Are Green Juices & Smoothies Actually Healthy? A Cardiologist Explains

Oh, the controversy over green smoothies and juices! Are they great for you...or not so great? Of course, if you're choosing between a green juice and a doughnut, there shouldn't even be a moment's discussion. But beyond that, the web is studded with debates and arguments for and against green juices and smoothies.

As I write this, I'm drinking a cold-pressed juice of chard, kale, celery, cucumber, lemon, and spinach, without added fruit. Am I causing harm or helping my health?

Let's dive into the science. In the last few years, a new system has been identified in our bodies that supports heart health: inorganic nitrates. Leafy greens and some other vegetables, like beets, are rich in them. When we swallow these nitrate-rich vegetables, they are rapidly absorbed in our GI tracts and appear in our bloodstream. They can be converted by the way of enzymes into nitric oxide (NO).

Let's all give a big cheer for NO. This miracle gas is made in the lining of our 50,000 miles of arteries (endothelium). When our arteries produce a lot of NO, our arteries relax, our blood pressure is normal, our blood is less likely to clot, and our arteries resist making plaque. There's another reason to be grateful for NO. When we want to have sex, it's NO that causes blood vessels to dilate and engorge the parts that need to grow. In other words: When you want to say yes to sex, say NO.

So when we eat leafy greens and drink our green juices and smoothies, the dietary nitrates power our blood vessels and improve the overall quality of our lives.

Then what's the controversy? There's an argument that to get the effects of dietary nitrates, our food needs to come in contact with bacteria on our tongue that convert the nitrates to make NO in our arteries. If you quickly gulp your green juices or smoothies past your tongue, you may not permit time for the bacteria to munch on the dietary nitrates.

But there is a secret, second pathway that you should know about. When our blood level of nitrates rise after eating or drinking plant-based nitrate-rich foods, the nitrates enter our salivary gland and are concentrated in our saliva. Our saliva may have nitrate concentrations 10 times that of our blood. How convenient! The green drink we swallowed 45 minutes ago may be secreted right on to our tongue to enjoy the bacteria-nitrate interaction. So if the bacteria don't get your dietary nitrates the first time down, this "entero-salivary" recirculation makes sure they get them the second time around. Is that not amazing?

So, fear not the green juices and smoothies. In fact, enjoy them! (But leave the fruit content low or absent.)

Here's one of my favorite detoxing green smoothies that will make your arteries say Hallelujah.

Ingredients

  • 1 cup green tea, chilled (or 1 teaspoon matcha green tea in water)
  • 1 cup loosely packed cilantro
  • 1 cup loosely packed organic baby kale (or another baby green)
  • 1 cup organic cucumber
  • 1 cup pineapple
  • juice of 1 lemon
  • 1 tablespoon fresh ginger, grated
  • ½ avocado

Preparation

Place ingredients into a blender and puree until smooth.

Joel Kahn, MD, FAAC

The Unexpected Source Of Household Toxins + How To Stay Safe: A Cardiologist Explains

I don't like to be an alarmist. The world is not coming to an end tomorrow. But the fact that we've created a far dirtier planet cannot escape posing some serious concerns.

In my field of cardiovascular disease, air pollution as a trigger for heart attack and death is rarely mentioned but is highly supported by quality research. Indeed, in a rather shocking analysis, living near a freeway was equated as a health risk to passively smoking 10 cigarettes a day. And the famous Framingham Heart study recently added to the huge database of research studies by identifying a relationship between air quality and cardiovascular inflammation.

So, perhaps like you, I hold my breath as long as possible when a truck or bus burps dark black fumes on the sidewalk—and I will not visit Beijing without a gas mask!

Of more immediate concern is indoor air pollution, right in your own home. The World Health Organization recently published a document that shocked me with statistics that might just push me into alarmist mode. Some of the facts they report on air quality in our homes and health include:

  1. Around 3 billion people cook and heat their homes using open fires and simple stoves burning biomass (wood, animal dung, and crop waste) and coal.
  2. Over 4 million people die prematurely from illness attributable to the household air pollution from cooking with solid fuels.
  3. More than 50 percent of premature deaths due to pneumonia among children under age 5 are caused by the particulate matter (soot) inhaled from household air pollution.
  4. There are 3.8 million premature deaths annually from noncommunicable diseases including stroke, heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer that are attributed to exposure to household air pollution.

Did you read the same words I read? Over 4 million people a year die from illnesses related to household air pollution. Of these deaths, 60 percent are due to stroke and heart disease—the conditions that I, as a cardiologist, am striving to prevent at all costs!

Two scientific studies have looked at the utility of high-quality air filters in the home to reduce indoor air pollution and heart disease measures, with different results. One demonstrated some reduction in the impact of nearby traffic air pollution in a residence using an air filter while another failed to show any benefit. A recent review on the topic favors a home air filter, with benefits for conditions from asthma to blood pressure. But clearly the jury is still out on the topic.

Until there is more information, here are five simple steps you can use to keep your indoor pollution down:

1. Keep your floors clean with door mats, regularly mop to pick up the dust, and use a vacuum with a HEPA filter.

2. Keep your home lower in humidity, as mites and mold love moisture. Fix leaky plumbing, vent the clothes dryer, don’t overwater plants, and use an exhaust fan when cooking, bathing, or running the dishwasher.

3. Make your home a no-smoking zone—that includes a wood-burning fireplace and grilling indoors. Do not have indoor fires whether for pleasure, heat, or cooking.

4. Test for radon periodically, which is linked to lung cancer and is odorless. This is true whether your home is new or old. Granite countertops have been linked to radon.

5. Avoid fragrances that use synthetic and volatile organic compounds (VOCs) that plug in, get thrown in the dryer, or are sprayed in the bathroom. Enjoy natural good smells as much as possible.

Considering all this, I've placed a powerful HEPA air filter in my bedroom. I have two rescue dogs that sleep on my bed every night after visiting every bush and flower bed all day long. Plus, the windows are open with screen doors blowing in all kinds of outside matter that I'd rather be filtered out. And I'm guilty of not taking my shoes off at the door (despite my wife’s reminders). I take comfort in knowing that the low-grade hum of a HEPA filter I hear at night is circulating and filtering the air I breathe. It may be a consideration for your home, too.

Joel Kahn, MD, FAAC

How To Defend Your Vegan Diet To Your Skeptical Doctor

How To Defend Your Vegan Diet To Your Skeptical Doctor

In this piece, renowned cardiologist Dr. Joel Kahn shares the benefits of a plant-based diet and explains how to present them to your own health care provider. If you're interested in learning more, check out his mindbodygreen course, Everyday Hacks for Long-Lasting Health: How to Eat, Move & Live for Longevity.

I've followed a plant-based diet since 1977, when the salad bar at my freshman dormitory at the University of Michigan was the only choice that looked edible. Today, I'm now an academic cardiologist as well as the owner of an award-winning plant-based restaurant in Ferndale, Michigan. That means I receive many questions about plant-based nutrition. One of the most common questions I get: "My doctor isn't supportive of a plant-based diet. What information can I share?”

Fortunately, the Kaiser-Permanente Medical Group, one of the nation's largest health plans, produced an excellent document, “Nutritional Update for Physicians: Plant-Based Diets,” that's a great resource to share with your health care provider. It appeared in a peer-reviewed journal and includes many scientific references your provider should respect. The paper presents a balanced view of plant-based nutrition—including five main benefits of the diet and five concerns—and can help your doctor understand your health journey. Here's a summary:

The key benefits of plant-based nutrition

1. It fights obesity.

In a review of studies on the topic of weight management, the report notes a number of main findings:

  • “A vegan diet caused more calories to be burned after meals in contrast to nonvegan diets."
  • “Vegetarian diets are nutrient dense and can be recommended for weight management without compromising diet quality."
  • “A plant-based diet seems to be a sensible approach for the prevention of obesity in children."
  • "Plant-based dietary patterns should be encouraged for optimal health.”

This information, along with the supporting references, can assist you in explaining why you're following a plant-based diet.

2. It can prevent diabetes.

The report also reviewed the fact that plant-based nutrition may offer an advantage for the prevention and management of diabetes. They noted that a "low-fat, plant-based diet with no or little meat may help to prevent and treat diabetes” and that “people on the low-fat vegan diet were able toreduce their medication."

3. It lowers high blood pressure.

When it comes to managing blood pressure, the report also found that “vegetarian diets were associated with lower systolic blood pressure and lower diastolic blood pressure."

4. It can reverse heart disease.

The strongest data for the health benefits of plant-based nutrition are for heart issues. The authors reviewed data from Dean Ornish, M.D., including the startling finding that “regression of even severe coronary atherosclerosis after only one year” was observed. In another study group, “vegetarians had a 24 percent reduction in ischemic heart disease death rates compared with nonvegetarians." Those are pretty convincing statements.

5. It could reduce mortality.

Need one more powerful reason to choose plant-based nutrition for your health goals? The Dietary Guidelines Advisory Committee notes that “plant-based diets were associated with a reduced risk of cardiovascular disease and mortality compared with non-plant-based diets."

The main concerns about plant-based nutrition:

1. Protein

The authors note that “generally, patients on a plant-based diet are not at risk for protein deficiency." They go on to say that “a well-balanced plant-based diet will provide adequate amounts of essential amino acids and prevent protein deficiency." Let’s give a giant supportive cheer—that should help answer the #1 objection you'll likely hear from your doctor.

2. Iron

Iron stores may be lower if you follow a plant-based diet. But the authors also note, "iron-deficiency anemia is rare even in individuals who follow a plant-based diet."

3. Vitamin B12

According to the report, “individuals who follow a plant-based diet that includes no animal products may be vulnerable to B12 deficiency and need to supplement their diet with vitamin B12." That is a fair statement and a good plan of action.

4. Calcium and vitamin D

There are a number of plant-based sources high in calcium, including greens and tofu. And vitamin D is found in soy milk and cereal grains. The report also notes: "Supplements are recommended for those who are at risk for low bone mineral density and for those found to be deficient in vitamin D." I'd advise you to ask for a blood level of your vitamin D-25OH.

5. Fatty acids

Linoleic acid (an omega-6 fatty acid) and alpha-linolenic acid (an omega-3 fatty acid) are the two essential fatty acids. Vegans are most likely to be deficient in omega-3. “Foods that are good sources of n-3 fats should be emphasized," the report says. "They include ground flaxseeds, flax oil, walnuts, and canola oil." Increasingly, blood tests that measure omega-3 levels are available and not expensive. I advise them for all of my patients, vegan or not.

Overall, the Kaiser-Permanente update is a great resource to help you explain your diet to your health team. The authors note that “the major benefits for patients who decide to start a plant-based diet are the possibility of reducing the number of medications they take to treat a variety of chronic conditions, lower body weight, decreased risk of cancer, and a reduction in their risk of death from ischemic heart disease”—that's a powerful endorsement that more in the medical world need to read and incorporate.

I recently handed out many copies of the Kaiser-Permanente paper to guests of my restaurant, which is often populated by medical residents, students, and health care providers. Print out the paper yourself, and share it with your health care team—I hope it makes your journey easier.

Joel Kahn, MD, FAAC

Evidence of Healthy Response of Arteries with Whole Foods

QUESTION:  

Dear Dr. Kahn,  

My Dad had two stents placed in his arteries, because scarring had occurred on a previous stent, causing another blockage. He has been following a plant based diet ever since and he wants to be sure he is doing everything he can to prevent a scarring blockage from recurring.                

- RU

ANSWER:  

Dear RU,

You may be referring to a rare process called restenosis after stents are placed. It means that tissue has grown back into the stent through small slots in the stents, and can re-narrow the artery.  While there is no data that I have seen showing diet prevents restenosis, the newer stents are drug coated and rarely re-narrow. To help prevent narrowing arteries elsewhere in the body however, there is a growing mountain of evidence that the rest of his arteries will likely respond to a whole food plant based diet (with no added oils, as in the Esselstyn style plant based diet).  

Joel Kahn MD

 

4 Foods Shown to Reverse Artery Disease

I was taught in medical school that coronary artery disease (CAD) progresses from minor “fatty streaks” in youth, to plaques in early adulthood, to complicated plaques causing heart attacks and death later in life. The arrows always pointed to the disease advancing and never reversing. This paradigm was first shown to be incorrect in 1990 by Dr. Dean Ornish, who used a plant-based diet without added fats along with walking, social support and stress management to reverse CAD on follow up angiograms. Since that first report, the data that heart disease can be reversed by intensive lifestyle changes emphasizing a plant based diet became so robust that the Ornish Lifestyle program was recognized by Medicare in 2010 for reimbursement as a therapy of CAD.

Although researchers like Dr. Ornish did not emphasize particular plant-based foods, subsequent studies suggest that certain foods may have special abilities to reverse CAD. Four foods that could reverse plaque in arteries are discussed here.

1) Garlic. The ability of garlic to lower blood pressure, cholesterol and blood clotting has been recognized for some time and has been shown again in a recent trial. In addition, garlic, along with onions, provides a source of sulfur in the diet which may be crucial for optimal amounts of antioxidants. In a study published earlier this year using baseline and follow up CT angiograms of heart arteries, garlic reduced areas of low attenuation plaque at the one-year follow-up.

2) Pomegranates have powerful antioxidant properties and may improve the function of the HDL cholesterol moiety to boost the “reverse cholesterol transport” that may reverse CAD. In studies of mice, pomegranates can reduce atherosclerosis. In humans with increased oxidative stress at risk for CAD, pomegranates reduced evidence of arterial damage. In another study using pomegranate juice for 3 years, the degree of narrowing in carotid arteries of five study subjects was reduced.

3) Bergamot. The bergamot is a citrus fruit that is native to the Calabria region of Italy. It has powerful antioxidant components that lower blood sugar and cholesterol. In a recent study of subjects with thickened carotid arteries, those given bergamot supplements had a marked reduction in carotid intimal thickening after six months of therapy.

4) Green tea. Green tea is comprised of many bio-active compounds that may lower oxidative stress, inflammation and cholesterol fractions leading to improved arterial health. In a study using angiographic analysis, the more green tea that was consumed, the lower was the risk of heart attack. A relationship between tea intake and lower cardiac mortality risk has also been reported.

The optimal goal of therapy of patients with CAD should be the reversal of disease with intensive lifestyle related measures and not just disease management. Indeed, in the Lifestyle Heart Trial, participants managed with medical therapy alone demonstrated progression of their CAD in follow-up. In addition to the scientifically proven approach utilizing a whole food, plant based diet without added oils, as demonstrated by the Lifestyle Heart Trial, certain specific plant based foods may have unique properties for promoting the reversal of CAD. A diet rich in garlic, pomegranates, bergamot fractions, and teas may accelerate the reversal of CAD.

Follow Joel Kahn, M.D. on Twitter: www.twitter.com/drjkahn

Reversing Type 2 Diabetes: An Urgent Call to Action

Reversing Type 2 Diabetes: An Urgent Call to Action

The explosion of Type 2 diabetes following the epidemic of obesity in Western countries is well known. The implications for a rise in heart attacks, strokes, blindness, kidney failure and amputations is overwhelming. Type 2 diabetes is to a large part a food-borne illness associated with excess calories and processed foods. Logic would have it that if poor food choices and obesity result in Type 2 diabetes, then better food choices and weight loss reverse the disease. 


The ability to reverse Type 2 seems so obvious that further scientific studies might seem superfluous. Dr. Neal Barnard previously demonstrated the superiority of a plant-based diet and weight loss to standard diets in Type 2 diabetes. My friend Marc Ramirez, a former University of Michigan right guard, developed Type 2 diabetes following weight gain in his 30s. On multiple medications for “management” of his disease, he was not aware of the potential to reverse it. After viewing the documentary Forks Over Knives he immediately transitioned to a low-fat, whole-food, plant-based diet just over four years ago. He lost weight easily and within a few months was off all medications with normal lab results. He remains free of medication to this point and has normal laboratory values. 


More hope comes from new data available this week. The new study involved 30 volunteers with Type 2 diabetes who followed a 600-700 calorie diet consisting of three diet shakes a day and 240 grams of non-starchy vegetables for eight weeks. Some had been treated for diabetes for up to 23 years. After eight weeks their usual diet was resumed but at one-third of their prior caloric intake and they were followed for six months. They were seen monthly.


What was found? Thirteen of the volunteers were free of Type 2 diabetes after six months of maintenance diet. Participants lost on average 30 pounds. Many remained overweight or obese but had lost enough to allow normal insulin production and action. 


Lead researcher Professor Roy Taylor commented that, “What we have shown is that it is possible to reverse your diabetes, even if you have had the condition for a long time, up to around 10 years. If you have had the diagnosis for longer than that, then don’t give up hope — major improvement in blood sugar control is possible. The study also answered the question that people often ask me — if I lose the weight and keep the weight off, will I stay free of diabetes? The simple answer is yes! The bottom line is that if a person really wants to get rid of their Type 2 diabetes, they can lose weight, keep it off and return to normal. This is good news for people who are very motivated to get rid of their diabetes.” 


While a larger trial of nearly 300 subjects is underway, the concept that Type 2 diabetes can be reversed, and not just managed, continues to build momentum as the best solution to the growing epidemic of “diabesity.”

Joel Kahn, MD, FAAC

Why The World Must Shift To Plant-Based Diets: A Doctor Explains

Maybe you already believe in the idea that “you are what you eat.” Now, a powerful new study takes that a step further, suggesting that the health of our planet is also what we eat.

In this new study, scientists calculated that eating more plant-based foods—and less meat—could reduce food-related greenhouse gas emissions 29 to 70 percent by the year 2050, as well as reduce mortality around the world between 6 and 10 percent. That translates to millions of lives and billions of dollars saved.

“Dietary change could have large health and environmental benefits,” Marco Springmann, the lead author of the study and a sustainability researcher at Oxford University, told the Washington Post.

Scientists used health and emissions models to predict the impact of dietary changes. By projecting what would happen to the health of the world and its citizens by eating more servings of fruit and vegetables, along with reducing the consumption of animal products, the scientists highlighted the profound global impact of a plant-based plate.

A plant-based diet will not only help us live longer but will also reduce the changes that are damaging our planet.

The Oxford study examined four different dietary scenarios out to the year 2050. One was a “business as usual" global diet. The second approach analyzed a healthier diet in which people, on average, consumed adequate calories based on a minimum of five portions of fruit and vegetables, less sugar, and just half a portion of red meat per day. The third and fourth patterns the scientists looked at were stronger dietary shifts toward vegetarianism, and finally full vegan-ism.

The results: if everyone followed the dietary recommendations in the second approach, food-related emissions would be reduced by 29 percent. If vegetarian diets were adopted, they'd be cut by as much as 63 percent. And as for full vegan-ism? Global emissions would be slashed by a stunning 70 percent.

Plus, the researchers estimated that dietary changes could lead to savings of $700 billion to $1 trillion per year on health care, unpaid care, and lost working days, while the economic benefit of reduced greenhouse gas emissions could be as much as $570 billion. The study also suggests that three-quarters of all benefits would occur in developing countries, although the per capita effects of dietary change would be greatest in developed nations, due to higher rates of meat consumption and obesity. “In terms of health care benefits, because the health expenditure is so large in the U.S., we find that the pure health care savings that would be associated with dietary shifts would be the largest actually of all countries,” Springmann said.

So what does this mean for you? Springmann went on to tell Reuters, “we do not expect everybody to become vegan." But he does believe that more are moving in a plant-based direction. “We already see a plateauing of meat consumption in higher income countries, like Europe,” he told theWashington Post.

And as this study shows, even small changes toward a more plant-based diet will not only help us live longer but will also reduce the changes that are damaging our planet.

Joel Kahn, MD, FAAC

Hottest Story in Heart Disease - The Vegan Gut

There is a revolution going on in understanding a new cause of heart disease and vegans, those following a plant based diet, are enjoying recognition for their superior health.  The revolution is a new connection between our dietary choices and the chance we will get clogged arteries and the bacteria in the GI tract are playing a central role. What is the news?

In 2011 researchers at the Cleveland Clinic searched for new and novel predictors of heart disease. The standard “risk factors” for heart disease were described in the 1960s from the Framingham Heart Study and include smoking, elevated cholesterol, elevated blood pressure, diabetes mellitus, and a first degree relative with early heart disease.  Not much has changed since then and it was time to search for further instigators of heart disease.

The researchers found 3 compounds, choline, betaine, and TMAO as suspicious new factors in heart disease.  TMAO or tri-methyl amine oxide, was new on the scene and is produced from choline and betaine in our diet.  Further study in animal and human models found that TMAO was produced from dietary choline and betaine and was the new factor causing heart disease.  The researchers showed that TMAO increased the accumulation of cholesterol in the wall of arteries to begin plaque buildup. Further work has shown that TMAO also prevents cleaning up of cholesterol diseased arteries so it is a double whammy.

TMAO is produced from choline, usually phosphatidyl choline, which is concentrated in egg yolks.  As soon as a typical research volunteer eats eggs the blood level of TMAO skyrockets up in the blood.  While some dietary choline is necessary for health, the higher the blood level of TMAO the more advanced and severe heart disease was found in patients at the Cleveland Clinic.  Subsequent research has shown that feeding l-carnitine to subjects, in the form of a steak, produces major rises in TMAO also. It is now understand that both choline, betaine, and l-carnitine in eggs, dairy and meat are converted by the bacteria of typical Americans to TMA and then our liver converts it to TMAO. Watch out arteries.

How do vegans figure in this story?  Researchers recruited vegans and paid them to eat eggs or steak and measured TMAO blood levels.  What happened?  Nothing.  Vegans have different bacteria in our GI tract than omnivores and apparently the enzyme that convert these food sources to TMA is absent or nearly so.  Certainly the bacterial flora of the vegans, and the inability to produce TMAO, is a major advantage in terms of avoiding heart disease.

What is brand new in TMAO research?  It is now known that TMAO causes scar tissue in kidneys and is both a marker of kidney damage and directly injures kidneys. Furthermore, elevated TMAO levels in congestive heart failure are now established and TMAO may scar the heart too.  Avoiding eggs, dairy and meat may be wise in these conditions. Researchers are working on blocking TMAO. If you block the conversion from TMA to TMAO you may end up smelling “fishy” and that may be an unpopular. A new agent, DMB, found in balsamic vinegar and some wines, has just been shown in an animal model to block the production of TMA from bacteria in the gut.  Whether this will be safe or effective in humans is unknown.

For now, avoiding dairy, eggs and meat is the wisest path to improve your health and avoid the chronic diseases including heart disease, cancer, adult diabetes, obesity and dementia. There is a brand new lab test for TMAO available and my heart prevention clinic is the first in Michigan to offer it.  So far my patients have been normal but I have a lot of vegan patients!  So when people ask you where do you get your protein, just ask them “Where do you get your TMAO”?

Proactively pursuing cardiovascular wellness; Can you help us unravel contradictory info so we can follow a well-planned diet?

Question:

My husband and I had a proactive cardiovascular wellness check up through our local hospital. He was diagnosed with Metabolic syndrome, Obesity, and Hypertension.  I have pre-Hypertension, and my Lipoprotein A is 125.  We then chose to start an Ornish-style plant-based diet, but were actually advised to eat meat,and eliminate grains and sugar, being told "Carbohydrates are your problem."  That just sounds like a backdoor to the Atkins diet.  Help us unravel contradictory info so we can follow a well-planned diet!

Answer:

My approach, as the only certified heart attack prevention MD in Michigan, is to clearly define the disease in the arteries via CT screening imaging of the heart, and carotid ImT ultrasound.  Then a hunt for inflammation, insulin resistance and other root causes is pursued. A diet without animal products that is low in oil and added sugars is the only proven diet to reverse disease. 

Joel Kahn MD

Eat your Greens!

How many times have you heard the recommendation to eat your greens? Kale, bok choy, mustard greens, broccoli and other vegetables have been praised as superfoods and are often rated as the healthiest foods to eat. Although there are many components of these foods that contribute to health like the fiber, minerals, micronutrients and antioxidants, the green color itself may aid our health. Why are these vegetables green?

They are green because they contain large amounts of chlorophyll. Chlorophyll is from the Latin “green leaf” and is the green color leaves and plants. Chlorophyll is formed in the cells of the leaves and other parts of the plants exposed to light. Green plants take in sunlight and transform it into energy. This is called photosynthesis. Chlorophyll is the chemical that permits this transformation. The structure of chlorophyll is nearly identical to hemoglobin, the molecule that carries oxygen in our blood. The major difference is chlorophyll has a magnesium molecule in its middle while hemoglobin has an iron molecule. There is a water soluble form of chlorophyll called chlorophyllin that exhibits actions as chlorophyll in many studies. There have been many benefits described by eating foods rich in chlorophyll. Scientists showed long ago that that chlorophyll kills bacteria. It kills strep and staph and harmful bacteria in the GI tract. Chlorophyll consumption increases the number of red blood cells and, therefore, increases oxygen utilization by the body. Chlorophyll also reduces the binding of carcinogens to DNA in the liver and other organs. It can also break down calcium oxalate kidney stones for elimination. Another function of chlorophyll may be to inactivate the actions of molds. The absorption of a mold toxin called aflatoxin B, linked to liver cancer, is reduced by chlorophyllin.

A research report in 2014 raises the question of whether mammals can also generate energy from from sunlight. Are we human plants? In the study the “powerhouse” of the cell, the mitochondria, were shown to generate ATP energy when exposed to sunlight when fed a chlorophyll rich diet. If this wild finding is confirmed it might explain why people feel energized by being in the sunshine, particularly if their diet is high in chlorophyll rich foods.

While all green plants and most vegetables that we eat contain chlorophyll, some vegetables contain particularly high amounts of total chlorophyll. Spinach is particularly high in chlorophyll. Other green vegetables that are sources of chlorophyll include:

* alfalfa

* asparagus

* beet greens

* bell peppers

* broccoli

* Brussels sprouts

* green cabbage

* celery

* collard greens

* green beans

* green peas

* kale

* leeks

* green olives

* parsley

* romaine lettuce

* sea vegetables

* Swiss chard

* turnip greens

So the next time you eat a green vegetable pause for a moment to appreciate the complex chemistry of chlorophyll that helps our health and prevents disease. By increasing your intake of greens you will power your heart and body to better performance and might just be helping it produce increased ATP energy like a plant.

Is it possible for someone with a stent to go plant based and eventually, safely, get off all of their heart medication?

Question:

Is it possible for someone with a stent to go plant based and eventually, safely, get off all of their heart medication?

Answer:

Aspirin is required lifelong and for the first year a second blood thinner is mandatory.  Others? Possible but must be monitored for vital signs and lab values. 

Joel Kahn MD

Is Juicing ok for a heart attack survivor?

Question:

I have been reading your book, The Whole Heart Solution. I was wondering what your thoughts were regarding Dr. Esselstyn's no juice or smoothies. I noticed that you encourage both in your book. Do you feel that ideally, someone who has had a massive heart attack would be better off staying away from the juice and smoothies and chewing their fruits and vegetables?

Answer:

I would not connect smoothies and juicing to actually having a heart attack. No way. Dr Esselstyn wants us to chew our veggies to activate a system that makes more nitric oxide in our bodies. I imagine if you chew juice or a smoothie the same thing happens. But ditch the fish and oil. 

Joel Kahn MD

Carrageenan, is it safe?

Question:

Hello, My question is about Almond Milk that has carrageenan as an additive. I was reading the ingredients on a container of Almond Milk recently and one of the ingredients is carrageenan. I have heard carrageenan is bad for you and it could even be carcinogenic. I looked up some research and see several papers agree that carrageenan could be risky to consume. I try to avoid carrageenan. I only buy products without it (including pet food). What are your thoughts on this?
 

Answer:

I searched and there is no new data.  Almond milk with carrageenan is a better choice than cow's milk unless you have GI issues.  Of course if you find a brand without it, even better. For my family, I have decided to purchase products that are free of carrageenan in order to avoid even a remote chance that they're pro-inflammatory and raise blood sugar.  

Joel Kahn MD

Dr. Joel: Plant-based Calcium deficiency is a load of C.R.A.P.

Got brainwash?

Calcium is only one of many nutrients important to optimal health but it gets nearly all the attention, next to the macro-nutrient protein, because of the campaigns the dairy industry has been waging for decades. These brain-washers, like Got Milk as well as the campaign to promote chocolate milk after athletic events, have created the impression that a deficiency of dairy and calcium was nutrition enemy public number one.  As we well know, public enemy number one is too much C.R.A.P. (Cow products, Refined food, Artificial ingredients, Processed hyper-caloric Frankenfoods).

I will share with you my secret to getting enough calcium daily that I have been using for 30 years….I never think about it.  I eat a broad range of fruits, vegetables, legumes, limited seeds, and whole grains.  And you can do the same.

As we well know, public enemy number one is too much C.R.A.P. (Cow products, Refined food, Artificial ingredients, Processed hyper-caloric Frankenfoods).

resources

However, for clarification, there are great resources  to learn more about the calcium content of plant-based foods and table listing those richest in calcium, such as PCRM's vegetarian starter kit. Collard greens, beans, figs, fortified “mylks,” and fortified orange juice (not a big fan of that sugary brew however) are all rich in calcium. 

it doesn't do a body good

Am I concerned about dairy intake beyond the issues of saturated fat and the impact of the cattle industry on the environment and the inhumane treatment of dairy cows?  I am concerned about the C of CRAP from a medical standpoint.  Excess animal protein introduces a large acid load to the body not found in plant-based diets that tend to alkalinize the body. It has been hypothesized that to overcome these slightly acidfying effects of animal-based diets, buffers in the bone, like bicarbonate, are released, and bone health suffers. There are communities that eat low amounts of calcium, are largely plant-based, and have low rates of osteoporosis. Finally, there is at least some concern that taking calcium supplements in excess can increase the development of heart disease, a point requiring further evaluation at present (http://www.ncbi.nlm.nih.gov/pubmed/23381719 ). 

easy advice

Overall, a daily plan to eat sources of calcium rich foods like beans, figs and greens, eating plant-based protein sources, enjoying some sunshine, taking a vitamin D supplement (around 2,000 IU a day), not smoking, and avoiding excess salt is a great plan for overall health and bone health too. 

Dr. Kahn from Camp Reboot: Should I juice?

Dr. Kahn is the keynote this speaker at Joe Cross' Camp Reboot, but took a few minutes to discuss all things juicing with us!

To Juice or Not To Juice Your Veggies? Some thoughts from Camp Reboot

For more information on Camp Reboot, click here

If you haven't seen Fat, Sick, and Nearly Dead and it's sequel, they are worth a look. You can find them on Netflix. Here's a preview:

For a limited time watch the film free: http://www.rebootwithjoe.com/watch-fat-sick-and-nearly-dead/ 100 pounds overweight, loaded up on steroids and suffering from a debilitating autoimmune disease, Joe Cross is at the end of his rope and the end of his hope.

Joel Kahn MD

Is Detox a Crock?

Everywhere you turn there is another detox program. Some use foods, some use powders, some have pills. Is this all nonsense?

Fortunately, almost all of the detoxifying foods are plant based with no added oil so stay strong, NO oil, and plant pure.


Actually I do not believe it is all a crock of poop.  I just read a fascinating research paper on how the body eliminates toxins from the body, a process that is continually ongoing.  Most of this is in the liver but we also eliminate toxins via urine, feces, breath, and sweat. The liver detoxification pathways depend on enzymes that through Phase I and Phase steps prepare toxins for elimination.  These enzymes are sensitive to many influences like pharmaceutical drugs but they are also sensitive to food. It turns out that a plant strong diet can facilitate these pathways and help the body eliminate its poisons and excesses.  Here are a few examples.


Cytochrome system: This family of enzymes is the first defense to metabolize hormones, toxins and drugs. Many foods have an impact on this system including:
Cruciferous vegetables like kale and cauliflower

  • green and black tea
  • curcumin
  • garlic
  • rosemary
  • soybeans
  • blueberries
  • pomegranate
  • grapes
  • yellow onions
  • dandelions

UGT system: This family, the UDP glucuronosyltransferases, enhances the elimination of transformed toxins via urine and feces. Foods that enhance the UGT system include:
cruciferous vegetables

  • citrus
  • dandelion
  • rooibos tea
  • rosemary
  • soy
  • pomegranates
  • whole grains
  • turmeric
  • resveratrol found in grapes and wine

SULT system: These are sulfur based transfer enzymes that reduce toxicity of a variety of substances.  The foods that have been reported to improve this systems activity are:

  • Legumes
  • barley
  • oatmeal
  • cruciferous vegetables
  • mustard
  • ginger
  • green tea

GST system.  Glutathione is crucial antioxidant in the body but also plays an important role in detoxification in the liver. Glutathione-s-transferases are enzymes that power this reaction and are increased by the following foods:

  • cruciferous vegetables
  • garlic and onions
  • grapes
  • citrus
  • turmeric
  • purple sweet potato
  • green tea
  • pomegranates
  • fermented soy products like tempeh and miso

Nrf2 System. This fascinating system deserves a whole lecture but it causes the bodies antioxidants to increase and protect the organs from oxidant stress. Foods can enhance the Nrf2 system and the most active ones are:

  • Tomatoes and watermelon rich in lycopene
  • turmeric
  • cruciferous vegetables
  • garlic
  • green tea
  • cocoa
  • grapes
  • purple sweet potato
  • rosemary
  • blueberries
  • pomegranate
  • whole grains

It is clear that one’s dietary intake and environmental influences have a large bearing on the incidence of chronic diseases  like heart disease and diabetes.  Food is medicine and food can assist the elimination of toxins from multiple sources in our diet and environment. Fortunately, almost all of the detoxifying foods are plant based with no added oil so stay strong, NO oil, and plant pure. 

Divine Intervention

Thanks to an angel that I do not remember.  In 1987 I was a vegetarian, but someone handed me a copy of A Diet for A New America by John Robbins and I chose to follow a vegan diet as the core of my health maintenance program. I want to explain why I continue to eat, shop and dine in this manner in the face of so many options, and why I recommend it to my patients. In fact, these are the reasons my son Daniel and I are opening GreenSpace Cafe, the first plant based restaurant in the USA with a dedicated NO OIL menu.

V is for Vitality. 

I eat many chlorophyll rich vegetables (including some raw and living foods such as sprouts, sea vegetables, and blue and green algaes), which helps me power me through long days with a bounce in my step and a sharp mind. I also get a bounty of fiber, phytonutrients, minerals, vitamins, and antioxidants, due to the rainbow of colors that make up my daily selections. This supplies protective biological pathways with the building blocks needed for optimal health and energy. Spices enhance my health and add flavor to my plate. Almost any chronic disease can be improved upon by the vitality in a plant-based menu.

E is for the environment.  

The world's population now exceeds 7 billion persons and by the year 2050, it will exceed 9 billion. Diets rich in meat, eggs and dairy, and the methods required for their production, will simply not be sustainable and will cause serious further damage to our planet promoting climate change. A few years ago, the United Nations Environment Programme called for a shift to a vegan diet for the planet Earth. The USDA and recently the Pope has followed suit and endorsed responsible eating emphasizing environmentally friendly plant-based diets.  I vote with my fork and spoon every day by reducing my carbon footprint and protecting the planet for my children and theirs.

G is for gastronomy.  

Vegan diets are anything, but boring or bland. Only a few food items are excluded, such as animal meat, animal dairy, and eggs. That leaves thousands of menu offerings from fruits, vegetables, grains, nuts, seeds, spices, and legumes. I have a favorite restaurant that offers a weekly 3-course vegan gourmet menu and, after nearly 5 years, the selections have never been repeated! Your palate can learn to appreciate the subtleties of flavors never to be found in meals overwhelmed by meat, eggs and dairy. If you don't believe me yet, come visit me at GreenSpace Cafe and we will wow you. 

A is for animal rights. 

Although we sometimes hide behind the word vegan, it is something to embrace, share and promote.

Simply put, the average piece of meat, chicken egg, or dairy product consumed in America is produced through cruel factory farmed methods that favor pain over compassion, and production numbers over quality or cleanliness. I agree with Leonardo da Vinci when he wrote that “the time will come when men such as I will look upon the murder of animals as they now look on the murder of men.”

N is for natural. 

Our food chain has been transformed in the last 50 years to a toxic soup of pesticides, herbicides, antibiotics, and hormone-treated choices. Food colorings, preservatives, and synthetic “vitamin” enhancements are prevalent. 

The vast number of choices in grocery stores and convenience shops are not farm food, but chemical “frankenfoods” catering to our food addictions but not our health. 

Although a plant based diet requires a familiarity with GMO and organic trends the food chain, in general, an apple, a bunch of kale, or a pound of flax seeds represent choices closer to the farm, more directly from a plant, and farther from a factory and its toxins.

I feel fortunate that a kind soul lent me John Robbins’ book over 25 years ago so I could embark on a plant pure health journey that has enhanced my life and allowed me to teach so many of its virtues. Although we sometimes hide behind the word vegan, it is something to embrace, share and promote. 

Chronic disease runs in my family. I think my genes are at fault. What can I do?

Is your health determined by the genetic code you inherited from your mother and father? Or do you have the ability to impact your fitness and longevity by practicing a healthy lifestyle? When completion of the Human Genome Project was announced in 2003 many expected that the paradigm that one gene for one malady would leave little control over our wellness.

Joel Kahn, MD

Joel Kahn, MD

That this concept was short lived was the center of conversation last night with my friend Evan. His belief was that there was heart disease in his family and it was inevitable that he would suffer the same fate. Evan was no lightweight. He had completed an advanced education degree years ago and was a successful business and community leader. The idea that his health was predetermined by his nature, or his genetic content, weighed on his mind.

The Human Genome Project determined that the human genetic code was smaller than expected, about 22,000 genes, which is "more than a chicken but less than a grape." Indeed, our genes, though not many in number compared to some species, are under the influence of our environment, and specifically our lifestyle. This scientific discovery is called epigenetics. The influence of diet, or nutrigenomics, plays a particularly potent role. While you may not eat your way into blond hair and blue eyes (genetically determined features that are not influenced by lifestyle) your risk of disease can be shifted dramatically and quickly.

The response that I got explaining this to Evan is one I share with many patients and inspires hope that nurturing our nature with a healthy lifestyle can determine the likelihood of years of health or disease. I explained to him some of the findings made by Dr. Dean Ornish in the last decade. For example, in a group of men with low-grade prostate cancer placed on plant based diets along with stress reduction and walking programs, 453 genes controlling tumor growth were less active and 48 genes related to tumor suppression were more active after only 3 months. In another study using the same program in 63 men with heart disease, 3 months after making lifestyle changes 26 genes were expressing different amount of proteins and after 1 year 143 genes were doing the same, reducing proinflammatory activity that harm arteries. Finally, if it is the fountain of youth you are after there is even more hope. Following the Ornish lifestyle program for five years led to measurements of relative telomere length, a marker of aging, disease, and premature morbidity, to increase favorably while a control group demonstrated the usual shortening or aging. Other factors that may play a role in controlling our genes included sleep, stress, exercise, and environmental exposures.

The power of understanding that we are not doomed to live out a pre-determined path controlled entirely by our genes is empowering and Evan responded with excitement. I could sense that relief and hope resulted from my brief scientific overview. While we have much to learn about the amount of control we have over the genetic input to our health, and the most effective methods of producing desired results, we should not wait. Clean food, air, and water along with sleep, and the avoidance of smoking and unmanaged stress is a powerful plan for nurturing our nature.