Monday, April 6, 2015


People over 50 will remember very clearly our mothers saying "Don't eat between meals, It will spoil your apetite"

How true.

Snacking is a myth that the "Snack Industry" has invented. This myth has been further established by so-called dieticians and nutritionists advising us to eat frequent small meals. 

According to them our meal plan should be :
  • Breakfast
  • Mid-morning Snack
  • Lunch
  • Mid-afternoon Snack
  • Dinner
  • Bedtime snack
The claim is that you can rev up your metabolism by eating. Nothing can be further from the truth. Never in the history of humanity has there been such a ridiculous way of eating. If you need that 100 calorie snack to survive, there is something seriously wrong with you.

It boggles my mind to see how such an un-scientific, absurd and actually detrimental piece of advice can gain so much popularity. All of a sudden people are having "mid-morning slumps" and "mid-afternoon crashes".

(Just for the record; these terms are totally "made-up" and do not exist in medical science !)

Millions of Americans are following this advice and there is no sign of anyone getting thinner or healthier.

Here's why :

Every meal, no matter how small causes an increase in blood glucose and is accompanied by a release in the hormone; insulin. Insulin is responsible for facilitating the use of glucose by the cells  and as soon as the blood glucose level drops in response to insulin we begin to experience hunger. If we satisfy this sensation of hunger by eating another small meal or snack the cycle is repeated and can go on forever. The problem with this eating pattern is that the metabolism never gets a break from insulin and doesn't get the chance to burn fat. A continous scretion of insulin also eventually leads to "insulin resistence" and further cravings for food. This is a viscious cycle that will lead to further obesity, diabetes and cardiovascular disease.

Small meals are not satisfying and will leave one obsessing about the next snack or meal. This extremely frustrating and psychologically detrimental preoccupation with food will eventually end in "binge eating" followed by feelings of guilt for having no will power and then going back to the same dietician sponsored unhealthy style  of eating.

Eating is not an event that needs a plan or will power. Eating is and should be a natural process. Eat when you are hungry and don't when you are not. Eat until you are full and satisfied and do not eat or snack until the next meal. Your mom was right. ( Remember there were very little overweight or obese people in those days, wonder why ? )

Wednesday, February 4, 2015

Go "Nuts" for Nuts !

Typicaly, nuts are not thought of as food.

Nuts are usually considered as something of a novelty you consume with a drink at a bar or on an airplane flight.

The fact is; Nuts have been part of our natural diet for hundreds of thousand years. In fact our "hunter-gatherer" diet may have consisted more on nuts, seeds, wild berries and herbs than the occasional kill. ( I am pretty sure that hunting an animal with sticks and stones wasn't that easy ! )

The health promoting properties of nuts have been known for a long time but this fact has never been publisized until recently.

A Harvard study recently published in the New England Journal of Medicine reports that; "frequency of nut consumption is inversely associated with total and cause-specific mortality".

The translation of this is : Eat nuts and you live longer !

Here's why ;

  • Heart Healthy Fats - Nuts contain unsaturated healthy fats ( mono-unsaturated and poly-unsaturated ) that lower the levels of bad cholesterol.
  • Omega-3 fatty acids- Most nuts are rich in omega-3 fatty acids that fight inflammation and protect the heart.
  • Plant Proteins - Half of our daily recommended protein intake should come from plant sources and nuts are packed with them.
  • Plant Sterols - Help to reduce bad cholesterol
  • Fiber - Reduces fat absorbtion from the bowels and helps to lower cholesterol, Fiber also makes you feel full, so you eat less.
  • Vitamin E - Is a powerful antioxidant that protects against heart disease and various cancers.
  • Selenium - Is associated with a reduction in cancer risk
  • L-arginine - In the body this essential amino acid is converted to "nitric oxide" (NO). Nitric oxide is a powerful neurotransmitter that helps blood vessels relax to improve circulation. ( A note for the guys; Viagra works through increasing NO !!! ) 

Walnuts, Pecans, Brazil Nuts, Hazelnuts, Almonds and Pistachios not only offer numerous health benefits but are tasty and satisfying. An ounce before meals will supress the apetite and prevent excess eating. Nuts are also an excelent choice as a snack when hunger knocks the door.

