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The Healing Power of Food. by Sue Stone MD. "Der Mensch ist, was er isst.“ "Man is what he eats.“ Ludwig Feuerbach (1804-1872). Objectives. Describe the scientific foundations and principles of a healthy diet.

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    1. The Healing Power of Food by Sue Stone MD

    2. "Der Mensch ist, was er isst.“ "Man is what he eats.“ Ludwig Feuerbach (1804-1872)

    3. Objectives • Describe the scientific foundations and principles of a healthy diet. • Inspire you incorporate these principles into your practice and teach nutrition to your patients • Recognize how specific foods and dietary modifications can be used to treat specific diseases

    4. Why teach nutrition to our patients? • Essential to maintaining wellness • Most disease states respond, at least in part, to dietary manipulation • The over-enthusiastic prescribing of a single supplement, out of context, can lead to lack of, or negative effects; food provides a balanced, effective “team” approach to obtaining nutrients

    5. Ten Principles of Good Nutrition • Eat a plant-based predominantly vegetarian diet • Modify fat intake • Eliminate refined sugar • Reduce exposure to pesticides, herbicides, and added growth factors • Eliminate food additives and coloring agents

    6. Ten Principles of Good Nutrition 6. Keep salt intake low, potassium high 7. Drink 32-48 ounces of water daily 8. Identify and address food allergies (sensitivities) 9. Determine caloric need 10. Eat 25-35 gm of fiber daily

    7. Stick with the basics • 50% vegetables & fruit • Organic: pesticide, hormone & antibiotic free • 15-25% fat • 15-20% protein • 55%-65% carbohydrate • Low-fat vs types of fats • Include non-animal sources of protein • Types of carbs—glycemic index, fiber • Sugar: refined vs unrefined • 25-35 gm of fiber daily

    8. My Pyramid--USDA • Grains 6 oz • Vegetables 2.5 C • Fruits 2 C • Milk 3 C • Meat/beans 5.5 oz

    9. Ten Principles of Good Nutrition • Eat a plant-based predominantly vegetarian diet • Modify fat intake • Eliminate refined sugar • Reduce exposure to pesticides, herbicides, and added growth factors • Eliminate food additives and coloring agents

    10. Eat a predominantly plant-based diet • Evolutionary and anatomical evidence that only 1.5% of our diet should be animal-based foods, not 50% • Fat content of domesticated animals is 25-30%, primarily saturated; wild game is 4% w/ 5X more PUFA especially omega 3’s • Cardiovascular and chronic degenerative diseases • Fiber and phytochemicals

    11. Protein • RDA for protein: wt in lbs X .36gm • 150 lb person = 54gm = 2 oz of protein daily • Actually daily protein in US ranges from 63-92 gm—72% from animals

    12. Biological value of protein • Proportion of amino acids that are absorbed, retained and used • In order: whey, egg, milk, fish, beef, soybeans, rice, whole wheat, corn, dry beans • Complete (animal) vs complementary (grains/legumes) • Legumes: peas, beans, peanuts, soybeans, clover (hay) and alfalfa • Nuts: pine nuts, walnuts, seeds

    13. Vegetarian 1000 mmg B12 sublingual if vegan (no dairy, fish or eggs) Monitor iron Encourage soybeans, beans, lentils, chickpeas, cashews, molasses, pumpkin seeds, walnuts, whole grains, seaweed, green leafies, potatoes, sesame & sunflower seeds, apricots

    14. Ten Principles of Good Nutrition • Eat a plant-based predominantly vegetarian diet • Modify fat intake • Eliminate refined sugar • Reduce exposure to pesticides, herbicides, and added growth factors • Eliminate food additives and coloring agents

    15. A Fat primer • Structural components of cell membranes; alteration in cell membrane function (fluidity) • Backbone of eicosanoids: prostaglandins, leukotrines, thromboxanes; critical influence on inflammation and thrombosis • Preferred energy source @ 9 kcals/gm

    16. Types of Fats • Saturated fatty acids • Polyunsaturated fatty acids (PUFA)= omega 3 & 6 • Monounsaturated fatty acids (MUFA)= omega 9 • Trans fatty acids=hydrogenated oils; behave like saturated fat and interfere with the body’s ability to utilize unsaturated fatty acids

    17. Saturated fats • Meat and dairy • Inflammatory • Atherogenic

    18. MUFA • Avocado, nuts & seeds • Olives/ oil • Canola oil • Raises HDL even better than omega-3’s • Non-fattening

    19. Omega 6 fatty acids (a PUFA) Corn, safflower and soybean oils egg yolk, organ meats, and other animal-based foods Processed and packaged foods Way too plentiful in diet Pro-inflammatory Vasoconstrictor Increase platelet aggregation

    20. Omega 3 fatty acids (a PUFA) wild salmon (15:1 ratio of 3’s to 6’s, compared to 3:1) mackerel, herring, halibut, wild trout, swordfish (Hg), blue fin tuna (Hg), anchovies, sardines walnuts, flax seeds, (soy) Anti-inflammatory Reduce platelet aggregation Vasodilator Numerous clinical applications

    21. Diseases linked to insufficient omega 3 fatty acids Acne Allergies Asthma CAD ADD Breast cancer Dementia Depression Diabetes Eczema HTN IBD PMS Cancer Osteoarthritis RA CVD PVD

    22. In a nutshell • Reduce fat to about 25% of diet • Reduce intake of meat and dairy (unless nonfat) • Increase cold water fish such as wild salmon, mackerel, herring, halibut, wild trout, swordfish (Hg), blue fin tuna; also walnuts, flax seeds, soy • Cook with olive, canola, macadamia, or coconut ( is saturated but medium and short-chain) oil • Eliminate trans fatty acids • Get most of your fat from nuts, seeds, legumes, fish and olive oil

