The Tastiest Ounce of Prevention, Ever

31 08 2011

Many previous times here we have brought you the happy news about the potential health benefits of chocolate. Now across the pond from the land of Cadbury (really, who doesn’t love those chocolate Easter eggs?) comes delicious news, presented at the recent European Society of Cardiology meeting. The study, published in the British Medical Journal[i], examined seven studies and over 114,000 people. The object was to look not just at heart attacks and stroke and such endpoints, but to also examine the risk of developing any cardiometabolic disorders that significantly affect the risk for such events as these. This includes the incidence of diabetes and metabolic syndrome. Amazingly, the highest levels of chocolate consumption were associated with a 37% risk reduction in heart attack and a 29% risk reduction in stroke compared to the lowest levels of consumption. Of the studies examined, one Japanese study looked at the risk of developing diabetes, and found a 35% reduction in men and a 27% reduction in women in those who consumed more chocolate.

The studies were not randomized and did not differentiate between dark chocolate and milk chocolate. Previous studies had suggested greater benefit for those consuming dark, as opposed to milk, chocolate. There is always a risk of overindulgence from anything, but if an ounce of prevention this tasty is worth a pound of cure to treat diabetes, heart disease and stroke, well who wouldn’t sign up for that program?

[i] (Buitrago-Lopez, et al., 2011)

Roasted corn and black-eyed pea salsa

30 08 2011

With Labor Day quickly approaching, fall is around the corner. Time to put away the whites and welcome the festive fall flavors. Here is a topping we used with the ropa veija that features the last bounty of summer, with fresh garden-ripened tomatoes and welcomes fall with hearty black-eyed peas and roasted corn.

To the basic salsa recipe (see under recipes in the side bar) add 1 pint of roasted grape tomatoes, 8 oz. of cooked blackeyed peas, 1/2 finely chopped roasted red pepper and the kernals from 2 ears of roasted corn

Basil Radio

29 08 2011

Join me tonight as I join Chef Jennifer on Basil Radio for some always lively and informative chat!

6:35 Eastern at Basil Radio

Some Old Clothes

28 08 2011

As Labor Day approaches, it heralds the arrival of fall and the packing away of white pants. To prepare for her arrival we brought out some old clothes. An excellent dish, with many world-wide variations, is old clothes also known by its much tastier Spanish name, Ropa vieja. Here we simply took a wonderful cut of pork shoulder seasoned with Doc’s South African 5 Spice, Doc’s Chili Powder, salt and pepper and braised for several hours on a bed of carrot, onion, leek, celery and garlic. The pork grew tender in some home-made chicken stock and delicious Spanish red wine. We served it with a fall inspired roasted corn and black-eyed pea salsa, all of which was piled upon a home-made flour and corn tortilla. A simple and oh so satisfying way to welcome fall.

Where’s the Beef?

25 08 2011

For many a year I have preached the Grassroots Gourmet Gospel about eating fresh and avoiding adulterated products through following The Path of The Three“Be’s”:

  • Be Aware and Avoid the call of the Junk Food/Fast Food Siren
  • Be Fresh-But No Adultery!
  • Be On Time and In Proportion

Yet, many people are still unaware that this goes beyond simply avoiding fast food or junk food. Simply because something is purchased at a supermarket does not mean it is free from prior manipulation. The act of altering our foodstuffs by adding or subtracting compounds and/or altering the form of the food by cooking, irradiating or freezing has some effects. Some, perhaps the vast majority, of these effects are negligible. Perhaps some only have significance with long cumulative exposure or critical combination. Perhaps others are altered, for better or worse, by a tincture of time. Other effects may only manifest in the setting of susceptible genetics or physiology. These are the great unknowns regarding the Law of Unintended Consequences. What is clear is that the variables and thus the result operate in equations much more complex than simple addition and subtraction.

And it is also an oversimplification to label groups of foods as simply good or bad. Red meat, as a group, contains the entire gamut of possibilities. There are fresh lean game cuts and grass fed free range beef steaks. AT the other end there are industrialized geometrically symmetrically processed patties with a list of additives longer than Keith Richards’ toxicology report. As chef and an interventional cardiologist I am often asked my opinion about red meat consumption. So I shall opine: as but one in long lineage of omnivores, to put it quite simply, I love my meatses. And I love my meatses fresh. Although my choices are driven by my taste buds and several million years of evolutionary hardwiring I find adjudication within the confines of medical science. As an example several recent studies, including a meta-analysis comprising over a million participants worldwide performed by Harvard, have failed to demonstrate a correlation between consumption of fresh red meat and increased cardiovascular risk[i],[ii],[iii],[iv],[v]. However, there did appear to be increased cardiovascular risk and an increased risk of developing diabetes when highly processed meat products were regularly consumed.

