How Not to Die

  Daily Recommendation:

  ¼ teaspoon of turmeric, along with any other (salt-free) herbs and spices you enjoy

  Here’s a simple tip: Use your senses to pick out healthy foods. There is a good biological reason you should be so attracted to the vibrant colors found in the produce aisle: In many cases, the colors are the antioxidants. You can figure out which of two tomatoes has more antioxidants just by looking at which has a deeper red color. Of course, the food industry tries to hijack this natural instinct for colorful foods with abominations like Froot Loops, but if you stick to green-light foods, you can let color guide you. The same is true, we’re now realizing, with flavor.

  Just as many of the plant pigments are beneficial, scientists are discovering that many of the flavor compounds in herbs and spices are powerful antioxidants as well.1 Guess where the antioxidant rosmarinic acid is found? What about cuminal, thymol, and gingerols? The flavors are the antioxidants. You can use this knowledge to help you make decisions at the supermarket. You can see that red onions have more antioxidants than white, and you can taste that regular onions have more antioxidants than mellower, milder Vidalia-type onions.2

  The bitter and pungent compounds in the cruciferous and allium families are thought to be responsible for their health benefits. Intense colors and intense flavors can be signs of intense benefit. For optimum health, you should try to eat both colorful and flavorful foods. Indeed, the dietary guidelines for a number of countries now specifically encourage the consumption of herbs and spices, not only as a substitute for salt but for the healthy properties they have in their own right.3 And on the top of my list of healthful herbs and spices is turmeric—a spice that is both colorful and flavorful.

  Why You Should Include Turmeric in Your Daily Diet

  In recent years, more than five thousand articles have been published in the medical literature about curcumin, the pigment in turmeric that gives it that bright yellow color. Many of these papers sport impressive-looking diagrams suggesting that curcumin can benefit a multitude of conditions with a dizzying array of mechanisms.4 Curcumin was first isolated more than a century ago, yet out of the thousands of experiments, only a few in the twentieth century were clinical studies involving actual human participants. But since the turn of the century, more than fifty clinical trials have tested curcumin against a variety of diseases, and dozens more studies are on the way.5

  We have seen how curcumin may play a role in preventing or treating lung disease, brain disease, and a variety of cancers, including multiple myeloma, colon cancer, and pancreatic cancer. But curcumin has also been shown to help speed recovery after surgery6 and effectively treat rheumatoid arthritis better than the leading drug of choice.7 It also may be effective in treating osteoarthritis8 and other inflammatory conditions, such as lupus9 and inflammatory bowel disease.10 In the latest trial for ulcerative colitis, a multicenter, randomized, placebo-controlled, double-blind study found that more than 50 percent of patients achieved remission within just one month on curcumin compared to none of the patients who received the placebo.11 If you are as convinced as I am that you should include turmeric in your diet to benefit from its pigment curcumin, the next questions, then, are: how much do you eat, how do you eat it, and what are the risks?

  Quarter of a Teaspoon of Turmeric Every Day

  Turmeric is potent stuff. If I took a sample of your blood and exposed it to an oxidizing chemical, researchers could quantify the damage it caused to the DNA in your blood cells with sophisticated technology that allows them to count the number of breaks in DNA strands. If I then gave you a single pinch of turmeric to eat once a day for a week, redrew your blood, and again exposed your blood cells to the same free radicals, you would see that with the tiny bit of turmeric on board, the number of cells with DNA damage could be cut in half.12 That’s not mixing turmeric with cells in a petri dish—that’s having you ingest the spice and then measuring the effects in your blood. And this was not some fancy curcumin supplement, not some turmeric extract. It was just the plain spice you can buy at any supermarket. And, the dose was tiny, about one-eighth of a teaspoon.

  Now that’s powerful!

  The doses of turmeric that have been used in human studies range from less than one-sixteenth of a teaspoon up to nearly two tablespoons a day.13 Few adverse effects have been reported even at high doses, but the studies typically have lasted only a month or so. We don’t know what long-term effects of high doses there may be. Because turmeric can have such powerful drug-like effects, until we have better safety data, I would not advise anyone to take more than the culinary doses that have a long-standing record of apparent safety. How much is that? Though traditional Indian diets can include up to about a teaspoon of turmeric daily, the average intake in India is closer to a quarter teaspoon a day.14 So that’s how much I recommend you get as part of your Daily Dozen.

