How to Outsmart the Grocery Store 

It’s happened to all of us. You ended up in the grocery store, hungry, tired and unprepared and suddenly you have a cart filled with frozen pizzas and potato chips. You end up staring at shelves upon shelves of Kraft Mac & Cheese, intriguing cereal boxes, microwave dinners and twelve different types of fruity, sugary yogurts. You definitely don’t need any of these items but you somehow end up with a cart full of them and you leave the store guilty of falling prey to the hidden psychology tricks of grocery stores. Have you ever noticed how essential foods like milk and eggs are spaced farthest from the entrance and to get back there you have to walk by all those packaged foods you didn’t even think you wanted? Or what about all the candy and sodas that are so conveniently placed by the checkout to tempt you while you stand in line waiting for your turn at the register?  Or take a look at how large grocery carts are lately, do you really need to fill that much space or could you opt for a smaller shopping basket? Grocery stores are smarter than we think…but we can beat them at their own game and here’s how! 

Make A List

Do not enter the grocery store without a list, whether it’s on your phone or written down on an old receipt you found in your car. Make sure to plan ahead, list out the items you truly need and do not allow yourself to deviate from this list once in the store. It may take an extra five minutes to do before you head in but it will save your wallet will be thankful for taking that time after you’re done the shopping!Also, don’t even think of walking down an aisle that doesn’t have one of the items you need.Not only will this save you from purchasing that junk food you don’t need, it will also save you time AND money. You could even turn this challenge into a game by timing yourself each time you go into the store. How quick can you get in and out? Get your friends in on the challenge and see who can make the best time!

Never Go To The Store Hungry 

This is a rule everyone should live by. Your eyes are always bigger than your stomach and going to a grocery store with an appetite can land you in the frozen dinner section, or even worse, the bakery section picking out a donut to eat as you stroll through the rest of the store. Have a healthy snack before you go like an apple or a hard boiled egg. This will provide you with the energy you need to tackle the produce aisle and stock up with all your fruits and vegetables for the week! If you end up at the grocery store without a snack, just grab an apple or a banana from the fruit section (but don’t forget to pay for it on your way out!!).

Avoid Grocery Stores Completely

That’s right! Abandon the grocery store completely! Buy meat from a butcher and get your fruits and vegetables from your local farmers market. Or if you have a busy schedule, grocery shop online. There are countless platforms like Vons and Amazon that will deliver groceries right to your door. After having a snack and making your list, you can opt to shop online for the healthy foods you really need to stock your kitchen. If you’re interested in learning to cook new recipes you could also try one of a meal delivery service like Blue Apron or HelloFresh! These services can be very affordable and help you inspire you with creative & healthy new dinner options. 

Stocking up your kitchen with the right foods is just one of the first steps of living your best health ever! If you can successfully get through your trip to the grocery store you’re already on your way to improving your health with meals that feature the foods you really need to fuel your body and your mind. If you need inspiration for your next meal, try out this great recipe from our friends at Whole30! 

 

 

 

Kidney Stones and Veggies- Which are Safe?

No good deed goes unpunished. I recently saw a young patient who had a severe coronary blockage requiring a stent. It was a true “Aha” moment and he dramatically improved his nutrition, lifestyle and stress management. He is one of my favorite patients (I’m probably not supposed to have favorites, but I’m human). Not just because of what a nice person he is, but because of his clear commitment to improving his health.

 

Gone were the processed foods and added sugars. They were quickly replaced by veggies, fish, healthy fats (including nuts and nut butters), and a clear focus on real foods. Not to mention his dediction to exercise and stress management. He re-examined his life, and revitalized his health.

 

Then it happened. Kidney stones. Ouch.

 

It turns out, some people absorb more oxalate from certain foods than others. Too much oxalate in your system can lead to calcium oxalate kidney stones (far and away the most common type of stone. Even though calcium is in the name, the oxalate is the more concerning component). Some of the biggest duetary offenders are spinach, beets and nuts.

 

As part of his real foods, veggie-based eating pattern he was consuming spinach and nuts every day. Ordinarily that would be fantastic! But not if you form oxalate stones. Oops.

 

The good news is, there are plenty of healthy veggie options that do not cause increased oxalate absorption. Some of the best greens for this are lacinto kale (also called dino kale), collard greens, and mustard greens.

 

Other low oxalate examples are broccoli, cauliflower, asparagus, Brussel sprouts

cabbage, zucchini, mushrooms, onions and peppers.

 

Last, taking more than 500mg of vitamin C has been implicated in increased oxalate production and should be limited.

 

Conclusion:

 

Don’t throw away your spinach or your almonds!

