Tag Archive for: fruit

Myths Busted: Eat Your Fruit

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If you’ve watched the video, you know Dr. Berry gave three myths of the sugars in fruit. We addressed Myth One and Myth Two in Tuesday’s Memo. Today let’s examine Myth Three, and then consider whether fruit will cause non-alcoholic fatty liver disease.

Myth Three: Fiber, Vitamins, Minerals, and Phytonutrients Aren’t Important

This myth is sort of grasping at straws to try to prove a point. He claims that the fiber, vitamins, minerals, and phytonutrients in fruit are meaningless because of all the sugar in the fruit. He makes the comparison of adding those nutrients to a 20-ounce cola and then asking if we would feed that to our child.

Let’s get the facts straight. A 3.3 ounce orange contains a total of 8.5 grams of sugars with all the associated nutrients that he’s saying aren’t important, and he’s comparing that to a 20-ounce cola with 65 grams of high-fructose corn syrup with some of those nutrients added. While the molecules may be identical (Myth Two), there are differences in metabolism between sucrose and high-fructose corn syrup he doesn’t seem to understand. A better way would have been to use equivalent serving sizes. Even better, don’t force an issue that’s marginal, at best, and uses observational science as the foundation.

Okay, I’ve used the term “observational science” several times—what does that mean? Dr. Berry appears to be a very good physician who has helped many people overcome type 2 diabetes and other metabolic disorders using a ketogenic diet. He deserves credit for that, but when you use what you observe as the basis for recommendations for everyone, that’s stretching it.

According to an observational rooster, his crowing makes the sun rise every morning. Observation alone isn’t enough basis for these kinds of recommendations. Unless you have documentation that someone eating 3.3 ounces of lemon containing a total of 2.3 grams of all sugars will spike her insulin and glucose levels, the argument is baseless. In fact, every example he gave should have actual examples to support it, not from the published science but from actual experience. (That would be easy enough to do just by feeding subjects the food in question and then checking their blood sugar at certain intervals.) And it should be published as a case study in a medical journal, because that metabolic response would be unusual to say the least. Until then, it’s observational science and is not meaningful applied to anyone else. Leave the observational science behind unless you have the data to support it.

The Bottom Line

In doing the background research, I found that eating fruit does not appear to be a cause of non-alcoholic fatty liver disease or even a fatty liver. Obesity always seems to precede metabolic disorders that lead to a fatty liver in the vast majority of people. The DASH Diet and the Mediterranean diet, which both recommend fruit, are often recommended to treat a fatty liver, and research shows they work—and that’s the complete opposite of what he recommends.

If you’re concerned about a fatty liver, don’t give that banana or bowl of berries a second thought; focus instead on weight reduction. As always, the key is the calories. Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

References:
1. Br J Nutr. 2020 Jul 14; 124(1): 1–13.
2. Iran J Public Health. 2017 Aug; 46(8): 1007–1017.

Fruit and Fatty Liver Disease

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Non-alcoholic fatty liver disease (NAFLD) is on the rise in the U.S. and around the world. Estimates are by 2030, NAFLD will be the primary cause of liver transplants in the world. NAFLD is caused by obesity; associated conditions such as type 2 diabetes and metabolic syndrome are contributing factors. But does fruit intake contribute to NAFLD? According to one physician it does; that inspired him to record a video titled “Secret Sugar in Fruit” or as he calls it, the Three Myths of Fruit. He’s an advocate of the ketogenic diet, as many people are today, but is he correct about fruit? I thought I’d check it out.

Myth One: Fruit Contains Only Fructose

His opening statement about fruit is that nutritionists and Internet gurus are suggesting that fructose is the only sugar in fruit. He gives examples of the breakdown of sugars in five fruits, based on the USDA Food Database. No problem with that. But to say that most nutritionists don’t know that fruit contains a variety of sugars means he’s never had a basic nutrition class on macronutrients, because it’s certainly taught in those classes. Anyone who’s ever looked up any type of fruit on the database would clearly see there’s more than one type of sugar.

He also claims that the sugar in some small servings of fruit with as little as two grams of glucose or sucrose will spike blood sugars and insulin levels and that five grams of fructose will cause a fatty liver. He offers no evidence to support those claims.

Myth One contains some accurate facts but is more observational science than fact. Myth One: busted.

Myth Two: The Chemical Structure of Sugars

According to Dr. Berry, nutritionists claim that the chemical structure of glucose, fructose, and sucrose are different in fruit than soda. Not exactly true; they’re chemically identical, but there’s more to it than that. Myth Two: mostly busted.