  How to Eat Turmeric

  Primitive peoples often used spices in sophisticated ways. For instance, quinine from cinchona bark was used to treat the symptoms of malaria long before the disease was even identified, and the raw ingredients of aspirin have been used as a popular painkiller long before Mr. Friedrich Bayer came along.15 Over the last twenty-five years, about half of new drug discoveries have come from natural products.16

  There’s a plant in South Asia called adhatoda (adu, meaning “goat,” and thoda, meaning “not touch”—it’s so bitter even the goats won’t eat it). Its leaves are steeped with pepper to make a folk remedy effective for treating asthma. Somehow it was figured out what scientists didn’t discover until 1928: Adding pepper vastly boosted the plant’s antiasthmatic properties. And now we know why. About 5 percent of black pepper by weight is composed of a compound called piperine, which accounts for pepper’s pungent flavor and aroma. But piperine is also a potent inhibitor of drug metabolism.17 One of the ways your liver gets rid of foreign substances is by making them water soluble so you can pee them out. This black pepper molecule, however, inhibits that process, thereby boosting blood levels of the medicinal compounds in adhatoda—and it can do the same for curcumin in turmeric root.

  Within an hour of eating turmeric, curcumin appears in your bloodstream, but only in small traces. Why only scant amounts? Presumably, your liver is actively working to get rid of it. But what if you suppress that elimination process by eating some black pepper? If you consume the same amount of curcumin but add a quarter teaspoon of black pepper, the level of curcumin in your blood shoots up by 2,000 percent.18 Even just the littlest pinch of pepper, just one-twentieth of a teaspoon, can significantly boost curcumin blood levels.19 And guess what is a common ingredient in many curry powders besides turmeric? Black pepper. Curry powder in India is also often served with a source of fat, which alone can enhance the bioavailability of curcumin seven- to eightfold.20 (Unfortunately, traditional knowledge appeared to fail here as to the best source of that fat. Indian cuisine employs a great deal of clarified butter, or ghee, which may explain the country’s relatively high rates of heart disease despite its otherwise relatively healthy diet.21)

  My favorite way to incorporate turmeric is to use fresh turmeric root. Any large Asian market should carry it in the produce aisle. It looks like skinny fingers of gingerroot, but when you snap it open, you are greeted by the most unreal, Day-Glo, fluorescent-orange color. My quarter of a teaspoon of dried turmeric recommendation translates into about a quarter of an inch of fresh turmeric root. The roots are about two inches long, cost about seven pence each, and can last for weeks in the fridge or basically forever in the freezer. Every year you can go to the shop and buy a twelve-month supply of fresh turmeric for about three pounds.

  There’s evidence to suggest that the cooked and raw forms may have different properties. Cooked turmeric appears to offer better DNA protection, while raw turmeric may have greater anti-inflammatory effects.22 I enjoy it both ways. I use a grater to add my daily quarter inch into whatever I may be cooking (or right onto a cooked sweet potato), or I
throw a raw slice into a smoothie. You probably won’t even taste it. Fresh turmeric has a much more subtle flavor than dried, so it may be an especially good option for those who don’t like turmeric’s taste. You will see it, though. Be careful—it can stain clothing and surfaces. Turmeric may not just make your health golden but your fingertips, as well.

  Consuming turmeric with soya may offer a double benefit for osteoarthritis sufferers.23 Scrambled tofu is the classic turmeric-soya combination, but let me share two of my favorites: one raw and one cooked. You can whip up a pumpkin pie smoothie in less than three minutes. Simply blend a tin of pumpkin purée, a handful of frozen cranberries and pitted dates, pumpkin pie spice to taste, a quarter of an inch turmeric slice (or quarter-teaspoon of powder), and unsweetened soya milk to reach your preferred consistency.

