Superfoods Presentation By Steven Pratt, M.d.

Health Benefits of Wild Salmon, Berries and Natural Vitamin E Steven G. Pratt, MD, FACS Kyäni Convention Ogden, Utah July 2007

HealthStyling Includes: • • • • • • • • • • • •

SuperFoods Healthy Fats SuperNutrients No Cigarettes Alcohol – ?? Sleep Stress Reduction Portion Control = Weight Control Spirituality Exercise = Burning Calories Load up on Fiber High Potassium—Low Sodium

Superfoods • Spinach

• Blueberries

• Salmon

• Citrus

• Turkey Breast

• Pumpkin

• Broccoli

• Yogurt

• Walnuts

• Oats

• Tomato

• Legumes

• Soy

• Green Tea

* Superfoods Rx: Fourteen Foods That Will Change Your Life

Superfoods • Apples

• Garlic

• Avocado

• Honey

• Dark chocolate

• Kiwi

• Dried fruits

• Onions

• Extra Virgin Olive Oil • Spices

• Pomegranates

* Superfoods HealthStyle: Proven Strategies for Lifelong Health, 2006

Supernutrients • Vitamin C • Vitamin D

• Lutein • Zeaxanthin

• Folic Acid

• Lycopene

• Selenium

• Beta Carotene

• Glutathione

• Alpha Carotene

• Resveratrol

• Beta Cryptozanthin

• Polyphenols

• Fiber

• n-3’s

Wild Salmon • Lowers the risk of heart disease and cancer • The more omega-3 fish oils you eat; the lower your blood pressure and heart rate • In one study eating the oil in fish cut cancer incidence by over 60% • 4x weekly ↓ risk for and progression of AMD • Men with the highest n-3’s 66% less likely to develop colorectal cancer

Wild Salmon • Studies suggest that fish consumption is associated with a lower risk for depression, violent behavior, Alzheimer’s disease, Attention Deficit Disorder, Atrial fibrillation, cognitive decline (dose response), Alzheimers • Improved bone mineral density • Anti-inflammatory • SPF nutrients • TRY TO EAT Wild salmon, halibut, sardines, etc. 2 to 4 times per week

Wild Salmon • Best dietary source of Vitamin D Sockeye Salmon

3.5 oz

670 I.U.

Albacore Tuna

3.5 oz

540 I.U.

Silver Salmon

3.5 oz

425 I.U.

King Salmon

3.5 oz

222 I.U.

• Adequate Vitamin D produced from sun exposure = 10-15 minutes 3-4x weekly (decreasing efficiency with increasing age)

Wild Salmon Sidekicks • • • • • • • •

Alaskan Halibut Canned Albacore Tuna Sardines Herring Trout Sea Bass Oysters Clams

* For healthy heart, brain, eyes—You must eat fish!!!

Vitamin D per 3.53 oz Alaskan Sockeye Salmon

687 IU

Alaskan Albacore Tuna

544 IU

Alaskan Silver Salmon

439 IU

Alaskan King Salmon

236 IU

Alaskan Sardines

222 IU

Alaskan Halibut

162 IU

Vitamin D • NAS - 15-50 yrs = 200 IU - 51-70 yrs = 400 IU - 71 and above = 600 IU

• Health Style Recommended /d - 800-2000 IU????

Food Sources of Vitamin D Food

Serving

Vitamin D IU

1 TBS

1360

Salmon, canned, pink

3 oz

360

Sardines, canned

3 oz

250

Mackerel, canned

3 oz

214

Tuna, canned

3 oz

200

Milk, fortified

1 cup

100

Orange juice, fortified

1 cup

100

Margarine, fortified

2 tsp

50

Cereal, fortified

1 cup

40

Liver, beef, cooked

3.5 oz

30

1 whole

20

Cod liver oil

Egg

Vitamin D • Deficiency is widespread in all age groups • Deficiency associated with ↑ risk for cancer (breast, prostate, colon, NHL, pancreas), ↓ survival from melanoma, Rheumatoid arthritis, type I DM, macular degeneration, frailty (falls), MS, fibromyalgia, gingivitis, muscle aches and pains, osteoporosis, HTN • Anti-inflammatory effect • ↓ Angiogeneis • Immune system booster • Regulate cell growth

