Questions and answers to the Phytonutrient and Cardiovascular Disease Webinar

Photospin.com jean-luc cochonneau

by Robin Allen, MSPH, RDN, LDN

Such a great webinar presented by Dr. Elvira DeMejia on March 15, 2017, Phytonutrients and Cardiovascular Disease.  The information shared and questions asked were stimulating and insightful to this vital topic. Below is a summary.

Overview:

Bioactive compounds are compounds found in plant foods such as phytonutrients or phytochemicals that have some biological activity beyond nutrition.

Dr. DeMejia discussed the benefits of bioactive compounds and their effect on inflammation, absorption, and metabolism of phenolic compounds, anthocyanin, and examples of proteins and peptides and the risk of cardiovascular disease (CVD). We need to educate our customers about bioactive compounds and their relationship to health.

Consumer studies have shown that 87% of Americans believe that foods have health benefits beyond basic nutrition. Between 43% to 85% of Americans are aware that specific food components such as omegas-3 fatty acids have health benefits.  So much of the public is aware that food has health benefits but may not be aware of which foods and the exact components.

Inflammation plays an important role in atherosclerosis.  Atherosclerosis is initiated by risk factors such as obesity, diabetes, and hypertension (HTN).  These risk factors can lead to inflamed regions on the arterial wall, which accumulates cells called macrophages.  These macrophages engulf lipid particles and develop into atherosclerotic lesions.  This inflammation is a contributor in the atherogenic process.  We need to know how to avoid these atherosclerotic lesions.

Scientific evidence has shown that diet can influence, decrease the inflammatory process.  The Mediterranean diet has been shown to decrease heart disease risk, decrease blood pressure, decrease low-density lipoprotein (LDL) cholesterol and increase mortality.

Questions from the webinar chat pod:

Question for participants: What does the phrase “bioactive compounds” mean to you? What do you think the connection is between bioactive compounds in plant food and cardiovascular disease?

  • Phytonutrients or phytochemicals is the broad name for a  group of compounds produced by plants such as fruits, vegetables, beans, and grains.  These compounds have a protective or disease preventive properties.  Some scientists estimate that there are more than 4000 phytochemicals with different functions.  Possible actions:
    • An antioxidant protects against oxidative damage.
    • Hormonal, in flavones found in soy imitate human estrogens.
    • Stimulation of enzymes, Indoles make estrogen less effective and could reduce the risk for breast cancer.
    • Interference with DNA replication, such as saponins in beans interferes with replication of cell DNA, preventing the multiplication of cancer cells.
    • Anti-bacterial, allicin from garlic has anti-bacterial qualities.
    • Physical action, some bind to cell walls preventing the adhesion of pathogens.

Which is higher in bioactives, the DASH diet or the Mediterranean diet?

  • Both are plant based but the Mediterranean diet has a greater diversity of foods both plant and animal based. The Mediterranean Diet also has the addition of wine.  Both are excellent diets.

Are bioactive compounds the most important part of these two eating patterns?

  • No, both of these diets are low in fat; low in saturated fat, low in sodium, promote healthy types of oils such as olive oil, and offer high-quality protein in addition to bioactive compounds.

Question for participants: What food sources are rich in bioactive compounds and therefore good to recommend to clients and patients?

  • Plant foods, berries, fruit, vegetables, hibiscus tea or dried hibiscus flowers.

Where can you buy hibiscus tea or flowers?

  • I have had dried hibiscus flowers as well; they taste great!
  • I am growing hibiscus…may try to make tea with the flowers.
  • I have seen them at our local grocery store, Meijer, Fiesta grocers sell dry hibiscus.

Are hibiscus leaves safe in pregnancy and lactation?

  • Yes

Are there contraindications for hibiscus tea/leaves?  Food/drug interactions, dialysis, etc.?

  • Some places, mainly in Asia, the soil is high magnesium and aluminum, but not in the United States. We have not found any adverse effects for hibiscus.

If hibiscus can lower blood pressure, should we caution patients that are on blood pressure medication?

  • Most studies have been on patients not taking blood pressure medication so the patient should be monitored medically.

Why is Mexican Oregano specified? Is there a difference in phenolic compound content in this specific type of oregano vs. other types of oregano?

  • Mexican oregano has a high concentration of phenolic compounds such as luteolin and apigene. These mitigate oxidated stress and activation of pro-inflammatory signals which help decrease the risk of CVD. Mexican oregano is a related to lemon verbena and has notes of citrus and mild licorice. Mediterranean oregano is a member of the mint family, also known as wild marjoram. See this blog http://www.thekitchn.com/whats-the-difference-mediterra-93923.

