Plant-based diet for treating heart disease

Coronary artery before (left) and after (right) plant-based diet (Esselstyn CB Jr: Preventive Cardiology 2001;4: 171-177)

Few people realise that a plant-based diet not only prevents heart disease but can also reverse it. Choosing whole grains, fruits and vegetables and avoiding simple sugars, and saturated and trans fats, as in meat and dairy products, has been shown to result in regression of coronary atherosclerosis after 1 and 5 years in some studies (1) (2) and to continue for over 12 years in other studies (3).

In contrast, standard medical interventions for cardiac patients, such as coronary artery bypass, bypass grafts, atherectomy, angioplasty or stenting, treat only the symptoms, not the disease.  It is therefore not surprising that patients who receive these interventions alone often experience progressive disease, graft shutdown, restenosis, more procedures, progressive disability, and ultimately death from disease (4).

Caldwell Esselstyn MD persuaded 18 cardiac patients to continue with a plant-based diet for over 12 years. Adherent patients experienced no extension of clinical disease, no coronary events, and no interventions. This finding is all the more compelling when we consider that the original compliant 18 participants experienced 49 coronary events in the 8 years before the study (4).

Some patients believe that there is no need to change their diet if they have had heart surgery, stents inserted and/or are taking drugs like statins and aspirin.

A recently published international study (5) indicated that individuals (more than 31,000 men and women of an average age of 66 in this study) who chose whole grains, fruits, vegetables, nuts, and fish over meat, eggs and refined carbohydrates had a 35% reduction in cardiac death rates over 5 years. That’s a 35% reduction in addition to the decrease from surgery and optimal medical management. And these men and women were older, where you’d expect diet to be able to reverse less.

So it is never too late to make simple changes to your diet and lifestyle to improve your long-term health, whether you have medically-managed heart disease or not.

If you have heart disease, you can eat a wonderful variety of delicious, nutrient-dense foods:

• All vegetables except avocado. Leafy green vegetables, root vegetables, vegetables that are red, green, purple, orange, and yellow – every colour of the rainbow
• All legumes—beans, peas, and lentils of all varieties.
• All whole grains and products, bread and pasta, that are made from them—as long as they do not contain added fats.
• All fruits

You need to avoid:

• Red meat, poultry and fish
• Dairy products
• Oils of all kinds (even olive oil)

 

For recipe ideas, tips and information about following a plant-based diet please sign up for my free newsletter and check out my website.

You can also find me on Facebook, Twitter and LinkedIn.

 

References

(1) Ornish, D. et al (1998). Intensive lifestyle changes for reversal of coronary heart disease. JAMA, Vol 280, No. 23, 2001-2007

(2) Ornish, D. et al (1990). Can lifestyle changes reverse coronary heart disease?  The Lancet, 21 July 1990, Vol 336, No. 8708, 129-133

(3) Esselstyn, C. (2001).  Resolving the coronary artery disease epidemic through plant-based nutrition.  Preventive Cardiology, 4, 171-177

(4) Esselstyn, C.  Updating a 12-Year Experience With Arrest and Reversal Therapy for Coronary Heart Disease (An Overdue Requiem for Palliative Cardiology).  Article on Caldwell Esselstyn’s website.

(5) Dehghan, M. et al. Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention: A Prospective Cohort Study of 31 546 High-Risk Individuals From 40 Countries. Circulation, 4 December 2012, 126: 2705-2712

Towards a new paradigm for public health

In 1990, physician and health economist Christopher Murray at Harvard University and medical demographer Alan Lopez at the World Health Organisation embarked on the first ever attempt to measure the global burden of disease and developed the now-famous Disability Adjusted Life Year (DALY) metric that made it possible to combine estimates of mortality and morbidity burden around the world. DALY is the sum of years lived with disability [YLD] and years of life lost [YLL].

Since then, there have been estimates in 1999 to 2002 and 2004. But the latest iteration of the project, Global Burden of Disease 2010, has been on a different scale, involving nearly 500 researchers from more than 300 institutions in 50 countries. It is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors.

