Healthy Food & Healthy Living by Dr. Ayala

Why cooking helps with weight loss and wellness

There’s a clear link between eating home cooked meals and diet quality. Eating more home-cooked meals is also associated with lower risk of obesity.

Teaching cooking skills is an important method for improving eating habits, and is more effective than just instructing people about nutrition, but what kind of cooking should be emphasized in these lessons? 

The healthfulness of cooking practices depends on both ingredients and techniques. Health promoting cooking methods include using whole grains, adding herbs and spices, using healthy oils such as olive oil, incorporating fruits and vegetables, using onion and garlic, and using lower amounts of fat. On the other hand are health compromising cooking methods such as deep frying, use of processed foods, animal fat, processed meat, and adding sugar and sweeteners in cooking. A method for quantifying healthy cooking has been established – the Healthy Cooking Index applies a point for each health promoting behavior, and deducts a point for health compromising actions. 

A new study in Appetite looks at about 150 overweight or obese people undergoing a weight loss program. The participants were assessed for cooking practices after the weight loss intervention.

And the results: those who had a higher healthy cooking score achieved more weight loss and ate healthier.

Next, the researchers attempted to identify cooking patterns and came up with three types of cooking: Red Meat Simple, Vegetarian Simple, and Health and Taste Enhancing. 

Red Meat Simple cooks used fewer healthful additions, such as whole grains, fruit, and vegetables, or olive oil while using more red meat and animal fat and cooked meat to high temperatures. 

Vegetarian Simple cooks cooked less meat, were more likely to add fruit and vegetables, to cook with herbs and spices, use healthy cooking techniques (baking, boiling, or steaming), moderate salt and oil use, and to avoid deep frying and cooking meats to high temperatures or charring. 

The Health and Taste Enhancing cooking is characterized by higher use of taste enhancers including herbs,  spices and alliums, as well as healthful use of oils such as olive oil, fruits, vegetables, and whole grains. These kind of cooks were more likely to marinade meat prior to cooking, and to use low-fat cooking methods and moderate the salt and oil when cooking. 

The researchers found that The Red Meat Simple cooking pattern was associated with less weight loss compared to the other patterns.

Why would that be? Healthier cooking habits translate diet advice into everyday life, and make guidelines into meals. Eat-more-veggies is an abstract aspiration, while a tasty salad bowl is an adoptable habit.

Other studies have shown that hands-on cooking lessons resulted in weight loss compared to guidance followed by demonstration only.

The cooking patterns analysis hints at what's most important to impart in cooking classes: “complexity is not a necessary aspect of healthy cooking,” the authors write. “Having more advanced technical cooking skills and, in turn, making more complex dishes does not necessarily yield healthier food consumption. Promoting cooking practices that are likely to positively impact the nutritional content of the foods prepared and deterring the use of practices that are likely to negatively impact the nutritional content of foods we prepare may be more important than trying to achieve advanced levels of culinary expertise.”

Cooking plants 

Since what’s missing most from the American diet is plant based foods and whole foods, practicing kitchen skills on these ingredients is the most valuable.

A study looking at the veggie consumption and cooking skills of university students in Brazil found that less than half the students ate vegetables regularly, but knowing how to cook was significantly associated with eating veggies daily. These results are in agreement with another study of more than 1000 freshmen in the US that found that confidence in the ability to cook from basic ingredients and to follow a recipe was associated with eating more fruits and vegetables and better weight status. 

The basic skills we all need as cooks should include salads knowhow, what to make with whole grains, and a few basic cooking techniques that incorporate vegetables with grains and with protein sources, such as making a stir fry, cooking a soup, and oven roasting.

Knowing how to make healthy, tasty, simple and affordable meals is key to health and weight control, it’s a practice that’s central to wellbeing.

Dr. Ayala

The foods that keep your brain young

As lifespan expands and many more people live into their 80s and 90s a big concern is cognitive decline later in life. Cognitive decline is related to several disease processes and the risk of intellectual deterioration has been associated with many lifestyle factors, including poor diet, obesity and sedentary lifestyle. 

On the other hand, healthy diets such as the Mediterranean diet are associated with lower rates of Alzheimer's disease and cognitive decline. A plant-rich diet could affect brain health directly, as plant polyphenols do cross into the brain, where they can act as antioxidants and anti-inflammatory agents, reducing harmful processes that lead to brain cell dysfunction and loss. 

These are consistent associations, but a new 18 month study reported in the American Journal of Clinical Nutrition, set out to test this link with an interventional clinical trial. The study was completed by 224 people who had either abdominal obesity (excess fat around the waistline) or abnormal lipid profiles (high cholesterol or triglycerides), and was conducted at a remote workplace, the nuclear facility in Dimona, Israel, in which lunch and exercise were provided and monitored onsite.

