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Hi Jeff,

I've seen you mention "high quality foods" and I was wondering if you can give us your top ten list of grains, fruits and veggies?

I know all whole foods are good and we shouldn't get to crazy about this but I'm very curious.

If I have a choice at lunch to have (as my starch) quinoa or rice - quinoa is the more nutritious grain, right? They both taste good to me so I want to pick the more nutritious food.

From what I've read the same applies to potatoes. Sweet potatoes are better than regular potatoes.

Can you help us out?

You would have to post the link and/or quote as I do not recommend people take the approach you are inquiring about.

In Health
Jeff

Thanks

What I am referring to is in comparison to the typical diet of refined and highly processed foods full of added salts, sugars, unhealthy fats, animal products, etc.



You answered your own question.

What matters most is overall dietary and lifestyle patterns and not debating brown rice vs quinoa.



In Health
Jeff

I understand. Do you ever make these calculations when you eat?

Do you opt for sweet potatoes over regular potatoes from a nutritional point of view? If they both taste the same to me doesn't it make sense to go w/ sweet potatoes? or at the end of the day is this approach futile because it results in zero difference from a nutrition standpoint?

You have to look at the overall picture from the total perspective and do so in view of a healthy diet and lifestyle.

So, if I am consuming a healthy diet of all fruits, veggies, starchy veggies, intact whole grains, beans and a few nuts a seeds and I swap out one serving of quinoa for one serving of brown rice, do you think it will really matter?

In Health
Jeff

Great question. I'm no scientiest but from what I read the types of foods we eat seem to matter even on a healthy plant based diet like you describe.


~ Michaud DS, Spiegelman D, Clinton SK, et al. Fruit and vegetable intake and incidence of bladder cancer in male prospective cohort. J Natl Cancer Inst 1999; 91(7): 605-13

What are your thoughts on this? and similar studies (if there are any)?

That is on a typical diet and it didnt take much to get the effect.

So again put it in the proper context as i did above

In health
Jeff

I'm not clear on your answer.

The study is saying that cruciferous veggies outperformed other veggies. It was the same 20% increase in veggies - just different types of veggies. Don't we see from this that the type of vegetable matters?

Well, let me ask you a few questions...

Is anyone here not recommending you to include cruciferous veggies as part of your diet?

Do you think that means you should only eat cruciferous veggies?

Do you look to see what a serving was and how many servings it took to have that benefit?

Do you see what the actual absolute benefit was and not the relative benefit?

Do you see what the population was that they did the study on, and what was the diet they were eating?

How do the answers from all these questions impact someone on a healthy diet and who is already eating cruciferous veggies in their daily diet.

The study was done in 1999. Have any other studies confirmed and supported these results, or contradicted them or refuted them?

In Health
Jeff

Great questions. We don't know the answers.

It goes both ways thought, doesn't it?

It could be that there will be studies that show that X amount of cruciferous veggies per day is advantageous to people on a healthy plant based diet. That amount may be double what the current recommendations are. Studies may come out that show McDougallers that eat more nutrient dense foods get sick less often.

I guess what I'm curious about is... maybe we should err on the side of caution?

Actually, we have a really good idea of the answer.

I was trying to get you to go and actually read the study because most all the questions I asked are answered in the study (which is available online for free).

So, let me do it for you.

1) Is anyone here not recommending you to include cruciferous veggies as part of your diet?

No. If anyone is following the basic guidelines and principles of the program, they are eating vegetables, including cruciferous veggies every day, if not at most meals. I am at the 10-day program right now and not only are there 2 large chafing dishes of veggies at lunch and dinner, veggies are mixed into most entrees and most soups and there is a also a salad bar at both meals too. Raw veggies, including cruciferous ones are available throughout the day, as snacks too.

2) Do you think that means you should only eat cruciferous veggies?

Of course not. We know that a variety of veggies are good.

3) Do you know what the population was that they did the study on, and what was the diet they were eating?

This was done on the Mens Health Professionals data set, which, we know from several other studies, were not eating a very healthy diet at all.

4) Did you look to see what a serving was and how many servings it took to have that benefit?

A serving is about 1/2 cup cooked and for broccoli, those who were eating the least amount were eating less than 1 serving per week. Those who were eating the high amount of were eating about 2 (or more) servings per week

For cabbage, those who were eating the least amount were eating less than 1 serving per month. Those who were eating the high amount were eating about 1 (or more) servings per week

So, this huge effect was seen by just eating about 1-2 servings per week but only when compared to those who were eating less than 1 serving per week or per month.

5) How do the answers from all these questions about this study impact someone on a healthy diet and who is already eating cruciferous veggies in their daily diet.

Doesn't really.

All it showed was that in an unhealthy population, by eating just one to three servings of broccoli and/or cabbage per week, they were able to get the benefit. In addition, typically, in these kinds of studies, the impact of the effects go way down as the diet of the subjects gets healthier (as we see in the nut studies). So, we see the biggest benefits in those who have the most room for improvement.

So, how does comparing two groups who are both consuming an unhealthy diet, who go from almost no servings of cruciferous veggies to consuming 1-2 serving per week compare to people already eating a health diet and consuming cruciferous veggies on a regular basis?

It doesn't.

6) The study was done in 1999. Have any other studies confirmed and supported these results, or contradicted them or refuted them?

