Posts Tagged ‘processed foods’

Dr. Siegel’s Interview on “Best In Health Radio”

May 18, 2013

Audio podcast of Shira Litwack of Toronto’s “Best In Health Radio) and Dr. Andrew Siegel’s illuminating discussion of “promiscuous eating” behaviors, delving into cravings; addictive foods; mindfulness; our relationship with what we eat; Freud; neuroplasticity; food stress; why we eat; processed foods; exercise; and setting a good example for children.

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The Skinny On Salt

October 26, 2012

 

Andrew Siegel, M.D.   Blog # 81

Most of us adore our saltshakers and put them to frequent use.  Salting our foods enhances taste—imagine how bland French fries, scrambled eggs or popcorn would be without salt (aka sodium).  Salt also serves a function as a food preservative and played an important role as such in the days before refrigeration was widely available.  Historically, salt has been a valuable commodity. Think for a moment of all of the salt idioms used in our English language, many of which that convey the value of this essential mineral: “Salt of the earth”; “Worth one’s salt”; “Back to the salt mines”; “Rub salt in a wound”; “To salt away.”

Sodium is an important mineral, a critical electrolyte in terms of regulating fluid exchange within the body compartments, including membrane permeability in cells, nerve conduction, and muscle cell contraction of skeletal, smooth and cardiac muscles. However, when consumed in excess, it can wreak havoc on our bodies. Unfortunately, the majority of Americans consume more than twice the recommended upper limit of sodium, with most of us eating/drinking about 3400 mg sodium daily.

Excessive sodium intake increases our blood volume, which causes increased pressure within the arterial walls, known as hypertension.  Hypertension within the arterial walls contributes to the following serious ailments: coronary artery disease; aneurysms; stroke; congestive heart failure; and kidney disease.  These cardiovascular diseases are the leading causes of death in the USA.  So clearly, excess sodium intake contributes to the hypertension present in at least one of three Americans; this hypertension in turn is linked to cardiovascular disease and death.  Excess dietary sodium also promotes fluid retention and edema.

Although the recommended daily allowance of sodium is 2300 mg (one teaspoon), our bodies actually only require 500 mg of sodium daily, and most Americans would do well to consume no more than 1500 mg daily.

Sources of sodium include table salt, pickles, olives, canned soups, luncheon meats and deli products, cheeses in general and cottage cheese in particular, and bread.  Pizza is very high in sodium.  Snack foods such as chips, pretzels, and popcorn pack a load of sodium.  Condiments and salad dressings are major culprits as are processed, prepared foods, fast foods and many sauces including tomato, soy, Worcestershire and Tabasco. Chinese food and Mexican food are often bathed in salt.  Flavor enhancers such as Accent, for example, are mono-sodium glutamate and are thus very high in sodium.  Restaurant meals are a major source of sodium.  That gyro that I consumed for dinner the other evening was so salt-laden that I was thirsty all evening and the following morning I had trouble getting my wedding ring on!

Generally speaking, roughly 80% of our sodium comes from processed foods and restaurant dining, 10% occurs naturally, 5% is added at the table and 5% is added during cooking.

What To Do:

Lowering salt intake is an inexpensive and practical way to make a major impact on our overall cardiovascular health and avoid morbidity and mortality:

  • Increase potassium intake by eating more potassium-rich foods including root vegetables; sweet potatoes; green, leafy vegetables; grapes; yogurt; and tuna. (Increasing our potassium intake helps to lower blood pressure by blunting the effects of sodium.)
  • Use salt substitutes such as potassium chloride.
  • Read food labels carefully and compare brands—you might be shocked at how many foods that you would not expect have very high levels of sodium.
  • The less processed the better in terms of sodium content—in general, the more highly processed foods have more ingredients, are touched by more hands, and are usually located in the central area of supermarkets.
  • Avoid “instant” foods that are often high in sodium, e.g., Ramen noodles and Rice-a-Roni.
  • Use alternative flavors: think spicy (like chili or red peppers) instead of salty.
  • Eat fresh foods including fresh fruits and vegetables, which are extremely low in sodium.
  • Any animal product will have some degree of sodium as sodium it is a vital chemical to biological existence. Even a glass of milk will have over 100 mg of sodium.
  • Rinse off canned vegetables, tuna, etc.
  • The DASH diet (Dietary Approaches to Stop Hypertension) can be a very effective approach to lowering sodium consumption.