Mediterranean plus

The volunteers were randomly assigned to one of three calorie restricted diets: A healthy dietary guidelines group receiving standard nutrition counseling, a Mediterranean diet group advised to follow a diet rich in veggies, with chicken and fish replacing part of the red meat and supplanted with about an ounce of walnuts daily, and a Green Mediterranean diet group, that in addition to the Mediterranean diet instructions also were instructed to avoid processed and red meat, to eat more plant-based foods and to drink 3-4 cups of green tea and about 3 ounces of Mankai (Wolffia globosa, an aquatic plant rich in polyphenols, protein, iron and B12) as a dinner replacement. All three groups also had a free gym membership and received similar physical activity guidance. 

Brain volume diminishes over time, a change apparent in brain imaging, and the brains of the participants were followed by MRIs before and after the intervention. One area of the brain is of special interest, the hippocampus, a brain area is involved with learning and memory. The hippocampus is located deep in the temporal lobe, and loss of volume there is considered a sensitive marker of brain decline, even before symptoms appear. 

And the results: After 18 months brain atrophy was associated with the age of the participants, with atrophy accelerated among those over 50 years of age. The rate of atrophy was however attenuated in both of the Mediterranean diet groups, and especially in the Green Mediterranean diet group. The same protective effect was also seen in the younger volunteers. 

Avoidance of red and processed meat, and consumption of walnuts and of “green” dietary components (Mankai and green tea) were associated with less loss of brain volume in the hippocampus. The researchers also saw that improvements in glucose tolerance, body weight and blood pressure with the ascribed diet correlated with less brain loss on MRIs. Moreover, urinary excretion of polyphenols, reflecting intake of plant foods, were also correlated with brain volume retention.

Do we have to eat walnuts?

This intervention – of 18 months – is shorter than a 4 year intervention study in 334 older people that showed improved cognition assessed by neuropsychological testing with a Mediterranean diet supplemented with olive oil and nuts. In this study, which showed a diet-brain volume correlation, neuropsychological testing didn’t measure differences between the three groups. These perhaps take more time to manifest.

Are these specific plant foods important? The walnuts and Mankai that were given to the participants were chosen because they’re rich in polyphenols, but they’re more an example of the type of food pattern that helps to maintain a healthy brain than an specific recipe: “we cannot claim an effect of specific foods or nutrients,” say the authors.

The list of polyphenol-rich foods is extensive, and includes berries, herbs and spices, vegetables such as broccoli, cocoa, coffee and tea. Most plant foods contain many types of polyphenols, and the level of content varies by the way the plant is grown, by the way the food is prepared, and many other factors. Polyphenol absorption also varies. 

This is why sensible diet recommendations are to eat a varied diet centered on plant based foods. You don't need to hunt exotic superfoods as there are many nutritiously rich foods that grow locally and are commonly available.

These plant foods are important for cardiovascular health, for protection from inflammation, diabetes and cancer, and may also stave off brain decline.

Dr. Ayala 

Can fruits and veggies relieve anxiety?

If you mention that grey skies make you sad you won’t get much pushback – many believe that rainy days bring about miserable moods and know at least one person who’s predictably affected – yet there’s genuine skepticism about food’s effect on our mental wellbeing.

Nutritional psychiatry is still an emerging field.

There’s growing evidence, however, that certain foods bring about better moods, and that other foods can bring you down.

Several studies have shown that a healthy diet, rich in fruits and vegetables, may impact mental health and is associated with lower rates of depression. Besides numerous studies that show a link between eating fruits and veggies and psychological benefits, there are also studies that actually put it to the test: a study of 171 young adults who usually don’t eat their 5-a-day were assigned to either start doing so or continue as usual. After 14 days the participants on the fruit and vegetable boosted diet reported greater psychological wellbeing.

De-stress with salad?

A new study in the journal Clinical Nutrition examines the connection between eating fruits and vegetables, and perceived stress levels. The researchers looked at a large population of more than 8600 25-91 year olds from the Australian Diabetes, Obesity and Lifestyle cohort. Diet and perceived stress were assessed by validated questionnaires. The stress questions were things like: “you feel rested”,“you feel that too many demands are made on you”, and “you are irritable or grouchy” on a sliding scale. 

And the results: Those eating the most fruits and vegetables (more than 470 grams a day, about 16 ounces, which is close to the recommended minimum of 5 servings a day) felt less stressed than those who ate the lower end of fruits and veggies (less than 240 grams or 8 ounces a day). These findings held after adjusting for confounding factors such as exercise, smoking and caloric intake. 

An inverse relationship between plant-based foods and stress has been shown in other studies. A recent systematic review of studies in the journal Nutrients, which included 61 studies, and looked at fruit and vegetable intake and a whole array of psychological symptoms, from depression to general mental wellbeing, quality of sleep, stress, nervousness and happiness, concludes that eating 5-a-day “seems to have a positive influence on mental health, as stated in the vast majority of the included studies.”

The inflammatory connection

This association doesn’t prove causality. The connection is plausible, though, and could be explained by the fact that fruits and vegetables contain antioxidant phytochemicals that reduce inflammation and cellular oxidative stress.

