Are We Killing Our Children With Kindness?

The Danger Of Ultraprocessed Foods 

Author: Dr. Stephen Chaney

fast foodIt breaks my heart when I see a mom and her children in the checkout line of a supermarket with a cart filled with sodas, sweets, and convenience foods and devoid of fresh fruits and vegetables – or when I see fast food restaurants packed with parents and their children.

I get it. Our kids love these foods. It seems like an act of kindness to give them the foods they crave. But are we killing our children with kindness?

Let me explain. The human brain is hardwired to crave sweets, salt, and fat. In prehistoric times each of these cravings had a survival benefit. For example:

  • Mother’s milk is naturally sweet. It only makes sense that babies should crave the nutrition source that is essential for their early growth and development.
  • Fruits provide a cornucopia of vitamins, minerals, and phytonutrients. But fruits were scarce and seasonal in prehistoric times. Their sweetness provided an incentive for early man to seek them out.
  • Some salt is essential for life. Yet in early history it was scare. It was worth its weight in gold.
  • In prehistoric times it was feast or famine. The human body has an unlimited capacity to store fat in times of plenty, and those fat stores carried early man through times of famine.

Today most Americans live in a time of food abundance. There are fast food restaurants on almost every street corner and in every shopping mall. We think of famine as the days we skipped lunch because we were busy.

Yet these cravings remain, and the food industry has weaponized them. They are churning out an endless supply highly processed foods and beverages. These foods are not being designed to improve their nutritional value. They are designed to satisfy our cravings and lure us and our children into consuming more of them every year.

Scientists have developed a classification system that assigns foods in the American diet to different groups based on the degree of processing of that food. As you might expect, the best classification is unprocessed foods. The worst classification is called “ultraprocessed foods”. [I will describe this classification system in more detail in the next section.]

It is time we asked how much ultraprocessed foods our children are eating and what it is doing to their health. That is the topic of the study (L Wang et al, JAMA, 326: 519-530, 2021) I will discuss today.

How Was This Study Done?

Clinical StudyThe data for this study were obtained from NHANES (National Health and Nutrition Examination Survey) dietary data collected from 33,795 American children (ages 2-19, average age = 10) between 1999 and 2018.

NHANES is a program conducted by the CDC to survey the health and nutritional status of adults and children in the United States. The survey has been conducted on a continuous, yearly basis since 1999.

The dietary data are collected via 24-hour dietary recalls conducted by trained interviewers, with a second recall administered over the phone 3-10 days later to improve the accuracy of the data.

  • Children aged 12-19 completed the dietary survey on their own.
  • For children aged 6-11, a parent or guardian assisted them in filling out the survey.
  • For children aged 2-5, a parent or guardian filled out the survey for them.

The foods and beverages consumed by the children were divided into 4 major groups based on the extent of processing using a well-established classification system called NOVA. The 4 groups are:

1) Unprocessed Or Minimally Processed Foods.

  • This includes whole foods and foods that are minimally processed without the addition of oils, fats, sugar, salt, or other ingredients to the food.
  • Examples of minimally processed foods include things like oatmeal, nut butters, dried fruit, frozen fruits or vegetables, and dried beans.

2) Processed Culinary Ingredients.

  • This includes recipes from restaurants or in-home cooking that add small amounts of oils, fats, sugar, salt, and seasonings to whole foods.

3) Processed Foods

  • This includes foods made in factories by the addition of salt, sugar, oil, or other substances added to whole or minimally processed foods.
  • Examples include tomato paste, canned fruits packed in sugar syrup, cheese, smoked or cured meat.

4) Ultraprocessed Foods

  • These are industrial formulations created in factories mostly or entirely from substances extracted from foods (oils, fats, sugar, starch, and proteins), derived from food constituents (hydrogenated fats and modified starch), or synthesized in laboratories (flavor enhancers, colors, and food additives).
  • Examples include sugar sweetened beverages; sweet or savory packaged snacks; chocolates and candies; burgers, hot dogs, and sausages; poultry and fish nuggets, pastries, cakes, and cake mixes.

