DR.

SAEED BAHR
MEDICAL NUTRITIONAL CONSLUTANT


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THE MOST PUBLICIZED ANTIOXIDANTS HAVE BEEN:

fat-soluble antioxidants: vitamin A and

carotenoids, vitamin E, Coenzyme Q10

water-soluble antioxidants: vitamin C, minerals

zinc, selenium, manganese

 Some

antioxidants are made in the body and are

poorly absorbed from the intestine.
One example is glutathione, which is made from
amino acids. Glutathion as a supplemet in the gut is
broken down and have little effect on the
concentration of glutathione in the body.
Ubiquinol (coenzyme Q) is also poorly absorbed
from the gut and is made in humans body.

The body has a limited ability to excrete vitamins and

minerals, so excessive consumption may cause a
number of health problems, even in relatively small
dosages.
Vitamin supplements may be necessary for individuals
whose diets don't provide the recommended amounts of
specific vitamins and especially important for pregnant
and nursing women and people with specific illnesses.
However, the benefits of vitamin supplements for the
general population remain uncertain.



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VITAMIN C
Sources:

fruits and vegetables vary in their

vitamin C content
Vitamin C, also known as ascorbic acid, is
a water-soluble vitamin.
Unlike most mammals, humans do not
have the ability to make their own
vitamin C. Therefore, we must obtain
vitamin C through our diet.
Vitamin C is known as a highly effective
antioxidant in living organisms.

Supplements: Vitamin C (ascorbic acid) is available in many

forms, but there is little scientific evidence that any one
form is better absorbed or more effective than another.
Natural vs. synthetic vitamin C:

Natural and synthetic ascorbic acid are chemically

identical and there are no known differences in their
biological activities or bioavailability
Toxicity: A number of possible problems with very large
doses of vitamin C have been suggested, mainly based
on in vitro experiments or isolated case reports,
including: genetic mutations, birth defects, cancer,
atherosclerosis, kidney stones, increased oxidative
stress, excess iron absorption, vitamin B-12 deficiency,
and erosion of dental enamel.

However, none of these adverse health effects have

been confirmed, and there is no reliable scientific
evidence that large amounts of vitamin C (up to 10
grams/day in adults) are toxic.

TOCOPHEROLS E

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VITAMIN E
Major

sources of alpha-tocopherol in the diet

include vegetable oils (olive, sunflower,
safflower oils), nuts, whole grains, and green
leafy vegetables.
The main function of alpha-tocopherol in humans
appears to be that of an antioxidant.
The term vitamin E describes a family of eight
antioxidants:

four tocopherols, alpha-, beta-, gamma- and delta-,

and four tocotrienols (also alpha-, beta-, gamma- and
delta-).

Alpha-tocopherol

is the only form of vitamin E

that is actively maintained in the human body.

Toxicity: High-dose vitamin E supplementation increases

the risk of hemorrhage.
Supplementation with 400 IU/day of vitamin E has been
found to accelerate the progression of retinitis
pigmentosa.

GOOD SOURCES
(THE RDA FOR VITAMIN E WAS PREVIOUSLY
AND 10 MG/DAY FOR MEN)

8 MG/DAY FOR WOMEN

Food

Serving

Alpha-tocopherol (mg)

Olive oil

1 tablespoon

1.9

Soybean oil

1 tablespoon

1.2

Corn oil

1 tablespoon

1.9

Canola oil

1 tablespoon

2.4

Safflower oil

1 tablespoon

4.6

Sunflower oil 1 tablespoon

5.6

Almonds

1 ounce (30 g)

7.3

Hazelnuts

1 ounce (30 g)

4.3

Peanuts

1 ounce (30 g)

2.4

Spinach

cup, raw chopped

1.8

Carrots

cup, raw chopped

0.4

Avocado

1 medium

3.4

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VITAMIN A

Vitamin A is a generic term for a large number of related

compounds:
Retinol (an alcohol) and retinal (an aldehyde) are often
referred to as preformed vitamin A. Retinol, retinal,
retinoic acid, and related compounds are known as
retinoids.
Beta-carotene and other carotenoids that can be
converted by the body into retinol are referred to as
provitamin A.
Hundreds of different carotenoids are synthesized by
plants, but only about 10% of them are provitamin A.
The main function of vitamin A in humans appears to be
that of an antioxidant, beta-carotene has stronger
antioxidant activity than retinol.

 The

combination of vitamin A and iron seems to

reduce anemia more effectively than either iron or
vitamin A alone.
Toxicity:
Vitamin A toxicity is relatively rare. Symptoms
include nausea, headache, fatigue, loss of
appetite, dizziness, and dry skin.
Consumption of excess vitamin A during
pregnancy is known to cause birth defects.

