Functional Foods Does One Size Fit All for Cardiovascular Health


– Is a Registered Dietitian, and she’s an Assistant Professor in our Department of Food
Science and Human Nutrition. And she’s the Director
of the Functional Foods and Human Health Laboratory
in our department. Her research focuses
on critically examining the efficacy and mechanisms by which nutritional interventions, primarily functional foods, improve risk factors for
cardiovascular disease and high-risk aging populations with a special interest
in post-menopausal women. How was that?
(laughing) – Good. – There’s a lot more. She has tons of publications
and tons of awards and she has promised to post
this bio on our website. She also has her cards up here, so after she’s done presenting, if you’d like to come and
talk to her or grab her card, you can do that. With no further ado, I
will introduce Sarah. (audience applauds) – All right, thank you very much for that wonderful introduction. And I tend to not speak very loud, so if you guys can’t hear me, please feel free to
let me know at any time to speak louder. Thank you all for coming to listen to this talk today. I am going to talk about functional foods with respect to cardiovascular health. Just some objectives on the study. I hope that you guys can see this okay. Basically at the end of this presentation, you should be able to just sort of generally define what
functional foods are, describe evidence supporting the role. Well, I guess this pointer
isn’t going to work, supporting the role of functional foods and their biological components
in cardiovascular health. You should be able to provide some evidence-based information for your patients and clients if any of you are practitioners. But if not, you can
provide the recommendations for yourself. You should be able to
discuss functional foods that can improve cardiovascular health in the context of different populations and what are the factors that influence the varying
ability of responses to these foods as well as
ways to incorporate them in your diet. I’m sure many of you are
already well aware of this, but chronic diseases and conditions in the United States are pretty prevalent. Most people in the United
State actually as of, let’s see if I can find it, so actually seven out the
10 leading causes of death in the United States are
chronic diseases or conditions. And as of 2012, about half of all adults had one or more chronic
diseases or conditions. One in four adults had two or more, so obviously very prevalent, and some people had even greater than two. In 2010, 86% of all of
the healthcare costs that were spent were attributed to chronic diseases and conditions. Obviously this is a problem. A lot of these chronic
diseases and conditions can be attenuated or prevented so
it’s definitely something to look into a little bit more. What causes chronic diseases? Well we have these
non-modifiable risk factors such as aging. You can’t control getting
older unfortunately. We haven’t come up with a
cure for aging just yet. Genetic predisposition and sex, gender and sex is a
non-modifiable risk factor. But there are these
modifiable risk factors such as smoking, excessive
alcohol consumption, poor diet, physical activity, and hopefully this picture of, has anyone here seen WALL-E? (chuckling) Hopefully that’s not truly
what our future looks like. Okay, it’s a good point. So usually these risk factors
are going to be expressed through some sort of
intermediate risk factor, so something that we can measure. This can include elevated blood pressure, increased blood glucose levels, abnormal lipids, overweight,
obesity, et cetera. Those are sort of signals that
we might be at a greater risk of developing chronic diseases. We have sort of this
web of chronic disease. A lot of these risk factors
are not just risk factors for one chronic disease or condition, but actually sort of intermingle, I guess you can say in this web, and can contribute to
numerous chronic diseases such as cardiovascular disease,
cancer, diabetes, et cetera. Some processes that are sort of underlying these disease states are oxidative stress and inflammation. That’s sort of working by
a directional relationship to contribute to chronic disease. Does everyone here know
what oxidative stress is? Have you heard of an antioxidant? All right, so we have these
free radicals in our body. They’re normal, they’re
supposed to be in there, but sometimes they sort of get out of, out of control, so we have more
free radicals than we should and not enough antioxidants to quench them so this is what we call oxidative stress. That means free radicals are
basically looking for something in the body to react with. They want to pair up with something, and usually they’re
going to find something to pair in our cells and our tissues, so they can cause damage
to our DNA, for example, damage to our cells, and those can contribute
to chronic disease. Inflammation is also a
normal physiological process. When you cut yourself,
you have redness there. It might turn a little bit warm. You would have pus. I know that sounds gross, sorry girl, but those are normal things
that are supposed to happen to help you heal. But when this is long-term and sustained, it’s not normal, and so that can contribute
to chronic disease. In the United States, we have several leading causes of death, many of which as I said are chronic diseases and conditions. Cardiovascular disease is the number one leading cause of death, pretty quickly followed by cancer. Basically cardiovascular disease has traditionally been thought
of as a disease of aging, as something that sort of
naturally as you can say, happens with aging. You can see that prevalence
increases as you get older and men are typically at
a greater risk than women until women undergo menopause
so they’re sort of protected before being at menopause
and then after menopause, their risk increases to match men, and sometimes exceeds their risk. Hopefully you guys can read this diagram but basically just very simply with aging, something that occurs
naturally is vascular aging. So our vasculature becomes more stiff, it becomes more rigid. The cells that sort of produce molecules within your blood vessel