Are We Killing Our Children With Kindness?

Obese ChildAs I said above, the important question is, “Are we killing our children with kindness when we give them the sugary drinks, sweets, convenience foods, and fast foods they crave?” After all, the foods we give them when they are young are the ones they are most likely to select when they get older.

Let’s start by looking at how pervasive these foods have become. That was the purpose of the study I am discussing today, and the results of this study are alarming. When they looked at the changes in food consumption by our children between 1999 and 2018:

  • The percentage of calories from ultraprocessed foods increased from 61.4% to 67%. That means:
    • Today, more than 2/3 of the calories our children consume daily come from ultraprocessed foods!
  • The percentage of calories from unprocessed and minimally processed foods decreased from 28.8% to 23.5%. That means:
    • In the span of just 19 years the diets of our children have gone from bad to worse!
  • Ultraprocessed foods were more likely to be consumed away from home and at fast food restaurants.

When the investigators looked at individual categories of ultraprocessed foods:

  • The percentage of calories coming from ready to heat and eat dishes like frozen pizzas and other frozen meals or snacks increased from 2.2% to 11.2%.
  • The percentage of calories coming from sweet snacks and desserts increased from 10.7% to 12.9%.
  • The percentage of calories coming from sugar sweetened beverages decreased from 10.8% to 5.3%.
    • This is potentially the only good news from this study.

The authors concluded. “Based on NHANES data from 1999 to 2018, the estimated energy intake from consumption of ultraprocessed foods has increased among youths in the US and has consistently comprised the majority of their total energy intake.”

“These results suggest that food processing may need to be considered as a food dimension in addition to nutrients and food groups in future dietary recommendations and food policies.”

The Danger Of Ultraprocessed Foods

Fast Food DangersThis study clearly shows that ultraprocessed foods have become the mainstay of our children’s diets. Forget a balanced diet! Forget “Eat your fruits and vegetables”! Our children’s diets have been fundamentally transformed by “Big Food, Inc”.

You might be saying to yourself, “So, they are eating their favorite processed foods. What’s the big deal? How bad can it be?” My answer is, “Pretty Bad”. I chose the title, “Are we killing our children with kindness”, for a reason.

When you look at what happens to children who eat a diet that is mostly ultraprocessed foods:

#1: Their nutrition suffers. When the investigators divided the children into 5 groups based on the percentage of calories coming from ultraprocessed foods, the children consuming the most ultraprocessed food had:

  • Significantly higher intakes of carbohydrates (mostly refined carbohydrates); total fats; polyunsaturated fats (mostly highly processed omega-6-rich vegetable oils); and added sugars.
  • Significantly lower intakes of fiber; protein; omega-3 polyunsaturated fatty acids; calcium; magnesium; potassium; zinc; vitamins A, C, D, and folate.
    • The low intake of fiber means our children will be less likely to have health-promoting friendly bacteria and more likely to have disease-promoting bad bacteria in their guts.
    • The low intake of calcium, magnesium, and vitamin D means they will be less likely to achieve maximum bone density as young adults and will be more likely to suffer from osteoporosis as they age.

#2: They are more likely to become obese. Remember, these are foods that are made in a factory, not grown on a farm.

  • They are high in fat, sugar, and refined carbohydrates. That means they have a high caloric density. Each bite has 2-3 times the calories found in a bite of fresh fruits and vegetables.
  • As I said earlier, the food industry has weaponized our natural cravings for sweet, salty, and fatty foods. They feed their prototypes to a series of consumer tasting panels until they find the perfect blend of sugar, salt, and fat to create maximum craving.
  • And if that weren’t enough, they add additives to create the perfect flavor and “mouth appeal”.
    • It is no wonder that clinical studies have found a strong correlation between high intake of ultraprocessed food and obesity in both children and adults.
    • It is also no wonder that the rate of childhood obesity has almost quadrupled (5% to 18.5%) in the last 40 years.

