Beets and apples salad

Is your diet too low in fiber? Here is a little unusual combination for a salad to try along with your main dishes.  It delivers lots of fiber even during the winter, when fresh salads may not be easily available.  

Use your imagination and add as many other ingredients as you wish (and have at hand). For example, for more splash of color, vitamins and fiber, add a grated carrot and/or a few slices of a tangerine.

For us, today "the main dish" is composed of a can of salmon with tahini-lemon-onion seasoning and baked chickpea balls. For these recipes, I will post additionally.



Beets and apples salad
Ingredients
1 Tbsp olive oil
1 Tbsp apple cider vinegar
1 Tbsp strawberry preserves (or any other preserves you like)
salt to taste
1 14-oz can of beets (whole or sliced)
1 medium apple, cored and diced (any variety you like)
chopped parsley (optional)

Directions
Mix the first four ingredients well and then combine with the apples and beets. Sprinkle with some parsley.

Negative Effects Of Dietary Fiber Deficiency

Another role for dietary fiber shown here, abstract:

Despite the accepted health benefits of consuming dietary fiber, little is known about the mechanisms by which fiber deprivation impacts the gut microbiota and alters disease risk. Using a gnotobiotic mouse model, in which animals were colonized with a synthetic human gut microbiota composed of fully sequenced commensal bacteria, we elucidated the functional interactions between dietary fiber, the gut microbiota, and the colonic mucus barrier, which serves as a primary defense against enteric pathogens. We show that during chronic or intermittent dietary fiber deficiency, the gut microbiota resorts to host-secreted mucus glycoproteins as a nutrient source, leading to erosion of the colonic mucus barrier. Dietary fiber deprivation, together with a fiber-deprived, mucus-eroding microbiota, promotes greater epithelial access and lethal colitis by the mucosal pathogen, Citrobacter rodentium. Our work reveals intricate pathways linking diet, the gut microbiome, and intestinal barrier dysfunction, which could be exploited to improve health using dietary therapeutics.

Dietary fiber can have many beneficial effects, including the production of short chain fatty acids that are good for colonic health and of course fiber helps with bowel movements to avoid constipation.  This mouse study shows that when there is a deficiency of dietary fiber, the gut microbiota that would normally digest fiber will instead start using the gut mucus as an energy source, eroding the protective lining on the colon and allowing pathogenic organisms to have access.

Eat your fiber!

Fiber And Microbiota

Dietary fiber can increase levels of certain gut microbiota bacterial species, as well as higher levels of butyrate, a short chain fatty acid with beneficial anti-cancer effects in the colon.  Abstract:

BACKGROUND:

Dysfunction of the gut microbiota is frequently reported as a manifestation of chronic diseases, and therefore presents as a modifiable risk factor in their development. Diet is a major regulator of the gut microbiota and certain types of dietary fiber may modify bacterial numbers and metabolism, including short-chain fatty acid (SCFA) generation.

OBJECTIVE:

A systematic review and meta-analysis were undertaken to assess the effect of dietary fiber interventions on gut microbiota composition in healthy adults.

DESIGN:

A systematic search was conducted across MEDLINE, EMBASE, CENTRAL, and CINAHL for randomized controlled trials using culture and/or molecular microbiological techniques evaluating the effect of fiber intervention on gut microbiota composition in healthy adults. Meta-analyses via a random-effects model were performed on alpha diversity, prespecified bacterial abundances including Bifidobacterium and Lactobacillus spp., and fecal SCFA concentrations comparing dietary fiber interventions with placebo/low-fiber comparators.

RESULTS:

A total of 64 studies involving 2099 participants were included. Dietary fiber intervention resulted in higher abundance of Bifidobacterium spp. [standardized mean difference (SMD) 0.64 (95% CI: 0.42, 0.86); P < 0.00001)] and Lactobacillus spp. [SMD: 0.22 (0.03, 0.41), P = 0.02] as well as fecal butyrate concentration [SMD: 0.24 (0.00, 0.47), P = 0.05] compared with placebo/low-fiber comparators. Subgroup analysis revealed that fructans and galacto-oligosaccharides led to significantly greater abundance of both Bifidobacterium spp. and Lactobacillus spp. compared with comparators (P < 0.00001 and P = 0.002, respectively). No differences in effect were found between fiber intervention and comparators for α-diversity, abundances of other prespecified bacteria, or other SCFA concentrations.