Vitamin D ↑ Vitamin A can ↓ vitamin D absorption • Sunscreen ↓’s vitamin D skin production ↓ skin production of vitamin D as go “North” ↓ skin production with age and ↑ skin melanin • 15 minutes sun exposure 3-4x weekly adequate (in SD) – Pale white skin can produce 20,000 IU vitamin D in 20 minutes (full sunlight) – Tan white skin ≅10,000 IU in 20 minutes – Dark brown skin ≅ 5,000 IU in 20 minutes

Vitamin D • Vitamin D3 vs. vitamin D2 – Summer sunlight can produce D3 from 0700 1700 with a peak synthesis of pre-vitamin D at 1230

• Conversion of 25 hydroxyvitamin D to active hormone; kidney > immune cells, colon cells, placenta, breast, prostate, and pancreas

“An estimated 30 people may die of cancers related to vitamin D deficiency for every person who dies from skin cancers caused by excessive sun exposure.” --Edward Giovannucci

“ I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D” --Edward Giovannucci

Vitamin D & the Metabolic Syndrome • Metabolic syndrome – Abdominal obesity – Atherogenic dyslipidemia ↑ BP – Insulin resistance – Proinflammatory state – Prothomotic state – 23.1% of adults in NHANE III – >2 million adolescents in U.S. – Low serum 25 hydroxyvitamin D is associated with an ↑ risk of metabolic syndrome

Obesity & Vitamin D Status • Vitamin D plays a role in glucose metabolism and insulin sensitivity • The hormonal form of vitamin D can inhibit the production of proinflammatory cytokines

Omega-3 Fatty Acids • Food and Nutrition Board – – – –

1.6 g/d ALA for men 1.1 g/d ALA for women 160 mg/d EPA/DHA for men 110 mg/d EPA/DHA for women

• My goal – – – –

1 g/d EPA/DHA for men (minimum) 0.7 g/d EPA/DHA for women (minimum) 1-2 TBSP/d ground flaxseed meal n-3/n-6 ratio between 1/1 → 1/3

Omega-3 Fatty Acids • EPA/DHA – – – – –

3 oz cooked Chinook (king) salmon = 1.5 g 3 oz sockeye salmon = 1 g 3 oz farmed Rainbow trout = 1 g 1 can sardines = .9 g 3 oz canned white tuna in water = .7 g

Omega-3 Fatty Acids • ALA – – – – – – – – – – –

1 tablespoon canola oil = 1.3 g 1 tablespoon soybean oil = .7 g 1 tablespoon walnut oil = 1.4 g 1 tablespoon flaxseed oil = 7.3 g 1 cup cooked spinach = .2 g 1 cup cooked collard greens = .2 g ½ cup dry roasted soy nuts = 1.2 g 1 tablespoon flaxseed = 2.2 g ½ cup wheat germ = .5 g 1 oz (14 halves) English walnuts = 2.6 g 1 omega-3 “vegetarian” hen egg = amounts vary

Omega-3 Fatty Acids • EPA/DHA vs. ALA ↓ Risk for “everything” • The easiest way to ↓ risk for sudden cardiac death = 1 gram fish oil/d • Healthy heart, brain, eyes • Roll in ↓ Atrial Fibrillation (25% of adults) • A major anti-inflammatory ↓ Triglycerides ↓ BP ↓ Heart rate

Omega-3 Fatty Acids • • • • • •

A major human deficiency state exists DHA concentrated in the brain and retina EPA/DHA supplements “work” Fish protein + EPA/DHA “best” Safety Immune system function – No adverse parameters with 3 or less grams/d

• Risk for hemorrhagic stroke with 10-12 g/d – Inuits consume 10-12 g/d

• 9 g/d effective treatment for depression

Natural Vitamin E • 8 compounds exhibiting vitamin E activity – 4 tocopherols – 4 tocotrienols