#3: They are more likely to become sick as adults and die prematurely.

  • Obesity; high intake of fat, sugar, and refined carbohydrates; and low intake of fiber, omega-3s, and essential nutrients all contribute to an increased risk of diabetes, heart disease, and some cancers.
    • It is no wonder that clinical studies have found a strong correlation between high intake of ultraprocessed food and increased risk of diabetes, heart disease, some cancers, and premature death in adults.
    • It is also no wonder a recent study found that type 2 diabetes in children has almost doubled between 2001 and 2017.

The data are clear. When we allow our children to subsist on a diet mostly made up of the ultraprocessed foods they crave, we may be giving them, not love, but a lifetime of obesity and declining health instead. And yes, we may be killing them with kindness.

Instead, my recommendations are:

  • expose your children to a variety of fresh fruits, vegetables, and minimally processed foods at an early age.
  • They will reject some of them, and that’s OK. Introduce others until you find whole, minimally processed foods they like. Reintroduce them to some of the foods they initially rejected as they get older.
  • Don’t keep tempting ultraprocessed foods in your house.
  • You may just succeed in putting your children on the path to a healthier diet and a healthier, longer life.

The Bottom Line

It breaks my heart when I see a mom and her children in the checkout line of a supermarket with a cart filled with sodas, sweets, and convenience foods and devoid of fresh fruits and vegetables – or when I see fast food restaurants packed with parents and their children.

I get it. Our kids love these foods. It seems like an act of kindness to give them the foods they crave. But are we killing our children with kindness?

It is time we asked how much ultraprocessed foods our children are eating and what it is doing to their health. A recent study did just that. When they looked at the changes in food consumption by our children between 1999 and 2018:

  • The percentage of calories from ultraprocessed foods increased from 61.4% to 67%. That means:
    • Today, more than 2/3 of the calories our children consume daily come from ultraprocessed foods!
  • The percentage of calories from unprocessed and minimally processed foods decreased from 28.8% to 23.5%. That means:
    • In the span of just 19 years the diets of our children have gone from bad to worse!

This study clearly shows that ultraprocessed foods have become the mainstay of our children’s diets. Forget a balanced diet! Forget “Eat your fruits and vegetables”! Our children’s diets have been fundamentally transformed by “Big Food, Inc”.

You might be saying to yourself, “So, they are eating their favorite processed foods. What’s the big deal? How bad can it be?” My answer is, “Pretty Bad”. I chose the title, “Are we killing our children with kindness”, for a reason.

When you look at what happens to children who eat a diet that is mostly ultraprocessed foods:

  • Their nutrition suffers.
  • They are more likely to become obese.
  • They are more likely to become sick as adults and die prematurely.

For more details about this study, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Which Diets Are Best In 2021?

Which Diet Should You Choose?

Emoticon-BadMany of you started 2021 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only 2 months ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2021”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited panel of 25 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 39 most popular diets.  They rated each diet in seven categories:

  • How easy it is to follow.
  • Its ability to produce short-term weight loss.
  • Its ability to produce long-term weight loss.
  • its nutritional completeness.
  • Its safety.
  • Its potential for preventing and managing diabetes.
  • Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct nine sets of Best Diets rankings:

