The Mediterranean Zone (15 page)

What we usually term as aging may be viewed as the combined consequences of either increased cellular inflammation and/or decreased metabolic efficiency. Thus, anything that reduces inflammation or increases metabolic efficacy should extend longevity. To find that connection, you have to return to the subject of gene transcription factors. Among the unique ability of polyphenols to reduce oxidative stress, they also activate other gene transcription factors in our cells that can help us to live longer by increasing metabolic efficacy and decreasing inflammation.

One of those factors is an enzyme known as AMP kinase. It is called the enzyme of life because it senses the chemical energy levels in the cell and then adjusts the metabolism of the cell to maximize energy (adenosine triphosphate, or ATP) production. AMP kinase is also a master genetic switch for increasing the efficacy of the metabolism in every one of the 10 trillion cells in the body. Once AMP kinase is activated, your ability to convert dietary calories into chemical energy becomes super-efficient.

Properly restricting calories without malnutrition is one way to activate this enzyme of life. The other way to activate this enzyme of life is to consume high levels of polyphenols, such as those ingested by drinking three glasses of red wine per day as Luigi Cornaro did. Cornaro was using both dietary approaches simultaneously to extend his life. Another way to look at this is that the fewer polyphenols you consume (the more white carbohydrates you eat) and the more calories you consume, the faster you age. The Mediterranean Zone allows you to replicate Luigi’s dual program of calorie restriction and high levels of polyphenols without needing to down three glasses of red wine a day on a highly restrictive diet.

One of the reasons people can’t maintain calorie-restricted diets is that they are always fatigued. Consuming adequate levels of polyphenols, as found in the Mediterranean Zone, presents a solution to this problem. By activating the enzyme of life (AMP kinase) with adequate levels of polyphenols, your body is able to maintain high levels of chemical energy even in the presence of significant calorie restriction. As a result, you won’t experience fatigue or hunger.

It is known that adherence to the traditional Mediterranean diet
appears to be related to increased longevity. But is there any data that a specific group of nutrients in the traditional Mediterranean diet might be responsible for this increase in longevity?

Three such studies published in 2013 indicate that increased polyphenol intake may be the answer. The first two were epidemiology studies from Harvard Medical School. The first indicated that increased consumption of nuts (about 1 ounce per day) provided up to a 20 percent decrease in overall mortality. The other study indicated that consuming increased levels of berries generated up to a 32 percent reduction in heart attacks in women. The third study, in the
Journal of Nutrition,
demonstrated that the higher the levels of polyphenols absorbed (as measured by the polyphenol metabolites in the urine) by elderly subjects in Italy, the longer they were likely to live. How much longer? About 30 percent longer. Luigi Cornaro would be proud.

Today we spend billions of research dollars looking for new and expensive treatments for heart disease and cancer in order to live longer. However, the improvements in the death rates from these diseases are now becoming more limited as competing risks (such as Alzheimer’s) are increasing. We are living longer, but maybe not better. In fact, there is also evidence that the improvement in the functional health status of elderly Americans halted more than a decade ago and that the length of our healthy lifespan (longevity minus years of disability) may actually be decreasing.

What we should be focusing on is how to delay aging—having a body and mind that are years younger than our actual chronological age, so we can be healthier and live a greater number of disability-free years. We don’t have to spend billions of research dollars because the answer may lie with simply following the Mediterranean Zone and its recommendation to consume at least 1 gram of polyphenols and 2.5 grams of omega-3 fatty acids per day. In addition, consuming the types of meals shown in
Chapter 5
, you are restricting calories without hunger or fatigue when you follow the Mediterranean Zone. Combine them both and you live that longer and better life we all seek.

