or not the inflammation is a co-factor of AMD -- or its
result -- needs to be further investigated.
Lowering CRP levels
What to do if your CRP levels are high? The first place to turn may be the
produce aisle of your local grocery store. A study published by St. Michael's
Hospital in Canada in the July 2003 issue of the Journal of the American Medical
Association, found those who ate a diet high in vegetables, fruits, soy
foods and nuts for one month lowered their CRP levels by an average of 28.2%.
Which nutrients might be effective in keeping CRP in check? Initial evidence
from USDA researchers at the Nutrition and Neurocognition Laboratory found an
inverse relationship between blood levels of vitamin C and CRP. Researchers
from the CDC replicated that result and found other nutrients which function
like kryptonite to CRP, including alpha-carotene, beta-carotene,
beta-cryptoxanthin, lutein/zeaxanthin, lycopene and selenium.
But whoa -- don't go reaching for a remedy by raiding the supplement shelf. As
we've reviewed before, antioxidant supplements will not reduce your risk of
cardiovascular disease, while consumption of certain vitamin pills -- A and E
in particular -- might raise your mortality risk. Here's what to eat to get the
anti-CRP antioxidants you need:
Vitamin C: red bell peppers, papaya, citrus, kiwis and broccoli.
Alpha carotene: carrots, butternut squash, pumpkin and persimmons.
Beta carotene: butternut squash, cantaloupe, carrots and apricots.
Beta cryptoxanthin: butternut squash, pumpkin, red pepper and tangerines.
Lycopene: watermelon, tomatoes, pink grapefruit and pink-fleshed guava.
Selenium: brazil nuts, rye, salmon and brown rice.
What else can you do? Get active. Research presented at the 52nd annual meeting
of the American College of Cardiology in 2003 found that people who exercised
four or more times a week had CRP levels that were 34.6% lower than people who
exercised less than once per week.
Also, try chilling out. Duke University researchers found that people who are
physically healthy but prone to anger, hostility and mild depression have
levels of CRP as much as two or three times higher than their calmer
counterparts. The study, published in the September 2004 Journal of
Psychosomatic Medicine, observed that "fifty percent of all heart
attacks occur among people without any traditional risk factors (obesity,
smoking, diabetes, hypertension, high cholesterol and sedentary lifestyle), so
it is critical to identify other factors" -- like stress. To learn how
listening can help lower stress, read on.
ENOUGH
ABOUT YOU ...
How Listening Can Lower Cardiovascular Risk
Next time someone interrupts you before you've finished your sentence you may
take a morbid degree of satisfaction that they have a higher risk of being
interrupted before they finish their life.
In a 22-year study of 750 white, middle class males, researchers at the
University of Kansas and University of California at Berkeley and San Francisco
found that those identified as socially dominant (as measured by several
markers, including the tendency to interrupt) were 60% more likely to die of
any cause during the study period. Study co-author Michael Babyak said, "We
don't know why this effect exists, but we theorize that socially dominant men
are more chronically ... stressed so they release more of the damaging stress
hormones."
Another study of 200 men and women by the University of Baltimore found that
those rated as having a dominant personality had a 47% higher risk of heart
disease, while those with highest scores of irritability had a 27% higher risk
as compared to their more patient, passive and unperturbed peers.
Among women, the increased risk was associated with more restrained displays of
anger, such as sarcasm and making faces, whereas men's risk rose relative to
more full-blown expressions of ire. Irritability was a cardiac risk factor for
both sexes.
The good news is that these behavioral risk factors can be modified through
recognition, intent and practice. Learn to be a better listener, and above all,
let it ride.
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 MEATY
MENACE
Study Bolsters Cancer-Beef Link
A new study published in the January 2005 issue of the Journal of the American
Medical Association presents perhaps the most compelling evidence yet
of the link between meat consumption and colorectal cancer. Nearly 150,000 men
and women participated in the American Cancer Society survey, which recorded
subjects' meat intake in 1982 and again in 1992 and 1993.
The upshot: Those with a high meat intake were 30% to 40% more likely to develop
colorectal cancer than their less carnivorous peers. High meat intake
was considered 3 ounces/day for men and 2 ounces/day for women (about the size
of a fast-food hamburger). Low intake was less than 4 ounces a week for men and
2 ounces a week for women. An even higher risk was associated with the
consumption of processed meat like bacon and bologna.
Researchers speculate that a few factors may be in play. Animal fat and
processed meat may harbor more toxins than other protein sources, while it's
also possible that high-meat diets might be lower in the fruit-and-vegetable
fiber that keeps digestion moving more quickly through the colon. Moreover, the
form of iron found in red meat may be hard on colon tissue, increasing its
vulnerability to cancer-causing free radical damage.
