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The Power of Phytonutrients

Deanna Minich, PhD, FACN, CNS, IFMCPApril 2016

www.drdeannaminich.com

Speaker Disclosures

- Consultant for Genova Diagnostics

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Learning Objectives

1. To understand the importance of phytonutrients in health and reducing chronic disease (RATIONALE)

2. To learn about new findings in phytonutrient research and apply them clinically (NEW CLINICAL FINDINGS)

3. To understand how to instruct a patient to get the most phytonutrients from their food (ACTION – THE “DO”)

Key Clinical Actions

1. To give patients ways to get more phytonutrients in their eating

2. To provide patients with tips on “eating smarter” when it comes to maximizing phytonutrient density.

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Learning Objectives




Eat plant foods, reduce chronic disease

• CVD• Cancer• Diabetes• Alzheimer’s disease• Cataracts• Age-related functional decline

Liu et al. Journal of Food Science Vol. 78, S1, 2013

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Where to Find Phytochemicals?

• Fruits

• Vegetables

• Nuts

• Seeds

• Whole grains

• Legumes

• Herbs

• Spices

Thousands of Phytochemicals

All plants produce (non-nutritive) chemical compounds— “phytochemicals”—as part of their normal metabolic activities

– Carbohydrates, fats, proteins, fiber

– Vitamins, minerals

– Secondary metabolites

– PigmentsThere are 5,000 to 10,000+

phytonutrients in our food supply!

Walsh et al., Am J Clin Nutr. 2007 Dec;86(6):1687-93.)

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Liu, Adv. Nutr. 4: 384S–392S, 2013.

TYPES OF PHYTOCHEMICALS

Small amounts, Significant impact

Carbohydrate = 250 gProtein = 100 gFat = 60 gPhytonutrients = 1.5 g

Walsh et al., Am J Clin Nutr. 2007 Dec;86(6):1687‐93.

• N=21 healthy individuals• Normal diet vs. 2-d low-phyto

diet vs. 2-d standard phyto diet

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Phytonutrients are more than antioxidants…

• Physiological location specificity

• Structure/function– Beta-carotene:

Corpus luteum—ovulation

– Lutein:

Macula—vision

– Anthocyanins:

Brain—cognition

©Metagenics, Inc.

Phytonutrients communicate messages to cell networks

Howitz KT, Sinclair DA. Xenohormesis: sensing the chemical cues of other species. Cell. 2008 May 2;133(3):387‐91.

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Howitz KT, Sinclair DA. Xenohormesis: sensing the chemical cues of other species. Cell. 2008 May 2;133(3):387‐91.

Eat stressed plants.

The Gut-Phytonutrient Connection

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Learning Objectives




Dietary phytochemical index

[PI=(phytochemical kJ/total kJ x 100]

“Foods that were included in the phytochemical-rich category included: fruits and vegetables (and prepared foods derived from these), legumes, whole grains, seeds, nuts, fruit or vegetable juices, olive oil, soy sources, wine, beer and cider.”

Vincent et al. J Hum Nutr Diet. 2010 Feb;23(1):20‐9. Epub 2009 Sep 4.

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Overweight adults eat less phytonutrients.


Phytonutrients & Inflammation


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Green, leafy vegetables & T2DM

Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta‐analysis. BMJ. 2010 Aug 18;341:c4229.

“An increase of 1.15 servings a day was associated with a 14% decrease in incidence.”

Greater intake of flavonoids and lower risk of dementia

Commenges D, et al. Intake of flavonoids and risk of dementia. Eur J Epidemiol. 2000 Apr;16(4):357‐63.N=1367 subjects above 65 yrs.5‐yr follow‐up

One cup of black tea = 312.3 mg flavonoids

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Are your patients getting enough phytonutrients?

