things to do
Things To Do
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Things To Do
April, 2013, Page 216
Portrait by Stephen Denton
Dr. Andrew Weil
What happens when diet-minded doctors and celebrity chefs team up to fight inflammation and Alzheimer’s?
All kale breaks loose. Deliciously.
It’s a typical lunchtime at True Food Kitchen, and diners cram the entryway like vegetables jammed into a juicer. Fresh-faced waitresses in scallion-green shorts squeeze between patrons, carrying plates of tofu-shiitake lettuce wraps and kale salad topped with omega-3-rich wild-caught salmon. No one thought a health food eatery would become this popular, least of all founders Dr. Andrew Weil and restaurateur Sam Fox, the oil and vinegar partnership that’s shaking up the nation. A restaurant based on the tenets of the anti-inflammatory diet? How do you make that sexy?
“I wasn’t convinced,” Fox writes in
True Food: Seasonal, Sustainable, Simple, Pure
(Little, Brown and Company), the new best-selling cookbook based on the restaurant’s menu. “When I thought of Andy Weil, I thought: hippie, Birkenstocks, vegan food. That wasn’t how I ate or lived.” Now, he can’t seem to sling sea buckthorn elixirs fast enough.
Unlikely chef-doctor partnerships are catching on like the kale craze. Dr. Marwan Sabbagh, a geriatric neurologist, dementia specialist and director of the Banner-Sun Health Research Institute in Sun City – about as unappetizing a title as you can imagine – has partnered with Beau MacMillan, chef at Elements at Sanctuary Resort, to create
The Alzheimer’s Prevention Cookbook
(Ten Speed Press). It’s based on a particularly brain-boosting version of the anti-inflammatory diet, and it’s filled with recipes like mushroom soba soup and spaghetti squash with caramelized onions – the kind of fare Hippocrates might have had in mind when he said, “Let food be thy medicine and medicine be thy food.”
More and more physicians and scientists are coming to the conclusion that inflammation is a root cause of a multitude of maladies – from heart disease and cancer to Parkinson’s and Alzheimer’s diseases – and that reducing inflammation through diet is a crucial component in the prevention and treatment of these diseases. But that’s a pretty sterile-sounding prescription. So doctors like Weil and Sabbagh found a way to bust out of the doctor’s office environment and the stigma of the preachy, pontificating physician to reach real people in a real way.
With cookbooks and restaurants, their recommendations are no longer dry lists of dos and don’ts. They are nutrition come to life, in Technicolor – emerald kale leaves bathed in sunny lemon juice and tangy balsamic vinegar, moist johnnycakes flecked with quinoa and topped with a snowdrift of Greek yogurt and juicy blueberries. At its core, the anti-inflammatory diet is a foodie’s philosophy, based on fresh, natural, delicious superfoods that fight disease and make you feel good. “It’s not a traditional diet in the way that people think of that word, where it’s a dirty word,” Weil says. “It’s an eating plan for life.”
Its focus on flavor is why it’s won over so many converts, from popcorn-addict Chef MacMillan to the yuppie-not-hippie diners at True Food to former kale-hater Weil himself.
“I would never touch raw kale growing up,” Weil says. Neither would most of us. Kale was the culinary equivalent of a throw blanket – a garnish stuffed into the sides of salad bars to cover up the stainless steel. Weil’s kale awakening came with the first forkful of a salad in Italy. “I had never had raw kale prepared like that before, with the extra-virgin olive oil, fresh lemon juice, garlic, black pepper, red pepper flakes, pecorino cheese and toasted bread crumbs, and it got me thinking. With most greens and vegetables, it’s simply a matter of preparing them properly so that their true flavors shine through.”
These foods have earned prominent spots on Dr. Andrew Weil’s Anti-Inflammatory Food Pyramid:
• Olive oil
• Kale and other leafy greens
• Turmeric and other spices and herbs,
such as ginger, garlic and astragalus root
• Sea buckthorn
• Whole grains
• Sweet potatoes
• Winter squashes
• Cool-climate fruits: berries, cherries, apples
• Salmon and other fish high in omega-3 fatty acids
• Splurges: red wine, dark chocolate and tea
(white, green or oolong)
That salad became the basis for True Food’s beloved side dish, and kale became one of the biggest building blocks in Weil’s nutritional pyramid. Now, with his anti-inflammatory diet and health empire, and in conjunction with True Food Chef Michael Stebner, he’s trying to give us all a similar awakening – introducing the true, delicious flavors of natural foods to a nation slowly being killed by inflammation.