The connection between inflammatory foods and mood disorders was examined in a recent meta-analysis in Public Health Nutrition, which included four studies and about 50,000 people, looking to see if the inflammatory profile of their diet is linked with developing depression.

The diet was scored using the Dietary Inflammatory Index, an index based on thousands of scientific articles, which enabled scoring most foods and nutrients.

The study found that a pro-inflammatory diet (a diet low on fruits and veggies, high on highly processed food, meat, refined grain, desserts and sugar) was associated with a higher incidence of depression, and that people eating diets with the highest inflammatory score had a 23 percent higher risk of becoming depressed.

As mentioned above, mental nutrition research is relatively new. The 5-a-day fruit and vegetable recommendation is already exhaustingly verified and established as a way to support health and wellbeing. The mental-health benefits, if they pan out, are just another added bonus.

Dr. Ayala

The best foods for love

Every day’s a good day to celebrate love, and a holiday that prompts us to pay attention to our loved ones and to the magic they bring to our lives is very welcome indeed, every year and this one especially.

A favorite way to say I love you is through food, now why’s that?

Food is love

Love is as yet impossible to completely define. The physiologic manifestations of falling in love and the early days of infatuation have been characterized as a kind of obsessive madness; other types of love are hard to explain biochemically and emotionally. 

Food, like undefinable love, elicits complex emotions. Consuming food elicits pleasure, and sometimes longing, and unease. Offering food, gifting food and sharing it lead to closeness between people. “The people who give you their food give you their heart,” wrote Cezar Chaves.

Food is the language of affection. Food may feel like love because it releases similar neurotransmitters, such as dopamine and norepinephrine. 

Food also brings us back to our original love, our earliest feelings of contentment and safety – our parents giving us sustenance and relieving the discomfort of hunger with sweet milk and gradually varied foods while holding us close. 

No wonder food, comfort and love are so entangled.

Aphrodisiac offerings

Are there foods that elicit love and desire better than others? 

“Eat oysters love longer” goes the saying. Aphrodite, the goddess of love, is the root of the term aphrodisiac, and the search for substances that enhance desire, pleasure and performance is as old as human history. Many of the traditional aphrodisiacs are herbs and foods, among them are maca root, ginseng, nutmeg, saffron, and cacao.

Do they work? There is some supporting evidence for their use. A double blind placebo-controlled study in men found that maca (a root plant from the South American Andes, not to be confused with matcha green tea) enhances perceived desire. Saffron, the golden hued spice made of the stigma of crocus flowers, has demonstrated aphrodisiac properties in male rats. Results in a pilot study of 20 men were promising, but a later study in 346 men failed to show improved sexual desire. Red ginseng was found to increase arousal in a double blind placebo controlled study of 32 menopausal women, and other studies have shown benefits in men.

Chocolate, regarded as an aphrodisiac since ancient times, is reported to release phenylethylamine and serotonin, lifting mood and desire, and it's no doubt delicious. A study of 153 Italian women reports significantly higher sexual desire in chocolate eaters, but no differences were found in arousal or satisfaction, and the effect disappeared when adjusted for age.

The evidential support for these aphrodisiacs is indeed scant, and the FDA doesn’t recognize any of over-the-counter ingredients as safe or effective love potions. 

Salad as love gesture

Nothing’s as critical for setting the mood for love as plain overall good health. To that end, a healthy diet, physical fitness and getting enough rest are the most effective aphrodisiacs. 

So chopping a big bowl of salad and letting your loved one sleep in could work, and a basket of colorful fruit is an excellent love offering – it’s not just chocolate in a heart-shaped box that says I love you.

And any food that’s shared is romantic.

Valentine’s Day food gifts aside, cooking and presenting healthy foods communicates love every day of the year, warmth that we can sense in our bones. 

Dr. Ayala

Spice up the new year

We’re cooking at home more – a positive development health-wise, despite its sad cause. Months of homemade meals day in and day out make us yearn for something new, different, better. 

How do you make the same raw ingredients rich and exciting?

Julia Child taught us an easy trick: “With enough butter, anything is good.” Likewise, some more salt, and added sweetness make food taste better. Alas, these easy fixes, if repeated often, make food less healthy, adding extra calories, extra salt and too much sugar to a diet already excessive in all of these.

There’s a better way: the spice way. 

Spices add a full palette of flavors, bring other worlds and cultures to the table, and most of them aren’t spicy, as in hot. Spices have antioxidant and anti-inflammatory properties, and can help ease several ailments; ginger is a proven remedy for nausea and vomiting and several studies suggest that cinnamon may improve glucose control in diabetics. Studies have shown cancer prevention activity of compounds that are present in spices in cell and animal models – the most promising compound is curcumin, abundant in turmeric.