Indirect Laboratory Markers• Inflammaging

– High hsCRP

– Low vitamin D

– High fasting glucose/insulin

– Low omega-3 Index

– Reduced lean body mass

– High homocysteine

• Elevated oxidative Stress Markers

– 8-OHdG

– Urine lipid peroxides

• Low levels of vitamins and minerals

• Advanced Glycation Endproducts – High Hgb A1C

• Elevated autoantibodies

• Lowered immune function (reduced WBCs)

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IFM Phytonutrient Assessment Questionnaire

Phytonutrient Assessment Questionnaire

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IFM 1-Day Lifestyle Journal

Sample Lifestyle

Journal to Look for

Color

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Learning Objectives




Plants as the ultimate eating unifier

Omnivore

Vegan

Vegetarian

Flexitarian

Fruitarian

PLANTS

©Deanna Minich

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Communication to the Patient: “Food is information”

The Brown, Yellow, White, High-Advanced Glycation Product, High-Processed,

High-Inflammation, High-Aging Diet

Do you have a color deficiency in your daily eating?

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Most people have a“phytonutrient gap.”

• 69% fall short in green

• 78% fall short in red

• 86% fall short in white

• 88% fall short in purple/blue

• 79% fall short in yellow/orange

America’s Phytonutrient Report, Nutrilite Health Institute, 2009;

Do you suffer from “color deficiency”?

The 2010 Dietary Guidelines for Americans recommend at least 9 servings of fruits and vegetables a day based on a 2000 kcal diet.

However, the average person in the United States consumes 3.6 servings of fruits and vegetables per day*


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What counts as “color”?

Fresh, cooked, and processed fruits and vegetables including frozen and canned, 100% fruit juices, 100% vegetable juices, and dried fruits are all considered as servings of fruits and vegetables.


Recommendations for a 2000 kcal diet: 4 servings (2 cups) of fruits5 servings (2.5 cups) of vegetables

Get a variety of colors.Smaller amounts of more…

“These findings indicate that botanical diversity plays a role in determining the bioactivity of high-VF diets and that smaller amounts of many phytochemicals may have greater beneficial effects than larger amounts of fewer phytochemicals.”

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Lower levels of friend contact were associated with reduced variety of fruits and vegetables in a graded trend for both genders; the trend was more pronounced among men.

Your tribe determines your fruit and

vegetable intake.

Soc Sci Med. 2013 Aug 28. pii: S0277‐9536(13)00470‐X. doi: 10.1016/j.socscimed.2013.08.018. [Epub ahead of print]

Mastering the phytochemical spectrum

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Copyright 2013 Food & Spirit 37

Red‐foodphytochemicals

Phytonutrient Benefits Found in

Lycopene* Reduces the risk of prostate, breast, and skin cancer; reduces the risk of heart attacks

Tomato‐based products (tomato juice, spaghetti sauce, tomato soup, tomato paste), watermelon, pink grapefruit, fresh tomato, guava

Anthocyanins* Reduce the risk of cancer; powerful antioxidants; help control high blood pressure; reduce the risk of diabetes complications; reduce the risk of heart attacks, reduce the risk of Alzheimer’s disease

Red raspberries, sweet cherries, strawberries, cranberries, beets, red apples (with skin), red cabbage, red onion, kidney beans, red beans

Astaxanthin Potent antioxidant, particularly for the liver; Gastroprotective effects; Immune stimulant; Chemoprotectant.

Microalgae, yeast, salmon, trout, krill, shrimp, crayfish, crustaceans,

*Provided by the National Cancer Institute, www.5aday.gov

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– Greater intakes of lycopene associated with increased CV health

– 5‐yr results of the prospective observational Women’s Health Study of 39,876 initially disease‐free women indicated that the risk for developing any form of CVD was inversely proportional to long‐term plasma lycopene concentration.

Nutrition. 2012 Jun;28(6):605‐10. Epub 2012 Apr 4. Novel phytonutrient contributors to antioxidant protection against cardiovascular disease. Riccioni G, et al.