CONCLUSIONS:

Dietary fiber intervention, particularly involving fructans and galacto-oligosaccharides, leads to higher fecal abundance of Bifidobacterium and Lactobacillus spp. but does not affect α-diversity. Further research is required to better understand the role of individual fiber types on the growth of microbes and the overall gut microbial community. This review was registered at PROSPERO as CRD42016053101.

Lentils, potatoes and sausage

There is nothing better than a steaming, fragrant bowl of soup on a chilly winter day. The one hour of soup cooking warms up the house and sharpens the senses for the upcoming treat.  

The added benefit is that the soup is high in fiber and it will support your effort for normal body weight.

Be prepared to cook for a crowd with this recipe! The low price of the ingredients puts this soup recipe on my short list of dishes for the winter.

Best lentil soup ever 

Ingredients
1 lb green lentils
1 large sweet onion, chopped into cubes
celery, sliced thinly (optional and to the taste)
1 cup carrots, chopped into chunks (or a handful of baby carrots)
garlic, chopped (I usually peel one entire head)
2 large potatoes, cubed (any type)
sausage (any type you like, in any quantity)
spices: salt, winter savory, paprika, hot pepper flakes, mint (anything beyond salt is optional, to your taste)
1 Tbsp olive oil (optional)
to serve: your favorite vinegar or lemon juice
 

Directions
Start with baking the sausage and cutting it into cubes.
While the sausage is baking, take the largest soup pot you have and in it, combine all vegetables except the lentils with 2-3 cups of water and a spoonful of olive oil (optional). Bring to boil and cook until the potatoes are soft (add water, as needed). 

Once the potatoes are soft, stop the heat and mash everything in the pot with a hand masher. After some of the potatoes are mashed (to create the thicker texture of the soup), add the lentils and water to almost the final volume of the soup. I usually add hot water pre-warmed in the microwave or on an additional stove burner.

Once the soup is boiling again, add the cubed sausage and cook until the lentils are ready. Add salt and spices according to your taste. Some suggestions on seasonings are listed above; however, you could change the soup taste by using cardamom, turmeric, bay leaf, etc. I usually stick to winter savory, mint, and hot flakes.

The aroma during the cooking is irresistible. You might notice the rest of the family being attracted to the kitchen by the tantalizing smell. Be patient! Once you add a few drops of lemon or apple cider vinegar to your  bowl, enjoy the most fragrant and nourishing soup ever! 

Bon appetit!

As I indicated, I cook the soup amount for a battalion (well, maybe for 18 - 20 servings).  Therefore, I usually portion the soup into glass jars and freeze. If you do so, be careful not to fill the jars to the brim (otherwise, they may break)!

Your Risk for Colon Cancer

50,630:
this is the projected number of colorectal cancer (CRC) -related deaths for 2018 in the U.S. Only lung cancer-related deaths exceed this number.

How does CRC start? It begins as a benign growth – polyp / adenoma. The most frequent initiating mutation is in the APC gene, and less frequently - in the proteins beta-Catenin, Axin, and KRAS. Given sufficient time - approximately 10 years - and the right mutations (i.e., mutations that allow self-sufficiency in growth signaling, resistance to apoptosis, potential for unlimited growth, etc), malignancy develops.

Once the malignancy has established itself, cure is unlikely. Therefore, the best approach is this of prevention; the words of Ben Franklin are still valid:

… an ounce of prevention is worth a pound of cure…

The power of prevention is best understood when we look at the leading causes of death for the past 100 years. NEJM has published a great review that summarizes the ten leading causes of death in the U.S. since 1900. If we compare 1900 to 2010, we will find that the three biggest killers in 1900 were the gastrointestinal infections, pneumonia, and TB.  However, these were no longer the biggest killers in 2010 (the last year in the NEJM review).

How did we achieve that? Sanitation, better nutrition, vaccination, and antibiotics. Except for the antibiotics, the rest of the measures/changes were preventive.

Since the 1960s we have also seen reduction in heart disease-associated deaths due to prevention with medications that control blood pressure and cholesterol.

The lesson is that any significant victory against a disease is achieved through preventive strategies. There is no doubt in my mind that we will claim a significant victory against cancer, when we dedicate more financial resources to prevention. Cervical cancer is the perfect example how prevention through screening and vaccines reduces cancer deaths.

However, can we prevent colorectal cancer (CRC)? Obviously, screening is one answer; although quite invasive, colonoscopy detects early lesions. What else can we do? The American Institute for Cancer Research (AICR) has estimated that approximately 45% of all CRC cases can be prevented mostly through lifestyle changes. The institute has come up with five simple recommendations … that may slash the number of CRC cases by half! The problem with all these recommendations is that they require self-discipline.

