New Scientific Findings on Whole Foods or Supplements
Health-e-Solutions comment: This article discusses the importance of placing a priority on healthy, whole foods over supplements. It is our conviction that most of our nutrition should be derived from whole, fresh, organic, very low-glycemic, nutrient dense foods; that supplements should be kept to a minimum and only used to address deficiencies or for detoxification purposes, which should be rare if the diet is clean and and lifestyle components are in balance.
This article describes the benefits of complexity in whole foods and the potentially detrimental effects associated with the simplicity of supplements. Synergy is an added benefit when combining whole fruits and vegetables, but not when combining supplement, especially those in high doses never found in the natural state of plants.
In the past 50 years, Americans have increasingly relied on the use of supplements as the magic bullet to optimal health. However, recent studies suggest that not only do whole nutritionally dense foods provide more benefits than isolated nutrients, but the unnaturally high doses of single nutrients supplied by supplements, by upsetting the integrated balance of active compounds found in whole foods, may actually induce detrimental effects on health.
Whole foods contain a wide array of nutrients including not only well known vitamins and minerals, but dozens of other biologically active compounds-all inter-related in a complex system supportive of the life of the plant or animal from which the food was derived. The more research is done, the more complex this life-giving nutrient web is revealed to be.
Supplements are fragments of this web, artificially isolated from the whole of interlocking parts within which they do their work in living systems. Just as their name implies, they are designed to supplement a healthy diet and provide insurance that nutritional needs are being fulfilled. They are no substitute for eating healthful whole foods.
Real Life Complexity vs. Supplement Simplicity
A whole foods diet contains a great diversity of phytonutrients – some set the stage for the activity of others or work synergistically with them, while some neutralize or balance the effects of others. When we take a supplement, we’re often ingesting a much larger amount of a single nutrient than would be obtained from food, plus the supplement may be in a synthetic product that is not bio-identical to the natural form of the nutrient. Isolating one nutrient normally found in the diet, then artificially boosting it, may have unwanted consequences. In the world of research, the whole food rather than supplement argument is, in large part, a question of complexity versus simplicity.
Researchers are just beginning to develop the tools to cope with the astounding interactive complexity of hundreds of nutrients found in whole foods. A study presented in July 2004 (discussed below) was the first to look at the combined effects of just two foods, broccoli and tomatoes. Prior to this, researchers have zeroed in on one, or at most, a couple of nutrients. (January 18, 2005)
According to Godfrey P. Oakley, professor of epidemiology, Emory University’s Rollins School of Public Health, “It’s really tough to know what’s in food, but you can know what’s in a pill…There were relationships between people eating fruits and vegetables, so we went after this one specific ingredient. It was a lab-based hypothesis chasing human effects.” Oakley adds, however, that in instances where a medicinal amount of a nutrient is warranted, supplements do have dose on their side. “You almost can’t eat enough nutrients in plants to get your blood levels to where they should be.“
Charles E. Elson, a University of Wisconsin at Madison nutritionist, agrees that it’s impossible to consume the high doses sometimes recommended for medical intervention in diseases such as cancer, from foods. However, Elson thinks that supplement advocates have oversimplified the issue: “People look at fruits and vegetables, take the prominent compound, and say that’s responsible.“
Elson suspects that the cumulative interactive effect of the multitude of active compounds found naturally in fruits and vegetables can be more effective than supplements, which, in comparison, go it alone. Instead of focusing on one micronutrient, Elson is developing research that will analyze the cumulative, synergistic effects of many isoprenoids – a group of phytonutrients, including lycopene, whose origin is the mevalonic acid pathway – and which, he suspects, account for much of the anti-cancer effects of fruits and vegetables.
Lycopene, whose most publicized source is tomatoes has been touted as a cancer-preventive supplement – despite the fact that the data supporting such a belief has been drawn from epidemiological and population studies of patterns of food consumption, not on the use of supplemental lycopene.
The Harvard study that put lycopene in the public limelight reviewed the eating patterns of nearly 48,000 men and showed that consuming tomato sauce a couple of times a week lowered prostate cancer risk. Research focusing only on lycopene has yielded conflicting results, but when investigators have calculated the amount of lycopene consumed daily from foods, men whose average intake was 19 milligrams a day were found to have a 16% lower risk of prostate cancer than men who took in 3 milligrams of lycopene daily.
