by Joan O’Keefe, RD
I’m a cancer survivor. At 26 years-old and while six months pregnant with our eldest son Jimmy, I was diagnosed with a metastatic cancer. That experience is just one of the many reasons I am so passionate about diet and lifestyle. In my career as a dietitian, I’ve seen many cancer patients and cancer survivors and there are ways to help decrease your chances of getting this disease (and others).

We’ve been touting the benefits of Vitamin D for quite some time now, but lately, we’ve come to understand the role Vitamin D plays in cancer prevention. It’s known that the majority of breast and colon cancer cases appear in the Vitamin D deficient and the majority of cases are appearing above 35 degrees latitude (about Atlanta, GA). North of this line, it is physically impossible to make Vitamin D in the winter from sun exposure.

Most of your cells have Vitamin D receptors, as well as your organs. When you have adequate Vitamin D in your blood stream, your cells’ vitamin D receptors are full of the vitamin and it acts as armor, defending your cells against invaders. Without enough Vitamin D, your cells are weak and vulnerable. When a cancer cell forms in your body, it approaches your other cells and wants to make them cancer cells too. Cells armored with enough Vitamin D can easily resist the cancer cell, but those without enough armor are too weak to resist.

How can you be sure you’ve got enough “armor?” Know your numbers. Get your Vitamin D levels checked. Check them now and again during the winter. If you’re deficient, discuss treatment plans with your physician or clinician. We can help you return your Vitamin D levels to normal and keep them there.

James and I banter all the time about nutrition and health matters. Most of the time we agree, but not always. For years I’d tell him that I just didn’t like non nutritive sweeteners and he’d say, “let people have something sweet. It’s fine.” I’d say, “No. I know there’s something not right with them. None of my clients lose weight when they’re using these.” And now, research is catching up with my observations. Recent research indicates that the use of non-nutritive (some might call them artificial) sweeteners increases one’s chances of developing the metabolic syndrome by up to 40 percent. Finally, my husband caved. He’ll even admit – I win this one.

I have never liked non-nutritive sweeteners. People call them artificial sweeteners, but that’s a misnomer. I prefer to call them non-nutritive sweeteners. I think there is a whole host of things wrong with them – especially when they’re given to kids. And it’s all of them: stevia, truvia, aspartame, splenda, nutrisweet, etc. It doesn’t matter if they’re “naturally sourced.” Our bodies still react to them.

When you eat non-nutritive sweeteners, your body senses the sweet taste and gears up your metabolism to break it down. However, you’ve just provided your body with no calories and your body is now looking for those calories. When you start your morning with non-nutritive sweetener, say Stevia, in your coffee, you are going to end up hunting for sweets all day. Chances are you’ll also eat more calories in the day. Research shows that those with no non-nutritive sweeteners in their diets eat approximately 1/3 fewer calories per day. You’re also increasing your chances of developing the metabolic syndrome by up to 40%. And guess what folks? When you get the metabolic syndrome, you are knocking on diabetes’ door.

I have heard from many people that have read our book and then shared with me the same testimonial. They all say, “I’m not perfect, but I did cut all non-nutritive sweeteners from my diet and I’ve now lost 40, 50, 60 pounds.” Then they all ask me why no one ever told them to cut non-nutritive sweeteners before.

Many people also want to know what I use for sweetener. I honestly don’t use sweeteners. Naturally sweet (from fruit, etc) is an acquired taste, but you can do it! If you must have a sweetener, try something completely natural, like:
• Honey
• Agave Nectar
Please use only a very small amount of these and then gradually wean yourself away from them. This will help you avoid blood sugar spikes and crashes caused by simple molecules (sugar and easily digested carbohydrate) entering your body. These are the same spikes and crashes that will eventually make you insulin resistant and/or diabetic.

And remember, sugar and non-nutritive sweeteners come in all shapes and forms. Watch for it in:
• Drinks
• Packaged foods
• Diet or fat-free jellos and puddings
• Yogurts
• Lite or fat-free packaged foods

Osteoporosis is a condition of decreased bone mass. You may have had a bone density screening in the past to test for signs of osteoporosis. Normal bones have small holes throughout, but an osteoporotic bone has large holes or appears “porous.” These large holes or pores are caused by insufficient amounts of calcium in the bones and many factors contribute to this. Inadequate calcium intake is one factor, but other lifestyle habits can be leeching calcium from your bones as well. Even if you already have osteoporosis or are at risk for the condition, there are lifestyle changes that you can make now that will help make your bones stronger and help you prevent the bone fractures all too common with osteoporosis.

