Dr. Greger’s Daily Dozen
Whole-food, plant-based nutrition—pretty self-explanatory, right? But aren’t some green-light foods better than others? For example, you can apparently live extended periods eating practically nothing but potatoes.1 That would, by definition, be a whole-food, plant-based diet—but not a very healthy one. All plant foods are not created equal.
The more I’ve researched over the years, the more I’ve come to realize that healthy foods are not necessary interchangeable. Some foods and food groups have special nutrients not found in abundance elsewhere. For example, sulforaphane, the amazing liver-enzyme detox-boosting compound I profiled in chapters 9 and 11, is derived nearly exclusively from cruciferous vegetables. You could eat tons of other kinds of greens and vegetables on a given day and get no appreciable sulforaphane if you didn’t eat something cruciferous. It’s the same with flaxseeds and the anticancer lignan compounds. As I mentioned in chapters 11 and 13, flax may average one hundred times more lignans than other foods. And mushrooms aren’t even plants at all; they belong to an entirely different biological classification and may contain nutrients (like ergothioneine) not made anywhere in the plant kingdom.2 (So technically, maybe I should be referring to a whole-food, plant- and fungus-based diet, but that just sounds kind of gross.)
It seems like every time I come home from the medical library buzzing with some exciting new data, my family rolls their eyes, sighs, and asks, “What can’t we eat now?” Or they’ll say, “Wait a second. Why does everything seem to have parsley in it all of a sudden?” My poor family. They’ve been very tolerant.
As the list of foods I tried to fit into my daily diet grew, I made a checklist and had it on a little dry-wipe board on the fridge. We would make a game out of ticking off the boxes. This evolved into the Daily Dozen (see figure 6).
By beans, I mean legumes, which comprise all the different kinds of beans, including soyabeans, split peas, chickpeas, and lentils. While eating a bowl of pea soup or dipping carrots into hummus may not seem like eating beans, it is. You should try to get three servings a day. A serving is defined as 60 grams of hummus or bean dip; 130 grams of cooked beans, split peas, lentils, tofu, or tempeh; or 150 grams of fresh peas or sprouted lentils. Though peanuts are technically legumes, nutritionally, I’ve grouped them in the Nuts category, just as I would consider green (snap or string) beans to be better placed in the Other Vegetables category.
Figure 6
A serving of berries is 60 grams of fresh or frozen, or 40 grams of dried. While biologically speaking, avocados, bananas, and even watermelons are technically berries, I’m using the colloquial term for any small edible fruit, which is why I include kumquats and grapes (and raisins) in this category, as well as fruits that are typically thought of as berries but aren’t technically, such as blackberries, cherries, mulberries, raspberries, and strawberries.
For other fruits, a serving is a medium-sized fruit, 120 grams of cut-up fruit, or 40 grams of dried fruit. Again, I’m using the colloquial rather than the botanical definition, so I place tomatoes in the Other Vegetables group. (Interestingly, this is something the U.S. Supreme Court actually ruled on in 1893.3 Arkansas decided to have it both ways, declaring tomatoes both the official state fruit and the official state vegetable.4)
Common cruciferous vegetables include broccoli, cabbage, collards, and kale. I recommend at least one serving a day (30–80 grams) and at least two additional servings of greens a day, cruciferous or otherwise. Serving sizes for other greens and vegetables are 60 grams for raw leafy vegetables, 50 grams for other raw or cooked vegetables, and 7 grams for dried mushrooms.
Everyone should try to incorporate one tablespoon of ground flaxseeds into his or her daily diet, in addition to a serving of nuts or other seeds. 30 grams of nuts is considered a serving, or two tablespoons of nut or seed butters, including peanut butter. (Chestnuts and coconuts don’t nutritionally count as nuts.)
I also recommend quarter of a teaspoon a day of the spice turmeric, along with any other (salt-free) herbs and spices you may enjoy.
A serving of whole grains can be considered 100 grams of hot cereal such as oatmeal, cooked grain such as rice (including the “pseudograins” amaranth, buckwheat, and quinoa), cooked pasta, or sweetcorn kernels; 50 grams of ready-to-eat (cold) cereal; one tortilla or slice of bread; half a bagel or english muffin; or 30 grams of popped popcorn.
