Exploring the sense and nonsense of food and health

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Dietary Fiber: How Much Do We Need?

Due to the recent attention to the ketogenic diet and other low carbohydrate diets, the issue of getting enough fiber has been questioned.

Just where is the fiber found?  For example, eating a bowl of Raisin Bran with a half-cup of strawberries for breakfast, a sandwich on whole-wheat bread with lettuce, tomatoes and an apple for lunch, eggplant Parmesan for dinner and popcorn for a snack will provide about 26 grams of fiber.

The following table will help to see just where the fiber lies.

Food/serving High Fiber Medium Fiber Low Fiber
Fiber per serv. 4-5 g 2-3 g 0.5-1g
Bread (1 slice) Whole wheat, rye White bread, bagel (1/2), tortilla (1/2), English muffin (1/2), graham crackers (2)
Cereals (1/2 c) All Bran, Bran Buds, 100% Bran Flakes 40% Bran, Shredded Wheast Cheerios, Rice Krispies
Rice and Pasta (1/2 c) Whole-wheat pasta, brown rice Macaroni, pasta, white rice
Fruits (1 med or 1/2 cup Berries, prunes Apple, apricot, banana, orange, raisins Melon, canned fruit, juice
Vegetables (1/2 c) Peas, broccoli, spinach Green beans, carrots, eggplant, cabbage, potatoes with skin, corn Asparagus, cauliflower, lettuce, tomatoes, zuchhini, peppers, potatoes (no skin), onions
Beans (1/2 c) Pinto beans, red kidney beans, black-eyed peas, chickpeas, black beans




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Confused About Diets? Try the N0-Diet Diet


Bread, Olive oil, Parmesan, Garlic

Looking for a good “diet”? It cannot be simpler than this. This blog has consistently emphasized healthy eating – so relax and settle into the Mediterranean Diet. Please click on SEARCH THIS SITE on this blog for Mediterranean Diet and take a look at the myriad of articles and help in incorporating this way of eating whether it is for health and /or weight maintenance.

However, the best diet is the one you choose for your lifestyle – try  Keto, Paleo, Carnivore (the latest  fads). However, honestly, those diets are hard to stick to due to their restrictive nature. You can also check out the Mediterrasian web site located on this blog under Blogroll loaded with recipes  and the research associated a healthy lifestyle. This website combines Mediterranean and Asian foods that are flavorful, healthy and satisfying. Following this way of eating does not restrict foods but encourages “what to eat” in a simple and more precise manner without gimmicks. For more, CLICK HERE.

Bon Appétit !

Sally J. Feltner, PhD, RDN



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Living with Dementia

Alzheimer’s Disease: Risk Factors and What To Do About Them?

By Sally J. Feltner, Ph.D., RDN

The pathogenesis of Alzheimer’s Disease (AD) is very complicated. it is important to examine its etiology and to look for solutions until research can hopefully offer a cure or at least management of the disease. So far this has not happened, so a new approach is presented here. Most of the information comes from a provocative article from the December 2018 issue of Scientific American, titled Alzheimer’s Under Attack: Lifestyle Plans That Improve Brain Health.

Risk Factors Related to Cognitive Decline and AD

Poor diet
Alcohol abuse
Lack of exercise
Head trauma
Small vessel disease
Poor sleep
High blood pressure
High cholesterol
ApoE4 gene

A common myth is that AD is a normal consequence of aging and that nothing much can be done to avoid it. At this point, there are few to none effective or safe drugs for treatment. In addition, lifestyle habit changes do not often come naturally to an aging population. Often we meet the challenges of any chronic disease after symptoms begin to appear. Prevention is more effective against cognitive decline and early Alzheimer symptoms rather than after symptoms become severe. In this state, damage is beginning to show but still may be in the normal range in many cognitive tests.

What Lifestyle Changes Should be Made to Prevent AD?

Much of the research on lifestyle interventions is primarily the result of hundreds of anecdotal stories of people afflicted with some degree of cognitive decline. From the available research, the lifestyle habits for a healthy brain were consolidated into the following conclusions:

  • A whole food plant-based diet rich in fruits, vegetables, beans, whole grains and healthy fats are what the brain needs to have for optimum health.
  • Physical exercise increases both the number of brain cells (neurons) and connections between them (synapses).
  • Chronic stress puts the brain in a highly inflammatory state. This can cause damage and impairment of its capacity to clean and clear it from harmful waste products. In the case of AD, this may refer to the clumping of harmful amyloid plaques and tangles of tau proteins.
  • The process of enough restorative sleep is necessary for cognitive and overall health. During this, the brain can apply its natural cleaning capacities to prevent the back up of housecleaning duties.
  • The brain thrives on higher education and performing complex cognitive activities even later in life.
  • Social support and meaningful associations with the community helps an aging brain to maintain its cognition and functional activities.

