Health Benefits of Health Benefits of Wild Salmon, Berries and Wild Salmon, Berries and

Natural Vitamin ENatural Vitamin E

Steven G. Pratt, MD, FACSSteven G. Pratt, MD, FACSKyKyäänini ConventionConvention

Ogden, UtahOgden, UtahJuly 2007July 2007

HealthStylingHealthStyling Includes:Includes:• SuperFoods• Healthy Fats• SuperNutrients• No Cigarettes• Alcohol – ??• Sleep • Stress Reduction• Portion Control = Weight Control • Spirituality • Exercise = Burning Calories• Load up on Fiber• High Potassium—Low Sodium

SuperfoodsSuperfoods

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

* Superfoods Rx: Fourteen Foods That Will Change Your Life

SuperfoodsSuperfoods

• Pomegranates• Extra Virgin Olive Oil• Spices

• Onions• Dried fruits

• Kiwi• Dark chocolate

• Honey• Avocado

• Garlic• Apples

* Superfoods HealthStyle: Proven Strategies for Lifelong Health, 2006

SupernutrientsSupernutrients

• Zeaxanthin• Vitamin D

• n-3’s

• Fiber• Polyphenols

• Beta Cryptozanthin• Resveratrol

• Alpha Carotene• Glutathione

• Beta Carotene• Selenium

• Lycopene• Folic Acid

• Lutein• Vitamin C

Wild SalmonWild Salmon• Lowers the risk of heart disease and cancer

• The more omega-3 fish oils you eat; the lower your blood pressure and heart rate

• In one study eating the oil in fish cut cancer incidence by over 60%

• 4x weekly ↓ risk for and progression of AMD

• Men with the highest n-3’s 66% lesslikely to develop colorectal cancer

Wild SalmonWild Salmon• Studies suggest that fish consumption is associated

with a lower risk for depression, violent behavior, Alzheimer’s disease, Attention Deficit Disorder, Atrialfibrillation, cognitive decline (dose response), Alzheimers

• Improved bone mineral density

• Anti-inflammatory

• SPF nutrients

• TRY TO EAT Wild salmon, halibut,sardines, etc. 2 to 4 times per week

• Best dietary source of Vitamin D

• Adequate Vitamin D produced from sun exposure = 10-15 minutes 3-4x weekly (decreasing efficiency with increasing age)

Wild SalmonWild Salmon

222 I.U.3.5 ozKing Salmon425 I.U.3.5 ozSilver Salmon540 I.U.3.5 ozAlbacore Tuna670 I.U.3.5 ozSockeye Salmon

Wild Salmon SidekicksWild Salmon Sidekicks• Alaskan Halibut• Canned Albacore Tuna• Sardines• Herring• Trout• Sea Bass• Oysters• Clams

* For healthy heart, brain, eyes—You must eat fish!!!

Vitamin D per 3.53 ozVitamin D per 3.53 oz

162 IUAlaskan Halibut

222 IUAlaskan Sardines

236 IUAlaskan King Salmon

439 IUAlaskan Silver Salmon

544 IUAlaskan Albacore Tuna

687 IUAlaskan Sockeye Salmon

Vitamin DVitamin D• NAS

- 15-50 yrs = 200 IU - 51-70 yrs = 400 IU - 71 and above = 600 IU

• Health Style Recommended /d- 800-2000 IU????

Food Sources of Vitamin DFood Sources of Vitamin D

201 wholeEgg303.5 ozLiver, beef, cooked401 cupCereal, fortified502 tspMargarine, fortified

1001 cupOrange juice, fortified1 cup3 oz3 oz3 oz3 oz

1 TBS

Serving Vitamin D IU

Food

100Milk, fortified200Tuna, canned214Mackerel, canned250Sardines, canned360Salmon, canned, pink

1360Cod liver oil

Vitamin DVitamin D• Deficiency is widespread in all age groups• Deficiency associated with ↑ risk for cancer

(breast, prostate, colon, NHL, pancreas), ↓survival from melanoma, Rheumatoid arthritis, type I DM, macular degeneration, frailty (falls), MS, fibromyalgia, gingivitis, muscle aches and pains, osteoporosis, HTN