You wouldn’t toss a lit match into a tumbler of vodka, or spritz a burning house with gasoline. But that’s figuratively what people do in their diets – with a cheeseburger and fries replacing flame and fuel as instruments of inner inflammation. Of course, one sinfully delicious meal will not inflame your body systems and strike you down with disease with quite the alacrity of a Molotov cocktail. But a constant, overall diet high in saturated fats, simple carbohydrates and refined sugars promotes unhealthy inflammation that can cause or exacerbate disease.
Inflammation occurs in the body naturally and, on a fundamental level, is a healthy process. It helps the body and its myriad organs, systems, blood vessels, tissue and nerves to heal by directing nourishment and immune responses (i.e. white blood cells) to the site of any wound or infection. Inflammation is at work when flesh reddens and pulses after being burned, when a lip puffs up and gets numb after a brawl, and when a toe throbs and tingles with pain after a collision with a curb. This is the body’s way of saying it acknowledges what happened and is taking steps to restore comfort and well-being.
Inflammation becomes a problem when it occurs even after the body has healed and should have cued it to stop. Chronic inflammation – that which persists, unfettered, beyond the fulfillment of its immune-boosting duties – actually damages the body and causes illness, much as cells that grow rapidly and unchecked can develop into cancer.
In autoimmune diseases such as lupus, rheumatoid arthritis, multiple sclerosis and type 1 diabetes, chronic inflammation causes the immune system to attack normal tissue. Inflammation has also been shown to be a contributing cause in the development of Alzheimer’s, dementia, Parkinson’s, heart disease, stroke, and cancer.
“There is growing evidence that chronic, low-level inflammation is the root cause of most serious illnesses,” says Weil, also founder of the Arizona Center for Integrative Medicine at U of A and an internationally renowned health guru. “Minimizing and eliminating this inflammation is the key to achieving optimum health and longevity.”
Photo Courtesy of Sanctuary
Chef Beau MacMillan
Several factors contribute to inflammation, some of which are beyond human control. Genetics, age, stress and exposure to environmental factors like toxins and pollutants all play a part in causing chronic inflammation. The biggest catalyst, though, is entirely controllable: diet.
“The mainstream American diet is too inflammatory,” says Weil, who cites the predominance of processed, chemical-laden and nutrient-deficient foods as the culprit. These “pro-inflammatory foods” – namely fats and carbohydrates from industrialized foods – induce chronic inflammation and provide no anti-inflammatory nutrients to counteract the damage. To continue the fire metaphor, they light a blaze and then throw away the fire extinguisher.
The main culprits of inflammation in the American diet are excessive consumption of omega-6 fatty acids, refined carbohydrates, and meats high in saturated fats. “Most people consume an excess of omega-6 fatty acids, from which the body synthesizes hormones that promote inflammation,” Weil writes on his website. “These fats are found in oil-rich seeds and the oils extracted from them, which are used in almost all snack foods and fast foods.” These oils include palm, corn, sunflower, safflower, soy, and cottonseed.
Omega-6 fatty acids can be balanced with consumption of omega-3 fatty acids, which are anti-inflammatory and are found in oily fish, flax, hemp, omega-3 or pastured eggs, and walnuts. They help to offset the inflammation caused by the hormone haywire of the omega-6s.
Food and drinks that contain quick-digesting flour and sugar – including bread, pastries, cookies, snack foods, sugary sodas and sports drinks – also trigger a chain reaction that causes inflammation. “These are classified as high-glycemic-load foods,” Weil writes in True Food, “because they raise blood sugar quickly, boost insulin resistance in the many of us who are genetically at risk for it, and increase inflammation.” Refined carbohydrates produce inflammatory compounds called advanced glycation end products (AGEs), which occur when the sugars react chemically with protein in the body. When the body tries to break the AGEs apart, immune cells release large amounts of cytokines, which cause inflammation.
