Randomized Results

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Randomized Results
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50 Great Ideas to Improve Health
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50 Great Ideas to Improve Health

• (Distilled down to 2
• you might actually remember)

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Substitute Bad Fats for Good

• Substituted just 2 of total calories from trans
  fats with the same amount of good fats, you could
  reduce your risk by 50.
• This will prevent 347,877 heart disease deaths
  per year.

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Good and Bad Fats
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Saturated fat

• Saturated fats have all the hydrogen atoms they
  can hold.
• Just about any plant or animal product that has
  fat in it has some saturated fat.
• Saturated fats generally come from animals and
  animal products and are solid at room
  temperature.
• Saturated fat raises blood cholesterol, which
  increases the risk of heart disease and stroke.
• Decrease good cholesterol
• Increase bad cholesterol

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Saturated fat

• Cheese
• whole milk
• dark chocolate
• butter
• ice cream
• fatty meats
• coconut milk
• lard

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Monounsaturated fat

• These fats are really oils.
• They are liquid at room temperature but get more
  solid when they are stored in the refrigerator.
• When substituted for saturated fat in a persons
  diet, monounsaturated fats appear to lower blood
  cholesterol.
• Increase good cholesterol
• Decrease bad cholesterol

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Monounsaturated fat

• olive oil
• canola oil
• peanut butter
• almonds
• nuts
• avocado
• sesame seeds
• pumpkin seeds

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Polyunsaturated fat

• They are liquid both at room temperature and when
  kept in the refrigerator.
• For some reason, polyunsaturated fats actually
  help lower total blood cholesterol and are heart
  healthy.
• Increase good cholesterol
• Decrease bad cholesterol
• Lower total cholesterol

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Polyunsaturated fat

• safflower oil
• corn oil
• sunflower oil
• soybean oil
• corn fish
• walnuts

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Trans fat

• These polyunsaturated fats that are altered in a
  process called hydrogenation. Healthy vegetable
  oils are heated to about 400 degrees and hydrogen
  gas and a metal catalyst are added.
• It is used to fry food over and over again
  without going rancid.
• Decrease good cholesterol
• Increase bad cholesterol

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Trans fat

• margarine
• vegetable shortening
• any deep fried foods
• French fries
• most bakery goods
• anything with shortening or partially
  hydrogenated vegetable oil in the ingredients

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All fats Together

• Nurses health study (n80,000)
• Looked at cardiovascular disease
• No difference in disease when high fat diets were
  compared to low fat diets.
• Bad fats cancelled out the effects of good fats.

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Type of Fat and Risk of Coronary Heart Disease
CVD risk
Hu, New Eng J Med1997
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Good Fats
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Searching the World for Healthy People

• The Mediterranean Diet
• nuts, breads, pastas, beans, and fruits and
  vegetables, some fish, poultry, dairy foods,
  meat, eggs, and wine and few sweets.
• olive oil was the primary source of fat

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Lyon Diet Heart Study

• 4 year study compared a Mediterranean and
  American Heart Association Diet in people with
  heart disease
• 600 men and women
• study stopped after 2.5 years
• 70 reduction in death from all causes

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Fish Oils

• 19 studies on fish oils
• 15 reduction in heart disease risk and death
• These oils help maintain a regular heart beat and
  prevent blood clotting

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Bad Fats (saturated fat)

• It is impossible to avoid saturated fat
  completely
• Greater risk for heart disease, stroke, diabetes,
  breast cancer and maybe colon and prostate
  cancers
• May be one of the causes of Alzheimers disease
  and appears possibly to be associated with
  schizophrenia

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• In general, women should eat no more than 20
  grams of total fat per day and men should eat
  less than 25 grams.

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Bad Fats (trans fat)

• Of all the calories Americans eat, just about 3
  come from trans fats.
• Of all the trans fats in our diets, half come
  from cakes, cookies, crackers, pies, and bread.
  The rest come from animal products, margarine,
  fried potatoes, potato chips, corn chips,
  popcorn, shortening, salad dressing, breakfast
  cereal, and candy.
• Trans fats are 10Xs worse than saturated fats

