nutrition – Steven Piriano, MD

Got Fiber?

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In my last post, I wrote about fiber and its many health benefits. I mentioned that it lowers cholesterol and triglycerides. I also stated that it reduces the risk of developing chronic diseases such as diabetes, heart disease, and several types of cancer. As an added bonus, it makes you feel fuller sooner and without increasing your caloric intake.

I stated how many different types of fiber are the food of choice for the 39 trillion bacteria living in our gut—our gut microbiome. Moreover, a thriving gut microbiome is responsible for many of the health benefits of fiber. When the bacteria in our gut are presented with different types of fiber, they produce small molecules called short-chain fatty acids (SCFAs). Aside from providing several of the health miracles described earlier, SCFAs also provide 70% of the energy needed by the cells of our colon, which will keep them functioning well.

To digress for a moment, have you ever heard of leaky gut syndrome? I certainly have. Over the years, I’ve had many patients who have told me they have this condition. But what exactly is a leaky gut? I mean, how does one’s gut leak? Well, it all comes down to the health of our colon cells. These cells are held closely together by molecules called tight junctions. If these junctions work normally, the colon cells will be held closely together. If these junctions are not operating as they should, the colon cells will separate, and there will now be spaces between cells. Substances within the gut, such as bacteria, bacterial toxins, and molecules from food, can now move through these openings and find themselves outside the gut. This, my friends, is a leaky gut.

You may wonder why it is such a problem if these things “leak” out of your gut. Well, the fact that 70% of your immune system lives just outside the gut is one big reason. When your immune system encounters these things, it can lead to allergies, excessive inflammation, and even autoimmunity. Furthermore, the muscles and nerves within the gut can be adversely affected, leading to distressing symptoms such as constipation, diarrhea, bloating, and abdominal pain.

Once again, I’d like to point out that you can lower the risk of developing many diseases and also allow yourself the opportunity to feel fantastic through the simple act of eating whole, healthy foods.

Thank you for taking the time to read this post. I hope you enjoyed it and found it informative. If so, please feel free to share it.

What’s All the Fuss About Fiber?

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What do foods such as broccoli, peppers, bananas, and apples have in common? Sure, they are loaded with vitamins, minerals, and antioxidants, which are essential to good health. The other indispensable component that they have is fiber.

I’m sure you’ve heard a lot about fiber. But, why is fiber so important for good health? What IS all the fuss about fiber? That is a terrific question, and I’m glad you asked.

Books can and have been written about the benefits of fiber. In this post and the next, I will distill down a few of the critical points.

You’ve probably heard that fiber can help you poop regularly. That’s true, and that is an important benefit of fiber. However, there is so much more to fiber than just helping to keep us pooping regularly.

First, it’s important to understand that our bodies cannot digest fiber, and we get no calories directly from fiber. Having said that, one of the things that fiber does is that it increases satiety. That’s right; it makes us feel full without increasing our caloric intake. That is a great thing in and of itself. Fiber also increases insulin sensitivity, which decreases the risk of diabetes. It lowers cholesterol and triglycerides. It also reduces the risk of heart disease as well as several cancers, such as colon cancer.

Now, if we can’t digest fiber, how does it work its miracles within us? Another great question—you’re on a roll. Fiber is actually the food of choice for the 39 trillion bacteria that live in our guts, also called our gut microbiome. Further discussion on that in my next post. Fun fact: 39 trillion microbes are living in our guts. Do you know how many human cells your body is made up of? About 30 trillion—give or take a trillion. Think about that—your body is likely composed of more bacterial than human cells. Amazing, right?

Moreover, we have an important relationship with these gut bacteria, and they are vital for good health. Thus, it would behoove us to give our gut bacteria what they need to thrive. And as mentioned earlier, their food of choice is fiber—many different fiber types.

Where do we get lots of different kinds of fiber? It comes from eating a variety of plant-based foods, especially whole plant-based foods such as fruits, vegetables, beans, lentils, oatmeal, flaxseed, and whole wheat pasta. Fiber is only found in plant foods. Animal foods have zero fiber.

One last thing: if you currently don’t eat many fiber-containing foods and want to start, that is fantastic. However, there is an important warning. Let’s say that your only source of fiber is something like a banana a day. If you go directly from that to eating five or six servings of fiber-containing foods the next day, you will likely feel pretty bad. You may experience abdominal pain, bloating, and feel gassy. The best way to increase your fiber intake is to do it slowly. If you’re starting low, then please go slow.

Solely by the simple act of eating whole, healthy foods, we can help improve and maintain excellent health.

Next time: Fiber part II.

I hope you enjoyed this post and found it informative. If you did, please feel free to share it.

The Swap Challenge: Week Four

Welcome to the end of the final week of the Swap Challenge!

I hope everyone was able to swap out at least one unhealthy meal for a healthy one each week over the past month. More importantly, I hope that you found it delicious and satisfying.

This week I’d like to share a tuna recipe without the tuna. It uses chickpeas and vegan mayonnaise and is delicious.

You can find it here: Chuna Salad Sandwich.

When I made mine, I didn’t have the pickles, and it was still mouthwatering.

If you are just beginning your journey to a healthy lifestyle, I hope this was a great start for you.

Be well!

The Swap Challenge: Week Three

How are you doing for week three of The Swap Challenge?

I hope that you have swapped out at least one unhealthy meal for a healthy one this week and are feeling great about it.

This week I made sweet potato-black bean enchiladas. This recipe was a bit more involved, but definitely worth it!

