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Medical Myths and Smoothies

July 29, 2010 Written by JP    [Font too small?]

Today’s edition of Twitter Thursday focuses of three topics that I think can positively impact your health care. In the first segment I’ll continue my quest to dispel the myth that eggs are an unhealthy food because of their cholesterol and saturated fat content. The middle segment will bring to light an emerging theory that some cases of appendicitis may not require surgical intervention. Lastly, I’ll add my two cents to a popular list of the “12 Best Smoothie Ingredients”. By the time you’re done reading today’s column, I hope you’ll take away a few ideas and insights about how to better serve your own wellness and beyond.

Do eggs contribute to cardiovascular disease and diabetes? A recent tweet by Dr. Bill Yates helps to address this ongoing nutritional controversy. The only way to truly get to the bottom of the debate is to go directly to the evidence. Two new studies appearing in the American Journal of Clinical Nutrition and The Nutrition Journal help to clarify the facts behind the claims and headlines.

In terms of diabetes, a prospective evaluation of 3,898 men and women determined that “there was no association between egg consumption or dietary cholesterol and increased risk of type 2 diabetes (T2D)”. This conclusion was based on an 11 year follow up period that measured dietary egg intake of 0 to 4 eggs weekly. Furthermore, egg consumption was not associated with “clinically meaningful differences in fasting glucose, fasting insulin, or measures of insulin resistance”. (1,2)

On the cardiovascular front, a randomized, placebo-controlled crossover trial involving 40 men and women with high cholesterol was recently published. The test subjects were given three different breakfast meals during separate 6 week test periods: a) 3 hard boiled eggs; b) an egg & sausage sandwich; c) 1/2 cup of egg substitute. Blood tests and measures of endothelial function were employed at the begin and end of each phase of the trial. The results indicate that “Egg consumption was found to be non-detrimental to endothelial function and serum lipids in hyperlipidemic adults, while egg substitute consumption was beneficial”. Based on prior studies, I suspect that using omega-3 enriched eggs would have yielded more positive results. (3,4,5)

Dr. Allen Greene is a leading figure in the field of integrative pediatrics. However, his medical advice often extends far beyond the care of children. This past week he alerted his Twitter followers that “Many cases of appendicitis are viral and people would recover fine without surgery”. This rather bold assertion is based on a recent paper published in the prestigious medical journal Archives of Surgery. Any surgery that can be avoided is desirable. But there’s more to the story than that. The appendix has recently undergone a makeover in the medical community. Until the last few decades, the appendix was often believed to be a “superfluous organ” with no important function. This all changed in 2007 when a landmark publication from Duke University proclaimed that, “the human appendix is well suited as a ‘safe house'” for good bacteria (probiotics) which play a vital role in maintaining a healthy digestive and immune system. The take home message here is to discuss treatment options other than surgery with your physicians if appendicitis is suspected. (6,7,8,9,10)

Approximate Essential Amino Acid Profile of Various Protein Sources

Isoleucine 4.4 6.1 5.5 4.7 4.9 5.7
Leucine 10.3 12.2 14.2 8.9 8.2 8.4
Lysine 8.1 10.2 10.2 7.6 6.3 6.8
Methionine 3.3 3.3 2.4 3.0 1.3 3.4
Phenylalanine 5.0 3.0 3.8 5.1 5.2 5.8
Threonine 4.5 6.8 5.5 4.4 3.8 4.6
Tryptophan 1.4 1.8 2.3 1.2 1.3 1.2
Valine 5.7 5.9 5.9 5.9 5.0 6.4
Total BCAAs 20.4 24.2 25.6 19.5 18.1 20.4
Total EAAs 42.7 49.2 49.8 40.7 36.0 42.3
Source: Nutr Metab (Lond). 2010; 7: 51. (link)

The Twitter account of Men’s Health Magazine recently posted its list of the “12 Best Smoothie Ingredients”. I beg to differ with some of the high-carbohydrate inclusions such as bananas, fat-free chocolate frozen yogurt and non-fat milk. However, we do agree on some of the items: ice, peanut butter and whey protein. (11,12)