The increased intake of fiber is one of the recommendations. Although the topic has been controversial for the past few decades, in 2003, two massive prospective epidemiological studies (one from Europe and one from the U.S.) concluded that fiber does protect against colon cancer: increasing the intake of fiber from 15 g to 35 g results in 40% decrease in risk.

Here is the summary of one of the studies:

Lancet 2003 May 3;361(9368):1496-501.Bingham SA:  
We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519978 individuals aged 25-70 years in ten European countries. Participants completed a dietary questionnaire in 1992-98 and were followed up for cancer incidence. …data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0.75 [95% CI 0.59-0.95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0.58 (0.41-0.85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated. In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%.

In 2011, AICR and the continuous update project announced that the protective effect of fiber against colon cancer is upgraded from probable to convincing.

Diet And Colorectal Cancer: Nucleus To Cell Membrane

Review article:

The International Agency for Research on Cancer recently released an assessment classifying red and processed meat as "carcinogenic to humans" on the basis of the positive association between increased consumption and risk for colorectal cancer. Diet, however, can also decrease the risk for colorectal cancer and be used as a chemopreventive strategy. Bioactive dietary molecules, such as n-3 polyunsaturated fatty acids, curcumin, and fermentable fiber, have been proposed to exert chemoprotective effects, and their molecular mechanisms have been the focus of research in the dietary/chemoprevention field. Using these bioactives as examples, this review surveys the proposed mechanisms by which they exert their effects, from the nucleus to the cellular membrane. In addition, we discuss emerging technologies involving the culturing of colonic organoids to study the physiological effects of dietary bioactives. Finally, we address future challenges to the field regarding the identification of additional molecular mechanisms and other bioactive dietary molecules that can be utilized in our fight to reduce the incidence of colorectal cancer.

Certain bioactive dietary factors have a protective effect against colorectal cancer, and scientists are investigating the cellular mechanisms behind these effects.

Eat your fiber!

Man Shall Not Live By Bread Alone

By 3268zauber - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=4298187

Let’s take a look at this article, which I find somewhat misleading.

First, the time periods the bread diets were evaluated were very short. What’s the long term effects of the different diets?  Second, while there may be individual variation in, for example, glycemic response, fact is, your average person is not going to have their metabolic responses to bread types analyzed. You’ll get the most “bang for the buck” with respect to population health providing generally healthy guidelines. Third, whole wheat bread has advantages of white bread with respect to fiber (the long range effects of which on colon cancer risk is going to be measured in years/decades, not a week or two) and vitamin content.

When studies like this are reported without giving all the context, it gives the general public license to gorge on food that is likely not optimal for health - looking forward to an entire lifetime, not just for a week or two.

Now, that doesn’t mean the findings should be ignored.  Maybe white bread isn’t as bad as it has been made at to be – but that needs to be evaluated over a long time frame.  The bottom line though is that whole wheat has a number of advantages for the average person and I don’t see why that should be ignored.  If you are going to eat a certain volume of bread, why not maximize fiber and various micronutrients?

Cabbage meal

Where I grew up, vegetarian dishes were popular and constituted 6/7th of the weekly menu (only on Sundays we had a bit of meat, but it was always cooked with of heaps of vegetables).

Although I love vegetarian dishes, I hated cabbage meal, so once on my own, I never cooked it, .... that is – until now. One day, at work someone was warming his lunch and it smelled like cooked cabbage. It drove me insane. The following weekend I bought a cabbage and re-created the dish from my childhood. I savored it, but my family was lukewarm to the dish, to say the least. The recipe is below if you want to try it. In addition to having compounds that lower cholesterol and kill cancer cells, cabbage is high in fiber and cheap. It should be a staple in a healthy diet. For more information on the beneficial effects of cabbage, read this post.

Cabbage dish

You will need one large onion, one can tomatoes (any type, 15 oz or larger), one medium size cabbage, 4 Tbsp olive oil, and spices. Dice the onion and soften it in the heated oil. Chop the cabbage and add it to the pot with the onion. Stir and let it soften with the oil. Once the cabbage has softened, add some water to prevent burning and a can of tomatoes (sauce or chopped tomatoes, any size of can). I also add paprika, salt, hot pepper flakes or black pepper. Let the cabbage simmer until completely soft and most of the water is absorbed. I serve the dish with a crust of bread and cheese.