H
ow did this epidemic of dietary-induced cellular inflammation begin in the first place? As with any tragedy, there is usually a good story behind it. The industrialization of the American diet essentially begins in the latter part of the nineteenth century when John Kellogg was the chief medical officer of a sanitarium operated by the Seventh-day Adventist Church in Battle Creek, Michigan. He was concerned about the lack of healthy gut function in his patients. (Perhaps
obsessed
might be a better word.) Kellogg was convinced the then-standard American breakfast of lard and bacon was killing people by clogging their colons. To test his theory that a healthy life begins with a healthy colon (including a lot of enemas), he starting experimenting by feeding his patients ready-to-eat breakfast cereals devoid of fat (and taste). His patients tolerated the stuff only because they were getting better. In 1904, C. W. Post, who had been a patient at the sanitarium, began production on a cereal similar to Kellogg’s, but with a significant difference: He added extra sugar to make the bark-like material more palatable. The sugar he chose was grape sugar, chemically known as maltose, which consists of two glucose molecules linked together (basically a super sugar), and he named his new product Grape-Nuts. With that product, Post Cereals was
born. What C. W. Post didn’t realize was that maltose would rapidly break down to glucose, quickly increasing insulin levels and leading to constant hunger. I personally found this out as a young athlete who routinely consumed about six large bowls of Grape-Nuts every day. This may explain my lack of progress as a basketball player.

Grape-Nuts has been a wildly successful product for Post Foods. While John Kellogg, a nutritional purist, maintained that his cereal recipes needed no extra sugar, his brother, Will, was not so rigid. He figured that all that was needed for the family business to really succeed was to add sugar to the God-awful-tasting kitchen creations made by the company he and his brother had formed in 1897 to make unsweetened corn flakes and other equally unappealing products. His brother had no interest in compromising his dietary principles, so Will Kellogg formed his own new company in 1906 that eventually became the Kellogg Company. His older brother no longer spoke to him, but his new venture launched the cereal wars to win over the hearts and minds of Americans that continue to this day.

By 1916 James L. Kraft learned how to make processed cheese in days instead of months. He accomplished this by replacing traditional microbes with sodium phosphate and then pasteurizing the resulting product so it could last for years at room temperature in cans.

And we cannot forget about Milton Hershey, a pioneer in the polyphenol business—or at least the chocolate polyphenol business. He believed if he added even more milk and more sugar to chocolate he could make products that were cheaper than existing European chocolates made by companies such as Nestlé, and in the process everyone in America could afford to buy lots of his products. He was right, and the mass candy-bar business was born.

After the end of World War II the industrialization of food accelerated as companies such as General Mills, General Foods, and of course Kraft Foods started to mix science and engineering to make foods cheaper and more convenient. At the same time Big Food did a remarkable job of reducing the cost of food by stripping out the key components of unprocessed foods that reduced the shelf life (omega-3 fatty acids and polyphenols) and replacing them with much cheaper omega-6 fatty acids (and their chemically modified cousins, trans fats) and refined carbohydrates.

There were benefits to this new industrialization. The longer shelf life meant the possibility of globalizing their processed food production because spoilage was no longer a major issue. In addition, far fewer individuals were needed to actually produce enough food to feed a growing population. In the process, it started the largest mass migration in history, allowing hundreds of millions of people to move from rural areas to urban centers (especially in China) where more and more lucrative employment opportunities were possible. This migration from rural to urban areas still continues today as more than 50 percent of all people in the world now live in urban areas. In the United States, the percentage is more than 80 percent, as most of our population lives in urban and suburban areas. Since the percentage of urban dwellers is likely only to increase in the future, this means billions of individuals will be dependent on an industrialized global agribusiness industry for their daily food.

There are always some unintended health consequences of the industrialization and globalization of processed food. Not all crops are ideally suited for aggressive industrialization. The ones that were most suitable were wheat, corn, and soybeans. From wheat and corn come refined carbohydrates that rapidly enter the blood as glucose. From corn and soybeans come refined oils rich in omega-6 fatty acids. Through a combination of industrialization and farm subsidies, both refined carbohydrates high in glucose and oils rich in omega-6 fatty acids quickly became the cheapest sources of calories in the world. That made them the foundation of processed foods.

