Newsletter AUGUST 2007

Article
Preventing Macular Degeneration

Ask the Doc
Barbeque and Cancer-Causing Chemicals

Doctor’s Pick
Find a Gluten-Free Restaurant

Recipes of the Month
Chilled Beet Soup
Cod Salad with Corn and Cilantro

Quote:
“To heal ourselves we must heal our planet and to heal our planet we must heal ourselves.”
Bobby McLeod

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Preventing Macular Degeneration
By Sarah Cimperman, ND

Macular degeneration (MD) is the leading cause of blindness in the United States. It is often referred to as age-related macular degeneration because the incidence increases with age. MD is caused by deterioration of the macula, the central part of the retina. The retina is the innermost layer of the eye containing receptors for vision called rods and cones, and the macula contains the highest concentration. Early stages of MD can cause visual deficits and advanced stages may result in permanent loss of central vision. Macular degeneration appears to have a genetic component, but studies have shown that diet, lifestyle and nutritional supplements can play prominent roles in prevention and progression of the disease.

Vitamin D

In recent years we have learned a lot about vitamin D and its protective effects against osteoporosis, cancer, hypertension, psoriasis and autoimmune disease. We now have reason to believe that it can prevent macular degeneration as well. A study published earlier this year in the Archives of Ophthalmology evaluated data from 7752 people who participated in the third National Health and Nutrition Examination Survey. Those with the highest levels of vitamin D in their blood had a forty percent lower risk of developing MD compared to adults with the lowest levels.

Researchers also analyzed the effects of different sources of vitamin D, including dairy, fish and supplements. Eating dairy products was associated with lower incidence of the early stages of macular degeneration and eating fish was associated with lower incidence of advanced MD. In adults who did not consume dairy products on a daily basis, those who used vitamin D supplements regularly had a lower risk of early MD compared to those who did not take supplements.

Omega-3 Fatty Acids

Fats also play a key role in the prevention and progression of macular degeneration. Docosahexaenoic acid (DHA), an omega-3 polyunsaturated fatty acid, is one of the healthy fats found in fish. It is particularly important for healthy eyes because it is a major structural component in the outer membrane of the retina. Researchers in Maryland followed 4519 adults between the ages of sixty and eighty and analyzed their dietary intake of omega-3 polyunsaturated fatty acids in fish. They found that those who ate more than two four-ounce servings of fish each week had reduced risk for developing MD.

In another study, researchers in Boston analyzed the diets of 261 adults aged sixty years or older who had already been diagnosed with MD. They found that eating foods rich in omega-3 fats, including fish and nuts, had a protective effect against progression of the disease. They also found that a higher intake of animal fat was associated with a two-fold higher risk of MD progression.

Antioxidants, Carotenoids and Anthocyanosides

Researchers at the National Institutes of Health have demonstrated the value of antioxidants and carotenoids in the prevention of macular degeneration. Antioxidants, including beta-carotene, vitamin C, vitamin E and zinc, inactivate free radicals that can damage the retina while carotenoids lutein and zeaxanthin accumulate in the macula and absorb ultraviolet radiation.

Although nutrients in supplement form may be helpful in preventing MD and slowing progression of the disease, foods are good sources as well. Beta-carotene is found in kale, spinach and carrots. Vitamin C is concentrated in citrus fruits, green peppers, broccoli, melon, tomatoes and potatoes. Sources of vitamin E include nuts, seeds, soybeans, fish, eggs, leafy green vegetables and wheat germ. Whole grains, beans and other legumes are good sources of zinc. Lutein is found in broccoli and dark green leafy vegetables including kale, spinach, collards and turnip greens. Orange bell peppers, yellow corn, mangoes, carrots, squash, tomatoes, persimmons and dark leafy greens are good sources of zeaxanthin.

Anthocyanosides are flavonoids that provide structural support for both the retina and cornea of the eye. Anthocyanosides are found in red and purple pigments of berries and other fruits. Blueberries are an especially concentrated dietary source and bilberries are a common source of anthocyanosides in supplement form.

Glycemic Index

Sugar is another important consideration in MD, according to researchers at Tufts University in Boston. They studied the relationship between glycemic index (a measure of the sweetness of foods) and macular degeneration in adults between the ages of fifty-five and eighty and concluded that those who had a higher dietary glycemic index also had a higher risk of MD. In other words, consuming foods that rank high on the dietary glycemic index, such as sugar, flour and processed foods, can increase risk of macular degeneration while whole grains, vegetables and legumes that rank much lower can reduce the risk.

Sun Exposure

Too much ultraviolet light can harm eyes, particularly the retina, and damage is cumulative over a lifetime. The Beaver Dam Eye Study was funded by the National Eye Institute to collect data on age-related eye diseases. Researchers studied over 5000 men and women between the ages of 43 and 86 in Beaver Dam, Wisconsin for fifteen years. They found that those who spent more than five hours per day in the summer sun had a higher risk of developing macular degeneration compared to those who were exposed less than two hours per day. Among those who reported the most sun exposure, wearing sunglasses or hats cut their risk in half.

To prevent macular degeneration, wear sunglasses outdoors, especially in the middle of the day and when the UV index is high. Choose frames that you like, so you will be more likely to wear them, and pick lenses with one hundred percent UV protection.

