Diet

Posted on autoimmune conditions, Diet, Lupus, Sjögren’s Syndrome

Research case series presents food as medicine as a potential treatment for lupus and other autoimmune diseases

The research published in Frontiers in Nutrition describes the history of three women with lupus and Sjögren’s syndrome who achieved remission of symptoms following dietary changes alone.
The research published in Frontiers in Nutrition describes the history of three women with lupus and Sjögren’s syndrome who achieved remission of symptoms following dietary changes alone.


A new research case series published in Frontiers in Nutrition presents food as medicine as a potential treatment for autoimmune diseases, describing three patients with chronic autoimmune disease who showed remarkable improvement after following a predominantly raw dietary pattern high in cruciferous vegetables and omega 3 fatty acids. 
The research focused on three women with systemic lupus erythematosus and Sjögren’s syndrome who adopted a nutrition protocol that emphasized leafy greens, cruciferous vegetables, flax or chia seeds for omega-3 polyunsaturated fatty acids, and water, and included predominately raw foods. All three women reported that nearly all their symptoms of both diseases resolved after just four weeks of making the dietary changes.

Furthermore, all three patients have remained symptom-free, with two of them reporting no symptoms for more than six years without recent medication use. The research was published as part of an upcoming special issue of the journal focused on food as medicine and edited by the American College of Lifestyle Medicine (ACLM).
“Although the healing benefits of a predominantly plant-based eating pattern have been clearly demonstrated for cardiometabolic outcomes, clinical attention and research has been lacking on its effectiveness at treating and managing autoimmune diseases,” the study’s author, Brooke Goldner, MD, said. “The dramatic improvements in symptoms and quality of life reported by the three patients in this case series demonstrates what I see every day in my practice, that autoimmune diseases can quickly improve with optimal nutrition.
“My hope is that these cases generate greater recognition, making patients and clinicians aware of food as medicine as a treatment option for systemic lupus erythematosus and Sjögren’s syndrome. This case series also reflects the immediate need for more research into dietary changes as a potential treatment strategy for autoimmune disease.”  
Dr. Goldner herself has been free from debilitating lupus symptoms, including arthritis, photosensitivity, renal impairment, and antiphospholipid antibody clotting issues for over 18 years, which she attributes to the nutrition protocol.
Systemic lupus erythematosus is the most common type of lupus, an autoimmune disease in which the immune system attacks its own tissues, according to the U.S. Centers for Disease Control and Prevention. It has no cure and common symptoms include extreme fatigue, joint pain and swelling as well as hair loss. Sjögren’s syndrome is an immune system disorder that causes symptoms such as dry mouth and eyes and can accompany systemic lupus erythematosus.
The patients presented in the case series followed a strict customized, plant-based nutrition protocol called the Rapid Recovery Protocol (RRP), which was developed by Dr. Goldner and eliminates all processed food. The nutrition protocol shares similarities with a whole-food, plant-based diet but focuses “on predominately raw foods and high intakes of leafy greens and cruciferous vegetables, omega-3 polyunsaturated fatty acids (whole, ground flax or chia seeds; cold pressed flaxseed oil), and water.” Once remission was achieved, patients were allowed to begin a maintenance phase and incorporate cooked whole plant foods, and more fruits, nuts, seeds, and whole grains. 
The study publication includes a supplemental set of personal accounts from the three patients, who described in their own words their experience of achieving remission of symptoms within four weeks or less. One patient, a 40-year old who was diagnosed with lupus when she was nine months pregnant, reported experiencing symptoms since 2010 that included fatigue, extreme photosensitivity and leg pain that required her to spend much of the day lying down. After beginning the RRP protocol in 2017, she reported that her joint pain dissipated within weeks and that she could experience sunlight comfortably again.
“The most exciting thing for me was when I realized being in direct sunlight didn’t hurt my skin,” she said. “I’ll never forget the feeling of going to the beach two months after giving birth and enjoying the feeling of the warmth of the sun on my face and body.”
The second patient, a 54-year-old educator, experienced photosensitivity, butterfly rash, itchy scalp, and constant fatigue. Before starting the protocol, she was frequently hospitalized with pleurisy, an inflammation of the tissue separating the lungs and chest wall, and suffered from severe dry mouth that made it difficult to eat. She had brain fog and worried at one point she suffered from early-onset Alzheimer’s.
After completing the protocol, she said “I can walk everywhere. I can play with my kids, I can remember things, and I don’t have to write everything down. I can type, I can text, and I don’t take any painkillers anymore.”
The third patient, a 45-year-old teacher and mother of four, suffered from severe brain fog, debilitating fatigue, nerve pain, a grittiness in her eyes, and patches of skin that hurt as if they were sunburned, among other symptoms. She started the protocol in 2021 and said many of her symptoms went away within weeks.
“I was able to stay up late,” she said. “I wasn’t tired anymore. My skin and joint pain vanished. I didn’t feel nauseous anymore. My body felt amazing…It absolutely feels amazing to be well.”
Posted on Diet

Food matters: flexitarian diets increase the economic and physical feasibility of 1.5°C

“We find that a more sustainable, flexitarian diet increases the feasibility of the Paris Agreement climate goals in different ways,” says Florian Humpenöder, PIK scientist and co-lead author of the study to be published in Science Advances. “The reduction of greenhouse gas emissions related to dietary shifts, especially methane from ruminant animals raised for their meat and milk, would allow us to extend our current global CO2 budget of 500 gigatons by 125 gigatons and still stay within the limits of 1.5°C with a 50 per cent chance,” he adds.



