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total wellness a ucla student wellness commission publication

food for thought alcohol

what to know about drinking


what’s in your cup of joe?

for the love of

the realities of

food addiction summer 2016 | vol 16 | issue 3


total wellness â–Ş summer 2016


a message from the director From Bruin Plate to Cafe 1919, dining halls and quick service restaurants are mainstays of dorm-dwellers and apartment-gatherers alike. Food is an essential part of human existence, and it not only serves as a major source of nutrition, but also brings us together during social events. Eating provides energy as well as vital nutrients for our developing bodies, and although we generally know what we ought to consume, figuring out how to build a balanced meal and even knowing when to eat can seem challenging. Fortunately, with the help of nutrition health educator Eve Lahijani, who shared her story during a Total Wellness nutrition workshop as well as a TEDxUCLA talk, we learned the importance of trusting our hunger as an indicator of when and how much we should eat instead of going on diets or limiting our food intake past certain hours. Tuning into our own bodies can help us discern the details of how to eat and allow us to enjoy the flavor of food, so with that said, let’s have a taste of what’s in this issue! This third and final issue of Volume 16 explores a world of food from the health benefits of nuts (page 41) and yogurt (page 20) to the potential risks of sugary or diet soda (page 9) and alcoholic drinks (page 26). In our “In the News” section, we take a look at the relationship between fructose consumption and gene expression as well as the effects of prediabetes and type II diabetes in groundbreaking studies at our own UCLA campus in addition to other research sites. So whatever knowledge your taste buds are craving, Total Wellness is ready to help break down the jargon-loaded research into palatable bites so that the gastronomical goodness is easy to stomach and understand. As you enjoy eating your next meal, remember to be mindful of what you munch on and take it one bite at a time. Our website (, which features select articles organized by topic, is chock-full of health and wellness resources. You can check out healthy recipes and tips by following us on Instagram (@uclatotalwellness), liking us on Facebook (/uclatotalwellness), or browsing our previous publications at As always, Total Wellness is here to give you food for thought. Cheers to your health, Christopher Phan Director

editor’s note

total wellness ▪ summer 2016

Dear readers, When brainstorming ideas for Volume 16, Issue 3, our writers unanimously converged upon the topic of food. The majority of college students likely have this enticing topic on their mind at one point or another in the course of the day. Most of us are constantly thinking about where, when, and what we should eat, in light of the many options available to us. But how many of us think so systematically about the health benefits or the health risks of what we eat? Almost all our issues feature at least one article about food and health—feel free to look at our food picks and recipes from the past. But this issue is wholly devoted to the topic. Our writers have written about your favorites, such as chocolate and coffee, as well as a few foods you may not really think about, such as superfruits and red wine vinegar. Many of our articles have recipes for you to try out—don’t hesitate to let us know what you think of them! Some of our articles also tackle more serious topics such as drinking and food addiction. If you have any questions about these topics, be sure to read the respective articles. You may very well learn a few things that you did not know before. Although much of our energy goes into actually producing our high-quality magazine, we on the Total Wellness team try to organize several events throughout the year to distribute our magazine and reach out to our audience. We saw many of you at our table during Bruin Health Week in the spring. For those of you who have not gotten the chance to see us in person, we hope you will be on the lookout for our next events. We love to see our readers and hear things from their perspective! Wishing you a good summer, Omid Mirfendereski Editor-in-Chief



NANCY VU Managing Editor


ALISON JENG Assistant Art Director

RUCHI DESAI Finance Director


cover: ryanjlane/istockphoto

NEGIN AMINIAN Outreach Director

total wellness â–Ş summer 2016


TALIN MARKARIAN Outreach Director

Total Wellness is a division of the Student Wellness Commission that is dedicated to spreading awareness of and sharing knowledge on issues of student health and health care. By providing an understanding of health and lifestyle issues, elucidating health concepts, providing recommendations for physical, mental, and social well-being, and making visible and accessible various health resources, programs, and events occurring at UCLA, Total Wellness seeks to empower students with up-to-date and accurate knowledge on the appropriate management of their health.


total wellness director


copy editor

Omid Mirfendereski

Payam Mirfendereski

managing editor

Christopher Phan

art director

assistant art director

web director

Jackie Nguyen

Alison Jeng

finance director Ruchi Desai

outreach director

Rachelle Juan

outreach director

Negin Aminian

Talin Markarian

writing Sydnie Bui Ruchi Desai Shriya Didwania Katie Farr Momoko Ishii Yoon Syuk Jun Omid Mirfendereski Payam Mirfendereski Masumi Padhye

Nancy Vu

Sepideh Parhami Christopher Phan Jamie Shin Jasmine Sidhu Sabrin Sidhu Richa Vakharia Natalie Vawter Nancy Vu Jefferey Yeung

finance Vivian Chen Ruchi Desai Michelle Ong



Sophia Fang Jenna Le Amir Ljuljanovic Jackie Nguyen Nezia Rahman Edith Ramirez Eun Ji Song Kandice Tsoi

Kenny Chang Chien Nicole Galisatus Katarina Haines Nancy Vu

web Alyssa Herman Rachelle Juan Harold Kim Erika Yoon

advisory & review Behnaz Esther Behmanesh, DO

Rena Orenstein, MPH

Physician, UCLA Arthur Ashe Student Health & Wellness Center

Director, UCLA Student Health Education

Dolores Hernandez, MA, RD

Nutrition Education Coordinator, UCLA Dining Services

Alicia Yang, RDN

Dietitian, UCLA Center for Human Nutrition

Eve Lahijani, MS, RD

Nutrition Health Educator, UCLA Office of Residential Life

total wellness â–Ş summer 2016

Total Wellness is a free, student-run publication and is supported by advertisers, the Student Wellness Commission (SWC), the Undergraduate Students Association (USAC), the Arthur Ashe Student Health and Wellness Center, UCLA Healthy Campus Initiative (HCI), UCLA Recreation, and UCLA Center for East-West Medicine. Contact 308 Westwood Blvd., Kerckhoff Hall 308 Los Angeles, CA 90024 Phone 310.825.7586, Fax 310.267.4732 Subscription, past issues, and advertising rates available upon request. Volume 16, Issue 03 Š 2016 by Total Wellness Magazine. All rights reserved. Parts of this magazine may be reproduced only with written permission from the editor. Although every precaution has been taken to ensure the accuracy of the published material, Total Wellness cannot be held responsible for the opinions expressed or facts supplied by authors. We do not necessarily endorse products and services advertised. The information in Total Wellness is not intended as medical advice and should not replace the advice of your physician. Always consult a health care provider for clarification.


meet the

committees of

The Body Image Task Force’s mission is to spread self acceptance and positive body image, which encompasses mental, physical, and emotional health. Love yourself and be confident in who you are!

[Bruin Consent Coalition]

BCC’s goal is to promote consensual sex, effective bystander intervention, and access to university resources that support survivors of sexual assault.

HNF is devoted to hosting fun and educational events that promote proper nutrition, an active lifestyle, and overall well-being.

Active Minds holds workshops and events to educate students and the surrounding Los Angeles community on the importance of mental health.

SEARCH (Student Education And Research of Contemporary Health) researches health topics pertinent to the UCLA student body to create interesting and educational events.


Bruin Run/Walk puts on an annual 5K charity run to raise awareness and funds to support the Chase Child Life Program at the Mattel Children’s Hospital UCLA.

The CPR and First Aid Program offers low-cost American Heart Association CPR and First Aid courses to the UCLA community ($10 for UCLA students, $15 for community members).

The Sexperts committee is dedicated to increasing the awareness of genderrelated health issues, stigmas, and identity at UCLA and beyond.

EARTH is committed to promoting student awareness about the dynamic relationship that exists between individual health and the health of the environment.

“SHA”s are trained to educate other students about various health issues including relationships and communication, stress management, body image, and alcohol harm reduction.

Total Wellness is dedicated to spreading awareness of and sharing knowledge on issues of student health and health care through quarterly magazine publications.

know your resources! Each committee within SWC holds health-related programs throughout the year for the UCLA student body. Like us on Facebook or visit to learn more, and never miss an opportunity to improve your health!


total wellness ▪ summer 2016

Aids Awareness works to increase campus awareness and knowledge of HIV/AIDS and promote safe sex practices.


02 message from the director & editor’s note

08 09 in the news



coffee: its perks and reasons to be bitter


food addiction: when the craving consumes you

41 going nuts

total totalwellness wellness â–Şâ–Ş summer summer 2016 2016


for the love of chocolate 6

eat well superfoods for a super you!


self care it’s kale! it’s açai! no…it’s red wine vinegar!


body in focus your ultimate yogurt guide


cover story hung up on alcohol

51 credits

total totalwellness wellness ▪▪ summer summer 2016 2016



article columns


in the news

food : groundbreaking research by payam mirfendereski| design by alison jeng

fructose can change the expression of genes in your brain Through soft drinks, syrups, and desserts, Americans consume an average of 27 pounds of high fructose corn syrup per year. The consumption of high levels of fructose, a sugar found naturally in small concentrations in fruits, has long posed concern because of its purported role in the obesity epidemic.1 Thanks to a study spearheaded by UCLA’s Xia Yang and Fernando Gomez-Pinilla, fructose has now been linked to changes in gene expression in regions of the brain important for metabolism and memory. By altering the biochemical groups present on the base cytosine in DNA, fructose can influence whether various genes get turned on or off in the brain. Yang and Gomez-Pinilla have linked the genetic disruption caused by fructose to increases in glucose, insulin, and triglycerides, which are markers for diseases such as diabetes and cardiovascular disease. Interestingly, the researchers have also discovered that an omega-3 fatty acid called DHA can prevent these changes in gene expression. Found in wild salmon and other types of fish, DHA is present in only low concentrations in our brain cells, and must be consumed in our diets. Although a diet low in high fructose corn syrup and balanced in DHA seems reasonable, more research needs to be done to see how these two compounds interact with each other and regulate brain function.2