 

Most of us will do just fine eating spinach, nuts and taking vitamin C. However, for those few of us who are prone to forming calcium oxalate kidney stones, it makes sense to limit these foods and instead focus on the wealth of other healthy options listed above.

 

Do you have questions regarding your healthy lifestyles and your health? Let us know, info@DrBretScher.com

 

Thanks for reading

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

 

 

Can Eating Better Save 400,000 Heart Attack Deaths?

By now you have likely heard the news that poor nutritional choices cause almost half of all cardiovascular deaths. Wouldn’t it be amazing if by eating better 400,000 people would still be alive today? You bet it would.

 

While it’s no surprise that nutrition and heart health are directly related, causing half of all cardiovascular deaths is a dramatic finding that deserves further scrutiny.

 

The recent study, funded by the Bill and Melinda Gates Foundation, was presented at the 2017 annual AHA meeting. They retrospectively looked at years of observational data to correlate nutritional habits and the subsequent risk of dying. Instead of focusing only on the “bad” foods that people ate, they also looked at the “good” foods people did not eat. They concluded that Americans need to eat more nuts, vegetables and whole grains, and less salt and trans fats.

 

Yawn. That finding is hardly earth shattering as we have been hearing this for decades. Does this new study add anything to the current literature? I’m afraid not.

 

We have plenty of observational data suggesting the same.  In fact, another similar study published in JAMA at the same time provided more observational evidence that 318,000 out of 702,000 cardiovascular and diabetes related deaths are related to (in order of statistical strength), too much salt, not enough nuts and seeds, too much processed meats, not enough omega 3 rich seafood, not enough veggies or fruit and too many sugary beverages.

 

Bad Studies Yield Bad Data

 

Two studies with similar results. Does that sound conclusive? Not so fast. The problem is that all this data is observational, and therefore weak data. It can point out associations, but it cannot prove cause and effect (see chapter 2 in my book, Your Best Health Ever for a more detailed discussion).  What we need is a randomized, controlled trial investigating the question of nutrition and cardiac deaths, not more observational drivel (see my post on The Best Weight Loss Trial You Will Never See here)

 

As an example, processed food is high in salt. Fruits and veggies are low in salt. Can we say with certainty that the salt is the problem? Or is it the company it keeps, i.e. too much crackers, chips and baked goods instead of fruits and veggies? This study cannot determine between the two. Also, those who eat more veggies also tend to be more health conscious, more physically active, and have less dangerous habits (i.e. smoking). The opposite is true for those who eat more processed junk food. Again, observational studies cannot completely control for those variables (they can try, but statistics are imperfect for this).

 

Does this mean we need to throw out the study completely? Not necessarily. It raises important questions, even if it does not provide clear answers.

 

Instead, we should combine the findings with the higher quality, randomized trials to see what the science truly supports.

 

Good Studies Yield Good Data

 

The more conclusive studies are the randomized controlled trials. One such recent trial was the PREDIMED study (see more on this study and the Mediterranean diet here).  Briefly, this trial investigated a diet that included a “high intake of olive oil, fruits, nuts and vegetables; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation with meals.” This pattern of eating significantly reduced the risk of cardiovascular disease when compared to low-fat diet.

 

Since this was a randomized trial, there was no need to control for other healthy habits and self-selection bias. In addition, they didn’t measure surrogate outcomes like blood pressure, weight, or cholesterol. They measured the events we really care about- heart attack, stroke and death. In the end, a simple nutritional intervention reduced that risk.

 

This is an impressive study that tells us something conclusive about nutrition. I hope you can see the difference between this study and the throngs of poor-quality observational trials.

 

Do you see any similarities between the PREDIMED study and the recent observational trials?

 

Encourage nuts, veggies, and fish. Discourage processed meats and sweets.

 

In short, eat real food.

 

Can We Find A Common Ground?

 

After that, the science gets murky.

 

What about poultry? It was encouraged in the PREDIMED study and was not mentioned much in the recent observational trials. There doesn’t seem to be significant evidence to avoid it, and there may be reason to eat it. So be aware of your portion size and go for it.

 

What about salt? It wasn’t limited in the PREDIMED study. Some studies suggest increased risk with high sodium intake, and some studies suggest increased risk with low sodium intake. In the observational trials, it can be difficult to separate salt from processed foods, and therefore difficult to know if it is dangerous.

 

You may be thinking, if there is any question, why not just avoid it?  Is there a compelling reason to eat salt? You bet there is. Taste. Salt helps food taste better. If you are adding it to your cookies, white bread or potato chips, you aren’t doing yourself any favors. However, if you are adding a sprinkle of sea salt on your freshly steamed veggies or your roasted broccoli, then go for it. An observational study can’t tell the difference between those two circumstances, but trust me, your body can.