  Another favorite is my pumpkin custard (aka crustless pie). All you need to do is blend one tin of pumpkin purée with about ten ounces of silken tofu (the Mori-Nu brand is convenient because it stays fresh without refrigeration), as much pumpkin pie spice as you like, and one to two dozen pitted dates (depending on how much of a sweet tooth you have). Pour into a dish and bake at 175°C until cracks appear on the surface. By skipping the piecrust and sticking with a custard, you’re left with vegetables, tofu, spices, and fruit. The more you eat, the healthier you are.

  Fresh or powdered, turmeric is a natural flavor fit for Indian and Moroccan cuisines, but I add it to almost anything. I find it pairs particularly well with brown rice dishes, lentil soup, and roasted cauliflower. Prepared yellow mustard typically already has turmeric in it for color, but try to find a salt-free variety—one that’s essentially just vinegar, a cruciferous vegetable (mustard seeds), and turmeric. I can’t think of a healthier condiment.

  What About Turmeric Supplements?

  Wouldn’t it be more convenient to just take a curcumin supplement every day? Added expense aside, I see three potential downsides. First, curcumin is not equivalent to turmeric. Supplement manufacturers often fall into the same reductionist trap as the drug companies do. Herbs are assumed to have only one main active ingredient, so the thinking goes that if you can isolate and purify it into a pill, you should be able to boost the effects. Well, curcumin is described as the active ingredient in turmeric,24 but is it the active ingredient or just an active ingredient? In fact, it’s just one of many different components of the whole-food spice.25

  Few studies have compared turmeric with curcumin, but some that have suggest that turmeric may work even better. For example, researchers at the MD Anderson Cancer Center in Texas pitted both turmeric and curcumin against seven different types of human cancer cells in vitro. Against breast cancer, for instance, curcumin kicked butt, but turmeric kicked even more butt. The same was true against pancreatic cancer, colon cancer, multiple myeloma, myelogenous leukemia, and others—turmeric came out on top, above just its yellow pigment curcumin. These findings suggest that components other than curcumin can also contribute to anticancer activities.26

  Although curcumin is believed to account for most of turmeric’s health-promoting activities, research published over the past decade has indicated that curcumin-free turmeric—turmeric with the so-called active ingredient removed—may be as effective as or even more effective than turmeric with curcumin. There are turmerones, for example, in turmeric (but processed out of curcumin supplements) that may exhibit both anticancer and anti-inflammatory activities. I naïvely assumed that the researchers who discovered this would advocate that people consume turmeric rather than take curcumin supplements, but instead, they suggested the production of all sorts of different turmeric-derived supplements.27 After all, who can make any money on a whole food that costs pennies a day?

  My second concern involves dosing. While the turmeric trials have used modest amounts that could conceivably be achieved through diet, curcumin-only trials have tested the amount of curcumin found in 150 grams of turmeric spice—one hundred times more than what curry lovers have been eating for centuries.28 Some supplements add black pepper as well, potentially boosting levels to the equivalent of over 4 kilograms a day of turmeric, which might result in enough curcumin in the blood to potentially cause DNA damage based on in vitro data.29

  Finally, there is a concern about contamination with toxic metals, such as arsenic, cadmium, and lead. None of the tested samples of powdered turmeric on the U.S. market has been found to be contaminated with heavy metals, but the same cannot be said of curcumin supplements.30

  None of these concerns (except cost) applies to supplements containing only whole ground turmeric powder. Nearly all turmeric supplements are extracts, however. How else could they get away with selling a small bottle of pills for £13 when the bulk spice may be less than £13 a pound? A bottle might last two or three months. For the same price, bulk turmeric could offer two or three years’ worth at Daily Dozen dosing.

  One compromise between convenience and cost may be to make your own turmeric capsules. There are capsule-stuffing gadgets that allow you to fill your own. Given the cost discrepancy between bulk turmeric and supplements, such a gadget would probably pay for itself after your first batch. A “00”-sized capsule would fit a day’s quarter-teaspoon dose. Making your own capsules might be a little time consuming, but if you won’t otherwise consume turmeric in your daily diet, it might be time well spent. If there were ever such thing as a magic pill, single-ingredient, ground turmeric root would probably come closest.

