What Should I Eat for My Specific Condition?

"To fight a disease after it has occurred is like trying to dig a well when one is thirsty or forging a weapon once a war has begun." The Yellow Emperor's Classic of Internal Medicine, The Nei Ching, c. 1000 B.C.

In The China Study, T. Colin Campbell and Thomas M. Campbell present a clear and concise message: if you want to be healthy, change your diet. The China Study describes the most comprehensive research ever undertaken (including more than 2,400 counties in China) to show the relationship between diet and the risk of developing diseases. The authors summarize their findings in the Eight Principles of Food and Health, listed below.

What are the eight principles of food and health?

1. Nutrition [1] represents the combined activities of countless food substances. The whole is greater than the sum of its parts.

2. Solely taking vitamin supplements is not the way to good health.

3. There are virtually no nutrients in animal-based foods that are not better provided by plants.

4. Genes do not determine diseases on their own. Genes function only by being activated or expressed, and nutrition plays a critical role in determining which genes, good and bad, are expressed.

5. Nutrition can substantially control the adverse effects of noxious chemicals.

6. The same nutrition that prevents disease in its early stages (before diagnosis) can also halt or reverse disease in later stages (after diagnosis).

7. Nutrition that is truly beneficial for one chronic disease will support health across the board.

8. Good nutrition creates health in all areas of our existence. All parts are interconnected.

As principle number seven states, nutrition that is truly beneficial for one chronic disease will support health across the board. There is remarkable convergence in recommendations for diet and health. Eating as a defense against one disease process may well influence another. For example, eating in a way to support bone health will likely decrease inflammation, keep the brain healthy, and promote heart health.

How can food help create health?

Below are checklists for four important health concerns. They include recommendations for foods to include (those that provide protection), as well as foods to exclude (to eliminate potential negative messages that could impact the ability of the body to create health).

• Bone health [2]
• Decrease inflammation [3] (IBD, arthritis, asthma)
• Brain health [4]
• Heart health [5]
• Overall health [6]

The recommendations can be used for either primary prevention (before diagnosis) or secondary prevention (after diagnosis).

Note that some alternative systems of medicine, such as Traditional Chinese Medicine [7] or Ayurveda [8], also suggest diets for specific conditions and offer a helpful approach for some people.

If you are interested in a detoxification diet, see "How to Feed Your Detoxification System" in How Are the Environment and Food Related? [9]

Foods for bone health

Osteoporosis refers to a loss of bone mass, during which the bones become porous and fragile. Our bones are constantly being remodeled, with bone tissue being broken down and rebuilt on a regular basis. Bone density usually increases until young adulthood, but after that, trouble can begin. Osteoporosis sets in when more bone is lost than can be rebuilt.

Foods to include:

• Calcium: Dairy products are one of the common sources of calcium, but many people choose not to eat them or can't tolerate them because of lactose intolerance or allergy. Other food sources of calcium include canned sardines, salmon, dark green vegetables (such as broccoli, collard greens, and bok choy), tofu, and calcium-fortified juices and soymilk. 
• Vitamin D: Vitamin D plays a pivotal role in allowing the body to absorb calcium. We get vitamin D from sunlight and fortified foods, such as milk. 
• Magnesium: Magnesium and calcium work together to promote bone health. Foods rich in magnesium include whole grains, spinach, tofu, almonds, broccoli, lentils, pumpkin seeds, and sunflower seeds.
• Vitamin K: Women who consume less vitamin K have a higher risk of hip fractures. Vitamin K positively affects calcium balance, a key mineral in bone metabolism. Vitamin K can not only increase bone density in people with osteoporosis, but also reduce fracture rates. The best sources are green leafy vegetables, such as spinach and broccoli. 
• Boron: Boron, usually classified as a trace mineral, has been recently identified as an important nutrient in bone health because it reduces urinary excretion of calcium and magnesium. (In 1993 the British Journal of Nutrition published a study on the influence of a low-boron diet and boron supplementation on bone, major mineral, and sex steroid metabolism in post menopausal women.) Boron can be found in tomato, pear, apple, soy, prunes, raisins, peanuts, almonds, dates, honey, filberts, and seafood.

