Not having enough to eat may cause obesity, diabetes, high blood pressure, and heart disease. Most of us think the chronic disease epidemic is fueled by abundance, but it may be fueled as much by food scarcity and insecurity as it is by excess. And, right now, America is suffering from the highest levels of poverty and food insecurity that it has seen in more than a decade.

In 2008 49 million Americans - including 16.7 million children - lived in a home at risk of not having enough food on the table every day. After working in Haiti, the poorest country in the Western hemisphere, I learned that one in two Haitians wake up every day not knowing where their next meal will come from. But right here in the wealthiest nation in the world, one in five children live in poverty, one in four children live on food stamps, and one in 10 people don't know where their next meal will come from.

The Census Bureau recently reported that the nation's poverty rate increased to 14.3 percent in 2009 - the highest level we've seen since 1994. 43.6 million Americans lived below the poverty line in 2009, earning less than $21,954 per year for a family of four or $10,956 for an individual. We now have the highest number of people living on the threshold of poverty in the history of government record keeping.

The poorest areas of the country are also the sickest and have the highest rates of obesity, diabetes, and premature death. These people are dying younger, and life expectancy is plummeting in the poorest states. These states also happen to be the fattest. For example, Mississippi - the poorest state in the union - has poverty rates over 20 percent, obesity rates over 33 percent, and extremely high childhood obesity rates. This is no coincidence.

In the first three articles in this series, we discussed which foods to eat and which foods to avoid. In this article we're going to talk about when to supplement and how to do it wisely. We've got a lot of material to cover, so you might want to grab a cup of tea and get comfortable!

There are three principles to supplementing wisely:

• Get nutrients from food whenever possible.
  
• Take nutrients in their naturally occurring form whenever possible.
  
• Be selective with your supplementation.

Get nutrients from food whenever possible

Humans are adapted to getting nutrients from whole foods. Most nutrients require enzymes, synergistic co-factors and organic mineral-activators to be properly absorbed. While these are naturally present in foods, they are often not included in synthetic vitamins with isolated nutrients.

In a paper published in the American Journal of Clinical Nutrition called Food Synergy: An Operational Concept For Understanding Nutrition emphasizing the importance of obtaining nutrients from whole foods, the authors concluded:

A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference Intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health. This review argues for the primacy of food over supplements in meeting nutritional requirements of the population.

They cautioned against the risk of reductionist thinking, which is common in conventional medicine and nutritional supplementation. Instead, they urge us to consider the importance of what they call "food synergy":

The concept of food synergy is based on the proposition that the interrelations between constituents in foods are significant. This significance is dependent on the balance between constituents within the food, how well the constituents survive digestion, and the extent to which they appear biologically active at the cellular level.

They go on to provide evidence that whole foods are more effective than supplements in meeting nutrient needs:

• Tomato consumption has a greater effect on human prostrate tissue than an equivalent amount of lycopene.
  
• Whole pomegranates and broccoli had greater antiproliferative and in vitro chemical effects than did some of their individual constituents.
  
• Free radicals were reduced by consumption of brassica vegetables, independent of micronutrient mix.

In short: get nutrients from food, not supplements, whenever you can.

Scientists have discovered the first evidence linking brain function variations between the left and right sides of the brain to size at birth and the weight of the placenta. The finding could shed new light on the causes of mental health problems in later life.

The research, conducted at the University of Southampton and the Medical Research Council (MRC) Lifecourse Epidemiology Unit at Southampton General Hospital, reveals that children who were born small, with relatively large placentas, showed more activity on the right side of their brains than the left. It is this pattern of brain activity that has been linked with mood disorders such as depression.

The study adds to a growing body of evidence showing that adverse environments experienced by fetuses during pregnancy (indicated by smaller birth size and larger placental size) can cause long-term changes in the function of the brain.

