Based on a six-week study of college students, the complexion achieved by eating my Daily Dozen recommendation of nine servings of fruits and vegetables a day was found to be significantly healthier and more attractive looking than that achieved by eating three daily servings.21 The healthier you eat, the healthier you look. Indeed, studies find that “individuals with the lowest fruit and vegetable intake may enjoy the most improvement in appearance.”22
What about wrinkles? A study out of Japan used the six-point Daniell scale to rate the extent of crow’s-feet wrinkles around the eyes of more than seven hundred women, with a score of one being the least severe and a score of six being the most severe. The researchers found that “a higher intake of green and yellow vegetables was associated with decreased facial wrinkling.” Women who ate less than one daily serving of green and yellow veggies averaged about a three on the Daniell scale, while women who ate more than two servings a day averaged closer to a two. The researchers celebrated “the potential for these studies to promote a healthy diet . . .”23
I am certainly not above appealing to vanity, especially for my younger patients who have seemed more interested in which dietary changes will clear their acne than which will clear their future risk of chronic disease. So I’m happy to see articles embrace these types of studies with headlines like “Greens to Be Gorgeous.”24 Still, although looking great on the outside is fine, looking great on the inside is even better.
Mushrooming Benefits
Ergothioneine is an unusual amino acid. Although it was discovered more than a century ago, it was ignored until recently when researchers found that humans have a transporter protein in their bodies specifically designed to pull ergothioneine out of food and into body tissue. This suggests that this amino acid plays some important physiological role. But what? Our first clue was the tissue distribution. Ergothioneine concentrates in parts of your body where there is a lot of oxidative stress—your liver and the lenses of your eyes, for example, as well as such sensitive tissues as bone marrow and semen. Researchers guessed, then, that it might act as a so-called cytoprotectant, a cell protector, and that’s indeed what was subsequently found.25
Ergothioneine appears to function as a potent intramitochondrial antioxidant, meaning it can get inside the mitochondria—the microscopic power plants within your cells. The DNA inside the mitochondria is especially vulnerable to free-radical damage, since many other antioxidants are unable to penetrate the mitochondrial membrane. This is one reason ergothioneine may be so important. Depriving human cells of this amino acid leads to accelerated DNA damage and cell death. Unfortunately, the human body cannot make ergothioneine; you can only get it through food. “Because of its dietary origin and the toxicity associated with its depletion,” Johns Hopkins University researchers concluded, “ET [ergothioneine] may represent a new vitamin . . .”26 If it were classified as such, that would make it the first new vitamin since vitamin B12 was isolated back in 1948.27
What are the best dietary sources of ergothioneine? The highest levels by far have been reported in mushrooms. For example, oyster mushrooms, which you can grow yourself in only two weeks from a just-add-water kit, have more than one thousand units (μg/dag) of ergothioneine, about nine times more than their closest competitor, black beans. And a serving of black beans has about eight times more than a serving of the third-leading source, chicken liver. Chicken meat, along with beef and pork, only has about ten units, one hundred times less than oyster mushrooms. Kidney beans have about four times more than meat, but even at forty-five units, they pale in comparison to some of the mushrooms.28
Ergothioneine is heat stable, which means it’s not destroyed when mushrooms are cooked.29 This is good news, because it’s best not to eat mushrooms raw; there’s a toxin in edible mushrooms called agaritine to which you should minimize your exposure. Thankfully, the toxin is destroyed by cooking. Just thirty seconds in the microwave wipes out most agaritine in mushrooms. Freezing also gets rid of most of it, but drying does not. If you put dried mushrooms in your soup, it’s best to boil them for at least five minutes.30 Morel mushrooms are a special case. The toxin levels appear higher and may react with alcohol even after cooking.31 I consider all other cooked edible mushrooms to be green-light foods and all other edible raw mushrooms yellow-light foods. However, raw morel mushrooms, cooked morels served with alcohol, and all wild-foraged mushrooms should be on the red-light list in my opinion.
