Brooke Douglas RD is back with her first of the month post, this time telling us about healthy fruits and healthy vegetables. Don’t miss a word.
Almost Everything You Ever Wanted to Know About Fruits and Vegetables
Research shows that people who eat even 2½ cups of fruits and vegetables a day have only half the cancer risk of those who eat less than one cup a day. Hundreds of studies show that increased fruit and vegetable consumption may also help prevent heart disease, stroke, hypertension, birth defects, cataracts, diabetes, obesity and other serious conditions.
Healthy Fruits and vegetables are nutritional powerhouses which:
Are excellent sources of vitamins and minerals and contain disease fighting fiber
Contain antioxidants and phytochemicals
Are virtually fat-free (exceptions: coconut, olives & avocado) and cholesterol-free
Are helpful in weight management, due to their high-fiber, high-water, and low-fat content
Vitamins and minerals: Are essential in maintaining the health of the brain, heart, bones, teeth and nerves; making/repairing red blood cells; regulating body’s balance of fluids; and in other vital functions.
Many healthy fruits and vegetables are particularly good sources of vitamins A, C, E and K, some B vitamins, and many important minerals needed for healthy bodies. Beta-carotene and related compounds called carotenoids are converted by the body to Vitamin A. Carotenoids are found in high concentrations in carrots and other orange and yellow vegetables and fruits such as winter squash and cantaloupes. Dark green, leafy vegetables, such as spinach, kale, broccoli, and other members of the cabbage family, also contain high concentrations of carotenoids.
Dark green vegetables are also excellent sources of folic acid (a B vitamin needed during pregnancy to reduce the risk of neural defects in the fetus), Vitamins E and K, and minerals such as calcium, magnesium, manganese, iron, and potassium. Many fruits are also a good source of minerals, such as chromium (grapes), iron (cherries), manganese (pineapple), and potassium (apricots, bananas, orange juice, peaches and prunes).
Citrus fruits are good sources of Vitamin C, as is the family of plants that includes tomatoes, red and green peppers, potatoes, and eggplant. Other good sources of Vitamin C include papayas, strawberries, kiwis, cantaloupe, and the cabbage family, including broccoli, cauliflower and Brussels sprouts.
While there is overlap in the vitamins/minerals supplied by fruits and vegetables, you need a wide variety of colorful healthy fruits and vegetables to fully benefit from the various nutrients they contain.
Antioxidants: Disease-fighting compounds found in many foods, especially healthy fruits and vegetables. Antioxidants neutralize free radicals (compounds that damage cells and lead to cardiovascular disease, cancer, cataracts, premature aging, and impaired immunity.) Antioxidants include vitamins A, C, and E; beta carotene, minerals (selenium, copper, zinc, and manganese) and some of the phytochemicals.
Phytochemicals: From plants, “plant chemicals” are recognized as powerful disease-fighting compounds. Fruits and vegetables contain thousands of different phytochemical compounds. Categorized as carotenoids, flavenoids (compounds that give flavor/colors to fruit/veg), and other compounds, such as allicin, indoles, lycopenes, lutein, and phenols. Scientists studying phytochemicals are finding an impressive range of health benefits.
Color & Examples
Phytochemical Examples
Potential Benefits
Red: apples, cherries, strawberries, watermelon, beets, red peppers, radicchio, tomatoes
Lycopene, anthocyanins
Maintain memory function, heart health urinary tract health; reduce blood pressure, fight infections, and reduce risk of some cancers
Improve heart health, maintain healthy cholesterol levels, and reduce risk of some cancers
Not all foods listed above, even within the same group, have the same health benefits. Foods with the same phytochemicals may contain different concentrations of the phytochemicals, and the compounds may be absorbed differently. Even different varieties of foods within the same category (such as different varieties of apples or lettuce) may contain widely varying concentrations and kinds of phytochemicals. However, those darker in color usually contain higher concentrations. So think “more color and more variety” in making your selections!
What is considered one serving of fruit?
• 1 medium whole fruit (apple, banana) • ½ cup of fresh, frozen or canned fruit
• 6 oz. (¾ cup) 100% fruit juice • ¼ cup of dried fruit
What is considered one serving of vegetables?