Unfortunately, this combination of food ingredients proved to be a deadly one. When high levels of insulin (responding to the rapid rise in blood glucose from refined carbohydrates) interacts with omega-6 fatty acids from soy, corn, and other vegetable and seed oils used to make the refined carbohydrates taste better, they accelerate the formation of arachidonic acid (AA) and, hence, set the stage for increased cellular inflammation.

Although refined carbohydrates such as white flour are the foundation for many processed foods, they taste like cardboard. Here the processed food industry learned to create a combination of ingredients that made their products so hard to resist for so many people: sugar, fat, and salt.

Humans have an innate desire for sugar. It is an ancient signal that indicated a food is probably safe to eat. We also know that the taste of sugar
means that quick energy is coming our way to alleviate low blood sugar levels. Unfortunately, we now also know that sugar is potentially addictive. This realization comes from animal studies that indicate sugar may be more addictive than cocaine. One such animal study with mice has suggested the true potential severity of our sugar addiction. The mice were fitted with a backpack that injected them with cocaine after they had learned to press a lever a certain number of times. They quickly figured out the reward cycle and were seen in the throes of a full-on cocaine addiction. The researchers then placed super-sweetened sugar water (water saturatated with table sugar plus some extra artificial sweetener to make it a super-sugar) in the cages of cocaine-addicted mice. Within three days, the cocaine-addicted mice switched their allegiance from cocaine to the super-sweetened sugar water. Why the rapid conversion? Because both cocaine and glucose activate the same reward mechanisms used by dopamine in the brain. Since the super-sweetened sugar water has fewer side effects than the cocaine, the switchover wasn’t a difficult choice to make.

Anytime you add sugar to a food product, such as tomato sauce or a breakfast cereal, people eat more of that product. This is why it is such an important ingredient in processed foods. However, there is a “bliss point” for sugar. Beyond a certain level in any food product the sugar level becomes
too
sweet and adding too much can create a “yuck” response. In other words, there is a zone (not to be confused with
the Zone you want to reach for maximum health and longevity
) and maintaining that range of sugar is the key to the appeal of processed foods.

Although we have identified taste receptors for sugar, no taste receptors for fat have been identified to date. Nonetheless, the processed food industry knows that there seems to be no bliss point for fat, especially if it is hidden from view (such as inside the crust of a Domino’s pizza). Add a little sugar to that fat, and you have the formula for unlimited consumption. This is why fried dough without sugar isn’t a popular item at the county fair, but if it is dusted with some sugar, you and your kids will be eating it all day long.

In the 1980s when fat was the “evil one,” the only way to make fat-free processed foods palatable was to increase their sugar content, and just to be on the safe side, add some extra salt. Although the mechanism of how salt enhances taste is still debated, there is no question that adding it to any processed food makes the food more desirable to the consumer. That’s
because the hormonal reward networks in the brain activated by sugar, fat, and salt are essentially the same. So whenever one of three ingredients (sugar, fat, or salt) was out of fashion, increasing the levels of other two could compensate for its absence so that processed food would still have its addictive allure.

The globalization of food and the increasing use of processed foods are generating diet-induced inflammation on a global level. The rise of diabetes represents the best example of this rapid global spread of diet-induced inflammation. In Mexico, diabetes has increased 700 percent in the past twenty years. China now has more than 100 million diabetics (America has “only” 25 million), and there are more than 250 million diabetics worldwide. As I said previously, as the epidemic of diabetes increases, the stage is set for an equally rapid coming worldwide explosion of Alzheimer’s.

I
t has become very trendy to try to assign the blame of our growing health-care crisis to a single food ingredient. I wish diet-induced inflammation were that simple. There is, at least, one artificial food ingredient that everyone agrees should be removed from every diet: trans fatty acids.