Foods to exclude:

• Excessive alcohol: People who drink alcohol to excess are more prone to fractures. This may be partially due to the diuretic effect of alcohol, which induces calcium losses through the urine. Alcohol can also decrease the absorption of calcium from the intestines and cause deficiencies in vitamin D and magnesium-both of which are important to bone health. In addition, those who drink excessively often choose alcohol over nutritious foods. Note that excessive means anything over one drink per day for women and two for men. One drink is 1.5 oz liquor, 12 oz beer, or 5 oz wine.
• High sodium intake: Several studies have demonstrated the harmful effects of high dietary sodium on bone integrity. Reducing sodium intake can reduce bone loss considerably. Avoid salty processed foods and fast food. 
• Caffeine: The caffeine in more than two cups of coffee a day may contribute to accelerated bone loss.  
• Large amounts of animal protein: Some studies have shown that a diet high in animal protein, which is acid producing, actually promotes bone loss by leaching calcium from the bones.

Return to list of health concerns [10]

Foods to decrease inflammation

Inflammation is the body's natural defense against infection, injury, toxins, and anything the body deems as enemy. But when the body's defense system is constantly triggered and becomes overwhelmed, inflammation increases and can negatively affect any system in the body.

Excess inflammation can produce the following negative effects in different parts of the body:

• Gastrointestinal system: inflammatory bowel disorders [11]
• Brain: neurological diseases, such as Alzheimer's
• Respiratory system: asthma 
• Skeletal system: joint swelling or arthritis [12]
• Cardiovascular system: contributes to heart disease [13]

One of the most common causes of excess inflammation is our diet, so dietary strategies to decrease inflammatory messages are helpful for multiple disease conditions.

Foods to include:

Omega-3 fatty acids: Omega-3 essential fatty acids are necessary for creating the body's anti-inflammatory messages, while turning off pro-inflammatory messages. Increase intake by eating salmon, halibut, mackerel, herring, tuna, sardines, walnuts, pumpkin seeds, and freshly ground flaxseeds or oil (note that rancid oils can increase inflammation).

Foods and specific nutrients shown to inhibit COX2, an enzyme responsible for inflammation. These include:

• Vitamin C found in citrus fruits, tomatoes, green leafy vegetables, parsley, cabbage, asparagus, avocados, cantaloupe, currants, mangos, kiwi, papaya, peppers, pineapple, and strawberries
• Green tea
• Soy, such as tofu, soybeans, soynuts, tempeh, and miso 
• Onions and garlic rich in quercitin, a phytonutrient 
• Rosemary 
• Ginger 
• Curcumin, a natural pigment that accounts for the yellow color of the spice turmeric 
• Cherries 
• Pineapple

Foods to exclude:

• Fats that encourage the synthesis of pro-inflammatory messages. Topping the list of these "bad fats" are trans-fatty acids or partially hydrogenated vegetable oils found in some processed baked goods, crackers, and deep-fried foods. 
• Foods such as corn oil, sunflower seed oil, and cottonseed oil, which produce inflammation in the body.
• Refined carbohydrates and sugars. An imbalance of insulin and glucose has been found to influence inflammation, which may in turn impact cardiovascular health [13].

Return to list of health concerns [10]

Foods for brain health

The brain is one of the most metabolically active parts of the body and a steady stream of nutrients is needed to fuel the brain. "Feeding" the brain not only allows it to function but also reduces the risk for cognitive decline. Not surprisingly, the very foods recommended to keep the body functioning are also important to include for brain health.

