How Not to Die

  Horseradish

  The serving sizes I offer here correspond roughly to the daily intake required to achieve cancer-preventive levels according to the innovative breast-surgery study I detailed in chapter 11. As you can see, horseradish has the smallest serving size, which means it’s the most concentrated of the cruciferous vegetables. One tablespoon and your Daily Dozen is down to an Everyday Eleven. Horseradish can be made into a sauce, relish, or dressing to score an extra check mark with a kick. It’s great in mashed potatoes or, for a healthier option still, mashed cauliflower. Just boil cauliflower for about ten minutes until tender and then mash with a fork or potato masher or purée in a food processor with some of the reserved cooking liquid until smooth. I season it with pepper, roasted garlic, and a dollop of horseradish and then pour mushroom gravy on it. Delicious!

  Roasting Cruciferous Vegetables

  As much as I love mashed cauliflower, roasted cauliflower (or broccoli, for that matter) is my favorite. Roasting brings out a nutty, caramelized flavor. I slice raw cauliflower into “steaks,” roast at 200°C for about half an hour, and then smother it in a lemon-tahini sauce. Sometimes I go minimalist and just sprinkle on lemon juice, zest, capers, and garlic. (This chapter is making me hungry!)

  Kale Crisps

  I’ll talk about some of the more traditional ways I prepare greens in the next section, but kale crisps deserve a special mention. You can use a dehydrator if you have one, but I often don’t have the patience. When I’m in the mood for kale crisps, I want them now. They can be as simple as one ingredient: kale. Pull the leaves off the stems and tear into large pieces. Make sure that they are dry, or they’ll steam rather than crisp. Lay out the torn leaves in a single layer on a baking tray lined with parchment paper or a silicone mat to prevent sticking, and bake at a low temperature (about 120°C) and check often to make sure they don’t burn. Within about twenty minutes, they transform into light, crispy snacks. Preseason the leaves before you roast them, or add your spices after they’re done. There are thousands of recipes online. I recommend starting with Ann Esselstyn’s recipe on her son Rip’s website, Engine2Diet.com.16 With kale crisps, the more you snack, the healthier you are.

  Cruciferous Garnishes

  Similar to the way I use an open tin of beans in the fridge as a reminder to try to bean-up any dish, we always have a purple (or red) cabbage in the crisper to help us cruciferize our meals. I slice off shreds and garnish nearly anything with them. Red cabbage averages about 65 pence per pound,17 is found at pretty much any supermarket or market, can last weeks in the fridge (though if it does, that means you’re not using it enough!), and has more antioxidants per pound than anything else you’ll find in the produce aisle. There are healthier foods you can buy, but not for the same amount of money. For example, purple cabbage may have nearly three times the antioxidant power per pound that blueberries do.18 In terms of eating healthfully on a budget, purple cabbage can’t be beaten. Or can it?

  After chopping and discarding the waste, red cabbage averages 45 cents a cup.19 But broccoli sprouts—if you make them yourself—may be even cheaper. Broccoli sprout seeds can be purchased online or at natural foods stores for about £13 a pound, but that makes almost 4 kilograms of sprouts. In terms of sulforaphane content, that may be around 27 kilograms of mature broccoli. So DIY broccoli sprouts provide a green-light sulforaphane source for about 3 pence a day.

  Sprouting broccoli sprouts is as easy as sprouting lentils. Start with a mason jar with a sprouting (screen) lid. Add a tablespoon of seeds, let them soak overnight in water, drain in the morning, and then after that, just quickly rinse and drain twice a day. Most people wait for about five days, until the seeds fully sprout (taking on the look of alfalfa sprouts), but new science suggests sulforaphane content peaks at forty-eight hours after the seeds are initially drained.20 This makes them even quicker and easier to grow and eat. When I’m not traveling, I usually have a few jars in rotation. It can be the middle of winter, and I’m growing my own salad on my kitchen counter! Every day, you can get fresh produce for your family without ever having to go to the shop.

  Cruciferous Supplements?