to cause your blood vessel to expand and contract, it
sort of buffers blood flow, and this is how it’s supposed to happen. This becomes dysfunctional
naturally as we get older. These are referred to as
endothelial dysfunction and arterial stiffness. Those are natural, however, certain processes and risk factors such as hypertension,
abnormal lipid levels diabetes, overweight
and obesity, et cetera can accelerate this vascular aging, increasing our risk for
developing cardiovascular disease. Once we have these processes
that become accelerated, you get a plaque formation in our arteries called atherosclerosis. We can develop hypertension
if we didn’t have it already, sort of this self-perpetuating cycle. The work that we do in our lab is trying to target some of
these intermediate risk factors for the development of chronic disease because I can’t do a
clinical intervention study with a population to follow you until you eventually pass away. Yeah, I know it’s a little morbid, but I can’t do that. But I can look at your vascular function, I can look at these risk factors
and try to improve these, they’re called surrogate partners. So it kind of helps me to get an idea of whether this intervention
can protect you against that would be cardiovascular disease. There are numerous risk factors
for cardiovascular disease. A lot of these are the same
as what I previously said, but high blood pressure, high
blood cholesterol, diabetes smoking, heavy alcohol use,
being physically inactive, and an unhealthy diet, these are all modifiable risk factors. With respect to diet and I think a lot of you
probably work with patients or you’re worried about it, or you just see this in
your day-to-day life, but basically, recently
from the dietary guidelines that recently came out
the last couple of years, they showed that the
majority of the US population is not meeting the US dietary guidelines. We’ll talk there. It is especially true for
vegetables and fruits. The side on the blue,the
blue side shows you where people either meet their needs, they’re either taking
in enough or not enough if that makes sense. With vegetables, less
than 20% of the population meets the recommendations here. For fruits, it’s a little bit over 20. Grains, definitely doing better. Dairy not enough. And then over here in the orange, it shows you how many
people are not having enough so definitely quite a lot. But we sure are getting plenty of sodium and saturated fats, added sugars. So those are things that
we need less of, I guess. The research that we do,
that I’m interested in like I said, is how can we
sort of prevent or manage some of these risk factors
that can increase our risk? We know that a lot of
these can be prevented managed, or treated, through
lifestyle approaches. One obvious one is exercise. We all know exercise
is good for you, right? Diet as well. This can include a healthy eating pattern. And there are numerous healthy
eating patterns that exist. The three most evidence-based patterns include the healthy US
style eating pattern which is sort of recommends foods within
the dietary guidelines. There is the dietary approaches to self, hypertension diet or the DASH diet. And there’s also the
Mediterranean dietary pattern which probably most of you
have heard of at some point. Not sure if you can see this, but basically, just
showing you how the DASH and the Mediterranean diet appear. Basically, the common denominators, the common themes in these
diets is that they are very focused on plant foods. So eating fruits,
vegetables, whole grains, having lean meats, low-fat
dairy or nonfat dairy, plenty of beans, nuts, legumes, and limiting your fats and sweets and oils other than olive oil, specifically for the Mediterranean diet. I took this from the dietary guidelines. I like this. Empower people to make healthy shifts. Making changes to eating
patterns can be overwhelming. That is definitely true. That’s why it’s important to emphasize that every food choice is an opportunity to move toward a healthy eating pattern. Small shifts, moving choices
over the course of a week, a day, or even a meal can
make a big difference. I’m a Registered Dietitian,
I still can practice. Right now I practice on my
husband who loves chicken wings. And sometimes he’s like,
I’m gonna go vegetarian. And I’m like, okay let’s go
in the middle, you know small. It doesn’t have to be one or the other. And that’s very true. So when you think about
making a dietary change, if you think about it in the context of all right, I’ve got to
change my whole diet, I’m going to get new food. I’m going to go to the grocery store. That can be really overwhelming
and hard to sustain, but if you start with small
choices, that’s a lot easier. It’s doable. If I’m gonna eat lunch right now, maybe I’ll replace this for a salad or something like that. Little things, not everything at once. Examples of this include
switching out high-calorie snacks for nutrient dense food, substituting fruit
products with added sugars for whole fruit, whole grains instead of refined grains, oils instead of solid fats. No sugar-added beverages
instead of those with sugar. One thing I’ve always heard, well not in those exact words, but what is in it for me? Basically especially when you’re young and healthy you don’t really see the immediate benefit of making dietary changes, right? You don’t see that it’s gonna
lower your blood cholesterol because your cholesterol is fine. We know that shifting our
overall dietary patterns away from these nutrient-dense
traditional foods that we are used to to more nutrient-dense options can support a healthy body weight and can help you to meet
your nutrition needs so you may have a deficiency in vitamin D and just not know that you do because you don’t feel it yet. Lessen the risk of chronic disease such as cardiovascular disease. One way that I like to think about this is you have to pay some time,
it’s like a credit card. You can either put it on your
credit card and pay later, or you can pay now and not pay later. When I think about foods and the foods that I
want to put in my body, I like to pay more now in