sugar addiction may be able to be treated by drugs that target nicotine addiction The behavioral and neurological characteristics shared between people who consume high amounts of sugar and people who take drugs suggest that sugar may be an “addictive” substance. Neuroscientists at the Queensland University of Technology have discovered that excess sugar consumption can cause similar changes in dopamine function as drugs of abuse like tobacco and cocaine.3 Specifically, high sugar intake leads to elevated dopamine levels initially and decreased dopamine levels later on. Both natural and artificial sweeteners have been found to induce these changes in dopamine function. The neuroscientists have also discovered that nicotinic acetylcholine receptor (nAChR) modulators can alleviate the withdrawal effects of sugar “addiction.” The FDA-approved nAChR modulator varenicline has been shown to reverse sugar dependency, and the neuroscientists suggest it and similar drugs may potentially prove effective in treating sugar addiction.4

prediabetes and diabetes affect over half of adults in California

total wellness ▪ summer 2016

A study conducted at UCLA estimates that 15.5 million California adults (55% of the state population) are afflicted with either prediabetes or diabetes. Of these, only 2.5 million have diagnosed diabetes, revealing that many adults live without knowledge of their conditions. Prediabetes is a condition of elevated blood glucose levels, levels that are not high enough to warrant a diabetes diagnosis yet still high enough to promote concern. Prediabetes is especially a problem for young adults, with 33% of those aged 18-39 in California estimated to have it. The study discovered that young adults of color and those of underprivileged backgrounds tend to have disproportionately higher rates of prediabetes. Nonetheless, it is important to know that both prediabetes and diabetes are preventable. While 75% of those with prediabetes develop diabetes later in their lifetimes, this escalation can be prevented through the implementation of effective dietary and lifestyle changes.5

antibiotics can destroy bad bacteria, but can nurture them too While antibiotics are often used to prevent the spread of infection and disease, they are known to cause various side effects due to their harmful effects on good bacteria in the gut. A study led by UC Davis professor Andreas Bäumler has now elucidated the mechanisms behind these adverse effects.6 Antibiotics typically deplete good bacteria in the gut in addition to certain pathogenic species. Among the good bacteria depleted are those that break down fiber and allow cells to take in oxygen. Antibiotics thus cause a buildup of oxygen in the gut lumen, creating an environment well-suited for the growth of pathogenic bacteria such as Salmonella. Antibiotics can therefore indirectly promote the expansion of pathogens, making individuals more vulnerable to future infections.7


References 1. “Pathogenesis of Cardiovascular and Metabolic Diseases: Are Fructose-Containing Sugars More Involved Than Other Dietary Calories?” Curr Hypertens Rep. (2016). 2. “Fructose alters hundreds of brain genes, which can lead to a wide range of diseases.” (2016). 3. “Treating sugar addiction like drug abuse.” (2016). 4. “Neuronal Nicotinic Acetylcholine Receptor Modulators Reduce Sugar Intake.” PLoS One. (2016). 5. “Majority of California adults have prediabetes or diabetes.” (2016). 6. “Antibiotics allow gut pathogens to breathe.” (2016). 7. “Depletion of Butyrate-Producing Clostridia from the Gut Microbiota Drives an Aerobic Luminal Expansion of Salmonella.” Cell Host Microbe. (2016).

&A: Q diet soda vs. regular soda


by masumi padhye| design by alison jeng

There is a constant debate about drinking soda, particularly on drinking diet versus regular. Some believe that diet soda is worse because of the “cancer-causing chemicals,” while others believe that regular soda is worse because of the “sugar.” In terms of popularity, though, the competition is close. Researchers from Gallup interviewed 2,027 adults in 2013 to study soda consumption in the United States. Of the 56% of adults who drank soda regularly, 57% drank regular soda while 43% percent drank diet soda.1

A: Regular soda contains sugar, high-fructose corn syrup, fruit juice, or a combination of the three. Diet soda, on the other hand, contains artificial sweeteners meant to reduce the caloric content of the soda. A popular artificial sweetener found in diet sodas is aspartame. Aspartame is one of the most commonly used sweeteners today, sold under various brands such as Equal and Nutrasweet. Aspartame is meant to mimic the taste of natural sugar. But since aspartame is about 200 times sweeter than sugar, much less of it can be used to provide the same level of sweetness, and this can help lower the caloric content of soda.3 Q: can diet soda help you lose weight? A: A 2014 study published in Obesity investigated the effect of non-nutritive sweetened beverages, which include diet soda, on weight loss. The researchers divided over 300 adults into two groups; one group was asked to drink at least 24 oz of non-nutritive sweetened beverages daily, and the other group was asked to drink at least 24 oz of water daily (and no non-nutritive sweetened beverages). Over 12 weeks, the participants drinking only water lost an average of 9 pounds while the participants allowed to drink diet soda lost an average of 13 pounds. Researchers concluded that this difference in weight loss was probably due to a reduction in hunger levels in the participants allowed to drink diet soda. They concluded that substituting regular soda with diet soda could potentially help those who drink soda regularly to lose weight.5 However, a 2010 study in the Yale Journal of Biology and Medicine found that although artificial sweeteners don’t contain calories, they encourage sugar craving and sugar dependence due to their sweetness. Repeated exposure to a particular flavor increases one’s preference for it. A strong correlation indeed exists between a person’s habitual intake of a flavor and his or her level of craving for that flavor.6

Q: does regular soda lead to weight gain? A: There is constant debate about high fructose corn syrup and whether it has a greater effect on weight gain and weight gain-related diseases than other sugar sources. A 2007 study published in Critical Food Reviews and Science Nutrition concluded that contrary to popular belief, high-fructose corn syrup does not lead to exacerbated weight gain in comparison to other sugar sources.4 On the other hand, a 2010 study published by Physiology & Behavior deduced that regular consumption of sugar-sweetened drinks, including soda, could lead to weight gain and an increased risk of developing type II diabetes. However, it is important to note that these risks are applicable mainly when drinking soda leads to excess caloric consumption and the intake of other sources of calories is not restricted in exchange. Research shows that soda is indeed a large contributor to excess sugar intake in the United States. Excess sugar could lead to insulin resistance and impaired betacell function, thereby leading to type II diabetes. (Beta cells are pancreatic cells that release insulin in order to regulate blood glucose levels.)2 Q: can diet soda cause cancer? A: A 2012 study published by the American Journal of Nutrition evaluated whether the consumption of aspartame and regular soda is associated with the development of hematopoietic cancers (cancers that occur in the cells of blood-forming tissue, such as the bone marrow, or in the cells of the immune system). While findings suggest that aspartame could play a role in triggering certain hematopoietic cancers, more evidence is required to draw concrete conclusions.7 The effect of diet soda on various types of cancer, including non-Hodgkin lymphoma (a cancer that affects the immune system), was also explored by three studies published in the American Journal of Nutrition. While the results shed light on the potentially cancerous effects of soft drinks, more long-term studies need to be conducted in order to provide definite conclusions.8 9

total wellness ▪ summer 2016

Q: what is the chemical difference between diet soda and regular soda?

Q: is there any correlation between diet and regular soda and other diseases or health issues? A: A 2010 study in Physiology & Behavior noted that there is emerging evidence for the adverse effects of sugar-sweetened drinks on other metabolic conditions, including hypertension, inflammation, atherogenic dyslipidemia (a metabolic abnormality), hyperuricemia (excess of uric acid in the blood), gout (a form of arthritis), gallstone, and kidney disease.2 However, more research is required to confirm the relationship between soda consumption and these diseases. In addition to weight gain and disease, soda can also cause tooth decay. Soft drinks contain phosphoric acid and sugar which attract bacteria such as Lactobacillus and Streptococcus that cause dental erosion. While diet soda is sugar-free, it can also cause tooth decay due to its acidity.9

bottom line: which one is better? While consuming soda in moderation is okay, it is important not to drink soda (diet or regular) on a daily basis. Opt for natural fruit juices or coconut water instead. However, these drinks have a high sugar content as well, so it is important to primarily drink water. In terms of whether diet or regular soda is better, it varies on a case by case basis. For example, for an obese person with high sugar levels, drinking diet soda in moderation would potentially be less harmful. Overall, regular soda and diet soda provide minimal nutritional benefit and increased chances of weight gain, disease, and tooth decay. As with all foods, if one chooses to drink soda, one should keep an eye out for changes in health. tw



left: geoffrey whiteway/stockvault

total wellness ▪ summer 2016

1. ”Soda Consumption In America: Who’s Drinking Regular And Diet?” (2013). 2. “Sugar-sweetened beverages and risk of obesity and type 2 diabetes: Epidemiologic evidence.” Physiol Behav. (2010). 3. “Aspartame: A Safety Evaluation Based on Current Use Levels, Regulations, and Toxicological and Epidemiological Studies.” Crit Rev Toxicol. (2007). 4. “A critical examination of the evidence relating high fructose corn syrup and weight gain.” Crit Rev Food Sci Nutr. (2007). 5. “The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program.” Obesity. (2014). 6. “Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings.” Yale J Biol Med. (2010). 7. “Consumption of artificial sweetener- and sugar-containing soda and risk of lymphoma and leukemia in men and women.” Am J Clin Nutr. (2012). 8. “Soft drinks, aspartame, and the risk of cancer and cardiovascular disease.” Am J Clin Nutr. (2012). 9. “Dental erosion and severe tooth decay related to soft drinks: a case report and literature review.” J Zhejiang Univ Sci B. (2009).

eat well


for a super you! by shriya didwania | design by nezia rahman

total wellness â–Ş summer 2016

Superfoods are foods that provide health benefits, contribute more than the required nutrients in the human diet, and potentially help with certain medical conditions. They may have a higher than average quantity of antioxidants, vitamins, minerals, and other nutrients that can potentially lower one’s risk of disease or enhance any other component of physical or emotional health. In this article, you will read about examples of superfoods, their categorization, and the health benefits of certain superfruits discussed in detail.


healthy oils

fruits and berries > goji berries > maqui berries > avocados > papayas

> fish oil > flaxseed oil > cod liver oil > pumpkin seed oil > avocado oil > coconut oil

what are examples of superfoods?

nuts and seeds

Some groups like the Cancer Research UK, however, claim that this term is simply used to market foods better and that there is no clear scientific basis to this categorization. For example, blueberries, often touted as a superfood, do not have an unusually high content of nutrients.

