Nutrition


A Healthy Dessert Option -- Dark Chocolate
Nutrition
Written by David Seaman, D.C., M.S., D.A.B.C.N., F.A.C.C.   
Sunday, 22 May 2005 15:28

darkchocolateWhen I attend chiropractic conventions/seminars, I am often invited to have a meal with other DC’s. Not uncommonly, the doc(s) will apologize in advance for eating unhealthy food, or ask me not to criticize them for eating such things as French fries or pancakes. For the record, I am not part of the diet police, so people need not worry about such things. However, there are certain eating guidelines that apply to all of us humans, and it is our choice as to how closely we wish to follow the guidelines.

We are genetically adapted to a diet that consists almost exclusively of “vegetation and animals that ate vegetation.” None of us is able to achieve this type of diet in our modern era, but we can try. The polar opposite of “vegetation and animals that ate vegetation” would be “grains and animals that ate grains,” a diet that was achieved in the documentary called “Supersize Me”.

Producer/director Morgan Spurlock decided to see what would happen if he ate only McDonald’s food for thirty days. At McDonald’s, the classic meals consist almost exclusively of grains and animals that ate grains, as well as sugar and engineered foods. In a mere thirty days, Spurlock gain about twenty-five pounds and showed signs of liver damage and heart disease; his physicians were in shock at the changes that took place.
 
Looking for healthier options

Humans tend to get very attached to their diets. Contrast the struggle that you may have trying to stop eating donuts or McDonald’s, for example, with a change in diet you institute with a pet. If you decide to change the dog’s diet, by shopping for dog food at the health food store, that is the end of the issue for your pooch. You put the new diet in front of the dog, and it is eaten. There is no negotiating; you make the change and the dog must live with it…and the dog lives on happily and is still your best friend. Humans don’t manage to change their diets quite so easily.

Telling someone who loves desserts that they can never have a dessert again is unreasonable and not a goal that is likely to be realized. Fortunately, eating healthy does not mean that we can’t also have desserts; and, further, eating desserts does not mean that the desserts have to be unhealthy. Dark chocolate is a healthy dessert option, so much so that a recent article suggested that we should include dark chocolate in the diet to help reduce heart disease.1

More recently, dark chocolate consumption by healthy volunteers resulted in a significant increase in insulin sensitivity and a decrease in blood pressure, while consumption of white chocolate did not.2 In another study, a modest reduction in LDL oxidation and an increase in HDL cholesterol have been detected within as little as four weeks of dark chocolate consumption.3  Eating dark chocolate has also been shown to favorably influence platelet activity, such that researchers were led to state that chocolate consumption has an aspirin-like effect.4  The consumption of dark chocolate has been shown to increase plasma flavonoid levels,5 and researchers think that the flavonoids found in dark chocolate provide for these various anti-inflammatory responses.

Dark chocolate can be eaten alone and added to other foods, such as cherries and blueberries. I like to pour a little bit of organic heavy cream on top of frozen cherries and/or blueberries. As the fruit thaws and the cream seeps into the fruit, I sprinkle on a little chopped up dark chocolate…talk about a magnificent tasting dessert. Try this for yourself; it is so good, you’re likely to stop buying regular ice cream and other desserts. Your patients are likely to have the same reaction.

Replacing ice cream, donuts, cookies, etc., with fruit and dark chocolate represents a highly anti-inflammatory activity. Couple this with eating more vegetables, and our patients can move toward pursuing an anti-inflammatory state that may be protective against numerous diseases. Adding a supplemental multi, magnesium, EPA/DHA, coenzyme Q10, and ginger/turmeric, will provide additional anti-inflammatory support.

References

1. Franco OH, Bonneux L, de Laet C, Peeters A, Steyerberg EW, Mackenbach JP. The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. Brit Med J  2004; 329:1447-50
2. Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutr  2005; 81:611-14
3. Wan Y, Vinson JA, Etherton TD, Proch J, Lazarus SA, Kris-Etherton PM. Effects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humans. Am J Clin Nutr. 2001;74(5):596–602.
4. Rein D, Paglieroni TG, Wun T, et al. Cocoa inhibits platelet activation and function. Am J Clin Nutr. 2000;72(1):30–35.
5. Wang JF, Schramm DD, Holt RR, et al. A dose-response effect from chocolate consumption on plasma epicatechin and oxidative damage. J Nutr 2000; 130 (8S Suppl):2115S–2119S.