The saturated fats found in meat – especially cows and chickens raised on grain-rich diets – spike cholesterol, which causes inflammation when the immune system defends itself from the cholesterol for longer than necessary. Any possible chemical interference in meats can be inflammatory as well, which is why farm-raised salmon can be inflammatory while wild-caught salmon is highly anti-inflammatory. When salmon are raised in a tightly-packed pen, they can be exposed to contaminated fish meal (which can contain toxic PCB chemicals – i.e. chemical runoff from electrical and coolant fluids, factories, etc.), plus antibiotics pumped into the excrement-filled pens to help the fish survive the unsanitary living conditions. Weil hasn’t eaten beef for more than 20 years and instead lauds anti-inflammatory proteins from vegetables (beans, lentils and other legumes), omega-3-rich oily fish and the occasional free-range, grass-fed bison burger, a popular menu item at True Food Kitchen.
With its meat-heavy meals, empty carbs and processed foods, Weil found the average American diet a poor bedrock on which to base his ideas. For a more model menu, he had to venture farther away. He had taken a year off between high school and college to travel the world, and has been an intrepid traveler, student and eater ever since. His journeys through Latin America and Africa were instrumental in his food education, but his food philosophy is more directly attributable to Asia and the Mediterranean. Weil observed the effects of the Mediterranean diet – laden with fruits, vegetables, fish and olive oil and light on heavy animal proteins and dairy – and studied it for years, eventually adopting it himself. A recent study from the
New England Journal of Medicine
found that at-risk individuals who adopted a Mediterranean diet cut their risk of cardiovascular problems including heart attack and stroke by 30 percent. Weil’s studies on health, disease, food and aging led him to pen a plethora of bestselling books and develop his own twist on the Mediterranean diet, geared toward disease prevention: the anti-inflammatory diet.
Photo Courtesy True Food
Superfood Spotlight: Turmeric
Turmeric is the sleeping giant of American spice racks, poised for a breakthrough in 2013. The ginger-related plant grows throughout southern Asia and is harvested, dried and crushed into a dusty goldenrod powder. Weil calls it “the most potent anti-inflammatory agent” and recommends adding a level tablespoon to soups, stews and bean dishes. Dr. Marwan Sabbagh, a geriatric neurologist and dementia specialist at Banner-Sun Health Research Institute, says Indian cuisine has led the way with turmeric in curries, marinades, chutneys and vegetable dishes. “The subcontinent of India has the lowest incidence of Alzheimer’s disease, which doctors attribute to three factors – one, their BMIs (body mass indices) are lower; two, their saturated fat is lower; and three, they consume more amounts of turmeric than anywhere in the world.” Add turmeric to your favorite recipes for a twist of flavor. “I love it in broth and stews,” MacMillan says, echoing Weil. “I’ll even plop some into my tea.”
“I used the Mediterranean diet as a template and tweaked it using Asian ingredients,” Weil says. His anti-inflammatory diet – complete with its own creative riff on the FDA’s food pyramid of yore – is chockablock with vegetables, fruits, whole grains, beans, high-quality dairy products, oily fish and healthy fats, especially olive oil. Asian touches are evident in the anti-inflammatory spice rack.
In his travels, Weil discovered some obscure superfoods and is bringing them into the mainstream. At True Food, diners can order a drink called Andy’s Elixir, made from sea buckthorn, a sour berry high in Vitamin C and antioxidants that inhibits histamines, allowing healing to occur at a normal and healthy rate. He also promotes astragalus root, common in Chinese medicine and cuisine, which boosts immunity and blocks the release of inflammatory histamines.
Weil also spotlights the inflammation-combating compounds of familiar favorites such as ginger, garlic and turmeric. Ginger inhibits inflammation by blocking lipoxygenase, an enzyme that increases production of inflammatory compounds. It also contains Kaempferol, an antioxidant that blocks another inflammatory agent, the Cox-2 enzyme. Garlic is a great source of sulfur and selenium, which promote a healthy immune system by helping produce a powerful antioxidant and an enzyme that aids in the breakdown of toxins. Turmeric contains curcumin, which blocks inflammation through nine biological processes, including blocking the buildup of beta-amyloid plaque, which can lead to the development of Alzheimer’s. Many spices, in fact, burst with brain-health benefits, which is why they’re also a hallmark of the Alzheimer’s prevention diet.
