Cutting-Edge Nutrition


Take sensible eating to the next level with our report on foods that contribute to good health.

In the pursuit of wellness and longevity, we’re all seeking an edge&emdash;a practice, product or diet that promises us vitality far into our golden years. In the interest of your continuing health, we at Sacramento magazine investigated some topics that wouldn’t even have been debated a century ago&emdash;trans fats, prebiotics and probiotics, alkaline diets and more&emdash;so you can make well-informed nutrition choices for your busy modern life. May your shopping cart be overflowing with foods that make you look and feel radiant.

A nutritional role model
We conferred with a well-known nutritionist to see what he eats and why. Dr. Ronald Cotterel is the director of the Sutter Center for Integrative Health. I am a firm believer in using your foods as medicine. By eating the right foods&emdash;sometimes known as superfoods for their nutritional punch&emdash;a person can hedge their bets at staying healthy and dodge the chronic diseases that plague our society, says Cotterel.

You are what you eat, Eat your vegetables and An apple a day keeps the doctor away ring true to this physician who focuses on nutrition as fuel. Cotterel also advocates staying away from pesticides. Eat organically as much as possible, he says. You can scrub your fruits and vegetables, but sometimes the pesticides get into the food. Although you’ll see in the following day’s diet that the he eats with a focus on fueling his body, he also advocates moderation and eating a treat now and then. If it’s your birthday, have a piece of cake! Treat yourself every once in a while. It won’t hurt you.

Let’s take a look at ingredients that make up a typical Day in the Life of Dr. Cotterel’s Eating.


Oatmeal&emdash;Contains water-soluble fiber, which helps lower LDL cholesterol
Ground flaxseed&emdash;Rich in Omega-3 essential fatty acids, which help decrease inflammation and prevent heart disease. Also contains lignins, soluble fibers that maintain bowel health and regularity
Walnuts&emdash;High in protein and Omega-3 oils, which lower cholesterol and protect the heart
Blueberries&emdash;A powerhouse of beneficial nutrients, including brain-boosting anthocyanins and cancer-preventing ellagic acid
Dried cranberries&emdash;Provide flavonoids, which act as antioxidants to ward off heart disease and cancer. Also prevent bacteria such as E. coli from sticking to the bladder, thereby helping to prevent bladder infections
Soy milk&emdash;A great source of high-quality protein, vitamins, minerals, soluble fiber and phytoestrogens, which may protect against osteoporosis, cancer and cardiovascular disease
Pomegranate juice&emdash;Loaded with polyphenolic antioxidants protecting against cancer, heart disease and possibly aging
Green tea&emdash;Contains more than 4,000 chemical compounds including a rich concentration of flavonoids. Also contains a low dose of caffeine for a morning energy boost and which may have an anticancer effect

Morning Snack
Apple&emdash;A good source of the soluble fiber pectin, which can lower LDL cholesterol, stabilize blood sugar and prevent constipation
Figs&emdash;Packed with fiber and minerals including potassium, calcium, and magnesium, which can fight hypertension