GOOD SOURCES, (RDA = 1000 MCG, OR 5000 IU, FOR ADULT MALES
AND 800 MCG, OR 4,000 IU, FOR ADULT FEMALES)

Food

Serving

Vitamin A,

Vitamin A,
IU

Cod liver oil

1 teaspoon

1,350 mcg

4,500 IU

Fortified breakfast cereals

1 serving

150-230 mcg

500-767 IU

Egg

1 large

91 mcg

303 IU

Butter

1 tablespoon

97 mcg

323 IU

Whole milk

1 cup (8 fl
ounces)

68 mcg

227 IU

Carrot (raw)

1/2 cup,
chopped

385 mcg

1,283 IU

Spinach

1/2 cup,
cooked

472 mcg

1,572 IU

Squash, butternut

1/2 cup,
cooked

572 mcg

1,906 IU

CAROTENOIDS

The main carotenoids: Alpha-Carotene, Beta-Carotene, BetaCryptoxanthin, Lycopene, Lutein and Zeaxanthin
Carotenoids are yellow, orange, and red pigments synthesized by
plants.
Fruits and vegetables provide most of the carotenoids in the human
diet.
Orange and yellow vegetables like carrots and winter squash are
rich sources of alpha- and beta-carotene. Spinach is also a rich
source of beta-carotene, although the chlorophyll in spinach leaves
hides the yellow-orange pigment.
Alpha-carotene, beta-carotene, and beta-cryptoxanthin are
provitamin A, meaning they can be converted by the body to retinol
(vitamin A).
Lutein, zeaxanthin, and lycopene have no vitamin A activity.

Beta-carotene is less easily absorbed than retinol

and must be converted to active form.
Two micrograms (mcg) of beta-carotene in oil provided
as a supplement can be converted by the body to 1 mcg
of retinol.
However, 6 mcg of beta-carotene from foods are
required to provide the body with 1 mcg of retinol.
Retinol is found in foods from animals. Plants contain
carotenoids.

Supplementation: Although diets rich in beta-carotene

have generally been associated with reduced
cardiovascular disease risk in observational studies,
there is no evidence that beta-carotene
supplementation reduces cardiovascular disease
risk.
Toxicity: Two randomized controlled trials found that
high-dose beta-carotene supplements increased the
risk of lung cancer in smokers.*

* Michaud DS, Feskanich D, Rimm EB, et al. Intake of specific carotenoids and risk of lung cancer in 2 prospective US cohorts. Am J Clin Nutr.
2000;72(4):990-997.
Holick CN, Michaud DS, Stolzenberg-Solomon R, et al. Dietary carotenoids, serum beta-carotene, and retinol and risk of lung cancer in the
alpha-tocopherol, beta-carotene cohort study. Am J Epidemiol. 2002;156(6):536-547.

THE VITAMIN A ACTIVITY OF BETA-CAROTENE IN FOODS IS 1/6 THAT OF RETINOL (PREFORMED

VITAMIN A). THUS, IT WOULD TAKE 6 MCG OF BETA-CAROTENE FROM FOODS TO PROVIDE THE
EQUIVALENT OF 1 MCG OF RETINOL.

Beta-Carotene Content of Selected Foods

Food

Serving

Beta-Carotene (mcg)

Carrot juice

1 cup (8 fl oz)

21,955

Pumpkin, canned

1 cup

17,003

Sweet potato, baked

1 medium

16,803

Spinach, frozen, cooked

1 cup

13,750

Carrots, cooked

1 cup

12,998

Collards, frozen, cooked

1 cup

11,591

Kale, frozen, cooked

1 cup

11,470

Pumpkin pie

1 piece

7,366

Dandelion greens, cooked

1 cup

6,248

Winter squash, cooked

1 cup

5,726

Cantaloupe, raw

1 cup

3,232

 MANGANESE

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Manganese
Rich sources of manganese include whole grains, nuts,
leafy vegetables, and teas.
Foods high in phytic acid, such as beans, seeds, nuts,
whole grains, and soy products, or foods high in oxalic
acid, such as cabbage, spinach, and sweet potatoes, may
slightly inhibit manganese absorption.
Although teas are rich sources of manganese, the tannins
present in tea may moderately reduce the absorption of
manganese
Manganese is a mineral element that is both nutritionally
essential and potentially toxic.

 Supplements:

Several forms of manganese are

found in supplements, including manganese
gluconate, manganese sulfate, manganese
ascorbate, and amino acid chelates of
manganese.
Relatively high levels of manganese ascorbate
may be found in a bone/joint health product
containing chondroitin sulfate and glucosamine
hydrochloride
Toxicity:

A single case of manganese toxicity

was reported in a person who took large
amounts of mineral supplements for years, while
another case was reported as a result of taking a
Chinese herbal supplement.

GOOD SOURCES
(RDA: 2-5 MG)
Food

Serving

Manganese (mg)

Pineapple, raw

1/2 cup, diced

1.28

Pineapple juice

1/2 cup (4 ounces)

1.24

Pecans

1 ounce

1.12

Almonds

1 ounce

0.74

Peanuts

1 ounce

0.59

Brown rice, cooked 1/2 cup

0.88

Whole wheat bread

1 slice

0.65

Beans, cooked

1/2 cup

0.48

Spinach, cooked

1/2 cup

0.84

Tea (green)

1 cup (8 ounces)

0.41-1.58

Tea (black)

1 cup (8 ounces)

0.18-0.77

SELENIUM

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SELENIUM
The richest food sources of selenium are organ meats
and seafood, followed by muscle meats.
In general, there is wide variation in the selenium content
of plants and grains because plants do not appear to
require selenium.
Thus, the incorporation of selenium into plant proteins is
dependent only on soil selenium content. Brazil nuts
grown in areas of Brazil with selenium-rich soil may
provide more than 100 mcg of selenium in one nut, while
those grown in selenium-poor soil may provide 10 times
less.
Selenium is a trace element that is essential in small
amounts, but can be toxic in larger amounts.
Humans and animals require selenium for the function of
a number of selenium-dependent enzymes, also known
as selenoproteins (e.g. coating of sperm is made from
selenoproteins).