Twenty years ago, the project assessed the burden of 107 diseases and injuries and ten selected risk factors for the world and eight major regions over one calendar year. Now, thanks to advances in technology, the availability of data, and the participation of experts around the world, as well as the leadership of a core group of researchers, the scope has increased to 291 diseases and injuries in 21 regions, for 20 age groups, and an estimation of trends from 1990 to 2010. Global Burden of Disease 2010 also includes an assessment of 67 risk factors.

The results, published yesterday in seven articles in The Lancet, are set to shake up health priorities across the world.

In summary, the analysis shows that infectious diseases, maternal and child illness, and malnutrition now cause fewer deaths and less illness than they did twenty years ago. As a result, fewer children are dying every year, but more young and middle-aged adults are dying and suffering from disease and injury, as non-communicable diseases, such as cancer and heart disease, become the dominant causes of death and disability worldwide. Since 1970, men and women worldwide have gained slightly more than ten years of life expectancy overall, but they spend more years living with injury and illness.

There were 52.8 million deaths in 2010 compared with 46.5 million deaths in 1990. Of these, 12.9 million were from ischaemic heart disease and stroke, or one in four deaths worldwide, compared with one in five in 1990. Cancer claimed 8 million lives in 2010 compared with 5.8 million in 1990; trachea, bronchus and lung cancer accounted for 20% of these. Twice as many people died of diabetes in 2010 – 1.3. million – than in 1990, which is higher than deaths from tuberculosis or malaria (1.2 million each). Deaths from HIV/AIDS increased from 0.30 million in 1990 to 1.5 million in 2010, reaching a peak of 1.7 million in 2006. The fraction of global deaths due to injuries (5.1 million deaths) was marginally higher in 2010 (9.6%) compared with two decades earlier (8.8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1.3 million in 2010) and a rise in deaths from falls.

The contributions of risk factors to regional and global burden of diseases and injuries has shifted substantially between 1990 and 2010, from risk factors that mainly cause communicable diseases in children to risk factors that mainly cause non-communicable diseases in adults.

The proportion of overall disease burden attributable to childhood underweight – the leading risk factor worldwide in 1990 – had more than halved by 2010, making childhood underweight the eighth risk worldwide, behind six behavioural and physiological risks, and household air pollution from solid fuels. Other risks for child mortality, such as non-exclusive and discontinued breastfeeding, micronutrient deficiencies, and unimproved water and sanitation, have also fallen. However, child and maternal undernutrition risks collectively still account for almost 7% of disease burden in 2010, with unimproved water and sanitation accounting for almost 1%.

Of the non-communicable disease risks, high blood pressure, high body-mass index, high fasting plasma glucose, alcohol use, and dietary risks have increased in relative importance. This overall shift has arisen from a combination of the ageing population, substantial achievements in lowering mortality of children aged younger than 5 years, and changes in risk factor exposure.

These broad global patterns mask enormous regional variation in risks to health. In sub-Saharan Africa, risks such as childhood underweight, household air pollution from solid fuels, and suboptimal breastfeeding continue to cause a disproportionate amount of health burden, despite decreasing. The shift to risk factors for non-communicable disease was clear in east Asia, North Africa and Middle East, and Latin America.

For people aged 15 to 49 years, the leading risk factor worldwide was alcohol use, followed by tobacco smoking including second-hand smoke, high blood pressure, high body-mass index, diet low in fruits, drug use, and occupational risk factors for injuries. Risk factor rankings in this age group stayed broadly similar between 1990, and 2010, with the exception of iron deficiency, which dropped from the fourth leading risk factor in 1990, to ninth in 2010.

High blood pressure, tobacco smoking including second-hand smoke, alcohol use, and diet low in fruits were all in the top five risk factors for adults aged 50 to 69 years and adults older than 70 years, in both 1990, and 2010, accounting for a large proportion of disease burden in both age groups. Globally, high blood pressure accounted for more than 20% of all health loss in adults aged 70 years and older in 2010, and around 15% in those aged 50 to 69 years. Tobacco smoking including second-hand smoke accounted for more than 10% of global disease burden in each of these age groups in 2010.

Globally, the sum of years lived with disability and years of life lost (DALY), was influenced most by dietary risk factors and physical inactivity – together these were responsible for 10% of the global disease burden in 2010.