 

What about red meat? This is a big one. We don’t have any evidence that red meat reduces the risk of cardiovascular disease. However, all the evidence suggesting that red meat and animal protein increase the risk of cardiovascular disease is poor quality observational data. In addition, there is plenty of poor quality observational data that claims the exact opposite, that red meat does not increase the risk of cardiovascular disease. So again, we must ask, if there is controversy, should we just avoid it? Is there a compelling reason to eat meat? For some there is. Animal meat is the most efficient source of B-vitamins, iron and protein, it is filling and it tastes great.

 

Once again, the specifics matter. Are you eating a 16oz porterhouse steak with mashed potatoes? Or are you eating a fresh vegetable salad with 6-ounces of grass-fed steak on top? A study may not know the difference, but your body sure does.

 

Wrap It Up

 

Can improving what you eat reduce your risk of heart attacks and strokes? It sure can. The PREDIMED study showed that.

 

Do these new observational studies add anything new? That’s debatable.

 

We come back to the basics. Eat more real food. Eat more veggies and fruits. Eat less processed junk. Avoid manufactured trans fats. If you do that, you are doing 95% of the work (I made up 95%, but it seems right to me).

 

Spend all the time you want arguing about the remaining 5%. There is plenty of evidence to support your claim whether you are for or against salt, meat, eggs etc.

 

As for me, I am going to step out of the argument and go eat my spinach and kale salad with Brussel sprouts, cauliflower, squash, nuts and seeds, topped with olive oil and 4 oz. of wild salmon and a hard-boiled pasture raised egg. Heaven on earth. Bon Appetite.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com 

 

Action Item:

Look for ways to add veggies, nuts and seeds to your meals. Sprinkle pumpkin seeds on your oatmeal, eggs or salad. Ask for a double portion of veggies and half the protein when you go out to dinner. Watch our veggies and eggs video to see how easy it is to make a veggie-based breakfast. Focus on real food, veggies first. Try it today and see how easy and rewarding it can be!

Local Farmers- The New Frontier of Health

I’m convinced that to be the best physician possible, to be the ultimate health advocate for my clients, I need to be a coach, a personal trainer, a nutritionist, and a farmer.

 

That’s right. Our health may rely on farmers as much as on doctors. Farmers control how our vegetables are grown and how our animal protein sources are raised. It turns out, that’s a pretty big deal.

 

200 Decisions per day!

 

Every day we make over 200 food and drink related decisions. Decisions to put substances into our bodies that either augment our health, or substances that poison our health.  Considering that over 60% of the average American’s calories come from moderately or heavily processed food, the poison seems to be winning.

 

Instead, we need to focus on a real-foods, plant-based nutrition with a high proportion of healthy fats and, for many, appropriate proportions of high-quality animal protein. With these nutritional choices, we would see the incidence of diabetes, heart disease, strokes, dementia and other chronic diseases plummet.

 

Better Than Good

 

But what if we are already pretty health conscious with how we eat? What if we want to make sure the food we put in our bodies augments our health as much as possible?

 

For that, we need to look beyond the macro-nutrients. We need to look to the farms.

 

We have all heard the buzz words that we should eat local, organic produce. We should eat grass fed beef. Our eggs and chickens should be pasture raised. But does it really make a difference?

 

Yes, Yes and Yes!

 

Studies have shown that grass-fed meat has higher levels of vitamin A, vitamin E, Omega 3 fatty acids, and more beneficial saturated fats (such as CLA and stearic acid) compared to grain fed meat. In addition, wild fish have fewer dioxin contaminants compared to farmed fish, and greater benefit to harm ratios that farmed fish. Pasture-raised chicken produce meat and eggs with higher levels of vitamin E, omega-3 fatty acids, and vitamin A compared to cage-raised poultry.

 

When it comes to animal proteins, quality matters. A lot.  Not to mention the ethical considerations of how these animals are raised.

 

The industrialization of the food industry has done nothing to improve the quality of our food, and in fact, has done the opposite. To be fair, it has allowed some populations to enjoy animal protein at an affordable price, but it has gone too far. I’m not sure of the exact definition of “too far,” but all you need do is see the conditions at a CAFO (Concentrated Animal Feeding Operation) to know we have gone too far.

 

CAFO’s have overcrowded, inhumane conditions that lead to excessive methane production, concentrated waste that destroys the soil and contaminates the water runoff, and the end result is meat that has reduced nutritional value.

 

But it does not have to be this way. Cattle and the environment can have a symbiotic relationship. In fact, they did for generations before humans developed and industrialized the land and forced cattle into confined spaces. 

