Optimism and Cardiovascular Health

Optimism and Cardiovascular Health By Jill Horn with Emeran A. Mayer, MD The concept of cardiovascular health (CVH) was developed by the American Heart Association, and is based on a shift of focus away from disease treatment and toward health prevention and promotion.1 CVH is a fundamental part of well-being even before the development of risk factors, and according to current research, less than 10% of middle-aged adults meet the criteria for favorable CVH.2 In fact, cardiovascular diseases make up the largest portion of the modern non-communicable chronic disease epidemic (which include metabolic syndrome, obesity, degenerative brain disorders, cancer and autoimmune diseases), and they are the leading cause of death on a global scale.3 Amongst other lifestyle factors, the Western diet has been identified as a major risk factor for all these diseases. There are several well-known factors that have been shown to positively affect CVH: a largely plant based diet (like the Mediterranean or Okinawan),4 low in saturated fat and in highly processed carbohydrates and high in fiber and polyphenols, regular physical exercise, the elimination of smoking, and a healthy body mass index.1 However, often neglected, research has also explored the role of the mind and mental states as an important determinant of CVH. According to a recent paper published by Julia Boehm and colleagues in the journal Psychosomatic Medicine, an optimistic view of life may have a small, but significantly favorable effect on CVH. The study, performed over a 10-year time period in 5,115 male and female participants from all socio demographic backgrounds found a small but statistically significant correlation between optimism and CVH, a correlation that was strongest in women.2 Even though the observed correlation was small, the authors emphasize the impact such a relatively small correlation can have on health outcomes across the life-span of a large population.2 In an earlier study, using a meta-analysis of 15 published studies, optimistic individuals were found to have a 35% decreased risk of suffering a cardiovascular event, when compared to individuals who were less optimistic.5 There are several reasons which could explain these findings: 1) Optimistic individuals often are more likely to pursue healthy lifestyles, including physical activity, healthy diets and social interactions, and are more likely to use effective coping strategies in the event of distress.6 More precisely, optimism was shown to reduce maladaptive coping mechanisms such as avoidance and withdrawal from stressful emotions. On the other hand,…

The Okinawa Diet

The Okinawa Diet By E. Dylan Mayer with Emeran Mayer, MD Okinawa is an island off of the coast of Japan. It is the largest of the Ryukyu Islands and belongs to one of the five regions of the world known as Blue Zones. It has been shown that people living in Blue Zones live much longer, healthier lives compared to those who do not.1 Okinawans’ atypical lifespans may be explained by several genetic, environmental and lifestyle factors, however many experts believe that one of the strongest factors is diet. What is the Okinawan Diet? [caption id="attachment_4194" align="alignright" width="400"] Traditional Okinawan diet food pyramid. From: Willcox DC, et al. The Okinawan diet: health implications of a low-calorie, nutrient-dense, antioxidant-rich dietary pattern low in glycemic load. J Am Coll Nutr. 2009 Aug;28 Suppl:500S-516S.[/caption]The Okinawan Diet has stayed similar throughout history, but the number of macronutrients has shifted in recent years. Complex carbohydrates used to make up approximately 85% of Okinawans’ caloric intake, today it is closer to 60%. Protein was much lower, taking up 9% in the past, while today is closer to 15%. The biggest shift has occurred in fat consumption: while it made up 6% (2% saturated) in the past, it has increased to close to 28% (7% saturated).2 Taking a look at Figure 2, these numbers make sense. Vegetables, fruits, legumes & grains dominate the Okinawan food pyramid, packed with complex carbohydrates (high in fiber and plant-based protein). Consumption of fish & lean meat (pork) only make up a small proportion of the Okinawan diet, while the majority of protein intake comes from plant-based sources. The staple foods in a traditional Okinawan diet are: Vegetables (60%): sweet potato (orange & purple), seaweed, kelp, bamboo shoots, daikon radish, bitter melon, cabbage, carrots, Chinese okra, pumpkin and green papaya. Grains (33%): millet, wheat, rice and noodles. Soy (5%): tofu, miso, natto and edamame. Meat & Seafood (1-2%): mostly small fish rich in omega-3 fatty acids, such as herring and occasional pork (all cuts, including organs). Other (1%): alcohol, tea, spices and dashi (broth). All of these foods are very nutritious, mostly plant-based and supply a generous number of polyphenols, fiber and omega-3 fatty acids, three things we, here at emeranmayer.com promote!! Consistent with recent evidence showing that it is not only the quantity, but the variety of types of consumed fruits and vegetables which is critical in optimizing the health…