Of the individual dietary risk factors, the largest attributable burden in 2010 was associated with diets low in fruits (4.9 million deaths), followed by diets high in sodium (4.0 million deaths), low in nuts and seeds (2.5 million deaths), low in whole grains (1.7 million), low in vegetables (1.8 million deaths), and low in seafood omega-3 fatty acids (1.4 million deaths). Physical inactivity and low physical activity accounted for 3.2 million deaths.

This impressive analysis of global health issues by Christopher Murray and colleagues provides much reason for hope but also challenges the current medical paradigm and global healthcare system.

It shows clearly that the focus of global health authorities in recent decades on reducing infection and malnutrition has paid off – life expectancy has increased almost everywhere. This focus needs to continue to minimise incidence of diseases like tuberculosis, malaria and HIV/AIDs.

It also reveals, however, that the leading causes of death in the modern developed world are conditions which cannot be controlled by vaccinations, antibiotics, improved sanitation or insecticides. The data provide evidence that the risk factors for non-communicable diseases like heart disease, cancer and diabetes, are predominantly related to poor diet and lifestyle.

The large attributable burden for dietary risk factors such as diets low in fruits, vegetables, whole grains, nuts and seeds, and seafood omega-3 fatty acids might come as a surprise to some. The large burden is caused by both high exposure, e.g., low intake of fruits and vegetables in many regions – and large effect sizes.

Given the crucial role of dietary and lifestyle factors in determining long-term health, the answer to alleviating the suffering created by these chronic non-communicable diseases does not lie in the current medical model, with its preoccupation with drugs and surgery. Our doctors are trained to relieve symptoms not to address the underlying causes of chronic disease. Powerful commercial interests in the food, pharmaceutical and health sectors drown out the voices of those who can see that the solution is really very simple.

Widespread consumption of plant-based diets, rich in vegetables, fruit, whole grains, beans, nuts and seeds, together with not smoking and more physical activity, would transform people’s lives and radically reduce healthcare costs. It is not rocket science.

Dr Murray, I salute you and your colleagues for a first rate piece of work. May the truths you have exposed become part of mainstream understanding as quickly as possible and lead to a sea change in our approach to health and well-being.

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References

Murray et al (2012). Global Burden of Disease 2010. The Lancet, 13 December 2012.

Secrets of a long and healthy life

Can we discover the fountain of youth?  Some answers lie with the healthiest people on earth – the elders of Okinawa in Japan.

Okinawa has a higher proportion of centenarians than anywhere on the planet  – more than four times that of the UK.  Not only this, but they remain healthy and active into advanced old age.  Compared with people of the same age in the UK, Okinawan elders have an 80 per cent lower risk of heart disease, stroke, breast and prostate cancer, a 50 per cent lower risk of other cancers, including colon, ovarian and lymphoma, a 50 per cent lower rate of hip fracture, and a 30 to 40 per cent lower incidence of dementia.

So what are their secrets?

Secret #1 is maintain a positive, optimistic attitude.  Okinawans believe that everything in life works itself out in the long run.  With this attitude, there is no need to worry.  They intentionally live a calm, peaceful life with little stress.  When they work, it is at their own pace, rather than putting pressure on themselves to get things done in a hurry.  Experts believe this relaxed way of being is vital for health.

Secret #2 is cultivate strong relationships.  Okinawans often meet with friends and family just to chat, laugh or offer support to one another.  Endless studies have shown that people are healthier when they have good relationships and an active, positive social life.

Secret #3 is eat a very healthy diet.  It is considered especially important that the traditional Okinawa diet is both simple and wholesome.  It consists mainly of plant food – whole grains, beans, vegetables, fruit, nuts and seeds – that are high in vitamins, minerals and phytonutrients, and fish that is rich in protein and omega-3 oils. They also eat less food than the average in countries such as the UK and USA and have a cultural tradition called hara hachi bu, which means eat until 80 per cent full.  Eating a natural unprocessed diet, low in sugar, saturated fat and salt, greatly reduces their risk of health problems related to overweight and obesity.

Secret # 4 is lead an active life. Most Okinawans are physically active. They walk everywhere, work in their gardens, dance and practice traditional martial arts like tai chi.