  • Best Diets Overall combines panelists’ ratings in all seven categories. However, all categories were not equally weighted. Short-term and long-term weight loss were combined, with long-term ratings getting twice the weight. Why? A diet’s true test is whether it can be sustained for years. And safety was double counted because no diet should be dangerous.
  • Best Commercial Diets uses the same approach to rank 15 structured diet programs that require a participation fee or promote the use of branded food or nutritional products.
  • Best Weight-Loss Diets was generated by combining short-term and long-term weight-loss ratings, weighting both equally. Some dieters want to drop pounds fast, while others, looking years ahead, are aiming for slow and steady. Equal weighting accepts both goals as worthy.
  • Best Diabetes Diets is based on averaged diabetes ratings.
  • Best Heart-Healthy Diets uses averaged heart-health ratings.
  • Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.
  • Easiest Diets to Follow represents panelists’ averaged judgments about each diet’s taste appeal, ease of initial adjustment, ability to keep dieters from feeling hungry and imposition of special requirements.
  • Best Plant-Based Diets uses the same approach as Best Diets Overall to rank 12 plans that emphasize minimally processed foods from plants.
  • Best Fast Weight-Loss Diets is based on short-term weight-loss ratings.

Which Diets Are Best In 2021?

The word WInner in white letters surrounded by a burst of colorful stars in 3d

Are you ready? If this were an awards program I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 5 and bottom 5 diets in each category (If you would like to see where your favorite diet ranked, click on this link). [Note: I excluded commercial diets from this review.]

Best Diets Overall 

The Top 5: 

#1: Mediterranean Diet

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: Mayo Clinic Diet

#5: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

The Bottom 5: 

#35: Modified Keto Diet

#36: Whole 30 Diet

#37: GAPS Diet (A diet designed to improve gut health).

#38: Keto Diet

#39: Dukan Diet

Best Weight-Loss DietsWeight Loss

The Top 5: 

#1: Flexitarian Diet

#2: Vegan Diet

#3: Volumetrics Diet (A diet based on the caloric density of foods).

#4: Mayo Clinic Diet

#5: Ornish Diet

The Bottom 5: 

#35: Fertility Diet

#36: Whole 30 Diet

#37: Alkaline Diet

#38: AIP Diet (A diet designed for people with autoimmune diseases)

#39: GAPS Diet

Best Diabetes Diets

The Top 5: 

#1: Flexitarian Diet

#2: Mediterranean Diet

#3: DASH Diet

#4: Mayo Clinic Diet

#5: Vegan Diet

The Bottom 5: 

#35: The Fast Diet

#36: AIP Diet

#37: GAPS Diet

#38: Whole 30 Diet (A diet designed for people with autoimmune diseases)

#39: Dukan Diet

strong heartBest Heart-Healthy Diets 

The Top 5: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Ornish Diet (A diet based on the caloric density of foods).

#4: Flexitarian Diet

#5: Vegan Diet

The Bottom 5: 

#35: Keto Diet

#36: AIP Diet

#37: Whole 30 Diet

#38: Modified Keto Diet

#39: GAPS Diet

Best Diets for Healthy Eating

The Top 5: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Flexitarian Diet

#4: TLC Diet (A diet designed to promote heart health)

#5: MIND Diet

The Bottom 5: 

#35: Atkins Diet

#36: Raw Food Diet

#37: Modified Keto Diet

#38: Dukan Diet

#39: Keto Diet 

Easiest Diets to FollowEasy

The Top 5: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: MIND Diet

#4: DASH Diet

#5: Fertility Diet

The Bottom 5: 

#35: Keto Diet and Modified Keto Diet (tie)

#36: Whole 30 Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Raw Foods Diet 

Best Fast Weight-Loss Diets

The Top 5 (Excluding Commercial Diets): 

#1: Atkins Diet

#2: Biggest Loser Diet

#3: Keto Diet

#4: Raw Food Diet

#5: Volumetrics Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleLet me start with some general principles:

#1: If you are looking for rapid weight loss, any whole food restrictive diet will do.

  • The Atkins and keto diets are meat heavy, low carb diets. They restrict fruits, some vegetables, grains, and most legumes.
  • The Biggest Loser diet relies on restrictive meal plan and exercise programs.
  • The restrictions of the raw food diet are obvious.
  • The volumetrics diet restricts foods with high caloric density.
  • The vegan diet, which ranks #7 on this list, is a very low fat diet that eliminates meat, dairy, eggs, and animal fats.
  • I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

#2: Restrictive diets ultimately fail.