The serving size in the beverage category is one glass (twelve ounces), and the recommended five glasses a day is in addition to the water you get naturally from the foods in your diet.
Finally, I advise one daily “serving” of exercise, which can be split up over the day. I recommend ninety minutes of moderate-intensity activity, such as brisk (four miles per hour) walking or forty minutes of vigorous activity (such as jogging or active sports) each day. Why so much? I’ll explain my reasoning in the Exercise chapter.
This may all sound like a lot of boxes to check, but it’s not difficult to knock off a bunch at one time. One simple peanut butter and banana sandwich and you just checked off four boxes. Or imagine sitting down to a big salad. 120 grams of spinach, a handful of rocket, a handful of toasted walnuts, 100 grams of chickpeas, 75 grams of red pepper, and a small tomato. You just knocked out seven boxes in one dish. Sprinkle on your flax, add a handful of goji berries, and enjoy it with a glass of water and fruit for dessert, and you could wipe out nearly half your daily check boxes in a single meal. And then if you ate it on a treadmill . . . just kidding!
Do I check off each glass of water I drink? No. In fact, I don’t even use the checklist anymore; I just used it initially as a tool to get me into a routine. Whenever I was sitting down to a meal, I would ask myself, Could I add greens to this? Could I add beans to that? (I always have an open tin of beans in the fridge.) Can I sprinkle on some flax or pumpkin seeds, or maybe some dried fruit? The checklist just got me into the habit of thinking, How can I make this meal even healthier?
I also found the checklist helped with grocery shopping. Although I always keep bags of frozen berries and greens in the freezer, if I’m at the shop and want to buy fresh produce for the week, it helps me figure out how much kale or blueberries I need.
The checklist also helps me picture what a meal might look like. Looking over the checklist, you’ll see there are three servings each of beans, fruits, and whole grains, and about twice as many veggies in total than any other food component. Glancing at my plate, I can imagine one quarter of it filled with grains, one quarter with legumes, and half a plate filled with vegetables, along with maybe a side salad and fruit for dessert. I prefer one-bowl meals where everything’s mixed together, but the checklist still helps me to visualize. Instead of a big bowl of spaghetti with some veggies and lentils on top, I think of a big bowl of vegetables with some pasta and lentils mixed in. Instead of a big plate of brown rice with some stir-fried vegetables on top, I picture a meal that’s mostly veggies—and oh look! There’s some rice and beans in there too.
But there is no need to be obsessive about the Daily Dozen. On hectic travel days when I’ve burned through my snacks and I’m trying to piece together some semblance of a healthy meal at the airport food court, sometimes I’m lucky if I even hit a quarter of my goals. If you eat poorly on one day, just try to eat better the next. My hope is that the checklist will serve you as a helpful reminder to try to eat a variety of the healthiest foods every day.
But should you eat your veggies raw or cooked? Do you need to choose organic or is conventional okay? What about GMOs? Gluten? All these questions and more will be answered as I go through each of the Daily Dozen in detail in the following chapters.
Beans
Dr. Greger’s Favorite Beans
Black beans, black-eyed peas, butter beans, cannellini beans, chickpeas (also known as garbanzo beans), edamame, english peas, great northern beans, kidney beans, lentils (beluga, french, and red varieties), miso, navy beans, pinto beans, small red beans, split peas (yellow or
green), and tempeh
Serving Sizes:
60 g hummus or bean dip
130 g cooked beans, split peas, lentils, tofu, or tempeh
150 g fresh peas or sprouted lentils
Daily Recommendation:
3 servings per day
The federal government’s MyPlate campaign was developed to prompt Americans to think about building healthy meals. Most of your plate should be covered with vegetables and grains, preferably whole grains, with the rest of the plate split between fruits and the protein group. Legumes were given special treatment, straddling both the protein and the vegetable groups. They’re loaded with protein, iron, and zinc, as you might expect from other protein sources like meat, but legumes also contain nutrients that are concentrated in the vegetable kingdom, including fibre, folate, and potassium. You get the best of both worlds with beans, all the while enjoying foods that are naturally low in saturated fat and sodium and free of cholesterol.