• 1 cup of raw, leafy vegetables • ½ cup cut up fresh, frozen or canned vegetables
• 6 oz. (¾ cup) 100% vegetable juice • ½ cup cooked beans, peas, or lentils
How Can I Get More…Healthy Fruits and Vegetables in My Diet?
At home:
• Top your hot or cold cereal with fresh fruit.
• Enjoy a glass of 100% real fruit or vegetable juice with breakfast.
• Make smoothies with fresh or frozen fruits and juices for a great breakfast or lunch choice.
• Choose hundred percent fruit and vegetable juices as delicious alternatives to soft drinks.
• At dinner, include salad/raw veggies; use low-fat or non-fat dressing to reduce fat and calories.
• Steamed vegetables are always a good side dish.
• Add vegetables to your favorite entrees, like tacos, lasagna, casseroles, and pasta dishes.
• Add pureed vegetables to sauces to fortify them.
• Try more vegetarian meals, like tofu, rice or pasta with vegetables, and Asian stir-fry dishes.
• For dessert, bake sweet potatoes, apples, peaches, pears, or bananas, or make fruit cobblers.
• Discover some of the many cookbooks that specialize in fruits and vegetable recipes.
• For a snack or when you’re on the go:
• Choose fruits and vegetables that can be eaten out of hand, like apple wedges, baby carrots, broccoli spears, or cherry tomatoes, grapes, bananas, and seasonal items like peaches and plums.
• In place of candy, choose dried fruit (easily packs in a bag/take on the road or eat at office.
When dining out:
• Order a dinner salad to begin your meal.
• Request an extra serving of vegetables as a side dish.
• Order meals that include vegetables or fruits as a major component. To keep fat and calories in check, request vegetables steamed without the addition of butter, oil or cream sauce.
• Ask for extra lettuce and tomato (or other vegetables) on sandwiches and burgers.
• Choose healthful desserts; fresh fruit, sherbet, sorbet, or angel food cake topped with fruit.
• Choose dishes on the nutrition charts of Healthy Dining Finder that have more servings of fruits/vegetables.
The ancient Greeks used running as a form of training and competition. It was a way to test personal fortitude and improve physical health. Many of the health benefits of running were known even in those ancient times. In modern times, many start running for the same reasons. They run to improve their physical endurance, lose weight and build muscle. While these common health benefits of running influence many to start running, runners are surprised to learn just how extensive the health benefits are. Running improves the quality of sleep, fights off depression and anxiety, and improves joint health and stability.
Sleep disorders affect a surprising percent of the population today. There is good news to those who suffer from them. Running can actually improve the decrease the symptoms of sleep disorders and improve the quality of sleep. It also appears to help people sleep more efficiently. That is, the amount of time spent actually sleeping while in bed increases. Running helps people fall asleep more quickly, toss-and-turn less through the night, and wake up more rested than those who do not run.
The runner’s high is a well-documented phenomenon, and major benefit, of running. This is a unique feeling often reported during long, strenuous amounts of exercise. The feeling can range from relaxed and peaceful to intensely euphoric. It is produced when endorphins flood the brain as part of a stress response to running. These endorphins are the natural drugs of the body. They reduce pain and are responsible for the happy and content feelings similar to many those produced by narcotics. While many runners experience this phenomenon, many do not realize the long-term positive effect that is has. Over time, the regular doses of endorphins to the brain can combat both anxiety and depression. In fact, many studies have shown that following a regular running program markedly reduces the symptoms of these disorders.
A common misconception is that the high-impact nature of running negatively affects the joints in the body. The truth is that running may actually improve joint health and stability. (1) This is done in a number of ways. First, running helps keep excess weight off. Just a ten-pound increase in body weight can cause a 45-pound increase in stress on the knees (2). Second, running causes cartilage to expand and contract with the natural movements created while running. This forces nutrients and oxygen into the cartilage cells. Without this, the cells will slowly die from oxygen depletion and starvation. Third, running strengthens the tendons and ligaments that support and stabilize joints. This prevents injury in the long-term. Overall, running greatly improves joints and prevents the onset of arthritis.