The reduction in prostate cancer risk was even greater when tomato sauce intake was considered. Men who ate two or more servings of tomato sauce each week were 23% less likely to develop prostate cancer during the study period than men who ate less than one serving of tomato sauce each month.
Could it be possible that lycopene is simply a marker – the tip of the cancer-protective phytonutrient iceberg – and not the only reason why tomatoes are beneficial?
In relation to gastrointestinal cancers, new research suggests supplements may not only be useless but damaging. A review study published by in the October 2004 issue of The Lancet found a number of studies showing that many antioxidant supplements are ineffective treatments for gastrointestinal cancers, and some may even cause harm. In these trials, no significant benefit was seen in supplementation with beta-carotene, vitamins A, C, E, and selenium (alone or in combination) compared to placebo in esophageal, gastric, colorectal, pancreatic or liver cancer incidence. While in four studies, selenium supplementation did significantly lower risk of gastrointestinal cancer, in a number of other trials, the combinations of beta-carotene and vitamin A, and beta-carotene and vitamin E significantly increased mortality.(January 18, 2005)
Studies on heart patients who have taken vitamin E supplements have had varied results, but when the nutrients are consumed as part of a whole foods diet, the results are consistently beneficial.
An observational study of 85,000 nurses found that the risk of heart disease was lowest in women with the highest dietary intake of vitamin E, and a second study of 39,000 males revealed similar results.
A meta-analysis of the research regarding antioxidant supplements and cardiovascular disease conducted by Penny Kris-Etherton and colleagues from Pennsylvania State University also suggests that antioxidant supplements generally do not treat cardiovascular disease, and some may have negative effects. In this review published in the August 2004 issue of Circulation, five out of nine studies on vitamin E and cardiovascular disease found no effect, three showed a beneficial effect, and one reported negative effects. Three out of four studies investigating beta-carotene found no effect, and one reported negative effects. In the five studies on multiple antioxidant supplements reviewed, two found no effect, and three showed negative effects.
In contrast, population studies clearly and consistently report that a diet rich in fruits and vegetables is protective against cardiovascular and many other chronic diseases.
Kris-Etherton and colleagues believe this is likely due to the fact that a fruit and vegetable rich diet naturally contains not only all the antioxidants but a wide array of active compounds that act synergistically to prevent disease and produce health.(January 18, 2005)
Whole Foods, But Not Supplements, Consistently Protect Against Disease
Literally hundreds of epidemiological studies have looked at the relationship between whole foods and chronic diseases such as cardiovascular disease, diabetes and cancer. Eating more whole foods has consistently been shown to result in decreased incidence of disease. Those individuals eating the diet that contains the most fresh vegetables, fruits, legumes, nuts, seeds, and whole grains are always in the group found to have the lowest risk, whatever the disease. [We would add that these foods should be very low-glycemic in the case of the person with diabetes – that would eliminate all grains and most legumes]
Whole Foods versus Refined Foods Diet
A study of 12 women compared the benefits of a whole foods diet to a refined foods diet and demonstrated the positive effects of a phytonutrient rich diet on lipoproteins, antioxidant defenses and colon function.
In this trial, 12 women with high cholesterol followed a refined-food diet for four weeks after which they immediately switched over to a whole foods diet. At the end of each four week diet, the women’s fasting bloods levels of cholesterol and triglycerides were measured along with their fasting levels of antioxidant enzymes. Although both diets provided the same amount of calories and fat, the women ate 61% less saturated fat while on the whole foods diet and their intake of dietary fiber, vitamin E, vitamin C and carotene intakes were 160%, 145%, 160% and 500% more, respectively, than the refined-food diet period.
Not surprisingly, with the increase in fiber, colon function improved on the whole foods diet, which also caused a drop of 13% in total cholesterol, 16% in LDL-C (the most dangerous form of LDL cholesterol). In addition, blood levels of two antioxidants the body produces internally when needed to defend against free radical attack dropped precipitously: superoxide dismutase decreased 69%, and glutathione peroxidase dropped 35%.
