Fish, a leaner protein than red meat, is a major component of the Mediterranean Diet.  Fatty fish like salmon, halibut, herring, black cod and sardines have high levels of omega 3 fatty acids, which support healthy memory and aging, and prevent heart disease. Interestingly, omega 3 fatty acids modestly increase LDL ( bad cholesterol), but they are beneficial in preventing heart disease and stroke because they prevent platelet stickiness and help lower blood triglyceride levels. Omega 3 fatty acids also reduce the risk of sudden death by preventing heart dangerous types of heart rhythm abnormalities.

Photograph Courtesy of Madelaine Bulkes

The Standard American Diet or SAD (pun intended) has large amounts of red meat, fried foods, processed grains, cured meats, and sugary sweets and beverages.  In contrast, the Mediterranean Diet is plant-based, with up to 10 servings of fruits and vegetables daily. 

Whole grains are another important feature of the Mediterranean Diet. Bread is eaten plain or dipped in olive oil.  Avoid butter, which has saturated fat, and margerine, which contains trans fat made by partially hydrogenating vegetable oils. Whole grains take longer to digest so they prevent sharp increases in blood sugar after meals. 

Americans more commonly eat processed grains, which have the outer covering of the grain removed.  Remember that whole wheat bread is not made of whole grain; instead it is made out of processed wheat flour (but still has more fiber than white bread). Whole grains have more fiber and are healthier for the colon than processed grains. A high fiber diet can reduce the risk of diverticulosis and colon cancer.  It takes more calories to digest whole grains than to digest processed grains.  A diet high in fiber can also lower blood  cholesterol levels. The Mediterranean Diet have high amounts of soluble (beans, legumes, cracked wheat)  and insoluble (fruits, vegetables, oat bran) fiber.

Substitute a whole wheat version of your favorite pasta, and remember to cook it al dente (not soft) in order to prevent increases in blood sugar after eating.

Red wine in moderation is acceptable in the Mediterranean Diet. However, if more than 5 ounces per day in women or 10 ounces a day in men is consumed, the benefits of the red wine are lost.  Women at risk for breast cancer or breast cancer

Photograph courtesy of Mark Phillips/Timba Limber

recurrence should consider restricting alcohol intake since this factor has been associated with breast cancer occurrence.  It is believed that the benefits of red wine to the heart are through the antioxidant action of the phytonutrient resveratrol, which is found in the skins of grapes. So the same benefits of wine can be achieved by eating red grapes or drinking pure red grape juice. 

Dr. Ancel Keyes and his colleagues (including Dr. Paul Dudley White, who later served as President Eisenhower’s heart doctor) developed the Seven Countries Study after World War II to evaluate the health of almost thirteen thousand middle-aged men in the United States, Greece, Italy, the Netherlands, Finland, Yugoslavia and Japan.  They discovered that people who ate a diet high in vegetables, fruits, legumes (beans, lentils), fish and whole grains were the healthiest. The healthiest men were the residents of Crete, who lived longer and had less heart disease than Americans in the post World War II era.  Dr. Keyes and his  associates hypothesized that it was the Mediterranean diet that the Cretans ate which contributed to their longevity and good health. The residents of Crete ate up to 10 servings of fruits and vegetables daily!

Studies have shown that the Mediterranean Diet decreases the risk of heart attack, stroke, Parkinson’s disease, Alzheimer’s disease and death from all causes. Although there have not been any prospective randomized, double blind, placebo controlled trials (the gold standard for evidence based medicine) comparing the Mediterranean diet to the standard American diet or weight loss programs, a number of studies have shown that people who follow the Mediterranean diet are leaner than people who follow other diets.

Cruciferous vegetables (shaped like a cross when cut)  such as broccoli, cauliflower, kale, cabbage and Brussels sprouts have antioxidants which prevent several kinds of cancer including breast and prostate.  Tomatoes have lycopene, an  antioxidant similar to vitamin A, which  reduces the risk of cancers such as breast and prostate. Cooking tomatoes or cooking with olive oil, such as in tomato sauce, increases the lycopene content.

Photograph courtesy of Merulapie

The low sodium Mediterranean diet combined with the high potassium content of fruits and vegetables such as various greens, legumes, potatoes and squash helps lower blood pressure.  Spinach, almonds, lentils, broccoli, pumpkin and sunflower seeds are good sources of magnesium, another element essential to maintain good blood pressure.