Secret # 5 is refrain from bad habits. There are very few older Okinawans who smoke cigarettes or drink alcohol

 

For more information about the effect of diet on health, plant-based diets, recipes and tips please sign up for my free newsletter and visit my website.

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Carbohydrates – the good, the bad and the ugly

Herby quinoa salad

Fierce controversy rages in the popular press about carbohydrates and their influence on our health.

Thanks to the popularity of the Atkins, South Beach and other low-carbohydrate diets, many believe that all carbohydrates are “bad” and a cause of the obesity epidemic.

Like many issues associated with nutrition, this is a dangerous over-simplification, rather like the “all fat is bad” message.

We now know that carbohydrates, the staple of most diets, are neither all good nor all bad.

Some kinds of carbohydrates promote health whilst others, when eaten often and in large quantities, actually increase the risk for obesity, diabetes, coronary heart disease and some cancers.

Easily digested carbohydrates from white bread, white rice, white pasta, biscuits, cakes, pastries, sugary drinks and other highly processed foods may indeed contribute to weight gain and interfere with weight loss.

Bad carbohydrates

Whole grains, beans, fruits, vegetables and other sources of intact carbohydrates do just the opposite – they promote good health.

Good carbohydrates

Blanket dismissal of carbohydrates is thus misleading as they are an important part of a healthy diet.

Carbohydrates provide the body with the fuel it needs for physical activity and for proper organ function.

The brain, for example, is totally reliant on carbohydrates to power its activity – 40 per cent of the carbohydrates we consume are used to provide glucose for the brain.

The best sources of carbohydrates – fruits, vegetables and whole grains – also deliver essential vitamins and minerals, fibre and a rich array of protective phytonutrients.

For optimal health, obtain your grains intact from foods such as whole wheat bread, brown rice, whole grain pasta, and other possibly unfamiliar grains like quinoa, whole oats, millet, buckwheat and bulgur.

Broad bean, bell pepper and quinoa salad with basil tahini dressing

Until recently, you could only buy whole-grain products in organic or non-traditional stores. Today they are available in most mainstream supermarkets. Here are some suggestions for adding more good carbohydrates to your diet:

• Start the day with whole grains. If you like hot cereals, try porridge made from whole oats, quinoa or brown rice. If you are a cold cereal person, look for muesli or one that lists whole wheat, whole oats, or other whole grain first on the ingredient list. Have fresh or dried fruit with your cereal.
• Use whole grain breads or crackers for lunch or snacks. Check the label to make sure that whole wheat or another whole grain is the first ingredient listed. Oatcakes with hummus (made from chickpeas) are an excellent ‘good carb’ snack.
• Reduce intake of potatoes. Instead, try brown rice or even “newer” grains like quinoa, millet, buckwheat or barley with your dinner. There is nothing wrong with potatoes per se – my message is about increasing the variety of starches in your diet, as each grain contains a wide array of nutrients and phytonutrients beneficial for health.
• Exchange ‘white’ foods for ‘brown’ foods. Brown rice usually needs to be cooked for longer than white rice. If the whole grain products are too chewy for you, look for those that are made with half whole-wheat flour and half white flour.
• Beans, nuts, seeds, fruit, vegetables. Beans are an excellent source of slowly digested carbohydrates as well as a great source of protein. Try adding them to casseroles and soups. Aim to eat 5 to 10 portions of vegetables and fruit per day.

For more information about the effect of diet on health, plant-based diets, recipes and tips please sign up for my free newsletter and visit my website.

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Alzheimer’s Disease, metabolic disorders and the role of diet

Accumulating evidence for the role of metabolic disorders such as insulin resistance, diabetes, obesity and hypertension in increasing the risk of Alzheimer’s disease and vascular dementia, is reviewed in a new paper published this month in the Archives of Neurology.

In the same journal, compelling evidence is presented that higher pre-diagnosis total cholesterol, low-density lipoprotein cholesterol, and diabetes are associated with faster cognitive decline in patients with incident Alzheimer’s disease.

A cohort of 156 patients with incident Alzheimer’s Disease (mean age 83 years) were followed for up to 10 years.  Changes in a composite score of cognitive ability were monitored from diagnosis onwards.