The psychological effects of the BP oil spill, the largest recorded environmental disaster in human history, extend far beyond people living around the areas of the Gulf of Mexico that were directly impacted by the spill, a new study finds.

Writing in the online edition of the journal Environmental Health Perspectives, a publication of the National Institutes of Health, the researchers reported that even in areas that did not have oil exposure, people still experienced elevated levels of anxiety and depression and reduced ability to show resilience in difficult emotional and financial situations because of the disaster.

"The findings highlight the substantial psychological impact that the oil spill has had on coastal communities in Florida and Alabama," said Dr. J. Glenn Morris, a UF public health expert in the department of medicine and director of the Emerging Pathogens Institute. "In particular, the impact was not directly related to the amount of oil that reached an area. Instead, it correlated most closely with financial loss resulting from the spill."

When the EPA phased out the widespread residential use of chlorpyrifos and other organophosphorus (OP) insecticides in 2000-2001 because of risks to child neurodevelopment, these compounds were largely replaced with pyrethroid insecticides. But the safety of these replacement insecticides remained unclear, as they had never been evaluated for long-term neurotoxic effects after low-level exposure. In the first study to examine the effects of these compounds on humans and the first evaluation of their potential toxicity to the developing fetal brain, scientists of the Columbia Center for Children's Environmental Health at Columbia University's Mailman School of Public Health found a significant association between piperonyl butoxide (PBO), a common additive in pyrethroid formulations, measured in personal air collected during the third trimester of pregnancy, and delayed mental development at 36 months.

Findings from the study are online in the journal, Pediatrics.

The study was conducted with a subset of 725 pregnant women participating in a prospective longitudinal study of black and Dominican women living in upper Manhattan and the South Bronx underway at the Columbia Center for Children's Environmental Health (CCCEH). The insecticide permethrin was selected for the evaluation because it is one of the most common pyrethroid insecticides used in U.S. homes, as well as the most commonly sold pesticide, according to a nationally representative sample. PBO, a chemical that is added to insecticides to increase efficacy was also selected for evaluation. Any detection of PBO in air is a marker of a pyrethroid insecticide application.

In all, 342 women were studied for permethrin exposure in personal air during pregnancy; 272 for permethrin in maternal and umbilical cord plasma; and 230 were evaluated for exposure to PBO. To collect the air samples, mothers from the CCCEH Mothers and Newborns cohort wore a small backpack holding a personal ambient air monitor for 48 hours during the third trimester of pregnancy.

It's true that your body needs sugar. But excess sugar is causing a real problem in the form of Advanced Glycation End-products, or AGEs for short. AGEs are the mutant molecules formed when rogue sugar molecules attach themselves to healthy proteins, lipids or various types of cells and tissues in your body.

These AGEs can secretly accumulate in your body under your immune system's radar, rob your healthy cells of essential nutrients and cause any number of health problems...

• Hardened eye lenses leading to cloudy vision
  
  
• Stiff, inflexible arteries making blood flow difficult
  
  
• Damaged collagen in skin cells creating premature aging and wrinkles
  
  
• Inflammation in your brain cells hindering your memory recall
  
  
• Impaired nephrons - filter units - in the kidneys hindering healthy kidney function

Unfortunately, until a decade ago scientists knew the AGEs problem existed, but they considered it a normal part of the aging process. However, researchers such as Anthony Cerami, Ph.D., of Rockefeller University in New York have now proven that certain nutrients can help deter the formation of AGEs as well as help remove existing AGEs from the cells of your body.

Calorie restriction is all the rage in anti-aging circles. A few mice and worm studies seem to show that drastic reductions in food intake over a long period of time have the effect of prolonging life - although I'm not sure I'd call it living. For one, these animals are actually restricted. There's no ad libitum access to food. They'd prefer to eat more, but are prevented from doing so. I guarantee you they're unhappy and, if they could put (cartoonish high-pitched) voice to physiological state, would say they're starving.