Cotterel eats a sandwich made with the following:
Nine-grain bread&emdash;Rich in B vitamins that help you cope with stress, as well as plenty of insoluble fiber
Hummus (garbanzo beans
with sesame seed paste)&emdash;Beans, including garbanzos, are great sources of protein and vitamins as well as soluble fiber to protect against heart disease, high cholesterol, diabetes and bowel problems such as diverticulosis. Sesame seeds provide manganese, copper, calcium, magnesium, iron, phosphorous, vitamin B-1, zinc and dietary fiber. Sesame seeds also contain two lignins, sesamin and sesamolin, which lower cholesterol, prevent high blood pressure and protect the liver from oxidative damage.
Bell peppers&emdash;Have a heart-protective effect due to both vitamin C and carotenoids such as lutein and zeaxanthin
Alfalfa sprouts&emdash;Studies on canavanine, an amino acid analog in alfalfa, have demonstrated that it inhibits pancreatic, colon and leukemia cancers. Plant estrogens, also abundant in sprouts, increase bone formation and density and prevent osteoporosis. The saponins found in alfalfa sprouts lower the bad LDL cholesterol but not the good HDL, as well as serve to stimulate the immune system.
Tomatoes&emdash;The tomato’s red color comes from the pigment lycopene, a powerful antioxidant that protects against cancers, and possibly even sun damage to the skin.
Pesto with basil, olive oil, garlic and pine nuts&emdash;Basil is an herb traditionally used to help relieve high blood pressure and the symptoms of peptic ulcers, colitis and asthma. Olive oil is a monounsaturated oil used liberally in the Mediterranean diet that protects against heart attacks. Garlic, also from the Mediterranean diet, contains allicin, which helps prevent blood from forming harmful clots and may lower cholesterol and blood pressure; it also has an antibiotic property to protect against infections. Pine nuts have a high concentration of monounsaturated fat, which paves the way for a healthier cardiovascular system. The vitamin D in pine nuts improves the body’s ability to absorb calcium, leading to stronger bones and teeth; vitamins A and C may sharpen vision and boost the immune system.
Coleslaw&emdash;Cabbage is a cruciferous cancer-fighting vegetable that is a great source of vitamin C, blood pressure-lowering potassium and folate, which helps lower homocysteine, a blood component contributing to coronary artery disease.
Carrot-celery juice&emdash;Carrots are rich in beta carotene, which protects against cancer and heart disease. Celery is loaded with the blood pressure-lowering mineral potassium and contains phytochemicals that may help modulate stress hormones.

Afternoon Snack
Dark chocolate square&emdash;Contains phenols (also in tea and red wine) that decrease LDL cholesterol. Also contains a number of minerals, including calcium, magnesium and potassium; has a stimulating effect; and improves mood by boosting serotonin and endorphin levels in the brain.

Spinach salad with pumpkin seeds&emdash;Spinach is power-packed with beneficial phytonutrients including carotenoids, antioxidants, vitamin K, coenzyme Q10, polyphenols and minerals. It combats many chronic diseases including cancer, heart disease and eye diseases such as macular degeneration and cataracts. Pumpkin seeds are
a good plant source of Omega-3 essential fatty acids.
Grilled wild salmon with lemon&emdash;Salmon is a high-quality protein rich in Omega-3s, which can help prevent cancer, heart disease, depression and autoimmune diseases such as lupus and rheumatoid arthritis. Lemons, a source of vitamin C, also contain rutin, a flavonoid that has an anti-inflammatory effect and acts as an antiviral agent.
Steamed broccoli&emdash;Broccoli is a nutrient-dense cruciferous vegetable providing vitamins C, K and folate, as well as powerful phytonutrients that help prevent many types of cancer. It also contains sulforaphane, which combats the bacteria implicated in stomach ulcer formation, H. pylori.
Baked potato&emdash;A great source of potassium and vitamins B6 and C.
Red wine&emdash;The alcohol in wine (in moderation) can raise the HDL (good) cholesterol. Flavonoids derived from the red grape skin prevent heart attacks by protecting the LDL cholesterol from damaging oxidation.
Peppermint tea&emdash;Peppermint has long been known as a digestive remedy for relief of heartburn, indigestion and nausea; it soothes the lower GI tract by decreasing spasms and gas formation.

Cotterel combines the following:
Yogurt&emdash;Along with providing protein, calcium, minerals and B vitamins, live culture yogurt helps replenish the bowel with friendly bacteria that help digest foods and prevent proliferation of harmful organisms.
Red grapes&emdash;Grape flavonoids protect the arteries from oxidative damage.
Grated ginger&emdash;Ginger contains active phytonutrients that decrease inflammation and prevent harmful blood clots. It also prevents motion sickness and other kinds of nausea.
Walnuts&emdash;A rich source of Omega-3s, as well as fiber, protein, magnesium, copper, folate, vitamin E and a host of heart disease- and cancer-preventing antioxidants.  &emdash;Lynne Marie Rominger

Fiber: you probably aren’t getting enough
Dietary fiber might just be the magic bullet we’ve all been looking for to make us healthier and lower the incidence of a host of medical problems&emdash;everything from irritable bowel syndrome, constipation and cardiovascular disease to cancer, osteoporosis, high cholesterol and Type 2 diabetes.