Like kale-hater-turned-kale-evangelist Dr. Andrew Weil, Dr. Marwan Sabbagh has revamped his eating habits, embracing once-shunned foods for their salutary rewards. “I was not a cinnamon fan,” Sabbagh says, “but now I add a teaspoon to my coffee every morning. I added more spices to my food for flavor and their health benefits – cloves, rosemary, thyme and turmeric. I add turmeric to Egg Beaters and spinach for breakfast every day. I eat more vegetables, I’ve cut out saturated fat in my diet by about 80 percent and, you know what? I don’t miss it.”
As director of the Banner-Sun Health Research Institute, Sabbagh says he has dedicated his career to finding a cure for Alzheimer’s and other age-related diseases. But until he finds that cure, he must focus on prevention. “I take care of people all day with Alzheimer’s and dementia, and their adult children ask me, every day of the week, ‘What can I do to prevent this?’” Sabbagh says. “There’s a disconnect between physicians’ recommendations and practical implementation. Doctors make broad-stroke recommendations, but people don’t always put them into practice or even know how to.”
His solution: Pair up with Chef Beau MacMillan, of Elements at Sanctuary Camelback Mountain Resort and Food Network fame, to write The Alzheimer’s Prevention Cookbook. “This [book] says, here are the basic principles, and here are some tasty options. Patients’ families say, ‘I can do that.’ It translates into something useful.”
For MacMillan, it also translated into a healthy lifestyle. The Iron Chef dropped 70 pounds since developing the recipes for the cookbook. “I’ve had my own personal struggle with weight,” MacMillan says. “I’ve been 220 pounds and playing hockey, and then I’ve been 330 and didn’t want to move… I’ve cleaned up my diet a lot – not as much carbs and sugars, more lean protein. I don’t snack on junk food. I love salty foods: pretzels, cheese, beer. I can crush a bag of popcorn like no one’s business. But it’s an instant feeling of satisfaction and then half an hour later, you’re like, ‘Oh my god, I’m bloated, I don’t want to make out with anyone.’ But if you have some fresh kale sautéed with almonds, maybe some roasted beets and a little salt, first of all, it tastes delicious. Second, half an hour later you feel great, you want to get married, life is beautiful. You have to take the time to appreciate what you’re eating and choose quality ingredients that are good to your body.”
The anti-Alzheimer’s diet shares a lot of overlap with the anti-inflammatory diet and espouses the same types of food. Sabbagh is a proponent of the Mediterranean diet and Weil’s innovative, anti-inflammatory iteration. “The Mediterranean diet is the convergence of all the healthy habits – legumes, vegetables, fruits, healthy fats,” Sabbagh says. “It’s not just heart-healthy and anti-inflammatory and antioxidant, but it’s just good for overall health. Contrast that with the Atkins diet, where you may lose weight, but it’s a disaster from a health standpoint, with an overload of saturated fats from meat.”
The Alzheimer’s prevention diet is concerned with overall health and disease prevention since many other diseases can contribute to the development of Alzheimer’s. Many of these modifiable precursor maladies can be exacerbated (or even caused) by chronic inflammation: hypertension (high blood pressure), elevated cholesterol, diabetes-elevated insulin levels, heart disease and high homocystine levels, strokes and transient ischemic attacks (TIAs), head injury, deficiency of folic acid (vitamin B9) and obesity. To combat these risk factors with diet, Sabbagh advocates antioxidant-rich and anti-inflammatory foods but narrows his focus on foods that specifically boost brain health and cognitive function.