  • Ice is a calorie-free way of bulking up a smoothie while simultaneously providing hydration. When combined with nut butters and whey protein it yields a frothy, slushy consistency with no down side whatsoever.
  • Organic, unsweetened peanut butter not only provides added fiber and protein, but also presents a variety of healthy fats and phytochemicals which have consistently been shown to lower LDL (“bad”), total cholesterol and triglycerides. In addition, it also elevates the beneficial HDL (“good”) cholesterol fraction. (13)
  • Whey protein is largely accepted as the preeminent source of essential amino acids which support muscle growth and maintenance when combined with resistance training. According to a recent review whey protein may also “enhance recovery from heavy exercise and possibly decrease muscle damage and soreness”. (14)

If I was asked to contribute one candidate to the list of smoothie ingredients, I would probably choose organic cocoa powder. Pure cocoa powder is very low in calories, but is loaded with flavor and free-radical fighters which discourage the oxidative damage that accompanies heavy physical exertion. In addition, the July 2010 issue of the Journal of Strength & Conditioning Research reports that a cocoa-based protein drink is capable of “decreasing the level of self-reported perceived soreness after exhaustive exercise”. A reduction in post-exercise soreness can ultimately lead to improved physical performance in subsequent training sessions and, therefore, improved long term results. (15)

To summarize: Eating a few to several organic, omega-3 enriched eggs for breakfast is unlikely to cause you harm in the context of a whole food based diet. I personally eat several such eggs a week and believe that they support my good health as part of a carbohydrate-restricted diet. You can also enjoy a refreshing Chocolate Peanut Butter Smoothie without any guilt. Just add cold water, ice, 1 Tbs of organic cocoa powder, 2 Tbs of organic peanut butter and 1 scoop of unsweetened vanilla whey protein into a blender and process until creamy. Put a few drops of liquid stevia into the mix if you need some added sweetness. Finally, please share the updated appendicitis research with your physicians. If progressive doctors such as Allen Greene are open to such revelations, your doctors may be as well.

Be well!


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Posted in Diabetes, Exercise, Heart Health

10 Comments & Updates to “Medical Myths and Smoothies”

  1. Oct Says:

    I want a cocoa and peanut butter protein shake now. yum

  2. JP Says:


    It couldn’t be easier to make. Enjoy one soon in good health! πŸ™‚

    Be well!


  3. Sage Says:

    To me, a smoothie is a meal, full of protein and some fat, too. I don’t use whey because it’s made from pasteurized (dead) milk and isolates. (Note: Mercola.com sells raw-milk whey, but it’s pricey.)

    My smoothies have these ingredients:
    3 Tbsp flax seeds (I grind them fresh per use)
    1/2 – 1 Tbsp raw cacao nibs (for chocolate flavor & energy boost)
    Raw/soaked sunflower seeds (2T) or almonds (handful)
    1 Tbsp raw coconut oil
    1 piece of fruit/berries (room temp or frozen)
    Green powder, such as spirulina, barley grass, or a combination of greens, or a non-soy protein powder w/greens added

  4. JP Says:

    Sounds like an excellent meal replacement, Sage. πŸ™‚

    Be well!


  5. anne h Says:

    When I saw that pb cup I thought of Oct!

  6. JP Says:

    Now that’s a sign of a good friend. Identification by food! πŸ™‚

    Be well, Anne!


  7. Evita Says:

    Hi JP

    Very informative.

    When it comes to eggs, there really is no black or white answer and the unfortunate part is that studies can be tweaked based on how they are run and interpreted to conclude whatever they need based on who is sponsoring them. Even the number of participants, which is low in the studies above, has to be accounted for.

    I think common sense is key, and listening to mainstream media, a lot of us have lost that. This is where I like that you emphasize organic eggs are key and a few a week are not a big deal.

    I find it funny that nutritional experts are still debating the fate of eggs, when obvious things like fast food meals and various processed food options are going to give us heart disease and/or diabetes way faster than eggs ever will.