I’ll cover the third myth on Saturday and set the record straight on fruit and NAFLD. You can watch the short video at the link below. He’s a personable guy, committed to keto, but reliant on observational science. We’ll talk about why that’s a problem next time.

What are you prepared to do today?

        Dr. Chet

References:
1. Gastroenterology. 2020 May;158(7):1851-1864.
2. https://www.youtube.com/watch?v=URMLzoK95V4

By Any Means Necessary, Part 2

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About a year ago, I wrote about the reasons we buy food pouches for Riley. He’s six and a half, and we’re still using them, because my thinking is I’m going to get those fruits and veggies into him by any means necessary. And the battle continues.

Some evenings we have a battle royal over eating vegetables. Riley would rather eat pasta and nothing else almost every night. While he will eat pouches with just about any vegetable in it but broccoli, he won’t eat the same vegetables on his plate. The other night it was green beans. He’s eaten them before, but he’s demonstrating a rebellious streak lately. We’re not insisting he clean his plate, just eat a few green beans. Paula will wait him out; she’ll sit at the table and read a book on her Kindle until he’s done eating them.

Me? Not so much. I decided we will enhance the flavor of the green beans. Hot sauce—which I knew wouldn’t make it onto his plate. Cinnamon sugar. Whip cream. Paula thought of a savory flavor and added a sandwich sprinkle blend. The winner? Close between the cinnamon sugar and the whipped cream with ketchup, which doesn’t taste nearly as bad as you might think. Even the sandwich sprinkles got a thumbs up. All the green beans were gone in short order.

I know that’s not a traditional approach to getting kids to eat vegetables. And yet, people who would never touch an onion will eat a deep-fried one with fat imploded into it and a creamy sauce to dip it into; compared to that, I think a dusting of cinnamon sugar is just fine. My philosophy is: by any means necessary. The benefit of the vegetable outweighs the little bit of sugar or whipped cream in my opinion, especially for a kid in the 4th percentile of BMI for his age.

It’s a long holiday weekend so we’ll be back with the Memo in a week. Be safe if you’re traveling. If you’re going to spend the weekend with picnics and such, don’t forgot about eating those vegetables—by any means necessary.

What are you prepared to do today?

        Dr. Chet

By Any Means Necessary

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Riley has finished his first week of in-classroom school. He seems to have adapted quite well, which is no surprise—he is the most social child I’ve ever known and makes friends with everyone.

Much like me, he’s not much of a morning eater. Occasionally I’ll eat breakfast but for the most part, it’s not going to happen until I’ve been awake for several hours. A cup of Joe isn’t going to work for Riley, so milk and water suffice. I gave him a fruit and vegetable pouch yesterday, but he wanted to take it for a snack at school. I talked him out of it; he ate about half and saved the rest for after school.

Riley is a choosy eater: he chooses to refuse many foods that most kids eat such as apples, oranges, and bananas. Until recently, he had a strong gag reflex that was triggered by many solid foods, so we’ve continued to use pouches as a nutritional stop-gap; we watch for sales and usually pay about a dollar per pouch.

The reason I hesitated to have him take it for snack was that I wasn’t sure kids who are five still use them, and I didn’t want him to get embarrassed among his new friends. Then my health brain kicked in. He’s gotten used to eating blueberries, raspberries, and grapes in small quantities, but that’s about it. Vegetables? Other than potatoes, carrots, and Grampa’s spaghetti sauce with hidden vegetables, it’s a tough sell. But in those pouches, he eats just about everything. What’s more important: eating the fruits and vegetables in whatever form or worrying about what people think? So if he wants to take pouches to school, he will because getting those fruits and veggies into him is more important by far.

Just as serious: how are you doing with your consumption of vegetables and fruit? If you don’t get your five to ten servings, check out the pouches. They contain one or two servings of pureed vegetables and fruits, organic with no additives, and include very interesting blends; some of Riley’s faves are in the illustration. I’ve tried them and if I didn’t like vegetables and fruits, I’d use them. Cold, they’re refreshing. They’re shelf stable, so you can keep them in your desk or locker or car for convenient, healthy snacks. It sure beats making or buying a smoothie every day, and they’re a better alternative than the doughnuts in the break room or whatever you find in the vending machine.

If you’re concerned about the ecological impact, the New York Times reports, “While the pouches are not recyclable through municipal services, they can be mailed to TerraCycle at a cost of at least $93 per shipment, except for a few brands that have set up free mail-in programs with the recycling company. Pouch caps are collected in some locations by Preserve, which manufactures goods like toothbrushes and razors from recycled plastic.”