The most comprehensive analysis of diet and cancer ever performed was published in 2007 by the American Institute for Cancer Research. Sifting through some half a million studies, nine independent research teams from around the globe created a landmark scientific consensus report reviewed by twenty-one of the top cancer researchers in the world. One of their summary cancer-prevention recommendations is to eat whole grains and/or legumes (beans, split peas, chickpeas, or lentils) with every meal.1 Not every week or every day. Every meal!
Having some oatmeal in the morning makes it easy enough to fulfill the whole grains recommendation, but legumes? Who eats beans for breakfast? Well, lots of people around the world do. A traditional English breakfast includes savory combinations of baked beans on toast, mushrooms, and grilled tomatoes. Japanese breakfasts traditionally include miso soup, and many children in India start their days with idli, a type of steamed lentil cake. More familiar ways for American palates to meet the cancer prevention guidelines might be a whole-grain bagel schmeared with hummus. My friend Paul mashes cannellini beans into his oatmeal and swears you can’t even see or taste them. Why not?
Soya
Soyabeans are probably the beans Americans are most comfortable incorporating into their breakfasts. Soya milk, for instance, has grown into a billion-dollar business. But soya milk and even tofu are processed foods. When it comes to the nutrients you tend to associate with legumes—fibre, iron, magnesium, potassium, protein, and zinc—about half are lost when soyabeans are converted into tofu. However, beans are so healthy that you can throw away half the nutrition and still have a really healthy food. If you do eat tofu, choose varieties made with calcium (you’ll see it in the ingredients list), which can weigh in at a whopping 550 mg of calcium per (3 oz) slice.2
Even better than tofu, though, would be a whole soya food like tempeh, which is a type of fermented soyabean burger. If you look closely at tempeh, you can actually see all the little soyabeans. I don’t usually eat tempeh for breakfast, but I do like to slice it thin, dip it into a thick flax “egg” mixture (see here for my recipe), dredge it through some rosemary-seasoned whole-grain bread crumbs or coarse blue cornmeal, and bake it in my oven at about 200°C until golden brown. Then I dip it in buffalo hot sauce for a healthier approximation of the chicken wings I enjoyed in my youth.
What About GMO Soya?
A prominent scientific journal recently editorialized that although we are now swimming in information about genetically modified crops, much of what we’re being told is wrong—from both sides of the debate. “But a lot of this incorrect information is sophisticated, backed by legitimate-sounding research and written with certitude,” the editorial read, quipping that when it comes to GMOs, a good gauge of a statement’s fallacy may be “the conviction with which it is delivered.”3
Monsanto’s Roundup Ready soyabeans are the number-one genetically modified crop, engineered to be resistant to the herbicide Roundup (also sold by Monsanto), which allows farmers to spray the crops to kill weeds while leaving the soya standing.4
Though much debate continues to swarm around the hypothetical risks of GMO crops, the greater concern for human health may be the potential for GMO crops to contain elevated pesticide residues.5 This fear was realized in 2014 when high levels of Roundup pesticides were reported on GMO soyabeans (but not on non-GMO or organic soyabeans).6 The pesticide levels were considered high compared to maximum allowable residue levels at the time, but were they high enough to have adverse effects on consumers?