The high fiber content of fruits, vegetables and whole grains stabilizes blood sugar and prevents diabetes.  Another benefit of fiber in the diet is that it keeps maintains a feeling of fullness, decreasing the temptation for eating unhealthy snacks when ravished! Mono unsaturated fats from foods such as avocados, olive oil and nuts increase the body’s ability to use insulin, which also decreases the risk of diabetes. 

Although nuts have healthy omega 3 fatty acids, they are composed of fat, so no more than a handful a day is recommended. Avoid salted or honey roasted nuts. Almonds, walnuts, hazelnuts, pine nuts, cashews and pistachios can be eaten as part of the Mediterranean diet.

Lean protein in the form of chicken and other poultry and fish (healthy portion  is checkbook cover size) are important components of the Mediterranean diet, and are consumed weekly. Red meat and pork is rarely eaten, no more than a few times a month, and in small portions (about the size of a deck of cards). Food is prepared simply, using fresh ingredients, without  sauces or gravies. Rosemary, garlic, thyme, basil and parsley are herbs commonly used in Mediterranean cuisine, and have been shown to have beneficial health effects.

Studies show that garlic decreases blood pressure and reduces risk of cardiovascular disease. Remember to allow cut garlic to sit out for at least 5 minutes before cooking, in order to retain its health benefits.

In the Mediterranean region, sweets are consumed infrequently (no more than twice weekly), and are usually made of natural sugars such as honey.  Aiming for a 75 calorie dessert is ideal. Sorbets, fruit and dark chocolate are the best dessert choices.

Low fat Greek yogurt, feta cheese, sardines, beans, Brussels sprouts, broccoli, spinach and kale are good sources of calcium.

Lentils, spinach, almonds, and poultry are good sources of iron. Eating citrus fruit or peppers provides vitamin C, which helps the absorption of iron in a meal. Lentils and beans are also good sources of potassium, magnesium, folic acid and soluble fiber. Soak beans and change the soaking water several times in order to decrease the gas producing substances in beans. Remember that beans are not a complete protein, meaning they lack some essential amino acids that the body must get through the diet; adding lean poultry and eggs provides these essential amino acids.  Egg yolks should be eaten no more than once a week due to the saturated fat content, but there is no limit to the amount of egg whites that can be consumed.

At least 30 minutes daily exercise or movement is a recommended part of the Mediterranean diet.

Finally, a very important component of the Mediterranean lifestyle is sharing food with friends and family. Enjoy the Mediterranean lifestyle, have a zest for life and improve health all at the same time!

Allain J. Nordmann, Katja Suter-Zimmerman, Heiner C. Bucher, Iris Shai, Katherine R. Tuttle, Ramon Estruch, Matthias Briel. Meta-Analysis Comparing Mediterranean to Low-Fat Diets for Modification of Cardiovascular Risk Factors. The American Journal of Medicine Volume 124, Issue 9, Pages 841-851.e2, September 2011.

Last updated on January 18, 2012 by Dr. Vee  Photograph courtesy of epSos.de

Ever notice how pervasive the internet is in our daily lives? And how one can lose track of time for hours with a single web search? A recent example: Halloween Trick or Treating. An age old American childhood tradition. It started out innocently enough.  I simply asked my son, “What do you think about dressing up as Abraham Lincoln for Halloween?” He is studying American history in Social Studies class so I thought this would be a respectable Halloween character, avoiding commercialized blockbuster movie or pop culture idols. I thought I would dress up as George Washington, his friends could dress up as Thomas Jefferson and Teddy Roosevelt and we could have a Mount Rushmore Road Show. This did not go over big with my son.  He looked at me, rolled his eyes and said nothing. I was worried he might be on Facebook “blocking” me or placing an ad on Craig’s List, “For Sale, One Lame Mom. Rants against energy drinks.  Eats brown rice. Still uses whole sentences to text. Takes notes at Parent-Teacher conferences. No, It’s NOT OK to contact me with other services, products or commercial interests.” I checked Angie’s List and became concerned when I was not listed as a preferred vender (mother).

Later that day my son used the most common type of adolescent communication: he texted, “Mom Please don’t embarrass me in public.” (At least he said please.) I texted back “How about dressing up like Facebook?” “OMG LOL!” was his immediate reply.

I thought that maybe his mind, like the American advertising community, had already moved past Halloween onto the more important Christmas shopping season, which starts directly after Back to School shopping season (I am still trying to figure what to do with those ten protractors for $20* I bought in the Back to School Specials frenzy). But no, he then emailed, “I think I’d like to dress up as a Google toolbar.” And so started the search for Google. 

