So, you popped your cholesterol meds then tucked into a juicy steak. The pill can handle a little cholesterol surge, right? “At times, patients don’t think they need to follow a healthy diet since their medications have already lowered their blood pressure and cholesterol—and that is wrong,” says Mahshid Dehghan, Ph.D., study author and nutritionist at McMaster University in Hamilton, Ontario. Eating well offers benefits beyond standard drug therapy.

In fact, researchers found patients taking drugs to prevent recurrent heart attacks and strokes who also ate a heart-healthy diet reduced their risk of cardiovascular death (by 35 percent), congestive heart failure (28 percent), stroke (19 percent), and new heart attacks (14 percent) compared to those with less healthy eating habits.

No License to Binge The Saturday Evening Post

But a new study suggests that the inability to hold off on things we desire may not be the result of upbringing or some kind of moral failing. Turns out, some of us are just hard-wired for instant gratification, according to a 40-year follow-up study led by B.J. Casey, director of the Sackler Institute for Developmental Psychobiology at Weill Cornell Medical College. The research first looked at the behavior of preschoolers who were offered the choice between a cookie now or two cookies later. Subsequent results show that the kids who couldn’t delay gratification grew into adults who were similarly unable to do so.

Over the course of the recent study, the researchers were able for the first time to identify the specific areas of the brain where desire takes hold. “This could have major implications in the treatment of obesity and addictions,” says Casey.

“I Want it Now!” The Saturday Evening Post

Caffeine: You’re probably well aware that coffee can cause erratic or rapid heartbeats. It can also lead to atrial fibrillation in susceptible people. Some feel palpitations when they consume caffeinated soda, tea, or chocolate.

Overeating: For some individuals over-indulging at the buffet table may cause symptoms. Why? A full stomach can irritate nearby nerves, stimulating the heart and triggering extra heartbeats.

Red Wine: Small amounts of alcohol, particularly red wine, can benefit the heart. In excess, however, alcohol may cause heart arrhythmias and “holiday heart,” or palpitations on Monday after a weekend binge.

Supplements: It’s impossible to say which dietary supplements can potentially affect the heartbeat (or interfere with heart medicines) because most are unregulated and untested. “Natural” does not mean “safe,” and consumers can unknowingly take products that contain hidden and potentially harmful ingredients. Diet pills can be especially dangerous. For example, the FDA warned last October that 20 brands of dietary supplements for weight loss were tainted with sibutramine—the active ingredient in prescription weight-loss drug Meridia that was linked to elevated blood pressure, heart rhythm problems, heart attacks, and stroke and removed from the U.S. market in 2010.

Common Causes of Irregular Heart Rhythms The Saturday Evening Post

Start today!

James suggests taping this list to the refrigerator and adopting one healthy habit a week:

• Begin each day with a good stretch and some deep breaths.
• Plan a week’s worth of meals on your day off.
• Spend 30 minutes twice a week cutting up fresh veggies to have ready for snacks and preparing meals. Next time you want scrambled eggs (or tofu), sauté some veggies first, then add eggs.
• Keep seasonal fruit on hand for when hunger (or a sweet tooth) strikes.
• Vary your food; if you eat it on Monday, don’t have it again until Friday.
• Eat at a table and chew well. Be thankful.
• Make your own vinaigrette with olive oil, lemon juice or vinegar, a little Dijon mustard, a minced garlic clove, and a pinch of salt and pepper.
• Sprinkle grated cheese on top of casseroles instead of mixing in larger amounts.
• Substitute raw nuts and seeds for processed granola bars.
• Have at least one day a week without meat—Meatless Monday, perhaps.
• Eat more leafy greens. Steam kale, chard, spinach, or radicchio, among others, for a couple minutes. Drain and set aside. Sauté some onions, garlic, and shitake mushrooms in olive oil for a few minutes. Add steamed greens, stir, and serve.
• Communicate well. Kindly speak your mind and be done with it. Don’t hold grudges. Forgive yourself and others.

12 Tips for Better Health The Saturday Evening Post

The Palo Alto Medical Foundation suggests the following alternatives to high sodium foods. For labeled items, select foods that are 5 percent or less of the Percent Daily Value for sodium.