    The other thing with eggs, though, is many people who are interested in various fitness routines down them like they are water, and this is very hard on our liver and gallbladder too, as any high protein diet can be.

    As for smoothies – love em and wouldn’t have a complete day without a green smoothie to start my morning πŸ™‚

  8. JP Says:

    Thank you for sharing your thoughts, Evita. Much appreciated!

    BTW, would you mind sharing the ingredients for your morning green smoothie? Would love to know.

    Be well!


  9. Stacey Says:

    Excellent post. Its almost a joke to look at the food charts and government food tables from the ‘experts.’ Green smoothies and eggs! Love them!

  10. JP Says:

    Update: Nuts & peanuts may lower all-cause mortality …


    Prospective Evaluation of the Association of Nut/Peanut Consumption With Total and Cause-Specific Mortality

    Importance: High intake of nuts has been linked to a reduced risk of mortality. Previous studies, however, were primarily conducted among people of European descent, particularly those of high socioeconomic status.

    Objective: To examine the association of nut consumption with total and cause-specific mortality in Americans of African and European descent who were predominantly of low socioeconomic status (SES) and in Chinese individuals in Shanghai, China.

    Design, Setting, and Participants: Three large cohorts were evaluated in the study. One included 71 764 US residents of African and European descent, primarily of low SES, who were participants in the Southern Community Cohort Study (SCCS) in the southeastern United States (March 2002 to September 2009), and the other 2 cohorts included 134 265 participants in the Shanghai Women’s Health Study (SWHS) (December 1996 to May 2000) and the Shanghai Men’s Health Study (SMHS) (January 2002 to September 2006) in Shanghai, China. Self-reported nut consumption in the SCCS (approximately 50% were peanuts) and peanut-only consumption in the SMHS/SWHS were assessed using validated food frequency questionnaires.

    Main Outcomes and Measures: Deaths were ascertained through linkage with the National Death Index and Social Security Administration mortality files in the SCCS and annual linkage with the Shanghai Vital Statistics Registry and by biennial home visits in the SWHS/SMHS. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs.

    Results: With a median follow-up of 5.4 years in the SCCS, 6.5 years in the SMHS, and 12.2 years in the SWHS, 14 440 deaths were identified. More than half of the women in the SCCS were ever smokers compared with only 2.8% in the SWHS. The ever-smoking rate for men was 77.1% in the SCCS and 69.6% in the SMHS. Nut intake was inversely associated with risk of total mortality in all 3 cohorts (all P < .001 for trend), with adjusted HRs associated with the highest vs lowest quintiles of intake being 0.79 (95% CI, 0.73-0.86) and 0.83 (95% CI, 0.77-0.88), respectively, for the US and Shanghai cohorts. This inverse association was predominantly driven by cardiovascular disease mortality (P < .05 for trend in the US cohort; P < .001 for trend in the Shanghai cohorts). When specific types of cardiovascular disease were examined, a significant inverse association was consistently seen for ischemic heart disease in all ethnic groups (HR, 0.62; 95% CI, 0.45-0.85 in blacks; HR, 0.60; 95% CI, 0.39-0.92 in whites; and HR, 0.70; 95% CI, 0.54-0.89 in Asians for the highest vs lowest quintile of nut intake). The associations for ischemic stroke (HR, 0.77; 95% CI, 0.60-1.00 for the highest vs lowest quintile of nut intake) and hemorrhagic stroke (HR, 0.77; 95% CI, 0.60-0.99 for the highest vs lowest quintile of nut intake) were significant only in Asians. The nut-mortality association was similar for men and women and for blacks, whites, and Asians and was not modified by the presence of metabolic conditions at study enrollment. Conclusions and Relevance: Nut consumption was associated with decreased overall and cardiovascular disease mortality across different ethnic groups and among individuals from low SES groups. Consumption of nuts, particularly peanuts given their general affordability, may be considered a cost-effective measure to improve cardiovascular health. Be well! JP

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