Whole Foods Protect against Cardiovascular Disease
In three of the largest, most significant studies that have looked at the relationship between diet and cardiovascular disease-the DART study, the GISSI trial, and the Lyon Heart Study-a whole foods diet consistently and significantly reduced cardiovascular disease risk and mortality.
According to a recent news roundup in the British Medical Journal, the combined evidence of a number of large population-based surveys suggests that for every additional portion of fruit or vegetables eaten, the risk of getting heart disease is reduced by 4%. In one population study, postmenopausal women who ate 10 daily servings of fruit and vegetables lowered their risk of heart attack by 40%.
In the Lyon Heart Study, those following the simple guidelines of increasing their consumption of vegetables, fruit, whole grains and legumes, while decreasing their consumption of saturated fat and eating healthy fats such those in olive oil, nuts and seeds, were found to have dropped their risk of death from cardiovascular disease by an amazing 70% after 27 months. And another recent study found that just eating a handful of nuts each day translates into a 30% reduction in cardiovascular disease risk.
The DASH (Dietary Approach to Stop Hypertension) study demonstrated that a higher intake of whole grains, fruits and vegetables can lower blood pressure. In this trial, a whole foods diet produced an average drop of systolic and diastolic blood pressure of 12mm/6mm in a group of individuals with moderately elevated blood pressure.
A review of human clinical studies conducted by Annie Lapointe and colleagues from Laval University in Quebec, and published in the February 2006 issue of the Journal of Nutritional Biochemistry has confirmed that following a Mediterranean-style diet, rich in olive oil, fruit and vegetables and fish, is more effective than taking supplements to protect against cardiovascular disease. In March 2005 in the Journal of Nutrition, Lapointe’s team published research conducted in Quebec in which 71 healthy women were provided with nutrition information and helped to follow a Mediterranean diet for 12 weeks. By the end of the study, the women’s blood levels of oxidized LDL had dropped by 11.3%.
Why are all these studies producing such consistently positive results? Here are just a few of the reasons:
- Foods rich in soluble fiber, such as oats, beans, and nuts, have been shown to lower LDL (bad) cholesterol significantly, not only in persons with high cholesterol, but even in healthy subjects.
- The fiber in a whole foods diet also lowers serum triglycerides, its potassium and magnesium drop blood pressure and its rich supply of antioxidants, such as vitamin E, protect cholesterol from free radical damage.
- The healthy polyunsaturated fats found in nuts significantly improve the quality of LDL cholesterol and body’s ability to process and clear it.
- Diets rich in plant foods are also high in arginine, an essential amino acid that research is now beginning to focus on as an essential constituent of nitric oxide (NO). A vasodilator, NO relaxes blood vessels, improving blood flow.
- Lapointe thinks a Mediterranean-style diet is more effective against cardiovascular disease because a highly protective synergy occurs among the wide variety of dietary antioxidant vitamins, healthy monounsaturated fats, and flavonoid-rich foods this healthy food pattern supplies. The synergistic effects produced by the combination of many antioxidant compounds and flavonoid-rich foods in a Mediterranean-style diet significantly reduce the susceptibility of LDL cholesterol to oxidation (free radical damage). Since only after LDL has been oxidized does it become involved in the development of atherosclerosis, this may help explain the cardiovascular benefits of the Mediterranean diet.
With all these beneficial actions, it’s not surprising that epidemiological studies have all indicated that a whole foods diet protects against cardiovascular disease.
Promising New Research on Whole Foods’ Cardio-protective Effects
A recently completed study on the effects of whole foods on atherosclerosis was presented at the May 2005 meetings of the American Heart Association and the American Society of Hypertension. For more than three years, Dr. Mark Houston, Associate Clinical Professor at Vanderbilt School of Medicine and Director of the Hypertension Institute in Nashville, followed a group of 50 cardiovascular patients, tracking a hallmark of the progression of cardiovascular disease-the amount of calcium being laid down in their coronary arteries.