Hot peppers to the rescue

And then, there’s the chilli pepper in all its varieties. New research presented at the latest American Heart Association’s Scientific Sessions reviewed thousands of studies that had data about  people who include hot peppers in their routine and those who avoid it. Overall, the study involved 570,000 people from around the world. People who ate hot peppers had 26 percent less cardiovascular deaths, 23 percent cancer deaths and 25 percent all-cause mortality.

These types of studies don’t prove causality – more research is clearly needed.

Spiciness, however, is clearly a nice add-on for flavor and variety. Spiciness can also help reduce the use of salt and lower blood pressure. There’s some research showing hot peppers can aid in weight loss and burn a few extra calories – warning: it’s very few calories, so don’t get over excited. A small study published in the American Journal of Clinical Nutrition showed that exposure to capsinoids – similar to the capsaicin in hot pepper – activated calorie-burning brown fat in men. A small randomized study in Appetite found that adding red chilli peppers to meals increases satiety and fullness after meals, and reduces the desire to eat after dinner.

A few tips on how to spice up the dish without a backlash: If you’re just starting out, go slow. Add just a little bit in your cooking, enough to create a pleasurable tingling, and bear in mind that spiciness is an acquired taste; you don’t want to scare your family members off. I place a hot pepper flake shaker on the table and sprinkle a hefty shake on many dishes: from curries, to pizza, pasta and soup. Likewise, I think that hot sauce (natural, with no added sugars) is a nice way to customize the meal to the spiciness level each diner prefers.

This is a holiday season like no other. We’re going to have to expand and divert from our traditions this winter, so why not replace some of the salt and sugar with spice in the next new year?

Dr. Ayala

 

A useful trick for eating healthier

What’s the perfect diet? We’ll probably never agree on that, nor is it likely that there’s just one optimal eating pattern, or that it fits everybody.

But there’s little doubt about this: A shift towards eating more plants and less meat will benefit your personal health and is more sustainable for the planet.

The Western diet – high in animal protein and low in plant-based food – is linked with chronic diseases: Obesity, type 2 diabetes, heart disease and cancer. Feeding plant crops directly to people is far more efficient, and the meat industry is a major contributor to greenhouse gasses, land deforestation, water contamination and environmental degradation.

Although interest in plant-based diets is rising, few people actually choose to adopt a vegetarian diet – just 5 percent of Americans avoid meat altogether. But if more people would shift a little towards plants and little away from meat it could make a big difference for both public health and preserving our environment.

One way to replace meat with plant-based protein is the booming market of plant based meat substitutes. Companies like Beyond Meat make products that imitate meat’s flavor and texture.

Another option is to simply replace part of the meat with legumes and vegetables in their original state. Dishes and recipes that combine meat with other ingredients are common to many cuisines, and shifting the proportions of meat to veggies might be a practical way to achieve this goal.

A new study in the journal Appetite tested students’ reception of lower-meat, more-plant dishes in a college setting. The research, led by Molly Spencer, included 150 California students.

Taking away two thirds of the meat

The students were tested three separate times, and were served three different burrito bowls, while not knowing which sample they were eating. The “control” burrito bowl had 60 percent meat (beef), 20 percent legumes, and 20 percent veggies, and was accompanied with mild salsa and layered on a bed of flour tortillas. The test bowls both had lower meat: 20 percent meat, 40 percent legumes, and 40 percent veggies. One of the lower meat bowls had mild salsa, and the other one had spicy salsa, and both were served with the same flour tortillas as the control. Both low meat bowls had a healthier nutrition profile: fewer calories, less salt and saturated fat, more fiber, potassium and vitamin C. The researchers studied student’s acceptance and opinion of the three dishes.

And the results: The students liked all three versions. The low meat bowls were just as appealing in texture and flavor, and just as satiating and filling. The students said they were equally likely to select any of the three preparations.

Interestingly, there were more complaints of “too much” about the legumes (beans) than the veggies in the lower meat dishes, and similarly, in the high meat dish, more people complained about “too little” of the veggies, rather than the beans. Veggies were more popular than beans, and this isn’t the first study to show that.

And what about spiciness? The spicier dish was perceived as a little saltier, a little more complex.

Shifting towards plant foods

Many healthy cuisines are plant-rich without avoiding animal products. The typical Mediterranean diet contains meat, but the meat is more of a flavoring, a condiment, than the majority presence on the plate. The Mediterranean traditional eating pattern is characterized by high consumption of fruit, vegetables, herbs, spices, legumes and complex carbs, moderate consumption of fish, and low consumption of meat and full fat dairy.

Likewise, the current Dietary Recommendations for American’s visualize in My Plate a dish half full with fruits and veggies. My Plate’s protein, which includes protein from all sources, including meat, poultry, eggs pulses, beans, nuts, seeds etc. represents just about a quarter of that plate.

This new study concludes that “a shift from meat-centric dishes to plant-forward dishes without the strictness of vegetarianism or veganism, is feasible,” and I think that places like schools, college cafeterias and health care facilities might be the great place to introduce people to this easy, gradual shift.