• Anti-inflammatory effect• ↓ Angiogeneis• Immune system booster• Regulate cell growth

Vitamin DVitamin D↑ Vitamin A can ↓ vitamin D absorption

• Sunscreen ↓’s vitamin D skin production↓ skin production of vitamin D as go “North”↓ skin production with age and ↑ skin melanin

• 15 minutes sun exposure 3-4x weekly adequate (in SD)– Pale white skin can produce 20,000 IU vitamin D

in 20 minutes (full sunlight)– Tan white skin ≅10,000 IU in 20 minutes– Dark brown skin ≅ 5,000 IU in 20 minutes

Vitamin DVitamin D

• Vitamin D3 vs. vitamin D2– Summer sunlight can produce D3 from 0700 1700

with a peak synthesis of pre-vitamin D at 1230

• Conversion of 25 hydroxyvitamin D to active hormone; kidney > immune cells, colon cells, placenta, breast, prostate, and pancreas

“An estimated 30 people may die of cancers related to vitamin D deficiency

for every person who dies from skin cancers caused by excessive sun

exposure.”--Edward Giovannucci

“ I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits

as vitamin D”--Edward Giovannucci

Vitamin D & the Metabolic Vitamin D & the Metabolic SyndromeSyndrome

• Metabolic syndrome– Abdominal obesity– Atherogenic dyslipidemia↑ BP

– Insulin resistance– Proinflammatory state– Prothomotic state– 23.1% of adults in NHANE III– >2 million adolescents in U.S. – Low serum 25 hydroxyvitamin D is associated with

an ↑ risk of metabolic syndrome

Obesity & Vitamin D StatusObesity & Vitamin D Status

• Vitamin D plays a role in glucose metabolism and insulin sensitivity

• The hormonal form of vitamin D can inhibit the production of proinflammatory cytokines

OmegaOmega--3 Fatty Acids3 Fatty Acids

• Food and Nutrition Board– 1.6 g/d ALA for men– 1.1 g/d ALA for women– 160 mg/d EPA/DHA for men– 110 mg/d EPA/DHA for women

• My goal– 1 g/d EPA/DHA for men (minimum)– 0.7 g/d EPA/DHA for women (minimum)– 1-2 TBSP/d ground flaxseed meal– n-3/n-6 ratio between 1/1 → 1/3

OmegaOmega--3 Fatty Acids3 Fatty Acids

• EPA/DHA– 3 oz cooked Chinook (king) salmon = 1.5 g– 3 oz sockeye salmon = 1 g– 3 oz farmed Rainbow trout = 1 g– 1 can sardines = .9 g– 3 oz canned white tuna in water = .7 g

OmegaOmega--3 Fatty Acids3 Fatty Acids• ALA

– 1 tablespoon canola oil = 1.3 g– 1 tablespoon soybean oil = .7 g– 1 tablespoon walnut oil = 1.4 g– 1 tablespoon flaxseed oil = 7.3 g– 1 cup cooked spinach = .2 g– 1 cup cooked collard greens = .2 g– ½ cup dry roasted soy nuts = 1.2 g– 1 tablespoon flaxseed = 2.2 g– ½ cup wheat germ = .5 g– 1 oz (14 halves) English walnuts = 2.6 g– 1 omega-3 “vegetarian” hen egg = amounts vary

OmegaOmega--3 Fatty Acids3 Fatty Acids• EPA/DHA vs. ALA↓ Risk for “everything”

• The easiest way to ↓ risk for sudden cardiac death = 1 gram fish oil/d

• Healthy heart, brain, eyes• Roll in ↓ Atrial Fibrillation (25% of adults)• A major anti-inflammatory↓ Triglycerides↓ BP↓ Heart rate

OmegaOmega--3 Fatty Acids3 Fatty Acids

• A major human deficiency state exists• DHA concentrated in the brain and retina• EPA/DHA supplements “work”• Fish protein + EPA/DHA “best”• Safety• Immune system function

– No adverse parameters with 3 or less grams/d• Risk for hemorrhagic stroke with 10-12 g/d