Prefer unsalted and dry roasted nuts.

2 ounces of an assortment of nuts per day should be part of our healthy nutrition plan.

Take Care,

Monday, February 2, 2015

The "King" of Vegetables : Broccoli !

In my article on "middle age nutrition" I mentioned that broccoli is a very special vegetable and is in a category of it's own.

All vegetables are an excellent source of vitamins, minerals and more importantly "phytochemical" molecules that possess a wide variety of health promoting properties. Broccoli is no exception;

Health Benefits of Broccoli 

  • Excellent source of dietary Fiber; essential for good digestion and regularity, cholesterol regulation and immune function.
  • Excellent source of vitamins; A, B, C and K
  • Excellent source of minerals; Calcium, Iron, Zinc and Phosphorous
  • Excellent source of the phytochemical molecule; Sulforaphane
Sulforaphane is what makes broccoli so special !

Health promoting properties of Sulforaphane
  • Sulforaphane is a very strong (indirect) antioxidant. It activates the body's natural antioxidant defense system through a gene called Nrf2. 
  • Sulforaphane is a very strong "anti-inflammatory" molecule.
  • Sulforaphane is the strongest natural "anticarcinogenic" molecule known to man.
With these properties Broccoli and Sulforaphane;
  • Protects against Heart Disease
  • Protects against Diabetes induced vascular and cardiac complications
  • Protects against Cancer
  • Protects against Neurodegenerative diseases like Alzheimer
  • Protects against Osteoarthritis
  • Protects against UV Radiation and skin cancer.
Broccoli is a must in the "middle age nutrition" menu !!

A cup of steamed Broccoli a day is an insurance policy against many age related chronic diseases.

Mediterranean Broccoli Dressing
  • 4 tablespoons Extra Virgin Olive Oil
  • Juice of 1 lemon
  • 2 cloves of crushed Garlic
  • 1 tablespoon crushed mustard seeds
Drizzle dressing over steamed Broccoli !

"Broccoli Sprouts"  

For those of you who need an extra "bang" of Sulforaphane; "Broccoli Sprouts" are an excellent option. Johns Hopkins researchers found that the 4 day old baby sprouts of the broccoli seeds contain 20 to 50 times more sulforaphane ounce per ounce than the mature vegetable.

Broccoli sprouts also has the advantage of being easier to consume ( no preperation needed as it is eaten raw ) and does not have the aroma of broccoli that can be offensive to some individuals.

Broccoli and/or Broccoli Sprouts are a must for middle age nutrition and should be consumed at least 3-4 times a week !

Bon Apetit,

Take Care,

The "True" Facts about Coronary Heart Disease

Coronary heart disease (CHD) is a disease in which a fatty substance called “plaque” builds up inside the coronary arteries. This process is called “atherosclerosis” and is the pathology that leads to heart attacks and strokes.

CHD is predominantly a disease of the “middle aged” and older population. Men over 40 and women over 50 are candidates for CHD. Lately we have begun to see CHD in even younger individuals, due to an increase in obesity and diabetes caused by “bad” nutrition.
Coronary heart disease is the # 1 cause of death among men and women in the US, claiming more than 600,000 lives a year ! ( thats like 3 Jumbo jets crashing every day ! )

CDC statistics reveal that approximately 750,000 Americans have a heart attack every year at a cost of over $110 billion in healthcare, medication and lost productivity. The incidence of CHD has been rising paralel to the rise in obesity and diabetes and has reached “pandemic” proportions.

Causes and Risk Factors of Coronary Heart Disease

For the past three decades CHD was blamed solely on “dietery fats” and cholesterol. The plaques that cause CHD were found to be made up of  a form of “bad cholesterol” (LDL) so logically the culprit had to be the bad cholesterol that we consume in our diet. High blood levels of LDL were associated with CHD.

The problem is that; decades of the “low fat” diet craze and cholesterol lowering “statin” drugs did nothing to curb the incidence of CHD. In fact the incidence kept rising.