Foods to include:

• Soybeans, peanuts, eggs, and other foods high in choline. Choline is a building block for acetylcholine, which is a crucial neurotransmitter that is responsible for healthy mental functioning. (Other foods include potatoes, cauliflower, tomatoes, banana, milk, oranges, lentils, oats, barley, sesame seeds, flax seeds, and whole wheat bread.)
• Omega 3 fatty acids: The brain is a fatty environment and anti-inflammatory fatty acids found in omega 3 fatty acids are very beneficial for brain health. Include salmon, halibut, mackerel, herring, and tuna, sardines, walnuts, pumpkin seeds, and freshly ground flaxseeds or oil.
• Vitamin E, which is especially needed as a fat-soluble antioxidant to protect the fatty environment of the brain.
• Whole grains rich in B-vitamins, which are effective in lowering elevated homocystine levels associated with dementia. Include oatmeal, brown rice, and quinoa.
• Zinc: A zinc deficiency is linked to cognitive decline in humans. Zinc is found in liver and red meat, egg yolks, dairy products, whole-grain cereals, seafood (particularly oysters and shellfish), sesame and sunflower seeds, and soybeans.
• Antioxidant-rich foods: The brain is highly susceptible to damage from free-radicals. The Free Radical Theory of aging, first researched more than 50 years ago, argues that aging results from an accumulation of cell damage initiated by continual attacks from particles called free radicals.

Chemically, free radicals are molecules that are missing an electron and are desperately trying to snatch one from any other molecule in order to neutralize themselves. However, in the process another free radical is formed. This newly formed free radical then searches out another molecule to rob an electron from, causing a chain reaction of free radical formation. Until subsequent free radicals can be deactivated, thousands of free radical reactions can occur within seconds of the initial reaction. Tissue damage from free radicals is known as oxidative stress.

To combat this, include foods rich in antioxidants. An antioxidant is a molecule able to give up an electron without becoming a free radical itself. Antioxidants thus stabilize free radicals so they can't cause damage. Antioxidants includes vitamin A, found in sweet potatoes, carrots, cantaloupe, spinach, cod liver oil (1 teaspoon) and those rich in vitamin C, found in oranges, grapefruit, tangerines, kiwi, strawberries, tomatoes, red pepper, and broccoli. Also include foods rich in selenium, which includes walnuts, Brazil nuts, shrimp, crabmeat, salmon, brown rice, and whole grains.

Foods to exclude:

• Fats that encourage the synthesis of pro-inflammatory messages. Topping the list of these "bad fats" are trans-fatty acids or partially hydrogenated vegetable oils found in some margarines and many processed baked goods, crackers, and deep-fried foods. The brain is a highly fatty environment. Trans-fatty acids increase the likelihood of excessively permeable cell membranes, which make the cell's protective barrier less effective, so that it lets in molecules that may damage the cell.
• Foods such as corn oil, sunflower seed oil, and cottonseed oil, which produce inflammation in the body.
• Refined carbohydrates and sugars. These can promote an imbalance of insulin and glucose, which can lead to insulin resistance, which in turn affects brain chemistry.

Return to list of health concerns [10]

Foods for heart health

It is estimated that more than 70 million Americans have some form of heart disease [13]. Risk factors that account for the high prevalence of this disease include family history, inflammation, insulin resistance, oxidative damage, stress response, and elevated cholesterol.

The relationship between diet and heart disease has been studied intensively for nearly a century. A study published in the Journal of the American Medical Association (2002), based on substantial evidence, proposed an optimal diet for prevention of heart disease [13]. This diet includes an abundance of fruits, vegetables, nuts, and whole grains with restricted refined grains. It also recommends increased amounts of non-hydrogenated and omega 3 fatty acids.

A recent study published in Journal of the American Dietetic Association (2008) is a systematic review of the evidence associated with key dietary factors and risk of cardiovascular diseases.