Lycopene

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http://www.nytimes.com/interactive/2013/05/26/sunday-review/26corn-ch.html?ref=sunday

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Orange-food phytochemicals


Beta‐carotene* Powerful antioxidant; boosts immunity; reduces risk for cancer; reduces risk of heart attacks; helps maintain good vision.

Carrots, sweet potatoes, pumpkin, butternut squash, cantaloupe, mangos, apricots, peaches

Bioflavonoids* Powerful antioxidants; Works with vitamin C to reduce the risk of heart attacks, reduce the risk of cancer, and to help maintain strong bones/teeth, healthy skin, and good vision.

Oranges, grapefruit, lemons, tangerines, clementines, peaches, papaya, apricots, nectarines, pears, pineapple, yellow raisins, yellow pepper


Top Carotenoid Containing Foods

Food Food Prep/Serving Size Phytonutrient Amount

1. Carrots Dehydrated/1 cup 106,917

2. Kale Steamed or Raw/1 cup 48,776

3. Carrots Cooked with butter/1 cup 40,650

4. Tomato products Canned paste with salt, heated/1 cup 30,771

5. Carrots Raw/1 cup 28,900

6. Spinach Cooked with butter or olive oil or steamed 17,535

7. Pasta sauce Cooked/1 cup 16,590

8. Grape leaves Raw/1 cup 16,194

9. Mangos Canned/Drained/1 cup 14,670

10. Pumpkin Canned, no salt/1 cup 11,735

Source: http://www.ars.usda.gov/nutrientdata, Accessed August 10, 2013

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Nagao A, Kotake‐Nara E, Hase M. Biosci Biotechnol Biochem. 2013 May 23;77(5):1055‐60. Epub 2013 May 7.

Bioaccessibility of Beta-Carotene

Carotenoids from papaya• Bioavailability of β-

carotene from papayas was ~ 3x higher than that from carrots and tomatoes, whereas differences in the bioavailability of β-carotene from carrots and tomatoes were insignificant.

• Lycopene was ~ 2·6 times more bioavailable from papayas than from tomatoes.

• Bioavailability of β-cryptoxanthin from papayas was shown to be 2·9 and 2·3 times higher than that of the other papaya carotenoids β-carotene and lycopene, respectively. Br J Nutr. 2013 Aug 12:1‐9. [Epub ahead of print]

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Fish oil and curcumin

47Ma et al. J Neurosci. 2009;29(28):9078‐89.

Curcuminand Mercury Exposure

“The study indicates that curcumin, an effective antioxidant, may have a protective effect through its routine dietary intake against mercury exposure. ”

Agarwal J.Appl. Toxicol. 2010

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Source: IFM

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Lutein & skin health- Women ingested an oral antioxidant complex containing 6 mg of lutein and 0.18 mg of zeaxanthin daily for an 8-week period.

- Lipid peroxidation in skin decreased within 2-weeks and continued to decrease.

- Moisture in the skin was increased as early as 2 weeks and continued to increase throughoutthe study.”

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Roberts RL. Lutein and zeaxanthin in eye and skin health. Clinics in Dermatology (2009) 27, 195‐201; Morganti P, Bruno C, Guarneri F, Cardillo A, Del Ciotto P, Valenzano F. Role of topical and nutritional supplements to modify the oxidative stress. Int J Cosmet Sci2002;24:331‐9.

Lutein and ARMD

“For reducing the risk of cataracts and age-related macular degeneration (AMD), 6 mg of lutein per day, either through diet or supplementation has been suggested.”

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Brown L, Rimm EB, Seddon JM, et al. A prospective study of carotenoid intake and risk of cataract extraction in US men. Am J ClinNutr 1999;70:517-24.

Chasan-Taber L, Willett WC, Seddon JM, et al. A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. Am J Clin Nutr 1999;70:509-16.