> brazil nuts > pumpkin seeds > cacao

vegetables > broccoli > pumpkin > carrots > shiitake mushroom > sweet potato > spirulina

total wellness ▪ summer 2016

grains > buckwheat > quinoa > oats > barley > seaweed > wheat


supplements and spices > turmeric > maca > ginseng > suma

left counter clockwise: meaduva/flickr, márton divényi/flickr, liliana fuchs/ flickr, swxxii/flickr, chinwei/flickr, stevepb/pixabary top right:chinwei/flickr bottom right: tesa photography/pixabary cover: stacy spensley/flickr

The National Institute of Health recognizes certain foods as superfoods, such as kiwi, whole grains, cranberries, fish, tomatoes, avocados, dark chocolate, berries, and others.1

Superfruits are a subcategory of superfoods marked by a high density of naturally occurring compounds like polyphenols, which are plant-based molecules with antioxidants.2

>> goji berries Also called wolfberries, these bright orange-red berries are native to China. Across Asia, these berries have been consumed for several generations because they are believed to help one live longer.3 Goji berries have nutrients like vitamin A, vitamin C, iron, and fiber, and they have been suggested to alleviate symptoms of high blood pressure, fever, diabetes, and age-related eye problems. These berries can be eaten raw or cooked and can be dried like raisins. They are often used in herbal teas, juices, wines, and medicines.4 In a 2011 study published in the Journal of Alternative and Complementary Medicine, healthy adults consumed goji berry juice for 14 days and showed higher ratings of energy level, concentration, and athletic performance. Moreover, they also experienced better sleep quality, ease of awakening, serenity, and feelings of health, happiness, and satisfaction. These adults also reported significant decreases in their levels of fatigue and stress.5 Another 2011 study published in Optometry and Vision Science discussed the impact of goji berry consumption among the elderly. According to the results, the subjects showed an increase in antioxidant levels as well as levels of plasma zeaxanthin, a carotenoid present in the retina of the eye. They were also protected from hypopigmentation, or loss of skin color, and from the buildup of soft drusen, or extracellular material, in the eye. However, the mechanism of goji berry on preventing macular degeneration is not clear.6

>> açai berries Native to South America, the açai palm produces a tiny, blackish-purple fruit which has been recognized as a superfood because of its high antioxidant content. In a 2011 pilot study in Nutrition Journal, researchers looked at the health benefits of açai on humans. Ten overweight adults took 100 grams of açai pulp twice a day for a month and showed reduced fasting glucose and insulin levels, as well as lower cholesterol levels. The study concluded that açai consumption decreased the risk of metabolic diseases in overweight adults.7 A 2015 study published in Biology of Sport assessed the effects of açai consumption on athletes’ performance. Seven junior hurdlers consumed an açai berry-based juice blend daily for 6 weeks and took blood tests before and after a sprint, both at the beginning and at the end of the 6 weeks of supplementation. The results at the end revealed greater antioxidant capacity of plasma (the fluid part of blood), alleviation of the muscle damage that exercise induced, and lower serum lipid.8


total wellness ▪ summer 2016


>> cacao seeds These seeds are categorized under superfruits because they are found within the fruit of the Theobroma cacao tree. Cocoa powder and chocolate are made from these seeds, which are native to the Amazon basin and other tropical areas of South America and Central America. To learn more about cacao, cocoa, and chocolate, read “For the Love of Chocolate” on page 45. A 2011 study in Chemistry Central Journal analyzed the antioxidant capacity, total polyphenol content, and total flavanol content of different fruit powders and retail fruit products. Flavanols are naturally occurring antioxidants found in several plants. According to the study’s findings, cocoa powder had the highest concentration of antioxidants and flavanol among the products tested. Moreover, dark chocolate had a significantly higher capacity of antioxidants and flavanol than the fruit juices. The study concluded that cacao seeds contain nutritive value due to their composition of micronutrients, including antioxidants such as flavanol, as well as their composition of macronutrients, which are carbohydrates, proteins, and fats.9

but a word of caution... It’s important to exercise caution and avoid overconsumption of these foods because their natural toxins could cause side effects, especially among kids and at-risk patients. Consulting a doctor is recommended, especially if you plan to consume these foods to treat or prevent a health disorder. Sometimes, there could be residues of arsenic and pesticides in imported foods, which could adversely impact your health. Arsenic can have immediate toxic effects when consumed, such as gastrointestinal problems, and it can also cause cancer in the skin, bladder, lungs, and kidneys.

References 1. “Superfoods.” (n.d.). 2. “Cacao seeds are a ‘Super Fruit’: A comparative analysis of various fruit powders and products.” Chem Cent J. (2011). 3. “Chapter 14: Biomolecular and Clinical Aspects of Chinese Wolfberry.” Herbal Medicine: Biomolecular and Clinical Aspects, 2nd edition. (2011). 4. “Goji Berries: Health Benefits and Side Effects.” (2015). 5. “A randomized, double-blind, placebo-controlled, clinical study of the general effects of a standardized Lycium barbarum (Goji) Juice, GoChi.” J Altern Complement Med. (2008). 6. “Goji berry effects on macular characteristics and plasma antioxidant levels.” Optom Vis Sci. (2011). 7. “Effects of Açai (Euterpe oleracea Mart.) berry preparation on metabolic parameters in a healthy overweight population: A pilot study.” Nutr J. (2011). 8. “Effects of supplementation with açai (Euterpe oleracea Mart.) berry-based juice blend on the blood antioxidant defence capacity and lipid profile in junior hurdlers. A pilot study.” Biol Sport. (2015). 9. “Cacao seeds are a “Super Fruit”: A comparative analysis of various fruit powders and products.” Chem Cent J. (2011). 10. “What are superfoods?” (2015).

total wellness ▪ summer 2016

Moreover, you should look into the amount of processing a food has undergone. If a food is highly processed as in the case of superfoods such as whole grains and green tea, its nutritional value can be significantly lowered. Processed foods often have a high sugar content and can therefore pack empty calories and result in weight gain.

There are plenty of other antioxidant and nutrient-rich superfoods that provide a host of benefits for one’s health and wellness. Superfoods are powerhouses of nutrients. Overall, superfoods are a stepping stone toward healthier diets, but besides these, there are several other healthy options that one can explore, even if they are not called “super.”10 t w


left: rajesh_india/flickr

the bottom line

self care

it’s kale! it’s açai! no…it’s

by richa vakharia | design by jenna le

Here in Los Angeles, where the sun is always shining and the celebrities are always dining, we have a list of eating fads that seems to be ever-growing. From gluten-free diets to kale smoothies to açai bowls, there is always some amazing superfood just around the corner. Recently, there has been another going around. It goes by the name of red wine vinegar.


total wellness ▪ summer 2016

red wine vinegar!

what is it?


cover: schuetz-mediendesign/pixabay left/right: viktor hanacek/picjumbo

left schuetz mediendesign pixabay

: / ; : total wellness â–Ş summer 2016

right viktor hanacek/picjumbo

Though red wine vinegar sounds pretty standard, it is important to know what it is that people are actually drinking. Vinegar is any substance that is 4% acetic acid in a solution of water and other chemicals. If anything else is added, like more water for less acidity, it must be stated on the packaging. If the acetic acid is fermented in red wine, it will then be titled something like “red wine vinegar.�1

research Now some may wonder: is red wine vinegar beneficial at all, or is it just a new fad that will pass without any answers? The truth is that yes, it does have many advantages. In fact, the health benefits of red wine vinegar don’t differ from those of regular vinegar. Because vinegar in itself has many advantages, though, it may give more credence to the red wine vinegar trend. Here are some of those advantages: body fat reduction

total wellness â–Ş summer 2016

A 12-week Japanese study published in Bioscience, Biotechnology, and Biochemistry in 2009 indicated that those who drank more vinegar each day had significantly lower body weights, BMIs, internal fat levels, and waist circumferences. The researchers controlled for initial body weight and diet during the study, and exercise regimen throughout the 12 weeks. After that, the participants that drank 30 mL of vinegar each day (as opposed to 15 mL or 0 mL) showed the most significant decreases in body fat.3


reduces blood pressure This has actually only been found to be true for animals. There is no support for vinegar being able to change blood pressure in humans.4


rumor Of course, red wine vinegar doesn’t do everything. Here are some common myths debunked by a study published in 2006 in Medscape General Medicine.


alleviates warts

stops infections It’s been found that using any type of vinegar for ear infections and lice may bear side effects. Drinking vinegar has not been found to stop infections, but it has not been found to increase chances of infection either.


left:geralt/pixabay ; rusn/istockphoto right: neufal54/pixabay

total wellness ▪ summer 2016

It’s been said that you should apply vinegar (be it red wine or not) to your skin to get rid of things like warts. However, there are only scattered reports supporting this. The only time that was found to work was in a controlled laboratory setting, and that was in addition to anesthesia and rapid removal of the wart itself.

follow up There are several potential health benefits to vinegar that don’t yet fall into either the research or rumor category, as there hasn’t been extensive research done on them to assess their validity. These potential benefits include:

cardiovascular benefits A 2001 study published in Bioscience, Biotechnology, and Biochemistry found that vinegar is linked to some cardiovascular advantages in rats, including reduction in blood pressure, though none of these advantages have been proven significant. Because of the lack of results, there hasn’t been further research done in humans.5

antitumor properties Unfortunately, no thorough research has been been done yet to substantiate the ability of vinegar to prevent tumors from growing. Interestingly, vinegar is a dietary source of polyphenols, which are associated with a reduced risk of cancer. It’s a great segue into future work regarding the benefits of vinegar, and hopefully we will see where that leads!4

So now that you know more about red wine vinegar (and vinegar in general), you can decide whether or not you want to be a part of this new trend. If you choose to, here are some fun recipes to try over the summer! t w > Vinegar marinade: combine red wine vinegar, olive oil, mustard, minced garlic, oregano, and red pepper > Vinegar veggies: grill veggies and use red wine vinegar combined with a little oil and herbs > Delicious dessert: slice up some fruit and add a dash of red wine vinegar on top6

total wellness ▪ summer 2016

conclusion (and some recipes!)