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession.  He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient.  Dr. Seaman can be reached by e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
New Review on the Pro-Inflammatory Modern Diet
Nutrition
Written by David Seaman, D.C., M.S., D.A.B.C.N., F.A.C.C.   
Friday, 22 April 2005 13:26

Over the past several years, Dr. Loren Cordain, author of The Paleodiet, has kept us abreast on the nature of the “hunter-gatherer” diet and its importance in human health. His most recent paper was published in the February issue of the American Journal of Clinical Nutrition. With several notable coauthors, Cordain describes the development of our “modern” Western diet and why it is pro-inflammatory.

The thesis of the Cordain, et al., article is straightforward: The changes in diet and other lifestyle conditions that began in certain regions of the world, some 10,000 years ago, occurred too recently on an evolutionary scale for the human genome to adapt. Accordingly, they explain that the expression of chronic disease is the rest of discordance between our “old” genes and our modern lifestyle.

Cordain, et al., focus on seven crucial nutritional characteristics of paleolithic diets that have been supplanted by the diet of modern man (see Table). The insults are cumulative in nature and impossible to circumvent by drugs, surgery, or nutritional supplements.

Diet-related chronic diseases, such as heart disease, cancer, Alzheimer’s, the arthritides, etc., represent the single largest cause of morbidity in the United States and most Western countries. Some 50-65 percent of the adult population in Western nations are afflicted with such chronic diseases, yet they are rare or nonexistent in hunter-gatherers and less Westernized people.1

Hunter-gatherers ate mostly vegetation and animals that ate vegetation. Unknown to them were fast foods, excessive grain consumption (whole or refined), dairy, salty foods, seed oils, and trans fats…all of which are pro-inflammatory, and the foods that most of your patients live on. When patients ask what foods are “good,” have them think about the foods that a hunter-gatherer would eat. Any suspicious food should be avoided, and replaced by a vegetable, fruit, or raw nuts. A suspicious food would be one that we cannot hunt or pick. This leads to a question about edible oils. You pick olives and coconuts, so they should be eaten and their oils consumed.

If patients feel the need for a treat, a mixture of dark chocolate, raisins, and raw nuts is both tasty (tastes like a candy bar) and anti-inflammatory. If patients wish to consume an adult beverage, stout beer and red wine are anti-inflammatory choices.

There is no adequate excuse for living a life of inflammation. Busy people do not have to be inflamed people. Business travelers blame travel, restaurants, and airports for their excess body fat and inflammation…a lame excuse indeed. I travel many weekends per year and every Sunday when I am tired and walking through an airport or two, the Cinnabon aroma beckons me to inflame…. I just force myself to walk faster and avoid it. There is no excuse to inflame oneself and pursue chronic disease; in these cases, the desire to inflame simply exceeds the desire to deflame.

The company we keep can play a significant role in whether or not we pursue inflammation. Simply stated, an alcoholic needs to stay away from bars and should not socialize with drinkers. The same holds true for inflame-aholics…stay away from those who beckon you to inflame. Eat anti-inflammatory foods and take supplements that augment the anti-inflammatory diet, including a multivitamin, magnesium, EPA/DHA, coenzyme Q10 and, if you get inadequate sunlight, supplement with vitamin D.

References

1. Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 2005; 81(2):341-54.

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession.  He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient.  Dr. Seaman can be reached by e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
Lots of Questions - One Basic Answer
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Nutrition
Written by David Seaman, D.C., M.S., D.A.B.C.N., F.A.C.C.   
Tuesday, 15 March 2005 02:51

cornucopiahealthydietEvery month I get lots of email questions about what to give for X, Y, Z conditions. In short, there is no good data on taking vitamin X or herb Z to cure condition Q. Medications don’t work that way, and neither do supplements. In other words, you can’t cure depression with Prozac, St. John’s Wort, 5-htp, SAM-e or anything else. Similarly, glucosamine will not cure arthritis, and hydroxyapatite will not cure osteoporosis. There is no magic pill for any one condition that will consistently fix the syndrome or disease.

If you go through the archives of  TAC issues on the Internet at www.theamericanchiropractor.com, and look up my past articles, you will notice a distinct trend; dietary and supplement recommendations are remarkably consistent. This is because nearly all conditions that we suffer from are driven by a chronic pro-inflammatory state.