Don’t Get Smoked

Avoid: Smoked, cured, salted, and canned meat, fish and poultry
Suggested Alternatives: Unsalted fresh or frozen beef, lamb, pork, fish, and poultry

(Three ounces of tuna canned in water contains 287 mg of sodium, while three ounces of fresh tuna cooked with dry heat contains 42 mg of sodium.)

The Cheese Culprit

Avoid: Processed cheese and regular peanut butter
Suggested Alternatives: Low-sodium cheese, low-sodium and some all-natural brands of peanut butter

(One slice of Kraft Nonfat American Cheese contains 273 mg of sodium.)

Soup’s Out

Avoid: Canned and dehydrated soups, broths, and bouillons
Suggested Alternatives: Low-sodium canned soups (note: even lower-sodium soups are still high in sodium, so check the label), broths, and bouillons

(One cup of Campbell’s Select Minestrone Soup contains 951 mg of sodium. Now, are you crushing up crackers on that soup?)

Saltine-Free

Avoid: Crackers with salted tops
Suggested Alternatives: Unsalted crackers, rice cakes, or no salt added Melba Toast crackers

Can Not

Avoid: Canned vegetables
Suggested Alternatives: Frozen or fresh vegetables, low-sodium or no salt added canned vegetables

(One cup of canned green beans contains 622 mg of sodium.)

If It’s in the Bag

Avoid: Salted snack foods
Suggested Alternatives: Unsalted tortilla chips, pretzels, potato chips, and popcorn. If these items are not available, try popping your own popcorn, baking your own pita chips, or making homemade potato fries by roasting potato wedges with a little bit of olive oil.

(Researchers found that movie theater popcorn can contain up to 1,500 milligrams of sodium.)

P.S. An average pickle spear has 306 mg of sodium.

Cut the Salt! The Saturday Evening Post

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Classic Covers: Dieting Through the Years The Saturday Evening Post

The analysis, completed at St. Michael’s Hospital and the University of Toronto, involved reviewing three studies on chocolate and stroke.

In the first study, people who ate one serving of chocolate per week were 22 percent less likely to have a stroke than those who ate none. In the second study, those who consumed 50 grams (1.7 oz) of chocolate once a week were 46 percent less likely to die following a stroke than the nonchocolate eaters. The third found no link between eating chocolate and risk of stroke or death.

Chocolate is rich in antioxidants called flavonoids and polyphenols which may help protect against stroke. A 1.4-ounce portion of dark chocolate contains an estimated 600 mg of polyphenols, compared to red wine (170 mg in 3.4 oz) or a medium apple (200 mg).

“More research is needed to determine whether chocolate truly lowers stroke risk, or whether healthier people are simply more likely to eat chocolate than others,” said Canadian study author Sarah Sahib, who suggests that additional and larger tests are needed.

Want to volunteer? Go to clinicaltrials.gov and search for “chocolate” http://www.clinicaltrials.gov/ct2/results?term=chocolate&pg=2. The last time we checked, we found five active studies related to chocolate.

Chocolate: A Sweet Treat for Health The Saturday Evening Post

Vitamin D deficiencies — both mild and severe — are rampant in this country. A national sample of nearly 19,000 individuals found that between 1988 and 2004, the proportion of Americans with adequate levels of vitamin D in their blood fell from 45 percent to 23 percent. Among blacks, those with sufficient levels plummeted from 12 percent to just 3 percent.

And that could spell trouble for a large portion of the U.S. population. Traditionally, scientists have thought of vitamin D as necessary mainly for bone health, because it helps the body absorb calcium. But recent research shows that vitamin D performs a multitude of other functions. And though much work remains to be done, one thing is clear: Vitamin D does far more than doctors realized even a decade ago.

“We should test for vitamin D as routinely as cholesterol,” says Dr. Daniel Nadeau, medical director of the Diabetes, Endocrine, and Nutrition Center at Exeter Hospital in
New Hampshire. Dr. Nadeau tests about 70 percent of his patients — and finds that almost all have suboptimal levels.

Deficiencies are being linked to some of the most serious chronic diseases. In 1997, epidemiologists Frank and Cedric Garland found that people with blood levels below 30 had three times the risk of colon cancer. Last year the famous Framingham heart study linked levels below 15 with a 60 percent greater likelihood of a heart attack.

