Pomegranate - The Rising Star
Written by Gloria Tsang R.D.
Published in December 2005

Pomegranate has quickly become one of the most talked about health foods in the past year. Many readers wrote to us and asked about the health benefits of pomegranate juice. Not only is it popular among the health conscious crowd, we are surprised to see that pomegranate fruits are becoming widely used as hot trendy home decor in more and more home decorating television programs!

Preliminary evidence suggests that drinking concentrated pomegranate juice may reduce cholesterol. Israeli researchers, published a small clinical study in June 2004 in Clinical Nutrition, suggested that drinking a glass of pomegranate juice a day for one year reduced blood pressure (particularly systolic pressure) and slowed down LDL cholesterol (the bad cholesterol) oxidation.

Pomegranate fruits contain polyphenols, tannins and anthocyanins - all are beneficial antioxidants. Interestingly, pomegranate juice contains high levels of antioxidants - higher than most other fruit juices, red wine or green tea.

The Bottom Line:
Many studies so far were small, thus more research is needed to fully evaluate the possible health benefits of pomegranate. Pomegranate juice is generally safe to drink. Most studies have administered a daily helping of 1.5 oz of pomegranate juice with no significant side effects.

For a sensible heart smart diet, emphasize fruits & vegetables, whole grains, fatty fish and choose skinless lean meats. Antioxidants are generally found in bright colored fruits and dark green vegetables as well as whole grains. In addition, the best dietary approach so far to reducing blood pressure is to follow the DASH diet developed by the National Heart, Lung and Blood Institute.

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Onions and Garlic May Prevent Cancers
By Jennifer Warner

Better load up on the breath mints; a new study suggests eating lots of garlic and onions may help prevent cancer.

Italian researchers found that people whose diets are rich in onions, garlic, and other alliums have a much lower risk of several types of cancer than those who avoid the pungent herbs.

Researcher Carlotta Galeone, of the Istituto di Ricerche Farmocologiche "Mario Negri" in Milan, and colleagues say the health benefits of onion and garlic have been touted for centuries, but few studies have been able to prove the benefits.

Pungent Cancer Prevention
In their study, researchers used data from several Italian and Swiss cancer studies to look at the relationship between onion and garlic consumption and cancer at several body sites, including the mouth, larynx, esophagus, colon, breast, ovary, and kidneys.

Overall, consumption of onions ranged from 0-14 portions per week among cancer patients and 0-22 portions per week among those without cancer.

Garlic use was also lower among people with cancer, except for those with cancer of the breast, ovary, or prostate.

Researchers found moderate consumption of onions appeared to reduce the risk of colorectal, laryngeal, and ovarian cancers.

The protective effect was even greater among those who ate the most onions compared to those who ate the least. People who ate the most onions also had a lower risk of oral and esophageal cancers than those who ate the least.

Moderate use of garlic was also associated with a lower risk of colorectal and renal cell (a type of kidney cancer) cancers.

Again, the anticancer effect increased with the more garlic they ate. People who ate the most garlic had a lower risk of all cancers except breast and prostate cancers, which are mainly associated with hormonal and reproductive issues, write the researchers.

Researchers say onion and garlic consumption could simply be a marker for a healthier lifestyle and a diet high in a variety of potentially cancer-fighting herbs and vegetables.

However, the protective effect of onions and garlic against cancer remained significant even when they controlled for total vegetable intake.

Their results appear the American Journal of Clinical Nutrition.

SOURCE: Galeone, C. American Journal of Clinical Nutrition, November 2006; vol 84: pp 1027-1032.

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Dark Chocolate Is Healthy Chocolate
By Daniel J. DeNoon

Got high blood pressure? Try a truffle. Worried about heart disease? Buy a bon-bon.

It's the best medical news in ages. Studies in two prestigious scientific journals say dark chocolate -- but not white chocolate or milk chocolate -- is good for you.

Dark Chocolate Lowers Blood Pressure
Dark chocolate -- not white chocolate -- lowers high blood pressure, say Dirk Taubert, MD, PhD, and colleagues at the University of Cologne, Germany. Their report appears in the Aug. 27 issue of The Journal of the American Medical Association.

But that's no license to go on a chocolate binge. Eating more dark chocolate can help lower blood pressure -- if you've reached a certain age and have mild high blood pressure, say the researchers. But you have to balance the extra calories by eating less of other things.