 Supplementation:

Selenium supplements are

available in several forms.
Sodium selenite and sodium selenate are
inorganic forms of selenium.
Selenate is almost completely absorbed, but a
significant amount is excreted in the urine before it
can be incorporated into proteins.
Selenite is only about 50% absorbed, but is better
retained than selenate, once absorbed.
Selenomethionine, an organic form of selenium
that occurs naturally in foods, is about 90%
absorbed (enriched are yeast, which are also
available as supplements).
It is not clear whether one form of selenium is
preferable to another.

Toxicity: Although selenium is required for health, high

doses can be toxic.

GOOD SOURCES

(RDA: 70 MCG FOR MEN, 55 MCG FOR WOMEN)

Food

Serving

Selenium (mcg)

Brazil nuts (from

selenium-rich soil)

1 ounce (6-8
kernels)

Shrimp

3 ounces (10-12)

34

Crab meat

3 ounces

40

Salmon

3 ounces

40

Halibut

3 ounces

40

Noodles, enriched

1 cup, cooked

35

Rice, brown

1 cup, cooked

19

Chicken (light meat)

3 ounces

20

Pork

3 ounces

33

Beef

3 ounces

17

Whole wheat bread

2 slices

15

Milk

8 ounces (1 cup)

Walnuts

1 ounce, shelled

839 (above the tolerable

upper intake level of 400

mcg/day)

ZINC
Shellfish, beef, and other red meats are rich sources of
zinc.
Nuts and legumes are relatively good plant sources.
Zinc bioavailability is relatively high in meat, eggs, and
seafood because of the relative absence of compounds
that inhibit zinc absorption and the presence of certain
amino acids (cysteine and methionine) that improve zinc
absorption.
The zinc in whole grain products and plant proteins
is less bioavailable due to their relatively high content of
phytic acid, a compound that inhibits zinc absorption.
The enzymatic action of yeast reduces the level of
phytic acid in foods. Therefore, leavened whole grain
breads have more bioavailable zinc than unleavened
whole grain breads.

Supplementation: A number of zinc supplements are

available, including zinc acetate, zinc gluconate, zinc
picolinate, and zinc sulfate.
Zinc picolinate has been promoted as a more
absorbable form of zinc, but there is little data to
support this idea in humans.

Adverse effects: The major consequence of long-term

consumption of excessive zinc is copper deficiency.

Drug Interactions: Zinc may decrease absorption of the

antibiotic. Taking zinc supplements and these antibiotics
at least two hours apart should prevent this interaction.

GOOD SOURCES
(RDA: 15 MG FOR MEN,

12 MG FOR WOMEN)

Food

Serving

Zinc (mg)

Oysters

6 medium (cooked)

43.4

Crab, Dungeness

3 ounces (cooked)

4.6

Beef

3 ounces (cooked)

5.8

Pork

3 ounces (cooked)

2.2

Chicken (dark meat)

3 ounces (cooked)

2.4

Turkey (dark meat) 3 ounces (cooked)

3.5

Yogurt, fruit

1 cup (8 ounces)

1.8

Cheese, cheddar

1 ounce

0.9

Milk

1 cup (8 ounces)

1.0

Cashews

1 ounce

1.6

Almonds

1 ounce

1.0

Peanuts

1 ounce

0.9

Beans, baked

1/2 cup

1.8

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GOOD SOURCES
Food

Serving

Coenzyme Q10(mg)

Beef, fried

3 ounces

2.6

Herring, marinated

3 ounces

2.3

Chicken, fried

3 ounces

1.4

Soybean oil

1 tablespoon

1.3

Canola oil

1 tablespoon

1.0

Rainbow trout, steamed

3 ounces

0.9

Peanuts, roasted

1 ounce

0.8

Sesame seeds, roasted

1 ounce

0.7

Pistachio nuts, roasted

1 ounce

0.6

Broccoli, boiled

1/2 cup, chopped

0.5

Cauliflower, boiled

1/2 cup, chopped

0.4

Orange

1 medium

0.3

Egg, boiled

1 medium

0.1

COENZYME Q10 (UBIQUINOL)

Coenzyme

Q10 is a fat-soluble compound

primarily synthesized by the body and
also consumed in the diet.
Coenzyme Q10 is a member of the
ubiquinone family of compounds, also
known as ubiquinone or ubiquinol.
All animals, including humans, can
synthesize ubiquinones, hence,
coenzyme Q10 cannot be considered a
vitamin.
Coenzyme Q10 is required for mitochondrial
ATP synthesis and functions as an
antioxidant in cell membranes and
lipoproteins.

CoQ10 has been widely used for the treatment of heart

disease (especially heart failure), gum diseases, and
also breast cancer.
Young people are able to make Q10 from the lower
numbered ubiquinones such as Q6 or Q8. The sick and
elderly may not be able to make enough.
Rich sources of dietary coenzyme Q10 include mainly
meat, poultry, and fish. Other relatively rich sources
include soybean and canola oils, and nuts. Fruits,
vegetables, eggs, and dairy products are reasonable
sources of coenzyme Q10.
Approximately 14%-32% of coenzyme Q10 was lost
during frying of vegetables and eggs, but the coenzyme
Q10 content of these foods did not change when they
were boiled.