“These findings indicate that controlling vascular conditions may be one way to delay the course of Alzheimer’s, which would be a major development in the treatment of this devastating disease as currently there are few treatments available to slow its progression,”

said Yaakov Stern, Ph.D., a professor at the Taub Institute for the Research on Alzheimer’s Disease and the Aging Brain and director of the Cognitive Neuroscience Division of the Gertrude H. Sergievsky Center at Columbia University Medical Center, and senior author of the paper.

“Preventing heart disease, stroke and diabetes – or making sure these conditions are well managed in patients diagnosed with them – can potentially slow the disease progression of Alzheimer’s,” said Dr. Stern.

Diets high in fruit, vegetables, fibre and unsaturated fats, and low in sugar, salt and saturated fat are known to reduce the risk of a range of chronic conditions, such as diabetes, heart disease and stroke.  This means eating more plant-based foods and less processed and animal-based foods.

Stabilising blood sugar is crucial.  This may be done by eating a diet with a low glycaemic load, that is, one that includes moderate quantities of complex carbohydrates which release glucose slowly into the bloodstream.  Whole grains, such as whole-wheat bread, brown rice, quinoa, millet and buckwheat are valuable for helping to ensure smooth regulation of blood sugar.  In contrast, highly refined carbohydrates, such as white bread, white rice, white pasta and table sugar, create a roller-coaster of blood sugar highs and lows, which if left unchecked, can ultimately give rise to insulin resistance and eventually to diabetes.  Potatoes release sugar into the bloodstream almost as fast as table sugar and thus should be eaten sparingly, unless you are lean and exercise regularly.  Consuming protein with carbohydrates at every meal has also been found to help regulation of blood sugar.

Increasing the quantity of vegetables and fruit in the diet is also vital.  Blood sugar levels are easier to maintain if vegetables are emphasized more than fruit, as some fruit contains a lot of sugar.  A minimum of 5 portions of fruit and vegetables per day is recommended.  For easy tips for increasing the amount of fruit and vegetables in your diet please click here.

Unsaturated fats found in plant oils, such as olive oil and the oils of nuts and seeds, and in oily fish, are beneficial for preventing heart disease and other vascular health conditions.  For practical suggestions for ways to incorporate more healthy unsaturated fats in your diet please click here.

For information and practical tuition in how to put all these recommendations together to create fabulous food that protects you from diabetes, heart disease and Alzheimer’s Disease, please come to a Cooking for Health course, run by nutrition expert, Dr Jane Philpott.

Fruit and vegetable consumption low across the world

A new study to be published in the May edition of the American Journal of Preventive Medicine paints a depressing picture of the dietary habits of modern man across the globe.

National Diet and Nutrition Surveys in the UK have found that less than 15 per cent of the population eats the recommended 5 portions of fruit and vegetables per day; a similar situation exists in the USA.  It appears that the same is also true in developing countries, where traditional diets are threatened by the introduction of processed food.

A survey of over 200,000 people in developing countries showed that overall 77.6 per cent of men and 78.4 per cent of women consumed less than the suggested five daily servings of produce. 

“Low fruit and vegetable consumption is a risk factor for overweight and obesity, and adequate consumption decreases risk for developing several chronic diseases,” said lead author Spencer Moore. “The release of the 2002-2003 World Health Survey data provided a unique opportunity to examine global differences in low fruit and vegetable consumption in a way that has until now simply not been possible.”

There were wide variations among nations, ranging from 37 percent of men in Ghana who did not meet that standard – to 99 percent of Pakistani men. The researchers saw similar findings in women with the same two countries at the high and low ends of the spectrum.

The prevalence of low fruit and vegetable intake increased with age and decreased with income. This contrasts with findings from the UK where, on average, older people consume more fruit and vegetables than younger people.

Epidemiological studies show that societies consuming high quantities of fruit, vegetables and whole grains are at lower risk of developing chronic diseases such as diabetes, heart disease and cancers than those that consume low quantities.  Such societies are often, but not exclusively, in less economically developed parts of the world.  As GDP per capita increases, countries opt for eating more meat, more processed food and less fruit, vegetables and whole grains.  This dietary shift leads to an epidemiological shift – away from infectious diseases and other diseases associated with lack of food, towards chronic noncommunicable diseases such as heart disease, stroke and cancer. 