  If you don’t like the taste of cruciferous vegetables but still want the benefits of the sulforaphane, what about the broccoli supplements currently on the market? Researchers recently put a leading commercial supplement to the test. BroccoMax boasts the equivalent of half a pound of broccoli in every capsule. Study subjects were given either six capsules a day or 50 grams of broccoli sprouts. The supplement hardly worked at all, whereas the sprouts boosted blood levels about eight times higher for eight times less cost. The researchers concluded that “our data provides further evidence that bioavailability of [sulforaphane] is dramatically lower when subjects consume broccoli supplements compared to fresh broccoli sprouts.”21

  Too Much of a Good Thing?

  If broccoli sprouts are so cheap and effective, why not eat bowls of them? A formal safety analysis found no significant adverse effects to about 75 grams a day,22 but we didn’t have data on a potential upper limit until a team of Italian researchers tried to push the envelope. They were attempting to come up with an intravenous infusion dose to use as chemotherapy, and so they wanted to know how high they could go. The researchers discovered that blood levels achieved by more than 200 grams of broccoli sprouts may indeed be detrimental.23 They concluded, however, that no harm was found at “nutritionally attainable concentrations.” But that’s not really true. Broccoli sprouts do have a radishy bite, but someone could theoretically eat 200 grams of sprouts a day. (They don’t know health nuts like I know some health nuts.)

  Let me tell you a story. A few years ago, someone came up to me after a lecture in Miami and told me he had heard that wheat-grass juice was good for you. “It cleans you out,” he had read. So he thought, Why not? and decided to stuff himself with it. He told me how he calculated the volume of the human digestive tract (all ten yards or so) and proceeded to drink that amount continuously, liter after liter, until it started coming out the other end. Intrigued, I asked him what happened. He looked up at me with an expression that I can only describe as rapturous and said, “It was volcanic.”

  It would be hard for me to say too many good things about crucifers. These vegetables do wonders for your health, from fighting cancer progression and boosting defenses against pathogens and pollutants to helping protect your brain and vision and more. And you can use this family of veggies as your excuse to play Mad Scientist in the kitchen, manipulating enzyme chemistry to maximize the health benefits.

  Greens

  Dr. Greger’s Favorite Greens

  Rocket, beetroot greens, collard greens, kale (black, green, and red), mesclun mix (assorted young salad greens), mustard greens, sorrel, spinach, swiss chard, and turnip greens

  Serving Sizes:

  60 g raw

  90 g cooked

  Daily Recommendation:

  2 servings per day

  Popeye was right when he bragged that he was strong to the finish because he ate his spinach. Dark-green, leafy vegetables are the healthiest foods on the planet. As whole foods go, they offer the most nutrition per calorie. Just to emphasize the point, there was a study published in the journal Nutrition and Cancer entitled “Antioxidant, Antimutagenic, and Antitumor Effects of Pine Needles.”1 Edible leaves, in all their shapes and sizes, it seems, can be healthy foods.

  In 1777, General George Washington issued a general order that American troops should forage for wild greens growing around their camps “as these vegetables are very conducive to health, and tend to prevent . . . all putrid disorders.”2 Since then, however, Americans have declared their independence from greens. Today, only about one in twenty-five even reach a dozen servings throughout the course of an entire month.3 I advise getting more than a dozen servings per week.

  IMPORTANT CAVEAT: Greens and Warfarin

  In 1984, the tragic case of a thirty-five-year-old woman unfolded when she failed to inform
her physician about her change in diet. Because of her mechanical heart valve, the woman was on a blood-thinning drug called warfarin. But because she wanted to lose weight, she started eating a diet composed almost entirely of salad, broccoli, turnip greens, and mustard greens. Five weeks later, she suffered a blood clot and died.4

  If you are on the drug warfarin (also known as Coumadin), talk with your physician before you increase your greens intake. The drug works (both as a rat poison and a human blood-thinner) by crippling the enzyme that recycles vitamin K, which is involved in clotting your blood. If your system gets an influx of fresh vitamin K, which is concentrated in greens, you can thereby undermine the effectiveness of the drug. You should still be able to eat your greens, but your physician will have to titrate the dose of the drug to match your regular greens intake.