Supplementation: Although coenzyme Q10

supplements are relatively safe, they may decrease the
anticoagulant efficacy of warfarin. Presently, it is unclear
whether individuals taking cholesterol-lowering
medications, known as statins, would benefit from
coenzyme Q10 supplementation.

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FOOD PRESERVATIVES
Antioxidants are used as food additives to help guard
against food deterioration.
Exposure to oxygen and sunlight are the two main factors
in the oxidation of food, so food is preserved by keeping in
the dark and sealing it in containers or even coating it in wax,
as with cucumbers.
However, as oxygen is also important for plant respiration,
storing plant materials in anaerobic conditions produces
unpleasant flavours and unappealing colours.
Consequently, packaging of fresh fruits and vegetables
contains an -8% oxygen atmosphere.
Some antioxidants are added to industrial products. A
common use is as stabilizers in foods and lubricants to
prevent oxidation.
Antioxidant preservatives are also added to fat-based
cosmetics such as lipstick and moisturizers to prevent
rancidity.

ORAC (oxygen radical absorption capacity) test

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BEANS

AN OVERVIEW

The United States is by far the world

leader in dry bean production.

Each year, U.S. farmers plant 1.5 to 1.7 million

acres of edible dry beans.

Although US is the chief consumer of these

beans, around 40% of these beans are
shipped to international markets in more than
100 different countries.

BEANS

NUTRITIONAL VALUE

Dry beans or legumes are an inexpensive and healthy

way to include additional servings of vegetables
into your diet.
Cooked beans are low in calories, loaded with complex
carbohydrates, and contain little fat.
In addition, beans are good sources of B vitamins,
potassium, and fiber, which promotes digestive health
and relieves constipation.

Introduce beans into your

diet gradually.
Beans count as a
substitute for meat.
A good tip would be to
replace meat with a bean
entre twice a week.

BEANS

The demand for bean products is growing because of the

presence of several health-promoting compounds in edible
bean products known as saponins, which are naturally occurring
compounds widely distributed in all cells of legume plants.

Clinical studies have suggested that saponins have the ability to:
Help protect the human body against cancers
Lower cholesterol
Lower blood glucose responses
In epidemiological studies,
saponins have been shown to
have an inverse relationship
with the incidence of kidney stones.
J Med Food. 2004; 7(1): 67-78.

BERRIES

AN OVERVIEW

Berries are one of the nations most

well liked fruits.

Berries are believed to have been first

incorporated into the diets and lifestyles
of Native Americans.

Traditionally, when we think of berries,

we think of things like blueberries,
strawberries, raspberries, and
blackberries, but there are also other
varieties such as cranberries,
boysenberries and gooseberries .

BERRIES

NUTRITIONAL VALUE

Many berries are suitable to eat raw after

rinsing and most types of berries vary
from 50 to 100 calories per serving when
eaten raw.
Berries are loaded with:
vitamin C, potassium, and fiber.
All berries with strong red and blue colors
have phytochemicals that can potentially
reduce cancer rates and other chronic
diseases.

Oxygen radical absorptive capacity (ORAC),

is a way to measure the antioxidant capacity of fruits and vegetables.
Berries have some of the highest antioxidant levels of any fresh fruits!

BERRIES

STRAWBERRIES

Because of the antioxidant power found in strawberries, regular

consumption of this fruit has been shown to have the potential to lower
ones risk of heart disease.

In addition, studies have shown that

strawberries are involved in inhibiting
enzymes. This reduces the
response that is involved in
etiology of many diseases.

Cr Rev Food Sci Nutr. 2004; 44:1-17.

inflammatory
inflammatory
the

STRAWBERRIES

RECENT FINDINGS

Studies on two antioxidant compounds in strawberrie (ellagic acid and quercetin)

have demonstrated that these substances:
Have anticancer activity
Work to block the initiation of carcinogenesis
Suppress progression and proliferation of tumors

Cr Rev Food Sci Nutr. 2004; 44:1-17.

CRUCIFEROUS VEGETABLES

OVERVIEW

Cabbage, broccoli and Brussels sprouts are in the

family of cruciferous vegetables.

The health benefits associated with cruciferous

vegetables has been attributed to their high
concentration of glucosinolates.

J Postgrad Med. 2004; 50(2): 145-9.

CRUCIFEROUS VEGETABLES

NUTRITIONAL VALUE

Cabbage is one of the oldest vegetables around. It continues to be a

dietary staple for many and is an inexpensive source of vitamins A and
C, and fiber.
Broccoli is a good source of:
vitamins A and C, potassium, folacin, iron, and fiber.
It has as much calcium per ounce as milk!
Brussels sprouts contain significant amounts of the antioxidants
vitamins A and C and is a good source of fiber. This vegetable is also a
good source of vegetable protein. However, this protein is not complete
protein, and should
be combined with whole grain and other
protein foods.

CDC

CRUCIFEROUS VEGETABLES

HEALTH BENEFITS
The consumption of cruciferous vegetables has
been associated with a reduced risk of cancer of
the lung, stomach, colon, and rectum.

J Postgrad Med. 2004; 50(2): 145-9.

CHOCOLATE

AN OVERVIEW

Cocoa and chocolate are food products made from cacao beans.

Although consumed by the Olmecs, Mayans, and Aztecs long

ago, cacao beans were first introduced to the Old World in 1502
by Christopher Columbus when he brought them back to Spain.