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Food Lutein ZeaxanthinVegetables Basil 70.5 in Parsley 64.0–106.5 in Spinach 59.3–79.0 in Kale 48.0–114.7 ‐Leek 36.8 in Pea 19.1 in Lettuce 10.0–47.8 ‐Green pepper 8.8 ‐Broccoli 7.1–33.0 in Carrot 2.5–5.1 in Red pepper 2.5–85.1 5.9–13.5 Eggs Egg yolk 3.84–13.2 ‐Nuts Pistachio 7.7–49.0 ‐Baked foods Corn tortilla 72.5 105.3 Corn chips 61.1 92.5 Grains Corn 21.9 10.3 Einkorn wheat 7.4 0.9 Khorasan wheat 5.5 0.7 Durum wheat 5.4 0.5

Selected commonly consumed foods as high sources of lutein and zeaxanthin(μg/g fresh weight except for corn tortilla and chips μg/g dry matter)

Nutrients 2013, 5, 1169‐1185; doi:10.3390/nu5041169

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Effects of Processing on Antioxidant Content in Foods

Food Type of ProcessingAntioxidant Content % Compared to Non-Processed Food

Apples Peeling (-)33-66%

Carrots Steaming (+)291%

Carrots Boiling (+)121-159%

Cucumbers Peeling (-)50%

Asparagus Steaming (+)205%

Broccoli Steaming (+)122-654%

Cabbage, green Steaming (+)448%

Cabbage, red Steaming (+)270%

Green pepper Steaming (+)467

Red pepper Steaming (+)180%

Potatoes Steaming (+)105-242%

Tomatoes Steaming (+)112-164%

Spinach Boiling (+)84-114%

Sweet potatoes Steaming (+)413%Halvorsen BL, Carlsen MH, Phillips KM, Bohn SK, Holte K, Jacobs DR Jr, Blomhoff R. Content of redox‐active compounds (ie, antioxidants) in foods consumed in the United States. Am J Clin Nutr. 2006 Jul;84(1):95‐135. 2006. PMID:16825686.

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Yellow-green food phytochemicalsPhytonutrient Benefits Found in

Lutein*/Zeaxanthin

Helps maintain good vision; reduces the risk of cataracts or macular degeneration.

Kale, spinach, leafy greens (turnip, collard, mustard), romaine lettuce, broccoli, green peas, kiwifruit, honeydew melon

Indoles* Reduce the risk of cancer (particularly breast and prostate cancers); reduce the risk of tumor growth in cancer patients.

Broccoli, cabbage, brussels sprouts, bokchoy, arugula, Swiss chard, turnips, rutabaga, watercress, cauliflower, kale

Chlorophyll Powerful antioxidant All green vegetables

Phytomethylators Methylation; cell growth. Leafy greens

Phytosterols Cholesterol reduction; Anti‐inflammatory; Reduce cancer risk (especially prostate ca)

Vegetable oils, whole grains, nuts, and legumes

Phytoestrogens May act as an estrogen agonist Soybeans and soy products, tempeh, linseed (flax), sesame seeds, wheatberries, fenugreek, oats, barley, beans, lentils, yams, rice, alfalfa, mung beans


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Source: IFM

The Mighty Avocado

“There are eight preliminary clinical studies showing that avocado consumption helps support cardiovascular health.”

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Half avocado (68 grams):

Fiber 4.6 gPotassium 345 mgFolate 60 mgMUFAs 6.7 g114 kcal

Critical Reviews in Food Science and Nutrition, 53:738–750 (2013)

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Chlorophyll and chlorophyllin as a binder in the gut• Anti-mutagen

– Anti-carcinogen (Inhibits the induction of liver, skin, esophageal and stomach cancer)

– Inhibits carcinogen binding to DNA

– Binds to reactive carcinogens and prevents their binding to macromolecules

• Supports phase I and II detoxification

• Antioxidant

• Greater than 50% reduction of aflatoxin binding to DNA in large study in China (Groopman and coworkers)

Egner PA, et al. PNAS. 2001 Dec 4;98(25):14601‐6. Epub 2001 Nov 27.