Of course, being internet savvy, he went directly to Wikipedia. When I moved to the United States from India at age five, one of my most prized possessions was a complete set of the Encyclopedia Britannica. It took my parents a long time to save up enough money to buy me a set. In fact, I have kept it until this day to peruse on those late nights when I don’t get 300 emails, 30 email newsletters from mailchimp or a notice urging me, “Read about Dr. Extraordinarily Smarter and More Accomplished than You and On the Verge of Winning a Nobel Prize’s updates on LinkedIn!” 

Today, it’s easier to search the internet than the Encyclopedia Britannica. So naturally we went to YouTube (My son on an I Pad, me on my IPhone) and searched, “How to dress up like Google toolbar. The search returned “Bert & Ernie try Gangsta-Rap.” We moved on to eBay. We put in a couple of bids for Einstein wigs after examining the complete 360 degree view of the hair.  Next we put up for sale 10 protractors, shipping included anywhere in the continental United States.

We even did an advanced search on Amazon (who was kind enough to offer me some suggestions of similar items that I might be interested in buying). I saved a couple of protractors (on sale for a mere 10 for $5 with $10 shipping!) on my Wish List and emailed the list to my relatives for Christmas present suggestions.  All courtesy of those helpful folks at Amazon.

We did a general search on “Healthy Halloween ideas” and were encouraged by advertisers to “Come on over to the dark side with dark chocolate mini candy bars.” The manufacturer told us that there was 1 gram of fiber per 5 mini chocolate bars. That means we only have to eat 150 mini candy bars to get the recommended daily intake of fiber.  After reading the label, my son thought the candy bars were practically a health food and plans on substituting them for broccoli! I find it annoying that manufacturers have jumped on the dark chocolate bandwagon (Fortunately they are interested in our health, not in their sales), trying to convince consumers that candy (of course when consumed “in moderation”) can be part of a sensible diet!

The manufacturer of this candy bar was even kind enough to provide a fascinating article on theobromine, “a compound closely related to caffeine that only has a mild stimulatory effect on the central nervous system.”  They told us, “Preliminary research indicates that even relatively high levels of theobromine does not interfere with attention or mood.”  For our further education, we find out that dogs metabolize theobromine very slowly and it “carries the same risk to dogs as coffee, tea, cola beverages and certain houseplants.”  I bet that piece of useful information was never included in the Encyclopedia Britannica! 

Of course I had to post that article on my Facebook wall so that everyone interested could “Like” theobromine! And I certainly could not leave Facebook (Keep me logged on, Check) without contacting the 5 friends with birthdays this month, see status updates on 22 friends, no lie, play a couple of games of word scramble,  learn how to make gazpacho from Bobby Flay (He might be traveling to my hometown for a Throwdown and I better be prepared!),  print out a couple of coupons for more protractors, start a new game of solitaire (advanced hand), say “maybe” to the 18 events I was invited to by people I’m not sure I know,  “Like” the 400^th “Baby’s first steps” pictures of someone I don’t recognize (Baby’s Mom, who I don’t actually know, asked to “Friend” me on Facebook and I agreed, since one has to exceed 7 friends on Facebook in order to well, Save Face) and whew, I am exhausted!

I told my son we HAD to get off the internet because we had exceeded the two hour daily limit of screen time recommended by the American Academy of Pediatrics. But not before we found websites to buy skull and crossbones ice cube trays, sour flush toilet candy, toxic waste candy, tongue tattoos, zombie blood energy drink, and a ketchup packet baby costume.

I thought idly about “quickly” checking behind the scenes photographs of Lindsay Lohan’s  first day of community service as a morgue janitor (CNN Entertainment informed me that “Thursday was suppose to be Lohan’s first day of work as a morgue janitor, but she was sent away after showing up late for the morning’s orientation. Her publicist blamed her tardiness on a combination of not knowing what entrance to go through and confusion caused by the media waiting for her arrival.”) As an act of good citizenship, I recommended this on Facebook (along with 586 other people!) as well as shared it on Twitter. 

Next I had to check what those down to Earth Housewives of Beverly Hills are up to on their behind the scenes blog (shopping, shopping, nails, hair, shopping, Spa, shopping, restaurants, shopping).  Learn about the newest medical breakthroughs on “The Doctors” (Who needs Mayo Clinic Proceedings?), Check. Let’s see what Mayo Clinic Center for Social Media, Deepak Chopra, KevinMD and Dr. Oz are tweeting about (dark chocolate) and we’ll call it a night.