Anyway, humans have picked up on this calorie restriction stuff. You might have seen one or two CR gurus giving "TED" talks; the exposed rib cages, gaunt faces, and complete lack of lean muscle mass are dead giveaways. Okay - that's a bit unfair. CR is a legitimate way to improve many health markers. I'm just not convinced actively restricting your calorie intake through sheer will is the true path to enjoyable longevity. I'd rather be robust, vibrant, and full of zest. I want to eat big strapping meals of steak and veggies smothered in butter without counting calories. On occasion, I like to devour an entire roasted chicken (yeah, yeah, chicken has more omega-6 than most animals, but I'll live). I want to maintain muscle mass and have enough energy to go on long hikes and have the legs to still leap for high passes (over the young guys) at the end of Ultimate games. And as I appreciate the neuroprotective and autophagy-promoting qualities of calorie restriction, I'd rather not expend the mental energy and fortitude required to maintain such a regimen day-in and day-out. Nor would I willingly subject myself to forced calorie restriction, a la the lab mice. No human-sized rat cages for me, even if they include a salt lick and a running wheel (don't get any ideas, Blaisdell). Based on the science, I don't think all that is necessary. I'll just IF instead.

Type 1 diabetes, also called "childhood" or "insulin-dependent" diabetes, is on the rise.

Type 2 diabetes, or "adult," diabetes, is also sharply escalating. But the causes for this are easy-to-identify: overconsumption of carbohydrates and resultant weight gain/obesity, inactivity, as well as genetic predisposition. A formerly rare disease is rapidly becoming the scourge of the century, expected to affect 1 in 3 adults within the next several decades.

Type 1 diabetes, on the other hand, generally occurs in young children, not uncommonly age 3 or 4. Type 1 diabetes also shares a genetic basis to some degree. But the genetic predisposition should be a constant. Obviously, lifestyle issues cannot be blamed in young children.
Then why would type 1 diabetes be on the rise?

For instance, this study by Vehik et al from the University of Colorado documents the approximate 3% per year increase in incidence in children with type 1 diabetes between 1978 and 2004:


(From Vehik 2007)

This is no small matter. Just ask any parent of a child diagnosed with type 1 diabetes who, after recovering from hearing the devastating diagnosis, then has to stick her child's fingers to check glucose several times per day, mind carefully what he or she eats or doesn't eat, watch carefully for signs of life-threatening hypoglycemic episodes, not to mention worry about her child's long-term health. Type 1 diabetes is a life-changing diagnosis for both child and parents.

Did you know that common over-the-counter drugs or prescriptions can cause memory loss and cognitive impairment?

Mild cognitive impairment is a common, age-linked condition that is often an early sign of Alzheimer's disease. Its cardinal symptom is forgetfulness or impairment of short-term memory.

Numerous drugs have been shown to produce mild cognitive impairment (MCI). They may create or aggravate Alzheimer's-type symptoms.

(NOTE: You should NOT stop taking medications without first consulting your physician.)

Most of the drugs that cause MCI have a property called "anti-cholinergic." They inhibit activity of the neurotransmitter acetylcholine, which plays a critical role in memory and cognitive function.

When glucose (a sugar) is absorbed from the gut into the bloodstream, a healthy pancreas will secrete the hormone insulin in response. One chief effect of insulin is to reduce blood sugar levels by facilitating the transfer of sugar into the body's cells. This is a critically important function, and without it sugar levels can rise to dangerously high and even fatal levels. Insulin is essential to life. But, as is the way, we can always get too much of a good thing. In the long term, high levels of insulin can predispose the body to a range of health issues including obesity, heart disease and type 2 diabetes.

With this in mind it does make sense to avoid eating much in the way of foods that disrupt blood sugar, and therefore insulin, levels.

The 'macronutrient' most renowned for its effect on blood sugar is carbohydrate - a term that encompasses sugars and starch. Much of the sugar and starch we consume in our diets is digested down to glucose prior to absorption.