Handling broccoli for optimum detox activity

• Glucosinolate (glucoraphanin) converts to isothiocyanates (I3C)

• Frozen broccoli products do not retain sulforaphane (myrosinase destroyed during blanching)

• Adding powdered mustard seeds (hardier myrosinase) to boiling water to cook broccoli can result in increased sulforaphane formation

• Glucosinolates decrease with cooking and lutein, beta-carotene, and tocopherols increase with cooking of broccoli.

J Food Sci. 2013 Sep;78(9):H1459-63. doi: 10.1111/1750-3841.12221. Epub 2013 Aug 5.Food Chem. 2013 Jun 1;138(2-3):1734-41. doi: 10.1016/j.foodchem.2012.10.119. Epub 2012 Nov 12.Int J Food Sci Nutr. 2013 Feb;64(1):103-11. doi: 10.3109/09637486.2012.704904. Epub 2012 Jul 10. 60

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Broccoli sprout-derived beverage providing daily doses of 600 umolglucoraphanin and 40 umolsulforaphane give to 291 participants in China for 12 weeks.

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Curr Atheroscler Rep. 2011 Dec;13(6):484‐92. Dietary nitrates, nitrites, and cardiovascular disease. Hord NG.

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Dietary nitrates and nitrites“It has been estimated that 1 serving of a high-nitrate vegetable, like spinach, results in more nitric oxide production from the reduction of nitrate to nitrite, and nitrite to NO, than what is endogenously formed by all the three NOS isoforms combined during a day.”

Hord NG. Dietary nitrates, nitrites, and cardiovascular disease. Curr Atheroscler Rep. 2011 Dec;13(6):484‐92.

Nitrates

Curr Atheroscler Rep. 2011 Dec;13(6):484‐92. Dietary nitrates, nitrites, and cardiovascular disease. Hord NG.

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Our intestinal cells “taste”.

68Cummings and Overduin, J. Clin. Invest. 117:13–23 (2007). doi:10.1172/JCI30227.

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TASTE RECEPTORS

69J Cell Biol. 2010 August 9; 190(3): 285–296.

The Beauty of Bitter

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Singh N. et al. BiochemBiophys Res Commun. 2011 Mar 4;406(1):146‐51. Epub2011 Feb 12.

Green tea Soy Leafy greensCaffeineBitter melonBerberineFenugreek

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Gut effects of bitter

71Current Opinion in Pharmacology 2007, 7:557–562

Bitter tasters have lower BMI

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GOLDSTEIN, GRETCHEN L., HENRYK DAUN, AND BEVERLY J. TEPPER. Adiposity in middle‐aged women isassociated with genetic taste blindness to 6‐npropylthiouracil. Obes Res. 2005;13:1017–1023.

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Blue-purple food phytochemicals



Anthocyanins* Reduce the risk of cancer; powerful antioxidants; reduce the risk of age‐related memory loss; help control high blood pressure; reduce the risk of diabetes complications; reduce the risk of heart attacks; reduce the risk of Alzheimer’s disease

Blueberries, blackberries, purple grapes, black currants, elderberries

Phenolics* Powerful antioxidants; may slow some of the effects of aging.

Dried plums (prunes), raisins, plums, eggplant

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Source: IFM

Berries = Beneficial Brain Signaling

• Cell & animal studies: Berry fruits mediate signaling pathways involved in inflammation and cell survival; enhance neuroplasticity, neurotransmission, and calcium buffering, all of which lead to attenuation of age- and pathology-related deficits in behavior.

• Recent clinical trials have extended these antioxidant, anti-inflammatory, and cognition-sparing effects to humans.

J Agric Food Chem.2012 Feb 3. [Epub ahead of print]

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Greater intakes of blueberries and strawberries were associated with slower rates of cognitive decline.