Other studies have drawn tentative links between low D and elevated risks for multiple sclerosis, rheumatoid arthritis, asthma, and depression. In fact, if you drew a chart of the human body with arrows pointing to each organ affected by vitamin D, it would start to resemble a painting of Saint Sebastian, the martyr who met his end in a hail of arrows.

Beyond Bone Health

Researchers who gave people 800 to 2,000 units of vitamin D a day have found that those who received the supplements had lower risks for a variety of ailments — 80 percent lower for type 1 diabetes, 72 percent lower for falls in nursing homes, and 60 percent lower for multiple cancers. More studies are needed, but the results so far point pretty consistently in the same direction. “Vitamin D is not a magic pill, but it’s as close as you’ll ever get,” says Dr. John Cannell, president of the Vitamin D Council.

How can one substance affect so much? Dr. Michael Holick, professor of medicine, physiology, and biophysics at Boston University Medical Center and author of The Vitamin D Solution, slated for release next spring, offers an explanation.

“Virtually every tissue in the body has vitamin D receptors,” he says. “They have to be there for a reason.”

And that reason seems to be that vitamin D helps regulate genes throughout the body — genes that help control blood pressure, cell proliferation, and inflammation, among other things. They even rev up the immune system — not the antibodies that target specific germs, but the general-purpose cells that attack any foreign invader. For this reason, Dr. Cannell speculates that vitamin D could be a huge help in battling viral infections, including the H1N1 (swine) flu. “You should still get the vaccine,” he says. “But I wouldn’t dream of letting my family face H1N1 this winter with blood levels under 50.” In principle, few problems are easier to fix than vitamin D deficiency.

D-Fining Sources

There are three sources of vitamin D — sunshine, supplements, and foods.

Foods naturally high in vitamin D include fish, such as salmon, mackerel, sardines, and tuna. Milk, breakfast cereals, and some brands of orange juice are fortified with vitamin D. Those rays of golden sun — specifically UV-B radiation — stimulate the synthesis of the vitamin in the skin. That distinguishes it from other vitamins, which can only be obtained through food or pills. Dr. Holick recommends venturing into the sun with bare arms and legs daily without sunblock, but only for five to 10 minutes.

“Moderation is the word,” he says.

That leaves daily supplements. Currently, the recommended level of supplemental vitamin D is 200 international units (IUs) for individuals 19-50; 400 IUs for those 51-70; and 600 IUs for 71-plus. The Institute of Medicine, however, is expected to issue revised recommendations in 2010.

Some researchers are already taking more.

At a meeting at the Centers for Disease Control and Prevention this year, Dr. Robert Heaney of Creighton University passed out slips of paper to the other vitamin D researchers and asked them to jot down how much they take. He takes 3,000 units a day. “The average among my peers was more than 5,000,” he says. That sounds breathtakingly high compared to the current guidelines, but it’s not. “People with high sun exposures get 15,000 to 20,000 IUs a day from the sun with no sign of vitamin D toxicity,” says Dr. Edward Giovannucci, professor of nutrition and epidemiology at Harvard School of Public Health.

That said, there will never be a one-size-fits-all recommendation for vitamin D intake. There are too many variables. The obese need more than the thin because of their larger body size. The elderly need more than the young because they are less efficient at synthesizing it. Those who live at northern latitudes need more than those near the equator, where sunshine is more abundant year-round. Even individuals have different requirements at different times of the year.

As for me, I finally got the results of my vitamin D test: My level was 34 — just barely acceptable, but at least in the ballpark. “Increase your supplementation and get tested again in six months,” my doctor advised. Mind you, I was already taking 1,200 IUs a day and probably getting a couple hundred more from food. And despite wearing sunblock, sun-protective clothing, and floppy hats, my supersensitive skin is probably still synthesizing vitamin D during my
45-minute daily walks.

Even though I had an acceptable level, Dr. Nadeau said it may be “because you got tested in the summer.” Come winter, he hinted, I might slip into inadequate territory — but nothing I couldn’t fix with a few more supplements.

Vitamin D Dilemma The Saturday Evening Post

An updated version of the Mediterranean Diet Pyramid includes general recommendations for foods, drinks, and exercise.

The recent report, published in the British Medical Journal and authored by Antonia Trichopoulou, M.D., Ph.D., University of Athens Medical School, and Dimitrios Trichopoulos, M.D., Ph.D., Harvard School of Public Health, followed 23,349 Greek men and women for a mean of 8.5 years.