Building muscle, losing weight, and strengthening the heart are the health benefits that motivate people to start running. However, it is the unspoken benefits that keep them running. As a whole, runners have better sleep, improved mental states, and healthier joints. Many runners feel that they are taking responsibility for their health by running. They physically feel better, less stressed and they have peace of mind. This is a reward all in itself.
Bio: Charles spends much of his free time running. On the side he also runs an automotive company, where he purchases vehicles.
In recent years it has become clear that in order to reap the full benefits of exercise that both aerobic exercise and resistance exercise is important. The recommendation of the CDC for adults of all ages is to incorporate strength exercises into the exercise regimen at least 2 days a week. Technically resistance exercise and strength exercise are not synonymous, but for practical purposes the terms are interchangeable. Resistance exercise is exercise where the major muscle groups exert force against a resistance. When the goal of this type of exercise is to increase strength it is strength exercise.
So what are the benefits of resistance exercise? Actually they are multiple, some obvious and others less obvious.
Resistance Exercise Builds Strength: This is one of the obvious benefits, but some aspects may not be appreciated. One aspect that some may not fully appreciate is that this benefit does not go away with age. One study of the elderly (average age 87) showed that an 8 week program of resistance training 3x/ week increased strength by over 100%, increased walking speed by 12%, and reduced the incidence of falls. With the sedentary life style many jobs enforce, and the lack of outdoors physical work by many of us, resistance training can make a huge difference in the way we feel, in our functional capacity to do tasks without hurting ourselves, and in our overall functional capacity.
Resistance Training Builds Bone Strength: Bones are a living tissue, constantly remodeling based on the stress loads placed upon them. Resistance training while bearing weight can lead to increased bone strength and help prevent the fractures of osteoporosis as we age.
Resistance Training Helps Lower Mild Hypertension: Aerobic exercise is the backbone of maintaining cardiovascular health, but resistance training also helps reduce blood pressure to at least some degree.
Resistance Training can Increase Metabolic Rate: Aerobic exercise is again the mainstay of weight control and maintenance, but there is considerable evidence that resistance training when combined with aerobic training leads to higher metabolic rate and more weight loss than aerobic training alone.
Improved Self Image: This is just my opinion and experience, but I believe that maintaining strength, physical capability and muscle mass is has a positive effect on self-image. I know I feel better about myself when I feel strong and fit. Resistance exercises are a key to this for me.
If you believe in the benefits of resistance exercise how should you go about setting up a program? First be real with yourself. Set goals that you believe are possible, sustainable and affordable. You can go to a gym, buy free weights or machines for home, or simply do exercises using your own body weight like pushups, pull-ups, and squats. Rubber band type resistance equipment is inexpensive and very effective. Secondly aim for 3 days a week for resistance exercise. Taking a day between training sessions gives the muscles exercised time to recover and grow. Third learn from Milo of Croton in that progressive overload is the principle behind steadily increasing strength. You don’t need a calf to carry every day until it has grown. Just start with exercises where 8-15 repetitions lead to fatigue. Once this is easy, slightly increase the resistance. Keep increasing the resistance as the exercise becomes easy. Last if a certain exercise leads to persistent pain, change something rather that thinking you can work through the pain. Often some minor change may avoid an overuse injury.
Add resistance training to your regular exercise to reap the full benefits of exercise. Enjoy.
At any holiday we tend to get out of our normal routines, and from a health standpoint some people can find themselves at risk of making choices that put them at serious risk. Here are some situations to avoid. Most involve people with specific medical conditions, but some apply to all of us.
Don’t let the holiday with the sometimes strong emotions, family discord, or memories tempt you to fall back to destructive habits like alcohol or tobacco. I see too many patients after the holidays each year who have relapsed at this time of year.
If you have congestive heart failure, don’t eat too much high sodium food. Emergency rooms see patients every holiday who consume too much hidden salt in foods at their family feasts, and decompensate.