8 Simple Lifestyle Steps for Preventing Osteoporosis

1. Adequate Calcium Intake – You’ve heard it time and time again and this one is never going to change. You’ve got to get enough calcium folks! Calcium in milk has a greater bioavailability than calcium in supplements, but if you can’t do milk products, supplements will suffice. If you simply don’t prefer milk products, please at least split the difference. I recommend taking your calcium plus vitamin D supplement with milk. This is a simple way to try to fool the body into thinking that the calcium supplement is as bioavailable as the calcium in milk.

2. Vitamin D – Calcium is not absorbed as well without vitamin D available in the system. Those with low Vitamin D levels do not absorb calcium well. Make sure you get your vitamin D levels checked and keep them up. Make sure you take your calcium with vitamin D.

3. Watch Your Sodium Intake.  Sodium will leech calcium from your bones. Keep your sodium intake to less than 1500 mg per day. The salt shaker is completely off limits, folks. Strictly limit processed foods and limit eating out – both are terrific sources of sodium. Sodium does occur naturally in milk and meats; however, you need these in your diet (see #1). Meats are complete protein sources and they are necessary to build and rebuild muscle mass broken down with exercise. Try whey protein isolate (I like CardioWhey ). Whey protein is not only a complete protein with every amino acid, but is a terrific way to build muscle and contains very little to no fat and sodium.

4. Alcohol.  Limit your alcohol consumption to one drink per day at the most. Consuming more than one drink per day is a risk factor for bone loss.

5. Pump Some Iron.  Weight lifting is very important for preventing osteoporosis, but why? When you work your upper body and build a strong core, you are building a strong, stable body. The more muscle you have, the more your bones have to carry around all day – and this is a good thing! More muscles lead to stronger bones.

6. Skip the Elliptical and Stair Climbing Machine.  Instead, run walk or jump. Good “pounding” exercises like these will strengthen your bones while whittling your weight. Jumping is the most effective bone building cardiovascular exercise that we know. Jump rope, do jumping jacks, jump on the kids’ trampoline, anything will work.

7. Follow exercise with whey protein.  Use whey within one hour of your workout (before or after). Working out breaks down muscles and whey protein gives the body the tools it needs to rebuild those muscles.

8. Eat Your Fruits and Vegetables.  Fruits and veggies are incredibly important as they help to prevent the leeching of calcium from your bones. Fruits and vegetables help balance the acid: base ratio in your body. Junk foods like cookies, donuts and potato chips make your body more acidic and this promotes calcium leeching from the bones. Excess sodium, junk food, and even meats will increase the acidity of your body’s fluids, but colorful fruits and vegetables will help to balance it and in turn help keep calcium in your bones where it belongs.

For more information about osteoporosis click here.

Be Picky about Your Protein

James O’Keefe, MD, FACC

Lean protein cranks up your metabolism and keeps you full longer after a meal. However, you must be very particular about your protein. The two highest quality protein sources are egg whites and whey protein. Nature designed both of these foods so they contain the precise amino acid building blocks needed to nurture young and developing animals and help them grow strong new tissues.
Fish, seafood, chicken or turkey breast meat, and non-fat dairy foods, are other great sources of animal protein. Even red meat is fine if it’s lean (92 to 100 percent fat free), fresh, and is not burned or over-processed. Also, consider nuts or legumes, like soybeans, lentils or red beans, for one of your protein sources each day.

Portion Sizes
Portion size is important also; an ideal protein serving size is about the size of the palm of your hand, with a width about as wide as your little finger at the middle joint. Fatty meats like full-fat hamburger and prime rib are off limits, as are over-processed meats like bacon and sausage. Jerky and deli meats, although often low in fat, are too high in salt and preservatives to eat on a daily basis.

Fruits and Veggies
Ideally, for each meal, you should be eating about three servings of colorful, fresh or fresh frozen vegetables and fruits to go along with your serving of healthy protein. Remember to start downing those fruits and veggies at breakfast, or you’ll have a tough time hitting your daily target of nine. Beverages should predominantly consist of non-caloric options like water, tea and coffee, or low-calorie, high-nutrient choices, such as low sodium V-8 juice, skim milk or soy milk.

You Are What You Drink
As important as what you choose to eat and drink is what you choose to avoid consuming. Pass up processed foods, especially those containing sugar, white flour, trans fats or high fructose corn syrup. Avoid products with long lists of ingredients and those bearing health claims like low fat or low carb–they are usually full of other bad stuff!

