1. SuperfoodsorSUPERSIZE? Victor Sierpina, MD Nicholson Professor of Integrative Medicine University of Texas Medical Branch

4. USA Dietary Patterns (1900-2000) High simple carbohydrate consumption Soda -3.5 cans/day White Flour - i.e.. baked goods Potatoes - French Fries Low Fruit & Vegetable (micronutrient/fiber) consumption 20:1 imbalance omega-6: omega-3 fatty acids 5-10 % calories from trans fats Grain-fed & fattened cows, pigs, chickens

8. Superfoods Spinach Blueberries Salmon Citrus Turkey Breast Pumpkin Broccoli Yogurt Walnuts Oats Tomato Legumes Soy Green Tea

9. Servings of Fruits & Vegetables Per Day—UTMB 2 nd yr Med Students

10. Supernutrients Vitamin C Lutein Folic Acid Zeaxanthin Selenium Lycopene Glutathione Beta Carotene Resveratrol Alpha Carotene Polyphenols Beta Cryptozanthin n-3’s Fiber

12. WILD SALMON SUPERFOOD #7: WILD SALMON Lowers the risk of heart disease and cancer. The more omega-3 fish oils you eat; the lower your blood pressure In one study eating the oil in fish cut cancer incidence by over 60% 4x weekly  risk for and progression of AMD Studies suggest that fish consumption is associated with a lower risk for depression, violent behavior, Alzheimer’s disease, Attention Deficit Disorder, Atrial fibrillation. SPF nutrients TRY TO EAT Wild salmon, halibut, sardines, etc. 2 to 4 times per week

13. American Heart Association Recommendations  Healthy individuals should take two servings of fish (salmon, sardines, tuna, mackerel, trout) weekly along with flaxseed, canola, and soybean oil Patients with CHD should consume higher doses, 1 g/d of EPA + DHA, which may require fish oil supplementation AHA Recommendations: Intake of omega-3 fatty acids. Women’s Health in Primary Care. 2003.6(1): 25-26 (Consensus opinion)

14. Indications from other studies Eating fish as little as once a week reduces the risk of sudden death in men Eating fish twice a week reduces CHD risk in women Fish intake reduces Alzheimer’s risk Harper, Beyond the Mediterranean Diet: the Role of Omega-3 Fatty Acids in the Prevention of CAD, Prev Cardiol, 2003 Morris, Consumption of fish and n-3 fatty acids and risk of Alzheimer dz,. Arch Neurol, 2003

15. How intake of Omega-3 Fatty Acids is helpful Stabilization of atherosclerotic plaques Reduction of inflammation by mediation prostaglandin synthesis pathway Improved ratio of omega-3 to omega 6 FA reduces arachidonic acid and pro- inflammatory, pro-platelet aggregatory cytokines Enhances PGE1 and PGE 3 and less inflammatory leukotrienes (see diagram) Thies F, et al. Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaque: RCT, Lancet, 2003;361:477-85

16. Omega 6 Fatty Acid (Linoleic Acid) Omega 3 Fatty Acids (alpha-linolenic acid) Δ6-Desaturase Gamma-linolenic acid (GLA) Evening Primrose Oil Borage Oil Black Current Oil Arachidonic Acid Leukotrienes Prostaglandins (PGE2) (Inflammatory) Lipoxygenase Cyclo-oxygenase (COX) Eicosapentaenoic Acid (EPA) Prostaglandins PGE1, PGE3 (Favorable) Less Inflammatory Leukotrienes Lipoxygenase Docosahexaenoic acid (DHA) COX Δ5-Desaturase

17. AHRQ study Most studies show very low cardiovascular mortality in populations with high fish consumption Strongest, most consistent effect of omega-3 fatty acids was reduction in triglycerides from 10-33%

18. BEANS SUPERFOOD #1: BEANS Lower your heart disease risk by 20% Beans lower cholesterol, reduce obesity, relieve hypertension. If you’re diabetic, you should eat beans: helps keep blood sugar under control SPF Nutrients TRY TO EAT: at least four ½ cup servings per week.