Take everything you read with a grain of salt, but trust me on this one—take your salt in moderation and your body will thank you!

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food: www.promiscuouseating.com

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Gluttony, Sloth, & Cardiac Care or Healthy Lifestyle & Wellness

February 4, 2012

Blog # 44   Andrew Siegel, M.D.

 

February is American Heart Month, so I put my heart into this narrative about this amazingly engineered, all-important organ that serves us tirelessly and relentlessly. Like our pet canines, this organ requires to be  well fed, to be exercised, and to be given tender loving care.  Be kind to it and it will return the favor big time.

Two hundred years ago, the following words on angina pectoris (chest pain from coronary artery occlusion) from John Warren, M.D. were published in the very first issue of the New England Journal of Medicine and Surgery:

The disease itself is excited more especially upon walking up hill,

and after a meal; that thus excited, it is accompanied with a sensation,

which threatens instant death if the motion is persisted in;

and that on stopping, the distress immediately abates, or altogether subsides.

 

Two centuries later, we are infinitely wiser regarding the diagnosis and management of heart disease, yet unfortunately this illness is more prevalent than ever.  The saddest aspect of this is that coronary artery disease is largely a preventable and avoidable problem.  Every day, many hearts are broken because of the premature and unnecessary demise of loved ones who succumb to cardiac disease. It is my heart’s desire that we become better caretakers of ourselves and avoid the 600,000 deaths to heart disease and 130,000 deaths to strokes that occur every year in the USA.

Cardiovascular disease (CVD), including heart disease and stroke, is the number one cause of death in the USA and other industrial countries.  The only year since 1900 in which CVD was not the leading cause of death was in 1918, the year of the influenza pandemic.  CVD is also the leading cause of death in every region of the world except for sub-Saharan Africa.  The burden of CVD is increasing because of our longer life spans, continued tobacco use, physical inactivity, unhealthy food consumption, obesity, high blood pressure, elevated LDL cholesterol and prevalence of type 2-diabetes.

The following paragraph is a brief historical perspective of some of the important medical advances with respect to the management of heart disease.  The 50-year cardiovascular Framingham study (1948-1998) linked high blood pressure and high cholesterol with angina and heart attacks and originated the novel concept that coronary artery disease and its complications could be prevented.  The advent of the coronary care unit (CCU) vastly decreased the death rate of patients admitted with acute heart attacks by provided sophisticated monitoring with electrocardiograms, closed chest cardiac massage, and external defibrillation (using electric paddles to shock the heart back into a normal rhythm).   Cardiac catheterization and coronary arteriography lead to the birth of cardiac surgery and coronary revascularization (coronary artery bypass).  The field of interventional cardiology enabled balloon angioplasty revascularization of occluded coronary arteries without the need for cracking one’s chest open, using access through a thigh artery.  Cardiac stents, initially metal and currently drug eluting, were developed to prevent coronary re-occlusion.  Statin medications to lower LDL-cholesterol levels and many new and potent cardiac drugs have provided significant advances.  Implantable pacemakers and implantable pacemaker-ventricular defibrillators have further improved the prognosis of those suffering with cardiovascular disease. Sophisticated tests including echocardiograms, treadmill tests, isotope stress tests, Holter monitoring, and computerized tomography of the heart are readily available to help pinpoint the precise cardiac diagnosis.

Despite all of the aforementioned incredible technological advances, coronary artery disease remains highly prevalent and is a major widow-maker and widower-maker.  Why?  It’s really very simple—those all-important, tiny blood vessels that provide the lifeline of blood flow of oxygen and nutrients to that vital organ that pumps our blood 24/7/365 get blocked with fatty plaques.  With clogged coronary arteries, when increased demand is placed on our life-sustaining pump, not enough oxygen can get delivered through the compromised coronary arteries and we develop angina and possibly sustain damage to the heart muscle (a myocardial infarction or heart attack) or its electrical conduction system (an arrhythmia).  Tragically, this compromise to our heart and blood vessels is too often self-induced through bad eating habits, physical inactivity, and the use of tobacco.