Life Out of Balance

Life Out of Balance By Emeran A. Mayer, MD Two weeks ago, I had thought about writing a post for this edition of the MGC Newsletter that deals with the possible relationship of an unhealthy diet, the epidemic of obesity and metabolic diseases, and the greater vulnerability of individuals on such a diet for COVID-19 related complications. But when I looked in disbelief at the orange sun in the smoke filled sky over the weekend, turning into a deeply red sunset over the Santa Monica mountains later in the evening, I felt an urgency to expand the planned topic of individual health and wellness, to the health of the planet. In particular, I wanted to find an answer to the question: Could there be a relationship between the catastrophic events unfolding along the Pacific coast and our own health? To say that what filled the news over the past two weeks has been shocking is a gross understatement: Following a historical heat wave – Los Angeles County had its hottest temperature on record when Woodland Hills hit 121 degrees on Sept. 6 - record breaking fires broke out in Northern California that turned into an epic firestorm hopscotching from the Mexican to Canadian borders, killed more than 30 people, wiped out entire towns and caused some of the worst air pollution ever seen in the region. In California and Oregon alone, fires have burned more than 5.0 million acres with California breaking its record of 1.8 million acres burned from 2 years ago.1 AAt the same time, and reminiscent of the movie The Day After, an Arctic front reached Colorado at the same time in early September, triggering the first heavy snowfall of the season, and leading to the powerful offshore winds on the Pacific coast which fanned the fires there. And a week later, a slow moving Hurricane hit the Gulf coast, with 4 more storms in the waiting – a historic first. The devastating fires didn’t arrive out of the blue. Federal government scientists had predicted two years ago that greenhouse gas emissions could triple the frequency of severe fires across the Western states,2 in part due to the increase in extreme temperatures. Global warming has increased the odds of unprecedented heat extremes across more than 80% of the planet and according to Stanford University climate scientist Noah Diffenbaugh “has doubled or even, in some areas, tripled the…

How Important Are Dietary Supplements for Our Health?

How Important Are Dietary Supplements for Our Health? By Juliette Frank with Emeran A. Mayer, MD [caption id="attachment_4143" align="alignleft" width="300"] hand, full, pills[/caption]Every year Americans spend somewhere around $35 billion on vitamins, minerals, and dietary supplements with over half the American population taking at least one vitamin daily. This fuels the $40 billion dietary supplement industry producing over 50,000 products that make large health and wellness claims such as weight loss, increased energy, and overall health and wellness. These products appeal to many looking for a quick fix or solution to their physical and mental health problems. What many consumers are unaware of is that dietary supplements do not need to be FDA-approved prior to marketing their products, meaning that it is not necessary to prove their effectiveness in well-designed clinical trials, and it is up to the company’s discretion to make sure the products are safe and effective.1 A new study in the Annals of Internal Medicine2 tested over a dozen vitamins and supplements, some including compounds generally referred to as antioxidants, vitamin A, vitamin B-complex, vitamin B6, vitamin C, vitamin E, vitamin D, calcium, iron, and multivitamins. The study found that most of them did not cause any harm but only omega-3 fatty acid (fish oil) and possibly folic acid, showed potential health benefits for some people. Scientists also found that supplements combining calcium and vitamin D might increase the risk of stroke.3 Furthermore, supplements may actually become harmful if taken in conjunction with certain medications that may alter the effects or not work how it is intended. The president for the Center of Science for the Public Interest, Peter Lurie, points out ephedra, one of the more notable examples of the possible harm supplements can have. Ephedra is a substance found in some plants and is marketed as an appetite suppressant and energy booster.4 The supplement was associated with cases of heart attack, stroke, and sudden death which led to 155 deaths until it was banned by the FDA in 2003. Lurie points out that without the required approval by the FDA prior to releasing vitamins and supplements to the market, the true damage of a product may only be exposed after it is too late. Similarly, another concern of Lurie’s is that there is little way of knowing what harmful effects or damage these supplements may have. Adulteration and contamination is a real problem, there is…

The Truth About Superfoods

The Truth About Superfoods By Emeran A. Mayer, MD “Superfoods”— mostly plant-based foods in addition to some fish — are foods that have been marketed based on a wide range of health benefit claims, ranging from anti-inflammatory, anticancer, antiaging and protective against cardiovascular diseases and cognitive decline, as well as more subjective “energy boosting” effects. Even though “superfoods” are considered an important contributor to the well documented health benefits of largely plant based diets (such as the traditional Mediterranean diet), specific health claims about these foods are generally based on the effects demonstrated on cells in test tubes or in mouse models. Unfortunately, and largely unknown to the public, the great majority of these claims are not based on evidence from well controlled clinical trials in humans, and it is unlikely that they ever will. Even though scientists claim that use of the term "superfood" is largely a marketing tool unsubstantiated by scientific evidence, manufacturers rely heavily on marketing ploys and lobbyists to shape the public's perception of their products.1 The problem starts with the question what qualifies as a “superfood”. According to the American Heart Association there are no set criteria for determining what is and what is not a superfood.2 Some superfoods stand out from other healthy plant-based foods, based on their high content of dietary fiber, vitamins, healthy fats (high omega-3 to omega-6 ratio), and high levels of a class of phytonutrients made up of large, poorly absorbable molecules, called polyphenols and phenolics.3 There are thousands of such phenolic compounds in different plants, with the majority of them belonging to the family of flavonoids.4 Polyphenols are the plants’ medicine, which they produce to protect themselves against pests, diseases, and other harmful influences, and they are usually contained in leaves, fruits and roots of most plants. Based on their in vitro effects, polyphenols and phenolics are generally mislabeled and promoted as antioxidants, even though in humans this only applies to the small fraction of such compounds which are absorbed in the small intestine and reach sufficient levels in the blood to exert antioxidant effects. However, as a growing body of science is demonstrating, less than 5 percent of these molecules are actually absorbed in the small intestine, while the rest has to travel further down the intestine, where they are broken down into smaller, absorbable metabolites by our gut microbiota. It is likely that the health benefits of…