Key components of the tried-and-true diet as identified by the investigators include:

* High consumption of vegetables, fruits, nuts, olive oil, and beans
* Low consumption of meat and meat products
* Moderate consumption of wine (with meals).

Mediterranean Diet Update The Saturday Evening Post

Dear Doctor Franklin:

As you get out onto the streets of Philadelphia, you will notice a remarkable number of fat people waddling about. Perhaps your return will cause renewed interest in your recommendation: “Eat and drink such an exact quantity as the constitution of thy body allows of, in reference to the services of the mind.” Indeed, we all should heed this advice from Poor Richard: “Excess in all other things whatever, as well as in meat and drink, is also to be avoided.”

While a younger man, you advocated daily exercise and restrained dining; you seemed particularly concerned about the effects of overeating. Poor Richard advised: “Many dishes, many diseases,” and “He that never eats too much will never be lazy.”

Your warning about eating habits and temperance, especially as it relates to a full belly, certainly makes sense to anyone today who walks out of a dining room stuffed to near explosion: “That quantity that is sufficient, the stomach can perfectly concoct and digest, and it sufficeth the due nourishment of the body.…The difficulty lies, in finding out an exact measure.”

Your words, sir, are truer today than in your own time because the portions served are now so large: “If thou eatest so much as makes thee unfit for study, or other business, thou exceedest the due measure.” Your ideas on due measure appear elsewhere in your writing as well: “If thou art dull and heavy after meat, it’s a sign thou hast exceeded the due measure; for meal and drink ought to refresh the body, and make it cheerful, and not to dull and oppress it.”

We’d all find it easier to resist temptation if we followed your suggestion to “keep out of the sight of feasts and banquets as much as may be; for ’tis more difficult to refrain good cheer, when it’s present, than from the desire of it when it is away.”

In fact, after the huge meal I had last night, I’m going to try your proposal to “fast the next meal, and all may be well again, provided it be not too often done; as if he exceed at dinner, let him refrain a supper.”

The hazards of overeating seemed much on your mind, yet in spite of your Puritan upbringing in Boston and your Quaker readers in Philadelphia, you never invoked divine condemnation of gluttony, only sound recommendations any modern nutritionist would offer.
Today’s experts, for example, grumble that our mode of seasoning food stimulates overeating. Their thought is hardly new, considering this query to your club, the Junto Society: “Whether those meats and drinks are not the best, that contain nothing but their natural tastes, nor have any thing added by art so pleasing as to induce us to eat or drink when we are not athirst or hungry.”

You were also centuries ahead of your time with this advice: “Use now and then a little exercise a quarter of an hour before meals, as to swing a weight, or swing your arms about with a small weight in each hand; to leap, or the like, for that stirs the muscles of the breast.” Moreover, my colleagues have confirmed the value of your observation: “A temperate diet arms the body against all external accidents; so that they are not so easily hurt by heat, cold, or labour; if they at any time should be prejudiced, they are more easily cured, either of wounds, dislocations or bruises.”

Finally, I should inform you that modern scientists have determined that rats kept on sparse diets live longer and remain healthier than those allowed unrestricted access to food. I doubt you’ll find such results surprising, considering this statement posed to members of the Junto Society: “Whether it is worth a rational man’s while to forego the pleasure arising from the present luxury of the age in eating and drinking and artful cookery, studying to gratify the appetite for the sake of enjoying healthy old age, a sound mind and a sound body, which are the advantages reasonably to be expected from a more simple and temperate diet.”

Dr. Green is a member of the Board of Directors of Friends of Franklin, Inc. His book, Dear Doctor Franklin: E-mails to a Founding Father about Science, Medicine and Technology, is available at Amazon.com.

To read the first e-mail conversation and more, visit saturdayeveningpost.com/ben-franklin.

An E-mail to Ben Franklin The Saturday Evening Post

Previously a Portuguese study showed adult asthmatics eating a Mediterranean-style diet were better able to control their asthma symptoms.

Diet Keeping Asthma Away The Saturday Evening Post

Pop a Grape Instead of a Pill The Saturday Evening Post

Healthy Life: Just a Bowl of Cherries? The Saturday Evening Post

Could the simple act of keeping track of your food intake help you lose weight?