If you know you’re never going to eat kale or spinach, try a pouch. As I said, get your fruits and vegetables by any means necessary.

What are you prepared to do today?

        Dr. Chet

More Carbs? Better Choices

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Have you decided whether the extra years you may get by eating too many or too few carbohydrates are worth the effort? How about if you don’t have to make that choice at all? What if you could eat more or fewer carbs and not have to worry about it? Here are the other significant results of the study we’ve looked at this week.

When the researchers considered what people would eat to replace carbohydrates if they chose a low-carb diet, they assumed it would be animal protein such as beef, pork, lamb, and cheese as well as chicken with and without the skin. Likewise when they considered the extra carbs if people ate over 60% carbohydrates, they assumed people would choose more refined carbohydrates. They concluded correctly the additional refined carbs would contribute to metabolic disorders such as type 2 diabetes. They suggested that, based on other studies, if a low-carbohydrate diet used plant-based sources of protein, fats, and oils, there was no increase in mortality on a low-carb diet.

I’ll take it a step further and it’s something you’ve heard before: eat better. It doesn’t matter whether you want to eat a high-carbohydrate or a low-carbohydrate diet. That’s your choice. You just have to eat your vegetables and fruits first, and I’m not talking about just peas, corn, and bananas; there are hundreds of other choices to explore. You can increase the carbs in your diet without hurting your health as long as you make the right choices. Lead with vegetables and you’ll get the fiber and phytonutrients your body needs.

High carb or low carb, it all comes down to eating better. The key to living longer? Eat less. Eat better. Move more.

What are you prepared to do today?

Dr. Chet

 

Reference: http://dx.doi.org/10.1016/ S2468-2667(18)30135-X.

 

The Bottom Line on Veggies and Carbs

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Go ahead and finish your oatmeal and drink your protein-kale smoothie—you do need those veggies. Meanwhile I’ll put the PURE study in perspective.

This is a large study that looks at the economics of food as well as the health benefits. In a separate publication, the analysis of the data focused on the cost of fruit and vegetable intake as a percentage of monthly income. They specifically collected data from low-, middle-, and high-income communities from 18 different countries. Researchers actually went to grocery markets in those countries to collect the cost data. As you might expect, the lower the income, the higher the percentage of monthly revenue spent on vegetables and fruits.

I think that explains part of the reason the second study on vegetable intake and mortality said there was no additional benefit beyond three or four servings per day: if people can’t afford more, it’s wrong to teach them that more is better if it might not be. But that doesn’t justify the headlines because the message that Americans hear is “I don’t have to eat those darn vegetables!”

Yes, you do. Here are the issues with each of the studies.

 

Do Carbs Kill?

In the first study on carbohydrate intake and mortality, researchers used a simple percentage of caloric intake in their analysis. Basically we have a math problem: if someone in a poor country eats 80% of their diet as carbohydrates from root vegetables but they only get 1,000 calories per day that’s a completely different situation from a person who eats 3,000 calories per day but 50% of their calories are from refined carbohydrates and sugars.

As I’ve said many times, while we should eat fewer refined carbohydrates, carbohydrates are not inherently bad; it is the overconsumption that’s the problem. If researchers didn’t analyze the total caloric intake from carbohydrates, protein, and fats, we don’t have the complete answer. The PURE study used a food frequency questionnaire. I’ll leave it at that because I rant too much about the FFQs.

Finally, the researchers simply jumped the gun by recommending that health education should now focus on increasing fat intake while reducing carbohydrates. All types of vegetables and fruits are carbohydrates. Because researchers did not parse out different sources of carbohydrates in their analysis, their recommendations are meaningless.

 

Don’t Bother with More Veggies?

PURE is an observational study; it cannot determine cause and effect. Also it can tell you a lot about a large group of people but nothing about an individual.

The lead researcher actually provided the perspective on vegetables and fruit during an interview: if the research shows that the benefit of eating more plant-based food is a 20% reduction in mortality, and the mortality rate of the population is just 1%, that means the reduction goes from 10 out of 1,000 to 8 out of 1,000. It’s virtually meaningless to an individual.

The researchers hesitated to tell people with very low incomes to spend more on additional servings of plant-based food if there was not a meaningful benefit. But for most of you, the cost of fruit and vegetables is not a hardship, so buy ’em and eat ’em.

 

The Bottom Line

These will not be the last headlines we hear from the PURE study because the data continues to be analyzed. One issue for me is that there’s no data from the U.S. included so the ability to generalize to the U.S. population is very limited. We lead the world in obesity and overweight and our food consumption patterns are different even from other Westernized countries.