19. The US Defecation Deficit Stool volume in US less than ½ that of “underdeveloped” countries—we’re being “outpooped”!! (with corollary health risks) Dr. Donald Ardell, author, 14 Days to a Wellness Lifestyle, 2003 Utilize complex carbohydrates, higher in fiber and lower in glycemic load to reduce risk of CHD Hu F, Willett W.Optimal diets for prevention of coronary heart disease. JAMA. 2002;288:2569-2578 {Systematic review }

20. 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” SPF Nutrients TRY TO EAT 1 to 2 cups daily BLUEBERRIES SUPERFOOD #2: BLUEBERRIES

21. Purple grapes Cranberries Boysenberries Raspberries Strawberries Currents Blackberries Cherries Pomegranates BLUEBERRY SIDEKICKS

23. BROCCOLI SUPERFOOD #3: BROCCOLI Broccoli is one of the best cancer fighters you can eat: 2 servings a day can result in 50% reduction in risk Most powerful, easiest to eat form of broccoli: broccoli sprouts (10 to 100x power of regular broccoli) Boosts the immune system, lowers the incidence of cataracts, supports cardiovascular health, builds bones and fights birth defects. SPF nutrients TRY TO EAT ½ to 1 cup daily

24. BROCCOLI SIDEKICKS BROCCOLI SIDEKICKS Brussels Sprouts Cabbage Kale Turnips Cauliflower Collards Bok Choy Mustard Greens Swiss Chard

25. OATS SUPERFOOD #4: OATS Reduced risk for diabetes, our fastest-growing chronic disease Lower cholesterol, reduce the risk of coronary heart disease, high in fiber and protein. Super breakfast: keeps you full, low in calories Fiber  Atherosclerosis progression SPF nutrients TRY TO EAT 5 to 7 servings a day of whole grains (for example, whole wheat bread would count!) or 10-21 grams whole grain fiber

26. OAT SIDEKICKS OAT SIDEKICKS Super Sidekicks –Wheat Germ –Ground Flaxseed Sidekicks –Brown Rice –Barley –Wheat –Buckwheat –Rye –Millet –Bulgar Wheat –Amaranth –Quinoa

27. ORANGES SUPERFOOD #5: ORANGES Vitamin C! This vitamin is too often neglected today. Low vitamin C intake doubles risk of hip fracture Support heart health and prevent cancer, stroke, diabetes and a host of chronic ailments. >200 mg vitamin C for >10 yrs  cataracts Highest vitamin C intake associated with lowest all cause mortality SPF nutrients TRY TO EAT 1 serving daily (drink high pulp OJ)

28. Lemons White and Pink Grapefruit Kumquats Tangerines Limes ORANGE SIDEKICKS

29. PUMPKIN SUPERFOOD #6: PUMPKIN Rich in alpha carotene and beta carotene –“Longevity nutrients” Helps lower the risk of various cancers (lung, colon, bladder, cervical, skin, and breast) and supplies nutrients necessary for healthy, youthful skin. Surprise: a great source of fiber! May  risk for cataracts An SPF powerhouse TRY TO EAT ½ cup most days

30. PUMPKIN SIDEKICKS Carrots Butternut Squash Sweet Potatoes Orange Bell Peppers

31. WILD SALMON SUPERFOOD #7: WILD SALMON Lowers the risk of heart disease and cancer. The more omega-3 fish oils you eat; the lower your blood pressure In one study eating the oil in fish cut cancer incidence by over 60% 4x weekly  risk for and progression of AMD Studies suggest that fish consumption is associated with a lower risk for depression, violent behavior, Alzheimer’s disease, Attention Deficit Disorder, Atrial fibrillation. SPF nutrients TRY TO EAT Wild salmon, halibut, sardines, etc. 2 to 4 times per week

32. WILD SALMON SIDEKICKS Alaskan Halibut Canned Albacore Tuna Sardines Herring Trout Sea Bass Oysters Clams * For healthy heart, brain, eyes—You must eat fish!!!