– Inuits consume 10-12 g/d• 9 g/d effective treatment for depression

Natural Vitamin ENatural Vitamin E

• 8 compounds exhibiting vitamin E activity– 4 tocopherols– 4 tocotrienols

• Alpha tocopherol has become synonymous with vitamin E and has been the main focus of research but…– It takes all 8 “E”’s to maximize vitamin E’s potential

• Essential to have all 8 forms in a supplement– The synergy of 8

• Absorbed from the small intestine

Natural Vitamin ENatural Vitamin E

• Healthy fat essential for bioavailability↓ Risk for CVD, cancer, AZ, degenerative eye disease

• Immune system booster• Safety issues??• Bioavailability issues in 10-15% of the population• N-3’s and vitamin E• Gamma tocopherol and inflammation

Vitamin EVitamin E• Daily goal from foods 16 mg

- 2 tablespoons wheat germ oil = 41 mg- 2 tablespoons soybean oil = 2.6 mg- 2 tablespoons canola oil = 13.6 mg- 2 tablespoons peanut oil = 9.2 mg- 2 tablespoons flaxseed oil = 4.8 mg- 2 tablespoons olive oil = 4 mg- 1 oz raw (23-24 whole kernels) almonds = 7.7 mg- ¼ cup hulled dry-roasted sunflower seeds = 6.8 mg- 2 tablespoons raw (untoasted) wheat germ = 5 mg- 1 medium orange bell pepper = 4.3 mg- 1 oz hazelnuts (20-21 kernels) = 4.3 mg- 2 tablespoons peanut butter = 3.2 mg- 1 cup blueberries = 2.8 mg

Gamma Gamma TocopherolTocopherol• Best sources

– Perilla seed– Pistachios– Pecans– Walnuts– Pumpkin seeds– Pine nuts– Cashews– Peanuts

TocotrienolsTocotrienols

• Alpha, beta, gamma, deltaα-tocotrienol is a better radical scavenger than α-tocopherol– 4 to 33x more efficient scavengers of peroxyl radicals

in a model (lab) system

• Heat ↓ levels of tocotrienols, tocopherols– Tocotrienols less stable under thermal oxidation

TocotrienolsTocotrienols• Anti-cancer properties

– Move readily within cell membranes– Recycles faster than α-tocopherol– Anti-oxidant– Free radical scavenger

↓ DNA damage↓ Tumor formation↓ Cell damage from carcinogens↑ Programmed cell death↓ Cancer cell proliferation

– ? Role in breast cancer prevention– May enhance the effect of tamoxifen– In all cultures effective against both estrogen receptor + and

estrogen receptor negative breast cancer

TocotrienolsTocotrienols• Cardiovascular health

– Up to 75% of hypercholesterolemic individuals respond to tocotrienols

• Most effective when combined with “Healthstyling”↓ TC, LDL-C↓ Apo-B↓ Thromboxanes affect on blood clotting

– A statin-like effect• Role for CoQ10

– Inhibitor of cholesterol synthesis– In humans may ↓ TC, LDL-C, apolipoprotein B, and

triglycerides– May ↑ HDL-C, apolipoprotein A1 – Cholesterol lowering ability of tocotrienols

• Beta < alpha < gamma < delta

αα --tocotrienoltocotrienol (mg/100g)(mg/100g)

8.5Wheat germ oil

21.4Wheat bran oil29.8Rice bran oil

22.4Palm oil

9.2Grapeseed oil

5.4Corn oil55.8Barley oil

αα --tocotrienoltocotrienol (mg/100g)(mg/100g)Whole Grains

0.3Wheat germ1.3Wheat bran0.3Wheat1.5Rye0.9Rice2.2Oat bran2.0OatsTrMillet0.4CornTrBuckwheat2.0BarleyTrAmaranth

αα --tocotrienoltocotrienol (mg/100g)(mg/100g)0.1Tuna

Fruits

0.1Plums0.3Pears15.4Black olive0.1Grape0.1Cranberry0.1Bing cherryTrBlueberry0.1Dried apricots

0.5Pistachio1.84Macadamia

Nuts

Vegetables

0.2Almond

0.1Sweet potato

αα --tocotrienol (mg/100g)tocotrienol (mg/100g)

BlueberriesBlueberries• 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”↓ Exercise associated oxidativestress

• Anti-inflammatory• Our vascular system loves berries• May protect CNS against space travel

radiation exposure• May mimic caloric restriction• SPF Nutrients• TRY TO EAT 1 to 2 cups daily

Blueberries ContainBlueberries Contain

• Riboflavin• Niacin• Phytoestrogens• Low calories• Resveratrol

• Salicylic acid• Carotenoids• Fiber• Folate• Vitamin C

• Manganese• Magnesium• Iron

• Polyphenols(anthocyanins, ellagic acid,quercetin, catechins)

• Vitamin E• Potassium

• A synergy of multiple nutrients & phytonutrients

Blueberry SidekicksBlueberry Sidekicks

• Purple grapes

• Boysenberries

• Strawberries

• Blackberries

• Pomegranates

• Cranberries

• Raspberries

• Currents

• Cherries

• Chokeberries

• Wolfberries

PolyphenolsPolyphenols• Daily goal from foods is not yet known

Whole Foods– Berries – Dates and figs– Prunes– Kale, spinach– Parsley, dried parsley– Apples with skin– Citrus– Grapes– Cherries

PolyphenolsPolyphenols• A great 21st century phytonutrient• Multiple functions

– Anti-oxidant – Anti-platelet– Anti-mutagenic – Synergy– Anti-inflammatory – Phytoestrogen– Cell signaling – Vasodilators– Metal chelation – Nutrigenomics

• Intake/d• Bioavailability• Safety • Cancer, CVD, neuro-degenerative disorders

PolyphenolsPolyphenolsJams• Trader Joe’s Organic Blueberry Fruit Spread • Knott’s Pure Boysenberry Preserves• Trader Joe’s Organic Blackberry Fruit Spread

Beverages• Green, black, oolong tea• Soymilk• 100 percent fruit juices (berry, pomegranate, Concord

grape, cherry, apple, citrus, prune)• Top 3 100 percent fruit juices:

- Odwalla C Monster- Trader Joe’s 100 percent Unfiltered Concord Grape Juice- R.W. Knudsen 100 percent Pomegranate Juice

PolyphenolsPolyphenols

61100% apple juice13727% cranberry juice cocktail

345L&A Black Cherry Juice

425R.W.Knudsen Just Blueberry

587R.W.Knudsen 100% Cranberry Juice

639R.W.Knudsen 100% Pomegranate Juice

670Trader Joe’s 100% Unfiltered Concord Grape Juice

845Odwalla C Monster

Mg of polyphenolsper 8 oz serving

Juices

* Superfoods Rx: Fourteen Foods That Will Change Your Life

PolyphenolsPolyphenols

60Welch’s Concord Grape Jam

100Knott’s Bing Cherry Pure Preserves

100Sorrell Ridge Wild Blueberry Spreadable Fruit

120Trader Joe’s Organic Morello Cherry Fruit Spread

120Trader Joe’s Organic Strawberry Fruit Spread

280Trader Joe’s Organic Blackberry Fruit Spread300Knott’s Pure Boysenberry Preserves400Trader Joe’s Organic Blueberry Fruit Spread

Mg of polyphenolsper 20 g—a trace over 1 Tablespoon

Jams

PolyphenolPolyphenol Content of Content of 40g40g’’s Dark Chocolates Dark Chocolate

739mg• Hershey’s Special Dark Mildly Sweet Chocolate

765mg• Cadbury Royal Dark Indulgent Dark Chocolate

811mg• Endangered Species Chocolate Company Wolf Bar

811mg• Dove Silky Dark Chocolate

955mg• Newman’s Own Sweet Dark Dark Chocolate

* Superfoods Health Style: Proven Strageties for Lifelong Health

PomegranatesPomegranates• ¼ cup ↓ LDL-C oxidation

↓ Blood pressure• 100% juice best

↓ Growth rate of prostate cancer • May play a role in preventing skin, lung, colon and breast

cancer↑ Dermal collagen↑ Carotid artery blood flow / ↓ carotid artery atherosclerotic plaques↑ Serum antioxidant status

• Sidekick: plums• 4-8 oz of 100% juice multiple times weekly & unlimited

seeds