    23. Ten Principles of Good Nutrition • Eat a plant-based predominantly vegetarian diet • Modify fat intake • Eliminate refined sugar • Reduce exposure to pesticides, herbicides, and added growth factors • Eliminate food additives and coloring agents

    24. Why are Sugar, HFCS and fructose different?

    25. High fructose corn syrup Glucose + fructose (sugar) processed into a “super sugar” Absorbed more quickly Enters cells quickly without the aid of insulin Fructose Absorbed less than ½ as quickly by intestinal villi

    26. Glycemic Index • Glycemic index = the average blood sugar response over a 2 hour period (area under the curve) of a group of people given the same carbohydrate on more than one occasion • Correlates with insulin response • Glycemic load = GI X gms of CHO per serving • diabetics

    27. Rate of insulin rise Sugar (61) Brown sugar High fructose corn syrup Sucrose Glucose (99) () Glycemic index Pure maple syrup or sugar Molasses Honey (40) Rapadura Cane juice Brown rice syrup Xylitol (8) Fructose (19)

    28. The New Glucose Revolution By Jennie Brand-Miller Ph.D.

    29. Ten Principles of Good Nutrition • Eat a plant-based predominantly vegetarian diet • Modify fat intake • Eliminate refined sugar • Reduce exposure to pesticides, herbicides, and added growth factors • Eliminate food additives and coloring agents

    30. Why Organic? • More nutritious • Free of known carcinogens and many other chemicals, which when acting synergistically cause cancer • Endocrine disruption • The EPA and the FDA do not protect us—we must protect ourselves • Children are particularly susceptible

    31. How important is it? • 110 pesticides used • 34 pesticide residues found by FDA • Organic about twice the $

    32. How important is it? • Generally not sprayed • Full of antioxidants • Organic about 4X the $

    33. EAT ORGANIC!!! Best foods Berries US melon Broccoli Asparagus Carrots Romaine lettuce Oranges Bananas Nectarines Kiwi Pears US grapes radishes Worst foods Strawberries Apples Bell peppers Spinach Cherries Peaches Melon (Mexican) Apricots Green beans Chilean grapes cucumbers

    34. Ten Principles of Good Nutrition 6. Keep salt intake low, potassium high 7. Drink 32-48 ounces of clean water daily 8. Identify and address food allergies (sensitivities) 9. Determine caloric need 10. Eat 25-35 gm of fiber daily

    35. IgG-mediated food sensitivity Dairy Gluten (wheat) Peanuts Soy Eggs Pork Tomatoes Corn Citrus chocolate Autopsy: asthma, chronic rhinitis, chronic OM, eczema Autoimmune disease Autism ADHD Migraines Arthralgias/myalgias Psychiatric disturbance Enuresis insomnia

    36. Ten Principles of Good Nutrition 6. Keep salt intake low, potassium high 7. Drink 32-48 ounces of clean water daily 8. Identify and address food allergies (sensitivities) 9. Determine caloric need 10. Eat 25-35 gm of fiber daily

    37. Fiber has many health benefits • Soluble fiber (oats, Metamucil, apples, legumes) lowers glycemic index by delaying gut emptying • Aids detoxification by increasing transit time and solubility of bile • Decreases blood levels of fats • Improves balance of colonic bacteria • More nutrients for cells in colon (SCFA’s) • Increases secretion of digestive enzymes

    38. A word about caffeine • Raises cholesterol (esp decaf) • Glycogen released from liver causes hypoglycemia and blood sugar instability • Promotes excretion of calcium, potassium, iron, and trace minerals • Elevates cortisol!!! • Irritates urinary tract • Aggravates HTN, insomnia, PMS, IBS., etc………….

    39. And fast food……… Supersize it!! McDonalds supersize fries have 610 calories and 29 gms of fat • Carl’s Jr: CrissCut Fries + double Western Bacon Cheeseburger = 73 gm fat (657 fat calories) • In 40 yrs per capita consumption of sodas has quadrupled • 32 oz coke (‘large’) = 310 calories • Bad quality food with no fiber, bad fats, bad sugars and too much of both • Subway best choice

    40. Nutrient loss due to food preparation and storage • Boiling : 66% loss • Pressure cooking: 47% • Microwaving 70-97% • Blanching/Freezing: 30% (fiber and minerals not affected) • Steaming: minimal impact

    41. Food as Medicine

    42. Let food be your medicine and let medicine be your food. Hippocrates

    43. Cruciferous Vegetables • Cabbage • Broccoli • Brussels sprouts • Cauliflower • Kale • Turnips • Collard greens

    44. Cruciferous Vegetables • help to shift hormone metabolism. Estradiol has a metabolite called 16aOHE1 which has been implicated in breast, cervical and prostate cancer. Even if estrogen levels are normal or high, if the metabolism is shifted in the wrong direction patients maybe at risk. Cruciferous vegetables contain diindolymethane (DIM),indole-3-carbinol (I3C) and Glucaric acid which shift the metabolism towards the 2OHE metabolite of estradiol.

    45. Medicinal Mushrooms • Maitake • Shitake • Reishi • Activity: enhance natural killer cells and other immune cells; reverse chemotherapy-induced neutropenia; anti-tumor; anti-viral; increase interferon levels and tumor necrosis factor; improves macrophage activity

    46. Nutrition and cancer risk Vitamin C, veggies: Fiber & veggies: Lycopene: Green tea: Folic acid: Selenium: Bladder Ca in men Colon CA GI tract & prostate Esophageal CA Colon CA Colon & prostate Ca, and ?melanoma