I must admit that, I too, was on the low fat and statin “bandwagon” until years later when I started to notice that it was not working. The moment of truth came when years ago I reviewed the lab data of the last 300 patients that I had operated on for CHD; More than half of these patients had normal levels of LDL !!! and that didn’t save them from getting CHD !? On the other hand we have seen thousands of people with high cholesterol levels and no evidence of CHD.

Why is LDL being deposited in the arteries of some people and not in others ?

The answer and truth began to surface in the last couple of years when we realized that there are actually two kinds of LDL and the  LDL we get from saturated animal fat is not the kind that is deposited in the arteries, these are large “fluffy” LDL molecules that are unable to settle in the artery walls. On the other hand the LDL molecules that can and will settle in the arteries to cause deposits and plaque are the “small dense LDL molecules”. Guess where these come from!; mostly the liver ! and they are made from sugars, not fat !!! ( Disclaimer : this does not mean we can eat all the animal protein and fat we like. We will get into that subject later ! ) In short; excess sugar is a more important risk factor than fats !

The second important factor in the development of CHD is “Inflammation”. Inflammation is the body's natural response to infection and allergens that cause iritation. Inflamation actualy fights these situations and aids in healing. When inflammation becomes chronic ( Chronic Whole Body Inflammation ) it sets the stage for a myriad of chronic diseases like CHD, Cancer and neurodegenerative diseases. In the case of CHD, inflammation damages the vascular tissues and make them susceptible to atherosclerotic changes.

Causes of Chronic Inflammation
  • Trans fats
  • High sugar consumption and diabetes
  • Obesity
  • Smoking
  • Artificial sweeteners, flavours, colorings.
  • Inactivity
In summary; quoting one of the pioneers in the field of preventative medicine; Dr. Caldwell Esselstyn of the Cleveland Clinic “CHD is a food-borne illness and need never to exist”. 
CHD is indeed a nutritional disease which can be avoided by proper nutrition; avoiding the “bad foods” and eating the foods that have the power to stop the disease process in it’s footsteps.
Midlife is a time in which many of the chronic diseases have already established a foundation and are just waiting for the right time to expolde. We have the means and power to reverse back into a healthy life.

In our future articles we will discuss the simple precautions to take in order to prevent and even reverse obesity, diabetes and coronary heart disease.

Take Care,

Saturday, January 31, 2015

Middle Age Nutrition - It's not just about weight !

A healthy diet is a given, but does this "ideal" diet change over time. The short answer is yes.

The ideal diet of a child, adolescent, grown-up and that of a middle aged person actually differ drasticaly. So, one diet does not fit all !

İn childhood and adolescence a diet high in vitamins, minerals and protein from a variety of sources is essential for proper growth and development. The unlimited energy of this age group also requires a high calorie intake. Once development is complete these requirements begin to decrease. Unless the adult individual is an athlete or body builder the requiremnt for protein and fats is dramaticaly reduced. At this point excess protein, fat and calories will only contribute to obesity and a wide variety of associated chronic diseases and premature aging.

What happens to our metabolism as we get older ?

By the time we are in our mid-thirties we are pretty much done with growing and developing. It is not a coincidence that most of us ( previously of normal weight ) begin to gain weight in these years. (The Middle age spread). A Harvard study found that people tend to gain an average of 20 pounds between the ages of 35 and 50.

Here's why;

  • We begin to ( physically ) slow down; less activity, less sports, less sex etc., thus burning less calories.
  • Sensing that our growth and development is done, a certain group of hormones like "Human Growth Hormone" ( HGH ), Testosterone and Estrogen begin to decrease. The decrease of these hormones not only cause a slowing of our metabolism, it is also associated with gradual muscle tissue loss ( "Sarcopenia" ). Loss of muscle results in a further decrease in metabolism.
So, by eating the same amount of food that we ate in our thirties we will end up gaining weight in our forties and fifties !!!

So what do we do ? ; Eat less or try to walk it off !!!

Well, we do both, but we'll get to that subject later.

It's not just about weight

Nutrients like proteins and fat that are vital for our development in youth may become actually very hazardous to our health in later years. ( But not for the reasons you think they are ! )

It's common knowledge that excess calories from refined carbohydrates and sugars end up being converted to fat and stored in the liver and any other place that is available ! The same goes for fats and without going into detail this process leads to obesity and our #1 killer cardiovascular disease.

