"…too many people nowadays are deathly afraid of their food…I am sure that an unhappy or suspicious stomach, constricted and uneasy with worry, cannot digest properly. And if digestion is poor, the whole body politic suffers." Julia Childs

Never before in the history of America have we been more fearful of food. More than half of Americans have been on a diet or will start again. We are more confused, counseled by more non-experts in nutrition, gaining more
weight and still not reducing the risks of heart disease and certain cancers, especially of the colon.

Yet, we all are seekers of longevity and ageless health hunting for the secret food of wellness. Perhaps in America we do not love our food enough. We do not eat with awareness. Food is fast, flame-broiled, fried, blackened, grilled and beat up in America. It is time to enjoy and work with whole foods, cook carefully and wisely.

Taking care of your heart with the right diet automatically benefits the gut. But the argument is what constitutes the "right" diet. It seems as though the American diet has shifted to non-protective foods, foods that do not benefit the heart or the gut.

Gorillas are 98% vegetarian, cattle do not eat others to gain protein, in fact, it’s against the law. A cow that gives milk does not drink milk to prevent osteoporosis. Rabbits fed animal casein develop artherosclerosis, but do not when fed plant proteins in a study that controlled for the same
amount of fat. Tigers, cats, dogs and other carnivores can ingest fat, lard, beef, tallow and still not develop heart disease. Give that same diet to a human and observe the increased risk of heart disease, cancer of the esophagus, stomach, colon, prostate, bladder, breast and lymph tissue.

This parallel association of the gut and heart is uncanny. To maintain a healthy heart, just feed your colon a healthy diet.

Fiber

Fiber has long been claimed beneficial to the colon even before the effects on cholesterol reduction were known. However, a retrospective study on 88,757 women (the Nurses Health Study) failed to demonstrate fiber’s protective role in preventing colorectal cancer. This study should not be taken as gospel since it was a retrospective analysis of self-reporting
diets. In addition, several other spins on the same study have gone against other acceptable practices. The Nurses Study does not reflect the general populace. Clearly, a high meat, low vegetable diet has been the reference diet for increased incidence of colorectal cancer especially confirmed in the
Burgundy, France study. A protective effect of vegetables was observed for left colon cancer.

For the heart, the addition of fiber both water-soluble fibers (guar gum, pectin) with non-water-soluble fibers (soy fiber, pea fiber, corn bran) has been shown to lower LDL-C as much as 12.1% (average) and 8.5% for cholesterol. A recent study of "diet by addition" was reported from Ontario, Canada.In patients already on a low fat, low cholesterol diet, LDL-C
decreased by an additional 8.5% with a diet high in soy, vegetable proteins and soluble fiber. Diet by addition rather than exclusion has a more pronounced effect on lipids and risk factor reduction. In fact, it is the basis of a recent cookbook, The Cooking Cardiologist.

Psyllium has long been prescribed by gastroenterologists, and so now have come the cardiologists and the FDA. In a meta-analysis of 8 controlled studies on soluble fibers, namely psyllium, the results confirmed that the additionof psyllium supplements can significantly lower risk from
cardiovascular disease. The FDA has recently authorized health claims for this supplement.

Fats

The biggest controversy in America is "fat". Dr. Atkins has said that fat is "healthy" while Dr. Ornish has preached that fat "kills". The USDA level of the average fat intake in America is often quoted below 40% of total calories. Hard to believe this fact when a vending machine dispenses on the average 55% of calories as fat and fast food chains have increased
significantly in the past ten years.

Fat is essential to growth and development, a bottom level lower that 5% of calories is dangerous. The Ornish diet lists 10% as maximum. Dr. Ornish has allowed the addition of fish oil to the diet, but still excludes fish itself. The protective effect of omega-3 fatty acids have been well known. A five-year collaborative analysis was recently completed on five prospective
studies looking specifically at death rates from ischemic heart disease in vegetarians and non-vegetarians with similar life styles. Mortality from ischemic heart disease was 24% lower in vegetarians than in non-vegetarians and 34% lower in people who ate fish, but not meat. Likewise for the colon, in a study of 10,149 cancer patients compared with 7,990 controls, those who consumed even small amounts of fish had a significantly reduced risk of colon and rectal cancer.

Protein Source

The problem with diets in America may not have anything to do with fat and carbohydrates, but with the protein source itself. We are consuming between 80 to 85% of our daily protein from animal sources. Other countries are approximately 50%. Our protein portions are also excessive, a distinct difference from the Mediterranean diet. With this "Western" diet has come colon cancer. For the heart and colon, the diets that have been found to be most protective are those of Ornish, McDougall and Pritiken which are mostly vegetarian based.