terms of money obviously, but just more work
instead of paying later. This one’s my favorite. It’s so expensive, it is
expensive to eat healthy. Sometimes it can be, but we
have to take a step back. I love coffee, I am not
putting down coffee. How many of you guys like
to drink your coffee? Like to buy coffee out? I love that too, but a lot of people see coffee as definitely affordable, you buy everyday, absolutely need it, can’t live without it. This can cost anywhere from $3.00 to probably some can be like $10.00. I bet if you add your espresso shots and all that fancy stuff. The calories, you can
get non-fat, sugar-free for 160 calories, or it can be over 600, probably (murmurs). Blueberries, too expensive,
an occasional treat. Depending on the season,
it can cost anywhere from $2 to $5 dollars, calories are only 85. I think if we prioritize and
think about what’s affordable, we can make room for this food. A central theme of these
healthy dietary patterns, as I said, includes the fact that they are rich in plant foods such
as fruits and vegetables. Certain foods, we’re talking
into what functional foods are can exert very specific
functional properties. I think that understanding
the health benefits of specific foods not only
can advance our understanding and help us come up with better
nutritional interventions and medical treatments,
but it can also encourage your consumption. If you know that something can
be good for your vasculature, then you are more willing to consume it than if you didn’t know, or it promotes brain health, right? What is a functional food? Has anyone here heard of
a functional food before? Has anyone not heard of a functional food? Basically in the United States there is actually no clear definition of what a functional food is. The United States Food
and Drug Administration, or the FDA, is essentially there to protect public health by ensuring safety, efficacy, security of human drugs, biological products, et cetera. But the FDA doesn’t have
a statutory definition of functional foods and
therefore, they do not regulate functional foods. They do however regulate any claims that are associated with food, so if you see soy protein on a package that it may protect against
coronary heart disease, that’s an FDA approved health statement, and they regulate that. If you make a false claim … POM Wonderful a couple of years ago had some pretty interesting health claims. Basically it could cure everything. Kind bar, I believe had one as well. There are a few companies
for various reasons that have put out a
non-approved health claim, so that would be under review. There are numerous organizations that do define functional foods. One of them is the National
Academy of Sciences and they define this as any modified food or food ingredient that may
provide a health benefit beyond that of the traditional
nutrients that it contains. The Academy of Nutrition and
Dietetics defines this as whole foods along with fortified,
enriched or enhanced foods that have a potentially
beneficial effect on health and when consumed as part of a varied diet on a regular basis, at effective levels based on significant
standards of evidence. That is a loaded definition. Basically that’s a very specific one. They protected themselves with that one but they support FDA
approved health claims. They also acknowledge
that basically any food can be functional on some level but certain foods have compounds that are not the traditional
nutrients that we think of that can have these additional
functional properties. I’ll get into that a
little bit more later. The Institute of Food Technologists
defines functional foods as foods as the components
that provide a health benefit beyond basic nutrition for
the intended population. And they include numerous foods in here such as conventional or fortified, enriched, enhanced foods, dietary supplements, et cetera. Then the International
Life Sciences Institute of North America has their own. Foods that by virtue of
physiologically active food components to provide health benefits beyond basic nutrition. The theme of these definitions
is that it’s a food that contains bioactive components that provides a health benefit
beyond basic nutrition. So every food can be functional. Sugar can be functional. That doesn’t mean that it
provides a health benefit beyond basic nutrition. The foods that you’re eating right now, lettuce for example, what makes it this green color? It has these plant compounds that contribute to the green color. Those are what we think of as these non-traditional nutrients
called phytochemicals. The traditional nutrients are more like vitamins, minerals, stuff that
you absolutely need to live. Those are more required,
traditional in that sense. Polyphenols, phytochemicals
are not required but definitely have health benefits. Functional foods, there are
so many different kinds. We can have everything
from your basic whole foods such as blueberries, legumes,
green leafy vegetables. We can have dried fruit. Those are dried plums up there. We have juices. I’m actually studying
beet juice right now. That’s a processed form
of a functional food. Tea, something that is preventative. Beet chips, not sure if that’s
quite a functional food. They call it a superfood, which
I will get into that later. Then there are all of these other calcium-fortified orange juices are technically considered
a functional food because they modified the
components that it contains to have a functional effect, which is to enhance bone health. Basically that is what that’s for. You have plant sterols added to butter, omega-3 enriched eggs, et cetera. These bioactive food components, what are they exactly? We want to talk about these today. I’m talking mostly in the
context of plant foods, but these do exist in dairy
and many other foods as well. These contain essential
and nonessential compounds. Essential being vitamins and minerals, things we need to live. Nonessential compounds
include polyphenols. These compounds are synthesized by plants for their normal plant function such as photosynthesis,
respiration, and growth. They also provide some protection against infection and predators, so they’re really
synthesized for the plants to live, to grow, to flourish, to not be eaten by insects, et cetera. And they can actually have
some of the same effects within our body. Beta-carotene, for example
is good for helping to protect plants against the sun. It actually helps you to protect
your skin against the sun. They may contribute to
color, flavor and aroma, and they have also been shown to exert biological effects on humans. That means they are able to interact at the cellular level, the
tissue level, the organ level and either enhance or potentially repair depending on the normal
function of our body. A lot of these are being
shown to have health promoting and disease preventive effects. As I mentioned, all foods
are functional on some level, but others may have very
specific functional intermediate and/or long-term effects. But there are a lot of
factors that can influence the functional effects that
these foods have on the body. It’s not just as simple as
blueberries are good for you, everybody can eat them, it’s going to exert the
same effect no matter what. I wish it was that simple, but it’s not. Actually I don’t because then
I wouldn’t (speaking softly). (audience laughs) So there are environmental factors such as the influence of
the farm-to-table continuum. So everything from planting
the food to harvesting it, to processing it, transporting
and those factors, the types and amounts of compounds that are within the foods,
the quantity consumed. You can’t have two
blueberries versus a cup and expect the same results. I’m always gonna use
blueberries as an example. I apologize about that. Factors include anything
digestion approaching metabolism, your duration of exposure, so how long are you
consuming this food for, as well as your baseline
physiological state. Are you a young healthy person or are you an older healthy person? Are you a Type II diabetic? All of these factors
can actually influence how you respond to these foods. When we think about the
farm-to-table continuum, we have pre-harvest over here which could include the genotype. That affects the specific phenotype with the colors, the variety,
the flavor, et cetera. Soil type, climate, so something
that’s grown in Colorado versus something that is grown in Africa may be totally different. Harvesting, so maturity at
harvest, harvesting methods. Postharvest, transportation, so some things are transported from the farm here to your house. Somethings are transported from Mexico to here in the wintertime when
some things aren’t in season. How was it harvested? Sorry, storage timing conditions. So certain foods can be stored for months, ripening for months, radiation, canning, hydration, freezing,
juicing, pasteurization. There are all of these factors and I am not saying that they’re bad because actually some of
these such as fermentation can enhance the functional
properties of foods. Juicing sometimes can
release certain compounds that might be hard for your body to extract from the food in general. Then there are consumer practices. So how do you select your foods? And what do you do with
them when you get home? How are they stored? How are they prepared? These are all contributing factors. An example, genotype is actually reported to account for between 40% and 92% of the variation in the
content and the composition of bioactive compounds in plants. Here’s a good example
that you guys have seen. Purple potatoes, red potatoes. And actually some purple potatoes aren’t colored all the way through so when it’s localized to the skin then the compounds are only on the skin whereas if it’s colored
all the way through the compounds are all the
way through the potato. The same thing with apples. We have green apples, red
apples, yellow apples. Broccoli is an example. When you buy frozen broccoli,
it’s actually been blanched prior to freezing and
that helps to preserve it and extend the shelf life
but blanching actually inactivates a very specific
enzyme that converts one of the biological
compounds into its active form, so potentially reducing
the bioavailability and efficacy there. Cooking and processing
tomatoes releases lycopenes. And lycopene is a phytochemical that gives it its red color. This actually releases
it from the cell matrix and makes it into a
more bioavailable form. If you add olive oil or
any kind of fat to it, it actually helps you to absorb it better. Interestingly, watermelon has
very bioavailable lycopenes, which means you should eat that fresh. In order for something to be bioavailable, bioavailability, just quickly, means that you’re able
to take the compounds out of the foods that you
contain, absorb it, metabolize it, and eliminate it. It needs to basically get into your body, get to the tissues that
you needed to get to to observe the effects, and be eliminated when it needs to be. If it can’t do that, then it can’t have its health benefits. Numerous factors can
influence bioavailability such as how you consume the foods, so eating a fresh green over a cooked one, the molecular structures, et cetera. I’m not going to get
into the details there, but basically, like I said in
order to observe its effects it needs to come out of the food matrix, get into your digestive tract, be metabolized, absorbed and reach the tissue of action. This is just showing
you how complex this is. We start with dietary polyphenols. Polyphenols, I’m not gonna
get into the chemistry here. I don’t want to bore you with that. But basically, it’s this
very specific structure. Polyphenols can be as simple as having one of those phenolic greens or it can have multiple of these greens bound together to other compounds and attached to sugars
and all sorts of things so your body basically has to be able to break that down in order to
get it into your bloodstream. It’s sort of like a medication. Your body’s trying to protect
you from having toxic effects from these compounds. Some are able to be absorbed directly from your small intestine
and go to the liver but some have to go to your
colon where bacteria there help to metabolize the compounds so
that it can then be absorbed to go to the liver and eventually
make it to the tissues. Some of it will be
metabolized and excreted in the kidney through the urine. And so they can be eliminated
through urine and feces. I’m sure if you all
have eaten beets before you have seen it dyes a few things red. That’s an example of that. Some of it’s been absorbed but some of it also passes through. There is definitely variability in metabolism of bioactive compounds. Some of us have genetic mutations that influence how we
metabolize certain compounds. We all have different microbiota. Microbiota in the gut is beneficial and sometimes
harmful bacteria there that help us to extract certain nutrients. There’s also the dietary context
of what your blood ingested and certain disease states can potentially alter this as well. Specific effects in the body that bioactive compounds can have. As I mentioned free radicals. Excessive free radicals can
lead to oxidative stress. These compounds within
fruits and vegetables can serve as antioxidants and directly scavenge these molecules. It can also interact
with antioxidant enzymes as well as the factors in our bodies that produce these antioxidant enzymes that we have in each of us right now to enhance their activity. They can inhibit the
absorption of certain nutrients during digestion so it could
be that it’s inhibiting or slowing the absorption of glucose which can be a good
thing sometimes, right? We can increase enzyme activity. It can interfere with enzyme activity. It can mimic certain signaling
molecules such as estrogen. They can serve as diuretics. So different foods
depending on the compounds that they contain, have
different effects on the body. I, obviously, for the sake of time can’t go over every functional food that has cardiovascular health benefits but what I do kind of want to do is give you an introduction
to a few foods and show you some differences in responses and what might be contributing to that. Soy protein is one of the foods that has an FDA approved health claim that is very specific to soy protein and coronary heart disease. Research, this is based on
tons of scientific evidence, and they have concluded that soy protein included in a diet low in
saturated fat and cholesterol can reduce the risk of
coronary heart disease by lowering blood cholesterol
levels by 2% to 7%. This includes total cholesterol and your bad LDL cholesterol, but this requires you to eat a total of a minimum of 25 grams
of soy protein per day which is quite a lot. It could be half of your protein depending on what your protein needs are. It is hypothesized that
some of these compounds, the peptides within the proteins can inhibit cholesterol
synthesis of the liver, that it may impair cholesterol
absorption from foods and then it can displace other
unhealthy foods in our diet. Research has also shown that it can reduce arterial stiffness and improve endothelial function. However, there is conflicting evidence so not all research is actually showing that it observes these
cardiovascular health benefits. Why is that? Also one of the primary compounds, so there’s three isoflavones. These are phytochemicals. They are structurally similar to estrogen which is up here in this box over here. Daidzein is one that needs
to be converted to equol which is a metabolite. It’s a metabolite produced
from metabolism in your body. Specifically, it’s converted
to this by your gut microbiota so we actually rely on
these gut microbiota to help us digest and
absorb certain nutrients. It turns out that only
20% to 35% of US adults are able to produce this metabolite. In China, where they consume
soy foods a lot more, they are much more
capable of producing this. Research has shown that the
cardiovascular protective soy are in people that able to produce equol as well as those that
are unable to produce it, but that the effects are greater in those that are capable of
producing this metabolite. There are a few other health
claims approved by the FDA. Diets rich in fruits,
vegetables, and grain products that contain soluble fiber can reduce the risk of
coronary heart disease. The consumption of soluble
fiber from certain foods can reduce the risk of
coronary heart disease. Plant sterols can reduce
the risk of heart disease. Whole grains, heart disease. Potassium, high blood pressure and stroke. Just to switch gears a
little bit to berries, this is an area that I’ve
done some research in. I think it’s fascinating of course. So berries, we all know berries are a commonly consumed
fruit in the United States, especially blackberries, raspberries, strawberries, blueberries, but there are also these
other berries like acai, aronia berries, black current, et cetera. These tend to be pretty low in calories but very nutrient dense. So they have dietary
fiber, vitamins, minerals, and a wealth of polyphenols as you can see from their vibrant color. And numerous studies in cells, animals, humans and
epidemiological research is showing that they are
very cardio protective. Blueberries, specifically, contain numerous vitamins and minerals. Vitamins A, C, folate, potassium, but they also contain
polyphenols such as flavonoids, phenolic acids, et cetera, et cetera. These are definitely a
promising functional food for cardiovascular health. And currently, research is
showing that they tend to improve arterial stiffness
and endothelial function. You can, there is some
research that show that a single dose of blueberries can exert some of these cardiovascular
protective effects but also very long-term or chronic so at least to eight weeks,
continues to be what’s needed for these cardiovascular
protective effects. And the mechanisms through
which they work in a single dose versus a chronic dosing regimen
is a little bit different. So, some examples of this. One researcher or one group
of researchers in Oklahoma showed that 50 grams of
freeze-dried blueberry powders, it’s like about two cups
of fresh blueberries a day improved systolic blood pressure, the top number of the
blood pressure reading as well as diastolic blood pressure and end markers of oxidative stress, specifically the lipids within our cell, in obese men and women
with metabolic syndrome and this was a middle-aged population of about 47 to 53 years old. We did a study when I was at Florida State where we looked at consumption of 22 grams and this is equivalent
to about a cup per day. And we found in post-menopausal women with elevated blood pressure, that they had a reduction
in blood pressure and arterial stiffness as well as increased nitric oxide metabolites. And nitric oxide is a molecule that’s produced by the vasculature to cause your arteries
to be able to expand for vasodilation. Interestingly, a couple of other studies did not find such an improvement
in cardiovascular health. One did find improvements
in endothelial function but did not see reductions
in blood pressure. That was a six-week study. Another one for six weeks was on healthy young to middle-aged men. They found zero effect
on endothelial function. Well, it turned out that these people had normal cardiovascular
health at baseline. So there wasn’t really any proof there. And this population was
a little bit younger and didn’t really have
elevated blood pressure. So when I sort of get into
interpreting research findings and what you see in the
media and stuff like that, I think it’s important
for people to consider that certain factors in the study can kind of lead to these effects. So if it didn’t have an
impairment at baseline, it’s like taking Advil for a
headache that doesn’t exist. Are you gonna improve
something that’s not there? Potential role of the gut microbiota. And so, even with Dr. Jen Teel
over here in the audience, we’re trying to pursue some funding to look at the role of the gut microbiota and it may be that theirs
was a very specific, chronic intervention
timeframe that’s needed to exert these beneficial effects. Interestingly, in human studies, blueberries have not been shown
to improve lipid metabolism, so they do not reduce cholesterol levels based on the current evidence. Strawberries, on the other hand, strongly influence lipid metabolism. And so it seems here that
the most promising effects are related to blood lipids,
so cholesterol levels. For example, oxidative
stress and inflammation, it’s very atherogenic molecules. So some examples here. 50 grams of strawberry powder produced killed a little LDL cholesterol but it has zero affect on blood pressure in middle-aged and older
adults with metabolic syndrome. They also attenuated adverse
effects, your high-fat meal. So when they fed
strawberries with the meal, they saw that the strawberries reduced the exacerbated elevation of
blood lipids after the meal. We did a study, again, that was at FSU, same population as our blueberry study. Interestingly, strawberries
did not improve blood pressure, did not improve arterial stiffness. There was a very modest effect
but it was not anything like we had observed it for
the blueberries study. This sort of leads me to believe
that these different foods, potentially through
the different compounds that they contain, work differently to exert these cardiovascular
health benefits. So with the effects, when you
combine these, are greater. And I think that’s
important to think about when we’re thinking
about our diet and food. If we could just eat one fruit everyday and live off of that and be healthy, then we wouldn’t have to
eat anything else, right. That would not be very fun, but I think you guys get the point. So this one is just to sort
of show you the influence of disease state and sort
of this repeated exposure. And by repeated exposure
I mean having something more than once, so eating
it everyday, for example. So an interesting pilot
study was a sort of, some emerging research. They found that 10 days of consuming grape polyphenols by either lean individuals or those that were overweight or obese, the lean individuals have
greater circulating metabolites following the 10-day exposure that their overweight
or obese counterparts suggesting that they had
improved bioavailability of these compounds. So it could be related to gut microbiota. Zucker diabetic fatty rats
have lower circulating and brain concentrations. And I don’t want to get too
much into the animal research but I thought it was kind of cool. So they have less of these
polyphenols and metabolites that were actually able
go into circulation to get to the brain than
their lean, controlled rats, so this suggests that certain
(murmurs) in this case, may influence the bioavailability and therefore the efficacy of this food. So the research is still
young in this area. As I said, it’s an emerging area but it suggests that liver
function could be impaired, so sometimes we have fat
accumulation in our liver that may affect function,
so you may have alterations in our metabolizing systems
including the gut microbiota. We have, for example,
with Type II diabetes and chronic kidney, sorry, chronic kidney disease, we may have increased
filtration of our blood into the kidneys, so increased clearance where the kidney’s, urine out
of our bloodstream quicker. As well as chronic
inflammation can all impact. So, back to superfoods because everybody, I’m sure has heard of superfood, right? Superfoods nonsense. (audience laughs) What makes a superfood super? Well, superfoods do not exist. They are a marketing term for you to buy. Marketers, the media. And I’m not going to spread
the fake news or anything. (audience laughs) I’ll relieve you from that. They’re not super but
they can be functional. Garlic cannot fly. No, it can’t do anything like that. You cannot eat a poor diet
and consume these superfoods and expect that you’re
going to be protected against chronic disease, right. They’re not that super but they can be functional. Consuming too much of any one food. So just because blueberries
are good for you does not mean that you should
eat like two pounds a day. You’re gonna be in the bathroom,
that’s not good for you. (audience laughs) Basically, too much of
one food or too few foods can also prevent you from
getting certain nutrients because you’re just
focusing on this one food and not having all of these other foods. Or can lead to overconsumption. So one, it can potentially
be good for you. It doesn’t mean a bottle every night is gonna prevent heart disease, right. It can actually cause it. If you have too much
chocolate, it might (murmurs). So why is nutrition science
so controversial in using? Part of this talk today
is just to introduce you to functional foods to show you that they can have these
cardiovascular health benefits but I think we’ve all have seen something where one day, they say it’s good for you, the next day, it’s not good for you. Well part of that is the
fact that sometimes findings can be exaggerated. They can be misinterpreted. Sometimes you just want somebody to click on your post, right? Isn’t that like a thing
that journalists do when they post stuff online. They want to see how many
clicks they could get. So the more sexy it is, the
more likely somebody’s gonna click on it. Studies don’t often apply to populations that weren’t studied. So if I studied a healthy population, it doesn’t mean that I can
extend those findings to people with chronic diseases. The health effects of foods and
diet, in general, in humans. When we’re doing research studies, the studies tend to be
pretty short in duration, unless you have a ton of money to follow that for several years. And so, it might be hard to capture the health effects in
that duration of time. Methodology differs. So there’s different ways
of conducting your research and collecting your data
and analyzing your data and acknowledging it as well. And we can’t control everything. Humans are not to be
able to be controlled. So if I ask you to not
to change your diet, it doesn’t mean you’re not
going to change your diet and then I have to take your word for it. So that can create some
variability as well. These are some controversial foods. I’m sure you guys have heard recently. And that’s sort of why
I put that picture here. In Time, the front of
Time magazine in the ’80s, cholesterol, fat was the devil, right. It was like awful for you and
now more recently in 2014, we eat butter and what were we thinking? It’s so good for you. (audience laughs) They sort of took some things
and exaggerated it, right. And probably, if you want
to read this magazine, but this is sort of some of the stuff that foods (murmurs). Coconut oil is one of those
that’s like a very hot food. It’s coconut water, it’s
good for sports and urine and all of that stuff. It’s probably true but coconut oil is still loaded with saturated fat. I’m not saying that’s
it’s not good for you, but right now we know that
too much saturated fat isn’t good for you. Coconut oil has a lot of it. Therefore, (murmurs) fat. I love coconuts, so
I’m sad about that too. Right now, basically,
based on this review, this is an interesting review
that came out recently, kind of talking about some
of these controversies. There’s just no evidence to
support that it’s good for you, so we can’t conclusively
say that it’s okay to have. Eggs. Eggs still increase cholesterol especially if you’re genetically prone to it. So some people just sort of took a snippet from the dietary guidelines
and said eggs are good for you and ran with it. And they are good for you,
but too much of anything is not good for you. Juicing. Juicing can remove the dietary
fiber which is important. It can concentrate the calories
and the sugar and make it not so good for you anymore. Gluten-free foods. There’s no evidence either way. So on the left, there’s evidence of harm. In the middle, there’s
inconclusive evidence. It doesn’t mean that it’s good or bad. It just means that we
don’t have enough evidence at the time. So high-dose antioxidant supplements, probably not as good for you
as you think or hoped to be. Extra-virgin olive oil, no. Based on the evidence,
it’s not as good for you. Blueberries. (audience laughs) But not too much. Blueberries and strawberries. 30 gram serving of nuts per day but portion control is needed because they’re high in calories. Green leafy vegetables
and plant-based proteins. Those have strong scientific evidence reporting cardiovascular health benefits. I think it’s important for us to have realistic expectations too. So when I present my research,
sometimes people say, well seven millimeter of mercury reduction blood pressure, it doesn’t
really seem like a lot. Shouldn’t it drop it by 20 or whatever? I’m like, well it’s a food. What do you expect from a single food? It’s not as perfect. So sometimes the effects may be modest, but you have to remember, it’s just food. Functional foods may
affect multiple tissues so it may not just have a
strong effect on one tissue. It can have small beneficial
effects on multiple tissues. Functional foods may not
be affected in all contexts and I think that’s okay. I think it’s sad that strawberries didn’t reduce blood pressure. Or I can think about it, well they have these other benefits. And these other foods have these benefits, why don’t we put them all together. That’s better, it’s more
of a comprehensive thing. And I like this quote here by Aristotle. The whole may be greater
than the sum of its parts. So we have to think that
you’re not eating any food in isolation; you’re
eating it in the context of your overall diet. When we think about it that way, the effects will be greater in the context of the healthy dietary pattern. So the bottom line is that the future of our global population, to
help our global population is dependent on a shifting to
a healthier dietary pattern. Small shifts can be achieved
through the incorporation of nutrient-dense foods
which can be incorporated into a meal, to a day, to a
week, to a month et cetera. Specific foods can have very
specific health benefits and can be incorporated into the diet to achieve these health benefits. So if you have high blood pressure, you can incorporate foods
such as blueberries or beets or watermelon that have been shown to exert anti-hypertensive effects and that may have an extra
functional protect for you. I think it’s important
to consider the influence of factors in our health,
in the environment, the food et cetera that may influence their
functional properties but don’t let that discourage
you from taking them. No single food is super. And all foods have different
arrays and amounts, many types of these biological compounds that are very likely working together. And so variety is the key. So just quickly, fling