Why? How? Is there a difference?  Isn’t eating any red meat the cardiovascular equivalent of launching an atherosclerotic drone into your coronary artery? The answer is there appear to be major differences and it’s time we moved beyond bovine bigotry by regarding all red meat as a single class of foodstuffs. It’s like lumping a Yugo and a Ferrari together as “cars” and being confused at the quarter mile time trial results.

Consistent with the previous data examining cardiovascular risk and the consumption of fresh red meat, the largest study to date examining red meat consumption and stroke risk was recently published[vi]. Over 40,000 Swedish men aged 45-79 were followed by questionnaire for over a ten year period. The researchers found that consumption “of processed meat, but not of fresh red meat, was positively associated with risk of stroke.”  The increased risk was over twenty percent. Dr. Robert Eckel, a Professor of Medicine at The University of Colorado and a past President of The American Heart Association also noted that the group with the highest intake of processed meat in the Swedish study also had a healthier diet overall, including more fruit, vegetables, and whole grains. He commented that this “suggests that the effects of processed meat may confound the benefit of a heart-healthy diet.”

This study follows on the heels of a very large and interesting study demonstrating the increased cardiovascular risk when the dietary ratio of sodium (often referred to as “salt intake”) to potassium is greater than one. This may explain why previous studies have failed to definitively link increased absolute amounts of sodium to cardiovascular morbidity and mortality. The effect may lie in a ratio, not absolutes. The processing of a piece of fresh pork, with sodium to potassium ratio less than one, to produce a slice of ham (even low-fat ham) inverts that ratio. The causative possibilities are intriguing, but the important question remains.

Where’s the beef?

It should be back on the menu-but only if you keep it fresh!

[i] (Micha, Wallace, & Mozaffarian, 2010)

[ii] (Siri-Tarino, Sun, Hu, & Krauss, 2010)

[iii] (Micha & Mozaffarian, Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence, 2010)

[iv] (Siri-Tarino P. , Sun, Hu, & Krauss, 2010)

[v] (Siri-Tarino P. , Sun, Hu, & Krauss, Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease, 2010)

[vi] (Larsson, Virtamo, & Wolk, 2011)

Vitamin D, not The Magic Bus

24 08 2011

Recently some folks have been touting Vitamin D (and specifically supplementation with Vitamin D3) as the next super supplement to confer immortality. This has been due to some recent information that had suggested a mortality benefit with the consumption of Vitamin D for a variety of conditions. Vitamin D, along with E, A and K, is a fat-soluble vitamin. It is naturally present in a several foods, available by supplementation and also produced by our bodies with exposure to sunlight. Once ingested or produced, Vitamin D undergoes two transformations in the body (called hydroxylation) to form the metabolically active compound.  These occur in the liver and kidneys and yield the physiologically active 1, 25-dihydroxyvitamin D, also known as calcitriol.

Vitamin D acts to help regulate calcium and phosphorus metabolism. This is important for a number of functions including bone formation and maintenance, immune function, cell growth, inflammation modulation, neurological function and proper muscle functioning. Daily intake recommendations vary with age but for most adults are on the order of 600 IU (15 micrograms) per day. Foods rich in Vitamin D include fatty fish like salmon and tuna, organ meats like liver, cheese and eggs. Common fortified foods are milk, yogurt, ice cream and orange juice. Recent interest had focused on oral supplementation with Vitamin D3 (cholecalciferol), generally produced by the irradiation of 7-dehydrocholesterol from lanolin and the chemical conversion of cholesterol (yes, cholesterol).

Some recent information had folks popping Vitamin D3 capsules as they boarded the magic bus to blissful immortality. Like a vampire’s kiss though, the data first reported does not seem to hold up under the direct light of more thorough examination. A more comprehensive study looking at 51 previous trials examined Vitamin D levels and the association between Vitamin D and cardiovascular outcomes, including death. The authors concluded that to date they “are unable to demonstrate a statistically significant reduction in mortality and cardiovascular risk associated with vitamin D. The quality of the available evidence is low to moderate at best.”[1]

However, there are consequences to over consumption. Over indulgence in supplements can result in anorexia, weight loss, excessive urination and heart arrhythmias. It can also cause vascular and tissue calcification, with subsequent damage to the heart, blood vessels, and kidneys. The use of supplements of both calcium (1,000 mg/day) and vitamin D (400 IU) by postmenopausal women was associated with a 17% increase in the risk of kidney stones over 7 years in the Women’s Health Initiative Study.

Eat well and try a little sunlight now and again. Unless of course you actually are a vampire-then I recommend a supplementation of Miss Sooki Stackhouse (see True Blood or the Charlene Harris’ books for those not in the know).

[1] (Elamin, et al., 2011)

Foodie and The Beast

23 08 2011

For those who missed the live broadcast, here’s the link to the archived show from last week:

Dr. Mike on Foodie and The Beast