The decline in consumption of fruit and vegetables in developing countries is disturbing as it is likely to give rise to an increase in the incidence of chronic diseases, leading to huge burdens on the healthcare systems of those countries, which may be ill-equipped to cope.

For information and practical tuition in how to create mouth-watering dishes with locally produced fruit and vegetables, come along to Cooking for Health courses held throughout the year in Somerset, UK.

If you are a caterer, or a professional responsible for encouraging healthier catering practices in your community, you will benefit from participating in a two-day training course on Healthier Catering.   By the end of the course, participants will: 

• Understand the basic principles of nutrition
• Be aware of the importance of food in the maintenance of health and well-being
• Appreciate the role of lifestyles and culture in influencing diet
• Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
• Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
• Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further details about the course content and the course tutor, Dr Jane Philpott, please see http://cookingforhealth-uk.com/healthier-catering.php.

Reference

Hall JN, et al. Global variability in fruit and vegetable consumption. Am J Prev Med. 36(5), 2009.

Over-eating when eating out

Recently, I gave the menu of a well-known chain restaurant to a group of students and asked them to select what they would eat if they were dining there. 

 

They selected a starter (garlic bread with cheese), a main course (traditional lasagne with a salad), a dessert (ice cream) and a drink (a can of coke). 

 

Using the restaurant’s own nutritional information, they calculated the nutrient content of what they had chosen (Table 1).  The results left the students open-mouthed.

 

Their menu selection had provided:

 

n 106% of the guideline daily amount of calories (assuming 2000 kcal per day);

n 141-171% of the guideline daily amount of protein (depending on whether they were male or female);

n 61% of the guideline daily carbohydrate;

n 109% of the guideline daily amount of total fat;

n 192% of the guideline daily amount of saturated fat

n 52% of the guideline daily amount of salt. 

 

It is worth noting that the dietary reference value for salt in the UK is 6 g per day, compared with 2.3 g per day in the USA.

 

Thus, one meal out would have provided more than the entire day’s requirement for calories; enough protein to last for one and a half days; and enough saturated fat to last for two days.

 

Most people have no idea of the nutrient content of the food they are eating, nor of the potentially damaging effects on their health of a dietary excess of sugar, saturated fat and salt. 

 

Given that at least one–third of household expenditure on food and drink is spent on food eaten outside the home in the UK, food manufacturers and caterers have a real opportunity to contribute to an improvement in public health whilst also making a profit themselves. 

 

There is now convincing research evidence to suggest that increasing the amount of fruit, vegetables and whole grains in the diet, whilst decreasing the amount of sugar, saturated fat and salt, helps to protect the body from chronic conditions such as obesity, type 2 diabetes, heart disease and various cancers.

 

A two-day professional training course is offered, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population.

 

By the end of the course, participants will:

• Understand the basic principles of nutrition
• Be aware of the importance of food in the maintenance of health and well-being
• Appreciate the role of lifestyles and culture in influencing diet
• Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
• Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
• Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further information on the course content and the course tutor, Dr Jane Philpott, please click http://cookingforhealth-uk.com/healthier-catering.php.

 

 

Table 1

Menu item	Calories per portion	Protein g per portion	Carbohydrate g per portion	Total fat g per portion	Saturated fat g per portion	Salt g per portion
Starter	568	29.8	35.6	34	16.5	1.15
Main course	934	42.2	74.4	33.1	14.6	1.84
Dessert	475	5.5	18.8	18.1	11.1	0.15
Drink	139	0	35	0	0	0
Total	2116	77.5	163.8	85.2	42.2	3.14
Gov guideline	2000 kcal	45 g/day (women) 55 g/day (men)	267 g per day	78 g per day	22 g per day	6 g per day
% of guidelines	106%	171% (women) 141% (men)	61%	109%	192%	52%

 

 

 

Farmer’s markets help to increase consumption of fresh fruit and vegetables

A new Farmer’s Market was started last November in Brownsville, Texas, in an effort to make locally grown produce more available and affordable to local residents, to increase the awareness of chronic diseases associated with obesity and to educate consumers on the importance of nutrition. Certain communities in this region have twice the US national average of diabetes, which is associated with obesity. The project is the brainchild of Belinda Reininger, Dr.P.H., associate professor of behavioural sciences at the University of Texas School of Public Health.