The answer is a resounding yes, according to a study that found keeping a food diary may actually double a person’s weight loss.

“The more food records people kept, the more weight they lost,” said lead author Jack Hollis, Ph.D., a researcher at Kaiser Permanente’s Center for Health Research in Portland, Oregon. “Those who kept daily food records lost twice as much weight as those who kept no records. It seems that the simple act of writing down what you eat encourages people to consume fewer calories.”

The findings, from one of the largest and longest-running weight-loss maintenance trials ever conducted, were published in the August ’08 issue of the American Journal of Preventive Medicine.

In addition to keeping food diaries and turning them in at weekly support group meetings, participants were asked to follow a heart-healthy DASH (Dietary Approaches to Stop Hypertension) diet rich in fruits and vegetables, as well as low-fat or non-fat dairy, and to exercise at moderate intensity levels for 30 minutes most days. After six months, the average, or mean, weight loss among the nearly 1,700 participants was approximately 13 pounds. More than two thirds of the participants lost at least nine pounds, enough to reduce their health risks.

“More than two thirds of Americans are overweight or obese. If we all lost just nine pounds, like the majority of people in this study did, our nation would see vast decreases in hypertension, high cholesterol, diabetes, heart disease, and stroke,” study coauthor Victor Stevens, Ph.D., a Kaiser Permanente researcher, told the Post.

In an earlier study, Stevens found that losing as little as five pounds can reduce the risk of developing high blood pressure by 20 percent.

“We’ve done many weight-loss programs and tend to work with middle-aged and older people,” Stevens says. “When you ask them why they want to lose weight, the first two or three reasons are always health-related: it’s not vanity. They have health issues—hypertension or trouble with their knees, hips, or back, for example. When the body carries an extra 100 pounds, it starts wearing out faster.”

Group meetings were an integral component of the program, largely because they hold individuals accountable.

“People get on the scale when they come in and report to the group how they’re doing with regard to exercise, dietary changes, what their plan was, and how it worked,” Stevens explained. “That accountability motivates them to think through what they’re going to do. In our experience, people are much more likely to follow through if they have a specific plan.”

Resolving to eat less may be a good start, but experts find that it’s not enough because, as Stevens notes, it “relies on willpower, which is notoriously poor in managing behavior.”

Group meetings, such as Weight Watchers, work well and are used in other kinds of health-promotion programs—smoking cessation, addiction, and other lifestyle change programs. But people can develop a social support system separate from a formal program.

“Formal programs are great, but they are not the only way to stay with your weight-loss plan,” agrees Stevens. “There are people who exercise together at a gym or community center, which helps them to stick with the program. If you are going to do that, pick someone who is interested: an uninterested family member or friend is not going to help. The best plan is if both people share similar goals and can help each other. Actually, three or four people is better than two.”

As for the diary, anything will do. The point is to write your daily food intake down as accurately as possible. Stevens recommends reading food labels, checking caloric counts, and getting a grip on portion size.

“The tricky part is getting an accurate estimate of portion size,” Stevens says. “We tend to underestimate. There’s been such inflation of portions served in restaurants and in commercial foods that people’s sense of what a serving is…is today really quite distorted.”

Holidays are a particularly troublesome time to maintain goals.

“From a weight-loss perspective, the holiday season begins in October with Halloween, and it goes all the way through mid-January,” says Stevens. “In our society, we have all these celebrations where we make exceptions—family birthdays, anniversaries, religious holidays, personal holidays, and office parties. Many people have special exceptions every week—sometimes two or three times a week. That’s where you get extra calories. Keeping a food diary during the holidays is helpful in managing what you eat. The bottom line is: if you want to lose weight, you have to cut back on calories—whatever time of year.”

For more information about the study or a free copy of a sample food diary, visit saturdayeveningpost.com/fooddiary.

Writing Your Way to Weight Loss The Saturday Evening Post

The key to success is consistency.

“The trick is to write down everything you eat or drink that has calories,” says Victor Stevens, a researcher at Kaiser Permanente’s Center for Health Research and coauthor of the study published in the American Journal of Preventive Medicine.

We look forward to hearing from you about your progress. Keep us posted!

Download Sample Food Diary [PDF]

Sample Food Diary The Saturday Evening Post