The Answer Is: An Anti-Inflammatory Diet

Humans are supposed to subsist almost exclusively on vegetation (herb spices, fruits, nuts, roots, tubers, vegetables and oils derived from the same, such as olive oil and coconut oil) and animals that eat vegetation. If you want alcohol, you have two healthy choices: Red wine and stout beer. If you want a treat, you have, basically, one choice: Dark chocolate (try raw almonds, raisins, and dark chocolate—tastes like a natural chunky candy bar). This type of eating naturally suppresses pro-inflammatory processes and, so, can be viewed as an anti-inflammatory diet.

Notice that grains, dairy, and soy are not part of the program. Whenever consumed in more than a condiment fashion, and only on an occasional basis, these three foods represent inflammation.

Beverage choices are straightforward…drink water. Additionally, green tea and freshly made vegetable and fruit juices are anti-inflammatory and highly recommended. A cup of coffee per day is fine for the die-hard coffee achievers.

Supplement recommendations are designed to augment the anti-inflammatory diet. Take a multivitamin (2-3 pills/day, usually), magnesium (400-1000 mg/d), EPA/DHA (1-3 gram/d), coenzyme Q10 (100 mg/d). Either spice all your meals with ginger, turmeric, garlic, rosemary, oregano, etc., or take supplements of each everyday that amount to a couple of grams worth of herbs. Combination supplements of these herbs are available and very popular.

Calcium can also be taken and, in my opinion, it should be supplemented in a 1:1 ratio with magnesium. More and more evidence is indicating that many people are vitamin D deficient. Regular exposure to sunshine is your best choice for vitamin D. Supplemental use of vitamin D needs to be applied on an individual basis and should be assessed/monitored via routine blood testing.

These anti-inflammatory suggestions apply to people with back pain, fatigue, arthritis, heart disease, osteoporosis, aging, and most other conditions. The approach is general and directed at reducing the diet-induced pro-inflammatory state.1

We create inflammation in three main ways: An inflammatory diet, lack of exercise or too much exercise, and mental/emotional-driven stress. This means that most of us are chronically inflamed prior to injury, and also prior to the seemingly insidious development of fatigue, malaise, aches, and pains. In addition to passive interventions, such as the chiropractic adjustment, we need to make anti-inflammatory lifestyle choices.

Here is the problem with the anti-inflammatory approach to health…most people like to eat pro-inflammatory foods and most people don’t exercise. People want a pill that will counteract the inflammatory foods, and they even want a pill that will exercise for them. Unfortunately, there are no pro-inflammatory loopholes, so we just have to make a choice and deal with the consequences.

References

1. Seaman DR. The diet-induced pro-inflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulat Physiol Ther 2002; 25: 168-179

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession.  He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient.  Dr. Seaman can be reached by e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
The Truth About the Dangers of COX-2 Inhibitors
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Nutrition
Written by David Seaman, D.C., M.S., D.A.B.C.N., F.A.C.C.   
Tuesday, 15 February 2005 01:22

As most readers are aware, Vioxx was recalled from the marketplace in late September of  2004. It was discovered that a significant number of patients taking Vioxx suffered from heart attacks or strokes.

A total of three COX-2 inhibitors have been in the marketplace. These drugs are sometimes referred to as “coxibs;” celecoxib (Celebrex), rofecoxib (Vioxx), and valdecoxib (Bextra). Celebrex and Bextra are still in use.

COX is the acronym for cyclo-oxygenase. In 1990, researchers discovered that there were two distinct COX enzymes, and referred to them as COX-1 and COX-2. More recently, it has been proposed that there is even a COX-3 enzyme.

The difference between COX-1 and COX-2 is generally straightforward. COX-1 is a constitutively expressed enzyme; in other words, it is involved in normal homeostatic functions such as gastric protection, hemostasis, and normal renal function.1  In contrast, COX-2 is not normally expressed and not involved in tissue homeostasis; instead, its activity is induced after tissue injury.1
 
Confusion about regular NSAID’s and COX-2 inhibitors

A substantial area of confusion revolves around the notion that COX-2 is an inflammatory enzyme; it is not. COX-2 is an enzyme that is induced by tissue injury. The subsequent pro- or anti-inflammatory outcome depends on the pro- or anti-inflammatory nature of the fatty acids in the cell membrane. COX-2 can act on three different cell membrane fatty acids, including arachidonic acid (AA), dihomo-gamma-linolenic acid (DGLA), and eicosapentaenoic acid (EPA).

If COX-2 acts on AA, the outcome will be the synthesis of pro-inflammatory eicosanoids, known as prostaglandin E2 (PGE2) and thromboxane A2 (TXA2). PGE2 sensitizes nociceptors and promotes inflammation. TXA2 causes local vasoconstriction and platelet aggregation. Anti-inflammatory drugs like ibuprofen and Celebrex are taken to block the production of these pro-inflammatory eicosanoids.