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Ingredients Enriched bleached wheat flour
contains bleached wheat flour, niacin, reduced
iron, thiamine mononitrate, riboflavin, folic
acid), dextrose, vegetable shortening (partially
hydrogenated soybean and/or cottonseed oil),
water, sugar, soy flour, egg yolks, vital wheat
gluten, yeast, nonfat milk, yeast nutrients
(calcium sulfate, ammonium sulfate), dough
conditioners (calcium dioxide, monocalcium and
dicalcium phosphate, diammonium phosphate, sodium
stearoyl-2-lactylate, whey, starch, ascorbic
acid, sodium bicarbonate, calcium carbonate),
salt, mono- and diglycerides, ethoxylated
mono-and diglycerides, lecithin, calcium
propionate (to retain freshness), cellulose gum,
natural and artificial flavors, fungal alpha
amylase, amylase, maltogenic amylase,
pentosanase, protease, sodium caseinate, corn
maltodextrin, corn syrup solids and BHT (to help
protect flavor).
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• The consumption of trans fats was positively
  associated with a 25 increase in heart disease
  risk.
• The minimum amount of trans fats a person can
  consume and not increase risk is zero.

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Margarine (tub)
Butter
Margarine
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Cake, Iced and Filled
Granola Bar
Sandwich Cookies
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Mini-Sandwich Crackers
Frozen Potatoes (e.g., French Fries)
Potato Chips
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Fast food companies are off the hook
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Current US Diet
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Substitute Bad Fats for Good

• Reduce the amount of saturated fat in your diet
  by 5 of total calories and increase the
  unsaturated portion by the same amount. You will
  reduce your chances of heart attack and death by
  40.

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Substitute Bad Fats for Good

• Substituted just 2 of total calories from trans
  fats with the same amount of good fats, you could
  reduce your risk by 50.
• This will prevent 347,877 heart disease deaths
  per year.

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Lung cancer and vegetable intake
Relative risk
Vegetable intake grams/day
Am Inst for Cancer Research, 1997
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Stomach cancer and vegetable intake
Relative risk
Vegetable intake grams/day
Am Inst for Cancer Research, 1997
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Stomach cancer and fruit intake
Relative risk
Fruit intake grams/day
Am Inst for Cancer Research, 1997
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Unpaired Electrons
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• Free radicals can
• Disrupt or destroy cells
• Damage DNA, lipid membranes, mitochondria, and
  proteins
• Disrupt vital functions

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• DNA in each cell gets a hit from a free radical
  every 10 seconds
• Each cell gets 10,000 hits/day

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Cancer deaths by age, in 2001
80 of all cancers occur after age 55
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Where do free radicals come from?

• Most are produced by our own bodies by the
  electron transport system (ETC)
• UV light
• burned food
• toxic chemicals
• Industrial
• automobile pollution
• unknown sources

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Cigarette Smoke

• One puff of smoke contains
• 100,000,000,000,000,000
• free radical species
• Tobacco is responsible for 31 of all cancers

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Cancer death and smoking
Relative risk
Number of cigarettes/day
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If you are a smoker
-14.5 yrs
-13.2 yrs
MMWR 199746444-51
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How do we protect our selves?
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Phytochemicals

• Carotenoids
• Beta-carotene
• Lycopene
• Lutein
• Zeaxanthin
• Organosulfurs
• Flavinoids

• Phytosterols
• Alkaloids
• Tannins
• Saponins
• 100,000 more we have yet to identify

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Spontaneous or inherited mutation
Abnormal cell
Normal cell
Repair
Carcinogen
Tumor
Metastasis
Cell proliferation
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Spontaneous or inherited mutation
Abnormal cell
Normal cell
Repair
Activated carcinogen
Tumor
Metastasis
Cell proliferation
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A Western Lifestyle

• Little Physical Activity
• Red meat
• Processed meat
• Butter
• Potatoes
• Refined grains
• High fat dairy foods

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WALL THICKENING and TIMEAGE
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H F Fritz, MD
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BMI
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Systolic Blood Pressure Reductions mm/Hg
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Diastolic Blood Pressure Reductions mm/Hg
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Total Cholesterol Reductions mg/dl
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Reductions in risk

• There is a 2-3 decrease in MI risk for
• Every 1 mmHg decrease in diastolic
• Every 1 decrease in total CHL

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Changes is Diastolic BP and CHL

• Diastolic BP mmHg
• Ideal -3.5
• High -10.4
• Dangerous -14.0

• Total CHL decr.
• Normal -9.2
• Borderline -13.2
• High -17.9

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Reductions in risk with these changes

• Diastolic BP
• Ideal 7-11
• High 21-31
• Dangerous 28-42

• Total CHL
• Normal 18-28
• Borderline 26-40
• High 36-54

64 - 96
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HDL Cholesterol Reductions mg/dl
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LDL Cholesterol Reductions mg/dl
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Triglyceride Changes mg/dl
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Glucose Reductions mg/dl
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BD Diabetes Study