Yes and no. Some have shown similar benefits and some have shown less benefit and some have shown no benefit in relation to cancer

A study in 2010 showed a similar benefit from raw broccoli intake and the difference was seen in those eating eating 1 or more servings per month vs those eating less than 1 serving per month;

Also, the latest report on Cancer and Nutrition, which reviewed over 7000 studies said that the overall data in relation to bladder cancer was either of too low quality, too inconsistent, or the number of studies too few to allow conclusions to be reached. And that while their earlier report showed that vegetables and fruits probably protect against bladder cancer, the evidence for these foods is now considered to be weaker, and in this case, very much so for this specific cancer.



We are in many ways.

First, we are already eating an diet that is way more nutrient dense then the healthiest diet any of the subjects in any of these studies is consuming.

Second, in this latter study, they got the benefit from eating just 1 serving a month. In the former study, they got the benefit from eating just 1-2 servings a week.

Well, those of us who are following the recommended guidelines & principles are eating 1-3 servings (or more), 1-2x a day (or more).

That is a 30-90x increase over the amount in the latter study and a 7-14x increase over the amount in the former study.

And, in addition, we are eating all of this as part of a diet that is already much healthier than the diet the subjects in the study were eating. It is also much lower in calorie density (a benefit to cancer risk reduction) and it is also much higher in overall nutrient density (another potential benefit to cancer risk reduction.)

Third, as I explained in this post (which is making the same point but in regard to carotenoids)...

viewtopic.php?f=22&t=6067&p=250825

"'Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids', Food and Nutrition Board. Institute of Medicine. National Academy Press, Washington D.C. Pp. 343-344 (2000)"

http://www.nap.edu/openbook.php?record_id=9810&page=353

"These data, although in varying populations, suggest that 3 to 6 mg/day of β-carotene from food sources is prudent to maintain plasma β-carotene concentrations in the range associated with a lower risk of various chronic disease outcomes (see Table 3)."

Table 3:

http://www.nap.edu/openbook.php?record_id=9810&page=341

As just detailed, plasma and tissue concentrations of carotenoids have been associated with a variety of health outcomes; that is, higher concentrations are associated with a lower risk of cancer, coronary heart disease, and all-cause mortality. This could be used as a possible indicator for establishing requirements for carotenoids. However, the limitation of this approach is that it is not clear whether observed health benefits are due to carotenoids per se or to other substances found in carotenoid-rich foods.

Thus, these data are suggestive of prudent intake levels, not required levels of intake. Recommendations have been made by a number of federal agencies and other organizations with regard to fruit and vegetable intake. Nutrient analysis of menus adhering to the U.S. Dietary Guidelines and the National Cancer Institute's Five-a-Day for Better Health Program, for example, indicates that persons following these diets would be consuming approximately 5.2 to 6.0 mg/day provitamin A carotenes on average if a variety of fruits and vegetables were consumed (Lachance, 1997). Similar levels would be obtained by following Canada's Food Guide for Healthy Eating which specifies a minimum of five servings of vegetables and fruit (Health Canada, 1997). Other food-based dietary patterns recommended for the prevention of cancer and other chronic diseases would provide approximately 9 to 18 mg/day of carotenoids (WCRF/AICR, 1997).

NOTE: this is 3-6x the amount recognized as being enough to lower disease risk.

It is also based on the WCRF/AICR report from 1997. In many other discussions here, I have quoted the newest WCRF/AICR report from 2007 saying that they now more than ever, recommend dietary "patterns" over recommending specific "individual foods".

In other words, if Americans would just get in the recommended amounts of fruits and veggies, it would not only provide carotenoids, but more than enough of all of them to produce the beneficial health outcomes, including reduced risks of cancer. And anyone following a Whole Food plant based diet, as recommended here, would already be consuming way more than enough.

So, yes, by following the basic principles and guidelines of the program, we are all doing way better than anyone in any of the studies (and the executive reports are recommending) and are already erring way on the side of caution.

For what you are saying to be true, you would need to show me some evidence that compared people who were already eating a very healthy diet that already including the amount of cruciferous veggies per day I mentioned, to someone eating the exact same healthy diet with a few more servings of cruciferous veggies per day.

Not only is there absolutely no shred of evidence supporting this, we do have some evidence that shows it really doesn't make a difference.

And, as David Katz, MD said, anyone telling you anything different is either "misguided, selling something or both."

In health
Jeff

Awesome post Jeff. Thanks for clarifying this!

Hey Jeff,

I'm curious if your reasoning from this post i.e.

would apply to what you said here i.e.

Maybe all these alcohol studies were done on people who weren't eating healthy. Had they been conducted on people on the McDougall program they probably would have concluded that a few drinks a week is harmless?

Thanks for your help.

No.

One is talking about the ability to extrapolate the same results from a single study (or two) that showed adding a healthy food to the diet of people who are following an unhealthy diet and who do not include much of the said healthy food to people already eating a healthy diet and include regular amounts of the said healthy food, which already is above and beyond the amount used in the study.

The other is discussing the results of decades of studies on all types of populations, including those that are considered healthier and following healthier diets and lifestyle, and the consistent impact of a Class 1 Carcinogen on these various populations.

Now, on a side note, is it possible that those who have a much healthier diet and lifestyle may be more protected from the impact of a carcinogen (or any other harmful substance)?

Possible.

But, I do not see how you can use that thought process to compare it to the other example.

One is talking about the diminishing returns of a healthy food on an already healthy diet with only benefits and no risk involved and the other is talking about the risk of adding a known carcinogen.

In Health
Jeff