  Eating greens nearly every day may be one of the most powerful steps you can take to prolong your life.5 Of all the food groups analyzed by a team of Harvard University researchers, greens turned out to be associated with the strongest protection against major chronic diseases,6 including up to about a 20 percent reduction in risk for both heart attacks7 and strokes8 for every additional daily serving.

  Imagine if there were a pill that could prolong your life and only had good side effects. Everyone would be taking it! It would be making billions of dollars for the lucky drug company that created it. All health plans by law would have to cover it. People from every walk of life and every corner of the globe would be clamoring for it. But when that “pill” is just eat-your-greens, people lose interest.

  Drug companies have yet to patent broccoli (though Monsanto is trying!9). Doctors, however, don’t have to wait for perky pharmaceutical sales reps to wine, dine, and cajole them into prescribing Pfizer-brand spinach or GlaxoSmithKline-brand collards. Here’s my prescription for you:

  If the full spectrum of colorful plant pigments are good for you, why are greens the healthiest? When autumn in New England becomes aflame with brilliant hues, where do those oranges and yellows come from? They were there all along, actually—just masked by the green pigment chlorophyll that starts to break down in the autumn.10 Similarly, the dark-green leaves of vegetables contain many of the other plant pigments all wrapped up in one package. As I mentioned, these colorful compounds are often the very same antioxidants implicated in many of the benefits of fruit and vegetable consumption. So, in essence, when you eat your greens, you are eating the rainbow.

  How to Regenerate Coenzyme Q10 Naturally

  One of the reasons greens are some of the healthiest green-light foods may be due to their green color. Decades ago, a search began for “interceptor” molecules that could serve as the body’s first line of defense against cancer. The theory was that if we could find something that could tightly bind to carcinogens and prevent them from slipping into our DNA, we might be able to prevent some of the mutations that lead to cancer. After years of combing for the existence of such carcinogen-binding molecules, an interceptor was found: chlorophyll, the most ubiquitous plant pigment in the world. It was right under our noses all along (provided we were eating healthfully!).11

  In a petri dish, certain DNA damage in human cells exposed to a carcinogen could be “totally abolished” by chlorophyll.12 But what about in people? In the name of science, volunteers drank a solution of radioactive aflatoxin (a carcinogen) with or without spinach chlorophyll. 360 grams of spinach worth of chlorophyll appeared to block about 40 percent of the carcinogen.13 Amazing! But that’s not all chlorophyll can do.

  In college, you learn that pretty much everything you were taught in high school biology wasn’t true. Then in graduate school, you unlearn all the oversimplifications you learned in college. Just when you think you understand something in biology, it always seems a little more complicated than you thought. For example, until recently, we assumed plants and plantlike organisms were the only ones that could directly capture and utilize the energy from the sun. Plants photosynthesize. Animals don’t. That’s because plants have chlorophyll and animals do not. Well, technically, you do have chlorophyll in your body—temporarily, at least—after you eat greens. But it would seem there’s no way the chlorophyll that enters your bloodstream after that salad could react with sunlight. After all, light can’t penetrate through your skin, right?

  Wrong. Any kid who’s ever shined a torch through her or his fingers could have told you that.

  The red wavelengths of sunlight do penetrate into your body.14 In fact, if you step outside on a sunny day, there’s enough light reaching your brain that you could actually read this page inside your skull.15 Your internal organs are bathed in sunlight, along with any chlorophyll circulating in your bloodstream. Although any energy produced by the chlorophyll would be negligible,16 it turns out that light-activated chlorophyll in your body may help regenerate a critical molecule called coenzyme Q10.17

  CoQ10, also known as ubiquinol, is an antioxidant. When ubiquinol extinguishes a free radical, it is oxidized to ubiquinone. To act as an effective antioxidant again, the body must regenerate ubiquinol from ubiquinone. Think of it like an electrical fuse: Ubiquinol can only be used once before having to be reset. That’s where sunlight and chlorophyll may come in.