“A significant portion of the obesity problem here is because local diets are high in carbohydrates and include very few vegetables and fruits,” said Rose Gowen, M.D., medical director of the Clinical Research Unit at the University of Texas School of Public Health and chair of the market’s board of directors. “Many of the diabetes cases are related to the problem of obesity, which is beginning in childhood and adolescence years.”

More than 400 residents shop weekly at the Saturday market and surveys have found 80 percent of them are now eating more fruits and vegetables and 78 percent reported eating a wider variety of fruits and vegetables. Surveys also revealed that 84 percent of shoppers find the quality of the produce at the market exceeds the quality of produce offered elsewhere.

Market shoppers also have access to health screenings and on-site nutrition, obesity and diabetes information provided by the UT School of Public Health, Texas Department of State Health Services (DSHS) and other organizations.

In common with the UK government, the U.S. Department of Agriculture recommends eating five servings of fruits and vegetables a day, which provide vitamins, minerals and phytonutrients that help maintain and improve overall health, as well as protect against chronic diseases such as diabetes. The 2000 Texas Healthy People Report revealed that only 23.4 percent of Texans were consuming five or more servings of fruits and vegetables per day.  In the UK, average fruit and vegetable consumption is less than three portions per day.

Low-income families can receive US$10 in vouchers to purchase fresh fruits and vegetables, which goes quite a long way at the market.

“Last week I bought four cucumbers, six grapefruits, a dozen farm eggs, fresh cilantro and dill, all for $10,” said Gowen, a long-time local resident and a driving force behind the market.

The market is in its final stage of a certification process to become a state-recognized farmer’s market. Once certified, organizers hope to allow families to use their Women, Infants and Children (WIC) card and food stamps to purchase fresh produce.  The committee also wants to provide cookery classes for attendees to learn healthier cooking options for their fresh produce.

If you would like ideas and practical tuition in how to include more fresh vegetables and fruits into your diet, why not come along to a Cooking for Health course, held throughout the year in Somerset, UK.

How to get your children to eat more vegetables

Give the vegetables cool names!

When 186 four-year olds were given carrots called “X-ray Vision Carrots” they ate nearly twice as many as they did on the lunch days when they were simply labelled as “carrots.”  The children continued to eat about 50 per cent more carrots even on the days when they were no longer labelled, according to a new study by researchers at Cornell University.

“Cool names can make for cool foods,” says lead author Professor Brian Wansink of Cornell University. “Whether it be ‘power peas’ or ‘dinosaur broccoli trees,’ giving a food a fun name makes kids think it will be more fun to eat. And it seems to keep working – even the next day.”

Similar results have been found with adults. A restaurant study showed that when the Seafood Filet was changed to “Succulent Italian Seafood Filet,” sales increased by 28 per cent and taste rating increased by 12 per cent.

“Same food, but different expectations, and a different experience,”

said Wansink, author of “Mindless Eating: Why We Eat More Than We Eat More Than We Think.”

Although the study was conducted in pre-schools, the researchers believe the same naming tricks can work with older children.

“I’ve been using this with my kids,” said researcher Collin Payne, “Whatever sparks their imagination seems to spark their appetite.”

Here are some more ideas to tempt your children to enjoy the wonders of the fruit and vegetable world:

• Ben 10’s Bionic Broccoli
• Elastigirl’s Shapeshifting Strawberries
• Hogwart’s Hufflepuff Herbs
• Lady Penelope’s Pinky Peaches
• Pokemon’s Powerblast Parsnips
• Spongebob’s Squarepants Supersonic Squash
• Thunderbirds’ Hypersonic Rocket Leaf
• Wonder Woman’s Wicked Watermelon

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Obesity in children

Overweight and obesity among children is widely regarded as being even more serious than it is among adults, with a very rapid rise in prevalence in the last two decades. Child obesity is likely to continue into adulthood, and many of the problems linked to obesity are more severe if the obesity has been present for a long period. Adults with the highest risk of diabetes, cardiovascular disorders, liver malfunction and orthopaedic dysfunction, are likely to have the most extreme levels of obesity and to have been obese since childhood[i].