Anti-GMO activists point to studies showing Roundup may interfere with embryonic development and disrupt hormones. These studies were, respectively, on sea urchin embryos7 and cells from mouse testicles.8 Blogs scream headlines like “Men! Save Your Testicles,” citing articles with concerning names like “Prepubertal Exposure to Commercial Formulation of the Herbicide Glyphosate Alters Testosterone Levels and Testicular Morphology.”9 But that study was about puberty in rats. I doubt the blog would have gotten as many hits if it had been titled “Men! Save Prepubescent Rats’ Testicles!”10
Am I being too harsh? After all, where could scientists find live human tissue to experiment on? A research team came up with a brilliant solution—study placentas! Millions of women in the United States give birth each year, and the placenta, the temporary organ formed in the uterus to nourish the fetus during pregnancy, is typically incinerated after delivery. Why not test Roundup on human placental tissue? The researchers did so and found that at the concentration that’s sprayed on crops in the fields, the pesticides did indeed have toxic effects on human tissue.11
That finding may help explain the few tentative studies suggesting adverse effects on pesticide workers12,13 and their children,14 but by the time the pesticides enter the food supply, they are highly diluted. Concentrations of Roundup pesticides may only reach a few parts per million in food and a few parts per billion in your body. Researchers, however, discovered the pesticide may still have effects at a few parts per trillion. Even at that minuscule dose, Roundup pesticides were found to have estrogenic effects in vitro, stimulating the growth of estrogen-receptor-positive human breast cancer cells.15
As we saw in chapter 11, though, soya consumption is associated with lower breast cancer risk and improved breast cancer survival. That may be because most GMO soya in the United States is used as feed for chickens, pigs, and cattle, whereas most of the major soya food manufacturers use non-GMO soya. It could also be because the benefits of eating any kind of soya far outweigh the risks. Regardless, why accept any risk at all when you can choose organic soya products, which by law exclude GMOs?
The bottom line is that there is no direct human data suggesting any harm from eating GMO crops, though such studies haven’t been done (which critics say is exactly the point).16 That’s why mandatory labeling on GMO products would be helpful, so that public health researchers can track whether or not GMOs are having any adverse effects.
But I believe it is important to put the GMO issue in perspective. As I’ve tried to show, there are dietary and lifestyle changes we can make that could eliminate most heart disease, strokes, diabetes, and cancer. Millions of lives could be saved. For this reason, I’m sympathetic to the biotech industry’s exasperation about GMO concerns when we still have people dropping dead from everything else they’re eating.17 As one review concluded: “Consumption of genetically modified food entails risk of undesirable effects similar to the consumption of traditional food.”18 In other words, buying the non-GMO Twinkie isn’t doing your body much good.
Miso is another fermented whole soya food. This thick paste is commonly mixed with hot water to make a delicious soup that’s a staple in Japanese cuisine. If you want to give it a try, I suggest white miso, which has a mellower flavor than red miso. Making miso soup can be as easy as mixing one tablespoon of miso with 500 ml of hot water and whatever vegetables you prefer. That’s it!
Because miso may contain probiotic bacteria,19 it’s probably best not to actually cook the miso, lest the good bugs be wiped o
ut. When I prepare it, I boil dried mushrooms, a pinch of arame seaweed, a few sun-dried tomatoes, and greens in a pot and ladle off about 60 ml of hot broth into a large bowl, add the miso, and mash it with a fork until only a thin paste remains. I then pour the rest of the soup into the bowl and stir to combine it with the miso. And, because I’m a bit of a hot-sauce freak, I add some Sriracha for a little kick. My new favorite addition is freshly toasted sesame seeds. I pour out a layer of raw, hulled sesame seeds, put them in the oven until they just start to turn golden, and then throw them sizzling into the soup. Makes the whole kitchen smell heavenly.
Miso Soup: Soya Versus Sodium
The process of producing miso involves adding salt—lots of salt. A single bowl of miso soup could contain half the American Heart Association’s recommended daily limit, which is why I always reflexively avoided it when I’d see it on a menu. But when I actually looked into it, I was surprised by what I found.
There are two principal reasons to avoid salt: stomach cancer and high blood pressure. Considered a “probable cause” of stomach cancer,20 excess salt intake may cause thousands of cases every year in the United States.21 The elevated stomach cancer risk associated with salt intake appears on par with that of smoking or heavy alcohol use but may only be half as bad as opium use22 or a daily serving of meat. A study of nearly half a million people found that a daily portion of meat (about the size of a deck of cards) was associated with up to five times the odds of stomach cancer.23
This may explain why people eating plant-based diets appear to be at significantly lower risk.24 But it’s not just sodium-rich animal products like processed meats and salted fish that are associated with higher stomach cancer risk—pickled plant foods are as well.25 Kimchi, a spicy pickled vegetable side dish, is a staple in Korean cuisine and could help explain why that country may have the highest stomach cancer rates in the world.26
How Not to Die Page 36