Richard Issacson, founder and director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical Center says:

“We’re trying to lay the groundwork for Alzheimer’s prevention and figure out what tools we should be using and what works best.”

  • What do we usually do?
    Lifestyle changes are not easy to follow so in response, Americans attempt to improve their health and make up for lost time by doing the following:
  • We join gyms we hardly ever go to.
  • We fall for any promise of “detoxification.” and “cleansing” schemes by consuming weird concoctions of purported nutrients to rid our bodies of unknown toxins.
  • We buy the latest “superfoods” promised by the food industry to prevent cancer, heart disease, brain health and overall well being.
  • These are obviously ineffective in maintaining our health and certainly not preventive actions.

What are the studies that support diet and AD prevention?

  • The Cardiovascular Health Study revealed that obesity in midlife increased AD dementia by 40%.
  • Columbia University researchers concluded that high insulin levels in elderly people could account for 39% of AD cases.
  • Plant-based diets consistently showed up as heart, kidney and brain protective; not a single study showed any benefits of eating meat.
  • Another study found that a Mediterranean diet reduced risks of mild cognitive Impairment (MCI) by 28% and those who did develop MCI had a 29% lower chance of progressing to AD.
  • The Framingham Longitudinal Study found that daily brisk walks resulted in a 40% lower risk of developing AD later in life.
  • Washington University research showed that sleep-deprived individuals had more amyloid plaques in their brains.
  • Rush University tested the DASH diet, Mediterranean Diet and the MIND diet. All three reduced AD risk but that even moderate adherence to the MIND diet improved brain health.
  • In a 2017 study at Columbia University, participants who ate a plant-based diet had a lower risk of cognitive decline over six years compared to those who ate a Standard American Diet.

The Blue Zone participants from Loma Linda and their lower rate of AD (5%) do not eat much meat and follow a plant-based diet as most Blue Zone residents do. This was in comparison to another adjacent community of San Bernadino, CA.

  • Conclusions
  • Any new approach is likely to be met with skepticism, especially from the medical establishment. Nutrition therapy in general is met with doubt. A clinical trial would be ideal, but almost impossible to conduct. It took at least 100 years before physicians began to believe the germ theory of disease. Dr. Ignaz Semmelweis recognized infectious disease as a factor in the high rate of women dying during childbirth in the 1800’s. He suggested that physicians wash their hands to prevent this occurrence which immediately reduced the death rate. The response from his colleagues ? — Their constant rejection of him sent him to a mental hospital where died ironically from an infection.
  • Healthy lifestyle factors appear to be successful practices in all five of the Blue Zones. Their disease rates are some of the lowest in the world as well as their longevity.  What else have we got to lose?

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The Obesity Epidemic: Why and What Can We Do?

Is it Genes or the Environment?  That is the big question on why the obesity epidemic happened in the first place. It is becoming apparent (my opinion) that since the 1960 ‘s something happened in our food environment that caused this serious public health problem and no one seems to quite know what to do about it .Preview (opens in a new window)

Many causes have been suggested.  Collectively, most likely, all have had some influence. On the list is portion size, increased food availability (restaurant and fast foods), stress and lack of sleep, ultra-processed foods (food in a box), sedentary behavior, lack of will power, food addiction, genetics and physiology, and even the microwave oven gets the blame. From this list, our genes and physiology have not changed considerably (my opinion) so the cause(s) mainly must lean toward environmental factors. For example, many researchers promote the role of insulin resistance and other hormones (leptin, ghrelin) as causative; however I would presume that the  human body has always had these factors at play when body weight is regulated normally.  If hormones are to blame, what factors caused their normal function to be altered?

The following excellent article originally published on The Conversation takes us from the beginning to where we stand now and offers some possible fixes that may help to stop this phenomenon from getting any worse than it already is. Another fact is that even though it affects our health care system and health care costs, not much mention is made from the political or community factions; if this was an infectious disease problem, reactions from all parties would be quite different.