  Researchers exposed some ubiquinone and dietary chlorophyll metabolites to the kind of light that reaches your bloodstream . . . and poof! CoQ10 was reborn. However, without the chlorophyll, or without the light, nothing happened. All along, we’ve been thinking that the main benefit of sunlight was only the formation of vitamin D and that the main benefit of greens was the antioxidants they contain. But now we suspect the combination of the two may actually help the body create and maintain its own internal stock of antioxidants.

  Eating a plant-based, chlorophyll-rich diet may be especially important for those on cholesterol-lowering statin drugs, as these medications can interfere with CoQ10 production.

  Green Can Taste Great

  I hope I’ve been able to convince you to eat greens as often as possible. The problem for many people is getting them to taste good. I’m afraid too many of us still suffer flashbacks from overcooked, slimy green lumps on school cafeteria trays.

  Take kale, for example. Fibrous and grassy tasting, right? Kind of bitter too? Some varieties are more palatable than others. In a good supermarket produce section, you may be able to find three types: green, black, and red. Nutritionally, the differences among them appear to be insignificant compared to how much of each you may be willing to eat.18,19 The healthiest kale is the one you’ll eat the most of.

  I would suggest using black kale (also called lacinato, dinosaur, or Tuscan kale), red kale (also found as red Russian kale), or baby kale, since these varieties are all milder and more tender than the more common mature green (curly) kale.

  Start by rinsing the leaves thoroughly under running water. Then rip off the stems and tear the leaves into bite-sized pieces. Alternatively, after the leaves are removed from their stems, roll them up and slice into thin ribbons. If you want to make it even easier on yourself, just use whatever type you can find frozen. Frozen greens are cheaper, last longer, and come prewashed and prechopped.

  There’s a phenomenon called flavor-flavor conditioning in which you can change your palate by linking a less pleasant flavor (for instance, sour or bitter) with a more pleasant one (say, sweet). For example, when researchers tried adding sugar to sour grapefruit juice, people liked it better. No surprise. But within a few days, the study subjects began to like even unsweetened grapefruit juice more than they did before the experiment started. In fact, this reconditioning of the palate lasted for at least weeks after the sugar was removed.20

  The same happens when researchers dip or spritz broccoli with sugar water or aspartame.21 I know that sounds gross, but they’re not actually making the broccoli taste sweet. The added sweetness merely masks the bitterness by fooling your taste buds.22 This is why the so-called secret ingredient in many collard greens recipes is a spoonful of sugar. Certainly
, if there were ever a food to justify the use of a yellow- or red-light condiment to boost consumption, it would be the single healthiest of all foods: greens. I use a balsamic glaze even though it has some added sugar in it. It would be healthier, though, to add green-light sweetness in the form of something like figs or grated apples.

  The sweetness trick is why green smoothies can be so delicious (if not a little odd looking). Smoothies can be a great way to introduce greens into children’s diets. The basic triad is a liquid, ripe fruit, and fresh greens. I’d start with a two-to-one ratio of fruits to greens to start with before tipping heavier toward greens on the scale. So, for example, 250 ml of water, a frozen banana, 120 grams of frozen berries, and 60 grams of packed baby spinach would be a classic green smoothie 101.

  I like to add fresh mint leaves as well for a boost of flavor (and even more greens). Fresh herbs can be expensive at the store, but mint can grow like a weed in your garden or in a pot on your windowsill. Eating greens for breakfast can be as delicious as mint chocolate oatmeal—cooked oatmeal, chopped mint leaves, cocoa powder, and a healthy sweetener (see here).

  When you’re thinking about ways to pair your greens with something you already love to make the greens more palatable, consider mixing them with a green-light source of fat: nuts, seeds, nut or seed butters, or avocados. Many of the nutrients greens are famous for are fat soluble, including beta-carotene, lutein, vitamin K, and zeaxanthin. So pairing your greens with a green-light source of fat may not only make them taste better but will maximize nutrient absorption. This can mean enjoying a creamy tahini-based dressing on your salad, putting walnuts in your pesto, or sprinkling some toasted sesame seeds on your sautéed kale.