Over the past three decades, chocolate has been viewed more as a confectionary
rather than as a medicine. In 2001-2002, the average world
cocoa
consumption was 1.17 pounds per person, with approximately
$73.2
billion dollars going to the confectionery market globally.

Nutrition Reviews. 2005; 63(12): 427-30.

ANTIOXIDANT CAPACITY

Cocoa powder and cocoa extracts have been shown

to exhibit a high antioxidant capacity.

When compared to several other flavanol-rich foods and food

extracts, cocoa powder and cocoa extracts were found to
exhibit a higher antioxidant capacity than:
Green and black tea
Red wine
Blueberries
Garlic
Strawberries

Am J Clin Nutr. 2005; 81(suppl): 298S-303S.

COCOA ANTIOXIDANTS & DISEASE

The antioxidants found in cocoa enhance vascular function and decrease platelet
stickiness and therefore influence the cardiovascular system beneficially.

Several studies support the suggestion that the consumption of flavanol-rich

foods, such cocoa powders and dark chocolates, may be associated with a
reduced risk for vascular disease.

Am J Clin Nutr. 2005; 81(suppl): 298S-303S.

ORANGES

Oranges are highly valued for their vitamin C content.

They are the primary source of vitamin C for most Americans.
However, oranges are also a good source of:
folacin, calcium, potassium, thiamin, niacin, and magnesium.
The juice contains more vitamin C per serving than does the whole fruit.
However orange juice does not contain fiber, whereas the fruit does.

Oranges belong to a class known as citrus fruits.

CITRUS FRUITS

Citrus fruits contain phytochemicals called flavonoids.

The flavonoid hesperidin was first described about two centuries ago.

Research throughout past years has confirmed that hesperidin is an

anti-inflammatory agent used to treat many conditions. Hesperidin blocks an enzyme
involved in an inflammatory reaction such as the release of histamine.

Current Medicinal Chemistry. 2001; 8: 135-153.

CITRUS FLAVONOIDS & CANCER

Research has shown that citrus flavonoids and

their metabolites are potent antioxidants. It is
believed that they are able to suppress many of
the events of cancer and inflammation which
involve reactive oxygen species.

Some of the flavonoids in citrus fruits such as

tangerine and orange are the most potent
cancer fighting compounds, particularly against
lung and prostate cancer cells.

Current Medicinal Chemistry. 2001; 8: 135-153.

PUMPKIN

BENEFITS

Pumpkins are loaded with an important antioxidant,

beta-carotene, and are a good source of potassium.

Beta-carotene is one of the plant carotenoids

converted to vitamin A in the body.

Foods high in beta-carotene are believed to:

Offer protection from the development of cancer
Offer protection against heart disease

Pumpkin Nutrition

PUMPKIN

BENEFITS

Pumpkin seeds and oil are also dietary sources of the

omega-3 fatty acid, alpha-linolenic acid.

There is strong evidence which supports the

beneficial effects of alpha-linolenic acid in the
prevention of cardiovascular disease (CVD).

Med Pregl. 2003; 56 (Suppl 1): 19-25.

FISH

OVERVIEW

Over 30 years ago, Danish researchers

found that the lower rates of heart disease
found in Greenland Eskimos were
associated with their higher intake of
seafood, particularly cold water fish.

There are two classes of essential fatty

acids: omega-3 and omega-6.

Fish oil is the most significant source of

dietary omega-3 fatty acid, and it consists of
both: eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA).

JABFP. 2005; 18: 28-36.

WHICH KINDS AND HOW MUCH?

Fatty Fish have the highest levels of
omega-3 FA

Fish is a good source of protein and low in saturated

fat. The following types of fish are especially good
sources of omega-3 fatty acids:
Mackerel
Lake trout
Herring
Sardines
Albacore tuna
Salmon

The American Heart Association

recommends eating fish
(particularly fatty fish) at least
two times per week.
AHA

FISH OIL & CVD

Numerous observational studies have shown that

omega-3 FA enriched diets are associated with a reduction of:
Cardiovascular mortality
Heart attack
Sudden death

In several studies, a higher fish intake was associated

with a decreased incidence of coronary artery disease
(CAD) and cardiovascular mortality.

Overall, it has
been shown that a
minimum of one
fish meal per week
translates to a
52% reduction in
sudden cardiac
death.

JABFP. 2005; 18: 28-36.

FISH OILS & RHEUMATOID ARTHRITIS

Over 15 clinical trials and 2 meta-analyses

favor the use of fish oil in patients with
rheumatoid arthritis (RA).

A double-blind placebo controlled trial

showed that fish oil supplementation of 130
mg/kg of body weight each day decreased
the following in the control group:
Number of stiff joints
Duration of morning stiffness
Pain
Global arthritis activity

JABFP. 2005; 18: 28-36.

Increased fish oil intake allows some

with RA to reduce or even eliminate the
use of non-steroidal anti-inflammatory
drug (NSAID) use.

SOY

AN OVERVIEW

There is a growing recognition of the health effects of soy on cholesterol levels.

A recent U.S. survey revealed that 76 percent of consumers considered soy
products to be healthy.
In 1999, the Food and Drug Administration (FDA) approved a health claim for the
cholesterol-lowering properties of soy protein.
One year later, the American Heart Association (AHA) recommended that
patients with elevated cholesterol should include soy protein foods in their diets.