 

Ranchers have started to recreate the “good ‘ol days” of cattle by setting up migratory grazing, and cycling their cattle, chickens, and crops. The result is more nutrient dense meat, milk, chicken and eggs. It also leaves healthier soil, and results in a sequestration of carbon in the soil (as opposed to unopposed release of carbon in methane).

 

So, what can you do to help this process? First, eat grass-fed, locally sourced meat. Eat pasture raised chicken and eggs. Buy from your local butcher or even mail order meat from sustainable ranches. You will dramatically improve the nutrients you derive from your food and you will benefit the environment.

 

Won’t this be more expensive? That leads me to the second point.

 

Eat less meat.  Remember, the healthiest meals are vegetable-based. That means the main portion of the meal consists of veggies. In contrast, today most meals have vegetables as a small side dish if they are eaten at all. Some sources state that only 41% of all dinners contain a vegetable at all.  

 

What takes their place? Animal proteins and simple carbs/grains.  By refocusing on making our meals veggie-based, we can reduce the unneeded simple grains and sugars, reduce the quantity of animal proteins and INCREASE their quality. Think about it. You can eat less of a more nutrient dense animal protein source, you can get the same satisfaction, better nutrition, and you can manage to keep the cost fairly constant. That’s a win-win by any definition.

 

Eat your Veggies!

 

But what about the veggies? The news isn’t all rosy there either.

 

The National Academy of Sciences issued an alert that our veggies ‘aint what they used to be.

 

It appears that the nutritional value of vegetables has declined compared to the 1970s. For instance, the vitamin C content of sweet peppers declined by 30%, the vitamin A in apples dropped by 40%, and the calcium in broccoli has been cut in half. 

 

The most likely explanation for the nutrient decline is modern farming’s evolution to maximize yields and profits. To this end, the health and diversity of the soil has largely been ignored, resulting in undernourished soil feeding a larger number of crops. 

 

It doesn’t take a mathematician to see that there are fewer nutrients to go around.

 

The recommended daily allowance (RDA) is 5 servings of veggies per day with an optimal intake of 9 servings per day. But those are based on the “old” nutrient values for veggies. Assuming a 30% decline in nutrient value across the board, the optimal number of vegetable servings would go up to 12 per day.

 

Considering 87% of American adults don’t consume the current RDA for vegetables, it would be safe to assume an even lower number are getting adequate nutrition from vegetables. Something must change.

 

Re-Define a Meal

The first step is reframing how we see our meals. We need to make veggies the center of our meals. We need to start seeing veggies as fun, sexy, and enticing. That means exploring new veggies (How about tubers, chard, Romanesco, kohlrabi, or just multi-colored carrots?), and experimenting with new ways to prepare them.

 

By making veggies exciting, we can begin to make them the center of the meal. No longer is the chicken the main dish. Now it is a veggie medley with chicken and avocado on top. No longer is it miso salmon on a bed of white rice. Now it is a spinach salad with grilled salmon and an array of fresh veggies. Now that is a step towards health!

 

Know your Farmer

 

The second step, however, is where we all need to be a farmer, or at least know a farmer.

 

We don’t have to rely on produce that has been stripped of its nutrients by modern farming techniques. We don’t have to rely on mega-food corporations that are far more concerned with their stockholders than public health. Mega-food corporations have lost the public’s trust, and for good reason.  We shouldn’t have to eat carcinogens mixed with our spinach or our berries.

 

Granted, local farmers still need to make a profit, but they are not beholden to stock holders and large corporate greed. They can maintain their beliefs about the proper way to treat soil, the healthiest way to grow vegetables, and the most efficient way to support their community.

 

And don’t forget about the new generation of entrepreneurs. Folks like Kimbal Musk and Tobias Peggs with Square Roots. Not only are they growing fresh organic vegetables in Brooklyn in the middle of the winter, but they are teaching others how to do the same. Their use of hydroponics and vertical farming promises to revolutionize urban farming.

 

And the result? More fresh, healthy vegetables on our plates year-round.

 

So, the next time you want to be proactive about your health, you can go see your physician. Or you can go see your local farmer or rancher. They have as much, if not more to offer you for promoting your health and preventing chronic diseases.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action item:

 

Find the closest farmers market to you and go there! Find out when it is and plan your schedule accordingly. That is your time to go grocery shopping. Notice how the fresh fruit and vegetables looks and smell differently than in the grocery store. Talk to the local farmer. Ask if they use pesticides or other chemicals. Learn more about their farm and farming practices. Feel the sense of community and take pride that you are helping support local farmers and your health.

Bret Scher, MD FACC

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