To quote the insightful and poetic Dr. David Katz who says it all:

“We are all offspring of predecessors who lived in a world where calories were relatively scarce and hard to get, and physical activity constant, arduous and unavoidable. We now live in a world where physical activity is scarce and hard  to get, and calories constant, effortless and unavoidable.

Atherosclerosis is the process that gives rise to the fatty plaques in our arterial walls that compromise blood flow to our organs.  Atherosclerosisis a chronic arterial inflammation that develops slowly, gradually and progressively over many years.  It happens in response to the biological effects of risk factors.  It begins with changes in the endothelial cells, the unique cells that line arteries.  When subjected to these risk factors, endothelial cells change their permeability and allow white blood cells and LDL cholesterol entrance into the cells.  The risk factors include the following:

  • high blood pressure within the arteries
  • oxidative stress from free radicals (highly reactive molecules known as free radicals are created as a consequence of how our body reacts with oxygen; these interact with other molecules within cells and cause oxidative damage)
  • biochemical stimuli (chemicals from tobacco, high levels of bad fats like LDL cholesterol in the blood, food toxins)
  • inflammatory factors

The presence of white blood cells and LDL cholesterol within the endothelial cells gives rise to a cascade of chemical reactions that causes proliferation of both endothelial and smooth muscle cells and the formation of plaques.  Plaques lead to symptoms by restricting flow through the arteries involved, or alternatively, by provoking clotting that interrupts blood flow.  If the plaque ruptures, more clotting will occur at the site of the disruption, perpetuating the restricted flow, and additionally, the ruptured plaque can travel and jam other blood vessels.  LDL cholesterol is clearly a major culprit and atherosclerosis occurs in direct proportion to LDL levels.

Occlusion of the coronary arteries is a big deal because damage of the blood flow to the heart—the most important organ in our body—is a major concern.  However, it is important to know that the process of atherosclerosis is by no means unique to the heart—it is just that the effects of atherosclerosis on the heart—including angina, heart attacks, arrhythmias and death—are ever so dramatic.  It is critical to realize that if you have atherosclerosis in your coronary arteries, you can bet you have it in every artery in the body—including the aorta and those arteries providing blood to the brain, kidneys, intestines, legs, genitals, etc.  This can give rise to strokes or transient ischemic attacks, kidney disease, pain in the abdomen after meals, pain in the legs when walking, sexual dysfunction, etc.  Suffice it to say that intact blood flow to transport oxygen and nutrients to every cell in our body is our lifeline and we don’t want it compromised.

It is nothing short of wonderful that the medical fields of cardiology and cardiovascular surgery have become so evolved and sophisticated and that we have the medical and surgical resources to manage CVD so well.  Countless lives and loved ones have been saved from premature deaths.  That being the case, I must make an appeal from the bottom of my heart for preventive and pre-emptive measures that can keep the disease away and the cardiac team at bay.  Nature and nurture have roles in CVD and we can’t do a thing about the genetic blueprint that we inherited from our parents that can predispose us to CVD, but we do have incredible power to shape our health destiny with our lifestyle.  In my heart of hearts, I can assure you the truth and the validity of the following statement: Genes load the gun, but lifestyle pulls the trigger.  Even if genetics has been unkind to you, you have the authority and choice to pull the trigger, keep your finger on the trigger, or withdraw your finger from the trigger.

Prostate cancer is the number one cancer in men and one that I spend a great deal of my time managing and treating. Can you guess what the leading cause of death is in prostate cancer patients?  If your answer was prostate cancer, you are wrong.  The leading cause of death in men with prostate cancer is CVD.  After CVD, cancer happens to be the second leading cause of death in the USA and in most developed countries.  Most of our knowledge regarding lifestyle and dietary change for CVD prevention applies to cancer prevention as well.  One of the most dramatic reductions in both CVD and cancer has been through smoking cessation.   A heart-healthy diet and lifestyle will contribute to health improvements in every part of our human anatomy, whether it is the heart, colon, prostate or genitals.

As individuals, we must take responsibility for our health and make every effort towards maximizing our fitness and well-being.  We are the stewards of our own health destiny—no one else is.  Yes, we have physicians, sophisticated diagnostic tests, medications and surgery to help us when things go south, but simply by being smart and living a healthy lifestyle, we can avoid personal grief and the grief of our families.