• Alpha tocopherol has become synonymous with vitamin E and has been the main focus of research but… – It takes all 8 “E”’s to maximize vitamin E’s potential

• Essential to have all 8 forms in a supplement – The synergy of 8

• Absorbed from the small intestine

Natural Vitamin E • Healthy fat essential for bioavailability ↓ Risk for CVD, cancer, AZ, degenerative eye disease • Immune system booster • Safety issues?? • Bioavailability issues in 10-15% of the population • N-3’s and vitamin E • Gamma tocopherol and inflammation

Vitamin E • Daily goal from foods 16 mg -

2 tablespoons wheat germ oil = 41 mg 2 tablespoons soybean oil = 2.6 mg 2 tablespoons canola oil = 13.6 mg 2 tablespoons peanut oil = 9.2 mg 2 tablespoons flaxseed oil = 4.8 mg 2 tablespoons olive oil = 4 mg 1 oz raw (23-24 whole kernels) almonds = 7.7 mg ¼ cup hulled dry-roasted sunflower seeds = 6.8 mg 2 tablespoons raw (untoasted) wheat germ = 5 mg 1 medium orange bell pepper = 4.3 mg 1 oz hazelnuts (20-21 kernels) = 4.3 mg 2 tablespoons peanut butter = 3.2 mg 1 cup blueberries = 2.8 mg

Gamma Tocopherol • Best sources – – – – – – – –

Perilla seed Pistachios Pecans Walnuts Pumpkin seeds Pine nuts Cashews Peanuts

Tocotrienols • Alpha, beta, gamma, delta α-tocotrienol is a better radical scavenger than α-tocopherol – 4 to 33x more efficient scavengers of peroxyl radicals in a model (lab) system

• Heat ↓ levels of tocotrienols, tocopherols – Tocotrienols less stable under thermal oxidation

Tocotrienols • Anti-cancer properties – – – –

Move readily within cell membranes Recycles faster than α-tocopherol Anti-oxidant Free radical scavenger ↓ DNA damage ↓ Tumor formation ↓ Cell damage from carcinogens ↑ Programmed cell death ↓ Cancer cell proliferation – ? Role in breast cancer prevention – May enhance the effect of tamoxifen – In all cultures effective against both estrogen receptor + and estrogen receptor negative breast cancer

Tocotrienols •

Cardiovascular health – Up to 75% of hypercholesterolemic individuals respond to tocotrienols • Most effective when combined with “Healthstyling”

↓ TC, LDL-C ↓ Apo-B ↓ Thromboxanes affect on blood clotting – A statin-like effect • Role for CoQ10

– Inhibitor of cholesterol synthesis – In humans may ↓ TC, LDL-C, apolipoprotein B, and triglycerides – May ↑ HDL-C, apolipoprotein A1 – Cholesterol lowering ability of tocotrienols • Beta < alpha < gamma < delta

α -tocotrienol (mg/100g) Barley oil

55.8

Corn oil

5.4

Grapeseed oil

9.2

Palm oil

22.4

Rice bran oil

29.8

Wheat bran oil

21.4

Wheat germ oil

8.5

α -tocotrienol (mg/100g) Whole Grains Amaranth

Tr

Barley

2.0

Buckwheat

Tr

Corn

0.4

Millet

Tr

Oats

2.0

Oat bran

2.2

Rice

0.9

Rye

1.5

Wheat

0.3

Wheat bran

1.3

Wheat germ

0.3

α -tocotrienol (mg/100g) 0.1

Tuna Fruits Dried apricots

0.1

Blueberry

Tr

Bing cherry

0.1

Cranberry

0.1

Grape

0.1

Black olive

15.4

Pears

0.3

Plums

0.1

α -tocotrienol (mg/100g) Vegetables Sweet potato

0.1

Almond

0.2

Macadamia

1.84

Pistachio

0.5

Nuts

Blueberries • Otherwise known as “brainberries” • Most exciting report: animal studies show actual reversal of brain deterioration • Lower the risk of cardiovascular disease and cancer • The best chance to move, think like a kid as you “mature” ↓ Exercise associated oxidative stress • Anti-inflammatory • Our vascular system loves berries • May protect CNS against space travel radiation exposure • May mimic caloric restriction • SPF Nutrients • TRY TO EAT 1 to 2 cups daily