Do you have to eat mushrooms to be healthy? No. (Otherwise, it would be the Daily Baker’s Dozen.) Famously in our family, my mum has never eaten a mushroom in her life and never will, because they “look funny.” But given the potential immune and anticancer benefits documented in chapters 5 and 11, I would encourage you to try to find ways to incorporate them into your diet.
My favorite way to enjoy mushrooms is to grill portobellos. I picked up a George Foreman Grill from my local thrift store, and my family has officially renamed it the Portobello Mushroom Grill. I know people tend to marinate portobellos first, but I just drizzle them with balsamic vinegar, grill until the juice starts dripping, and then add cracked pepper. They’re so good we eat them just like that.
Pop quiz: Which is healthier? Plain white mushrooms or portobellos? Trick question! They’re the same mushroom. The little white button mushrooms grow up to be portobellos. White mushrooms are just baby ’bellos.
Mushrooms can be stuffed, enjoyed in soups like mushroom barley, act as the star of a creamy risotto or pâté, serve as the base of a great gravy or as a flavorful addition to any pasta sauce, or simply be braised with crushed garlic in red wine.
Even More Vegetables!
My favorite way to eat raw veggies is to dip pepper strips, carrots, or snap peas in a hummus or bean dip, and my favorite way to eat them cooked is by roasting them. Roasting can transform vegetables into otherworldly creations. If you don’t believe me, try roasting red peppers, brussels sprouts, beetroot, or squash. Never thought you liked okra because it’s too slimy? Try it roasted.
One of my favorite springtime dishes is roasted asparagus dipped in guacamole. (Here’s an interesting asparagus fact: Did you know there are four types of people in the world? Those whose pee turns stinky after eating asparagus, and those whose doesn’t, and those who are apparently genetically incapable of smelling the asparagus pee odor, and, finally, those who can. So some people may not think they get stinky pee from asparagus, but they actually do and just can’t smell it!32)
Sweet potatoes are one of my favorite snacks. During harsh Boston winters while I was in medical school, I would take two freshly microwaved sweet potatoes and pop them in my coat pockets as natural hand warmers. When they cooled down, my hand warmers became instant healthy snacks! It’s actually better to boil them, though, to best preserve their nutritional content.33 Regardless of your cooking method, be sure to keep on the skin. The peel of the sweet potato has nearly ten times the antioxidant power as the inner flesh (on a per-weight basis), giving them an antioxidant capacity approaching that of blueberries.34
Sweet potatoes themselves can be considered a superfood.35 They are ranked as one of the healthiest foods on the planet36 and one day, perhaps, even off the planet—NASA has chosen them for future space missions.37 In fact, they’re among the healthiest and cheapest, with one of the highest nutrient-rich food scores per pound.38 When picking out varieties at the supermarket, remember that a sweet potato’s nutritional content is tied directly to the intensity of its color. The more yellow or orange its flesh, the healthier it may be.39
Sweet potatoes are healthier than plain potatoes, but if you’re going to choose the latter, seek out those with blue or purple flesh. The consumption of one boiled purple potato a day for six weeks was found to significantly decrease inflammation, something neither white nor yellow potatoes were able to accomplish.40 The same was found for oxidation, but much faster. Within hours of consumption, purple potatoes increased the antioxidant capacity of study subjects’ bloodstream, wh
ereas white potato starch appeared to actually have a pro-oxidant effect.41 Blue potatoes may have ten times more antioxidant power than regular white ones.42 The most exciting purple potato study to date had people with hypertension eat six to eight microwaved small purple potatoes a day, and they were able to significantly bring down their blood pressure levels within a month.43
Purple sweet potatoes may offer the best of both worlds.44 I was so excited to discover them that I bought them as Christmas gifts for my family one year—stocking stuffers they could stuff themselves with!