  • The truth is 90-95% of people who lose weight quickly on a restrictive diet regain most of that weight in the next two years. The pounds come back and often bring their friends along as well. Many people regain more weight than they lost. This is the famous “Yo-Yo Effect”.
  • If dieters paid for one of the commercial diets, they may as well have burned their money.
  • When I talk with people about weight loss, many of them tell me the Atkins diet is the only one they can lose weight on. That would be impressive if they were at a healthy weight, but most are not. They are overweight. I am starting to see the same thing from overweight people who have used the keto diet to lose weight and have regained their weight.

#3: We should ask what happens when we get tired of restrictive diets and add back some of your favorite foods.

  • If you lose weight on a vegan diet and add back some of your favorite foods, you might end up with a semi-vegetarian diet. This is a healthy diet that can help you maintain your weight loss.
  • If you lose weight on the Atkins or keto diets and add back some of your favorite foods, you end up with the typical American diet – one that is high in both fat and carbs. This is not a recipe for long-term success.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight. In a recent article in “Health Tips From The Professor” I wrote about an organization called the National Weight Control Registry. These are people who have been successful at keeping the weight off. For purposes of this discussion, two points are important.
  • They lost weight on every possible diet.
  • They kept the weight off by following a healthy reduced calorie, low fat diet. (For what else they did, click here).

Which Diet Should You Choose?

Which Diet Is BestWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

  • Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.
  • Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.
  • Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian.
  • Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.
    • On the minus side, none of the diets include sodas, junk foods, and highly processed foods. Teose foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
    • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line 

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories. In the article above I summarize the US News & World Report’s “Best Diets In 2021”.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are some general principles:

  • If you are looking for rapid weight loss, any whole food restrictive diet will do.
  • Restrictive diets ultimately fail.
  • We should ask what happens when we get tired of restrictive diets and add back some of our favorite foods.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight.

#2: Which diet should you choose? Here the principles are:

  • Choose a diet that fits your needs.
  • Choose diets that are healthy and associated with long term weight loss.
  • Choose diets that are easy to follow.
  • Choose diets that fit your lifestyle and dietary preferences.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can Vitamin C Prevent Heart Disease?

Where Should I Get My Vitamin C?

vitamin CThe vitamin C controversy continues. Some people call vitamin C a “miracle” nutrient. Others consider it little more than “fairy dust”. What is the truth?

Let’s look at the effect of vitamin C on heart disease risk as an example of why it is so difficult to resolve questions like this.

Association studies are ideal for measuring long-term effects of nutrient consumption on health outcomes. These studies have consistently found an inverse association between dietary vitamin C and plasma vitamin C levels with the risk of heart disease. Simply put, the more vitamin C from dietary sources, the lower the risk of heart disease.

However, association studies do not prove cause and effect. The primary reason for this is that association studies are complicated by “confounding variables”. For example, most vitamin C in the diet comes from fruits and vegetables. So, the question arises, “Is it the vitamin C in fruits and vegetables that is responsible for the decreased heart disease risk, or is it the fiber that is also present in fruits and vegetables?” Previous studies have not been designed to answer this question.

Placebo-controlled clinical trials solve the confounding variable issue because they involve supplementation with pure vitamin C or a placebo. There is only a single variable. However, placebo-controlled clinical trials only last for a short time. That means they can measure biological markers that may affect heart disease risk but seldom last long enough to directly measure the effect of vitamin C on heart disease risk.

For example, previous studies have shown that high-dose (500 to 4,000 mg/day) supplementation with vitamin C improves the function of the endothelial lining of our blood cells and reduces blood pressure. These are biological markers that might be expected to reduce heart disease risk.

However, heart disease takes decades to develop. No studies of vitamin C supplementation have lasted long enough to show an actual decrease in heart disease outcomes.