References 1. “CPG Sec. 525.825 Vinegar, Definitions—Adulteration with Vinegar Eels.” (2015). 2. “Vinegar ingestion at mealtime reduced fasting blood glucose concentrations in healthy adults at risk for type 2 diabetes.” J Funct Foods. (2013). 3. “Vinegar Intake Reduced Body Weight, Body Fat Mass, and Serum Triglyceride in Obese Japanese Subjects.” Biosci Biotech Biochem. (2009). 4. “Vinegar: Medicinal Uses and Antiglycemic Effect.” Medscape Gen Med. (2006). 5. “Antihypertensive effects of acetic acid and vinegar on spontaneously hypertensive rats.” Biosci Biotech Biochem. (2001). 6. “Red Wine Vinegar, 3 Ways.” (2013).


body in focus

your ultimate yogurt guide by natalie vawter| design by eunji song

total wellness ▪ summer 2016

In 1908, a Russian scientist named Elie Metchnikoff argued that people in Bulgaria were living longer and healthier lives because they were regularly eating yogurt. He believed that the bacteria living in yogurt have the power to foster healthy microbiomes, which profoundly influence people’s health.1 Metchnikoff advocated consuming a daily probiotic, “good” bacteria, made from yogurt containing lactic acid bacteria.1 Today, the notion that individuals can enhance their health by cultivating healthy microbiomes has escalated into a popular health craze, but it can be unclear how much truth actually exists among all the hype. To learn in depth about how probiotics and the microbiome affect your health, check out “What Are Microorganisms Doing in My Food?” (Volume 15, Issue 3). To learn about how the bacteria in yogurt confer a plethora of health benefits on yogurt-eaters, read on. People all around the world eat yogurt and make it from the milk of many mammals, from cows to camels to water buffalo. These days there are many types of yogurt to choose from, ranging from sugary choices like “GoGurt” to exotic options like green tea yogurt. Some kinds are healthier than others, and examining the nutrition facts can clue you into this—by choosing types with high protein levels and minimal to no added sugar, you can feel confident that your yogurt is both delicious and nutritious.


what is it?

beneficial bacteri-yum

Yogurt is essentially fermented milk. Fermentation is a process in which carbohydrates are broken down into acid or alcohol. Milk contains a type of sugar called lactose, and bacteria in yogurt ferment this lactose to produce the lactic acid that gives yogurt its unique, tangy flavor.

Yogurt is loaded with bacterial “good guys” that populate your digestive tract to create a healthy microbiome. The most common microorganisms in yogurt are S. thermophilus, L. bulgaricus, and L. acidophilus.2 These bacteria yield important health benefits, including inflammation reduction in obese people and the prevention of various types of infections.

obesity & inflammation

Obesity causes inflammation in the gut and impairment of gut bacteria, compromising the integrity of the intestinal lining and allowing harmful toxins to leak from the gut into the bloodstream.2 Studies show that yogurt consumption helps reduce inflammation in the intestines by aiding immune function, strengthening the intestinal lining, and potentially keeping appetite in check.2 For these reasons, eating yogurt may benefit obese individuals.

infection prevention Additionally, a 2015 study published in the Cochrane Reviews found that probiotic consumption reduced upper respiratory tract infections in study participants, suggesting that regularly consuming yogurt could reduce the number of pesky colds you get.3 Yogurt also seems to prevent vaginal yeast infections in women. A 1992 study published in Annals of Internal Medicine found that women who consumed 8 oz of yogurt daily had fewer vaginal yeast infections than women who did not, suggesting that the Lactobacillus acidophilus bacteria hinders yeast colonization.4 The microbes in yogurt do lots of work that makes you healthier.

In addition to the health benefits discussed above, the bacteria in yogurt also help make yogurt easily digestible. Lactoseintolerant people lack the enzyme lactase and therefore cannot break down lactose, the sugar in milk. When these individuals consume milk, the lactose passes undigested into the colon where it is fermented by bacteria, resulting in diarrhea and flatulence.2 However, lactose-intolerant people can consume yogurt without worrying about these unpleasant side effects. They can tolerate yogurt much better than milk, because the process of fermentation breaks down the lactose so the body doesn’t have to, making yogurt easier to digest.2

total wellness ▪ summer 2016

cover: ponce_photography/pixabay left: chapmanizer/pixabay

lactose-intolerance no more


a spoonful of nutrients Because the typical American diet is lacking in calcium and potassium, the Dietary Guidelines for Americans recommend regular consumption of dairy products such as yogurt, which contains plenty of calcium and potassium.5 Importantly, the calcium in yogurt is extremely usable by the body, because the lactose and amino acids help with active transport and passive diffusion, two processes important for the absorption of nutrients.2 Calcium is a crucial mineral that the body needs in order for muscles, nerves, hormones, cell-signaling, and blood vessels to work properly.6 Consuming a lot of calcium also keeps your bones strong! Yogurt is also a good source of B vitamins, which cells need in order to convert the energy you get from food into energy that your body can use.6 Additionally, some yogurts are fortified with vitamin D, which also contributes to healthy bones.

added bonuses Yogurt offers more nutrients on top of those it actually contains, since the bacteria undergo the process of fermentation and that produces additional nutrients. For example, the bacterium S. Thermophilus produces folate, an important vitamin, through fermentation.6 Additionally, yogurt contains conjugated linoleic acid, which may increase lean muscle mass and decrease fat mass.6 All of yogurt’s beneficial nutrients come packaged with very little salt—a large bowl of yogurt contains only 1 g of salt!7 Consuming too much salt can cause high blood pressure, and keeping salt consumption low can keep blood pressure stable.7 Yogurt may also confer protection against certain types of cancer; a 2008 study published in the American Journal of Clinical Nutrition found that people who ate the most yogurt had the lowest levels of bladder cancer, although more studies need to be done in order to confirm these results.2 Yogurt can also benefit patients with gastrointestinal problems like constipation and diarrhea.

total wellness ▪ summer 2016

but what about the fat? People sometimes avoid dairy products like yogurt because they worry that the saturated fat could lead to cardiovascular disease. However, a 2009 study published in the European Journal of Nutrition showed that there is actually no association between eating dairy and developing cardiovascular disease.2 On top of this, yogurt may actually aid with weight loss; a recent study published in 2015 in Food, Science, & Nutrition found that overweight women were able to lose weight by consuming fewer calories and eating more protein and nonfat yogurt.8 This suggests that the added yogurt in these women’s diets contributed to their weight loss success. A possible explanation for this is that high-protein yogurt may increase satiety, the feeling of fullness, and aid with weight loss by suppressing appetite. By incorporating yogurt into your diet, you are setting up your body to be healthy for all these reasons.


trendy types frozen yogurt Frozen yogurt is popular because it offers a lower fat alternative to ice cream. The microbes in yogurt can survive being frozen, so your froyo could be benefitting your microbiome.9 A downside of frozen yogurt is that it contains a high amount of carbohydrates and sugar: according to the USDA, a typical serving of one cup contains 38 g of carbs, 35 g of sugar, and 6 g of fat.10 That’s a whole lot more sugar than regular yogurt! The same portion of ice cream contains 31 g of carbs, 28 g of sugar, and 15 g of fat.11 Even though ice cream has more fat than frozen yogurt, frozen yogurt has considerably more sugar. Frozen yogurt should be viewed as a dessert to be eaten in moderation in order to fit into a balanced diet.

greek yogurt Greek yogurt is popular for a reason—it contains a ton of protein. This helps you feel more full, and is therefore effective for weight loss. The plain type is healthiest, and adding fruit, mint, and even vanilla extract can pump up the flavor without compromising the nutrition.12 A cup of plain, non-fat Greek yogurt contains 23 g of protein, only 8 g of carbs, and minimal sugar.13

coconut yogurt Made from coconut milk, this yogurt is dairy free, and therefore a good choice for people who are vegan or lactose-intolerant. One drawback of coconut yogurt is its fat content. A 6 oz container contains 6 g of saturated fat, which is 30% of the percent daily value recommended by the FDA.14

A 1998 study published in Biotechnology Progress looked at Bulgarian yogurt, which contains a type of bacteria called Lactobacillus bulgaricus, and found that these bacteria produce high levels of amino acids.15 Your body takes these amino acids and uses them to build many types of proteins, from muscle cell proteins that allow you to move to antibodies that fight infections. For this reason, Bulgarian yogurt could be a particularly rich yogurt in terms of both health benefits and flavor!

total wellness ▪ summer 2016

left: angelo gilardelli/istockphoto; malerapaso/istockphoto; okea/istocphoto right: wacomka/istockphoto

bulgarian yogurt

icelandic yogurt (skyr) The bacteria in Icelandic yogurt (skyr) are especially beneficial.16 Skyr has a very tangy taste and thick texture, with lots of protein. It contains almost no sugar and very little fat, making it a very healthy choice. Skyr has a plain, tart taste—by adding berries, you can sweeten it up naturally.


make it yo-self If you’re feeling adventurous, you can make your own yogurt at home! Here’s how:17

ingredients (makes 10 servings) ❯ 2 quarts fresh milk (whole, low-fat, or non-fat—whichever you prefer) ❯ ¼ cup heavy cream (optional) ❯ 3 to 4 tablespoons plain whole milk yogurt with live and active cultures

directions ❯ Rinse the inside of a pot with cold water. Add milk and cream and bring to a simmer, until bubbles form around the edges of the pot, stirring occasionally. ❯ Remove pot from the stove and let cool until it feels warm, not hot. ❯ Transfer ½ cup of the milk into a bowl and whisk in the yogurt until the mixture is smooth. Stir this into the pot with the rest of the milk and cover the pot. Keep the pot warm by wrapping it in a towel or putting it on top of your refrigerator, which is usually warm. ❯ Let the yogurt sit for 6 to 12 hours, until it is thick and tangy. If you prefer a tangier taste, let it sit for 12 hours. ❯ Place the pot in refrigerator and chill for another 4 hours so it thickens.