Getting Kids (and Parents) to Eat Their Veggies
Published strategies for getting kids (of all ages) to eat their vegetables include cutting them into slices, sticks, or stars—the most popular shape.45 Supposedly, putting an Elmo sticker on veggies swayed 50 percent of children to choose broccoli over a chocolate bar.46 If they’re still not biting, though, you can apply the same trick I use to get our dog to take her pills: Dip the veggies in peanut butter. A study found that pairing vegetables with peanut butter successfully increases intake “even in vegetable-resistant children.”47 Offering a salad dressing dip has also been found to help.48
Simply having healthy foods out and available can boost intake. Guess what happened when researchers put out bowls of cut-up fresh fruit in addition to the regular party fare brought by parents for kindergarten or preschool celebrations? No special effort was made to encourage students to choose the fruit—the researchers just put it out on the table with all the other food. Would kids actually eat fruit when such foods as birthday cake, ice cream, and cheese puffs were available? Yes! On average, each kid ate a full fruit serving.49 Take that, cheese puffs!
Even just calling vegetables by different names can help. Elementary schools were able to double vegetable consumption simply by coming up with names that better appealed to the kids. Students ate twice the number of carrots if they were called “X-Ray Vision Carrots,” compared to when they were just carrots or generically called the “Food of the Day.”50 Are adults as gullible? Apparently so. For example, grown-ups reported “Traditional Cajun Red Beans and Rice” tasted better than just “Red Beans with Rice” . . . even though they were the exact same dish.51
When school cafeterias put out signs like Power Punch Broccoli and Silly Dilly Green Beans, or called broccoli Tiny Tasty Tree Tops, selection of broccoli increased by about 110 percent, and selection of green beans jumped by nearly 180 percent.52 The researchers concluded that “these studies demonstrate that using an attractive name to describe a healthy food in a cafeteria is robustly effective, persistent, and scalable with little or no money or experience. These names were not carefully crafted, discussed in focus groups, and then pretested.” They were just invented out of thin air. And kids were fooled into eating healthier for weeks simply by adults’ putting out silly little signs. Indeed, in the school displaying these playful new names in the cafeteria queue, vegetable purchasing went up nearly 100 percent, while in the control school without signs, vegetable purchases started low and actually got worse.53 So why isn’t every single school in the country doing this right now? Bring it up at your next PTA meeting.
Let’s not forget the hide-the-veggies strategy. Studies have shown that broccoli, cauliflower, tomatoes, squash, and courgette can be added covertly to familiar dishes such that the appearance, flavor, and texture of the original recipes are maintained (like puréeing vegetables into a pasta sauce).54 Studies found the trick works for adults too. Researchers were able to slip in up to a pound of clandestine vegetables a day (resulting in 350 fewer calories eaten).55 Surreptitiously incorporating vegetables into foods shouldn’t be the only way that vegetables are served to children, though. Since the appetite for an initially unappetizing vegetable can be increased through repeated exposure, it is important to use several strategies to ensure that kids experience whole vegetables. After all, they’re not always going to be eating at home. One of the most important predictors of children’s fruit and vegetable consumption has been found to be parents’ consumption,56 so if you want your kids to eat healthfully, it helps to be a healthy role model.
The Top Cancer-Fighting Vegetables
According to a landmark American Institute for Cancer Research report, any effect of plant-based diets is “likely to be due not only to the exclusion of meat, but also to the inclusion of a larger number and of wider range of plant foods, containing an extensive variety of potential cancer-preventive substances.”57 In other words, it may not be enough to cut down on meat; you need to eat as many whole, healthy plant foods as possible. Meatless Mondays are great, but even more so when followed by Tomato Tuesdays, Watercress Wednesdays, and so on.