A real-life situation offers an explanation about what may be occurring here. “Genetic analysis of the Pima Indian population living in Arizona has identified a number of genes that may be responsible for this group’s tendency to store excess body fat. When this genetic susceptibility is combined with an environment that fosters a sedentary lifestyle and consumption of high-calorie, high-fat (or carbohydrate) processed foods, the outcome is the strikingly high incidence of obesity seen in this population.”  Nutrition: Science and Applications, Smolin and Grosvenor, Third Edition (2013).

The Pima Indians living in Mexico with entirely different lifestyles and diet (farmers) have an average Body Mass Index of about 23.0 while the Arizona population with the same genetic background have a BMI about 30.0  BMI’s over 30.0 signify obesity. while those below 25.0 have been stated as having a healthy weight.

This may be too simple an explanation for our epidemic and it is understood that this public health dilemma has many more complex causes.

It still remains after all that the the simple fix of “eat less, move more” has not helped us to significantly deal with this  phenomenon and the fixes will take a lot more effort in order to stem this problem. A previous post on solutions can be found HERE. Any suggestions or comments will be welcome.


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Vitamin D: Another Myth?


A  decade ago, vitamin D was the “miracle” vitamin if you believed the headlines.that suggested we have finally found  the “cure” for almost every malady known.  Low levels in the body of the vitamin were proclaimed  to be involved with increased “risks of a dozen common diseases, including heart disease, cancer, fibromyalgia and multiple sclerosis (MS) as well as depression and early death”.  (The Diet Myth, Tim Spector, 2015, pages 229-231)

Due to its newly alleged benefits, there were reports of some physicians suggesting that patients begin taking extremely high vitamin D supplements to counteract the proclaimed deficits found in population and observational studies. Aside  from its function to prevent the abnormalities of rickets, what caused this sudden interest? The newest claim involved its role in preventing bone fractures.

It is important to remember that vitamin D is stored in the body (as all fat-soluble vitamins (ADEK) are), and that toxicity is always more of a concern when compared to water-soluble vitamins.

Too much vitamin D in the body can cause high blood calcium concentrations that can be deposited in the blood vessels and kidneys and cause damage. It is also important to realize that this does not occur when vitamin D is made in the body from sunlight. However, over supplementation and fortification can pose a risk. The  Tolerable Upper Intake Level (UL) is 4000 IU (100 ug/day). 

This is what can happen when supplement companies publish headlines about the merits of their products without informing the consumer that many of the nutrition headlines claiming health benefits from dietary supplements are not based on sound research such as clinical trials and instead based on unconfirmed observational studies.  Subsequent research usually finds that much of the inflated “hype” does not support the purported claims. Studies began to appear in the medical journals that failed to support all the previous studies that could certainly help the supplement industry profits.



Vitamin B12: What Vegetarians Need to Know

Vegan diets appear to be a choice of many people since many studies have supported a plant-based diet for better health and longevity. As mentioned in a previous post, some nutrients fall short on vegan diets with some serious consequences if not corrected by proper supplementation or fortification.  Vitamin B 12 deficiency is not only a issue for vegans, but also found to be common in the elderly who may experience absorption problems of the vitamin. Here is why:

  • Vitamin B12 in food is bound to protein, making it too large a molecule to be easily absorbed.
  • In the stomach, acid and pepsin help release the vitamin from proteins.
  • Normally, cells in the stomach lining release intrinsic factor (IF), needed for B12 absorption.
  • In the small intestine, intrinsic factor binds to vitamin B12 and this complex (B12-IF) binds to receptors on cells to allow absorption into the blood.
  • B12 is made in the large intestine by microbes but cannot be absorbed.
  • An anemia can occur when intrinsic factor is lacking, commonly found in the elderly.
  • Vitamin B12 is found in pork, beef, trout, chicken, 2% milk, and cheddar cheese.


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How to Be an Informed Vegan

Beans, Legumes

Plant-based diets are currently the trend toward eating healthy. Some people may try to convert to a vegan diet for various reasons: health, animal welfare, helping the environment,  religious restrictions. However, there are several problem nutrients (vitamin D, calcium, vitamin B12) that come to mind if you are not an informed vegan.  Plant proteins like beans and legumes are essential.

The following article can increase awareness on how to become a “smart” vegan and avoid any nutritional deficiencies that may occur.