Fiber is the parts of a plant that cannot be digested by humans. Nutritionists just can’t say enough good things about eating a diet high in fiber. But if we can’t digest it, why do we need to eat it?

Fiber is so important, but most people still look at it as something just to keep them regular. They don’t see it as [being] integral to weight loss and weight maintenance, to slowing the aging process, to fighting chronic disease including diabetes, says Bronwyn Schweigerdt, M.S., nutrition lecturer and author of The UnDiet. A fiber-rich meal makes you feel full and is digested more slowly. Usually it’s lower in fat, added sugar and calories, too. High-fiber foods tend to be loaded with micronutrients and healthful plant chemicals (phytochemicals) such as antioxidants and phytoestrogens. But the average person does not get the recommended 25 to 40 grams of fiber a day from their food. Most Americans are probably getting less than 10 grams in their food a day, Schweigerdt says.

Fiber is an indigestible carbohydrate. Essentially, we get to eat and enjoy the carbohydrates, and they make us feel full and satiated because soluble fiber expands in the stomach with water. Fiber regulates the blood sugar. So you’re not bottoming out and willing to eat whatever is closest to you, Schweigerdt says, adding that the best part is the [indigestible] calories literally go out the back door.

High-fiber foods include beans and other legumes, nuts, fruits, vegetables and whole grains. Schweigerdt says the source of fiber matters: It has to be food; it can’t be supplements. It’s not hard to get enough fiber from food if you make wise choices. Nuts and avocados, for example, are great sources of fiber that many people enjoy, but often we avoid them because they are high in fat.

Schweigerdt isn’t nearly as concerned with caloric intake as she is with fiber intake. I couldn’t care less about how many calories I eat in a day. It’s really not about the intake, it’s about the calories in minus the calories out. That’s because eating fiber raises your metabolism. For every 1 gram of fiber we eat in food, our body burns about 7 calories to process it. If people ate the recommended amount of fiber, they could easily be burning 200 additional calories a day just by eating strategically&emdash;not eating less, not exercising more, but eating strategically. Those burned calories from fiber add up. In a year, if that was a lifestyle change, that would be 24 pounds they would lose. &emdash;Sara E. Wilson

Trans Fat: What’s the problem?
In 1902, a German chemist heated liquid vegetable oils in the presence of hydrogen, and it resulted in a stiffer fat, often referred to as trans fatty acids or trans fat. These man-made or processed fats are very stable, meaning they have a long shelf life, which is attractive to food companies, says Marlia Braun, registered dietitian and sports and health nutritionist for the UC Davis Sports Medicine Clinic. These fats are also cheaper to make and use compared to butter.

So what’s the harm? Food manufacturers save a buck and we can keep our snacks and goodies on the shelf until we’re ready to eat them. But Braun says there’s a consequence for that convenience. Trans fat poses a higher risk of heart disease than saturated fat. While it is true that saturated fat raises total cholesterol levels, trans fat takes it a step further, says Braun. Trans fat not only raises cholesterol levels, but also reduces good cholesterol (HDL) levels, which protects against heart disease. Over time, this results in clogging of arteries that feed the heart and the brain, thus leading to a heart attack or stroke. For strong evidence, Braun cites an eight-year trial that included nearly 49,000 women. The Nurse’s Health Study, the largest investigation of women and chronic disease, found trans fat intake doubles the risk of heart disease in women.