More bad news for burgers and baby backs was borne by a University of
Manchester study published in the December 2004 journal Arthritis and Rheumatism
linking meat consumption with increased risk of developing inflammatory
arthritis. After adjusting for smoking and other risk factors, the analysis of
data on nearly 26,000 men and women ages 45 to 75 over the course of nine years
found a twofold risk among the biggest beef-eaters.
"It may be that the high collagen content of meat leads to collagen
sensitization and consequent production of anti-collagen anti-bodies," said
study authors Professors Alan Silman and Deborah Symmons, though they caution
that more research is necessary to confirm a causal relationship. This latest
finding fleshed out an earlier study that found a higher risk of rheumatoid
arthritis among those who ate fruits and vegetables.
As we've discussed in previous newsletters, excessive meat consumption also
raises your risk of developing non-Hodgkin's lymphoma and a woman's risk of
developing endometriosis.
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 YOUR
GUIDE TO THE NEW GUIDELINES
More Fruit, Vegetables, Grain, Fish & Fitness
Last month, government officials unveiled the sixth iteration of the Dietary
Guidelines for Americans. Every five years, a panel of nutrition
experts revises these guidelines to reflect the latest research on nutrition
and health, which helps provide dietary information to individuals as well as
policy makers, nutrition educators and health professionals.
As predicted, fresh produce, fish, whole grains and lentils took center stage,
while Americans were urged to increase exercise and decrease consumption of
saturated and trans fats, sugar and salt.
We sat down with the DNI's Director of Nutrition Marketing and Research, Amy
Myrdal, MS, RD, to get her read on the changes and what the new guidelines mean
for the average consumer.
DNN: How would you sum up the overall message of the new Dietary Guidelines for
Americans 2005? Was there any kind of theme or big news?
AM: The overriding theme of this year's guidelines release was nutrient-density
-- with a goal of steering consumers toward more nutrient-dense and
lower-calorie foods.
DNN: Is that because of the heightened concern about America's obesity
epidemic?
AM: Obesity was a huge concern for the advisory panel from the beginning. These
are the first guidelines to include the term "discretionary calories," which is
kind of a wake-up call to consumers that the majority of your calories should
come from nutrient-dense foods. If you're physically active you may have the
opportunity to use discretionary calories on treats, but the bulk of your
calories should come in the form of nutrient-dense foods, like fruits,
vegetables, whole grains, legumes, low-fat dairy and lean sources of protein.
DNN: So there's more of a focus on not just what you need but getting what you
need within a calorie-conscious framework?
AM: Absolutely. With 65% of Americans overweight or obese, people have to start
paying attention to their food choices, portions and physical activity levels.
DNN: What else is new?
AM: There's a significant change in terms of increasing fruit and vegetable
intake. Also, there's a very strong emphasis on whole grains -- as opposed to
refined grains. And the increase in the low and nonfat dairy to three servings
a day -- it used to be two to three, now they're very firm on three because of
concerns about inadequate calcium intake across the entire population.
DNN: That raises several interesting questions. First, regarding the increased
fruit and vegetable intake -- now it's nine servings a day, with a range of
five to 13 as opposed to the old five to nine a day. I've read some consumer
comments along the lines of: How am I going to eat that much fruit when I'm
having trouble getting five servings? What would you say to that?
AM: One of the smartest things this committee did was to change the
recommendation from servings to cups, so that nine servings
translates to four and a half cups, which can be easily done with a large
salad. An eight-ounce glass of orange juice and a banana on your breakfast
cereal nets you three servings right there. At lunch, a vegetable-based soup
gives you two more -- and a piece of fruit for dessert provides a sixth. You're
two thirds of the way toward meeting your requirement. Have two plant-based
sides with dinner and another piece of fruit for a snack or dessert and you're
all the way there.
Another one of the other consumer-friendly ways to communicate this message is
the message to fill half your plate with fruits and vegetables -- or to get
half your foods at any meal from fruits and vegetables.
DNN: On to the whole grains question. You mentioned that it was a significant
change to make half of the grains whole grains -- and obviously there's a lot
of scientific evidence to support the health benefits that would result from
such a switch. But here's my question: Do you really need to eat any refined
grains in your diet at all if you're getting adequate carbohydrates from your
fruit and vegetable consumption. So -- refined grains, if you're not eating
them, do you need to start?
AM: At lower calorie intakes -- i.e. if you're consuming less than 1,600
calories a day -- then you don't necessarily need them to meet your calorie
needs, but they are an important source of essential B vitamins. The grains and
refined carbohydrates, they're an incredible source of energy. But granted most
people don't have to worry about getting adequate energy -- most people are
getting too much!
DNN: So what you're saying is that if you're having trouble keeping weight on
or meeting calorie requirements -- then refined grains will pack relatively
more calories into less filling packages.
AM: Well said.