It has been estimated in the United States that with a shift to healthier diets, $71 billion a year would be saved in medical costs, lost productivity and premature deaths associated with coronary heart disease, cancer, stroke, diabetes, hypertension, obesity and osteoporosis.

One last comment on protein sources:

Heart disease and colon cancer seem to be going hand in hand. It may someday be shown that it isn’t the type of protein, but how we are preparing animal food substances. Mark Twain once said, "There are two things that you should never watch being made in America…laws and
sausage." The American Cancer Society has recommended that the consumption of nitrites in hot dogs and luncheon meats be eliminated in our country. Ralph Nader has said that the American hot dog is the deadliest missile in America.

We are also tough on our food in America…grilling, blackening, flaming, and frying. Our cooking techniques are anything but genteel. In France, they sauté, poach, bake and steam, while we flame broil-fast, hot, and now.  The proteins on the grill with temperatures above 500 degrees begin to develop heterocyclic amines (carcinogens). Fried, charbroiled, over cooked, degraded proteins may be the culprit to both an unhealthy heart and colon.

Garlic

The benefit of the Mediterranean diet may not be in the olive oil, but in garlic itself. It has been shown to lower cholesterol, blood pressure, and even to stabilize plaques. Garlic for gastric ulcers and H. Pylori has had some interesting controversy. More studies are needed to confirm allium’s anti-bacterial effect. Garlic is also a powerful antioxidant. Garlic is sure to enter this century as a functional food.

Carotenoids and Other Veggies

Mom was right. Eat those vegetables. Tomatoes have recently been in the headline news. A study at Northwestern University concluded that tomatoes, namely the lycopenes, strongly protect against prostate cancer. The bowel is right behind with recent findings that tomato intake correlates
with reduced colorectal cancer risk.

Alcohol: The Paradox

Studies have suggested that the French paradox may be due to the intake of wine, namely red wine that is richer in flavonoids. Charting the intake curve of alcohol to mortality shows that alcohol is protective to a certain level. Beyond 4-5 glasses of wine per day, the curve begins to fall off with
increases in death rate from breast cancer for women, GI problems, cirrhosis and motor vehicle accidents. A recent study had suggested that grape juice may be just as protective…a finding that truly would have been a disappoint-ment to W. C. Fields.

Anti-Oxidants

More studies are needed in the role of anti-oxidants. Vitamin A has fallen to the wayside. Synthetic Vitamin E may be next. A recent trial called the HOPE study did not confirm Vitamin E’s protection on the heart. It may require Vitamin C to be effective. In addition, there are many substrates of Vitamin E that need to be studied in more detail. The list of anti-oxidants is long and need further study on the cardiovascular system and the gut.

Fat Blockers

A newly released pharmaceutical from Roche, Xenical TM, blocks the intake of fat by inhibiting intestinal lipase. It can block up to 30% of fat being absorbed. This can account for 100 to 200 calories lost per day. Obesity represents a large shadow over cardiovascular disease as more than 70% of obese individuals have co-morbidities of diabetes, hyperten-
sion, and hyperlipidemia. Obesity is related to all major cancers except lung. The GI side effects have been documented including "GI moments" and decreased absorption of fat-soluble vitamins. The use of oristat is counter-indicated in malabsorptive states, cholestasis, pregnancy, hyper-
sensitivity to the drug or in organic causes of obesity. To be effective, it must be combined with life style change, namely exercise and a hypocaloric diet. It is effective in reducing weight, improving glucose intolerance, and lipid values.

Anti-Inflammatory Medicines

Aspirin’s protective role may not be the effect on platelet activity, but its role as an anti-inflammatory agent. Recent studies have pointed to inflammation as the cause of plaque rupture with thinning of the fibrous cap over the plaque. The role of bacterium in the plaque needs further
investigation. We are at the same level of plaque understanding as we were years ago in understanding the mechanism of gastric ulcers. It is interesting as well that anti-inflammatory agents have had a role in reducing colon cancer risks. We may some day see the same formula applied to the heart.

Calcium

The DASH diet has been shown to be quite effective in lowering blood pressure as good as first step therapy. The diet is rich in calcium, fruits, fiber, vegetables and restricted fats. Sound familiar for the GI tract? Calciumhas a beneficial effect on the colon by reducing colonic neoplasia. Tofu has been shown to reduce the incidenceof colonic polyps.

What makes a healthy heart, makes a healthy colon. Feed the stomach, feed the heart. To live long, cook well.