If you travel don’t forget your medications. If you do forget, figure out a way to get needed meds. Find out if your pharmacy can transfer your prescription to a pharmacy near where you are staying.
Be aware that holidays can be emotionally challenging. If you struggle with depression, be aware that this time of year can be difficult. Take care to get enough sleep, enough exercise, to eat well, and just take good care of yourself. If you feel terribly depressed, and suicide is a concern, get help. Watch out for depression in those around you.
Overeating is typical at holiday get-togethers. Accept this, and focus on the rest of the holiday period. Don’t let one or two meals get you out of your usual healthy eating routines.
New Year’s resolutions are fine, but don’t let the anticipation of a New Year’s resolution lead you to completely overdoing it regards to eating and drinking up until Jan. 1.
If you have good ideas to add to the list, please leave a comment.
After nearly 25 years in practice as a family doctor I have accumulated a large number of patients with diabetes. Every day I see several patients for help managing their diabetes, and realize that many of them can use a bit of extra encouragement. I have set up @diabetictweets account to allow any patients with diabetes to get frequent words of encouragement and bits of advice I hope will be helpful. I’ll also add tweets with links to articles and posts I think may be of interest. Feel free to pass this on to your friends, patients, and anyone you feel may be interested.
Research shows that women do of course sweat, and like men sweat more with exercise. The difference is in volume of sweat. A recent study in the Journal of Experimental Physiology found that women, whether fit or not, are less able to use sweating to get rid of body heat than men. This is expecially true of unfit women. An article in the NY Times by Gretchen Reynolds discusses the results of a simple but interesting study where fit and unfit men and women are evaluated for their sweat production, body temperature, and physiologic responses to exercise in a hot environment. It shows once again that men and women are different.
Growing up in the 1960’s I thought of radicals as people who protested Vietnam, took LSD, or burned flags or bras. In medical school I learned about free radicals, molecules produced in our bodies as a part of metabolism that have been linked with all sorts of bad things like cell damage and atherosclerosis. When we exercise our muscles produce lots of free radicals, and in response some people take antioxidant vitamins to try to prevent the production of free radicals from exercise. A rule of thumb over the years has been that trying to use supplemental vitamins or other products often is less effective than we would hope, and may have consequences we didn’t plan on. Tara Parker Pope’s Well section in the NY Times has an article informing us that we may want to “Free the Free Radicals.” Enjoy.
In this week’s issue of the Annals of Internal Medicine (unfortunately you need a subscription to see the article) Dr. Andrew Gray MD, and Mark Bolland PhD write an interesting editorial called Vitamin D: A Place in the Sun. In it they discuss the current flood of claims for health benefits of vitamin D. When analyzing a finding such as the link between Vitamin D levels and a disease state, one of the most difficult aspects is to control for “confounding variables.” The definition of a confounding variable in The Free Dictionary online is, “interference by a third variable so as to distort the association being studied between two other variables, because of a strong relationship with both of the other variables.” Low vitamin D levels are associated with such potential confounding variables as obesity, sedentary lifestyle, and lack of sunlight exposure. These conditions and others are potentially associated with depression, diabetes, and many of the other conditions for which low vitamin D levels has been suggested as a risk factor Hence the concern about confounding variables not accounted for in the association of these conditions with vitamin D. This is elegantly stated in these authors middle paragraph of their editorial:
“Although some evidence from preclinical studies suggests thatcomponents of the vitamin D system might impact favorably onsome diseases,4 it seems intuitively unlikely that a singlehormone could play a substantial role in preventing or amelioratingthe diverse range of diseases that have been linked to low levelsof vitamin D. A more plausible and prosaic explanation for thefindings of the observational vitamin D studies is the presenceof common confounders. Vitamin D levels are directly relatedto sunlight exposure and physical activity, and inversely relatedto adiposity.5-6 It is likely that less healthy individuals,who are more likely to subsequently experience morbid events,will be heavier, less active, and more sunlight-deprived thanhealthier ones and therefore have lower levels of 25(OH)D. Thisnotion is supported by previous studies7and by the study ofLlewellyn et al,2 in which several indices of poor health weremore commonly observed at baseline in those with lower levelsof vitamin D. Thus, low vitamin D levels may simply be a markerfor lower health status rather than a cause of it. Healthinessis difficult to measure and adjust for, as illustrated by thedisparate results of observational studies and randomized controlledtrials (RCTs) of postmenopausal hormone therapy and cardiovasculardisease or antioxidant treatment and cardiovascular diseaseand cancer.8-11 We should therefore treat the data from observationalstudies of vitamin D with caution.”