What is quercetin?

  • Quercetin is a flavonoid found in vegetables and fruit, which is high in antioxidants. Antioxidants can help protect our cells from damage caused by free radicals.

Fermented berry wine versus fermented berry juice, are the benefits the same?

  • Fermentation helps make the bioactive compounds more available. However, if you do not drink wine then berry juice is the alternative.

What foods have quercetin?

  • Capers, lovage leaves (parsley), red onion, berries, kale, apples, spinach, and red grapes.

Are the effects of anthocyanin reduced if the food is cooked?

  • Many antioxidants are water soluble and can be destroyed by heat but it depends on the cooking method. Some vegetables such as tomatoes become more potent and increase in the antioxidant capacity such as tomatoes and lycopene.    According to a study in the Journal of Food Science, cooking with griddles, microwave ovens and ovens have the least impact on antioxidants.  Boiling, cooking at high temperatures for long periods have the most impact.

Where do we find phytosterols naturally?

  • Phytosterols are found in plant-derived foods, in the membrane, which is similar in structure and function to cholesterol. High intakes of plant sterols or stanols reduce the absorption of cholesterol.  Phytosterols reduce the absorption of cholesterol in the intestinal lumen by interfering with cholesterol incorporation into mixed micelles and/or interfering with the absorption of cholesterol into the cells of the small intestine.

Does anyone have a list of the products that have phytosterols added?

  • Products include Benecol spread (0.85g/tbsp), Healthy Heart Yogurt 0.4g/6 oz.), Lifetime low-fat cheese (0.65g/1 oz.), Minute Maid Premium Heartwise orange juice (0.04g/8 oz.), Nature Valley Healthy Heart Chewy Granola Bars (0.4g/bar), Orowheat whole grain bread (0.4g/1 1/2 slices) and Take Control spread (1.7g/Tbsp)

Comment from a participant:  I have read studies about phytosterols helping to reduce the metastasis of Cancer cells unlike normal cells, cancerous cells lose their ability to respond to death signals that initiate apoptosis (programmed cell death). Sitosterol has been found to induce apoptosis when added to cultured human prostate, breast, and colon cancer cells. These studies are found in the references.

So the recommendation to drain and rinse canned vegetables and beans may be counter- productive?

  • Not necessarily, canned vegetables also have very high salt content so is better to drain. If you soak beans, try to include the water in cooking.

One recipe I saw called for amaranth leaves, not the grain/seed. Do leaves have the same components as the grain?

  • Very good questions. amaranth greens are cultivated by many Asian cultures as a leaf vegetable.  Both the leaves and seeds (grain) are edible.  We use the seeds and extract the oil, which is highly unsaturated, very aromatic.  The seeds are an excellent source linoleic oil, omega fatty acids, contains a high concentration of protein, 17 %, and an excellent source of calcium and potassium. The leaves contain mainly saponins and alkaloids and have a lower protein content. Many people enjoy the leaves, which contain color compounds that have important antioxidants thus improving free radical scavenging activity.

What do you recommend regarding black cumin seeds?

  • Not a lot of experience but there are some studies showing some anti-inflammatory and antioxidant properties.

What is the research on turmeric and heart disease?

  • Several studies have been conducted but there is a need to focus on more human studies.

Does dairy have an inflammatory effect?

  • Yes, proteins in milk when digested produce a smaller sequence of amino acids called peptides, which have inflammatory potential.

Is it better to use fermented dairy?

  • Yes, just because but when you ferment you have the light microorganism that also comes to play in fermenting some bioactive compounds and improving the bioavailability. Fermented dairy is excellent to increase the good microbes in our body.

Are there any benefits with white tea?

  • White tea comes from young leaves, not fermented tea leaves. It is delicious with high concentrates of catechins, epicatechins; the most prevalent is epigallocatechin gallate, which is a type of natural polyphenol that acts as antioxidants.  White tea has more bioactive properties than green and black tea.

We hope you enjoyed this webinar as much as we did. If you could not attend, please listen to the recording at https://learn.extension.org/events/2962.  Registered Dietitians can still earn 1.0 CPEU for up to 1 year after the date of the webinar.