J Nutr. 2002. 132: 547S-551S.

ADDING SOY INTO THE DIET

A daily intake 25 grams of soy protein per day

is considered beneficial.

Most dont realize it, but a lot of foods that are

eaten every day contain soy.

Soybean oil accounts for 79% of the edible fats used annually in the U.S.

The ingredient lists of several commonly consumed food items show that soybean
oil is high on the list: mayonnaise, margarines, salad dressings, and vegetable
shortenings.

FDA

SOY ISOFLAVONES

BENEFITS

Soy has phytoestrogens called isoflavones. Two of the most

common ones are daidzein and genistein.

Soy isoflavones are believed to play a role in

prostate cancer, where supplementation with isoflavones has
shown a reduction in prostate cancer risk in studies.

Soy isoflavones, and possibly soy proteins as well, are believed

to play a role in bone health.

J Nutr. 2002. 132: 547S-551S.

SOY PROTEIN

BENEFITS

There is also the biologically active non-isoflavone

component of soy that has received much attention
in past years soy protein.

The protein part is believed to be responsible for the

additional benefits seen from soy consumption, which are:
Cholesterol-lowering effects
Blood pressure-lowering effects
Reduction of cancer risks
Favorable effects on kidney function

J Nutr. 2002. 132: 547S-551S.

SPINACH

Spinach is one of the most important

antioxidative vegetables and is consumed
either fresh or cooked.

Spinach is composed of various active

compounds, such as flavonoids and other
polyphenolic active ingredients. These
compounds are believed to act in
combination with one another as:
Anti-inflammatory agents
Antioxidative agents
Anticancer agents

Nutrition and Cancer. 2003; 46(2): 222-231 and CDC

SPINACH

ACTIVE COMPONENTS

The active compounds are believed to be highly available to the body.

A powerful, water-soluble, natural antioxidant mixture (NAO) was identified in

spinach leaves, which contains its main active compounds.

NAO is stable at high temperatures and is nontoxic. It is used in studies of

chemoprevention and dietary intervention in humans.

Nutrition and Cancer. 2003; 46(2): 222-231.

SWEET POTATOES

Sweet potatoes are believed to have been first cultivated in 1648 in the U.S.

Today, in the South sweet potatoes are generally preferred to Irish potatoes as a
staple food. In the North, the reverse is true.

The sweet potato blends with herbs, spices and flavorings producing delicious
dishes of all types. From processed baby foods to the main dishes, casseroles,
salads, breads and desserts, sweet potatoes add valuable, appetizing nutrients and
color to any meal.

Sweet Potato Facts, CDC

SWEET POTATOES

NUTRITIONAL VALUE

One baked sweet potato (3 ounce serving) provides about twice the
recommended daily allowance for vitamin A.

One baked sweet potato contains only about 140 calories and
this nutritious vegetable provides:
42 percent of the Recommended Daily Allowance (RDA) for vitamin C
6 percent of the RDA for calcium
10 percent of the RDA for iron
8 percent of the RDA for thiamine for healthy adults.

Sweet Potato Facts

SWEET POTATOES

It is low in sodium and is a good source of fiber and other important

vitamins and minerals.

Because sweet potatoes are a good source of beta carotene, consumption

of this food is likely to help reduce your risk of certain cancers.

Sweet Potato Facts

TEA

Tea, in the form of green or black tea, is one of the

most widely consumed beverages in the world.

Although its consumption does varies from place to

place, it is believed to be second only to water.

Black tea is consumed predominantly in Western

countries, along with some Asian countries, whereas
green tea is consumed predominantly in China,
Japan, India, and a number of countries in north
Africa and the Middle East.

J Alt Compl Med. 2005; 11(3): 521-528.

GREEN TEA

OVERVIEW

J Alt Compl Med. 2005; 11(3): 521-528.

Green tea comes from the mature leaves of

the plant and is sold as either fresh or dried
unfermented leaves.
The very early shoots are highly sought after
and from these, white tea is made.
Total polyphenols in these early shoots
comprise about 20-30% by weight,
60 to 80 percent of which are catechins.
Mature leaves naturally contain lesser
amounts of catechins than do the early
leaves, and with the processing of green
tea, the concentration is further
decreased (~15%).

BLACK TEA

OVERVIEW

Unlike green tea, the preparation of black tea requires fermentation.

During this process, catechins in black tea are partially converted to theaflavins.
A less extensive fermentation leads to a lighter flavored tea, called oolong tea.
Therefore, of the teas mentioned, white tea has the highest concentration of
catechins, followed by green tea, oolong tea and, lastly, black tea.

J Alt Compl Med. 2005; 11(3): 521-528.

GREEN TEA

HEALTH EFFECTS

The catechins found in green tea have been shown to possess biological activity
which may be beneficial in the prevention and treatment of various forms of cancer.
Green tea is also believed to exhibit
beneficial effects on the following:
Arthritis
Bone Density
Stress
In addition, it has also found to exhibit:
Antiviral properties
Anticariogenic effects
Ultraviolet skin protection
J Alt Compl Med. 2005; 11(3): 521-528.

TOMATOES

OVERVIEW

Lycopene is the pigment principally responsible for the deep-red color

of ripe tomato fruits and tomato products.

Tomato products, including ketchup, tomato juice, and pizza sauce, are the
richest sources of lycopene in the U.S. diet, accounting for > 80% of the total
lycopene intake of Americans.