As would be the family meal.

Dr. Ayala

Want kids to eat their veggies? Try herbs and spices

Vegetables shouldn’t be such a hard sell. They’re colorful, pretty, crunchy, and in my personal opinion, quite delicious even in their raw, unadorned state.

But despite lots of urging from every health authority and mom, people don’t eat enough of them. Eating veggies has never been as important: Veggies, with their abundance of fiber, phytonutrients, antioxidants, vitamins and minerals, not only reduce the risk of several chronic diseases – such as heart disease and diabetes – eating them can replace other foods, and there is no other food group with fewer calories and more filling capacity. They’re the food that societies facing rising rates of obesity should turn to and delight in – a carrot, after all, is much tastier than the “stick” of food avoidance.

Shockingly, only about 2 percent of American teens eat the recommended amount of vegetables daily.

Multiple strategies have been employed to change this sorry statistic – education campaigns have been quite successful in making people aware of the benefits of 5-a-day, but they have not moved the needle enough – and one of the promising ones is adding flavor and interest to vegetables.

A pinch of flavor

A new study, published in Food Quality and Preference tests how the addition of herbs and spices may affect teens’ fondness of vegetable dishes.

The study was conducted in a rural Pennsylvania school, among teens aged 14-18. Surveys taken before the study showed that about 75 percent of students reported that the main reason they don’t eat more veggies at school is their taste. The kids also had very little familiarity with herbs and spices.

Nevertheless, when vegetables such as carrots, green beans, cauliflower and broccoli were prepared with herbs and spices, students liked and selected them more, and preferred them over the plain versions. The kids favored the seasoned dishes even when the spices and herbs were unfamiliar to them – dill-seasoned broccoli and cauliflower with coriander got better ratings than plain broccoli and cauliflower, even though dill and coriander were unfamiliar to the kids.

And since meals – both at school and at home – strive to reduce added salt and oil, recipes with healthy spices and herbs could make vegetables more desirable.

Another recent study in Appetite tested vegetable consumption in a university cafeteria, comparing the selection of seasoned vegetables to steamed ones. The researchers tested several different vegetables – carrots, broccoli, and green beans – steaming and seasoning them with things like garlic, parsley, dill, cinnamon and black pepper, as well as some oil and salt, as opposed to just steaming them with vegetable oil and salt. Given the choice, students preferred the seasoned vegetable, and even people who otherwise wouldn’t have selected a vegetable side were 1.6 times more likely to pick one if it was seasoned.

Dare to flavor

Processed food is very high in flavor – much of it comes from sugar and salt, with other flavorings, not all of them natural, added to the mix. Regardless, the profile of most of these craveable foods is the polar opposite of bland.

Yet when parents and cafeterias prepare vegetables they often add very little flavor to them. Serving veggies raw and plain can work if they’re at the height of ripeness, freshness and flavor, and if people already love that particular veggie.

For other vegetables, especially those with a hint of bitterness, seasoning could make a huge difference, and a little effort and attention could elevate veggies' desirability and consumption among kids.

“I like to start off with something they are familiar with, like Italian seasoning,” says registered dietitian and chef Julie Harrington. “Most children are familiar with the Italian seasoning that is on their pizza or in their pasta sauce.”

Kids’ cooking teacher Katie Kimball likes to combine the novel with the familiar: “When I use a spice like turmeric, for example, I like to call the veggies "mustard veggies" because all my kids adore mustard. That explains the yellow color and reduces their skepticism. We add smoked paprika to veggies in a breakfast hash, a very strong flavor that many might think is too much for kids - but along with oregano, it helps veggies taste a little like pizza. And of course, pumpkin pie spice makes numerous recipes including squash or sweet potatoes go right down the hatch!”

Registered dietitian Jennifer Glockner offers these tips:

Spices and herbs may have a powerful flavor so just a tiny amount may go a long way. Pureed or finely chopped herbs work well for kids.

Cinnamon or nutmeg can pair well with sweet vegetables such as sweet potatoes and carrots.

Dill or chive works well with cruciferous vegetables like cabbage or cauliflower.

Mint and/or citrus (juice, zest, slices) adds brightness to salads (tomatoes, cucumber, bell peppers).

Paprika is a fun spice that adds smokiness and color to vegetables.

Jennifer also reminds us that we should “try, try, try again. It can take up to 12 tries to like a new food including vegetables and seasonings.”

Let’s celebrate the last days of National Nutrition Month and “Go Further With Food” by breathing new flavors with spices and herbs. These wonderful natural, healthy flavorings from nature unlock veggies’ potential and can make them exciting to both kids and adults.

Dr. Ayala

Is anti-inflammatory food for real?

Inflammation is the body’s useful reaction to injury and infection by outside invaders such as bacteria and viruses. Low grade chronic inflammation -- an immune system that’s a bit overactive at all times -- on the hand, is detrimental to our health and leads to serious trouble: from heart disease to cancer, depression, Alzheimer’s and arthritis, not to mention the role it plays in aging. Reduce undue inflammation and you’ll reduce the risk of these diseases.