So, how do we decrease trans fats in our diet? Read labels. Braun says that as of Jan. 1, 2006, Nutrition Facts labels on processed foods sold at supermarkets must list trans fat. However, trans fat does not have to be listed if the total fat in a food is less than 0.5 grams per serving. Therefore, consumers may see a few products that list 0 grams trans fat on the label while the ingredient list still has ‘shortening’ or ‘partially hydrogenated vegetable oil’ on it, says Braun, who suggests keeping a mental list of foods that can be high in trans fat: fast foods, doughnuts, muffins, crackers, cookies, cereals, chips, cakes, pies, microwavable popcorn and canned biscuits. Foods that come from nature won’t contain hydrogenated fats: fruits, vegetables, poultry, fish, beans, whole grains, as well as some breads and cereals.

Braun also suggests shopping the perimeter of the grocery store. Most of the processed foods containing trans fats are in the inner aisles, says Braun. In addition, having a plan for meals and snacks will help avoid the last-minute scramble for fast food and highly processed foods. However, if you must, choose the lower fat version when purchasing processed foods.&emdash;Dawn Blunk

What food combining should mean

For many, the term food combining means not combining foods. It means limiting the foods you eat at one time or consuming foods in a certain order during a meal. You may have heard that it’s bad to drink ice water before a meal because it lowers the level of helpful digestive acids in your gastrointestinal tract. Or that eating proteins and leafy greens is a good combination, but that eating citrus and starch together is bad for digestion.

Food combining for health was proposed in the early 20th century by Dr. William Howard Hay. He believed that digestive chemistry dictates the types of foods that should be eaten together. Dr. Herbert M. Shelton helped popularize the practice with his 1940 book Food Combining Made Easy. Today, on the Internet and in books, you can find elaborate charts and lists outlining what combinations to eat and what to avoid. Modern-day devotees of the practice include Suzanne Somers and Marilu Henner.

Bronwyn Schweigerdt, M.S., disagrees with the premise of food combining, saying, I would never believe that. Your digestive tract is amazingly intelligent. It’s going to respond to whatever you put in it.
Variety is not only the spice of life but also of health; the more variety you have in your meals, the more satisfied you’ll be after you eat them, Schweigerdt explains. There is a synergistic effect of food, meaning the nutrients work together to be more bioavailable (better absorbed). That’s good. If your meal is a high-fiber one, your beneficial bacteria will make your colon more acidic, which increases the bioavailability of certain minerals, like calcium.


Nutrition consultant Jeannie Moloo agrees that you should not limit the variety of foods you eat together. We know that some nutrients are rendered more biologically available from food sources when combined with other nutrients or foods. For example, absorption of lycopene in tomatoes is enhanced when consumed along with a little fat. Calcium absorption is improved when consumed with acidic foods or vitamin C-rich foods, she says.

For Schweigerdt, food combining means eating proteins and starches together when possible. She believes food combining should be about being sensible and eating what’s good for you and what will satisfy your body. If you don’t get enough fiber, protein and fat in each meal, you’re more likely to get hungry between meals and grab whatever (unhealthy) snack is at hand, she says.&emdash;Sara E. Wilson

High fructose corn syrup: Is it worse than table sugar?
The average American consumed approximately 42.3 pounds of high fructose corn syrup versus 44 pounds of sugar in 2004. Japanese researchers developed the production process for high fructose corn syrup, a newer, sweeter version of corn syrup, in the 1970s. High fructose corn syrup is made from corn starch, which is physically separated from the kernel during a milling process. The starch is then broken down to glucose. Enzymes are applied to convert the glucose into fructose. The glucose and fructose are blended together to make high fructose corn syrup, explains Marlia Braun, registered dietitian. The industry can make HFCS-42 (42 percent fructose used in foods for its mild sweetness) and HFCS-55 (55 percent fructose used in carbonated colas and soft drinks).

Is the sweetener worse for you than table sugar? Because the increase in high fructose corn syrup intake in America has coincided with rising obesity rates, that question has been on the minds of researchers. Some nutritionists believe that the corn product is metabolized differently from table sugar, resulting in an urge to eat more and an increased ability to store fat. Others nutritionists are skeptical of such claims.

High fructose corn syrup, table sugar and honey are roughly the same in fructose and glucose content, says Braun. In fact, when table sugar and high fructose corn syrup are consumed . . . they seem to be metabolized similarly, she says. Therefore, from a digestive and metabolism standpoint, they appear the same.

Dr. Tom Hopkins, chief medical correspondent for KCRA Channel 3, who is board-certified in internal medicine with a specialty practice in bariatric medicine, advises his patients to pay more attention to their overall intake of calories than to whether they are consuming high fructose corn syrup. I don’t make much of the HFCS [versus table sugar distinction] to my patients because it all boils down to the fact that anything you don’t burn off, you store as fat, he says.

Braun agrees and recommends choosing foods that are low in sugar, thereby steering clear of high fructose corn syrup. I recommend people limit their sugar intake to foods that naturally contain sugar such as fruit, dairy, beans, whole grains and vegetables, says Braun.

Karen Chew, a registered dietitian at Mercy General, summarizes: For a healthy daily diet, eat 6 ounces of grains, two and a half cups of vegetables, two cups of fruit, two to three cups of milk and about 6 ounces of meat and beans. Always try to choose moderate- to low-fat foods and lower sodium and sugar-added items. Drink plenty of water and exercise in accordance with your physician’s recommendations.  &emdash;Dawn Blunk

Prebiotics: Food for Good Bacteria   
Prebiotics are particular compounds found in some high-fiber foods. Jeannie Moloo, Ph.D, R.D., a Roseville-based nutrition consultant and national spokesperson for the American Dietetic Association, says prebiotics may provide health benefits for cardiovascular disease, Type 2 diabetes and the GI tract and relieve constipation.

Prebiotics work in the body to promote good digestive microflora (bifidobacteria and lactobacillus). Think of prebiotics as carbohydrates that resist digestion in the upper gastrointestinal tract and stay intact until they get to the large intestine and colon. These nutrients function as food for the friendly bacteria that live there. The good bacteria break down the prebiotic nutrients in a fermentation process, increasing the acidity of the colon and promoting the absorption of minerals.

When the good intestinal bacteria are thriving due to a steady supply of prebiotics, they help the body in many valuable ways: Good intestinal bacteria help absorb more nutrients. They help prevent osteoporosis by helping to absorb more calcium and magnesium. They help regulate blood sugar. They can help prevent or even reverse diabetes. They lower triglicerides, says Bronwyn Schweigerdt, M.S.

An association with reducing certain disease risks has been observed with prebiotics, but has not reached scientific consensus, Moloo explains. Many of the claims are being investigated. Hopefully in time we will have more definitive answers. It appears to be a promising new area of nutritional science, however. Other conditions prebiotics may help are inflammatory bowel disease, antibiotic diarrhea, lactose intolerance and possibly some allergies, Moloo says. Thriving good bacteria seem to crowd out bad bacteria, possibly producing antimicrobial substances and stimulating the immune response.

With more and more pre- and probiotic capsules filling the supplement shelves at health food stores, should you add them to your daily regimen? Schweigerdt thinks not. You shouldn’t need a supplement, she says. Prebiotics are naturally occurring in foods&emdash;the same foods as the high-fiber foods. Garlic, onions, leeks, bananas, asparagus, Jerusalem artichokes, chicory, raw oats and unrefined wheat or barley are all natural sources of prebiotics to support your friendly microflora. &emdash;Sara E. Wilson

Prebiotics and Probiotics: Benefits of bacteria

Probiotics: Friendly Bacteria
What’s the difference between prebiotics and probiotics? Probiotics are live, beneficial bacteria that are ingested to restore balance to the body; prebiotics are the nutrients that those bacteria eat. We get probiotics either in the form of a dietary supplement or consume them naturally in dairy products such as yogurt, kefir, some cottage cheeses and sweet acidophilus milk, or fermented products such as tempeh and miso.