Statistically, calcium deposition as measured by EBT scores goes up about 50% per year, but study subjects, who made no other lifestyle changes other than consuming two products made from concentrated whole foods-Juice Plus and Vineyard Plus, experienced a much lower rate of calcification. “If concentrated whole foods products can lower the rate of calcium deposition, then we need to broaden our approach in cardiovascular treatment to emphasize a whole foods diet,” says Houston.
Houston became interested in a whole foods approach to atherosclerosis when his review of the epidemiological literature clearly showed that whole foods did reduce the incidence of cardiovascular disease, but when he looked for the prospective clinical trials that had proven the benefits of whole foods, he found none. A medical pioneer who, in addition to his clinical work is also Editor-in-Chief of the Journal of the American Nutraceutical Association, Dr. Houston decided to do his own prospective trial. Houston has measured not only calcium deposition, but also a wide array of indicators of oxidative stress that the latest research shows clearly impact cardiovascular disease. Houston initially reported the calcium EBT scores, but, as the wealth of data he is gathering is analyzed, we can look forward to a number of articles presenting correlations between whole foods consumption and reductions in oxidative stress.
Whole Foods Protect against Cancer
Bruce N. Ames, PhD, the renowned U. C. Berkeley nutritionist, reports that more than 200 epidemiological studies indicate that a diet high in fruits and vegetables can reduce cancer risk. A whole foods diet is richly endowed not only with all the well-known vitamins and minerals, but also with literally hundreds of phytonutrients whose benefits researchers are just beginning to uncover.
The following provide just a few examples:
- Substantial evidence suggests that the folic acid abundant in vegetables, especially leafy greens, reduces the risk of colon cancer as well as cardiovascular disease.
- Broccoli and other members of the cruciferous vegetable family contain glucosinolates that turn on and turn up enzymes that detoxify carcinogenic substances.
- Regular consumption of tomatoes, which are rich in a phytonutrient called lycopene, is highly correlated with a lower risk of developing prostate cancer.
- Powerful anthocyanins found in blueberries, which have a dramatic ability to penetrate cell membranes and provide cells with antioxidant protection, can decrease levels of inflammation and help prevent DNA damage throughout the body.
Whole Foods Team Up to Provide Greater Cancer Protection
A study presented July 15, 2004, at the two-day WCRF/AICR International Research Conference on Food, Nutrition and Cancer in Washington, D.C., examined the effect of eating whole foods in combination instead of isolated nutrients, and not surprisingly, the beneficial synergy among nutrients that results when we consume a variety of healthful foods beat taking single nutrients by a mile.
According to this research, eating broccoli along with tomatoes maximizes the cancer protection both foods provide.
In the study, rats fed a tomato-and-broccoli combo had way less prostate tumor growth than rats given diets containing either food alone or normal rat chow diets supplemented with lycopene (a cancer-fighting carotenoid isolated from tomatoes) or finasteride (the drug commonly prescribed to men with benign prostatic hyperplasia or BPH).
When the results were analyzed, the researchers were surprised to find that all of the diets (tomato-and-broccoli, tomato, broccoli, and lycopene) were more effective in suppressing prostate tumor growth than the drug (finasteride).
At a press conference, lead researcher John W. Erdman, Ph.D., Professor of Food Science and Human Nutrition at the University of Illinois at Urbana, explained the rationale behind this new approach to nutrition research:
“We decided to look at these foods in combination because we believed it was a way to learn more about real diets eaten by real people. People don’t eat nutrients, they eat food. And they don’t eat one food; they eat many foods in combination.”
Erdman also noted, “Studies that examine individual substances in isolation are simply not designed to tell us anything about the interactions that occur between those substances, much less between foods that each contains its own anti-cancer arsenal.”
Erdman was quick to assert that the food synergy between tomatoes and broccoli is not unique, that “This interactivity is likely taking place in any diet high in a variety of plant foods – fruits, vegetables, whole grains and beans.”
His colleague, Jeff Prince, Vice-President for Education at the American Institute for Cancer Research, echoed Erdman’s belief: “The take-home message isn’t just about tomatoes and broccoli. The inferences to be drawn are more tentative and a lot broader. A lycopene supplement may not hurt you, but the whole tomato can help you more. A whole tomato may help you, but a tomato eaten with broccoli will help you more. Tomato with broccoli may help you, but a medley of different vegetables eaten together will bolster the body’s different defenses against chronic disease.”