Go for Vegetables, Not Vegetarianism Part 1
By James H. O’Keefe, M.D.

America today is a land that indulges our freedom of choice. You can choose to have green hair and blue eyes, or to watch Sponge Bob Square Pants around the clock, or for your morning coffee you can choose to have a vanilla, half-caf, 1 percent, extra-hot, no-foam latte—but you can’t yet choose your genes. Those genes, the blueprint your cells use to build and maintain you, specify the kinds of foods upon which you will either thrive or decay. That’s why not all diets are created equal, and why food cannot be like fashion fads that come and go.

Many vital nutrients are found predominantly in meat, fish, eggs, dairy, and other animal by-products.   These include:

• essential amino acids
• DHA (an omega-3 fat)
• Vitamin B12
• Vitamin A
• Vitamin D
• Calcium
• Zinc

So paradoxically, while fresh produce (vegetables and fruits) is the single most important component of a healthy diet, strict vegetarianism does not foster optimum human health. The traditional vegetarian diets, as in India, always included eggs, dairy, and/or fish, which provided these nutrients.

Unfortunately, most animal-based foods in our modern diet are over-processed and unhealthy due to unnaturally high levels of saturated fats, sodium, nitrites, preservatives, and other additives; giving meat a bad reputation in many nutritional circles. Yet if you want a strong body, a sharp mind, and a powerful and vigilant immune system, you should try to consume lean, healthy, fresh protein three times a day.

Next week:  Part 2: Be Picky About Your Protein

Got your attention, didn’t I? Parents and health experts are outraged by childhood obesity, but kids aren’t the only ones suffering. I do a lot of workplace wellness talks and I keep noticing that soda pop and other high-calorie, sugary drinks are the most readily available beverages in most offices. How many of you have soda machines, sugary coffee creamers and other unhealthy beverages within 20 feet of your desk? I see many more soda machines than water coolers and this really drives me nuts.

Scientific data show that consumption of one or more sugary soft drinks during the day increases the chance of developing Type 2 diabetes by 67%. Non-caloric, diet soft drinks are no better. Artificial sweeteners not only turn on the sweet tooth for the day, thereby increasing daily calorie intake, but research shows that regular consumption of artificial sweeteners increases the likelihood of developing the metabolic syndrome by 40%.

Reality is most employees spend all day sitting at a desk. They’re not exercising and chances are they’re drinking sugar all day, whether as coffee creamer, soda pop or lemonade, causing constant spiking and crashing of the blood sugar and increasing disease risk. Business owners and managers bring me in to talk about health and wellness in an effort to improve employee health, but also to improve health insurance costs. Bottom line is employers themselves need to do a better job of getting healthy beverages (we’ll talk snacks later) into the workplace and employees need to ask for them.

Here are some healthy options for workplace beverages:

• Water: Learn to drink water again. Everything does not have to be flavored.
• Tea and Coffee (limit caffeine after noon and avoid sweeteners)
• Sparkling waters (we like LaCroix, Mendota Springs and Ice Mountain)
• Have access to ice and a water cooler and provide cups – getting water needs to be as convenient as getting a can of soda pop (and providing it free of charge helps).

Recently, the Wall Street Journal published an article about children and supplements. This is an issue that receives a lot of attention and debate, but finding accurate information can be difficult. We’re often asked our opinions on this issue and about which supplements we give our own kids.

As a Preventive Cardiologist (James) and Registered Dietitian (Joan) and the parents of four healthy children who regularly take vitamin D and omega-3 supplements, we’re happy to share our opinions from both professional/scientific and personal perspectives.

First, when discussing supplements, many people fail to recognize the difference between bringing a deficient level of a nutrient to a normal level versus bringing an already normal level to a super-normal level. When you supplement a deficiency and restore the level of the essential nutrient to a normal range, you typically see predictable, measurable results in a number of health parameters. Unfortunately, many American children fall into the deficient category and hover in deficient ranges for both vitamin D and omega 3 fats.

Omega-3 fats are considered essential fatty acids as they are critically important for long term optimal health. Unfortunately, foods rich in omega-3 fats are largely absent in the standard American diet, and children are often deficient in this nutrient. Omega-3 fats and DHA in particular are needed by every cell in the body and are vital for healthy brain and vision development. Fatty fish are the most plentiful dietary source of DHA and EPA; however, these fish can sometimes contain high levels of mercury and other heavy metals, and environmental contaminants like PCBs; and for this reason parents have often been advised to limit children’s fish intake.