Although low vitamin D levels are associated with multiple conditions it will be interesting to see if supplementation of vitamin D lowers the risk of these conditions or whether only improving the confounding conditions, like more exercise, lower levels of obesity, more sunlight, etc. works to prevent the medical conditions. It will sure be nice if just taking those nice small, easy to swallow yellow capsules works, but as for me I remain skeptical.
Most of us who exercise believe that exercise just makes us feel better, sleep better, look better and be better. In today’s NY Times is a very nice article on exercise and brain regeneration and growth. Enjoy:
What goes on inside your brain when you exercise? That question has preoccupied a growing number of scientists in recent years, as well as many of us who exercise. In the late 1990s, Dr. Fred Gage and his colleagues at the Laboratory of Genetics at the Salk Institute in San Diego elegantly proved that human and animal brains produce new brain cells (a process called neurogenesis) and that exercise increases neurogenesis. The brains of mice and rats that were allowed to run on wheels pulsed with vigorous, newly born neurons, and those animals then breezed through mazes and other tests of rodent I.Q., showing that neurogenesis improves thinking. Read the full article
I am amazed sometimes at the things my patients do to (for?) themselves in the name of trying to find natural ways to be more healthy. Even more amazing to me is the incredibly unnatural things they do that they natural. We are in a society where doing unnatural things to be more natural is the natural thing to do. Mainstream western medicine is almost by definition unnatural. We try to encourage patients to do what is not natural to them in terms of lifestyle behavior modification(if it was natural to eat well, exercise more, stay thin, etc. we would be doing it). We give medications and do procedures and tests to find and cure natural diseases like diabetes, pneumonia, strep throat, appendicitis, … The increased life expectancy and improved health of first world citizens has come about in large part by unnaturally supplying clean water, unnaturally separating sewer from drinking water supplies, and immunizing against and treating natural diseases. We almost eliminated childhood rickets by adding vitamin D to the bread and mild supplies. We prevent tooth decay by using fluoride containing toothpaste and getting preventative dentistry. As a society we seem behave in a way that supports our belief that preventing diseases and improving health by unnatural means is a desirable goal Yet there is something alluring about the word natural. I see ads for natural makeup, natural foods, and natural medications. Here are some of the most unnatural things I can think of that patients do to themselves, often at the advice of a naturopath:
Enemas of all types: Naturally things come out of the anus, and move from top to bottom on the gastrointestinal tract. Is there much less natural than squirting stuff up your rectum? I hear about coffee enemas, and nearly every web site about naturopathic remedies has an enema product to sell usually priced at $60-80 for proprietary ingredients. The theory is that somehow removing the waste material from the distal bowel improves bowel function and overall health. Does it work? I doubt it, but whether it works or not, it is a stretch to call it natural to squirt coffee up your rectum.
Mega doses of vitamins: Naturally our food contains small to modest doses of vitamins. There is some evidence in this day of eating a lot of refined foods we may miss out on some trace minerals and vitamins. A multiple vitamin daily is probably reasonable for many people. There is some evidence that higher doses of some vitamins, especially vitamin D is beneficial. Yet I see many patients who spend a large percent of their limited income on large amounts of redundant vitamins, usually of a proprietary and therefore expensive brand, in hopes of improving their health. This is both unnatural and of unproven efficacy. I often see patients on a multiple vitamin, two or three types of B-complex vitamins, supplemental vitamins C, D,E, B-12, co-enzyme Q-10, calcium, other minerals, and often also mixtures of so many other ingredients I cannot read all the labels in less than several minutes. This seems nuts to me. Spending this money on fresh fruits and vegetables would be far more likely to help, and would truly be natural.