Probiotic supplements are sometimes recommended after you’ve taken antibiotics for the treatment of a bacterial infection, as the antibiotics can wipe out all microflora in your body, not just the ones making you sick. When your body’s levels of friendly bacteria are low, you may become more susceptible to another nasty bacterial or Candida yeast infection. Probiotics can also be helpful if a person has recently had surgery or has GI conditions such as irritable bowel syndrome or ulcerative colitis, says Moloo.

However, Moloo also says food sources of probiotics may be superior to pill forms: The advantage of food sources of probiotics is that they supply a combination of other nutrients besides probiotics, which may also help ensure survival of probiotics in the intestinal tract. Dietary supplements are not regulated by the Food and Drug Administration. Not all probiotics are alike, and as a result, clinical benefits will differ among people, she says.

Schweigerdt recommends food sources, too. I’m a big anti-supplement person, unless someone had to be on antibiotics for a prolonged period of time. In that case, I would recommend getting the acidophilus and bifidus from soy yogurt, she says.

Both nutritionists recommend eating high-fiber foods that contain natural prebiotics and fermented soy or dairy foods containing live bacteria cultures. Doing so should amply support your friendly bacterial passengers. &emdash;Sara E. Wilson

*Prebiotic foods
(nutrition for friendly microflora)
Flax seeds
Other whole grains
Greens (especially dandelion greens, but also spinach, collard greens, chard, kale and mustard greens)
Legumes (lentils, kidney beans, chickpeas, navy beans, white beans and black beans)
Jerusalem artichokes
Onions, leeks, shallots and garlic

Probiotic foods
(contain live cultures)
Other fermented foods

Alkaline-forming diets: lots of vegetables, little consensus

Most doctors advise eating a diet loaded with vegetables, fruits and whole grains, with less meat and fat. Yet a few&emdash;those who promote an alkaline over an acid-forming diet as the road to better health&emdash;would suggest cutting out grains, beans, most meat, some dairy and some nuts. 

The diets we encourage are alkaline-forming, says William Mora, M.D., of Sacramento’s Health Associates.

Different parts of the body have different pH levels, but in general, a person’s body is slightly alkaline. The theory behind alkalizing diets is that the foods we eat should help the body maintain that alkalinity. Some experts, especially alternative medicine practitioners, believe that excess acidity can lead to a host of problems, including low energy, frequent colds and infections, headaches and even cardiovascular disease, diabetes and cancer.

Research has shown that lowering acidity lowers the risk of osteoporosis.

The higher acidity you are, the more you tend to leach calcium away from the bones to neutralize the acid, says Mora. If you’re drinking a lot of sodas or coffee that are acid-forming, that’s going to leach more calcium.

Bronwyn Schweigerdt, M.S., author of The UnDiet, says that animal protein, which is acid-forming, is a major culprit in osteoporosis, and that’s a problem that eating a lot of dairy products won’t fix.
Americans consume the most dairy products and/or calcium supplements of any country, but we have the highest [levels of] osteoporosis, so it’s obviously not linked to calcium intake, she says. It’s linked to calcium depletion from too much animal protein.

Drinking water mixed with lemon juice, apple cider vinegar or bicarbonate of soda creates alkalinity, as does drinking green tea and dandelion, ginseng and other herbal teas. Alkaline-forming foods include apples, oranges, broccoli, cucumbers, garlic, onions and spinach. (The tendency of a food to be alkaline-forming has nothing to do with the pH of the food itself. For instance, lemons are acidic, but they stimulate alkalinity in the body.)

Marlia Braun, registered dietitian, and sports and health nutritionist for the UC Davis Sports Medicine Clinic, doesn’t believe the concept of alkaline-forming diets has much value, but nevertheless endorses some alkaline-forming diet practices, with a caveat: There are many ‘pH-balancing’ diets on the Internet, recommending 80 percent alkalizing and 20 percent acidifying foods in the diet. [They] recommend a diet with fruits and vegetables that’s low in fat, saturated fat and alcohol. These are similar to the recommendations made by the American Cancer Society, just approached differently. However, the ‘pH-balancing’ type diets recommend less whole grain foods, which are great sources of fiber.
&emdash;Dell Richards