If COX-2 acts on DGLA, the outcome will be the synthesis of non-nociceptive/inflammatory PGE1 and non-vasoconstricting/aggregating TXA1. These non-inflammatory eicosanoids do not cause pain and inflammation.

If COX-2 acts on EPA, the outcome will be the synthesis of non-nociceptive/inflammatory PGE3 and non-vasoconstricting/aggregating TXA3. Again, the outcome of these non-inflammatory eicosanoids will be a reduction of pain and inflammation.

Clearly, the inflammatory potential of our tissues depends on the inflammatory potential of the fatty acids in our cell membranes. Pharmacology articles1 and pathology texts2 do not make this distinction, which is why many of us are led to believe that COX-2 enzymes are inherently inflammatory.

Cell membrane fatty acids and inflammation

Almost all DC’s learned about essential fatty acids (EFA’s) in biochemistry or nutrition class while going to chiropractic college. EFA’s are the special fatty acids we must get from our diets, as we cannot synthesize them ourselves. The two EFA’s include linoleic acid (LA), an omega-6 (n-6) fatty acid, and a-linolenic acid (ALA), an omega-3 (n-3) fatty acid. Linoleic acid is converted into DGLA and then into AA (also n-6), whereas, a-linolenic acid is converted into EPA (also n-3).

The ratio of LA:ALA, or our n-6:n-3 dietary ratio is supposed to be about 1:1; at least below 4:1 is the goal. With an LA:ALA ratio of 4:1 or less, the outcome will be the modulation and control of excessive immune responses and inflammation.3 This is because a dietary ratio of below 4:1 insures that there will be an even distribution of AA, DGLA, and EPA into cell membranes, which then leads to the synthesis of more anti-inflammatory eicosanoids compared to pro-inflammatory.

Not surprisingly, the average American has a an n-6:n-3 ratio of  20:1 or greater, which means that we are eating 20 or more n-6 fatty acids for every single n-3 fatty acid. This leads to a significant increase in the synthesis of AA and its related pro-inflammatory eicosanoids,3 and is a main reason why Americans medicate with excessive amounts of  ibuprofen, Celebrex and other anti-inflammatory drugs.

We, literally, eat ourselves into a state of inflammation and pain, and then have to take medications as a counteractive measure. The excessive inflammation created by n6 fatty acids is also thought to be the driving force behind the development of cancer, heart disease, stroke, and other inflammatory diseases.3

Diet and supplements to increase cell membrane n-3 fatty acids

An n6:n3 ratio of 4:1 or better is found in fruits, vegetables, grass fed animal products, wild game, and specially fed n-3 chicken eggs. Accordingly, these foods can be referred to as anti-inflammatory.

In contrast, all grains have a ratio of 20:1 or greater and grain-fed animals have ratios above 4:1, and so should be referred to as pro-inflammatory foods. Most packaged goods are prepared with oils that have n-6:n-3 ratios greater than 4:1, such as safflower, sunflower, and corn oil. Margarine is almost purely an omega-6 fatty acid. Additionally, margarine has been chemically altered by the partial hydrogenation process, which increases the inflammatory potential of margarine.

At this point, it should be clear that the COX-2 is really not the problem; the issue is our excessive consumption of n-6 fatty acids, which increases the level of pro-inflammatory AA in cell membranes. The COX-2 enzyme merely acts on the pro-inflammatory fatty acids that we eat.

Research suggests that most people would do well to take n-3 fatty acid supplements to get a boost in the anti-inflammatory direction. EPA/DHA is the most common n-3 fatty acid supplement. Patients should take 1-3 grams per day, levels which are extremely safe for nearly everyone save for patients taking strong anti-coagulants, such as coumadin.

References

1.  Gajraj NM. Cyclooxygenase-2 inhibitors. Anesth Analg 2003; 96:1720-38
2.  Cotran RS, Kumar V, Collins T. Robbins Pathologic Basis of Disease. 6th ed. Philadelphia: WB Saunders; 1999
3.  Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr  1999; 70(3 Suppl):560S-569S

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession.  He is on the faculty of Palmer College of Chiropractic Florida and on the postgraduate faculties of several other chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient.  Dr. Seaman believes that chiropractors should be thinking like chiropractors, while providing nutritional recommendations.  Doctors and patients who follow his programs report improved feelings of well-being, weight loss, dramatic increases in energy, and significant pain reduction.  Dr. Seaman can  be reached by e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
Your Lifestyle Tells Your Genes to Express Disease
Nutrition
Written by David Seaman, D.C., M.S., D.A.B.C.N., F.A.C.C.   
Saturday, 15 January 2005 00:11

More and more research is demonstrating how our genes determine the types of diseases we develop and our degree of susceptibility to a given disease. This issue should not be taken lightly, particularly when making specific suggestions to patients.  For example, most have probably heard the “urban legend” that grilled meat causes colorectal cancer. Is this true? The answer is yes and no, and it depends on your genes.