The fascinating finding is that we can affect inflammation not just with powerful drugs but also with our fork.

What’s in our plate affects disease and health, so let’s take a look at which foods have that power, and at the latest science looking at the food - inflammation - disease connection.

The diet for controlling inflammation

To paint with a broad brush and help you remember, think of a stereotypical American diet -- low on fruits and veggies, high on meat, refined grain, highly processed foods, desserts and sugary drinks – and you’ve described the pro-inflammatory diet. Add to that obesity and sitting on a chair most of the day, and you’re imagining the perfect conditions for a pro-inflammatory state that predisposes our bodies to degenerative diseases.

To paint with another broad brush, an anti-inflammatory diet would be a classic Mediterranean diet – centered on fruits, veggies, spices and herbs, whole grains, garlic, onion, olive oil, fish and wine.

To be more specific, the tool used in most research into pro- and anti-inflammatory foods is the Dietary Inflammatory Index. To create the index thousands of scientific articles were reviewed, and each food and nutrient got a score.

Foods and nutrients that have strong anti-inflammatory activity include turmeric, fiber, tea, wine, ginger, all these wonderful phytochemichals in plant-foods, -- flavones, flavonols, flavonones, anthocyanidins, isoflavones -- vitamins such A, E, D, C, and many from the B family, magnesium, mono and poly unsaturated fats, and omega-3 fats.

Foods and nutrients with pro-inflammatory activity include total fat, saturated fat, protein, carbs and iron.

Do anti-inflammatory foods reduce disease?

 A growing body of research certainly suggests so.

A pro-inflammatory diet was associated with higher hypertension incidence in the 7000 women followed in a recent study. It was also associated with higher risk of colorectal cancer in another study that followed about 35,000 women.

Another study in the International Journal of Cardiology found that an anti-inflammatory diet lowered the incidence of heart disease in 3000 Greek volunteers followed for 10 years – at least for those of them that didn’t already have metabolic syndrome.

A brand new, large prospective study published in the Journal of Nutrition found that an anti-inflammatory diet lowered the risk of depression, especially in men.

Add to that the vast evidence linking Mediterranean diets with better health outcomes and, at least for me, it’s reason enough to pay attention to anti-inflammation foods – it’s an intriguing topic I’m sure we’ll hear more about.

The take home message: try to limit the pro-inflammatory foods – refined carbs, fried foods, soda, red and processed meat, margarine and lard, and try to include more foods that fight inflammation, such as fruits, veggies, spices, herbs, nuts and fatty fish.

Dr. Ayala

The lifelong benefits of spices

Hillary Clinton credits her stamina to hot sauce. She reportedly picked up her spice habit in 1992, after reading that hot chilies help the immune system.

I, too, am one of those people who carry hot pepper flakes in my bag – such is my fear of bland food.

Spices for healing are an old belief with a modern incarnation. Hippocrates, the father of medicine, famously said: “Let thy food be thy medicine and thy medicine be thy food,” and used spices and herbs he collected in the Greek hills for healing. A spiced wine recipe containing cinnamon, cloves, allspice and honey – sounds delicious – is attributed to him, and was allegedly prescribed for many common ills. Mulled wine is an ancient remedy for the broken heart and aching body.

Current research is providing evidence of the benefits of spices. Spices have antioxidant and anti-inflammatory properties, have been shown to affect fat metabolism, and have been found to aid in several conditions; ginger is a proven remedy for nausea and vomiting and several small studies suggest that cinnamon may improve glucose control in diabetics. Studies have shown anti-cancer activity of compounds that are present in spices in cell and animal models – the most promising compound is curcumin, abundant in turmeric.

A new study in PLOS one, that I’m sure will please hot sauce fans, looked to see if people who eat hot peppers live longer.

Hot pepper and mortality

The researchers, Mustafa Chopan and Benjamin Littenberg, included more than 16,000 Americans, whose hot pepper consumption was assessed through a food frequency questionnaire, and who were followed for about 19 years. During the follow up, almost 5000 of these people died.

Participants who reported eating hot peppers on a regular basis died 13 percent less than the people who didn’t eat spicy. The more hot peppers people ate, the less the risk of their dying from all causes, and these findings were adjusted to minimize known confounders such as obesity, income, exercise, education, marital status, smoking and dietary habits such as eating meat and vegetables.

This is of course an association. It doesn’t prove that hot peppers affect longevity.

The researchers remind us, though, that this association was demonstrated in another population: A recent study from 2015 including more than 500,000(!) Chinese people found a 14 percent risk-of-death reduction in spicy food eaters. They also suggest several mechanisms, which might explain the connection, among them, that capsaicin, the main substance that causes the tingling hotness in peppers, has antimicrobial properties. These might affect the bacteria in the gut, and cause the microbiome of individuals to be colonized by more healthful bacteria. The microbiome, a hot research topic, we are discovering, is linked to many diseases -- from diabetes to obesity and heart disease.