Blueberries Contain • A synergy of multiple nutrients & phytonutrients

• Vitamin E • Potassium

• Polyphenols (anthocyanins, ellagic acid, quercetin, catechins)

• Manganese • Magnesium • Iron • Riboflavin • Niacin • Phytoestrogens • Low calories • Resveratrol

• Salicylic acid • Carotenoids • Fiber • Folate • Vitamin C

Blueberry Sidekicks • Purple grapes

• Cranberries

• Boysenberries

• Raspberries

• Strawberries

• Currents

• Blackberries

• Cherries

• Pomegranates

• Chokeberries • Wolfberries

Polyphenols • Daily goal from foods is not yet known Whole Foods – Berries – Dates and figs – Prunes – Kale, spinach – Parsley, dried parsley – Apples with skin – Citrus – Grapes – Cherries

Polyphenols • A great 21st century phytonutrient • Multiple functions – – – – –

• • • •

Anti-oxidant Anti-mutagenic Anti-inflammatory Cell signaling Metal chelation

– Anti-platelet – Synergy – Phytoestrogen – Vasodilators – Nutrigenomics

Intake/d Bioavailability Safety Cancer, CVD, neuro-degenerative disorders

Polyphenols Jams • Trader Joe’s Organic Blueberry Fruit Spread • Knott’s Pure Boysenberry Preserves • Trader Joe’s Organic Blackberry Fruit Spread

Beverages • Green, black, oolong tea • Soymilk • 100 percent fruit juices (berry, pomegranate, Concord grape, cherry, apple, citrus, prune) • Top 3 100 percent fruit juices: - Odwalla C Monster - Trader Joe’s 100 percent Unfiltered Concord Grape Juice - R.W. Knudsen 100 percent Pomegranate Juice

Polyphenols Juices

Mg of polyphenols per 8 oz serving

Odwalla C Monster

845

Trader Joe’s 100% Unfiltered Concord Grape Juice

670

R.W.Knudsen 100% Pomegranate Juice

639

R.W.Knudsen 100% Cranberry Juice

587

R.W.Knudsen Just Blueberry

425

L&A Black Cherry Juice

345

27% cranberry juice cocktail

137

100% apple juice

61

* Superfoods Rx: Fourteen Foods That Will Change Your Life

Polyphenols Jams

Mg of polyphenols per 20 g—a trace over 1 Tablespoon

Trader Joe’s Organic Blueberry Fruit Spread

400

Knott’s Pure Boysenberry Preserves

300

Trader Joe’s Organic Blackberry Fruit Spread

280

Trader Joe’s Organic Strawberry Fruit Spread

120

Trader Joe’s Organic Morello Cherry Fruit Spread

120

Sorrell Ridge Wild Blueberry Spreadable Fruit

100

Knott’s Bing Cherry Pure Preserves

100

Welch’s Concord Grape Jam

60

Polyphenol Content of 40g’s Dark Chocolate

*

• Newman’s Own Sweet Dark Dark Chocolate

955mg

• Dove Silky Dark Chocolate

811mg

• Endangered Species Chocolate Company Wolf Bar

811mg

• Cadbury Royal Dark Indulgent Dark Chocolate

765mg

• Hershey’s Special Dark Mildly Sweet Chocolate

739mg

Superfoods Health Style: Proven Strageties for Lifelong Health

Pomegranates • ¼ cup ↓ LDL-C oxidation ↓ Blood pressure • 100% juice best ↓ Growth rate of prostate cancer • May play a role in preventing skin, lung, colon and breast cancer ↑ Dermal collagen ↑ Carotid artery blood flow / ↓ carotid artery atherosclerotic plaques ↑ Serum antioxidant status • Sidekick: plums • 4-8 oz of 100% juice multiple times weekly & unlimited seeds