What about animal protein ( meat ) ? What happens when we consume too much meat ?

( Disclaimer : I am not a vegetarian and I actually enjoy a good juicy steak now and then ! ) 

But the following is not so pleasent for us middle aged  meat eaters; 

Meat proteins are digested and broken down into "amino acids". These amino acids are utilized to regenerate new cells, muscle tissue, blood and a variety of substances necessary for our metabolism. In middle age we still need protein to maintain these processes but our growth process is long over and we don't need so much for building muscle and bones etc. ( unless you are working out regularly and vigorously). So what happens when we have too much of amino acids circulating in our blood ?  The excess can't just be flushed out like in the case of salt or minerals and can not be pooped away like fiber. The answer is that just like in the case of excess sugar these amino acids are converted into sugar ( "gluconeogenesis" ) and then fat and stored, resulting in obesity, insulin rersistence and yes, diabetes and heart disease!

Meat consumption is percieved as a sign of "plenty" and "bounty" by our evolutianary metabolism. In times of bounty our metabolism gears up for growth and various mechanisms are set into action. One of these mechanisms is the production and release of a hormone called IGF 1 ( Insulin Like Growth Factor 1 ). Ordinarily this hormone promotes cell division and growth but if you are a full grown adult, cell growth may not be a good thing ! Unfortunately, at our age IGF 1 promotes and fuels Cancer growth.

A Harvard study that followed 120,000 people over 30 years was published in 2012 and reports that; Red meat consumption is associated with an increased risk of cardiovascular and cancer mortality.

Conclusion : At our age we need to reduce our intake of animal protein !

How much do we eat ? : The Dietary Guidlines for Americans recommends we eat about 50 grams (46 grams for women and 56 grams for men) of protein per day. This number may be too low for people in their twenties and thirties but too high for us middle aged. It is wise to divide this protein intake so that half comes from animal sources ( meats, eggs and dairy ) and half from plant sources (legumes, nuts and vegetables).

Just as a reference point :

  • A 4-ounce piece of meat has about 28 grams of protein
  • A cup of dry beans has about 16 grams
  • An 8-ounce container of natural yogurt has about 11 grams
  • A 3-ounce serving of broccoli has 3 grams

OK, we are told to limit our sugar and carbohydrate consumption, we now see that we need to limit our (animal) protein consumption. So what do we eat ?

In midlife it seems that we are aging more rapidly and we are now more vulnerable to chronic diseases like cardiovascular disease and cancer. At this point our nutrition should be focused on getting as much antioxidants and cancer fighting foods as possible; Fruits and vegetables.

The aging process, though not fully understood, is likened to the oxidation ( rusting ) of our tissues due to internal and external factors. This process called "oxidative stress" causes inflammation and damage to our tissues making them vulnerable to "aging" and chronic diseases.

The Solution : Antioxidants !

Food based natural antioxidants are the "antidote" to oxidative stress. All fruits and vegetables contain not only essential vitamins, minerals and fiber, but large quantities of different antioxidants.

Antioxidant Superstars
  • Green Leafy Vegetables and Salad Greens : Especially Spinach, Kale, Arugula
  • Apples
  • Citrus Fruit
  • Pomegranates
  • Blueberries ( and other Berries )
  • Red Cabbage
  • Red Beet Root
  • Tomatoes and Peppers
  • Beans
  • Nuts ( especially Walnuts )
  • Spices ( Cinnamon, Cloves, Turmeric, Ginger )
  • and last but not least ; Broccoli ; Broccoli is in a class of its own as it has very strong antioxidant and anti-cancer properties ( More on Broccoli in another article )
In Conclusion ; Middle age nutrition should be "fine tuned" as follows;
  • Less sugar and refined carbohydrates
  • Less animal protein 
  • Less processed foods
  • Much much more plant based whole foods.
Take Care,

Friday, January 30, 2015

Midlife Crisis; Fact or Myth ?