Different vegetables may target different cancers—sometimes even in the same organ. For example, cabbage, cauliflower, broccoli, and brussels sprouts are associated with lower risk of colon cancer in the middle and right side of your body, whereas risk of colon cancer farther down on the left side appears to be lowered more by carrots, pumpkins, and apples.58
An extraordinary study published in the journal Food Chemistry pitted thirty-four common vegetables in vitro against eight different types of human cancer cells: breast cancer, brain tumors, kidney cancer, lung cancer, childhood brain tumors, pancreatic cancer, prostate cancer, and stomach cancer. Take breast cancer, for example. Seven vegetables (aubergine, bok choy, carrot, tomato, endive, fennel bulb, and romaine lettuce) appeared useless, suppressing breast cancer cell growth no more than the control. Six vegetables (orange pepper, english cucumber, radicchio, jalapeño, potato, and beetroot) nearly halved cancer growth, but five veggies (cauliflower, brussels sprouts, green onion, leek, and garlic) “abolished” cancer growth completely, stopping breast tumor cells dead in their tracks.59
There were two take-home messages to come out of this remarkable study. The first is that you should eat a portfolio of vegetables. Radishes, for example, are completely unable to stop pancreatic cancer cell growth. However, radishes were 100 percent effective at halting the growth of stomach cancer cells. Orange peppers were useless against stomach cancer, but they were able to suppress prostate cancer cell growth by more than 75 percent. In the words of the researchers, “a diversified diet, containing several distinct classes of vegetables (and hence of phytochemicals) is essential for effective prevention of cancer.”60
How to Make a Cancer-Fighting Salad
Imagine you’re standing in the queue at one of those made-to-order salad places where you get to choose your lettuce, your toppings, and your dressing. You start with the greens. For the sake of this example, let’s say you are offered a choice between the five covered in the Food Chemistry study: Boston lettuce, endive, radicchio, romaine lettuce, and spinach. Which should you choose? Based on the study findings: spinach. Out of the five options, spinach beat out the others against breast cancer, brain tumors, kidney cancer, lung cancer, pediatric brain tumors, pancreatic cancer, prostate cancer, and stomach cancer. The runner up? Radicchio.61
Which toppings should you add to your spinach salad? You only get five to choose from and, after consulting the Daily Dozen cheat sheet in your wallet, you can tick three check boxes immediately: beans, berries, and nuts. Now you only have two toppings left. Out of the thirty-two remaining vegetables included in the study, which two of the following should you pick? Choose carefully:
Aubergine
Acorn squash
Asparagus
Beetroot
Bok choy
Boston lettuce
Broccoli
Brussels sprouts
Cabbage
Carrot
Cauliflower
Celery
Curly cabbage
Endive
English cucumber
Fennel bulb
Fiddleheads
Garlic
Green beans
Green onions
Jalapeño
Kale
Leek
Orange pepper
Po
tato
Radicchio
Radish
Red cabbage
Romaine lettuce
Swede
Tomato
Yellow onion
Which two did you choose? If one of your choices was brussels sprouts, cabbage, curly cabbage, or kale, and the other choice was garlic, green onions, or leek, you get a gold star! Of all the vegetables tested, those had the most cancer-preventing potential. Notice anything they have in common? All the top choices belong to one of only two superfood families: cruciferous vegetables and the allium veggie family, which includes garlic and onions. As the researchers put it, “the inclusion of cruciferous and Allium vegetables in the diet is essential for effective dietary-based chemopreventive [cancer-preventing] strategies.”62
Note that the most common vegetables didn’t make the cut. “The majority of the vegetable extracts tested in this study, including vegetables that are commonly consumed in Western countries such as potato, carrot, lettuce and tomato,” the researchers concluded, “had little effect on the proliferation of the tumour cell lines.”63
The single most effective vegetable was garlic, which came in first against breast cancer, both child and adult brain cancer, lung cancer, pancreatic cancer, prostate cancer, and stomach cancer, and second after leeks against kidney cancer. So might I suggest a garlicky salad dressing like the one here?
Garlic and Onions
As the above salad example illustrates, garlic, onions, leeks, and other vegetables in the allium family appear to have special properties. Wait a second, though. Like chemotherapy, maybe garlic isn’t just toxic to cancer cells but toxic to all cells? That wouldn’t be good. Researchers also wondered about this, so they decided to compare the effects of garlic and other vegetables on the growth of both cancer cells and normal cells. The same garlic dose that blocked nearly 80 percent of cancer cell proliferation appeared to have no effect whatsoever against normal cells, and similar results were found for the other allium and cruciferous vegetables. In other words, vegetables are selective; they destroy cancer cells but leave normal cells alone.
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