Please take the following advice to heart:

Pearls to keep your heart ** healthy:

  1.  No smoking or tobacco
  2.  Maintain a healthy weight
  3.  Eat a healthy diet: nutrient-dense, non-processed, whole foods; lean protein including seafood which is abundant in heart-healthy omega-3 fats; eat meat and dairy sparingly (use fat-free dairy products); fruits, vegetables and legumes; nuts and seeds; whole-grain carbohydrates
  4.  Exercise daily: walking is great, but try to get some exercise that makes you sweat, breathe hard and gets your heart pumping. Exercise is all about adaptation. Our hearts and bodies are remarkably adaptable to the “stresses” that we place upon them, whether they be vigorous exercise or sitting on the couch.   
  5.  See a medical doctor for periodic health check-ups: don’t take better care of your car than you do of yourself!
  6.  Minimize and manage stress
  7.  Know your blood pressure and cholesterol levels and maintain them at healthy levels

 ** And every other organ in your body as well.

 

Heartfully Yours,

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

www.PromiscuousEating.com

What Is The Best Diet For Us?

August 6, 2011

What is the best type of diet for us?  There are a lot of zealots and fanatics out there touting the advantages of one diet over another.  What to believe?

Vegetarian? Vegan?  Raw? Flexitarian (mostly vegetarian, but some meat)?  Pescatarian (fish)?   Paleolithic (like our cavemen ancestors)?  Carnivorous (like lions)?  Herbivorous (like deer)?  Granivorous (nuts and seeds) like squirrels?  Frugivorous (fruits) like lemurs?  Foliovorous  (leaves) like koalas?  Omnivorous?

When it comes to eating—like religion—I don’t like other people foisting their views on me.  That stated, when it comes to diet, eating and nutrition, there are some basic facts that are relevant to our health and wellness. In our modern society, if you want to stay on track regarding diet and weight, it is not so much what you choose to eat, but what you elect not to eat that count.  Essentially, by avoiding the “bad,” by default you will be fueling yourself with the “good.”  In other words, there are a great variety of healthy, high quality foods that can nourish us, and it is not important what your specific choices are as long as there is balance, sufficient intake of macro-nutrients (protein, fats and carbs) and micro-nutrients (vitamins and minerals), and avoidance of excessive calories. The key is to stay away from processed, reconstituted, unhealthy, mystery, faux foods. Processed food can be defined as real food that has been altered in order to lower its production cost, lengthen its shelf life, make it look more appealing and make us want to eat more of it, resulting in a reduction of nutritional content and an increase in chemicals, dyes, preservatives and toxins.

Humans are remarkably omnivorous, meaning that there are a great variety of different foods—plants and animal in origin—that can both provide energy for our metabolic processes and sustain us in terms of cellular and tissue replenishment. Regarding what to eat to maintain good health, the celebrated author Michael Pollen famously stated: Eat food, not too much, mostly plants.  I borrow his maxim and reverse it in an effort to summarize what to eat to promote poor health: Eat imitation food, eat a lot of it, mostly animal-based. And there we have the Western diet—processed foods, lots of meats, refined carbs, fats and sugar—the eating style that has contributed to two-thirds of Americans being overweight or obese. The Western diet is largely responsible for the diseases of Western civilization, namely hypertension, diabetes, cardiovascular disease and some cancers.

Processed garbage foods are ubiquitous in the United States of Obesity. These run the gamut from doughnuts to hot dogs to the myriad of chemical-laden, nutritionally-depleted food-like substances that are readily available, aggressively marketed and promoted, relatively inexpensive, and potentially addictive.  Fast foods, junk foods and many packaged foods—cheap, easy, and a staple of many adults and children—are in this category. Much of this is not actually food, but enhanced food-like matter, highly processed and laden with additives, preservatives, and loaded with fat, sugar, salt and other chemicals (most of which are unknown, unpronounceable, unrecognizable, un-food-like concoctions)—engineered in a science lab.  The “killer” triad of processing is enriched wheat flour, high fructose corn syrup and partially hydrogenated vegetable oils.  In contrast to wholesome, slow-digesting, natural foods that contain abundant fiber—which slows and regulates glucose absorption and leaves us feeling full and satisfied—nutritionally-void, packaged foods laden with fat, sugar, and salt promote addiction.  These highly-refined food substances are essentially pre-chewed, pre-digested, melts-in-your-mouth adult baby food that is absorbed very rapidly because of the fiber-stripping and refinement process.

