From the FMS Global News Desk of Jeanne Hambleton (UK)
Courtesy of WebMD.com
By Elizabeth Lee -Reviewed by Louise Chang, MD – WebMD Feature
A best-selling diet book promises to prevent disease by teaching you to cook like a chef and think like a doctor.
Imagine preventing breast cancer by eating broccoli and kalamata olive pizza, avoiding Alzheimer’s by skipping the turnip greens, and holding off heart disease with an ounce of dark chocolate and a handful of almonds every day.
Sounds yummy, yes?
Eating your way to better health is a belief that echoes through the centuries, from the green tea of China to Hippocrates’ advice to “let food be your medicine, and medicine be your food.” Its most recent form comes in best-sellers like ChefMD’s Big Book of Culinary Medicine by John La Puma, MD.
Like La Puma’s other books — he co-wrote Cooking the RealAge Way and The RealAge Diet — culinary medicine promises that eating healthy foods can slow the effects of aging, prevent disease, and boost overall health.
Along with the usual super foods — almonds, blueberries, salmon, and the like — La Puma includes such gourmet fare as Parmigiano-Reggiano cheese, red wine, and the occasional indulgence of grass-fed beef.
Will preparing healthy recipes such as a Warm Beef Tenderloin Salad With Mango and Avocado keep the doctor away?
Maybe, nutritionists say. But they caution against focusing on any single ingredient.
“I think of food as nourishing and pleasurable, and I like to leave medicine to the pharmaceutical industry,” says Marion Nestle, PhD, MPH, a professor of nutrition and food studies at New York University and the author of What to Eat. “But eating a reasonable diet is one of the best things people can do for their health.”
Culinary Medicine: Healthy Foods = Healthy You?
La Puma was an internist and medical ethicist before he enrolled in culinary school to learn to prepare healthy foods in an appealing way. He worked for a time in the kitchens of Chicago chef Rick Bayless, known for his embrace of “sustainably” grown food and authentic Mexican food.
Now La Puma is medical director of the Santa Barbara Institute for Medical Nutrition and Healthy Weight. He promotes culinary medicine through appearances on Lifetime Television’s Health Corner and on his web sites, chefmd.com and drjohnlapuma.com.
“You have restaurant-quality food that helps to prevent disease,” La Puma says. “This is a fresh approach because of the soundness of the science and the flavorfulness of the food.”
By offering healthy food that is also tasty, in recipes that come together in 30 minutes or less with no more than 10 ingredients, La Puma hopes to encourage cooking at home. That will cut down on consumption of highly processed foods and increase the intake of whole foods higher in nutrients.
The healthy recipes are also low in calories, to help keep weight in line and reduce the risk of cancer, heart disease, diabetes, and stroke. That advice follows mainstream medical thinking, as public health workers have increasingly focused on reducing obesity rates to help prevent chronic disease.
So far, so good, nutritionists say. But where is the exercise, equally key to good health and maintaining optimal weight?
Culinary medicine focuses on food, not fitness. But it does include an eight-week plan for optimal health that counsels being active at least six days a week, for 30 minutes.
“I don’t know anyone who would separate those two,” La Puma says. “If exercise as a regime had a pharmaceutical name, it would be penicillin.”
Culinary Medicine: What Nutritionist Say
La Puma’s culinary prescriptions are filled with references to studies of nutrition and chronic disease. But nutritionists say some of the connections the book draws between what you consume and long-term health effects are tenuous.
“There is no one nutrient, there is no one food that is going to reduce your risk of cancer,” says Colleen Doyle, MS, RD, director of nutrition and physical activity for the American Cancer Society. “What is important, and it sounds so boring, is the overall dietary pattern.”
Mainstream nutritional guidance, including government recommendations, calls for a diet rich in fruits and vegetables, whole grains, and low-fat dairy products, supplemented with lean meats, fish, beans, eggs, and nuts. Diets should be low in added sugar, salt, saturated fat, and trans-fatty acids, or trans fats.
La Puma echoes that advice, while also recommending tea, wine, and small amounts of dark chocolate.