Fortunately, I am pleased to report that my son did not dress up like Tron, Harry Potter (Ok, I admit that’s who he was last year), Charlie Sheen, any vampire from Twilight, Jack Sparrow (SO last year) or an IPad 2. (Why dress up as an IPad 2 when one only has to enter 5 or 6 thousand internet advertising contests in order to have a “chance” to win one?)  He also nixed the Mt. Rushmore Road Show mother-son bonding idea (South Dakota or bust!) as well as, ultimately, the Google toolbar costume (If it’s not found on YouTube it can’t be worth making). I tweeted to the world @VeeMD “My son is dressing up as a Mad Scientist for Halloween and I am dressing up as a Petri dish.” (Less than140 characters.)

*when bought with qualifying $50 minimum purchase

Updated on October 30, 2011 by Dr. Vee

Photograph of Peapod Courtesy of Catherine Merulpie

How Antioxidant Foods Affect your Epigenetics

You are your genes. Better stated, you are your epigenetics. If you have DNA that may increase the risk of certain cancers, can you change your own risk? Epigenetics refers to the cellular environment of our genes—how the expression of the genes are affected without changing the underlying DNA sequences.

How do broccoli and other cruciferous vegetable such as Brussels sprouts or cauliflower decrease the risk of cancer? Certain nutrients, such as sulforaphanes in broccoli and diallyl in garlic affect epigenetics by activating genes involved in the development of cancer (tumor promoters, tumor suppressor genes, DNA repair genes). Selenium, vitamin A, folate and vitamin D are also believed to impact on the development of cancer by affecting epigenetics.

Could it really be that easy? Just eat a lot of broccoli? More coldwater fish? Grape Juice? Dark chocolate? Green tea? Vitamin D supplements?

Actually, at least four factors—Timing, Quantity, Combination and Organ Exposure—play a role in how phytonutrients (beneficial food substances) affect the development of certain cancers.

Timing

The actual timing of a body organ’s exposure to a cancer fighting substance makes a difference. For example, taking folic acid when there are underlying pre-cancerous colon cancer cells in the body actually increases the risk of developing colon cancer.

Regular soy intake (preferably whole soy products such as miso) by adolescent and young women decreases their risk of breast cancer by about 15 %. Isoflavones in soy attach to the estrogen receptor and block the body’s intrinsic estrogen from attaching to estrogen receptors. By blocking estrogen from attaching to receptors, isoflavones may prevent development of breast cancer.

However, in women who already have estrogen positive breast cancer or who are on tomoxifen, soy intake is generally not recommended. In these women with current or previous history of breast cancer, isoflavones are believed to attach to estrogen receptors and mimics the effect of estrogen to promote the development of breast cancer. (But even that conventional wisdom is evolving! Stay tuned for several recent studies in breast cancer survivors that suggest that soy intake is safe, even in women who are taking anti-estrogen/progesterone receptor therapy.)
In general, whole soy foods rather than soy supplements or powders are recommended. This is an active area of breast cancer research, so hopefully the true effects of soy in women at risk for breast cancer or who have had breast cancer can be more clearly understood.

Quantity of Antioxidants Ingested

The total amount of a potential cancer preventing nutrient that is ingested is also important. In general, increasing vitamin D intake decreases the risk of certain cancers, especially breast and prostate cancer. But more is not always better! Patients who have very high blood levels of vitamin D actually increase their risk of prostate cancer. Very high intake of the combination of selenium, beta carotene and vitamin E has been shown to increase the risk of death in patients with esophageal cancer. So be cautious in your intake of supplements –more is not always better, and it is possible to have toxicity from high levels of supplements.

Combination

Combining an antioxidant with other substances makes a difference. The prime example is the use of beta carotene supplements in smokers, which actually increases the risk of lung cancer more than in smokers who did not take beta carotene. Of course we all know that quitting tobacco makes the biggest difference in decreasing lung cancer risk.
Combining fruits and vegetables with unhealthy fats (such as trans fats) rather than olive and canola oils eliminate many of their beneficial antioxidant effects.

The Organ Exposed

Finally, the organ that is exposed to the antioxidants in foods is affected in different ways. For example, the calcium in milk is believed to decrease the risk of colon cancer but may increase the risk of prostate cancer. The effects of calcium in milk cannot be explained just by the fat content of milk because in general, high fat intake increases the risk of both colon and prostate cancer.