The consumption of tomatoes and tomato products containing lycopene have

been shown to be associated with decreased risk of chronic diseases like cancer
and cardiovascular diseases in several recent studies.

Plant Physiology. 2002; 130: 1077-1078.

TOMATOES AND PROSTATE CANCER

HPFS STUDY

In 1995, a study was conducted examining the relationship

between the intake of various carotenoids, fruits, and
vegetables and the risk of prostate cancer.

Of the 46 fruits, vegetables, and related products that

were analyzed in the study, only four were significantly
associated with a lower prostate cancer risk.

Of these four, tomato sauce, tomatoes and pizza sauce, but

not strawberries, were primary sources of lycopene.

Plant Physiology. 2002; 130: 1077-1078.

PROCESSED OR FRESH TOMATOES?

Studies have found that tomato paste and other processed

products are even more effective than fresh tomatoes
preventing prostate cancer. This seems to be in contrast to the
messages that we hear, of consuming fresh fruits and vegetables
whenever possible for maximum health benefits.

tomato
in

However, numerous studies have revealed that tomato processing actually

increases the bioavailability of lycopene to humans. This is because processing
converts much of the trans-form of lycopene found in fresh tomatoes into the
cis-form, which is much more readily taken up in humans.

Plant Physiology. 2002; 130: 1077-1078.

TOMATOES AND OTHER EFFECTS

The evidence suggests that the anti-proliferative properties of lycopene

may
extend its effects to other types of cancer, beyond just that of prostate cancer.

In addition, lycopene may be useful in preventing heart disease.

Studies have shown that lycopene inhibits cholesterol synthesis and enhances the
breakdown of the bad cholesterol, low-density lipoprotein (LDL).

Plant Physiology. 2002; 130: 1077-1078.

NUTS

OVERVIEW

In 2003, the U.S. FDA approved this package label:

Scientific evidence suggests but does not prove that eating 1.5
ounces per day of most nuts, as part of a diet low in saturated fat
and cholesterol, may reduce the risk of heart disease.

According to FDA, "Types of nuts eligible for this claim are

restricted to almonds, hazelnuts, peanuts, pecans, some pine
nuts, pistachio nuts and walnuts..

Nuts for Nutrition

NUTS

NUTRITIONAL VALUE

Nuts are important for what they dont offer:

1. Nuts do not contain cholesterol.
2. Nuts only contain trace amounts of sodium.
(Unless it has been added to the nuts during processing)

Nuts are usually thought of as a high fat food. Although, this is true
nuts are high in fat-- it is not the same as animal fat. Nuts are mostly high
in heart-healthy unsaturated fats, the fats that lower your bad cholesterol.

Nuts for Nutrition

THE IMPORTANCE OF SPECIFIC NUTS

Walnuts

Almonds

One ounce of walnuts (about 14 shelled walnut halves) is all that is needed
to meet the 2002 dietary recommendations for omega-3 FA. The type of
omega-3 FA found in walnuts is alpha-linolenic acid, which can be
transformed into either EPA or DHA in humans and animals.

One ounce of almonds (about 20-24 shelled whole almonds) provides 35%
of the daily value for vitamin E.

Peanuts

Although it is often discussed with nuts, peanuts are actually a legume,

along with dry beans, peas and lentils. One ounce of roasted peanuts
provides about 10% of the daily value for folate.

Nuts for Nutrition

THE IMPORTANCE OF SPECIFIC NUTS

As discussed earlier, omega-3 fatty acids (alpha-linolenic acid

found in walnuts and other sources included) help to decrease
ones risk for CVD.

Vitamin E is an antioxidant and is important in that it is believed

to help promote healthy aging. A recent study has also
suggested that a diet rich in foods containing vitamin E may
help protect some against the development of Alzheimers
disease.

Folate is a B vitamin that has been recognized for some time

now, particularly for women of childbearing age, as it is believed
to help reduce the incidence of birth defects and lower the risk
of heart disease.
Nuts for Nutrition

WHOLE GRAINS

AN OVERVIEW

As defined by the 2005 Dietary Guidelines

for Americans, a whole grain is a grain that
contains the entire grain kernel:
- Outer bran layer
- Endosperm
- Inner germ layer

The outer bran layer is rich in B

vitamins and phytonutrients such as
flavonoids and indoles, along with a
small amount of protein. The
endosperm is predominantly
carbohydrate, and the germ layer is
concentrated with minerals such as
iron and zinc, along with the
antioxidant vitamin E.

Mypyramid.gov

Proceedings of the Nutrition Society. 2003; 62: 123-127.

GRAINS

THE MILLING PROCESS

The milling process, which removes both the bran and the germ, determines how much
of the whole grain is retained. It impacts the nutritional value of the end product.

A refined grain is a grain that has been milled. Milling has negative effects in that it
takes dietary fiber, iron, and many B vitamins from the grain.

To make up for this loss of nutrients during the milling process, most refined grains are
enriched after processing, where certain B vitamins (such as thiamin, riboflavin, niacin,
and folic acid) and iron are added back. However, the fiber content of the original grain
is not restored.

Mypyramid.gov
Proceedings of the Nutrition Society. 2003; 62: 123-127.

WHOLE GRAINS

HOW MUCH?

Benefits associated with whole wheat foods can be achieved at relatively low
levels of intake (between 2 and 3 servings/d).