While I don’t think Sriracha will help you cheat death, and the magic properties of hot peppers are far from conclusively proven, one thing’s for sure: When food is properly seasoned it’s tastier and more appealing.

Season healthy food well, and it’ll help you eat healthy.

Spices also add a whole host of antioxidants and nutrients to your dish and reduce the need for salt, sugar and fat.

Spices are old. They have been valued for their ability to bring other worlds and cultures to our table, to make food delicious, interesting and beautiful well before the advent of these recent discoveries. Every sprinkle might also add a little health bonus.

Dr. Ayala

Zucchini “pappardelle” with lemon and herbs

As spring turns to summer, here’s a wonderfully fragrant and fresh light dish that uses what’s best this season. Serve it cold on a warm night, or heat it up (microwave is fine!) for extra comfort on a chilly evening.

Ingredients:

• 4-5 medium zucchini
• 2 lemons
• 5 garlic cloves
• ¼ cup olive oil
• 2 tablespoons capers
• A few sprigs of thyme
• Pinch of red pepper flakes
• 4 tablespoons finely grated parmesan
• 3 tablespoons pine nuts
• 2 tablespoons finely chopped mint leaves
• Salt and pepper to taste

Special equipment: mandolin, or a good vegetable peeler

To make:

Using a mandolin or peeler, cut the zucchini lengthwise into long thin ribbons. Cut those pieces lengthwise into narrower strips. Set aside in a large serving bowl

Cut the lemon into very thin – almost transparent – slices, using the mandolin. Pile the slices, and cut into 4. Add to the large bowl

Sliver the garlic cloves into the thinnest slices – again, mandolin is best.

To make the dressing, place the olive oil, garlic slices, thyme leaves, capers and pepper flakes in a large skillet. Turn the heat onto medium. Don’t preheat the pan. As the oil heats up watch carefully so that the garlic doesn’t burn. Stir the garlic gently. Continue cooking until the garlic is slightly golden, about 1 minute. Let cool

Add into the large bowl with the zucchini the rest of the ingredients: Parmesan cheese, pine nuts, mint, salt and pepper, and the toasted olive oil/garlic dressing

Mix well, correct taste and serve

Serves 4-8

Enjoy,

Dr. Ayala

Black lentil, sweet potato and carrot soup

I love green lentils, and use red ones a lot too, but once you try the black variety I think you'll never look back. Black lentils soften quite quickly, but remain intact after cooking, dotting this satisfying, nutritious soup with dark contrasting-colored bits of delicious beauty.

Ingredients:

• 2 sweet onions
• 2 tablespoons olive oil
• 5 carrots, cut into large cubes
• 2-3 sweet potatoes, cut into large cubes
• 1 tablespoon paprika
• dash of cayenne pepper
• 1/2 teaspoon tumeric
• Salt and pepper to taste
• 6 cups water
• 2 tablespoons miso paste (I prefer the white mellow)
• 1 cup washed black lentils
• 2 cups spinach leaves, chopped
• ½ cup dill, finely chopped
• Garnish: fresh dill or cilantro, chopped

Preparation:

• In a large pot, on medium-high heat, sauté the onions in olive oil until soft and golden. Add the carrots, sweet potatoes, paprika, cayenne pepper, turmeric, salt and pepper, and sauté for about 15 minutes, until sweet potatoes are quite soft. Add a little water if the the pot seems too dry
• Add the water, bring to a boil, simmer until the vegetables are soft but still tender
• Remove from heat, add the miso paste to the pot, and with an immersion blender process until smooth
• Wash the lentils in a sieve with plenty of cold water. Add to the pot, bring to a boil, lower to a simmer, and cook about 20-30 minutes, until the lentils are soft, turn off heat
• Add the spinach and the dill (heat's already off, but the soup is still very hot, so spinach will wilt nicely)
• Taste and correct seasoning.
• Garnish with a spinkle of herbs and serve with a nice loaf of bread. 

Enjoy!

Dr. Ayala

A pleasurable way to cut salt

There are many good reasons to add spices and herbs to your life. They add flavor, aroma, color and healthfulness; they bring with them the memories and atmosphere of faraway places.

Here’s another reason to make use of your spice rack: they can help reduce salt intake.

In a new study in the American Journal of Clinical Nutrition a group of men and women from Baltimore – all of whom were at high risk and were advised to eat no more that 1500 mg of sodium daily – were started on 4-week low sodium diet in which all food and drink was supplied.

To figure out how much sodium each person consumed, rather than rely on self-reports, which are especially difficult in the case of salt, urinary sodium excretion over a day was measured, as we know the what’s found in the urine represents what’s in the food quite well.

And this indeed worked. Adhering to a supplied diet the participants showed a remarkable drop in the collected sodium – from about 3500mg/day to 1650mg/day.