In summary, antioxidants in food can decrease the risk of cancer by affecting the epigenetics of DNA susceptible to promoting cancer, but attention must be paid to other factors that can affect these phytonutrients.

This post is not meant to diagnose, treat or recommend any course of therapy. It provides general information on cancer genetics and nutrition. Check with your physician how these factors may impact on your health.

Last updated by Dr. Vee on August 6, 2011

Photographs Courtesy of Albaflickr/J.Jorge

Super Fruits are fruits that are packed with nutrients and antioxidants.

Free radicals are toxic molecules created naturally in the body when food is digested and energy is utilized by the body. Antioxidants are ingredients in fruits that fight damage created by free radicals. Cancer, heart disease, Alzheimer’s disease and eye problems can develop if free radicals aren’t neutralized by antioxidants in the body. Super Fruits have antioxidants which scavenge free radicals and decrease inflammation in the body. Antioxidants also boost the immune system to help fight infections. Many fruits have high levels of potassium, which helps prevent high blood pressure.

1.Blackberries–Purple berries have the highest antioxidant content of any food, so when it comes to fruits and vegetables, purple is the new green! Anthocyanins are the antioxidants in blackberries (and black currants) that give berries their deep purple color and protect against heart disease and cancer. Blackberries also have high levels of vitamin C, which help boost the immune system. Blueberries, raspberries, strawberries and cranberries also have high levels of antioxidants. Cranberries may help prevent bladder infections.

2. Tomatoes–(fruit though we think of as vegetable). Red fruit such as tomatoes have an antioxidant called lycopene which helps prevent heart disease and certain types of cancer. Cooking tomatoes increases antioxidant levels. Tomatoes contain high levels of Vitamin E, vitamin C and iron.

3. Avocado–also known as an alligator pear. Contains more protein than in a steak! Avocados have essential amino acids (can only eat in the food, not made naturally in the body) to build muscle. They contain heart healthy omega 3 fatty acids. The monosaturated oil in avacodos help lower bad cholesterol levels. Contains lutein, which helps preserve eyesight. The antioxidants in avocados are great for the skin when applied as a masque.

4. Red grapes and grape juice–Contains the same heart healthy antioxidant resveratrol found in red wine. Resveratrol is felt to help prevent heart disease and blood clots. The skin of red grapes are packed with polyphenol antioxidants so eat the grapes with the peels on!

5. Pomegranates–one of the earliest cultivated fruits. High in fiber, vitamin C and potassium. Contains antioxidants called polyphenols (tannins, anthocyanins, and ellagic acid) that help prevent heart disease.

6. Kiwi–Can be mashed and spread on meat as a natural tenderizer. Good source of fiber, vitamin C, potassium and vitamin E. Has antioxidants to help vision and prevent heart disease. Mild flavor so kids will enjoy. One study showed kiwi fruit helped reduce the inflammation of asthma in children.

7. Chili Peppers–All peppers have seeds so are considered fruit (though we often cook them like vegetables). Contain antioxidant called capsaicin, which treats inflammation pain due to osteoarthritis. It is also used as a natural remedy for nasal congestion. Also increases endorphins in the brain so may help improve mood. Peppers contain more vitamin C than oranges! They also have high levels of the antioxidants beta carotene (to help prevent cancer) and lutein (to preserve vision).

8. Figs–Contain lutein that helps maintain good vision. High in iron, fiber, potassium and calcium. Contain polyphenol antioxidants.

9. Oranges–high in fiber and vitamin C, which helps boost immune system. May be helpful in reducing the inflammation associated with asthma and rheumatoid arthritis. Vitamin C helps the absorption of iron from the stomach.

10. Apples–Contains pectin, a soluble fiber that lowers cholesterol and blood sugar levels. Pectin binds heavy metals like lead and mercury to help the body get rid of these toxins. Contain high levels of vitamin K which helps with clotting function, and vitamin C which helps make healthy connective tissue. Trace mineral selenium helps body’s natural antioxidant system. Antioxidants in apples help preserve brain and memory function. Lots of nutrients in the peel of apples. Consider splurging for organic apples to avoid possible pesticide exposure.

Last updated on March 15, 2011 by Dr. Vee

Photographs courtesy of epSos.de

The INCA study was a placebo controlled study carried out in the Netherlands that showed a hypoallergenic diet helps treat hyperactivity, inattentiveness and oppositional defiant behavior (such as temper tantrums!) in children not on stimulant medication.