Projections of child obesity based on trends from the 1980s and 1990s indicate that the annual increase in child obesity prevalence is itself increasing[ii]. By the year 2010, some 26 million school children in the EU are expected to be overweight, of which 6 million will be obese. The numbers of overweight children will rise by some 1.3 million per year, of which the numbers of obese children will rise by over 0.3 million per year.

At a conservative estimate, over a million obese children in the EU are likely to show a range of indicators for cardiovascular disease, including high blood pressure and raised blood cholesterol levels, and to have three or more indicators of the metabolic syndrome[iii]. Over 1.4 million children could have early stages of liver disorder.

The costs of childhood obesity have not been estimated but should include lost educational opportunity. A study of children’s quality of life found the psychological effects of severe obesity to be equivalent to a diagnosis of cancer[iv].

Behaviour, learning and mental health problems in children are rising as fast as rates of obesity and diabetes. Food affects brains as well as bodies, and early malnourishment can have devastating effects on both. Conversely, improving nutrition can help reduce antisocial behaviour as well as symptoms of ADHD, dyslexia, depression and related conditions[v].

The only pan-European estimates of children’s food consumption patterns are from self-reported surveys of health behaviours of children aged 11-15 years[vi]. The most recent (for 2001-2002) found:

• In virtually all countries fewer than 50 per cent of children ate vegetables every day. On average, 30 per cent of children said they ate vegetables daily, but the children in countries once famous for their Mediterranean diets reported lower than average levels, especially Spain, where vegetables were typically eaten daily by only 12 per cent of children.
• In virtually all countries fewer than 50 per cent of children ate fruit every day. On average, 30 per cent of boys and 37 per cent of girls reported eating fruit daily, but in sixteen countries only 25 per cent of children were eating fruit more than once a week. Lowest levels of consumption were reported among children in Northern European countries.
• Soft drinks and confectionery were consumed daily by about 30 per cent of children (over 40 per cent in some countries).

According to the last National Diet and Nutrition Survey in the UK[vii]:

• 92 per cent of children consume more saturated fat than is recommended
• 86 per cent consume too much sugar
• 72 per cent consume too much salt
• 96 per cent do not consume enough fruit and vegetables

Governments are trying to improve children’s diets, but young people’s exposure to marketing pressures in our time-poor, anxiety-ridden, media-driven society is at an all-time high.

Widespread action is needed to reverse current trends – and we all need to take responsibility for what we are feeding young bodies and minds.

In a Cooking for Health class focused on Healthy Cooking for Your Children, we look at:

• The best and the worst food for children
• Easy steps to free your child from food traps
• Simple, child-friendly recipes
• Practical tips to help your child make the best food choices

The class involves 100% hands-on practical cooking in a small, supervised group, combined with teaching of up-to-date information and research findings on the effects of diet on health. Clear, easy-to-follow presentations and handouts are provided with plenty of opportunity for questions and discussion.

References

[i] Policy options for responding to obesity. Summary report of the EC-funded project to map the view of stakeholders involved in tackling obesity – the PorGrow project. Dr Tim Lobstein and Professor Erik Millstone. http://www.sussex.ac.uk/spru/porgrow

[ii] Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatric Obesit 2006;1:26-32.

[iii] Lobstein T, Jackson-Leach R. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatric Obesity 2006;1:33-41.

[iv] Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. J Am Med Ass 2003;289:1813-9.

[v] Richardson, A. They Are What You Feed Them. Harper Thorsons (5 Jun 2006)

[vi] HBSC. Young people’s health in context: Health Behaviour in School-aged Children 2001/2002. Health Policy for Children and Adolescents 4. C Currie et al (eds) Copenhagen: WHO Regional Office for Europe, 2004.

[vii] Gregory, J. et al. National Diet and Nutrition Survey: Young People Aged 4-18 years (The Stationery Office, 2000)