This Month’s Food as Medicine Roundup: February 2020

Sahra Pak February 28, 2020
Sahra Pak
As a registered dietitian, Sahra brings her extensive experience in health care and public health to Lighter to improve the health of the population through effective communication, sustainable behavior modification approaches and upstream intervention strategies. Through her work with Los Angeles and Solano County Departments of Public Health, Kaiser Permanente, and partnering with health advocacy organizations such as CSPI (Center for Science in the Public Interest), Sahra has helped create sustainable food systems, adapted public policy, implemented environmental change, and health education programs.

Thank you for checking out this week’s edition of our Food as Medicine News Roundup! Once a month, I’ll share a collection of important and trending articles in the food as medicine space.

February is American heart month and it’s also Black History Month ⏤ where we celebrate and pay tribute to the generations of African Americans that overcame adversity and struggle to find success and liberation. Read on to find out why heart health matters, particularly for African Americans and rural communities, how highly processed (junk!) food affects appetite signals, and how food Rx can alleviate much of our health woes. 


Heart health starts on your plate and in your community  

Recent data shows that 1 in every 4 deaths is due to heart disease and one person dies every 37 seconds in the United States from cardiovascular disease. Not only is heart disease our number one killer but it is also the most expensive, costing nearly a billion dollars each day. Recent projections show that by 2035, 45 percent of American adults will have some type of cardiovascular disease at a cost of more than $1 trillion a year. 


“By 2035, nearly half of the U.S. population will have some form of cardiovascular disease.”

Cardiovascular Disease: A costly burden for America, Projections through 2035, American Heart Association 


Most notably, African Americans are 20 percent more likely to die from heart disease than whites and African American women are 60 percent more likely to have high blood pressure compared to whites. 

The good news is that 80 percent of cardiovascular disease is preventable. Lifestyle changes such as getting enough sleep, eating a plant-based diet, exercising regularly, and not smoking are some of the ways to combat this chronic and life-threatening condition. 

For example, a recent study found that increases in trimethylamine N-oxide (TMAO) during a ten year period were significantly linked to an increased risk for coronary heart disease (CHD). TMAO is produced by the gut bacteria when foods such as red meat and fish that contain precursors to produce TMAO is consumed. However, the study found that the relationship between TMAO and CHD is reduced when patients consumed and adhered to a plant-based diet. 


“Measuring longitudinal changes in TMAO may help identify high-risk populations of heart diseases. In addition, clinicians may recommend healthy plant-based diets to their patients.” 

⏤Lu Qi, MD, Ph.D., FAHA, Director, Tulane University Obesity Research Center, lead study author


In addition, healthy living matters for everyone in our community. This year, the American Heart Association (AHA) is focusing its efforts to reach out to the rural population. Did you know that there is a 3-year life expectancy gap between rural and urban populations? Rural communities have 20 percent higher death rates for cardiovascular disease and stroke and 40 percent higher CVD prevalence rates than those living in urban areas. Specific factors that lead to higher rates of CVD in the rural population include poor housing quality, transportation issues, less access to grocery stores that sell nutritious foods, and lower incomes. AHA is committed to expanding its research and programs to address the shortage of health professionals in rural areas and support the delivery of high-quality care that addresses the specific needs and solutions that work best in rural communities. 


Junk food vs food Rx 

While it’s not new to hear about the negative health effects of ‘junk foods’ (highly- and ultra-processed products), a recent study found that just after seven days, study participants who ate a high energy western diet consisting of meals high in fat, sugar, and processed ingredients, scored worse on memory tests and craved more energy-dense foods. Based on earlier studies, junk food seems to impair the hippocampus ⏤ the brain region involved in memory and appetite control. 


After a week on a western-style diet, palatable food such as snacks and chocolate becomes...harder to resist, leading you to eat more, which in turn generates more damage to the hippocampus and a vicious cycle of overeating.”

⏤Richard Stevenson, professor of psychology, Macquarie University, Sydney, study author 


Consuming processed foods, including processed meat, is significantly associated with incident cardiovascular disease and all-cause mortality. But higher adherence to a healthy diet or eating pattern such as those recommended by the Dietary Guidelines for Americans (a diet consisting of whole unprocessed plant-based foods with some lean protein including legumes/beans) is associated with lower risks of incident CVD, CVD mortality, and all-cause mortality among U.S. adults. What’s more, a recent study in the European Heart Journal found that intake of every 10 grams of additional fiber a day was associated with a 23% lower risk of ischemic stroke


"The most important finding is that higher consumption of both dietary fiber and fruit and vegetables was strongly associated with lower risks of ischemic stroke" 

⏤Tammy Tong, study author

So...what’s the best diet? 

And what’s the best diet for heart health (or health in general)? Many studies, including one of the most recent studies from the University of Otago in New Zealand, have found that the best ‘diet’ is the one that a person will actually stick to in the long run. The diet that received the highest adherence rate consisted of whole, minimally processed foods like fruits, vegetables, whole grains, nuts, and seeds. Participants in this group ate red meat less than once a week and were told to avoid processed food, butter, and sugary drinks. A little over half (57%) of the participants were able to stay with the meal plan for a full year. Even if the diet was followed imperfectly, this group of participants had better measures of blood pressure and glycemic control than the other diet groups (such as fasting and paleo). 


Consumers are fed up with diets - but open to mindful eating     

And consumers are getting tired of dieting! A recent survey of 1,012 Americans found that 3 in 5 consumers are interested in intuitive eating due to the frustrations over fad diets that are extremely challenging to stick to. Many of these diets leave consumers feeling fatigued, hungry, and unsuccessful in achieving their weight loss or health goals. 

Food can reverse and prevent many chronic illnesses such as heart disease, but changing food behaviors takes time and patience. But we now know that even an imperfectly followed meal plan is much more powerful than having no plan at all. So we hope you will keep encouraging your patients to stay on track no matter how imperfect it may be ⏤ outcome will be positive and plentiful.

Food is medicine. Let’s stay on this journey, together! 🍏