B-complex vitamins – especially B6, B9 and B12 – are crucial in the prevention of Alzheimer’s and other forms of cognitive decay and dementia. B vitamins are found in a broad range of foods, including chicken, beef, fish, shellfish, liver, mushrooms, legumes, avocado, leafy greens, nuts, eggs, corn, potatoes, peppers, whole grains, nutritional yeast and brewer’s yeast. B1 (thiamin) aids in reaction time, mental energy and the brain’s metabolic functions. B3 (niacin) is pivotal for glucose metabolism and can lower cholesterol and increase blood flow. B5 helps produce acetylcholine, a neurotransmitter that assists in learning and memory and is obliterated by Alzheimer’s. B6 plays a role in balancing chemicals, such as sodium and potassium, and produces the neurotransmitters dopamine, serotonin, adrenaline and noradrenaline. B9 increases cognitive function in the elderly. B12 plays perhaps the most important role in brain health by helping build myelin sheaths, the coating around nerve cells.
Omega-3 fatty acids are also key for cognitive health. Sabbagh cites a study of omega-3-rich fish-eaters and non-fish-eaters in the cookbook. He writes, “Across the board, populations with elevated fish consumption experience a lowered risk of cognitive decline… So even if we don’t yet fully understand the precise mechanisms by which fish protects our brains, we can definitely conclude that a high intake of omega-3 fatty acids is essential for both natural cognitive development and normal brain functioning. We have very little to lose – and everything to gain – by eating more fatty fish.”
The cookbook has given Sabbagh a new way to relate to patients and disseminate information in a user-friendly package. However, he says, “I have to be very careful to say that this is not a prescriptive diet. It’s altering risks based on what science says. I gave Chef Beau themes and an ingredients list that boost brain health, and he took it from there and developed these sensational recipes.”
Both Sabbagh and Weil clarify that diet alone cannot prevent or cure any one disease, let alone fend off a host of them with advancing age. Rather, they stress the importance of making health a holistic lifestyle choice. Diet is the first step, but not the last.
“It’s a good starting point, but you have to take prevention in totality,” Sabbagh says. “You can’t eat a bad diet and take supplements and expect them to take care of everything. You can’t eat a fish meal once a week and eat burgers every other night. Every day you have to be engaged in and participate in your health, with exercise and a healthy diet.”
It seems simple: Exercise and eat quality ingredients that are naturally wholesome and good for you. So why is there a need for labels, new diet nomenclature and detailed food and health guides? Isn’t it all just common sense? As Weil points out, “There’s an enormous shortage of common sense in medicine and nutrition.” But the anti-inflammatory diet seems to make so much sense that Weil says he has found nary an opponent to his eating plan. “There are certainly plenty of detractors against integrative medicine, but I haven’t encountered any detractors of the anti-inflammatory diet.”
Weil is quick to assert that his is not a stereotypical diet – no fads declaring foods to be miraculously healthy one day and then demonizing them as toxic the next. There are no bold promises to whittle waistlines in a snap or cure diseases with a bite of spinach and a swig of red wine. Weil is no waif, and he stresses the importance of overall health as opposed to mere physical shaping. “Most people who follow [the anti-inflammatory diet] find that their weight has normalized,” he says. “There’s also growing evidence that obesity has an inflammatory effect and that this way of eating can combat that. New evidence might also show a link between inflammation and emotional well-being as well.”
It all fits into Weil’s philosophy of integrative medicine, a holistic way to approach health and wellness that combines the scientific, evidence-driven medicine of Western society with the alternative healing methods of Eastern cultures, such as meditation, herbal remedies and a healthful diet. Last year, Weil opened the Arizona Integrative Health Center in Phoenix, the country’s first primary care facility that combines traditional and alternative medicines. Patients see a physician, a health coach and a nutritionist, and can elect to see an integrative chiropractic physician, an acupuncturist or a mind-body specialist.
As Weil points out, traditional medicine is often wary of integrated medicine. Still, if Weil can win over Sam Fox, creator of the bacon-and-Thousand-Island-topped Samburger, might he also win over traditional doctors – and the general public? For Fox, all it took was one transcendent meal at Weil’s secluded home outside of Tucson: curried cauliflower soup, roasted salmon and, of course, kale salad. Fox may not have given up his burgers, but it’s a step in the right direction.
“The first step is to eliminate refined, processed and manufactured foods,” Weil says. “Anything people do to move in that direction is beneficial. People will see that this way of eating has a very broad appeal... First and foremost, it is food that is delicious and it happens to be good for you.”
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