33. SOY SUPERFOOD #8: SOY Helps prevent cardiovascular disease, cancer, and osteoporosis, and helps relieve menopausal and menstrual symptoms. Super alternative protein; the only plant-based complete high-quality protein Lower risk for breast/prostate cancer An SPF powerhouse TRY TO EAT at least 10-15 grams of soy protein per day and divide total soy intake to two separate meals or snacks

34. SOY SIDEKICKS (FORMS OF SOY) Tofu Soymilk Soy Nuts Edamame Tempeh Miso

35. SPINACH SUPERFOOD #9: SPINACH The more spinach you eat, the lower your risk for cancer Decreases the chance of cardiovascular diseases, age-related macular degeneration and cataracts. One of the healthiest foods you can eat. Remember, the darker the greens, the more phytonutrients SPF nutrients TRY TO EAT 1 cup steamed or 2 cups raw, dark, leafy greens most days

36. SPINACH SIDEKICKS Kale Collards Swiss Chard Mustard Greens Turnip Greens Bok Choy Romaine Lettuce Orange Bell Peppers

37. TEA SUPERFOOD #10: TEA The cheapest, easiest, no-calorie way to improve your diet and live longer Boosts the immune system, helps prevent cancer and osteoporosis, lowers the risk of stroke Not just women: Men who drink tea may reduce their risk of heart attack by 44% with just one cup daily  Risk for cataracts, hypertension SPF nutrients TRY TO DRINK 1 or more cups green or black tea daily

38. TOMATOES SUPERFOOD #11: TOMATOES Lower the likelihood of cancer, can play a role in preventing cataracts, age-related macular degeneration, cancer, and cardiovascular disease. The lycopene in tomatoes actually acts like an internal sunblock In one study on elderly nuns, the ones with the highest levels of lycopene functioned almost 4 times better than those with lowest levels TRY TO EAT 1 serving of canned tomatoes per day and multiple servings per week of fresh tomatoes. Pizza can be a health food if you modify it slightly: more sauce; less cheese plus whole grain crust

39. TOMATO SIDEKICKS Red Watermelon Pink Grapefruit Japanese Persimmons Red-fleshed Papaya Strawberry Guava

40. TURKEY SUPERFOOD #12: TURKEY A perfect example of a twenty-first century "healthy" protein source, extremely low in fat, and provides multiple nutrients which help build a strong immune system Cheap, low-fat protein – lower in fat and calories than chicken SPF nutrients TRY TO EAT 3 to 4 servings per week (3 - 4 ounces)

41. TURKEY SIDEKICKS Skinless Chicken Breast

42. WALNUTS SUPERFOOD #13: WALNUTS A handful a day can cut your risk of cardiovascular event by as much as 51% Two tablespoons of peanut butter 5 times/week cuts risk of type II diabetes by 20% Along with tea, the easiest way to improve your heath  Risk/progression of AMD SPF nutrients TRY TO EAT a handful of nuts, five times a week * Skip the salt and added oils

43. WALNUT SIDEKICKS Almonds Pistachios Sesame Seeds Peanuts Pumpkin and Sunflower Seeds Macadamia Nuts Pecans Hazelnuts Cashews

44. YOGURT SUPERFOOD #14: YOGURT Great source of digestible protein; double the protein of milk Promotes strong bones and a healthy heart, great source of calcium. Helps lower blood pressure Immune system booster, probiotics TRY TO EAT 2 cups daily

45. YOGURT SIDEKICKS Kefir Stoneyfield Farm yogurt / fruit smoothie

46. 10 Foods to Avoid-The Oprah Factor Donuts White Bread Bread with < 3 grams fiber/ slice Soda Stick Margarines White Pasta Full Fat Dairy Movie Theatre Popcorn Luncheon Meats Sugar Coated Cereal

50. Cardiovascular Exercise Per Week— UTMB 2 nd yr Med Students

52. Dr. Victor Sierpina’s Nutritional Supplement Formula High potency B- complex with antioxidants/trace minerals in AM 500 mg Vit C in AM&PM 400 IU Vit E as mixed tocopherols or “natural” vit E in AM&PM Garlic, red wine, olive oil, green tea, Mediterranean type diet Fish oil or flaxseed oil daily Be thankful for your food….SAY GRACE

54. http://cam.utmb.edu