In today’s issue of “Health Tips From The Professor” I would like to address three questions:

1) Does dietary vitamin C reduce heart disease risk?

2) How much of the risk reduction is due to the fiber content of fruits and vegetables rather than their vitamin C content?

3) Does supplementation with vitamin C reduce heart disease risk?

I will focus on a recent study (N Martin-Calvo and MA Martinez-Gonzalez, Nutrients, 9: 954, 2017, doi.org/10.3390/nu909054) that was designed to answer these questions.

How Was The Study Done?

Heart Health StudyThis study was an offshoot of an ongoing Spanish research program called Seguimiento Universidad de Navarra (SUN) follow-up study. This program is following graduates of the University of Navarra to gauge the effect of diet and lifestyle on health outcomes.

Health, lifestyle, and diet information is collected when graduates enroll in the program and by mailed questionnaires every two years thereafter.

Graduates who were enrolled in the SUN program in 2014 or earlier were invited to participate in this vitamin C and heart disease study.

  • Vitamin C intake from diet and from supplements was assessed from the dietary analysis.
  • A diagnosis of heart disease was obtained from the Health questionnaire and confirmed by physician follow-up.
  • Deaths due to heart disease were obtained from the Spanish National Death Index cross-referenced to participants in the study and were confirmed by participants next of kin, work associates, or postal authorities.

The study excluded:

  • Participants with pre-existing heart disease at the beginning of the study.
  • Participants who were younger than 40 at the beginning of the study.
  • Participants with either very high or very low vitamin C intake.

That left 13,421 participants who were young (average age = 42), at a healthy weight (average BMI = 24), healthy, and taking few medications.

Can Vitamin C Prevent Heart Disease?

Healthy HeartThe 13,421 participants in this study were followed for an average of 11 years.

They were divided into three groups based on their vitamin C intake.

  • Group 1 averaged 148 mg/day.
  • Group 2 averaged 257 mg/day.
  • Group 3 averaged 445 mg/day.

There are two noteworthy observations about their vitamin C intake:

  • None of the groups were vitamin C deficient. All three groups were getting well above the RDA for vitamin C (75 mg/day for women and 90 mg/day for men).
  • Most of the vitamin C came from fruits and vegetables in the diet. The group with the highest vitamin C intake (445 mg/day) only averaged about 10 mg/day from supplements.

The results of the study were intriguing. When the investigators compared the group with the highest vitamin C intake to the group with the lowest vitamin C intake:

  • Vitamin C significantly decreased both the risk of developing heart disease and the risk of dying from heart disease.
    • Statistically adjusting the data for age, gender, weight, lifestyle, and medicine use did not affect the outcome.
    • Statistically adjusting the data for fiber from sources other than fruits and vegetables did not affect the outcome.
    • Statistically adjusting the data for adherence to a healthy diet (the Mediterranean diet) did not affect the outcome.

However, when the data were statistically adjusted for total fiber (including fiber from fruits and vegetables) the high fiberresults painted a slightly different picture. With this adjustment:

  • Vitamin C decreased the risk of developing heart disease by 26%, but this decrease was not statistically significant.
  • Vitamin C decreased the risk of dying from heart disease by 70%, and this decrease was highly significant.

This was the first study to consider the relative importance of vitamin C from fruits and vegetables and fiber from fruits and vegetables on heart disease outcomes and the results were interesting. Here are the important conclusions.

1) Both the fiber and the vitamin C from fruits and vegetables contributed to a decreased risk of developing heart disease. This study was unable to separate their contributions.

Of course, it is important to note that this was a young, healthy population, none of whom were deficient in vitamin C. It would be interesting to repeat this study with an older, sicker population with a more restrictive diet.

2) Vitamin C from fruits and vegetables reduced the risk of dying from heart disease independent of the beneficial effects of fruit and vegetable fiber.