However, the consumption of whole wheat foods in some Western countries has
been noted to be less than one serving per day, which is equivalent to less than
one slice of whole wheat bread per day.

Proceedings of the Nutrition Society. 2003; 62: 123-127.

2005 DIETARY GUIDELINES FOR AMERICANS

MAKE HALF YOUR GRAINS WHOLE
The new recommendations for Americans tell us that half of the grains
we consume daily should be whole grains.

Why is this
Important?
Because regular consumption of whole grain foods has been
associated with a reduction in:
Incidence of cardiovascular disease
Incidence of diabetes
Cancer mortality at certain sites
Premature death

Proceedings of the Nutrition Society. 2003; 62: 123-127.

YOGURT

In recent years, many studies have been published on the heath

effects of yogurt and the bacterial cultures used in the
production of yogurt.

The lactic acid-producing bacteria (LAB) used in the U.S.

include Lactobacillus and Streptococcus species

Dairy products are generally considered an excellent source of

high-quality protein, calcium, potassium, phosphorus,
magnesium, zinc, and the B vitamins riboflavin, niacin, vitamin
B-6, and vitamin B-12. However, the final nutritional value of
yogurt depends on several factors.

Am J Clin Nutr. 2004; 80: 245-56.

YOGURT AS A PROBIOTIC?

In 2002, a definition was proposed by the Joint Food and Agriculture Organization/World
Health Organization Working Group. They state that a probiotic is a:
Live microorganism which when administered in adequate
amounts confer a health benefit to the host.

Current scientific concepts agree that yogurt cultures are probiotics if two criteria are met:
1. A beneficial physiological effect can be obtained by consumption of the live cultures
2. The benefit has been sustained appropriately in human studies.

Br J Nutr. 2005; 93: 783-786.

BENEFITS OF YOGURT

The benefits of yogurt and LAB on gastrointestinal health have been explored mainly
in animal models and, occasionally in human subjects as well.

In some studies using yogurt, individual LAB species, or both, promising health
benefits were found for individuals with:

Lactose Intolerance
Constipation
Diarrheal diseases
Colon Cancer
Inflammatory Bowel Disease (IBD)
Helicobacter pylori infection
Allergies

Am J Clin Nutr. 2004; 80: 245-56.

WEB REFERENCES

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/beans.htm

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/berries.htm

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/cabbage.htm

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/broccoli.htm

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/brussels_sprouts.htm

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/orange.htm

http://www.urbanext.uiuc.edu/Pumpkins/nutrition.html

WEB REFERENCES

http://www.americanheart.org/presenter.jhtml?identifier=4632

http://www.fda.gov/fdac/features/2000/300_soy.html

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/spinach.htm

http://aggie-horticulture.tamu.edu/plantanswers/vegetables/sweetpotato.html

http://www.cdc.gov/nccdphp/dnpa/5ADay/month/sweet_potato.htm

http://lancaster.unl.edu/food/ftmar04.htm

http://www.mypyramid.gov

ARTICLE REFERENCES
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Shi J et al. Saponins from edible legumes: chemistry, processing, and

health benefits. J Med Food. 2004; 7(1): 67-78.

Hannum S. Potential impact of strawberries on human health:

a review of the science. Cr Rev Food Sci Nutr. 2004; 44:1-17.

Heber D. Vegetables, fruits and phytoestrogens in the prevention of

diseases. J Postgrad Med. 2004; 50(2): 145-9

Ariefdjohan M, Savaiano D. Chocolate and cardiovascular health:

is it too good to be true? Nutrition Reviews. 2005; 63(12): 427-30

Keen C et al. Cocoa antioxidants and cardiovascular health.

Am J Clin Nutr. 2005; 81(suppl): 298S-303S

Manthey J, Guthrie N, Grohmann K. Biological properties of citrus

flavonoids pertaining to cancer and inflammation. Current Medicinal
Chemistry. 2001; 8: 135-153

ARTICLE REFERENCES
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Ristic-Medic D, Ristic G, Tepsic V. Alpha-linolenic acid and cardiovascular

diseases. Med Pregl. 2003; 56 (Suppl 1): 19-25

Oh, R. Primary applications of fish oil (-3 fatty acids) in primary care.
JABFP. 2005; 18: 28-36

Messina M, Gardner C, Barnes S. Gaining insight into the health effects of

soy but a long way still to go: commentary on the fourth international
symposium on the role of soy in preventing and treating chronic disease. J
Nutr. 2002. 132: 547S-551S

Lomnitski L, et al. Composition, efficacy, and safety of spinach extracts.

Nutrition and Cancer. 2003; 46(2): 222-231

ARTICLE REFERENCES
o

Cooper R, Morre J, Morre D. Medicinal benefits of green tea:

part 1- review of noncancer health benefits. J Alt Compl Med.
2005; 11(3): 521-528

Minorsky P. Lycopene and the prevention of prostate cancer.

Plant Physiology. 2002; 130: 1077-1078

Lang R, Jebb S. Who consumes whole grains, and how much?

Proceedings of the Nutrition Society. 2003; 62: 123-127

Adolfsson O, Meydani S, Russell R. Yogurt and gut function.

Am J Clin Nutr. 2004; 80: 245-56Guarner F et al. Should yoghurt
cultures be considered probiotic? Br J Nutr. 2005; 93: 783-786