Natural herbal supplements: Somehow if a substance is derived from plant matter it seems to be assumed to be healthy. Obviously some famous exceptions exist, hemlock, nightshade, etc. I appreciate that Eastern medicine, and possibly native American healers have some basis for their remedies, but I doubt that the sales people at the mega-supplement stores have the expertise to help patients be more healthy, and instead primarily make their bosses more wealthy. Taken at the recommendation of a bonefide naturopathic practitioner or other expert these may be reasonable, but taken at the advice of a retail salesperson they are sketchy at best.
Healthy Fruits – Healthy Vegetables:Brooke Douglas RD Tells All
Brooke Douglas RD is back with her first of the month post, this time telling us about healthy fruits and healthy vegetables. Don’t miss a word.
Almost Everything You Ever Wanted to Know About Fruits and Vegetables
Research shows that people who eat even 2½ cups of fruits and vegetables a day have only half the cancer risk of those who eat less than one cup a day. Hundreds of studies show that increased fruit and vegetable consumption may also help prevent heart disease, stroke, hypertension, birth defects, cataracts, diabetes, obesity and other serious conditions.
Healthy Fruits and vegetables are nutritional powerhouses which:
Vitamins and minerals: Are essential in maintaining the health of the brain, heart, bones, teeth and nerves; making/repairing red blood cells; regulating body’s balance of fluids; and in other vital functions.
Many healthy fruits and vegetables are particularly good sources of vitamins A, C, E and K, some B vitamins, and many important minerals needed for healthy bodies. Beta-carotene and related compounds called carotenoids are converted by the body to Vitamin A. Carotenoids are found in high concentrations in carrots and other orange and yellow vegetables and fruits such as winter squash and cantaloupes. Dark green, leafy vegetables, such as spinach, kale, broccoli, and other members of the cabbage family, also contain high concentrations of carotenoids.
Dark green vegetables are also excellent sources of folic acid (a B vitamin needed during pregnancy to reduce the risk of neural defects in the fetus), Vitamins E and K, and minerals such as calcium, magnesium, manganese, iron, and potassium. Many fruits are also a good source of minerals, such as chromium (grapes), iron (cherries), manganese (pineapple), and potassium (apricots, bananas, orange juice, peaches and prunes).
Citrus fruits are good sources of Vitamin C, as is the family of plants that includes tomatoes, red and green peppers, potatoes, and eggplant. Other good sources of Vitamin C include papayas, strawberries, kiwis, cantaloupe, and the cabbage family, including broccoli, cauliflower and Brussels sprouts.
While there is overlap in the vitamins/minerals supplied by fruits and vegetables, you need a wide variety of colorful healthy fruits and vegetables to fully benefit from the various nutrients they contain.
Antioxidants: Disease-fighting compounds found in many foods, especially healthy fruits and vegetables. Antioxidants neutralize free radicals (compounds that damage cells and lead to cardiovascular disease, cancer, cataracts, premature aging, and impaired immunity.) Antioxidants include vitamins A, C, and E; beta carotene, minerals (selenium, copper, zinc, and manganese) and some of the phytochemicals.
Phytochemicals: From plants, “plant chemicals” are recognized as powerful disease-fighting compounds. Fruits and vegetables contain thousands of different phytochemical compounds. Categorized as carotenoids, flavenoids (compounds that give flavor/colors to fruit/veg), and other compounds, such as allicin, indoles, lycopenes, lutein, and phenols. Scientists studying phytochemicals are finding an impressive range of health benefits.
Not all foods listed above, even within the same group, have the same health benefits. Foods with the same phytochemicals may contain different concentrations of the phytochemicals, and the compounds may be absorbed differently. Even different varieties of foods within the same category (such as different varieties of apples or lettuce) may contain widely varying concentrations and kinds of phytochemicals. However, those darker in color usually contain higher concentrations. So think “more color and more variety” in making your selections!
What is considered one serving of fruit?
What is considered one serving of vegetables?
How Can I Get More…Healthy Fruits and Vegetables in My Diet?
At home:
When dining out: