Issue 4 - 2011 (10)
Management of erectile dysfunction with a novel orodispersible formulation of the PDE-5 inhibitor vardenafilWritten by Maria Cordina
Maria Cordina - A man with the problem of ED may feel robbed of his identity
by Karen Attard, Maurice ZarbAdami, Lilian M. Azzopardi and Anthony Serracino-Inglott
by Albert Cilia-Vincenti
This series reviews Dean Ornish’s evidence-based claims of healing & disease reversal by dietary and lifestyle changes. He is a California University Professor of Medicine in San Francisco. This instalment discusses energy balance and dietary content.
There’s no mystery in how to lose weight – burn more calories and/or eat fewer ones – it’s all about energy balance. Exercise burns more calories. Simple changes like using stairs instead of the lift, parking a little further from your destination, and walking 30 minutes a day, can make a significant difference – small changes can eventually lead to big improvements.
An easy way than portion control to consume less calories, is to eat less fat, because fat (whether saturated, monounsaturated or polyunsaturated) has more than twice the calories per gram of protein or of carbohydrate. Eating less fat means consuming fewer calories without having to eat less food, thus increasing satiety without adding calories.
Food volume (and not calories) primarily determines how full you feel. Most good (complex) carbohydrates, like fruits and vegetables, are low in fat (low caloric density) and high in fibre, so you feel full before consuming too many calories. Researchers at Pennsylvania State University found that healthy women instinctively ate about 3 pounds of food daily, irrespective of whether the foods were high or low in calories. They found that those on a low-fat diet plus fruits and vegetables lost more weight than those on a low-fat diet alone.1
Food consumption data from the US Department of Agriculture’s National Food Consumption Surveys (NFCS) and the Continuing Survey of Food Intakes by Individuals (CSFII) states, “Individuals of all ages who consume a diet with fewer than 30 per cent of calories from fat, consistently have lower energy intakes. The data suggest that reducing fat intake is one effective strategy for also reducing total energy consumption. Given the increasing rates of obesity in the US at an earlier age, dietary-fat reduction may be an effective part of an overall strategy to balance energy consumption with energy needs”.
Another cause of getting too many calories is consumption of too many bad (simple) carbohydrates. These are low in fibre, and large quantities of calories can be consumed without feeling full. Factory processing and lack of fibre may cause these foods to have a high glycaemic index and often a high glycaemic load, meaning that they are absorbed rapidly, causing blood glucose spikes and insulin surges. These surges may cause a reactive hypoglycaemia, increasing hunger and a desire to eat more simple carbohydrates in a vicious circle, sometimes called “carbohydrate cravings”. An optimal diet is therefore low in both fat and bad carbohydrates.
Protein also helps increase satiety, and both plant proteins and animal proteins achieve this. However in general, plant-based proteins and seafood-based proteins are more healthy than animal-derived ones.2 Body weight is inversely associated with dietary fibre and carbohydrates, and is positively associated with protein intake. Meat has virtually no dietary fibre.
Professor Ornish’s dietary advice is about abundance, not deprivation – feeling better, not just living longer. He emphasises eating more foods that are beneficial rather than just eating fewer unhealthy ones. There are at least 100,000 substances in foods that have powerful anti-cancer, anti-heart disease, and anti-ageing properties. They include phyto-chemicals, bioflavonoids, carotenoids, retinols, isoflavones, genistein, lycopene, polyphenols, sulforaphanes and others. These protective factors are essentially found in fruits, vegetables, whole grains, legumes, soy products and some fish. These are rich in good carbohydrates, good fats, good proteins, and other protective substances.3
Ornish’s Preventive Medicine Research Institute conducted a double-blind, placebo-controlled, randomised controlled trial looking at the effects of pomegranate juice in people with coronary heart disease. After only 3 months, they found that blood flow to the heart was improved in those who drank one eight-ounce glass of pomegranate juice each day, whereas patients on placebo got marginally worse.4
Other studies are showing that pomegranate juice may help prevent and even slow the growth of prostate cancer and other tumours. A study at showed that a daily eight-ounce glass of pomegranate juice may reduce the recurrence of prostate cancer. Researchers claim that the effect may be so large as to help older men outlive the disease.5
Red wine may be good for your heart, but you can receive similar benefits from unfermented wine, i.e., grape juice. Substances such as flavonoids in grapes help keep arterial walls flexible, improve blood flow and reduce risk of thrombosis. They also help keep blood cholesterol from ending up in your arterial walls. Antioxidants in grape juice appear to linger longer in the body than in wine, according to researchers at the University of California’s institute of wine science at Davis, suggesting that alcohol may actually hasten the breakdown of antioxidants in the blood.
Researchers at Harvard Medical School and the National Institute on Aging, report that resveratrol, a natural substance found in the skin of red grapes and red wine, helps reduce the harmful effects of a high-calorie diet in mice and significantly extended their life span. However, the amounts of resveratrol given to the mice were equivalent to drinking 750 to 1,500 bottles of red wine daily.
- Ello-Martin JA, Liane SR, Ledikwe JH, Beach AM and Rolls BJ. Dietary energy density in the treatment of obesity: A year-long trial comparing 2 weight-loss diets. Am J Clin Nutr; 2007; 85 (6): 1465-77.
- Ludwig DS, Pereira MA, Kroenke CH et al. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. JAMA: 1999; 282 (16): 1539-46.
- Dewell A, Weidner G, Sumner MD, Chi CS and Ornish D. A very low-fat vegan diet increases intake of protective dietary factors and decreases intake of pathogenic dietary factors. J A m Diet Assoc; 2007.
- Sumner MD, Elliott-Eller M, Weidner G, Danbenmier JJ, Chew MH, Marlin R, Raisin CJ, Ornish D. Effects of pomegranate juice consumption on myocardial perfusion in patients with coronary heart disease. Am J Cardiol; 2005; 96: 810-14.
- Pantuck AJ, Leppert J, Zomorodian H, Aronson W, Hong J, Barnard RJ, Seeram N, Liker H et al. Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer. Clin Cancer Rev; 2006; 12 (13): 4018-26.
by Charmaine Gauci