The term processed is a derivative of the word procession. A procession is a movement that occurs in an orderly fashion, for example, a parade. The procession that results in processed food on our plates involves the farmer, the processor, the baker, the distributor, the retailer, and ultimately us, the consumer. For example, wheat is grown and harvested by the farmer and the process of threshing separates the wheat kernels from the chaff (husks of the wheat grains). The process of milling enables the wheat kernel components to be separated such that the bran and germ are removed, leaving the pure, silky, highly refined powder that we know as wheat flour. This wheat flour is then used as one of the many unhealthy components of processed foods, for example—a Twinkie. After the Twinkie is configured, baked, sealed in plastic wrap and boxed, the distributor trucks and ships the product to our local supermarket retailer where it can be purchased. So what starts out as a healthy and natural grain, after much processing, ends up as unhealthy junk food. The final product bears little relationship to the original farmed product. The bottom line is that the more that is done to our food, the more it gets depleted of its nutritional value.

Remember the game called “telephone” we used to play when we were kids? A bunch of us would sit in a circle and the first person would whisper a few sentences into the ear of the person sitting next to him or her. That person would repeat it to the next person, and soon around the circle. The last person would announce the message they heard. The message that the final person announced was virtually always very different and distorted from the original message, usually in a very funny way. My point is that the processing of food is not unlike this game in that the final product bears little, if any, relationship to the original, with each step in the production process resulting in increasing adulteration.

Minimizing one’s exposure to processed foods, as difficult as that might be, is a noble idea in terms of avoiding being overweight or obese and maintaining good health. Examples of processed foods are: Pop Tarts, Hostess Twinkies, Spam, Doritos…the list is virtually endless. Processed foods can be as detrimental to our health as tobacco has been proven to be, contributing to diabetes, obesity, hypertension, cardiovascular disease and cancer.

As much as I am denigrating processed foods, it is important to understand that not all processed foods are bad and that food processing is a necessity. We cannot all be farmers and grow a variety of vegetables and fruits and raise cattle and other livestock and must rely upon intermediaries to transform a raw product such as wheat grain into an edible form. However, the desirable goal is to eat a healthy, nutritious, robust, wholesome processed product, for example, 100% whole grain wheat bread vs. the infamous un-wholesome Twinkie. Obviously, the closer any food item resembles its original and natural form, the healthier it is, but many original forms do need to be processed to some extent to make the food available to us. In general, real food comes from the earth and not the laboratory, and the less processing the better. The corollary of this is that the more processed and highly altered the food is, the less nutritious—and oftentimes more hazardous—it becomes.  Processed foods in addition to being unhealthy and nutritionally void, have an abundance of sugar, salt, fat, additives, preservatives, flavor enhancers, chemicals, and dyes. Some processed foods are filled with mystery components. Often, to make up for loss of nutrients during processing, synthetic vitamins and minerals are added.

I am a pragmatist and am not advocating absolute purism with complete avoidance of processed and junk foods, but am a big supporter of minimizing our intake of them.  I suggest making a concerted effort to eat healthy, wholesome and natural foods as much as possible, but the occasional succumbing to the urge and craving to consume some processed junk food is acceptable…everything in moderation.

Bottom line: In my opinion, the healthiest kind of diet is a non-processed diet.  Any diet that provides sufficient but not excessive calories, is balanced in terms of macro and micronutrients, and is largely non-processed should prove to be a healthy diet. Non-processed will ensure the intake of an abundance of natural and wholesome foods.  The surest way to ruin the health benefits of a vegetarian or a vegan diet—those diets that are touted as quite healthy—is to couple them with the intake of processed foods!  There are way too many vegetarians who are overweight for this reason.  I am an omnivore who espouses avoiding processed foods and encourages a diet that emphasizes vegetables, fruits, legumes, whole grains, and lean animal products in moderation. I believe that if this kind of diet was adhered to, it would contribute positively to curtailing the American obesity epidemic.

Andrew Siegel, M.D.

This is just a taste of what you will find in Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food. The website for the book is: www.promiscuouseating.com.

It provides information on the book, a trailer, excerpts, ordering instructions, as well as links to a wealth of excellent resources on healthy living.  It is also available on Amazon Kindle.

To see my YouTube video on Processed Foods: