Category Archives: Fruits

February 15, 2016 · 6:01 AM

Recipe: Frozen Fruit Smoothie #2

 

Similar to an Icee, but healthier for you

This is double the serving size below. Similar to an Icee, but healthier for you.

Fruits are thought to be one of the healthy components of the traditional Mediterranean diet. Try this smoothie for dessert instead of calorie-laden items like pie, cake, cookies, and ice cream. Unlike this smoothie, those aren’t very nutrient-dense, either. Since I provide the nutritional analysis below, you can easily incorporate this into the Low-Carb Mediterranean Diet.

At the Parker Compound, we mix this in a Vitamix. Other devices may work, but I’m not familiar with them.

It's all here

It’s all here

Ingredients

1 cup (240 ml) frozen raspberries

1/2 cup (120 ml) frozen blueberries

1 cup (240 ml) frozen strawberries

1 frozen banana (7 inches or 18 cm), cut into 3–4 pieces

1 tbsp (13 g) chia seeds

1 handful (1/2 ounce?) raw kale

2.5 cups (590 ml) water

1 cup (240 ml) ice cubes

Instructions

First item into the Vitamix is the water, then banana, all berries, chia seeds, then top off with the ice. Start mixing on variable speed 1 then slowly increase spin rate to 10, for a total mix of 45–60 seconds. Soon after you get started you’ll probably have to use the “plunger” a few times to un-clump the top items.

Loaded and ready to spin

Loaded and ready to spin

Depending on your batch of fruits, this drink may not be as sweet as you like. You could easily sweeten it up with your favorite artificial non-caloric sweetener. I used 1.5 tsp (7.5 ml) of Truvia to good effect, just thrown in with every thing else before or after the primary mix. Or you could use table sugar, about 4 tsp (20 ml), instead of the Truvia. Most of us eat too much sugar. If you go the sugar route, you’ll increase the calories per serving by 7, and increase carbohydrate grams by 2 per serving.

My able assistant wields the plunger

My able assistant wields the plunger

Number of Servings: 7 servings of 6 fl oz (175 ml) each

Nutritional Analysis per Serving:

7% fat

90% carbohydrate

3% protein

100 calories

23 g carbohydrate

3 g fiber

20 g digestible carbohydrate

3 mg sodium

150 mg potassium

Prominent features: Fair dose of vitamin C, homeopathic amounts of sodium

Steve Parker, M.D.

PS: I credit my wife with this recipe.

 

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October 3, 2013 · 2:00 AM

Experts Debate Composition of the Mediterranean Diet

…but they have some good ideas as to the healthy components, according to a report in MedPageToday. A sample:

Through a subtractive statistical technique, the EPIC investigators calculated that the biggest chunk of the health advantage—24%—came from moderate alcohol consumption (predominantly wine).

The other relative contributions were:

  • 17% from low consumption of meat and meat products
  • 16% from high vegetable consumption
  • 11% from high fruit and nut consumption
  • 11% from high monounsaturated-to-saturated lipid ratio (largely due to olive oil consumption)
  • 10% from high legume consumption

Here’s my definition of the Mediterranean diet.

Steve Parker, M.D.

Reference:
Sofi F, et al “Ideal consumption for each food group composing Mediterranean diet score for preventing total and cardiovascular mortality” EuroPRevent 2013; Abstract P106.

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August 25, 2013 · 11:34 PM

Should Diabetics Avoid or Seek Fruit?

Advanced Mediterranean Diet, paleo diet, paleobetic diet

Grapes probably destined for wine

Newly diagnosed type 2 diabetics have no need to avoid fruit …according to an article in Nutrition Journal.  Fruit is a prominent component of the Mediterranean and paleo diets.  It can be good for us, containing phytonutrients, fiber, etc.  But fruit has the potential to increase blood sugars, too, which may be harmful over the long run.  So whadda you do?

Researchers took newly diagnosed type 2 diabetics and split them into two groups. One group was told to eat at least two pieces of fruit daily, the other was told to eat no more than two pieces.

The researchers conclusions:

A recommendation to reduce fruit intake as part of standard medical nutrition therapy in overweight patients with newly diagnosed type 2 diabetes resulted in eating less fruit. It had however no effect on HbA1c, weight loss or waist circumference. We recommend that the intake of fruit should not be restricted in patients with type 2 diabetes.

Read the full research report.

PS: I haven’t read the full report yet.

Steve Parker, M.D.

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April 6, 2013 · 2:00 AM

Which Diseases Do Vegetables and Fruits Prevent?

Potential answers are in the American Journal of Clinical Nutrition (2012).  I quote:

For hypertension, coronary heart disease, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, chronic obstructive pulmonary disease, and rheumatoid arthritis indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For inflammatory bowel disease, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.

It bothers me that vegetables and fruits are lumped together: they’re not the same.

All of my diets—Advanced Mediterranean, Low-Carb Mediterranean, and Ketogenic Mediterranean—provide plenty of fruits and vegetables.

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October 11, 2010 · 7:18 AM

Paleo Diet for Heart Patients With Diabetes and Prediabetes

A Paleolithic diet lowered blood sugar levels better than a control diet in coronary heart disease patients with elevated blood sugars, according to Swedish researchers reporting in 2007.

About half of patients with coronary heart disease have abnormal glucose (blood sugar) metabolism.  Lindeberg and associates wondered if a Paleolithic diet (aka “Old Stone Age,” “caveman,” or ancestral human diet) would lead to improved blood sugar levels in heart patients, compared to healthy, Mediterranean-style, Western diet.

Methodology

Investigators at the University of Lund found enrolled 38 male heart patients—average age 61—patients and randomized them to either a paleo diet or a “consensus” (Mediterranean-like) diet to be followed for 12 weeks.  Average weight was 94 kg.  Nine participants dropped out before completing the study, so results are based on 29 participants.  All subjects had either prediabetes or type 2 diabetes (the majority) but none were taking medications to lower blood sugar.  Baseline hemoglobin A1c’s were around 4.8%.  Average fasting blood sugar was 125 mg/dl (6.9 mmol/l); average sugar two hours after 75 g of oral glucose was 160 mg/dl (8.9 mmol/l).

The paleo diet was based on lean meat, fish, fruits, leafy and cruciferous vegetables, root vegetables (potatoes limited to two or fewer medium-sized per day), eggs, and nuts (no grains, rice, dairy products, salt, or refined fats and sugar). 

The Mediterranean-like diet focused on low-fat dairy, whole grains, vegetables, fruits, potatoes, fatty fish, oils and margarines rich in monounsaturated fatty acids and alpha-linolenic acid. 

Both groups were allowed up to one glass of wine daily.

No effort was made to restrict total caloric intake with a goal of weight loss.

Results

Absolute carbohydrate consumption was 43% lower in the paleo group (134 g versus 231 g), and 23% lower in terms of total calorie consumption (40% versus 52%).  Glycemic load was 47% lower in the paleo group (65 versus 122), mostly reflecting lack of cereal grains.

The paleo group ate significantly more nuts, fruit, and vegetables.  The Mediterranean group ate significantly more cereal grains,oil, margarine, and dairy products.

Glucose control improved by 26% in the paleo group compared to 7% in the consensus group.  The improvement was statisically significant only in the paleo group.  The researchers believe the improvement was independent of energy consumption, glycemic load, and dietary carb/protein/fat percentages.

High fruit consumption inthe paleo group (493 g versus 252 g daily) didn’t seem to impair glucose tolerance. 

Hemoglobin A1c’s did not change or differ significantly between the groups.

Neither group showed a change in insulin sensitivity (HOMA-IR method).

Comments

The authors’ bottom line:

In conclusion, we found marked improvement of glucose tolerance in ischemic heart disease patients with increased blood glucose or diabetes after advice to follow a Palaeolithic [sic] diet compared with a healthy Western diet.  The larger improvement of glucose tolerance in the Palaeolithic group was independent of energy intake and macronutrient composition, which suggests that avoiding Western foods is more important than counting calories, fat, carbohydrate or protein.  The study adds to the notion that healthy diets based on whole-grain cereals and low-fat dairy products are only the second best choice in the prevention and treatment of type 2 diabetes.

This was a small study; I consider it a promising pilot.  Results apply to men only, and perhaps only to Swedish men.  I have no reason to think they wouldn’t apply to women, too.  Who knows about other ethnic groups?

This study and the one I mention below are the only two studies I’ve seen that look at the paleo diet as applied to human diabetics.  If you know of others, please mention in the Comments section. 

The higher fruit consumption of the paleo group didn’t adversely affect glucose control, which is surprising.  Fruit is supposed to raise blood sugar.  At 493 grams a day, men in the paleo group ate almost seven times the average fruit intake of Swedish men (75 g/day).  Perhaps lack of adverse effect on glucose control here reflects that these diabetics and prediabetics were mild cases early in the course of the condition—diabetes tends to worsen over time.

ResearchBlogging.orgPresent day paleo and low-carb advocates share a degree of simpatico, mostly because of carbohydrate restriction—at least to some degree—by paleo dieters.  Both groups favor natural, relatively unprocessed foods.  Note that the average American eats 250-300 g of carbohydrates a day.  Total carb intake in the paleo group was 134 g (40% of calories) versus 231 g (55% of calories) in the Mediterranean-style diet.  Other versions of the paleo diet will yield different numbers, as will individual choices for various fruits and vegetables.  Forty percent of total energy consumption from carbs barely qualifies as low-carb. 

Study participants were mild, diet-controlled diabetics or prediabetics, not representative of the overall diabetic population, most of whom take drugs for it and have much higher hemoglobin A1c’s.

Lindeberg and associates in 2009 published results of a paleo diet versus standard diabetic diet trial in 13 diabetics.  Although a small trial (13 subjects, crossover design), it suggested advantages to the paleo diet in terms of heart disease risk factors and improved hemoglobin A1c.  Most participants were on glucose lowering drugs; none were on insulin.  Glucose levels were under fairly good control at the outset.  Compared to the standard diabetic diet, the Paleo diet yielded lower hemoglobin A1c’s (0.4% lower—absolute difference), lower trigylcerides, lower diastolic blood pressure, lower weight, lower body mass index, lower waist circumference, lower total energy (caloric) intake, and higher HDL cholesterol.  Glucose tolerance was the same for both diets.  Fasting blood sugars tended to decrease more on the Paleo diet, but did not reach statistical significance (p=0.08).

The paleo diet shows promise as a treatment or preventative for prediabetes and type 2 diabetes.  Only time will tell if it’s better than a low-carb Mediterranean diet or other low-carb diets. 

Steve Parker, M.D.

Reference: Lindeberg, S., Jönsson, T., Granfeldt, Y., Borgstrand, E., Soffman, J., Sjöström, K., & Ahrén, B. (2007). A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease Diabetologia, 50 (9), 1795-1807 DOI: 10.1007/s00125-007-0716-y

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July 15, 2010 · 10:01 AM

Maybe Diet Prevents Alzheimer Dementia After All

I blogged about a study by Gu et al on April 30, 2010, that found significantly lower incidence of Alzheimer dementia in people in Manhattan who followed this dietary pattern:

  • relatively high consumption of salad dressing, nuts, fish, tomatoes, fruits, dark green leafy vegetables, and cruciferous  vegetables
  • relatively low consumption of poultry, red meat, butter, and high-fat dairy

About the same time, a National Institutes of Health expert panel pooh-poohed the possibility that diet had any effect one way or the other on Alzheimer’s. 

Why does this matter?  Five million U.S. adults have Alzheimer dementia already, and it’s going to get much worse over the coming decades.

A June, 2010, issue of Journal of the American Medical Association has a commentary by two doctors (Martha Morris, Sc.D., and Christine Tangney, Ph.D.), experts in the field of nutrition.  Here’s their explanation of the NIH panel’s negative findings:

Many of the inconsistencies among studies of dietary factors can be attributed to the complexity of nutrition science and the omission of nutrition expertise in the design and analysis of both epidemiological and randomized controlled trials.

Morris and Tangney think the findings of Gu et al are valid, confirming prior studies showing benefit to diets high in vitamin E (from food) and low in saturated fat from animals.  They point out that the animal foods may simply be displacing beneficial nutrients in other foods, rather than directly causing harm.

Until we have further data, anyone at risk for Alzhiemer’s may be better off following the dietary pattern above, or the Mediterranean diet.  The two are similar.

Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physican before making any dietary or exercise changes. 

Reference: Morris, M., & Tangney, C.  Diet and Prevention of Alzheimer Disease.  The Journal of the American Medical Association, 303 (2010): 2,519-2,520.    doi: 10.1001/jama.2010.844

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June 3, 2010 · 6:37 PM

Berries Galore

Quick now!  Which has more carbohydrate per serving?  Cherries, blueberries, blackberries, or raspberries?

Don’t worry about fiber carbs since those are not digested.

According to the USDA National Nutrient Database, here are the digestible carb counts in one cup:

  • Sweet raw cherries:  19 g
  • Raw blueberries:  18 g
  • Raw blackberries:  6 g
  • Raw raspberries:  7 g

To determine digestible carb counts, I take the total carb grams in a serving and subtract the fiber grams.  Not exactly rocket science.

These carb counts are not obvious to most people.  If you’re trying to limit your carb consumption, you need a database like the USDA’s.  The pocket-sized carb-count guides are handy for some.  Most are based on the USDA database. 

My wife is getting some great deals right now on fresh berries and cherries at Sam’s Club.  We’re enjoying them while they last.

Steve Parker, M.D.

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April 11, 2010 · 2:00 AM

Longevity Components of the Mediterranean Diet

According to Greek researchers, the components of the Mediterranean diet that contribute to longer lifespan are:

  • moderate alcohol consumption
  • low consumption of meat
  • high consumption of vegetables, fruits, nuts, olive oil, and legumes

The following didn’t seem to contribute much, if any:

  • cereals (the grain of a grass such as wheat, corn, oats)
  • dairy products
  • fish and seafood

Investigators at the University of Athens examined the Greek portion of the European Prospective Investigation into Cancer (EPIC) and Nutrition, which included 23,349 men and women free of diabetes, cancer, and coronary heart disease at the outset.  Food habits were documented by questionnaire. 

The focus of this particular study was death rates over an average follow-up of 8.5 years.  Adherence to the traditional Mediterranean diet ranged from minimal to high, as would be expected. 

As with numerous other studies of the Mediterranean diet, higher adherence to the Mediterranean diet was associated with lower chance of death. 

My Comments

The lack of benefit from fish is unexpected.  I have no explanation.  A preponderance of evidence elsewhere suggests fish consumption helps prolong life via lowered rates of heart disease.

Alcohol can be dangerous, of course.  Some people should not partake, ever.     

For people with diabetes who wish to avoid the carbohydrate load in cereals and dairy products, you don’t need to worry much about cutting those out of an otherwise Mediterranean-style diet.

Steve Parker, M.D. 

Reference:  Trichopoulou, Antonia, et al.  Anatomy of health effects of the Mediterranean diet: Greek EPIC prospective cohort study.  British Medical Journal, 338 (2009): b2337.  DOI: 10.1136/bmj.b2337.

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April 10, 2010 · 2:00 AM

Fruits and Vegetables DON’T Prevent Heart Disease

Fruit and vegetable consumption does not seem to reduce the risk of heart attacks (coronary heart disease), according to a recent literature review by French epidemiologists.

I recently wrote about a study that found no overall reduced risk of cancer via consumption of fruits and vegetables.

Heart attacks and cancer are the first and second leading causes of death in the developed world.

So just why, again, are we supposed to be eating our fruits and vegetables?

Here’s most of the abstract written by the epidemiologists:

This Review summarizes the evidence for a relationship between fruit and vegetable consumption and the occurrence of coronary heart disease…Most of the evidence supporting a cardioprotective effect comes from observational epidemiological studies; these studies have reported either weak or nonsignificant associations.  Controlled nutritional prevention trials are scarce and the existing data do not show any clear protective effects of fruit and vegetables on coronary heart disease.  Under rigorously controlled experimental conditions, fruit and vegetable consumption is associated with a decrease in blood pressure, which is an important cardiovascular risk factor.  However, the effects of fruit and vegetable consumption on plasma lipid levels, diabetes, and body weight have not yet been thoroughly explored.  Finally, the hypothesis that nutrients in fruit and vegetables have a protective role in reducing the formation of atherosclerotic plaques and preventing complications of atherosclerosis has not been tested in prevention trials.  Evidence that fruit and vegetable consumption reduces the risk of cardiovascular disease remains scarce thus far.

What do they mean by controlled prevention trials?  Here’s an example.  Find 20,000 people with similar characteristics.  Randomly assign half of them to eat significantly more fruits and vegetables, and make sure they do it.  The other half eats their usual way, and make sure they do it.  Analyze the entire group’s health and food consumption after 10 years and see which half has more or less heart disease.   

Such a study is very difficult and costly.  Even if the fruit and veggie group had less heart disease, someone would argue that the heart benefit was gained because of what they cut out of their eating to make way for the fruits and veggies!  “They quit eating Cheetos; that’s why they had fewer heart attacks.”

Bottom Line

Fruits and vegetables don’t prevent heart disease, according to these researchers.

Fruits and vegetables are components of overall healthy diet patterns such as the Mediterranean diet, the DASH diet, and the “prudent diet.”  Is it possible they reduce the risk of stroke, the second leading cause of death?  I’ll leave that for another day.

I’m starting to think if I read enough nutritional literature, I won’t know anything with certainty.

Steve Parker, M.D. 

Dauchet L., Amouyel, P., and Dallongeville, J. (via MedScape).  Fruits, vegetables and coronary heart disease.  Nature Reviews Cardiology, 6 (2009): 599-608.  doi: 1011038/nrcardio.2009.131

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March 22, 2010 · 2:00 AM

Vinegar to Treat Diabetes?

Vinegar reduces blood sugar elevations after meals containing complex carbohydrates, according to the Department of Nutrition at Arizona State University.

Meals containing carbohydrates (and to a lesser extent, proteins) raise blood sugar after meals in people with or without diabetes.  [I’ve written previously about the normal ranges of blood sugars.]  Previous studies established that a single vinegar dose around mealtime lowers postprandial (after meal) blood sugar levels by up to 50%.  Arizona investigators wanted to know the best dose and timing for reducing postprandial blood sugar elevations.

They ran multiple tests on about 40 adults who reported they were generally healthy except nine had type 2 diabetes (not taking insulin). 

Findings

Mealtime vinegar ingestion reduced postprandial (two hours after meal)  blood sugars by about 20% compared to placebo.  The test meal was white bagel (variable amounts), 20 g of butter, and 200 g of juice. 

The most effective dose of vinegar was 10 g (about two teaspoons or 10 ml) of 5% acetic acid vinegar (either Heinz apple cider vinegar or Star Fine Foods raspberry vinegar).  This equates to two tablespoons of vinaigrette dressing (two parts oil/1 part vinegar) as might be used on a salad.  The authors also say that “…two teaspoons of vinegar could be consumed palatably in hot tea with lemon at mealtime.”

Discussion

The study authors suggest that the blood-sugar-lowering effect of vinegar may be related to inhibition of digestive enzymes or to a slower rate of empyting by the stomach.  Remember that most of digestion and absorption of nutrients occurs in the small intestine; the stomach first has to empty food into the small intestine.  Vinegar seems to inhibit digestion of starch but not of simple (monosaccharide) sugars.

They also note another study that found vinegar slowed the rate of stomach emptying by almost 40% in type 1 diabetics with gastoparesis, potentially raising the risk of low blood sugar.

Take-Home Points

The development of cardiovascular disease, like heart attacks and strokes, seems to be tied especially to elevations of blood sugar after meals as compared to before-meal or fasting sugar levels.  This may be related to formation of free radicals  and inflammatory mediators.  So reduction of postprandial blood sugar elevations by vinegar may be particularly helpful in preventing heart disease.  It will be many years before we can prove this by a clinical study, if ever. 

Diabetics, especially type 2’s without gastroparesis, may better tolerate grains, fruits, and legumes—in terms of lower blood sugar spikes—if they eat them in a meal that includes two teaspoons of vinegar. 

Steve Parker, M.D.

Reference:  Johnston, Carol, et al.  Examination of the antiglycemic properties of vinegar in healthy adults.  Annals of Nutrition and Metabolism, 56 (2010): 74-79.

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