Nutrient Synergy Needed for Cancer Prevention
The conclusion scientists have drawn from hundreds of studies is that cancer protection must come from a combination of phytochemicals, not isolated nutrients. In an article in the December 2004 issue of the Journal of Nutrition, Dr. Rui Lui of Cornell University sums up current thinking when he writes,
“It is now widely believed that the actions of the antioxidant nutrients alone do not explain the observed health benefits of diets rich in fruits and vegetables, because taken alone, the individual antioxidants studied in clinical trials do not appear to have consistent preventive effects. Work performed by our group and others has shown that fruits and vegetable phytochemical extracts exhibit strong antioxidant and antiproliferative activities and that the major part of total antioxidant activity is from the combination of phytochemicals.
The additive and synergistic effects of phytochemicals in fruits and vegetables are responsible for these potent antioxidant and anticancer activities and the benefit of a diet rich in fruits and vegetables is attributed to the complex mixture of phytochemicals present in whole foods.
This explains why no single antioxidant can replace the combination of natural phytochemicals in fruits and vegetables to achieve the health benefits. The evidence suggests that antioxidants or bioactive compounds are best acquired through whole-food consumption, not from expensive dietary supplements. We believe that a recommendation that consumers eat 5 to 10 servings of a wide variety of fruits and vegetables daily is an appropriate strategy for significantly reducing the risk of chronic diseases and to meet their nutrient requirements for optimal health.” (January 18, 2005)
Whole Foods Protect against Diabetes
A whole foods’ diet also provides well-established benefits for persons with diabetes. In fact, data collected in the Nurses Health Study suggest…
A whole foods diet may be the most successful treatment available for managing onset of the insulin resistance that characterizes early stage Type 2 diabetes.
A whole foods diet provides not only high levels of anti-inflammatory antioxidants and phytonutrients, which lessen the damage caused by high blood levels of glucose [hyperglycemia], but an excellent supply of fiber, which slows digestion, lowers insulin requirements, provides better control of blood glucose, and reduces blood cholesterol levels.
Supplements – Not a Magic Bullet for Good Health
Of all the studies that have investigated a relationship between nutrition, heart disease, cancer and diabetes, about two-thirds have focused on individual nutrients (e.g., beta carotene, lycopene, vitamins E and C). These studies using a single or even several nutrients have produced a good deal of controversial and conflicting data.
One highly publicized example of unpalatable data on the use of supplements is the Alpha Tocopherol Beta Carotene Trial. In this randomized study, 29,133 Finnish male smokers were divided into three groups and followed for a period of up to eight years. One group received placebo, a second was given synthetic beta-carotene, and the third was treated with dl-alpha tocopherol (a synthetic form of one of the four fractions of vitamin E). This study made headline news when, not only did the supplements provide no benefit, but an unexpected increase in the risk of fatal stroke was identified in the vitamin E group, and treatment with synthetic beta-carotene actually lead to a jump in the number of deaths linked to lung cancer.
Vitamin E, along with vitamin C, beta-carotene, and selenium also caused problems in another cardiovascular treatment trial. In this study, a combination of niacin and the drug simvastatin reduced clinical cardiovascular events by 90%, but when the antioxidant supplement was added, the rise in beneficial HDL seen with niacin-simvastatin therapy was much lower. Similarly, studies on heart patients who have taken vitamin E supplements have had varied results, but when the nutrients are consumed as part of a whole foods diet, the results are consistently beneficial. An observational study of 85,000 nurses found that the risk of heart disease was lowest in women with the highest dietary intake of vitamin E, and a second study of 39,000 males revealed similar results.
Other supplementation trials using beta-carotene have also found an increase, rather than a decrease, in lung cancer risk. In a 12 year follow up study of participants in the CARET (beta-Carotene and Retinol Efficacy) Trial, investigators used data from food frequency questionnaires to examine how compounds in fruits and vegetables affect lung cancer risk. What they found was that fruit and vegetable consumption did provide a reduction in lung cancer risk-but only to those in the placebo group-those who were not given the beta-carotene and retinyl palmitate supplements. The researchers concluded: “This report provides evidence that plant foods have an important preventive influence in a population at high risk for lung cancer. However, persons who use beta-carotene supplements do not benefit from the protective compounds in plant foods.”