on my Dietition hat, so since we’re incorporating
some foods into your diet so if you need more beta carotene
or want more beta carotene, sweet potatoes can be
substituted for regular fries. You can slice them and
put them in olive oil, bake them in the oven
for 10 to 15 minutes. Lycopene. Bioavailability can be improved by cooking and adding olive oil or
you can eat watermelon. Zero to two, work-out time this evening. (audience laughs) Try whole grain breads and pastas. Some people don’t like
the whole grain flavor, well some are stronger than others. Beans, apples, citrus fruits. They all have soluble fiber. You can put them in various
foods, you can choose a salad. There are many ways you can
incorporate them into your diet. You can make your own
mixed nuts such as almonds and walnuts and add in some
dried fruit to go with you. That’s something that you
have, something’s this easy. Add berries to your yogurt
in the morning as well. You can add fruit and
extra-virgin olive oil to your vegetables, it adds flavor. And to get any more, olive oil et cetera. And that concludes my presentation. (audience applauds) Yes, how can I help you? – [Man] We see all these
fruits and vegetables. They’re good. I don’t hear much about the yams. (audience laughs) – There is some potassium in ’em. And they actually function as a prebiotic so they’d be easier for
your gut microbiota. Your gut microbiota
needs to be fed everyday. So eat fruits, vegetables,
whole grains, they need that to survive. So that’s one reason why people
going on the Atkin’s Diet or something, all of these
things that could happen. – [Man] Okay, how about
freeze-dried fruit, how’s that stand up? – Freeze drying is probably
the best way to preserve fruit, to preserve as much as
the compounds as possible. It does change some of the
compounds and the composition and then the amount. But some research, there’s
not a lot of research in this area yet in humans, so a lot of it is showing that even though it does have small changes, the types and amounts,
it actually still has the same cardiovascular
benefits when given in-vitro. And the reason that we use
that for our research studies it’s a little less applicable
to the real world, you know if it’s been all freeze-dried
blueberry powder, we eat blueberries, right? So there’s some variability
there and the compounds and how it’s stored and those types of things. But for research purposes,
it would be the compounds. We know exactly what we’re doing so it’s a little bit
easier to see the effects. We recently finished up
a study with fresh pears, so we had to use two
different types of pears due to the seasonality. There were issues in ripening and storage. Who knows if we had a
different form of pears, what the results would look like. The results were modest on
cardio metabolic health, but I think the fact
that we had those issues is one of the strongest
aspects of our study because it’s more
applicable to what we worked and the real-world challenges. – [Woman] So I’m curious
about freeze-dried versus just using like a dehydrator. I mean if you freeze dry, do
you just like lay things out on a cookie sheet in your
freezer and freeze them until they are dry or how does that work? – They need some expensive
equipment, I don’t know. – [Woman] So do you
know how it compares to just like a dehydrator
that has the layers? – I think it’s more quickly,
it’s like a flash version. – [Woman] So probably
better nutritionally? – Yeah, so it sort of
preserves the nutrients a little bit better. It’s been shown to retain nutrients better than other types of (murmurs). – [Woman] Would almond
milk with added calcium be considered a functional food? Is there any difference in
the bioavailability (murmurs)? – I didn’t realize, plus
it depends so like calcium and iron you’re going
to need for absorption. I don’t think that they would
put iron into almond milk. I don’t actually know. I would think that it
would still be absorbed. – [Woman] Sarah, are we
finding that as the food system has become more hybrid-based, that there’s less bioavailability or fewer functionalities versus the variatals and the things
that (speaks softly)? Is the whole production system screwing up some of the functionality of foods? – I don’t know about that. It’s just like the aspect. I get it, it could. I think that it kind of would work. – [Woman] But nobody’s
really looked at like a hybrid potato versus
say, a varietal tomato. – A lot of those studies
are done in like cell models and they kind of, they’ll look
at the phytoactive compounds within the hybrid coming over to this, another type of tomato. And then do a self-study to show that it has antioxidant effects, but that doesn’t always
translate to humans, so I can’t really say that. I’m hoping that the
USDA will start funding more research studies that
test that sort of thing, but it didn’t work. To not just look at who’s in
the context of eating them, but you need to look at the
influence of the farm to table, to continue on that. – [Woman] I have a question
about your broccoli. In broccoli, you talked
about how that enzyme gets destroyed in
blanching (speaks softly). Do you know that if that
study looked at any form of (murmurs) or cooking or (murmurs) or specifically, blanching in the water? Or would like roasted broccoli
or any broccoli that’s thin destroy that enzyme? Is it better to eat it raw? – I think it could. I think that’s one of the
benefits of not cooking it too death. (audience laughs) When I grew up, I gagged
when I ate broccoli because my mom would just like boil it and I don’t know what it turned into, but it wasn’t broccoli. It just smelled, it tasted awful. I think a lot of nutrients died as well. So definitely, steaming. Let it steam. – [Woman] I’m aware of the time and I know that people
have other commitments, so I’m gonna go ahead and end this now. Please stay. Talk to Sarah, Dr. Jones,
visit if you would like to or mingle with each other. For those of you who need to know to go, I know you need to do this. Thank you again. (audience applauds) (audience speaking over each other)

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