  Who Should Not Take Turmeric

  If you suffer from gallstones, turmeric may trigger pain. Turmeric is a cholecystokinetic agent, meaning it facilitates the pumping action of the gallbladder to keep bile from stagnating.31 Ultrasound studies show that quarter of a teaspoon of turmeric causes the gallbladder to contract, squeezing out half of its contents.32 In this way, it may help prevent gallstones from forming in the first place. But what if you already have a stone obstructing your bile duct? That turmeric-induced squeeze could be painful.33 For everyone else, though, the effect of turmeric would be expected to reduce the risk of gallstone formation and ultimately even reduce the risk of gallbladder cancer.34

  Too much turmeric, however, may increase the risk of certain kidney stones. Turmeric is high in soluble oxalates, which can bind to calcium and develop into the most common form of kidney stone—insoluble calcium oxalate, which is responsible for about 75 percent of all cases. Those who have a tendency to form those stones should probably restrict consumption of total dietary oxalate to no more than 50 mg per day. This would mean no more than a teaspoon of turmeric daily at most.35 (Turmeric, by the way, is considered safe during pregnancy, but curcumin supplements may not be.36)

  My recommended daily quarter of a teaspoon of turmeric is in addition to whatever other (salt-free) herbs and spices you enjoy. The reason the Daily Dozen encourages herb and spice consumption in general and not just turmeric is not because they’re all interchangeable—turmeric appears to have unique benefits—but because there’s evidence other herbs and spices have health benefits as well. I’ve talked about the role of saffron, for example, in the treatment of Alzheimer’s (chapter 3) and depression (chapter 12). Spices don’t just make food taste better; they make food better for you. I encourage you to keep a well-stocked spice cabinet and make it a habit to add whatever herbs and spices you find appealing to any dish you might be eating.

  What follows here is a more in-depth examination of some of the herbs and spices for which we have the most scientific data. I will describe some of the fascinating studies that illustrate the benefits of these flavor boosters and explain some of the easiest ways to add them to your meals.

  Fenugreek

  Powdered fenugreek seed is a spice found commonly in Indian and Middle Eastern cuisines. Fenugreek appears to significantly improve muscle strength and weight-lifting power output, allowing men in training, for example, to leg press an extra eighty pounds compared to those ingesting a placebo.37 Fenugreek may also possess “potent anticancer propert
ies” in vitro.38 I don’t like the taste of the powder, so I just throw in fenugreek seeds with my broccoli seeds when I’m sprouting.

  There is a side effect of fenugreek seed consumption, however: It can make your armpits smell like maple syrup.39 I kid you not. It’s a harmless phenomenon, but what isn’t harmless, however, is maple syrup urine disease, a serious congenital disorder. Breast-feeding infants with mothers who use fenugreek to boost their milk production may be misdiagnosed with this completely unrelated disorder.40 If you’re pregnant or breast-feeding and eating fenugreek, make sure to tell your obstetrician just so she or he doesn’t think your baby has maple syrup urine disease.

  Coriander

  One sign of changing U.S. demographics is that salsa has replaced ketchup as America’s top table condiment.41 One popular salsa ingredient is coriander, one of the most polarizing and divisive food ingredients known to humankind. Some people absolutely love it, and some people absolutely hate it. What’s interesting is that the lovers and the haters appear to experience the taste differently. Individuals who like coriander may describe it as fresh, fragrant, or citrusy, whereas people who dislike the herb report that it tastes like soap, mold, dirt, or insects.42 I’m not sure how people know what insects taste like, but rarely are polarizing opinions about flavors so extreme.

  Different ethnic groups do seem to have different rates of coriander dislike, with Ashkenazi Jews scoring among the highest on the coriander hate-o-meter.43 Another clue came from twin studies that show that identical twins tend to share coriander preferences, whereas fraternal twins do not have such a strong correlation.44 The human genetic code contains about three billion letters, so we’d have to analyze the DNA of roughly ten thousand people to find a coriander gene. Obviously, genetic researchers have better things to do than undertake that challenge . . . right?