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bottom line Yogurt contains lots of good bacteria that flourish in your gut to help cultivate a healthy microbiome. This can reduce dangerous chronic inflammation in your intestines, protect against infections, and help you manage your weight by increasing your satiety.18 Yogurt contains plenty of calcium, potassium, and B vitamins, and some evidence suggests that eating it regularly may ward off certain kinds of cancer. You can use it to replace high-fat foods like mayonnaise and sour cream or as leavening in baked goods. Yogurt comes in many forms and flavors and can be a very healthy and tasty meal or snack. Whatever types are to your taste, incorporating yogurt as a regular part of your diet can bestow amazing benefits on your body! t w


References 1. “Recycling Metchnikoff: Probiotics, the Intestinal Microbiome and the Quest for Long Life.” Front Public Health. (2013). 2. “Evidence for the Effects of Yogurt on Gut Health and Obesity.” Crit. Rev. Food Sci. Nutr. (2015). 3. “Probiotics (live micro-organisms) to prevent upper respiratory tract infections (URTIs) (for example, the common cold).” CDSR. (2015). 4. “Ingestion of Yogurt Containing Lactobacillus acidphilus as Prophylaxis for Candidal Vaginitis.” Ann Intern Med. (1992). 5. “The role of Yogurt in improving the quality of the American diet and meeting dietary guidelines.” Oxford Journals Nutrition Reviews. (2014). 6. “Prostate Cancer, Nutrition, and Dietary Supplements.” PDQ Cancer Information Summaires [Internet]. (2016). 7. “High blood pressure: Tips for reducing your salt intake.” Informed Health Online [lnternet]. (2012). 8. “An energy-reduced dietary pattern, including moderate protein and increased nonfat diary intake combined with promotes beneficial body composition and metabolic changes in women with excess adiposity: a randomized comparative trial. Food Sci Nutr. (2015). 9. “Survival of Lactobacillus acidophilus and Bifidobacterium bifidum in Ice Cream for Use as Probiotic Food.” J Dairy Sci. (1992). 10. “Basic Report: 42187, Frozen yogurts, flavors other than chocolate.” United States Department of Agriculture Agricultural Research Service. (n.d.). 11. “Basic Report: 19095, Ice creams, vanilla.” United States Department of Agriculture Agricultural Research Service. (n.d.). 12. “The effects of increased dietary protein yogurt snack in the afternoon on appetite control and eating in healthy women.” J Nutr. (2013). 13. “Basic Report: 01256, Yogurt, Greek, plain, nonfat.” United States Department of Agriculture Agricultural Research Service. (n.d.). 14. “So Delicious Dairy-Free Cultured Coconut Milk, Plain Yogurt.” (n.d.). 15. “Production of Amino Acids by Yogurt Bacteria.” Bicotechno. Prog. (1998). 16. “Micro-organisms in Icelandic curd (Skyr).” Vorratspflege und Lebensmittelforschung. (1940). 17. “Creamy Homemade Yogurt.” New York Times. (2016). 18. “Impact of yogurt on appetite control, energy balance, and body composition.” Oxford Journals Nutrition Reviews. (2015).

left: unsplash/pexels right: victor hanacek/picjumbo

❯ *Optional: If you want to make Greek yogurt, place a cheesecloth in a colander over a bowl and pour the yogurt into the colander, allowing it to drain in the refrigerator for 4 hours. The resulting yogurt will have the thicker consistency of Greek yogurt.

totalwellness ›› on the cover

total wellness ▪ summer 2016

“One cannot think well, love well, sleep well, if one has not dined well.” – VIRGINIA WOOLF



left left: evgeniy lukyanov/freeimages, left middle:jarmoluk/pixabay, left right: jarmoluk/pixabay; right left: jean noel/flickr, right right:jtiano/flickr

total wellness â–Ş summer 2016

cover story

hung up on alcohol by jasmine sidhu | design by edith ramirez & nancy vu

Are you feeling nauseated, exhausted, debilitated, and possibly irritated? Before

you have your next drink, you should know what the research says about blaming it on the alcohol. According to the National Institute of Health, nearly 88,000 people (around 62,000 men and 26,000 women) die from alcohol-related causes every year. This makes alcohol-related incidents the 4th most common preventable cause of death in America.1 Internationally, the World Health Organization has found that alcohol contributes to the development of over 200 diseases and injury-related health conditions and 3.3 million deaths worldwide. Alcohol consumption is also responsible for 25% of the total deaths of people in the age group 20 to 39.2 If these statistics haven’t alerted you enough, then read on to discover the dangers of what you may be putting in your body and how to drink safely if you do choose to drink!

what is alcohol and how does it work?

total wellness â–Ş summer 2016

Alcohol is a depressant that negatively affects an area of the brain called the cerebellum, which normally controls balance, attention, and language. Consequently, an individual who consumes alcohol is at risk for difficulty walking, impaired memory, blurred vision, slurred speech, and slow reaction times. Alcohol works by affecting chemical messengers called neurotransmitters in your brain, specifically by increasing the release of dopamine. Dopamine is a neurotransmitter that is associated with pleasurable events and is released as a response to reward. However, alcohol also increases the effect of inhibitory neurotransmitters, such as GABA, that decrease activity in different parts of the brain and thus increase feelings of depression (hence alcohol’s categorization as a depressant). 3


moderate drinking—is it risky? According to the CDC, moderate drinking is considered having 1 drink per day for women and 1 to 2 drinks per day for men. One drink can be considered as 12 oz of beer (~5% alcohol content), 8 oz of malt liquor (~7% alcohol content), 5 oz of wine (~12% alcohol content), or 1.5 oz or a “shot” of 80-proof (~40% alcohol content) distilled spirits (e.g., gin, rum, vodka, whiskey).5 Although many people think that moderate drinking is less risky, individuals should be aware that for conditions like cancer or liver disease, there is no known safe level of alcohol consumption.5 Contrary to popular belief that a glass of wine can have possible health benefits, the USDA insists no one should drink assuming that there are potential benefits associated with the consumption of alcohol.5,6 Rather, they recommend that if one chooses to drink, one choose to be a moderate drinker.5,7

binge drinking According to the CDC, binge drinking, or heavy episodic drinking, is considered consuming 5 or more drinks at once for men and consuming 4 or more drinks at once for women. Continuous binge drinking can result in serious injuries, liver diseases, and cancers.8 Over half of the deaths caused by excessive drinking are the result of binge drinking.5 In spite of this, based on national surveys, 1 in 6 U.S. adults binge drinks 4 times a month and has approximately 8 drinks per binge. Additional consequences of binge drinking include stroke, alcohol poisoning, high blood pressure, neurological damage, and injury, among others.9

what are the main types of alcohol and their alcohol concentrations?4

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wine typically 12.5 to 17.5%


champagne 12%

tequila typically 40%, but can go up to 60%

vodka 35 to 50%

distilled spirit 40%

whisky typically 45%, but can go up to 68%

left: baggiohuy/flickr; right: leo delauncey/maionline

beer typically 3 to 6%

the serious consequences (that may affect us all!) cancer Numerous studies have found a strong correlation between alcohol consumption and high incidences of cancer. Excessive alcohol consumption is most often linked to head and neck cancer, esophageal cancer, liver cancer, breast cancer, and colorectal cancer. In fact, over 100 epidemiological studies have been conducted finding an increased risk of breast cancer in correlation with increased alcohol consumption.10,11

brain damage Excessive alcohol consumption is also capable of causing significant brain damage. Damage can result from: 1. Toxic effects of alcohol on brain cells 2. Biological stress from repeated intoxication and withdrawal 3. Cerebrovascular disease due to alcohol consumption 4. Head injuries from falls when one is under the influence14,16

liver disease In Western countries, alcohol is one of the most frequent causes of liver disease. Excessive alcohol consumption is the number one cause of cirrhosis, which is the scarring of liver tissue. If cirrhosis is not treated, it can lead to immediate liver failure.12,13

hangovers A hangover is probably the most obvious consequence of drinking alcohol. It is associated with dizziness, nausea, fatigue, sweating, anxiety, and loss of appetite. Although there is no set cure for hangovers, the best choice is to drink in moderation.5

wenickle-korsakoff’s syndrome

total wellness ▪ summer 2016

Wernicke-Korsakoff’s syndrome is a rare condition most commonly caused by alcohol. This disease results from a severe deficiency in thiamine, a B vitamin—an issue that comes to surface with alcohol consumption. Because of the thiamine deficiency, patients with Korsakoff’s syndrome suffer from severe memory loss, inability to form new memories, hallucinations, disorientation, and poor balance.14,15


safety measures

drinking and driving

There is a drunk driving-related death every 51 minutes in the United States. Those in the age group 21 to 30 are the most at risk for a drunk driving incident.17 In California, you are legally drunk if you have a blood alcohol concentration of 0.08% or higher. A DUI offense in California has the following consequences: 1st offense: 4 days to 6 months in jail, fine of up to $1000, and a license suspension of 30 days to 10 months 2nd offense: 10 days to 1 year in jail, fine of up to $1800, and a license suspension for 2 years18

what you all want to know: what do you do the next morning? 1. Drink as much water as you can before going to sleep. 2. Eat as soon as you can. Foods that alleviate hangover symptoms include bananas, cereal, and egg with toast. 3. Drink some coffee or a caffeinated drink to make you feel less tired. 4. If your stomach hurts, try the medication Pepto-Bismol, and if you have a headache, take ibuprofen, a painreliever. (Don’t take any medication with acetaminophen because it can cause serious liver problems.) 5. If you drank heavily, then abstain from having alcohol for at least 48 hours. 6. Learn from your mistakes and realize what your limits are.19,20

if you choose to drink: 1. Know your limits. Ask your parents and relatives if there are any people who suffer from alcoholism or depression in your family. If you have further questions, consult a doctor to figure out your probability of becoming an alcoholic. 2. Eat before before you drink and while you drink because doing so will slow the absorption of alcohol into your bloodstream. 3. Never leave your drink unattended. To avoid untowardly situations, make sure you are consuming alcohol around people you trust. 4. Plan how you are going to get home before you leave to go drink. Consider ridesharing with apps like Uber or Lyft or having a designated driver. 5. Alcohol dehydrates your body and warm weather can aggravate the dehydration, so if you’re going to drink on hot days (most of the year for Los Angeles residents) then make sure you’re drinking extra water throughout the day.

individuals who should abstain from having alcohol are: 1. Women who are pregnant or who are trying to become pregnant 2. Individuals who are taking prescription or over-thecounter medications that may cause harmful reactions when mixed with alcohol (consult your doctor) 3. Individuals under the age of 21 4. Recovering alcoholics 5. People suffering from other medical conditions that may be aggravated by alcohol consumption (see your doctor)