It is also our professional opinion that the RDA of vitamin D for children is outdated. It is important to note that the current suggested daily intake values were established generations ago, at a time when children spent their days outside and before the development and widespread use of sunscreen and sunblock products. Additionally, risk factors for vitamin D deficiency are much more prevalent today; these include inadequate sun exposure (SPF 15 and above blocks 99% of vitamin D synthesis in the skin), darker skin, and obesity. In short, vitamin D deficiency is common in the American population including children and adolescents; vitamin D supplied via supplements can safely bring them into the normal (healthy) range.

One could argue that the most compelling stories in nutrition science today are omega-3 fats and vitamin D. First, scientific evidence points that both nutrients are deficient in American children. At the same time, both are easily treatable with supplements, vitamin D and omega-3 fatty acids. We feel strongly that most children be considered for omega-3 fatty acids and for vitamin D supplementation. Of course it is not appropriate for all. Parents should ask their pediatricians if their children would benefit from omega-3 or vitamin D supplements.

Whole Foods discontinues krill, citing ’sustainability issues’.

Read about the sustainability of CardioTabs Ocean Safe Omega-3.  http://www1.cardiotabs.com/oceansafefaq.asp

You can get a free sample of Ocean Safe Omega-3 from CardioTabs.  Simply send an email requesting yours to info@cardiotabs.com.

Q. Do you have any thoughts on the validity of the benefits of kombucha?

A. We thought this was such a good question that we want to share the answer with all of you. First and foremost, realize that we are evidence-based practitioners. There are supplements that we recommend, but all of them have significant science backing their use. If we’re going to recommend something, you’d better show us the science!

Kombucha is a combination of bacteria and yeast that is added to black tea and sugar and allowed to ferment. There are no human scientific studies supporting the use of this concoction. Most of the reported benefits are simply from people’s stories and are heresy, not science. There are some animal studies, but kombucha there is no scientific evidence of benefits in humans.

The thing that really worries us about kombucha is that there are risks involved. Risks include allergic reactions, gastrointestinal upset, and contamination. There have even been reports of metabolic acidosis with kombucha. With a concoction like this it is really the nature of the beast that contamination may often exist.
We cannot recommend kombucha. Right now, as far as the science is concerned, the risks definitely outweigh the benefits.

Good Things are In-Season Now.

If you haven’t been through the produce section of your local supermarket lately, now is your time to get there!  Move away from the frozen fruits and vegetables and check out what’s fresh.  I try to buy organic whenever possible, but realistically, this is still expensive to do.  Even more important than organic on my list: buying local.  

Locally grown produce is available at your neighborhood supermarket or farmers’ market.  The benefits of buying local are many fold.

• Buying locally grown produce helps your local economy.
• When grown locally, transportation time is null.  Your fruits and veggies get from the farm to your plate in a much shorter time than if they’re grown somewhere in South America.  Travel time is huge for retaining nutrients.  The lesser the time in transit, the more nutrient dense your produce will be.  (Less time in transit also equals less gas used – you’re benefitting the environment!)

The most important thing when buying produce is to buy a variety of colors as every color is associated with a different type of antioxidant behavior.  Again, I buy organic when possible, but ultimately, it’s the look and firmness of the fruit or vegetable that sells me.  Just always make sure to wash your fresh produce thoroughly.

Springtime Fresh Fruits and Veggies You’ve Got to Try:

Have you noticed the strawberries this spring?  They’ve been gorgeous this year.  It’s only Tuesday and our family is on our second case this week!  We cut them up and serve with dinner – a giant bowl is gone in minutes at our house.  They taste great and are loaded with antioxidants.  They’re a power food!

Clementine oranges are affordable by the case right now.  They’re easy to peel and you can eat two or three at a pop.  A plus – kids love them!

Asparagus is everywhere this month.  We brush it with olive oil and a little Mrs. Dash or other salt-free seasoning and grill it on foil outside.  Grill it just enough so that it’s a little soft outside and crunchy on the inside.  This is another kid favorite and is high in vitamin C, and has a ton of antioxidant behavior. 

Artichokes are another seasonal veggie that are often overlooked.  They’ve looked great lately, too.  We simply steam them, pull off the leaves and eat the bottoms.  Then be sure to pull the ends of the leaves and eat the heart.  At dinner, we make two artichokes and everyone shares (except the heart – there is always a fight for that at our house)!