“Berry intake appears to delay cognitive aging by up to 2.5 years.”

N=16,010 participants (70+ yrs); Nurses’ Health studyAnn Neurol. 2012 Jul;72(1):135‐43. doi: 10.1002/ana.23594. Epub 2012 Apr 26.

The Top Proanthocyanidin- Containing Foods


Cocoa beans Ground, powder/ 1 cup 9,481

Cinnamon, ground Ground/1 tbsp. 8,108

Sorghum, bran 1 cup 4,604.97

Sorghum, grain 1 cup 1,902

Baking chocolate Unsweetened squares/1 cup 1,635

Chocolate Liquor/1 cup 1,477

Cocoa Dry, powder/1 cup 1,373

Beans, pinto Cooked/1 cup 767

Choke Berries Raw/1 cup 664

Cranberries Raw/1 cup 419

Source: http://www.ars.usda.gov/nutrientdata, Accessed August 10, 2013 78

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Ellagitannin-rich berries

Bioavailability of ellagitannins appears to be dependent on the composition of gut microbiota.

Mol Nutr Food Res. 2013 Aug 12. doi: 10.1002/mnfr.201300280. [Epub ahead of print]


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Molecules.2011 Feb 10;16(2):1471‐85. doi: 10.3390/molecules16021471.

“In the CNS several flavones bind to the benzodiazepine site on the GABA(A)-receptor resulting in sedation, anxiolytic or anti-convulsive effects.

Flavonoids of several classes are inhibitors of monoamine oxidase A or B, thereby working as anti-depressants or to improve the conditions of Parkinson's patients.

Flavanols, flavanones and anthocyanidins have protective effects preventing inflammatory processes leading to nerve injury. Flavonoids seem capable of influencing health and mood.”

Flavonoids – Brain Superstars


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Colorless Phytochemicals

Colorless phytochemicals in unprocessed foods may be lost during the cooking process because no visual guide exists to ensure their retention.

Extensive metabolism by phase I/II enzymes and by the gut microbiome may also create compounds that the eye is never allowed to appreciate.

Adv. Nutr. 4: 327S–334S, 2013.

Phenolic content is not consistently associated with color


“Golden raisins had higher phenolic content and antioxidant activity than the sun-dried raisin (Yeung and others 2003).”

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Carrots Dehydrated/1 cup 106,917

Collards(greens) Chopped, boiled/1 cup 18,527

Cocoa beans Ground, powder/1 cup 9,481.37

Beet greens Steamed, sautéed with butter/ 1cup 2,619

Broccoli Steamed, sautéed with butter/1cup 2,016

Brussel Sprouts Cooked, boiled, drained without salt/1 cup 2,389

Kale Steamed without salt/1 cup 1,112Watercress cooked, boiled, drained, without salt/ 1cup 886Swiss Chard Steamed, sautéed with butter/1 cup 895

Bok Choy Steamed/1 cup 865Arugula Steamed, raw/1 cup 604Spinach Steamed, sautéed with butter/1 cup 707

Cauliflower Steamed, sautéed with butter/1 cup 315

Tomatoes Chopped, heated as sauce/1 cup 186

Strawberries Raw/1 cup 184Blackberries Raw/ 1 cup 171Leeks Steamed/1 cup 135Red Bell Peppers Chopped, raw, heated/1 cup 265

Mushrooms Chopped, sautéed with butter/ 1cup 238

Garlic Chopped, sautéed with olive oil/ 1 clove 109

The Top Phytonutrient Containing Foods

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Summary & Takeaways

1. Phytonutrients are important agents in health through their pleiotropic effects

2. Clinical research suggests associations between phytonutrients and chronic disease

3. It is worthwhile to teach a patient how to assess their phytonutrient content and get the most from their diet

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Thank You!www.deannaminich.com

the power of phytonutrients - c.ymcdn.com power of phytonutrients deanna ... vegetables including...

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