Antioxidants in Dark Chocolate
Dark chocolate -- but not milk chocolate or dark chocolate eaten with milk -- is a potent antioxidant, report Mauro Serafini, PhD, of Italy's National Institute for Food and Nutrition Research in Rome, and colleagues. Their report appears in the Aug. 28 issue of Nature. Antioxidants gobble up free radicals, destructive molecules that are implicated in heart disease and other ailments.

"Our findings indicate that milk may interfere with the absorption of antioxidants from chocolate ... and may therefore negate the potential health benefits that can be derived from eating moderate amounts of dark chocolate."

Translation: Say "Dark, please," when ordering at the chocolate counter. Don't even think of washing it down with milk. And if health is your excuse for eating chocolate, remember the word "moderate" as you nibble.

The Studies
Taubert's team signed up six men and seven women aged 55-64. All had just been diagnosed with mild high blood pressure -- on average, systolic blood pressure (the top number) of 153 and diastolic blood pressure (the bottom number) of 84.

Every day for two weeks, they ate a 100-gram candy bar and were asked to balance its 480 calories by not eating other foods similar in nutrients and calories. Half the patients got dark chocolate and half got white chocolate.

Those who ate dark chocolate had a significant drop in blood pressure (by an average of 5 points for systolic and an average of 2 points for diastolic blood pressure). Those who ate white chocolate did not.

In the second study, Serafini's team signed up seven healthy women and five healthy men aged 25-35. On different days they each ate 100 grams of dark chocolate by itself, 100 grams of dark chocolate with a small glass of whole milk, or 200 grams of milk chocolate.

An hour later, those who ate dark chocolate alone had the most total antioxidants in their blood. And they had higher levels of epicatechin, a particularly healthy compound found in chocolate. The milk chocolate eaters had the lowest epicatechin levels of all.

Chocolate for Blood Pressure: Darker Is Better
What is it about dark chocolate? The answer is plant phenols -- cocoa phenols, to be exact. These compounds are known to lower blood pressure.

Chocolates made in Europe are generally richer in cocoa phenols than those made in the U.S. So if you're going to try this at home, remember: Darker is better.

Just remember to balance the calories. A 100-gram serving of Hershey's Special Dark Chocolate Bar has 531 calories, according to the U.S. Department of Agriculture. If you ate that much raw apple you'd only take in 52 calories. But then, you'd miss out on the delicious blood pressure benefit.

A hint: Don't replace healthy foods with chocolate. Most people's diets have plenty of sweets. Switch those for some chocolate if you're going to try the truffle treatment.

SOURCES: Taubert, D. The Journal of the American Medical Association, Aug. 27, 2003; vol 290: pp 1029-1030. Serafini, M. Nature, Aug. 28, 2003; vol 424: p 1013. U.S. Department of Agriculture Nutrient Data Laboratory.

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Aspirin Therapy: Right for Your Heart?
By Matthew Hoffman, MD

Sandra Rose, a nurse in Raleigh, NC, started taking a daily aspirin because "it seemed like a wonder drug," preventing heart attacks and strokes. "All the patients seemed to be on a low-dose aspirin," 63-year-old Rose says. She started taking one herself.

Then, after hearing reports of stomach bleeding caused by aspirin, this wonder drug had Rose wondering: How can you tell if a daily aspirin is right for you?

Cardiovascular Disease and Aspirin Therapy
Heart attacks and strokes cause almost a million deaths every year in the U.S. The culprits are blood clots, which choke off the blood supply to vital organs. Aspirin works on blood cells that cause clots (platelets), making blood less likely to clot.

So if clots cause cardiovascular disease, and aspirin helps prevents clots, taking aspirin should be a no-brainer, right?

Not so fast. Aspirin's benefit comes at a cost -- an increased risk of bleeding, which usually occurs in the stomach, intestine and other gastrointestinal areas. While most of this type of bleeding is minor and stops on its own, it can be life-threatening. And there's no sure way to predict if or when it will happen.

"No medicine is innocuous," says Terry Jacobson, MD, director of the Office of Health Promotion and Disease Prevention at Emory University in Atlanta. "Anyone who's not at a high risk of heart disease has to weigh the benefits against the risks."

The right time to take aspirin is when the benefits -- reducing risk from heart attacks and strokes -- outweigh the risk of aspirin itself: dangerous stomach bleeding. This is a decision that can only be made between you and your doctor, but learning your own risk level can help you feel good about your choice.