The restriction elimination diet included turkey, lamb, rice, water, salt and pepper, and many vegetables, including cauliflower and cabbage. Children were then challenged with foods, added back one by one, to see which foods caused worsening attention and behavior symptoms. Surprisingly, foods that worsened symptoms in an individual child did not correlate to high IgG immunoglobulin levels as would be expected in food allergy/intolerance. IgE allergy to food was not tested. The authors recommend that food allergy testing not be used to guide food therapy in children with ADHD, instead eliminating food that clinically caused problems in a particular child.

The details of the restriction elimination (RED) diet and the Food Journals used by families enrolled in the study are included n the appendix of the journal The Lancet.

An important detail of this study is that all children were screened to determine if they actually met criteria for ADHD, were of school age and did not take any stimulant medication.

Remember that many kids with ADHD have been found to have zinc deficiency, so it is a good idea to supplement with a multivitamin/mineral. High doses of zinc are not recommended.

Here is my WJXT Morning Show interview discussing a hypoallergenic diet and ADHD.

Reference:

Dr Lidy M Pelsser MSc, Klaas Frankena PhD, Jan Toorman MD, Prof Huub F Savelkoul PhD, Prof Anthony E Dubois MD, Rob Rodrigues Pereira MD, Ton A Haagen MD, Nanda N Rommelse PhD, Prof Jan K Buitelaar MD. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. The Lancet, Volume 377, 5 February 2011 doi:10.1016/S0140-6736(10)62227-1.

Last updated by Dr. Vee on February 28, 2011

Leptin is a protein secreted by adipose (fat) tissue. It was named after the Greek word leptos, meaning “thin.” The more stored fat a person has, the more leptin is secreted. Of course we used to think that fat just sort of, well, grew around the midline and thighs, and was inert. Now scientists know that fat is actually an active organ and makes hormones such as leptin.

Leptin binds specific receptors in the body tissues and organs. High leptin levels also signal the brain to decrease appetite and food intake. Leptin also interacts with the areas of the brain that involves motivation to eat and reward for eating as well as the feeling of being full.

Overeating, high sugar levels, high insulin levels, internal steroids and estrogens all increase leptin levels in the bloodstream.

Losing weight, a lack of body fat such as in patients with anorexia, HIV related weight loss, fasting state, adrenaline, thyroid hormones, testosterone all decrease leptin levels in the body.

Many of us think we have a hormonal reason for being overweight. The truth is that leptin deficiency is exceedingly rare. Rare cases of leptin deficiency are seen in childhood when children eat tremendous amounts of food and become morbidly obese. Because of their leptin deficiency, these children do not enter puberty. It is essential in obese children to determine if leptin deficiency is playing a role. These children respond to pharmaceutical replacement with leptin.

So how about the rest of us? Can leptin injections help with weight loss? Well, the truth is, most people who are obese already have very high levels of circulating leptin. They should lose weight due to the effects of leptin on the appetite and satiety centers in the brain but they don’t! Unfortunately, most people’s brains become resistant to the effects of chronically elevated leptin levels, just like diabetics become resistant to the effects of high insulin in their bloodstream. The exact mechanisms for this leptin resistance is unknown.

So it turns out that leptin is not the magic weight loss drug we thought it could be. Early studies with high dose leptin admininstration did not lead to significant weight loss. Some researchers propose that the addition of a pancreatic hormone called amylin may sensitize the body’s response to leptin. Preliminary studies suggest that the addition of an analogue of amylin called pramlintide may help aid weight loss, although like most weight loss studies, the patient withdrawal rate in this study was high, making conclusions difficult to interpret.

Where leptin may play a role is in the maintenance of weight loss. It is hypothesized that decreasing leptin levels in people who have lost weight increases their appetite and reverses the weight loss they attained. Hence the yo-yo weight loss/weight gain cycle that is so familiar to many of us. So in the future, it may be possible to maintain that hard earned weight loss with the use of exogenous leptin. For right now though, eating healthy portions and exercising are the best way to maintain that weight loss!

Last updated by Dr. Vee on February 27, 2011

Photograph of Pumpkin Soup Courtesy of Egal

Superfoods are foods packed with higher than average nutrients and antioxidants to fight cancer and heart disease

1. Berries. Blackberries, blueberries, strawberries, raspberries and cranberries—rich in antioxidants.

• Chokeberries and elderberries (difficult to find) are berries with the greatest antioxidant content

2. Pumpkin—use canned pumpkin (not pumpkin pie mix).

• Has antioxidants vitamin A, E and beta carotene.
• Use in pumpkin pancakes, soup, pumpkin ravioli (fun to make with the kids).