How can supplementation with an antioxidant nutrient like beta-carotene promote cancer?
In addition to the issue that synthetically produced vitamins are not identical to their natural counterparts and therefore cannot be expected to produce identical results, even when naturally bio-identical supplements are used, other recent research suggests that the unnaturally high doses of single nutrients provided may cause unwanted effects. Marvin Legator, professor of preventive medicine and community health at the University of Texas Medical School at Galveston, and colleagues from Bologna, Italy, have shown that, in rat lungs, high doses of beta carotene increase levels of carcinogen-metabolizing enzymes. In non-smokers, these agents might be helpful or at least harmless, but when they react with compounds in tobacco smoke, the resulting chemicals actually promote cancer.
Legator cautions supplement use should be carefully considered because not only beta-carotene, but many nutrients can increase these enzymes. In whole foods, nutrients are found in a balanced matrix, but isolated micronutrients-or fractions of micronutrients such as the alpha tocopherol fraction of vitamin E that lowered beneficial HDL-are not and could have analogous unintended effects.
Supplemental Vitamin C Increases Risk of Death in Postmenopausal Women with Diabetes
A variation on the above theme appears in research published in the November 2004 issue of the American Journal of Clinical Nutrition, which found that, in postmenopausal women with diabetes, supplementation with vitamin C increased risk of death from all types of cardiovascular disease, coronary artery disease and stroke. Vitamin C from foods, however, had no negative effects.
This 15-year study followed 1,923 post-menopausal diabetic women who were free of cardiovascular disease at its start. The authors discuss the results in some detail explaining that while vitamin C is known to be a potent antioxidant, under certain laboratory conditions it has been shown to become a pro-oxidant that promotes protein glycation [AGEs] (the binding of sugar to proteins, which results in a protein that is no longer able to do its job properly). They also note that the antioxidants present in food are balanced biochemically, forming a mixture of redox agents in which any pro-oxidants are balanced by antioxidants. Supplements lack this balance. Plus, our bodies defend themselves against free radicals by engaging a whole team of interacting micronutrients, and using a single antioxidant at a high dose could easily disrupt this team effort.
According to an April 2003 WHO/FAO Expert Report, chronic diseases resulting from poor diet contributed to 59% of the 56.5 million deaths worldwide and nearly half the burden of global disease in 2001. Statistics from the National Cancer Institute in Bethesda Maryland, show that only 23% of American adults eat at least five daily servings of fruit and vegetables, and only 4% of men consume nine servings. About 33% of the US population eats only two servings and another 4% eat even less than that.
Research is showing time after time that the beneficial effects of a diet composed of whole, unrefined foods cannot be matched by a diet based on refined foods, and expecting a handful of supplements to bridge the gap is simply not realistic. Whole grains, dark green and yellow/orange vegetables and fruits, legumes, nuts and seeds, contain high concentrations of antioxidant phenolics, fibers and numerous other phytonutrients that work together to offer protection against many types of chronic disease.
Take the advice of the World Health Organization and eat a diet abundant in fruits and vegetables and low in foods that are high in saturated fats and sugars and combine it with an active lifestyle to fight chronic diseases including obesity, cancer, cardiovascular diseases and diabetes.
Health-e-Solutions comment: Put your body in a position of strength by promoting, supporting and creating health. Poor health feeds poor health in a vicious cycle, or negative feedback loop that is increasingly difficult to break the longer it runs. Improving health creates a positive feedback loop instead.
Our motto is “Focus on Food.” We think this must be the foundation for awesome #BloodSugarControl and better living. We consider the right foods to be the most important of our 5 pillars supporting thriving health.
Modern, industrialized food modification, farming, and processing have contributed to the unprecedented rise in chronic lifestyle and autoimmune diseases. A fundamental problem in diabetes is the body’s inability to metabolize glucose properly. This in-depth report provides information, evidence and data with which to understand the methodology behind #TheRomanDiet and the Health-e-Solutions lifestyle. It provides you with insight into why we think it works so well for BloodSugarControl and better living.
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