Before you pick up your next drink, make sure you look into your family history, assess your tolerance level, and know the proper proportions of what is considered a drink. When you are intoxicated, you not only run the risk of hurting others but also put yourself at risk for developing a multitude of health problems. From cancer and liver disease to neurodegeneration, alcohol can have significant impacts on your health. If you have any questions regarding your health and alcohol or are feeling depressed, do not hesitate to see your doctor! Remember, you are far more likely to suffer academically, engage in violence, be robbed, or get hurt when you are under the influence, so make sure you think before you drink! t w


References 1. “Alcohol Statistics and Facts.” (2015). 2. “Alcohol.” (2016). 3. “Alcohol’s Damaging Effects on the Brain.” nih. gov. (2004). 4. “Alcohol Guidelines: Reducing the Risks.” (n.d.) 5. “Fact Sheets: Moderate Drinking.” (2015). 6. “The Health Benefits of Wine.” Annu Rev Nutr. (2000). 7. “Dietary Guidelines.” (2010). 8. “Alcohol and Public Health.” (2016). 9. “Fact Sheets: Binge Drinking.” (2015). 10. “Alcohol and Cancer Risk.” (2013). 11. “Alcohol and Cancer.” Lancet Oncol. (2006). 12. “Alcoholic Liver Disease.” World J Hepatol. (2012). 13. “Cirrhosis.” (2015). 14. “Korsakoff Syndrome.” (2016). 15. “What is Alcohol Related Brain Damage.” (2016). 16. “Alcohol-Related Brain Damage.” PLoS One. (2014). 17. “Sobering Facts: Drunk Driving State Fact Sheets.” (2015). 18. “California Drunk Driving Penalties.” dui.drivinglaws. (2015). 19. “Tips to Beat a Hangover.” (2015). 20. “Tips for Staying Safe If You Plan on Drinking.” (2015).

left middle: kaprisuli/flickr, hussain haseeb/flickr, left right:clkerfreevectorimages/pixabay

total wellness ▪ summer 2016




its perks and reasons to be bitter by sepideh parhami| design by alison jeng

total wellness â–Ş summer 2016

The sweet and smoky fragrances of a cup of Joe in the morning (or afternoon, or at any time of the day really) rarely fail to arouse our senses and minds. It’s no wonder that 54% of Americans drink coffee every day.1 Although many of the components are the same, coffee is prepared in a wide variety of ways that determine the balance of chemicals and nutrients that end up in your cup. Research shows that it can benefit many diverse bodily systems, but excessive consumption presents concerns, mostly because of the physiological and mental effects of caffeine. We introduce both the positive and negative health effects so you can make an informed decision on how much coffee consumption feels healthy for you.


acids caffeine (or not) Caffeine is a chemical compound naturally occurring in plants. Because it increases cognitive, motor, and involuntary functions, it is considered a stimulant. Caffeine works by blocking the adenosine receptor, so the molecule adenosine can’t bind and induce processes like sleep. It also increases dopamine, a signaling molecule in the brain which elevates energy and mood (see Dopamine Q&A in Volume 14, Issue 3).3 There are on average 100 mg of caffeine in an 8 oz cup, enough for a noticeable stimulant effect. The caffeine concentration can vary greatly by roast and brand. For example, 8 oz of plain Starbucks coffee (much less than their standard cup sizes) has as much as 180 mg of caffeine!4 Your cup of Joe may also be decaffeinated, meaning that the caffeine has been dissolved out of young coffee beans to produce what’s commonly known as decaf. However, an 8 oz cup of decaf may still contain anywhere from 2 to 12 mg of caffeine.5

Coffee contains lots of chlorogenic acid, up to 12% of dried coffee beans by weight. This and other acids contribute to the bitter taste of coffee. They also contribute to the deep brown hue of beans after roasting.7 Acidity in the beverage does not necessarily mean you’ll feel acidic in your stomach, although coffee may provoke heartburn by stimulating production of body acids that tend to leak back into the esophagus in certain people.8

water Nearly 99% of a cup of coffee!2

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th anatom cup of


polyphenols Polyphenols give many plants, including the coffee bean, their color and act as antioxidants.9 Antioxidants are commonly lauded for protecting against cancer, maintaining vision, and reducing the risk of heart disease, although evidence is mostly inconclusive for all of these.10 A variety of antioxidants in coffee are absorbed into the bloodstream and protect against damage from free radicals.6 Free radicals (unpaired electrons) are extremely reactive and will break apart molecules in the body, but antioxidants absorb the damage by eliminating the radical (with an unpaired electron of their own).11

extras for taste This accounts for all the things you add into your coffee after it’s been brewed, like cream, sugar, and flavorings. Coffee by itself has only about 2 calories per cup—but cream and sugar can add up to 50 calories of nutritionally-empty carbohydrates each.12

fats Diterpenes, a kind of fat present in coffee oil, can raise cholesterol. Instant varieties are especially high in diterpenes because there is no paper filter involved to absorb the fats.6

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he my of a f coffee

aromatic compounds Coffee is made up of around 850 different volatile compounds that easily evaporate and allow us to smell that distinct fragrance of coffee we know and love. These chemicals are produced in the process of roasting.6

what determines the balance of these things? The balance of the chemical components of coffee is influenced by inherent properties of the coffee bean and production techniques like roasting and brewing. Roasting is heating the beans at a temperature between 356 and 446°F for a given amount of time. The exact temperature depends on the roast being made. It brings out the bean’s flavors and scents by generating aromatic compounds.13 Finally, brewing processes take roasted coffee grounds and steep them in water for anywhere from a few seconds to several hours to allow the compounds in coffee to mix into the liquid and make the beverage we know and love.14 Flip to the next page for the variations in beans, roasts, and brewing techniques!



A species of coffee bean that constitutes about 75% of global coffee production. Common in specialty coffees. Thought to produce a superior taste. Lower in caffeine and less acidic than robusta, but higher in polyphenols and fats.15, 16


A species of coffee bean that constitutes about 25% of global coffee production. Common in instant varieties. Easier to grow and more resilient and thus cheaper on the market. It is high in caffeine and acids, but low in polyphenols and fats.15, 16

the bean

the roast

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the brew


Dark brown or even black in color. Bitter, smoky taste. Produced by roasting beans at relatively high temperatures (437 to 446°F). Used to produce espresso or French roasts. Contrary to common intuition, darker roasts are the least concentrated in caffeine—the process of roasting actually breaks down caffeine naturally present in the beans. They’re also the least acidic and highest in fat.


Medium brown in color. Roasted in the middle range of 410 to 428°F. Considered an intermediate between dark and light, with balanced flavor, aroma, and acidity. Also known as regular, American, or breakfast roast.

light (blond)

Light brown in color. Best retains flavors of original bean with more acidic tastes. Roasted at relatively low temperatures (356 to 401°F) for shorter durations. May be called a cinnamon or New England roast. It has the highest caffeine content of the three roasts and is the most acidic.


Hot water is filtered through coffee grounds so the caffeine, fats, aromatic compounds, polyphenols, and acids are quickly dissolved into the water at an optimal temperature. Examples of this are standard coffee makers or French press. The result is a steaming, fragrant cup of Joe that is best consumed fresh as it begins to taste acidic and bitter as time passes.


cold brew


Instant coffee is coffee that has been pre-brewed and dried out and is often sold as powder or crystals. It can be dissolved directly into hot water and is quick to prepare. Instant coffee tends to contain high levels of fat that are dissolved straight into the beverage instead of being passed through the filter and have a reputation for being lower quality in terms of taste. Coffee grounds are put into room temperature water and allowed to sit for anywhere between 3 and 24 hours. The solids are filtered out before serving. The cold temperature keeps the fragrant compounds from evaporating as quickly and reduces the amount of acids that can dissolve into the water. Cold brews end up very concentrated because of the long steeping time and the amount of coffee grounds used, so they are usually enjoyed diluted with milk or water.

health effects of coffee part of body

positive effects

negative effects


increases attention and cognition In low doses, coffee improves mental performance. A cup or two of coffee speeds reaction time to light stimuli, although adverse effects begin to set in after that point. One study found that coffee increased speed and accuracy in subjects taking a mock GRE exam. Another study observed that 200 to 400 mg caffeine, or 2 to 4 cups of coffee, decreased lapses in attention in a night-driving simulation. This effect is due to dopamine and other similarly structured signaling molecules.17

sleep disruption Caffeine taken less than 6 hours before bedtime can reduce sleep time and quality of sleep. The study used a 400 mg dose, the equivalent of 2 large coffees or 4 small cups.18

protects from neurodegenerative disease Long-term coffee use correlates to a reduced risk of cognitive decline in old age and developing diseases like Alzheimer’s or dementia.7

increases urination Subjects drinking caffeinated coffee reported higher urgency and frequency to urinate when compared to controls who drank decaf. The effect is most pronounced among low-coffee users. Caffeine has a diuretic (water-expelling) effect in the body, so it causes dehydration but there is no evidence to say it’s pathological.21

digestive system may reduce risk of type II diabetes

Both caffeinated and decaffeinated coffee were shown to correlate with reduced risk of type II diabetes, where the body fatigues its capacity to break down sugars. It’s thought that coffee enhances the ability of fat cells to take up sugar, and this effect may be due to chlorogenic acid.22,23

can induce bowel movements For certain individuals, coffee consumption can increase movement through the far end of the colon and induce a desire to defecate in as little as 5 minutes. The effect is independent of caffeine, meaning that traditional and decaf brews have the same effect. Coffee also stimulates the release of gastrin, a hormone known to facilitate contractions of the colon. This can be a positive effect, though, if you’re looking to “move things along.”24


fights bacteria Polyphenols, present in high concentrations in high caffeine varieties of coffee, prevent binding of certain bacteria to the tooth surface.25,26

stains enamel Polyphenols are also responsible for the infamous brown tint of coffee-stained teeth. These compounds, responsible for the rich color of coffee, can deposit and bind directly onto the tooth surface.27


increases physical performance In trained athletes and at high doses, caffeine improves performance during both short exercise intervals and longer physical activities. It increases overall force output, a measure of effort, and time to fatigue, a measure of endurance. One likely mechanism is breaking down fat for energy instead of relying solely on muscle energy stores.28

raises cholesterol A large-scale study in 1983 found that coffee consumption was associated with higher overall blood cholesterol and triglycerides and lower HDL, or good, cholesterol. This could be due to the diterpenes present in coffee oil.6,31

reduces risk of certain cancers Various studies have reported that coffee consumption is linked to lower risk of melanoma, a cancer of the skin, and breast, liver, kidney, and colorectal cancers.29,30 In animal studies, however, caffeine has been shown to both suppress and stimulate tumors.7 Additionally, coffee also contains acrylamide, a potential carcinogen produced during roasting, but research on its effects are inconclusive.6