Maintaining a low sodium diet in the real world, in which prepared food already contain an abundance of salt, is much harder, and that’s what the second phase of the study was all about. The group was divided randomly into two: in one group the participants received individual and group counseling, and were advised about the use of spices and herbs as a way to curb salt intake, and in the other participants were just given general advice about salt reduction.

Although overall the salt intake increased above the level achieved in phase 1 in both groups the first group did much better: the group receiving the behavioral intervention consumed remarkably less salt (and its urinary sodium was about 1000 mg/day less).

Interestingly, the participants were given a blinded taste of chicken broth with 8 differing concentrations of salt – from 0 to 1.5 percent salt – before and after the low salt diet. After just 4 weeks on a low-salt diet the participants tasted significantly more salt in the 0 percent broth, suggesting that it doesn’t take long to become sensitized to the taste of salt.

Spice it up

While the authors say they placed “particular emphasis on the use of spices and herbs”, since the treatment group received several behavioral interventions, we can’t give spices all the credit.

We do know that positive messaging (eat more fruit) usually feels better than hearing about what we shouldn’t be doing (candy will make you fat and rot your teeth) and may be more effective.

So instead of advising people to eat less salt – which sounds bland and boring – maybe the better message is: Spice it up.

Dr. Ayala

 

Roasted herb and spice chickpeas

Chickpeas, also called garbanzo beans, are healthy and fun to nibble on, and this recipe makes them spicy, delicious, crispy and super snackable. Serve warm, straight out of the oven, or store in an airtight container.

Ingredients 

• 1 ½ cups dried chickpeas soaked overnight in cold water, or 2 (15oz) cans of chickpeas, drained and rinsed
• 2 tablespoons olive oil
• 1 tablespoon paprika
• ½ teaspoon cayenne pepper
  2 tablespoons dried dill weed
• ¼ teaspoon salt

Preparation

• Place chickpeas in a large pot with plenty of water – water should cover the chickpeas by a few inches. Bring to a boil, lower to a simmer, and cook until soft, about 60 minutes. Drain thoroughly. Skip this step if using canned chickpeas.
• Heat oven to 400 °F.
• Toss chickpeas with the rest of the ingredients.
• Bake until crisp and crunchy, 20-30 minutes.

Enjoy,

Dr. Ayala

Arugula, spinach, pomegranate and quinoa salad

A seasonal colorful and crunchy salad to decorate your festive table, and it’s also perfect for guests on a vegan and gluten free diet. The recipe is more greens than grain, but you can change the greens to quinoa ratio for a more hearty dish.

 

Ingredients

Salad

½ cup quinoa, rinsed

1 cup water

2 tablespoon finely chopped sweet onion or shallot

2-3 cups baby arugula

2-3 cups baby spinach

2 tablespoons chopped parsley

¼ cup dried cranberries

½ cup pomegranate seeds

2 tablespoons toasted sliced almonds

Crumbled soft goat cheese (optional)

 

Dressing

¼ cup extra virgin olive oil

Zest from one lemon

2 tablespoons lemon juice

½ teaspoon honey or agave

Salt and pepper to taste 

 

Preparation 

 

In a small pot bring quinoa and 1 cup of water to a boil. Lower heat to medium-low and simmer for 15-20 minutes, until quinoa starts to get translucent and small curly tails sprout (the tail is the quinoa’s germ). Let cool

Combine the rest of the salad ingredients in a large bowl. Add cooked quinoa 

To make the dressing whisk all the ingredients in a small bowl

Just before serving, pour the dressing, toss, test and correct seasoning and serve immediately.

Enjoy,

Dr. Ayala

Delicious parsley, toasted sesame and miso salad

Is parsley the new kale? Taste this salad and you’ll believe it! But I’m not here to foster rivalry between dark green leafy veggies – they’re all very good to eat -- just to give you a taste of this new salad of mine that has turned a few friends into serious parsley fans.

Ingredients:

For the salad

4 tablespoons sesame seeds

2 large bunches flat leaf parsley, stems removed, coarsely chopped

1 small shallot, very finely chopped

A handful of raisins

2 tablespoon very finely grated Parmesan cheese

1 apple, diced

For the dressing

1 tablespoon white miso paste

2 tablespoons rice vinegar

½ teaspoon honey

3 tablespoons toasted sesame oil

freshly ground black pepper to taste

Preparation:

To toast the sesame seeds: Heat a small pan on medium heat on the stovetop. Add sesame seeds, shake the pan occasionally, and toast until the seeds just start to turn brown and become fragrant (this will take about 2-3 minutes). Allow seeds to cool

Combine all the salad ingredients in a large serving bowl

Dressing: Whisk miso paste with the rice vinegar, and once you have a thinner paste, whisk the rest of the ingredients. If the dressing seems too thick add a teaspoon of water

Add the dressing to the salad just before serving

Serves about 8

 

Enjoy!

Dr. Ayala