Guidelines are more specific for preventing or easing conditions from acne to ulcerative colitis: Yogurt can help with diarrhea, and migraine sufferers should avoid beer. Coffee can protect men from Parkinson’s disease and in women, may prevent diabetes, as well as colon and breast cancer, according to the book.
Not so fast, Doyle says.
“The American Cancer Society is not aware of any evidence that coffee impacts colon cancer significantly,” she says. “I think that is a leap from research to practice. We haven’t seen it.”
Christine Gerbstadt, MD, RD, is a spokeswoman for the American Dietetic Association and a lifestyle coach who operates a Florida practice that focuses on food as the first medicine. “My advice is always, if you do not drink coffee, do not start. If you do not drink alcohol, do not start,” Gerbstadt says. “There is no one thing that is absolutely required to be healthy, other than breathing.”
La Puma advises avoiding high-fructose corn syrup, choosing organic meats and produce when possible, and using full-fat salad dressings rather than reduced-fat or nonfat, to make sure nutrients in produce can be absorbed by the body.
There is no scientific consensus on those topics, nutritionists say. “I personally avoid poultry and meat raised with antibiotics and hormones, but I think there is a lot more emotion about it than there is science,” Gerbstadt says.
The same holds true for the claim that high-fructose corn syrup is more unhealthy than white or brown sugar, she says. They are all simple sugars that have the same amount of calories per teaspoon, Gerbstadt says, and affect the metabolism in similar ways.
Studies have shown higher nutrient levels in organic produce raised in richer soils, one of the reasons La Puma recommends choosing organic. He emphasizes organic for produce with thinner skin such as apples, berries, peaches, and potatoes, which are more prone to containing chemical pesticides. Nestle agrees, but for the environmental reasons — reduced exposure to pesticides.
“Whether the higher nutrient levels make any difference clinically remains to be seen,” she says.
The health benefits of dark chocolate are also a tough sell. La Puma points to studies that have shown it can lower blood pressure. But chocolate is high in calories, and weight gain can increase blood pressure. He recommends keeping portions small.
“Is there evidence that dark chocolate is going to prevent chronic disease? No,” Doyle says. “But if you like dark chocolate, it has some healthy fats and antioxidants.”
Culinary Medicine: Preventing Chronic Disease
La Puma advocates eating a variety of healthy foods, saying the combination of certain foods can be especially beneficial: turmeric and onion, and broccoli with tomatoes. Eating a variety of foods is advice most nutrition professionals agree on.
But how food affects chronic health conditions is still up for debate. Chronic diseases like cancer take time to develop. That makes studying the impact of a single ingredient difficult. Many studies that do so, including those on dark chocolate and blood pressure, focus on a small number of people, followed for just a few weeks or months.
Nestle says she sees hardly any direct connections between consuming a specific food and health benefits. “The only one I can think of is alcohol and the risk for heart disease. People who drink moderately have a lower risk for heart disease.”
La Puma allows that specific foods only go so far, but says he wants to motivate people to adopt a healthier lifestyle.
La Puma says he believes that at least 70% of heart disease and 80% of cancer is preventable, and that some can be reversed. Before age 50, genes determine much of an individual’s health. After that, it depends on the individual’s choices, he says.
“Doctors understand that what I am trying to do is inspire people to make changes, and the science is all sound,” he says.
“If I get just one more clinician to say to a patient, ‘Look, I want you to try this eight-week plan, I want you to have better food before we put you on cholesterol medicine or triglyceride medicine or high blood pressure medicine, and here is a reference to start,’ that part of my job is done.”
Culinary Medicine: Tips for Improving Health Through Eating
- Learn how to use a knife. Having even basic cooking skills is the secret to putting better food in your diet.
- Eat breakfast. People who eat breakfast live longer, weigh less, and keep weight off once they have lost it.
- If you want to make a change, find a structure. That could be Weight Watchers or Jenny Craig, weighing yourself, having a pedometer count, or writing down what you eat daily.
- Do not worry about being perfect. If you are choosing a baked potato instead of a deep-fried one, you know what? That is progress. If you are ordering fish instead of meat or beef, if you are eating nuts instead of chips, that is progress.
- Start with easy recipes.
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