A Google search on “midlife” will give over 6 million results, 99 percent of them pertaining to the “midlife crisis”. Somehow midlife has become synonomous with a crisis! What is a “midlife crisis”? Does every middle aged person have a crisis at that time in their lives?

The popular and largely caricatured perception of a midlife crisis is a middle aged guy “behaving badly”, trying to hide his anxiety and fear of growing older. Buying a flashy sports car, newfound attention to health and appearence, cheating on the wife, quitting a job and divorce have been considered the hallmarks of the midlife crisis. Please notice that the midlife crisis is almost exclusively attributed to men and there is very little mention of the midlife crisis of women.

How many 50 year old guys do you know that suddenly quits their jobs, grows a ponytail, gets a tatoo, buys a “Harley” and drives off into the sunset with a bimbo?

So what is the “midlife crisis” and how prevalent is it?

 The term “midlife crisis” was coined by the Canadian psycholoanalyst Elliott Jacques in 1965. Jacques defines the period of 40 to 60 as a time where the individual realizes their own mortality and gets the feeling that time is running out.

Reflection upon ones life in middle age is quite common. The average person may have such thoughts on occasion but very few actually brood on the subject to eventually have a full blown “crisis”.

Statistics show that the divorce rate in midlife is actually on average less than the other age groups. The highest incidence of divorce is in the first 8 years of the marriage and is more prevalent in the late thirties and early forties, not in midlife !

The so called “midlife crisis” is a personal crisis due to a bad relationship, job or financial situation or any one of hundreds of different reasons that cause one to get depressed or confused and cause “abnormal” behavior. It can happen at anytime in ones life and is not specific to midlife. Less than 10 percent of middle aged individuals have a “crisis”.

Midlife doesn’t own the crisis,
I was having a crisis in my twenties, 
I’m only having a midlife crisis because I’m in my midlife.
I had a crisis in my twenties, a crisis in my thirties….
Ray Romano 

 In a nationwide survey; middle aged people overwhelmingly expressed content with their lives. The fact is our middle ages are more characterized with competence, confidence and content.

So why is aging and the “midlife crisis” on the agenda so often ?

Probably because there are so many feeding on it ! The midlife crisis has always been a topic of interest for Hollywood, the cosmetic industry, the pharmaceutical industry, unscrupulous  psychologists and the anti-aging industry. First they fuel and foment the insecurities of the middle aged and then offer to sell a cure !

The “Midlife Crisis” is a myth.

Enjoy these wonderful years.

Friday, January 23, 2015

Are You "Middle Aged" ?

For those of you who are not sure; Here are some hints !

resim 1

  • If you read the paper at arms length; You are “Middle Aged” (Buy a pair of reading glasses) 
  • If loud music disturbs you; You are “Middle Aged"
  • If you need help from your kids to download and run a computer program; You are “Middle Aged”
  • If you see your mother/ father when you look into the mirror; You are “Middle Aged”
  • If you wake up in the morning feeling tired; You are “Middle Aged”
  • If your hairdresser and make-up bills are growing; You are “Middle Aged”
  • If you have aches and pains on a regular basis; You are “Middle Aged”
  • If you don’t miss the evening news; You are “Middle Aged”
  • If you are doing a comb-over or growing a ponytail; You are in a “Mid Life Crisis” (shoot yourself)
  • If sex begins to seem like a chore; You are “Middle Aged”resim 2
  • If certain foods don’t “agree” with you; You are “Middle Aged”
  • If smart phones and TV remotes confuse you; You are “Middle Aged”
  • If you are considering “Botox”; You are “Middle Aged”
  • If health shows on TV ( Dr. Oz ) grab your attention; You are “Middle Aged”
  • If you begin stories with “in my days”; You are “Middle Aged”
  • If you re-connect with old friends on facebook (the ones you didn’t bother to call for 20 years): You are “Middle Aged”
  • If you make “grunting” noises when getting in or out of your car; You are “Middle Aged”
  • If you have begun to dress “sensibly”; You are “Middle Aged”
  • If you have more than 5 prescription drugs, vitamins or supplements in your medicine cabinet; You are “Middle Aged”
  • And Finally
  • If your logic overrides your feelings; You are “Middle Aged”