3) This study was not able to address the effect of vitamin C supplementation on heart disease risk. That is because the Spaniards supplement much less frequently than Americans and this study excluded anyone with unusually high vitamin C intake. The average supplemental vitamin C in the 3 groups ranged from 0.56 mg/day to 9.6 mg/day.

4) This study also emphasizes the importance of getting fiber from a variety of food sources. It showed that fiber from fruits and vegetables was more beneficial at reducing heart disease risk than fiber from other food sources. That means restrictive diets that eliminate fruits and/or vegetables may be bad for your heart.

Where Should I Get My Vitamin C?

Vegan FoodsThis study reinforces the importance of getting lots of fresh fruits and vegetables in your diet.

  • You could make a list of all the vitamin C-rich fruits and vegetables like citrus fruits, red & green peppers, broccoli, etc. and make sure you are including them in your diet.
  • You could total up the vitamin C in each food you eat and try to reach the 445 mg/day in the group with the highest vitamin C in this study.

However, it doesn’t have to be that complicated. If you eat a primarily plant-based diet, aim for 5-9 servings of fruits and vegetables a day, and “eat the rainbow” you will get plenty of vitamin C from your diet.

Also, don’t worry about whether the benefits of fruit and vegetable consumption come from their vitamin C or from their fiber. That’s the beauty of eating whole foods. You get both in the same package.

Of course, you are probably also wondering whether vitamin C supplementation will reduce your risk of heart disease. As I described earlier, there are lots of reasons for thinking that vitamin C supplementation might decrease heart disease risk.

  • Several studies show that higher vitamin C intake and higher vitamin C levels in the blood are associated with lower heart disease risk.
  • This study showed that vitamin C reduces the risk of dying from heart disease independent of fiber from fruits and vegetables and independent of an overall healthy diet. This suggests that vitamin C plays an independent role in reducing heart disease risk.
  • Placebo controlled clinical trials show that vitamin C supplementation reduces risk factors that contribute to heart disease.

However, none of these studies prove that vitamin C supplementation reduces heart disease risk. That requires placebo-controlled clinical trials measuring the effect of vitamin C supplementation on heart disease outcomes. Unfortunately, these studies are usually doomed to failure.

Chronic diseases like heart disease takes decades to develop. Placebo-controlled, randomized studies are almost never large enough or last long enough to show an effect of supplementation on chronic diseases.

The best we can say at present is that vitamin C supplementation along with a primarily plant-based diet with lots of colorful fruits and vegetables may reduce your risk of heart disease.

The Bottom Line

A recent study in Spain followed 13,421 healthy college graduates with an average age of 42 for 11 years and looked at the effect of vitamin C intake on the risk of developing heart disease and the risk of dying from heart disease.

This was the first study to consider the relative importance of vitamin C from fruits and vegetables and fiber from fruits and vegetables on heart disease outcomes and the results are intriguing. Here are the important conclusions.

1) Both the fiber and the vitamin C from fruits and vegetables contributed to a decreased risk of developing heart disease. This study was unable to separate their contributions.

Of course, it is important to note that this was a young, healthy population, none of whom were deficient in vitamin C. It would be interesting to repeat this study with an older, sicker population with a more restrictive die

2) Vitamin C from fruits and vegetables reduced the risk of dying from heart disease by 70%, and this effect was independent of the beneficial effects of fruit and vegetable fiber.

3) This study was not able to address the effect of vitamin C supplementation on heart disease risk. That is because the Spaniards supplement much less frequently than Americans and this study excluded anyone with unusually high vitamin C intake. The average supplemental vitamin C in the 3 groups ranged from 0.56 mg/day to 9.6 mg/day.

4) This study also emphasizes the importance of getting fiber from a variety of food sources. It showed that fiber from fruits and vegetables was more beneficial at reducing heart disease risk than fiber from other food sources. That means restrictive diets that eliminate fruits and/or vegetables may be bad for your heart.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

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