Exercise

Data from the Beaver Dam Eye study also showed that physical activity is protective against macular degeneration. Researchers found that adults who exercised three or more times per week were less likely to develop MD, regardless of age or smoking status. Exercise supports a healthy retina because it increases circulation to the small blood vessels supplying the macula with the nutrients and oxygen that are critical for good vision.

Exercise is also critical to achieving and maintaining a healthy body weight. And a healthy body weight is critical to preventing macular degeneration. A study at Harvard Medical School compared 560 adults with advanced MD to 280 controls who did not have MD. Researchers found that those with a body mass index above 29 (and those who smoked cigarettes) had a higher risk of developing the disease. Other studies have supported this outcome and some have shown that weight loss in overweight people can lower risk of MD as well as slow progression in those who have already been diagnosed.

Expert Advice


Talk to your doctor before engaging in any new exercise or starting any new supplements. If appropriate, also address conditions that affect blood vessels and increase risk for macular degeneration, such as high blood pressure, atherosclerosis and diabetes mellitus.

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Ask the Doc: Barbeque and Cancer-Causing Compounds

I’ve heard that eating charred foods can be dangerous. Is this true?
Patrick P
Staten Island, New York

Cooking meat at high temperatures can create chemicals called heterocyclic amines (HCAs) that increase the risk of cancer. In animal studies, HCAs have been linked to breast, prostate, stomach and colon cancer. Any animal protein that has been charred by fire, like meats cooked on the barbeque or over any open flame, contain higher amounts of HCAs and should be avoided.

Always cook meat slowly over low temperatures and use a thermometer to make sure it is done. Insert the thermometer into the thickest part of the meat and follow these minimum temperature guidelines recommended by the US Department of Agriculture Food Safety:

• Ground beef, veal, pork, lamb: 160F
• Ground poultry: 165F
• Beef, veal and lamb (roasts, steaks and chops): 145F
• Pork (roasts, steaks and chops): 160F
• Whole poultry: 180F
• Poultry breast: 170F

Cook poultry thighs and wings until the juices run clear. Cook seafood until opaque and flaky. Round out each meal with veggies, as they contain nutrients that can help prevent cancer.

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Find a Gluten-Free Restaurant

The Gluten-Free Restaurant Awareness Program, from the Gluten Intolerance Group, will help you find restaurants that provide gluten-free meals. Click on “Find a Restaurant” to enter your zip code and the distance you are willing to travel. You will be provided with names, addresses and details about restaurants with a gluten-free menu.

http://glutenfreerestaurants.org

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Chilled Beet Soup

1 bunch beets, roasted *
1 to 2 cloves garlic, chopped
1 shallot, chopped
½ cup fresh chopped dill or cilantro
1 cup chopped cucumber or fresh beet greens
½ cup organic plain yogurt (more for garnish optional)
Juice of 1 lemon
Sea salt
Fresh ground pepper
Diced cucumber for garnish (optional)

Remove the root and stem ends of each roasted beet, leaving the skin intact. Chop them roughly and add to a blender or food processor with the garlic, shallot, herb, cucumber or greens, yogurt, lemon juice, salt and pepper. Puree to desired consistency, adding a tablespoon or two of water if needed for blending. Chill for 2 hours or more.

Remove from the fridge just before serving and garnish with a dollop of plain yogurt and/or diced cucumber if desired.

* To roast beets, remove and reserve greens, then scrub them well. Bake at 375F for one hour or until tender. Cool to room temperature. Use immediately or store in the fridge until ready to use.

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Cod Salad with Corn and Cilantro

This is a great way to use leftover fish. Make your own mayonnaise (recipe follows) or shop for a healthy one made with olive or canola oil and without preservatives, like those from Spectrum Naturals.

1 cup cooked, flaked cod *
½ cup fresh sweet corn kernels, steamed or grilled
¼ cup chopped cilantro leaves
1 tbsp mayonnaise
1 tbsp plain yogurt
Sea salt and ground pepper
1 tbsp lemon juice
2 tbsp diced red bell pepper to garnish

Add the flaked fish, corn kernels, cilantro, mayonnaise and plain yogurt to a mixing bowl. Toss to combine thoroughly. Add lemon juice, salt and pepper; toss to combine again. Taste and adjust seasoning if necessary.

Serve as a salad on top of a lettuce leaf or as an open-faced sandwich on a slice of whole grain bread. Garnish with diced red pepper.

* Simmer cod fillets in one to two inches of water for 8 minutes, or until fish is opaque and flakes easily. Cool to room temperature before assembling salad. If not making salad immediately, store fish in fridge until ready to use.

Real Mayonnaise:

2 egg yolks from organically fed, range-free chickens
1 tbsp Dijon mustard
1 cup extra virgin olive oil
Lemon juice or vinegar
Salt and pepper

Combine the egg yolk and mustard in a small bowl and whisk until creamy. (A food processor or manual egg beater will make this easier, but it is not required.) Continue to whisk while adding the olive oil drop by drop until the mixture begins to thicken. Then add the remaining oil in a thin stream until the mixture is thick. Add the lemon juice or vinegar to thin the mayonnaise and achieve the desired consistency and flavor. Add salt and pepper to taste. Store in the refrigerator for up to two days.

Optional: To give your mayonnaise extra flavor, mix in a pinch of curry powder, minced garlic, chives or tarragon once it is prepared.

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