Your Heart Disease Risk and Aspirin Therapy
There's little question aspirin has earned its reputation as a powerful drug. Studies comparing aspirin with placebo including almost 100,000 apparently healthy men and women showed:

• In men, daily aspirin therapy cut the risk of a first heart attack by a third.
• In women, daily aspirin therapy reduced the rate of strokes by 17%.

Certain conditions increase the likelihood of heart attacks and strokes. If you fit in this category, there's little argument: an aspirin a day helps keep trouble away.

High Risk Men and Women Who May Want Aspirin Therapy
You're considered at high risk if you have:

• A prior heart attack or stroke caused by a blood clot
• Known blockages or narrowing of arteries (atherosclerosis) in the heart, neck, or legs
• Diabetes
• Family history of heart disease
• Multiple risk factors, such as high blood pressure, smoking, obesity, and elevated cholesterol levels and low "good" HDL cholesterol

"For people with known heart disease, it's clear that they benefit from being on an aspirin," says Jacobson, yet "people shouldn't start taking it on their own." Talking to a doctor first is essential to make sure you're not at increased risk of bleeding.

Very Low-Risk Men and Women Who May Not Want Aspirin Therapy
Low-risk people include men under 40 and women under 50. While it helps to know that aspirin does reduce healthy people's risk of heart disease and stroke, their risk is low to begin with. And daily aspirin may increase their risk of internal bleeding. For example, if 1,000 healthy people took an aspirin daily for about six years:

• Daily aspirin would prevent three or four serious cardiovascular events (heart attacks, strokes, or heart disease deaths).
• However, aspirin would cause about three life-threatening gastrointestinal bleeds.

Unless you have risk factors for heart disease, an aspirin won't help, and may do harm. Talk to a doctor before taking daily aspirin -- because you probably shouldn't.

Low to Medium Risk: Your Choice on Aspirin Therapy
So people at high risk should take an aspirin, and people at very low risk shouldn't. What about everyone in between -- the vast majority of us?

The answer is: it depends. Jacobson suggests putting this question to your doctor: Am I at high enough cardiovascular risk to justify taking an aspirin, even with the small but real risk of significant bleeding?

"The more risk factors that you have, the greater the chance that you will benefit" from daily aspirin, Jacobson tells WebMD.

Your doctor can calculate your cardiovascular disease risks based on the following factors:

• Your medical history
• Age
• Smoking
• High blood pressure
• Total and "good" cholesterol levels
• History of heart disease in close relatives

If you know your blood pressure and cholesterol, you can calculate your own 10-year risk of serious cardiovascular disease using the same tool that doctors use. Called the "Framingham risk calculator," it's available online at: http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=prof

If the benefits do outweigh the risks for you, how much aspirin should you take? Talk to your doctor first. The standard dose is one baby aspirin (81 milligrams) a day. Higher doses are no more effective, and can cause more stomach upset.

Aspirin: Different Benefits for Men and Women
When it comes to heart attacks and strokes, men and women are not created equal. Women develop cardiovascular disease later than men -- usually after menopause, and often well into their 70s. Their disease symptoms and survival can be very different from men.

For many women, this difference means the risk of cardiovascular disease doesn't justify aspirin until later in life. However, the risk of bleeding while on aspirin also goes up with age, making the choice more complicated.

And women are different from men when it comes to the response to aspirin as well, says Nanette Wenger, MD, spokesperson for the American Heart Association. Based on study data:

• For healthy men aspirin seems to prevent heart attacks, but not strokes.
• For healthy women under 65, aspirin prevents strokes, but not heart attacks.
• For healthy women over 65, aspirin appears to prevent heart attacks similarly to men.

In general, for healthy women under 65, an aspirin isn't recommended, says Wenger. Again, it's best to talk to your doctor.

Most of all, it's important to recognize that taking aspirin doesn't reduce the risk of cardiovascular disease nearly as much as good old-fashioned measures like losing weight, exercising, quitting smoking, and controlling blood pressure and cholesterol. These measures can lower the risk of serious disease by up to 80% according to some studies -- leaving aspirin in the dust.

Yet aspirin is a valuable tool for people who want to do everything they can to prevent heart attacks and stroke. After seeing her doctor, Sandra Rose decided she was one of them. She decided to stay on her aspirin, even though her cardiovascular risk was already low. "I wanted to get it even lower," she said, despite the risk of bleeding. Knowing the benefits, and the risks, let her make an informed choice.

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