3. Dark Chocolate

• Avoid chocolate with refined sugar, milk fats and hydrogenated oils.
• Want high purity cocoa powder that is high in antioxidants. Avoid cocoa that has been alkalinized by the Dutching process (boils away nutrients). Label should state cocoa/dark chocolate has not been alkalized, has been dried and cold pressed rather than roasted.
• Should consist of at least 70% cocoa
• use cocoa butter instead of milk fats or hydrogenated oils
• contain natural, low glycemic sweeteners such as raw sugar cane rather than refined sugars

4. Nuts have omega 3 Fatty acids.

• Almonds and walnuts are the healthiest source. Almond butter.
• Child’s handful daily.

5. Popcorn—lots of fiber.

• Use unsalted and unbuttered.
• No more than three cup serving (not the huge bag at the theater!).
• It is better to pop popcorn yourself (and more fun with the kids!) than to eat pre-packaged microwave kind. Microwave containers have perfluorooctanoic acid (PFOA), a fluorotelmer in the lining of the bag. Can leak into popcorn during microwave cooking. to infertility, liver, testicular, and pancreatic cancer. Popcorn manufacturers have promised to voluntarily phase out PFOA by 2015 under a voluntary EPA plan. Accumulates in the body and stays there for years.
• Wait until age one to serve corn and age four for popcorn to avoid choking hazard

6. Antioxidant Lycopene in tomatoes (and tomato ketchup—does that make it a health food????).

•prevention of cancers of the prostate, pancreas, stomach, breast, cervix and lung
•prevention of heart disease
•Better available when tomatoes are cooked, packed in oil or in tomato juice (but these forms have high levels of sodium or dietary salt)
Whole wheat pasta with marinara sauce is a good source of lycopene

7.Cruciferous (like a cross) vegetables (cauliflower, broccoli, Brussel Sprouts)—steam lightly–nutrients remain even after cooking. (Nutritious value of broccoli INCREASES when cooked).

Vitamin C and K, beta carotene (powerful antioxidant converted to vitamin A in the body), iron, folic acid and potassium.

Contains phytochemicals which prevent cancer by preventing damage to cell DNA. Sulphorophanes prevent damage from carcinogens.

Broccoli sprouts have more sulphorophanes than bean sprouts.
Healthiest cruciferous plant is kale, which is a superfood because it is a great source of antioxidant vitamin C, vitamin A, vitamin K, and micronutrients that help eye health (lutein and zeaxanthin). Mix a little in a fruit smoothie or mix in cooked dishes.

8. Beans/lentils-Black beans have the highest concentration of the antioxidant anthocyanin phytonutrients. Other beans with high levels of antioxidants include soybeans, navy beans, split peas, lentils, pinto beans and garbanzo beans.

•Can make soups and hummus.
•Packed with protein, complex carbohydrates (low glycemic index) and fiber.
•Good source of iron, magnesium, folate, calcium, potassium, and zinc. Use in hummus, soups.

9. Sweet potatoes
•twice the recommended daily allowance of vitamin A
•42 percent of the recommendation for vitamin C
•four times the RDA for beta carotene,
•When eaten with the skin, sweet potatoes have more fiber than oatmeal.
•130 to 160 calories for small to medium sweet potato
•Cinnamon added to sweet potato helps stabilize blood sugar.
•Sweet potato digests more slowly than white potatoes so they are lower glycemic load.

10.Whole grain breads instead of wheat or white bread. Whole grains are rich in fiber and vitamin E

•very low in fat
•The germ and outer coating in wheat and other grains has most nutritional value. Avoid refined grain foods such as white bread and certain breakfast cereals.
•Whole grains typically fortified with folic acid, B vitamins, iron, and zinc.me whole grain breakfast cereals contain added calcium and vitamin D, too.
•Give kids whole grain breakfast cereals instead of highly processed, sugary cereals. Use whole grain breads for toast and sandwiches, whole grain crackers for snacks, oat bran muffins.
•brown rice instead of white
•quinoa, buckwheat, barley
•whole wheat pasta.
•Add roiled oats to meat loaf

11. Red grape juice—has resveratrol (a flavenoid antioxidant that protects agains blood clots and heart disease) like in red red wine.