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urinary system

cover: victor hanacek/picjumbo spread: victor hanacek/picjumbo top left: alptraum/istockphoto middle left: malerapaso/istockphoto bottom left: studiocasper/istockphoto right: illustrations/freepik back:jeshoots/pexels

anxiety Caffeine produces anxious behaviors when administered in high doses to rats.19 In human experiments, men who rarely or never drink caffeinated beverages have increased blood pressure (a physiological indicator of anxiety) and higher self-reported anxiety ratings after drinking coffee.20

recommendations › Feel free to enjoy your daily cup of Joe! The European Food Safety Authority (EFSA) says that it is generally safe to drink moderate amounts of caffeine (no more than 400 mg) on a daily basis.32 › Take note of what coffee’s effects are for you personally— the amount of mental stimulation, anxiety, withdrawal, and gastrointestinal disturbances vary greatly from person to person.

the message to go Coffee is a part of daily life for many of us and is a habit that has a lot of benefits for the body and mind. However, consumption should be limited to where the negatives don’t outweigh the positives. You should be able to understand what kind of coffee and how much suits you best and gives you the energy, cognition, and disease protection you need. t w

References “Coffee by the Numbers.” (2016). “What’s Inside a Cup of Coffee?” (2009). 3. “Caffeine.” (2016). 4. “The Complete Guide to Starbucks Caffeine.” (2016). 5. “Caffeine content for coffee, tea, soda and more.” (2014). 6. “All about coffee.” (2016). 7. “Chemistry in every cup.” (2011). 8. “Pathogenesis of Coffee-Induced Gastrointestinal Symptoms.” NEJM. (1980). 9. “Polyphenols as Natural Food Pigments: Changes During Food Processing.” Am J Food Technol. (2007). 10. “Antioxidants: Beyond the Hype.” (2016). 11. “Chemical and molecular mechanisms of antioxidants: experimental approaches and model systems.” J Cell Mol Med. (2010). 12. “I’m trying to lose weight. Should I cut back on coffee?” (2014). 13. “Coffee Roasts from Light to Dark.” (2016). 14. “Coffee Brewing Chemistry: Hot Brew vs. Cold Brew.” (2014). 15. “10 Differences between Robusta & Arabica Coffee.” (2014). 16. “Comparative study of polyphenols and caffeine in different coffee varieties affected by the degree of roasting.” Food Chem. (2011). 17. “Caffeine and human behavior: Arousal, anxiety, and performance effects.” J Behav Med. (1982). 18. “Caffeine Effects on Sleep Taken 0, 3, or 6 Hours Before Going to Bed.” J Clin Sleep Med. (2013). 19. “Anxiogenic action of caffeine: an experimental study in rats.” J Psychopharmacol. (1997). 20. “Storm in a coffee cup: caffeine modifies brain activation to social signals of threat.” Soc Cog Affect Neurosci. (2011). 21. “Prospective study on the effects of regular and decaffeinated coffee on urinary symptoms in young and healthy volunteers.” Neurourol Urodyn. (2015). 22. “Coffee, Caffeine, and Risk of Type 2 Diabetes.” Diabetes Care. (2006). 23. “Roles of Chlorogenic Acid on Regulating Glucose and Lipids Metabolism: A Review.” Evid Based Complement Alternat Med. (2013). 24. “Effect of coffee on distal colon function.” Gut. (1990). 25. “Antiadhesive Effect of Green and Roasted Coffee on Streptococcus mutans’ Adhesive Properties on SalivaCoated Hydroxyapatite Beads.” J Agric Food Chem. (2002). 26. “Anti-cariogenic effects of polyphenols from plant stimulant beverages (cocoa, coffee, tea).” Fitoterapia. (2009). 27. “Dental Discoloration: An Overview.” J Esthet Restor Dent. (2007). 28. “Caffeine and Exercise Performance.” Sports Sci. (1996). 29. “Coffee consumption and the risk of cutaneous melanoma: a meta-analysis.” Eur J Nutr. (2015). 30. “Coffee consumption and the risk of cancer: An overview.” Cancer Lett. (2008). 31. “The Tromsø Heart Study — Does Coffee Raise Serum Cholesterol?” N Engl J Med. (1983). 32. “Scientific opinion on the safety of caffeine.” EFSA J. (2015). 1.

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food addiction: when the craving consumes you

It’s not uncommon to hear people talking about how they are addicted to cheese, are chocoholics, or just can't get enough of bread. While we may throw around the term “addiction” loosely when we discuss our favorite foods, food addiction is actually a highly contested term, and many scientists and doctors still debate over whether this is a real concept. The closest disorder that has been accepted by the medical community is bingeeating disorder. Binge-eating disorder is a disease in which an individual consumes a large amount of food and has difficulty stopping eating.1 While this disorder focuses more generally on overeating, the term food addiction seems to suggest that certain types of foods are not only overeaten, but are also addictive in nature. Read on to learn about what a food addiction is, how it works, and what the science has to say!


total wellness ▪ summer 2016

by ruchi desai | design by amir ljuljanovic

background While scientific use of the term “addiction” in regard to food can be traced back to the 19th century, the term “food addiction” only became more popular in the last few years. Its rise in popularity can be traced back to the beginning of the 21st century when people began worrying about processed foods.2 Because the term food addiction is relatively new, many researchers have attempted to draw parallels between it and substance abuse.

basic definitions › food addiction

Addiction, in terms of drug addiction, has been defined as an extreme psychological state in which an individual has lost control over drug use. The individual may suffer from physical consequences when attempting to stop drug use.3 In a broader sense, addiction is defined as failure to stop doing a certain kind of activity despite attempting to do so. The word addiction generally has a negative connotation, and many clinical criteria focus on the negative effects of addiction on one’s body.

› food dependence

This is another term that has to be defined in terms of drugs. Drug dependence is a phenomenon in which an individual needs a drug to function normally and, when refraining from using the drug, suffers from withdrawal. 3 Theoretically, food dependence would constitute a similar phenomenon.

Oftentimes, when individuals think of food addiction, they associate obesity and weight issues with the disease. However, there is currently no consensus on whether or not a person of normal body weight can be a food addict or if food addiction is a disease restricted to individuals that are overweight or obese.

› food craving

A food craving is an intense desire to eat a certain kind of food. Individuals with a food craving are able to recognize that they have one. 3

understanding addictions

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When we think about addictions we usually think about substance abuse in terms of drugs, alcohol, and chemicals. As such, it’s not surprising that the majority of research on food addiction has focused on the similarities between food cravings and drug cravings. In fact, the Food Addiction Institute considers food addiction to be a form of chemical dependency. 5 According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), in order for a person to be considered addicted to or dependent on a substance, 3 of the following 7 symptoms must be present: › tolerance: increasing amounts of the substance are needed to achieve the same amount of pleasure each time › withdrawal: physical and emotional symptoms that arise when an individual stops using a particular substance › using large amounts of the substance › having a feeling of intense desire for the substance and being unable to control its use › spending a lot of time using the substance, looking for the substance, or recovering from its effects › using the substance despite it interfering with other aspects of the individual’s life › using the substance despite prior knowledge about its ill effects.6 In order to determine the existence of food addictions, researchers have used the DSM-V criteria for substance addictions and have attempted to draw parallels between food addiction and drug addiction. More specifically, researchers have looked into the neurochemistry and neuroimaging similarities between these two concepts.


what does the research say? › neurochemistry Dopamine, a neuromodulator in the brain, is considered to reinforce the effects of food, drug abuse, and pleasure. A 2003 study in NeuroImage found that consuming food causes the brain to release dopamine and that the amount of dopamine released is positively correlated with the degree of pleasure experienced.7 A 2009 review in the Journal of Nutrition analyzed a number of studies which demonstrated that consuming excess amounts of sugar can produce endogenous opioid dependency, a condition in which a food addict’s brain produces its own opium-like chemicals and becomes dependent on them. Release of endogenous opioids leads to higher levels of dopamine, which trigger pleasure or a rewarding effect. In layman’s terms this means that food addicts produce chemical signals in their brains that are very similar to those produced in the brains of opiate drug addicts. 4

› neuroimaging A 2004 study in NeuroImage conducted brain imaging scans to study food cravings. The researchers used functional magnetic resonance imaging (fMRI), which detects changes in blood flow in order to measure brain activity. They found that craving-related changes in the fMRI images occurred in the hippocampus, insula, and caudate nucleus, three areas of the brain that are also involved in drug craving. This study provides evidence for the idea that a common component in food and drugs causes cravings.8

cover: debbi smirnoff/istockphoto left: freepik in food/flaticon; right: mariuszblach/istockphoto back cover:stockpik/pexels

A 2013 study in the American Journal of Clinical Nutrition found that after consuming a high glycemic meal, men experienced an initial spike in blood sugar followed by a sharp crash a few hours later. fMRI scans showed that the crash in blood sugar activated a part of the brain that is known to be involved in addictive behaviors—the nucleus accumbens. It is important to note that the study focused solely on men that were overweight and obese and that the sample may not have been representative of the population.9

specific foods may be addictive Foods that are high in fat or sugar are usually the ones that are considered “addictive.” In fact, foods that are high in fats, carbohydrates, and salts have a high glycemic load. This means that they are absorbed much faster by the body and give rise to an intense spike in blood sugar. This spike in blood sugar is often what is considered problematic and may be what gives rise to the development of food cravings and addictions.10 However, when it comes to specific types of food, things get a bit trickier. The two food items that seem to be discussed most often are chocolate and cheese.

