The constant barrage of diet and nutrition information that is published can make it difficult for clinicians to separate the wheat from the chaff when counseling patients, but research tells us that nutrition is a critical component to human health. Here are six evidence-based tips that are easily shared with patients.
1. Choose foods with a wide variety of colors and textures, in their most natural forms
Although recent RCT evidence has raised questions about the benefits of omega-3 supplementation to prevent clinical CVD [cardiovascular disease] events, the recommendation for patients with prevalent CHD [coronary heart disease] such as a recent MI remains essentially unchanged: Treatment with omega-3 PUFA [polyunsaturated fatty acid] supplements is reasonable for these patients. Even a potential modest reduction in CHD mortality (10%) in this clinical population would justify treatment with a relatively safe therapy.
Research has also found that vitamin D works in conjunction with the omega-3s to improve cognitive function and social behavior, as well as overall mood.[8]
5. Forego red meat and live longer. Although red meat is a principal source of protein and fat, research shows that consumption of red meat is linked to increased risks for cancer, diabetes, and cardiovascular disease, all of which decrease longevity.
In a 2012 study titled "Red Meat Consumption and Mortality: Results from Two Prospective Cohort Studies," Pan and colleagues[9] prospectively followed 37,698 men and 83,644 women, all of whom were health professionals, during a maximum period of 28 years. These participants did not have cardiovascular disease or cancer at baseline. The researchers found that consumption of red meat increased risk for cardiovascular, cancer, and total mortality.
The researchers also found that substituting one serving of red meat per day with one serving of fish, poultry, legumes, nuts, whole grains, and low-fat dairy was associated with a 7%-19% reduction in mortality risk. Moreover, if participants consumed less than one half a serving of meat per day (< 42 g), then 9.3% of deaths in men and 7.6% of deaths in women could have been prevented.
More recent research has shown that red meat consumption is correlated with a risk of dying of many diseases.
6. Consume fermented foods/probiotics and fiber for gastrointestinal and overall health. Probiotics contain microorganisms that confer gastrointestinal benefit. They are commonly found in yogurt, kefir, and unpasteurized fermented foods and drinks. They can also be taken in supplement form. In order to thrive, probiotics require prebiotics as food, which can be found in fiber.
Probiotics contain nonpathogenic yeast and bacteria that lower intestinal pH, decrease the invasion of pathogenic organisms in the gut, and modify immune response.[10] The human microbiome has been implicated in a wide variety of health and disease states. An extensive body of research is still exploring how that research can be made translational for several conditions, but for now, probiotics have definitely been found to benefit gut health.[10]
[R]ecommending high-quality fermented and cultured foods, along with whole grains and other fiber-rich foods, is a very good idea.
In a 2010 clinical review on probiotics, Williams[10] stated, "The strongest evidence for the clinical effectiveness of probiotics has been in the treatment of acute diarrhea, most commonly due to rotavirus, and pouchitis."
One recent study found that indolepropionic acid, a metabolite produced by intestinal bacteria and fortified by a fiber-rich diet, is protective against type 2 diabetes, whereas another study found a protective link against colon cancer. Research into the microbiome/mental health connection has also been intriguing.
Although this is still a very young research area, the results are promising enough that recommending high-quality fermented and cultured foods, along with whole grains and other fiber-rich foods, is a very good idea.
It is said that human beings can only remember four things at once. Anecdotal evidence has suggested seven. Above, there are six key pieces of nutritional advice that most every patient could benefit from.
Should a patient with an extraordinary memory manifest, physicians can add two more bits of related advice to the nutrition list: Avoid alcohol, or limit consumption to one drink per day for women or two for men; and try not to substitute food sources with vitamin supplements. Alcohol has been linked to several conditions and diseases, including seven cancers. And although supplements may not cause harm, they could potentially make patients a bit more lax in terms of trying to eat a healthful diet, and evidence that supplements can replace genuine nutrition is scarce.[11,12]
Traditionally, physicians have focused on clinical treatments, leaving matters of diet to the registered dietitians and nutritionists. With an unwieldy amount of diet advice being bandied around on a regular basis, some might be tempted to stay clear of this domain. Because evidence is mounting that diet plays a significant role in health and disease, though, it is important that each clinician remind patients of the most important dietary tips they should be following. With enough reinforcement, it could make a difference.