• Be careful of sugar—dilute with water and limit intake, especially in toddlers.
•Cranberries and pomegranate juice provides antioxidants, but be careful of the concentrated sugar in juices.

Fatty Cold Water Fish- heart healthy omega-3 fatty acids.

• Choose wild-caught Alaska salmon over farmed salmon. Farmed salmon has been shown to contain 10 times more toxins, including Polychlorinated biphenyls (PCB) and dioxin, than wild salmon. Farmed salmon are fatter, and the PCBs are stored in this fat. In addition, salmon farms can harbor parasites. Some salmon farms use artificial colorings, which may be harmful to health.
• No more than two or three ounces fish/week for children between the ages of two and six years old.
• Canned tuna is composed of smaller tuna types such as skipjack and albacore (more mercury in albacore than white tuna). In general, the smaller the fish, the less potential for mercury.
• Stick with one tuna fish sandwich weekly in children
• Careful with tuna steaks (made from larger, older tuna which have accumulated mercury).
• Avoid fish such as grouper, tilefish, shark due to high mercury content

Last Updated by Dr. Vee on February 14, 2011

Photograph Courtesy of Gina Smith

I’m in a panic because it is November and I have already missed the “first” Black Friday and now am about to miss the “second” Black Friday of the holiday season. I am fascinated by the marketing phenomenon of this year’s “early” Black Friday. “Traditional” Black Friday (I am waiting for the greeting card industry to get in on this one so I have yet another card to send during the year) is, of course as every smart American shopper knows, the day after Thanksgiving. (Another requirement for a greeting card, I rest my case.)

Last year, a few “genius” manufacturers decided to advertise an “early” Black Friday and they scored a home run in sales. In response, this year, many retailers, desperate for business in difficult economic times, started “early” Black Friday advertising (AKA “sales” and “deep discounts”) as early as July.

No wonder parents feel like a pawn in the endless sea of toy and electronic gadget advertising, aimlessly trying to determine which toys will be “the IT toy” of the holiday season. (Hint: Cabbage patch dolls are NOT hot this year!). Not necessarily the most fun toy, but the item that one “must have.” Kids are still determining which toys they “must have” from Santa this year while manufacturers jockey for position to be the “ultimate number one” toy to have in 2010. (Ta Da!)

I am embarrassed to say that as a pediatrician and a parent, I too have succumbed to the pressure of finding the “IT” toy before the item “runs out” and I have to buy it online for ten times the suggested retail price. Of course, suggested retail price is a relative term, determined primarily by the phenomenon of the “sale” price. I’d rather spend $30 on a toy that is “slashed” from the suggested retail price of $60 than actually buy an item that costs the suggested retail price of $30. And if I can find a coupon for $5 off, well, I am in parents’ retail heaven.

Whew, I am sweating at the mere thought of not being able to get the “right toy” so that my child is not an outcast at school for getting that “educational” holiday present (AKA books or “reading material”). Parents (AKA “consumers”) are now used to the annual ritual of fighting for a small supply of the most popular toys (which will surely be determined by a multitude of manufacturing experts writing online articles now that the first two “early” Black Fridays are over so that one may prepare for the “original” Black Friday, followed by the “late” Black Fridays of the holiday season.) Parents are forced by manufacturers to believe that a toy can’t be valuable unless it is in short supply. The aura of a holiday present is not quite the same unless your Santa gets it when other kids’ Santas were unable to find it in time for the holidays! (Of course finding a coupon and a “drastic reduction” in price helps. None of us wants to admit going overboard on holiday presents!).

Of course the unknown deciding factors this year are the holiday movies geared toward children and teenagers. Can one really accurately determine the “best toys of 2010” until after the movies have come out? (Surely they will be released on what will be known as the third and fourth “early” Black Fridays of this year.) That’s a lot for parents to think about (along with internet safety, bullying and underage drinking)!

How is a parent to deal with all of this? Well go on the internet of course! Right after each Black Friday, there will be plenty of retail “experts” writing internet articles telling us which items are the “official” “must have” items for 2010. I have already read ten “Top Ten Toys of 2010” lists online in the time it took me to write this blog post!

For a second there, I toyed with the idea of dawdling enough to get presents at the “the last and final early Black Friday” of 2010, also known as the “Day after Christmas sale,” which I now believe will be called “the first earliest Black Friday of 2011.” Nah…

Last Updated by Dr. Vee on November 26, 2010