Genetic Disposition for Colorectal Cancer

Heterocyclic amines (HCA) are thought to be the carcinogens that are formed in meat when it is cooked at high temperatures for long durations. HCA’s are not carcinogenic on their own; after we eat them, our liver has enzymes that must metabolically activate the HCA’s before they can bind to DNA and do their dirty work. The enzymes are called cytochrome P4501A2 (CYP1A2) or N-acetyltransferase 2 (NAT2).

As it turns out, we can either have a slow, intermediate, or rapid phenotype for CYP1A2 and NAT2; in other words, we are genetically endowed with slow, intermediate or rapidly acting enzymes. Our risk for developing colorectal cancer is thought to be increased, if we have a rapid phenotype for CYP1A2 and NAT2. This association may be particularly strong in smokers, because smoking is known to induce the activity of CYP1A2.1

Reducing Formation of HCA’s

To determine the details of these relationships, researchers performed some lab tests to assess phenotype for CYP1A2 and NAT2. The results demonstrated that there was a 9-fold increase in colorectal cancer risk for smokers who preferred their red meat well done, and if they had a rapid metabolic phenotype for both NAT2 and CYP1A2. Well-done meat was not associated with risk among nonsmokers, or even smokers with a slow or intermediate phenotype for on these enzymes.1

This study suggests that exposure to carcinogens through the consumption of well-done red meat increases the risk of colorectal cancer only in genetically susceptible individuals, as determined by polymorphically expressed genes, and only in smokers. We are told that the best way to reduce HCA’s in cooked meat include marinating, precooking by microwaving, and frequently turning the meat over during cooking.1

To Be Lucky or Not

From a clinical perspective, we need to appreciate the fact that we can be pre-disposed to developing colorectal cancer, for example; however; we have to push our genes to express the disease by adopting certain lifestyle habits. This is likely to be the case for most diseases, which suggests that one person can pursue a lifestyle of near health perfection, yet, because they slacked at a mere 2%, they develop cancer or heart disease. Meanwhile, the next-door neighbors literally pursue disease with every lifestyle choice, yet they remain free of disease. Our health habits must be commingled with our genes to determine the expression of disease. Some of us are lucky, others are not, and substantial differences can exist among family members. So you really never know who is lucky or not, until the expression of disease occurs.

What can we do?

So, how do you know what your genes have in store for you? Basically, we all have to wait and see, which is not a great answer, because it implies that we are at the mercy of our genes. Although we are, indeed, partially at the mercy of our genes, we can pursue a lifestyle that does not readily induce them to express their disease potential. In the next issue, I will discuss some mechanisms in more detail; however, for now, here are some practical ideas.

Prevent the Expression of Free Radicals

It is now known that, to a large degree, cancer, heart disease, Alzheimer’s disease, and other chronic degenerative and neurodegenerative diseases are manifestations of chronic inflammation. In particular, our dietary choices actually nudge or induce our cells to express their inflammatory potential.

Free radicals and pro-inflammatory cytokines act to induce the expression of cell-driven inflammation. So, we need to create an environment that does not allow for the proliferation of free radicals and cytokines, and this is easy to do. We need to eat less grain products (whole or refined), avoid refined sugar, and eat a lot more fruits and vegetables. Grass-fed animal products and wild game are both anti-inflammatory choices for protein. If we can adopt these eating habits and add four basic supplements (multivitamin, magnesium, EPA/DHA, and CoQ10), we will go a long way toward reducing pro-inflammatory responses that lead to the expression of disease.

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession.  He is on the faculty of Palmer College of Chiropractic Florida and on the postgraduate faculties of several other chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient.  Dr. Seaman believes that chiropractors should be thinking like chiropractors, while providing nutritional recommendations.  Doctors and patients who follow his programs report improved feelings of well-being, weight loss, dramatic increases in energy, and significant pain reduction.  Dr. Seaman can  be reached by e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
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