 

References:

Richelle M, Enslen M, Hager C, et al. Both free and esterified plant sterols reduce cholesterol absorption and the bioavailability of beta-carotene and alpha-tocopherol in normocholesterolemic humans. Am J Clin Nutr. 2004;80(1):171-177.  http://ajcn.nutrition.org/content/80/1/171.long

von Holtz RL, Fink CS, Awad AB. beta-Sitosterol activates the sphingomyelin cycle and induces apoptosis in LNCaP human prostate cancer cells. Nutr Cancer. 1998;32(1):8-12.  https://www.ncbi.nlm.nih.gov/pubmed/9824850

Awad AB, Roy R, Fink CS. Beta-sitosterol, a plant sterol, induces apoptosis and activates key caspases in MDA-MB-231 human breast cancer cells. Oncol Rep. 2003;10(2):497-500.  https://www.ncbi.nlm.nih.gov/pubmed/12579296

Choi YH, Kong KR, Kim YA, et al. Induction of Bax and activation of caspases during beta-sitosterol-mediated apoptosis in human colon cancer cells. Int J Oncol. 2003;23(6):1657-1662. https://www.ncbi.nlm.nih.gov/pubmed/14612938

http://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/phytosterols#food-sources

http://www.phytochemicals.info/

 

This blog was posted by Robin Allen, a member of the Military Families Learning Network (MFLN) Nutrition and Wellness team that aims to support the development of professionals working with military families.  Find out more about the MFLN Nutrition and Wellness concentration on our website, on Facebookon Twitterand LinkedIn.

Nutrition during Cancer Treatment

Photospin.com/ Toh Kheng Ho

Blog by Joanna Manero

Treating a client undergoing cancer treatment can be a difficult task.  Many things are happening in their lives, which may lead to nutrition being put on the back burner.  However, we know how important proper nutrition can be during this time.  According to the American Cancer Society, proper nutrition during treatment can lead to feeling better, keeping up strength and energy, maintaining weight and body nutrient stores, better-tolerating side effects, lower risk of infection, and a faster recovery.

Cancer treatments may result in an altered sense of smell, taste, and appetite, which may lead to malnutrition.  These changes are especially problematic in this population as it may leave patients too weak to fight disease.  Furthermore, other side effects of cancer treatment include anorexia, anxiety, constipation, depression, dry mouth, diarrhea, mouth sores, nausea, and trouble swallowing.  These side effects can further inhibit someone’s willingness to eat. If you find that your client is struggling to consume adequate energy and nutrients during cancer treatments, try some of the tips below.

If the problem is appetite:

  • Eat five or six small meals per day.
  • Eat large meals when you are hungry.
  • Start a meal with high-protein foods.
  • Keep your favorite high-energy foods and drinks nearby at all times.
  • Try to be physically active to help stimulate hunger.
  • Ask a family member for help with meal preparation.
  • Drink your calories using smoothies and semi-solid foods that require less chewing.

If the problem is nausea:

  • Avoid strong smelling foods.
  • Eat small, frequent meals.
  • Eat sitting up.
  • Having small sips of clear, room-temperature fluid, may be better tolerated.
  • Sip on drinks between meals rather than with a meal.
  • Avoid foods that are heavily spiced, greasy, or overly sweet.
  • Nibble on plain foods such as pretzels and crackers to help control vomiting.

If the problem is fatigue:

  • Ask for a family member to help prepare meals.
  • Prepare large meals when you have energy and freeze leftovers.
  • Stay hydrated.
  • Temporarily consume ready-to-eat meals.
  • Look into programs that can provide meals such as Meals on Wheels.

If the problem is altered taste and smell:

  • Choose foods that you enjoy.
  • Consume foods at lower temperatures; often lower temperature can help mask the smell and taste of foods.
  • If food tastes bitter or salty, try adding small amounts of sugar.
  • Brush your teeth and rinse your mouth regularly.
  • Try marinades or spices that taste and smell good to you to mask the off-taste of other foods.

As you can imagine, this is only a short list of problems that can arise during cancer treatment.  Check out the resources below for more information and please join us for a free webinar featuring Dr. Anna Arthur Parker on May 4th, 2017 at 10 am CT to learn more. Register at https://learn.extension.org/events/3026

Resources/References:

https://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/nutrition/nutrition-during-treatment/benefits.html

http://www.mealsonwheelsamerica.org/

https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq

http://www.aicr.org/assets/docs/pdf/education/heal-well-guide.pdf

 

This blog was posted by Robin Allen, a member of the Military Families Learning Network (MFLN) Nutrition and Wellness team that aims to support the development of professionals working with military families.  Find out more about the MFLN Nutrition and Wellness concentration on our website, on Facebookon Twitterand LinkedIn.