You can find it here: sweet potato-black bean enchiladas.

One more week to go!

The Swap Challenge: Week Two

Welcome to week two of the Swap Challenge!

I hope everyone has been having a great week.

Feel free to leave a comment if you have swapped out an unhealthy meal for a healthy one.

I prepared pizza with creamed spinach, sun-dried tomatoes, red onion, and olives this week. The cream part of the creamed spinach was made from tofu!

I found the recipe on forksoverknives.com.

It was delicious.

Be well, and have a fantastic week!

The Swap Challenge: Week One

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Welcome to the Swap Challenge Week One!

I hope everyone is doing great.

If anyone has swapped out an unhealthy meal for a healthy one, please feel free to comment and share what meal you prepared and how things went.

I’ll start—I found this recipe for vegan crab cakes on the CNS Kitchen site that was very easy to make and delicious. I thought it tasted better than the crab cakes I used to eat. Oh, and the tartar sauce was so good.

Until next week, be well!

A Food-Borne Illness

As an Emergency Medicine physician, when I hear the term “food-borne illness,” it immediately conjures images of people with vomiting and diarrhea secondary to consuming undercooked or spoiled food contaminated with bacteria or their toxins. However, I recently learned of a new usage of this term. In his article, “Is the Present Therapy for Coronary Artery Disease the Radical Mastectomy of the Twenty-First Century?” Dr. Caldwell Esselstyn ascribes a new meaning to the phrase “food-borne illness,” referring to coronary artery disease as this type of illness. According to the CDC, coronary artery disease (CAD) is the most common type of heart disease in the United States. It is the narrowing and blockage of blood vessels supplying blood to the heart, which can eventually lead to heart attacks. The CDC also states that in the United States, over 20 million adults over age 20 have CAD and that someone has a heart attack every 40 seconds.

Those are some pretty frightening statistics. But luckily, doctors have treatments for heart disease. We have an armamentarium of medications as well as procedures such as coronary stents and coronary artery bypass surgeries. These are remarkable advances that are lifesaving for those that are having a heart attack. However, as Dr. Esselstyn states, “…none of the present therapies targets the cause: the Western diet.” Yes, our Western diet—filled with processed foods, fried foods, meats, oils, and dairy. He describes cultures that consume a plant-based diet in which CAD is almost non-existent. Moreover, the converse is also true. When plant-based cultures adopt a Western diet, guess what? Yes, that’s right, they develop CAD. Thus, it seems as though heart disease really is a food-borne illness.

History also teaches us this lesson. Between 1939 and 1945, Norway was occupied by Nazi Germany. During this time, the Germans removed all animal livestock, forcing the population to subsist on whole grains, legumes, fruits, and vegetables. Following this, deaths from heart attacks and strokes fell. When the war ended, and animal products became available again, deaths from these illnesses rose to prewar levels. Thought-provoking, isn’t it?

In his article, Dr. Esselstyn mentions a study he conducted on very ill patients with CAD that he placed on a plant-based diet. These patients have thus far been followed for twenty years, and the results are fascinating. A plant-based diet not only stopped the progression of heart disease but even reversed it! Yes, reversed it. Furthermore, this study and its follow-up showed that people with CAD would stick with dietary changes for decades. If provided with an understanding of the link between diet and disease, I believe that people will want to take control of their own health and give themselves the opportunity to be better.

Consequences

Cheeseburgers and chocolate cake are delicious. Eat a cheeseburger for lunch, and you will likely feel really good. And that piece of rich chocolate cake—definitely mouthwatering. The same goes for pizza dripping with cheese, juicy porterhouse steaks, hot dogs with all the fixins, moist frosted creme donuts, and many others. Undoubtedly tasty and gratifying.

Eating such foods on infrequent occasions is pleasurable and will probably cause no harm. However, filling your plate with these types of foods on most days of the week is an entirely different story—one whose ending is difficult to visualize in the present moment.

Many of us are probably aware that foods high in sugars, fats, and cholesterol are not the healthiest options. They increase the risk of developing many chronic diseases, including heart disease. Moreover, this risk increases the more often these foods are consumed. I’d bet that countless people who understand the dangers of eating these foods consistently still do so. Why would this be?

The likely answer is that the consequences of regularly eating unhealthy foods do not occur right away. As a matter of fact, the results of these actions will typically take years to manifest. If you knew that eating cheeseburgers a few times every week would increase your risk of suffering a heart attack ten or fifteen years down the road, it might not bother you too much. However, if you knew that eating a cheeseburger on Monday would cause you to have a heart attack on Tuesday, I’ll bet that you’d think twice about it.

The converse is also true. Eating a vegetable salad on Monday will not turn you into a picture of good health on Tuesday. But eat lots of fruits and vegetables every day, and you will undoubtedly see and feel the difference in the following months and years. Again, when there is a lot of time separating actions and consequences, people will oftentimes only care about the immediate or near-term results without giving much regard to the long-term effects of their choices.

This concept was explained very well by Ray Dalio in his book Principles. He refers to near-term effects as first-order consequences and long-term effects as second- and subsequent-order consequences. As Mr. Dalio says, “Quite often the first-order consequences are the temptations that cost us what we really want, and sometimes they are the barriers that stand in our way.”

The next time you are about to order that cheeseburger, don’t just think about how it will make you feel as you’re eating it. Consider how it may affect you a few years into the future. After all, it is still you that will bear the consequences.