Foods to include:

• Beneficial fats such as oils from fish or olive oil. These fats have been shown to reduce the inflammation often associated with the risk for cardiovascular disease.
• Nuts and seeds. Nuts have been shown to lower LDL cholesterol and reduce the risk of blood clots. All nuts and seeds have value, especially almonds and pumpkin sees. As always watch the salt content. And of course, limit to a small handful daily, as nuts and seeds are high in calories.
• Whole grains rich in B-vitamins, including oatmeal, brown rice, and quinoa. B-vitamins are effective in lowering homocycsteine levels associated with cardiovascular diseases.
• A variety of fruits and vegetables, which increase antioxidant levels to blunt the effect of free radical damage to the heart. Include antioxidant-rich foods, such as sweet potatoes, carrots, cantaloupe, spinach, and cod liver oil (1 teaspoon), which are rich in vitamin A, as well as oranges, grapefruit, tangerines, kiwi, strawberries, tomatoes, red pepper and broccoli, which are all rich in vitamin D.
• Soy has been shown to not only reduce LDL cholesterol but also to reduce inflammation. Include tofu, soybeans, soynuts, tempeh, and miso.
• Dark chocolate! Cocoa has been shown to inhibit platelet clumping in an "aspirin-like" manner.

Foods to exclude:

• Animal fats, which give the body pro-inflammatory messages. If you choose to eat meat, chose 100 percent grass-fed. (Beware of less than 100 percent grass-fed because the producers may just have given grass right at the end of the animal's life.)
• Vegetable shortening, all partially-hydrogenated oils, and all deep-fried foods, as these types of fat promote inflammation and potential damage to the vessels of the heart.
• Refined grains and simple sugary foods, such as candy and sweets. An imbalance between insulin and glucose (called insulin resistance) is a risk factor for the development of heart disease.
• Sodium. Excess sodium has been shown to increase the risk for hypertension.
• Excess alcohol. Limit alcohol to no more than one drink per day for women and 2 per day for men.

Return to list of health concerns [10]

What should I eat?

The Mediterranean diet is not a specific diet plan or program, but rather a collection of eating habits traditionally followed by people of the Mediterranean region including Greece, Crete, southern France, and parts of Italy.

Scientific research indicates that the Mediterranean diet can improve health and longevity.

While there is no universal definition of the Mediterranean Diet, many components have been consistently identified, including an abundance of natural, whole foods, especially fruits and vegetables, along with olive oil, fish, nuts, and a moderate amount of wine.

For more information, see The Mediterranean Diet [14].

Return to list of health concerns [10]

References and Further Reading

Bourre, J.M. (2006). Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part I micronutrients. Journal of Nutrition and Healthy Aging, 10(5), 377-385.

Campbell, T. Colin, Campbell, Thomas M. (2005). The China Study. Dallas, Texas: Benbella Books.

Curtis B, O'Keefe, JH. (2002). Understanding the Mediterranean diet. Post Graduate Medicine, 112(2), 35-45.

de Lorgeril, M et. al. (1999). Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after Myocardial infarction: final report of the Lyon heart Study. Circulation, 99(6), 779-785.

Hu, F.B., Willett, W.C. (2002). Optimal diet for prevention of heart disease. Journal of the American Medical Association, 288, 2569-2578.

Korkmaz, M. (1993). Estimation of human daily boron exposure in a boron-rich area. British Journal of Nutrition, 98(3), 571-575.

Metro, PN, et al. (2007). Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH AARP Diet and health Study. Archives of Internal Medicine, 167(22), 2461-8.

O'Keefe, J.H., Gheewala, N.M., O'Keefe, J.O. (2008). Dietary strategies for improving post-prandial glucose, lipid, inflammation and cardiovascular health. Journal of the American College of Cardiology, 51(3), 249-255.

Van Horn, L., et al. (2008). The evidence for dietary prevention and treatment of cardiovascular disease. Journal of the American Dietetic Association, 108, 287-331.

Weil, A. (2005). Healthy Aging. New York: Alfred Knopf.

Willett W. (2001). Eat Drink and be Healthy. New York: Simon & Schuster.