Putting a price on greenhouse gas (GHG) emissions in the energy and land system is an important policy instrument to stay within the limits of 1.5°C warming. “Our results show that compared to continued dietary trends, a more sustainable diet not only reduces impacts from food production within the land system, such as deforestation and nitrogen losses. It also reduces GHG emissions from the land system to such an extent that it cuts economy-wide 1.5°C-compatible GHG prices in 2050 by 43 per cent,” explains co-lead author Alexander Popp, leader of the working group land-use management at PIK. “Moreover, healthy diets would also reduce our dependency on carbon dioxide removal in 2050 by 39 per cent,” he adds.  

A flexitarian diet could make a marked difference for the feasibility of the 1.5°C target.

Until now, the existing literature has not allowed the single-out contribution of dietary shifts for the feasibility of the 1.5°C limit. In the new study, PIK scientists investigated how dietary shifts would contribute towards the feasibility of 1.5°C transformation pathways relative to a scenario without dietary shifts. The researchers used the open-source Integrated Assessment Modelling framework REMIND-MAgPIE to simulate 1.5°C pathways, one including dietary shifts towards the EAT-Lancet Planetary Health Diet by 2050 in all world regions. “The EAT-Lancet Planetary Health Diet is a flexitarian diet predominantly featuring a wide variety of plant-based foods, a marked reduction of livestock products, especially in high- and middle-income regions, and restricted intake of added sugars, among other things,” says co-author Isabelle Weindl from PIK.

However, considerable challenges are yet to be addressed: Decision-making in food policy is often dispersed across different institutions and ministries, which hinders the implementation of coherent policies in support of healthy diets. Moreover, social inclusion and compensation schemes are central for a just transition to healthy diets, the authors state.

„The results indicate that a shift in our diets could make a considerable difference if we do not want to crash through the 1.5°C limit in the next 10 to 15 years. This calls for globally concerted efforts to support the transition towards sustainable healthy diets,” concludes Johan Rockström, PIK director and co-author of the study.

Posted on Diabetes, Diet

Eggs may not be bad for your heart after all

Subgroup analyses signal a possible benefit among older adults and those with diabetes
Subgroup analyses signal a possible benefit among older adults and those with diabetes

Whether you like your eggs sunny-side up, hard boiled or scrambled, many hesitate to eat them amid concerns that eggs may raise cholesterol levels and be bad for heart health. However, results from a prospective, controlled trial presented at the American College of Cardiology’s Annual Scientific Session show that over a four-month period cholesterol levels were similar among people who ate fortified eggs most days of the week compared with those who didn’t eat eggs.

A total of 140 patients with or at high risk for cardiovascular disease were enrolled in the PROSPERITY trial, which aimed to assess the effects of eating 12 or more fortified eggs a week versus a non-egg diet (consuming less than two eggs a week) on HDL- and LDL-cholesterol, as well as other key markers of cardiovascular health over a four-month study period.

“We know that cardiovascular disease is, to some extent, mediated through risk factors like high blood pressure, high cholesterol and increased BMI and diabetes. Dietary patterns and habits can have a notable influence on these and there’s been a lot of conflicting information about whether or not eggs are safe to eat, especially for people who have or are at risk for heart disease,” said Nina Nouhravesh, MD, a research fellow at the Duke Clinical Research Institute in Durham, North Carolina, and the study’s lead author. “This is a small study, but it gives us reassurance that eating fortified eggs is OK with regard to lipid effects over four months, even among a more high-risk population.”

Eggs are a common and relatively inexpensive source of protein and dietary cholesterol. Nouhravesh and her team wanted to look specifically at fortified eggs as they contain less saturated fat and additional vitamins and minerals, such as iodine, vitamin D, selenium, vitamin B2, 5 and 12, and omega-3 fatty acids.

For this study, patients were randomly assigned to eat 12 fortified eggs a week (cooked in whatever manner they chose) or to eat fewer than two eggs of any kind (fortified or not) per week.  All patients were 50 years of age or older (the average age was 66 years), half were female and 27% were Black. All patients had experienced one prior cardiovascular event or had two cardiovascular risk factors, such as high blood pressure, high cholesterol, increased BMI or diabetes. The co-primary endpoint was LDL and HDL cholesterol at four months. Secondary endpoints included lipid, cardiometabolic and inflammatory biomarkers and levels of vitamin and minerals. 