DNN: Well, what about whole grains? Are the guidelines saying -- hey, if you're
eating bread and cereal, switch to whole grain bread or cereal -- OR are they
saying, whole grains are going to give you something that you're not going to
get from other food groups -- i.e. legumes, fruit and vegetables?
AM: The guidelines recommend getting half your grains from whole grains to help
reach fiber intake goals, and they state that eating three or more servings of
whole grains each day can reduce the risk of several chronic diseases and may
help with weight management. These potential health benefits are due to the
fiber and compounds such as lignans, phytoestrogens, phenolic compounds and
phytic acid, naturally present in whole grains. Many of these substances are
also present in fruits, vegetables and legumes. So, are whole grains giving you
something you can't get elsewhere? No. But grain-based foods are the leading
source of essential B vitamins in the typical American diet.
DNN: Is that because of fortification?
AM: No, these vitamins are naturally present in the grains. Now, when a grain
is refined and processed, fiber is stripped out -- as are many of the B
vitamins. Enrichment puts the missing B vitamins back, but it doesn't put back
things like vitamin E or fiber.
DNN: So, fruits and vegetables alone aren't going to give you adequate B
vitamins and fiber?
AM: They could -- for example, potatoes are an excellent source for fiber and
many B vitamins, found in whole grains -- but I'm not talking potato chips and
french fries!
DNN: OK. Getting back to your earlier response -- let's talk about dairy. As
you mentioned, they increased the recommended intake from two to three, to a
firm three. I hate to ask, but I have to: What about those critics, like the
Marion Nestle (author of Food Politics), who claim that industry
pressures bring undue influence on these recommendations? Do you see any
evidence of that?
AM: Absolutely. First let me address why the dairy recommendation was moved to
a firm three -- it was driven by calcium concerns: Three full servings of low-
or non-fat dairy will provide at least 1,000 mg of calcium, thereby meeting the
needs of the majority of adults in this country. There is also evidence that
those who eat the most milk-based products are most likely to meet nutrient
needs. Milk provides more than just calcium. Now, to the issue of industry
influence, how this process works is that the public is invited to provide
input and commentary, and industry is well mobilized to provide input and
comment over small organizations or individuals.
DNN: And the better-funded industries -- such as processed foods, sugar, dairy
and beef -- are among the best mobilized.
AM: That's correct. There's also the issue that the dietary guidelines need to
meet certain nutrient needs -- the committee then needs to translate nutrients
into foods, and they need to keep in mind the food environment that the average
American lives in. They also keep in mind issues such as socio-economic status.
So, while the majority of advisory committee members would agree that a
plant-based diet with minimal fish and poultry is optimal in terms of health
promotion and disease risk reduction, they know that those recommendations
would fall flat because many Americans cannot afford or gain access to the most
healthful foods.
DNN: Is there anything in the dietary guidelines you do not agree with -- or
that you think you would more strongly qualify?
AM: Honestly, I admire the work the advisory board did. They spent countless
hours reviewing and discussing research before putting pen to paper to write
their recommendations. Probably the only change I would have liked to have seen
is the release of the new food guidance system (i.e. Food Guide Pyramid) at the
same time these guidelines were released so consumers could have gotten a
visual message of what to do. But that will happen within the next four to six
weeks. And before we know it, it will be time to start revising these
guidelines again.
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Foaming
Vanilla Honey Bath
Courtesy of Janice Cox, author of Natural Beauty for All Seasons
1 cup oil
1/2 cup honey
1/2 cup liquid soap
1 tbsp. vanilla extract
Adding honey to the bath makes your skin feel silky smooth. It is one of my
favorite beauty recipes because of its simplicity and effectiveness. This
foaming bath uses golden honey and vanilla to create a delicious, subtle scent.
Made from kitchen basics, this rich bath is full of fragrant, foaming bubbles.
For a special gift, I like to package the bath liquid in multicolored glass
bottles. Use silicone glue and attach a few glass marbles or beads to an
ordinary cork for an interesting bottle stopper.
Mix together all the ingredients and pour into a clean bottle with a
tight-fitting stopper or lid. To use: Shake before using. Pour 1/4 cup into the
bathtub under running water.
Yield: 16 ounces, enough for 8 baths.
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Last Issue: What to do when someone you love is overweight? The majority of you
said: speak up. 53.54% would share your concern about health. 35.35% would
offer to exercise with an overweight loved one.
Far fewer -- 7.07% -- would suggest diet tips, while a paltry 4.04% would
practice avoidance by saying nothing. Make sure to catch next issue's
Director's Corner to see how your answers stack up against the dieticians we
polled.
This Issue: What would you prefer to receive for Valentine's Day?
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Candy
-- it's my time of the year to splurge |
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A
love letter |
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Jewelry |
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Flowers |
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A
stuffed monkey or other non-serious gift |
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