One thing remains clear to me: we should all eat more vegetables and fruit and reduce refined carbohydrates. The recommendation never changes: eat less, eat better, move more.

What are you prepared to do today?

Dr. Chet

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References:
1. DOI: http://dx.doi.org/10.1016/S0140-6736(17)32252-3.
2. DOI: http://dx.doi.org/10.1016/S2213-8587(17)30283-8.

 

PURE Headline 2: Don’t Bother with More Veggies?

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Using the same data base of subjects in the PURE Study, researchers examined the vegetable, fruit, and legume intake on total mortality, mortality, and major cardiac events such as heart attacks.

The most important finding was that higher vegetable, fruit, and legume intake was associated with a reduced risk of mortality and morbidity. Simply put, the more plant-based the diet, the better off you are from an overall health perspective.

But that’s not what the headline messages said. They focused on the part of the study that said there appeared to be no additional benefits if subjects ate more than a few servings of vegetables, fruits, and legumes. That seems to fly in the face of the “more is better” results that previous research has shown.

Have all the prior studies been wrong? Have you been eating kale for no good reason? No, and I’ll explain why the headlines are wrong on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: DOI: http://dx.doi.org/10.1016/S0140-6736(17)32253-5.

 

Fruit Intake and Men’s Health

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On Monday I talked about a recent study on vegetables and glaucoma. Today the subject is fruit intake and men’s health, specifically, the relationship between eating certain types of fruit and erectile dysfunction. Wonder why I didn’t put that in the title? Because it would have ended in up in your spam folder. But this isn’t about inanimate objects such as computer programs and how they evaluate subject lines, it’s about phytonutrients.

Researchers again examined the data from the Healthcare Professionals Follow-up Study. This time, they examined the relationship between the specific phytonutrient intake typically . . .

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Fruits, Vegetables, Weight Loss, and Independence Day

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This is a very long holiday weekend so I decided on a very long title for this week’s only message—three topics in one message. Let’s get to it.

Research Review: Fruits, Vegetables, and Weight Loss

The headlines have read “Eating Your Veggies Worthless for Weight Loss” and “Fruits and Veggies Won’t Lead to Weight Loss” this past week. They’ll certainly get your attention, but what’s it all about? Nothing. Really—nothing. Here’s why.

Researchers culled all the published studies looking for studies where subjects were told to add fruits and vegetables to their diet (1). The studies they included could not include any diets or attempts to lose weight—only additional vegetables and fruits. What they found is exactly what was reported: simply adding vegetables and fruit to your diet won’t cause you to lose weight.

Really? You mean an apple a day added to my highly-refined, deep-fat fried, and vegetable-free diet won’t help me lose weight? Not even adding a salad with half a bottle of blue cheese dressing?

I don’t know what they’re putting in the water at the University of Birmingham in Alabama research labs, but someone should check on it. This is the second study in two weeks that attempts to question what they believe is conventional thinking regarding weight loss. The other is that eating breakfast is worthless (2). In both cases, neither the headlines nor the researchers’ press comments represent in any way what the research actually examined.

Let me be clear, because they’re not: if you intentionally replace some of the highly-refined and high-fat foods with fruits and vegetables, you will lose weight. Period. And you can start this 4th of July by eating red, white, and blue.

Fruits, Vegetables, and the 4th of July

Red. White. Blue. As you celebrate this week with the rest of America, make sure that whatever you eat this week, it contains some foods with the colors of our flag, and challenge your kids to do the same. Those colors of the flag represent our independence. You can start your journey to physical independence from disease by starting this week to get at least seven servings of vegetables and fruit in your everyday diet.

Do desserts count? Sure, why not, as long as there’s at least a half cup of fruit in your serving.

Here are some examples:

Red: tomatoes, ketchup, strawberries, watermelon, raspberries, cherries and every variety of red-skin apples. Even barbecue rubs that contain paprika, chili powder, and other red spices have great nutrients that are good for us.

White: onions, garlic, potatoes, turnips, parsnips, and every type of apples. Yes, because of the excellent nutrients and fiber in apples, they can fall into two categories.

Blue: blueberries, blackberries, blue cheese dressing—because if you’re smoking wings, you have to dip them in something! Remember, it’s always about the quantity.

That’s a good beginning that you can carry over into your everyday life. Add the green and yellow and you’re on your way! Set your path for health independence by eating your vegetables and fruit this 4th of July and every day from now on.

Happy Independence Day

Paula and I wish you the best this 4th of July and every day. If you’re driving, be safe in your travels.

What are you prepared to do today?

Dr. Chet