Patients had in-person clinic visits at the start of the study and visits at one and four months to take vital signs and have bloodwork done. Phone check-ins occurred at two and three months and patients in the fortified egg group were asked about their weekly egg consumption. Those with low adherence were provided additional education materials.

Results showed a -0.64 mg/dL and a -3.14 mg/dL reduction in HDL-cholesterol (“good” cholesterol) and LDL cholesterol (“bad” cholesterol), respectively, in the fortified egg group. While these differences weren’t statistically significant, the researchers said the differences suggest that eating 12 fortified eggs each week had no adverse effect on blood cholesterol. In terms of secondary endpoints, researchers observed a numerical reduction in total cholesterol, LDL particle number, another lipid biomarker called apoB, high-sensitivity troponin (a marker of heart damage), and insulin resistance scores in the fortified egg group, while vitamin B increased.

“While this is a neutral study, we did not observe adverse effects on biomarkers of cardiovascular health and there were signals of potential benefits of eating fortified eggs that warrant further investigation in larger studies as they are more hypothesis generating here,” Nouhravesh said, explaining that subgroup analyses revealed numerical increases in HDL cholesterol and reductions in LDL cholesterol in patients 65 years or older and those with diabetes in the fortified egg group compared with those eating fewer than two eggs.

So why have eggs gotten a bad rap? Some of the confusion stems from the fact that egg yolks contain cholesterol. Experts said a more important consideration, especially in the context of these findings, might be what people are eating alongside their eggs, such as buttered toast, bacon and other processed meats, which are not heart healthy choices. As always, Nouhravesh said it’s a good idea for people with heart disease to talk with their doctor about a heart healthy diet.

This single-center study is limited by its small size and reliance on patients’ self-reporting of their egg consumption and other dietary patterns. It was also an unblinded study, which means patients knew what study group they were in, which can influence their health behaviors.

Posted on Diet

An avocado a day may improve overall diet quality, researchers report

 According to a team led by researchers in Penn State’s Department of Nutritional Sciences, eating one avocado per day may improve overall diet quality. Poor diet quality is a risk factor for many diseases, including heart disease, and many American adults have poor diet quality and do not meet key dietary recommendations provided by the Dietary Guidelines for Americans.

This study was led by Kristina Petersen, associate professor of nutritional sciences, and Penny Kris-Etherton, retired Evan Pugh University Professor of Nutritional Sciences, and recently published in the journal Current Developments in Nutrition.  The researchers examined how a food-based intervention — one avocado per day — impacts overall diet quality.

“Avocados are a nutrient-dense food, containing a lot of fiber and other important nutrients. We wanted to see if regular intake of this food would lead to an increase in diet quality,” Petersen said. “Previous observational research suggests avocado consumers have higher diet quality than non-consumers. So, we developed this study to determine if there is a causational link between avocado consumption and overall diet quality.” 

Petersen stated that because only 2% of American adults are regular avocado consumers, the researchers wanted to determine if including avocados in an individual’s daily diet could significantly increase their diet quality.

Researchers conducted phone interviews with participants before the study began and at a few points throughout to determine what their dietary intake was like in the previous 24 hours and evaluated their diets using the Healthy Eating Index to determine how well they adhered to the Dietary Guidelines for Americans. Adherence to the guidelines was used as a measure of overall diet quality.

The study consisted of 1,008 participants who were split into two groups. One group continued their usual diet and limited their avocado intake during the 26-week study, while the other group incorporated one avocado per day into their diet.

“We found that the participants who had an avocado per day significantly increased their adherence to dietary guidelines,” Petersen said. “This suggests that strategies, like eating one avocado per day, can help people follow dietary guidelines and improve the quality of their diets.”

Although researchers said they were not surprised to see that eating avocados daily improved diet quality, they had not predicted how participants were able to achieve it.

“We determined that participants were using avocados as a substitute for some foods higher in refined grains and sodium,” Petersen said. “In our study, we classified avocados as a vegetable and did see an increase in vegetable consumption attributed to the avocado intake, but also participants used the avocados to replace some unhealthier options.”

According to Petersen, having poor diet quality substantially increases the risk for conditions like heart disease, type 2 diabetes, kidney disease and many other preventable diseases.

“By improving people’s adherence to dietary guidelines, we can help to reduce their risk of developing these chronic conditions and prolong healthy life expectancy,” Petersen said.

Petersen has also conducted similar studies investigating the impact of food-based interventions, including the relationship between pistachios and diet quality, but said that more research is needed to determine what other food-based strategies can be used to improve people’s adherence to dietary guidelines. 

“In studies like this one, we are able to determine food-based ways to improve diet quality, but behavioral strategies are also needed to help people adhere to dietary guidelines and reduce their risk of chronic disease,” Petersen said.