› chocolate “Chocoholics” are individuals that have an intense desire and love for chocolate. However, is this desire actually an addiction? According to a 2000 study in Pharmacology, Biochemistry, and Behavior, the answer would be no. The authors argue that much of the so-called addictive properties of chocolate are actually byproducts of social and cultural perceptions about appropriate intake and uses of chocolate. Food items like chocolate, desserts, and sweets are often considered nice but unhealthy and as such are consumed in addition to our normal meals as treats or rewards. As a result, many of us try to restrict our intake of these items. However, dietary restriction only seems to make chocolate more desirable, leading to the phenomenon that we label as a food craving instead of hunger because we have been conditioned to think of chocolate as an indulgence rather than a necessity.3

› cheese Cheese contains casein, a protein found in most dairy products. When casein is broken down, it forms small protein fragments called casomorphins, which can bind to the receptors for opioid molecules in the brain. As explained earlier, the release of opioids in the brain has been connected to feelings of pleasure and may be associated with drug addiction as well.10 In the 2009 scientific report by the European Food Safety Authority, researchers found that even though casomorphins can reduce pain in mice, they do not have the same effect as morphine, which is an opioid.11 This is significant, because it demonstrates that while cheese may have some properties that intensify pleasure, it does not intensify pleasure on the same level as drugs. So all of those “cheese is as addictive as crack” headlines that you may have read were really quite misleading.


bottom line Scientists and doctors are still divided on whether or not food addictions exist. While there seems to be some evidence that foods that have high levels of fat, sugar, and carbohydrates have the potential to be more addictive, there does not seem to be as much evidence that certain kinds of foods like chocolate and cheese are specifically addictive. t w

References 1. “Binge-eating disorder.” (2016). 2. “Back by Popular Demand: a Narrative View on the history of Food addiction Research.” Yale J Biol and Med. (2015). 3. “Food Craving and Food “Addiction”: A Critical Review of the Evidence From a Biopsychosocial Perspective.”Pharmacol Biochem Be. (2000). 4. “Food addiction in Humans.”J Nutr. (2009). 5. “What is Food Addiction?” (2016). 6. “Symposium Overview- Food Addiction: Fact or Fiction?” J Nutr. (2009). 7. “Feeding-induced dopamine release in dorsal striatum correlates with meal pleasantness ratings in healthy human volunteers.” NeuroImage. (2003). 8. “Images of Desire: Food Craving activation during fMRI.” NeuroImage. (2004). 9. “Effects of dietary glycemic index on brain regions related to reward and craving in men.” Am J Clin Nutr. (2013). 10. “No Cheese is not just like Crack.” (2015). 11. “Review of the potential health impact of β-casomorphins and related peptides.” European Food Safety Authority. (2009).



going nuts! by

sabrin sidhu | design by amir ljuljanovic

Have you been feeling nutty lately? Maybe you should consider adding nuts to your life! Nuts are becoming a popular health fad, and many people may be wondering whether nuts are actually worth the hype. According to the USDA, nuts are considered an integral part of a diet that’s low in saturated fat and cholesterol.1 Despite the fact that nuts have the potential to pack a punch in our meals, only 4 in 10 Americans eat nuts on a daily basis.2 The top three nuts of choice in America are almonds, walnuts, and pecans, but with so many options out there, why not see what other nuts have to offer?1 Read on to see what different nuts can do for you!


general benefits of consuming nuts › nutrients Nuts are a rich source of protein and can be beneficial for vegetarians or other people with dietary limitations. They also provide your body with monounsaturated and polyunsaturated fats (the kinds of fat you want in your body) and fiber. As an added bonus, nuts are rich in nutrients like magnesium, folate, and vitamin B6.3

› heart health

Nuts are about 80% fat but most of the fat is unsaturated fat.4 Unsaturated fat is beneficial for your body because it lowers cholesterol levels and reduces the risk of developing heart disease and type II diabetes.5

› body weight

According to a 2009 study published in the American Journal of Clinical Nutrition, daily consumption of nuts is associated with lower body weight and lower risk of developing obesity.6 Because of the high fiber content of nuts, people who frequently eat nuts do not feel as hungry and usually feel more full, suggesting that controlled consumption of nuts can actually lead to weight loss. Nuts are a great choice for people who need energy like students or those who work long hours.3,7

general risks of consuming nuts › calories

Because nuts are mostly fat, they have a lot of calories. That’s why, like other foods, nuts should be eaten in moderation. A good rule of thumb is that 1 oz, which is a good portion size, is typically equal to a small palm-full of nuts.8

› additives

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Be careful when choosing what nuts to eat. While most nuts are good for you, salted nuts or chocolate covered nuts can have risks that outweigh the benefits!8

› oils

Nut oils can be a good option for cooking because they add unique flavors to dishes like salads or sautés. Remember, though, that such oils don’t have the same fiber content that whole, raw nuts do.8

› allergies

Remember to always be careful when consuming nuts. Contact a doctor first if you think you may be allergic.


different types of nuts and their health benefits almonds

A 2012 study published in the Journal of Agriculture and Food Chemistry found that almonds not only reduce cholesterol but also help prevent oxidative stress and inflammation from developing.9 In terms of nutrients, almonds are rich in magnesium and vitamin E.


According to the American Institute for Cancer Research, walnuts are one of the best foods you can eat to prevent cancer. This is because they are high in polyphenols, which are phytochemicals (“phyto” means plant) that have numerous antioxidant benefits that have been linked to reduced risk of cancer.10 Walnuts are considered the best nut for brain health. According to a 2011 study published in the Journal of Plant Foods for Human Nutrition, walnuts may have beneficial effects on memory and learning because they contain omega-3 fatty acids, which possibly improve memory.11 Multiple studies suggest that walnuts are one of the best nuts to consume to lower your risk of developing heart disease. Walnuts can potentially lower heart disease risk in two major ways:

A 2008 study published in the Journal of Nutrition found that peanuts, when combined with other dietary measures, may help individuals lose weight. Among popular nuts, they are the lowest in calories and one of the lowest in fat.3,14 Peanuts are also considered a very powerful food because they are rich in folate, which is a type of B-vitamin important for cellular function, particularly for the production of DNA. Peanuts also have the highest source of protein among nuts—100 grams of peanuts offer 25.8 grams of protein. Peanut butter is also considered a valid substitute for peanuts and has many of the same health benefits, but beware of any added sugar.3,15

brazil nuts

Brazil nuts may be one of the best choices for men. Of all foods, they are one of the richest in selenium. A 2013 study in Nutrients suggested that while a correlation between selenium intake and reduced risk of prostate cancer in men wasn’t directly visible, selenium could still be of value to certain subpopulations.16,17

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cover: kaboompics/istockphoto left: kjpargeter/freepik; okea/istockphoto right: sasimoto/istockphoto; okea/istockphoto back: okea/istockphoto; stocksnapper/istcokphoto


1. Walnuts can reduce low-density lipoprotein cholesterol (aka bad cholesterol) by 9 to 16%. 2. Walnuts can lower blood pressure.12,13



Pistachios are rich in protein, dietary fiber, potassium, magnesium, and vitamin K. They help individuals control and lose weight and also reduce the risk of developing heart disease.18


Cashews are commonly used to treat stomach and intestinal problems. Additionally, a paste can be made from cashews to treat warts or corns, which are hardened areas of skin.19 Cashews are also low in fat compared to other nuts.3

macadamia nuts

A 2007 study published in the Journal of Lipids found that daily consumption of macadamia nuts may lower the risk of developing coronary heart disease.20 Another 2008 study published in the Journal of Nutrition found that macadamia nuts lower cholesterol and cardiovascular disease risk factors. 21 However, be cautious when you munch on macadamias because, among all nuts, they are the highest in calories and fat.3

Have a food craving? Make a snack with nuts, like this one:

dark chocolate nut bark

› 2 cups dark chocolate, melted

› 1 ½ assorted nuts › dried fruit (like

total wellness ▪ summer 2016

cranberries) Putting it all together! 1. Line a rimmed baking sheet with foil. (Take care to avoid wrinkles.) Combine melted chocolate and nuts in a medium bowl. Scrape the mixture onto the foil and spread it into an approximate 12-by9-inch rectangle. Sprinkle with additional finely chopped nuts, if desired. 2. * Optional: garnish with dried fruits. 3. Refrigerate until set, about 20 minutes. 4. Transfer the bark and foil to a cutting board. Use a sharp knife to cut into 1½-inch pieces.



in a nutshell... If eaten in correct proportions, nuts can form an important part of a healthy diet. Because of the many ways nuts can be used, it’s easy to incorporate your favorite nut into your meals and snacks in a unique way. Try adding nuts or nut oils to your salads, having nut butter with a piece of fruit, or replacing chips with your favorite nuts to increase your intake of nutrients. There are lots of nuts to choose from, and each type of nut has varied health benefits. It’s best to weigh the pros and cons of different kinds of nuts and eat those that suit your health needs best! t w References 1. “Fruit and Tree Nuts.” (2012). 2. “Nut Consumption Among U.S. Adults, 2009-2010.” (2014). 3.. “Health Benefits of Nut Consumption.” Nutrients. (2010). 4. “Nuts and Your Health: What to Know.” (2014). 5. “Dietary Fats: Know Which Types to Choose.” (2016). 6. “Nuts and health outcomes: new epidemiologic evidence.” Am J Clin Nutr. (2009). 7. “Nuts: source of energy and macronutrients.” Br J Nutr. (2006). 8. “Nuts and your heart: Eating nuts for heart health.” (2014). 9. “Health benefits of almonds beyond cholesterol reduction.” J Agric Food Chem. (2012). 10. “Walnuts.” American Cancer Association. (2013). 11. “Effects of Walnuts on Learning and Memory Functions.” Plant Foods Hum Nutr. (2011). 12. “Walnuts Decrease Risk of Cardiovascular Disease: A Summary of Efficacy and Biological Mechanisms.” J Nutr. (2014). 13. “The Scientific Evidence for a Beneficial Health Relationship Between Walnuts and Coronary Heart Disease.” J Nutr. (2002). 14. “Impact of peanuts and tree nuts on body weight and healthy weight loss in adults.” J Nutr. (2008). 15. “Folic Acid.” (2016). 16. “Selenium and Prostate Cancer Prevention: Insights from the Selenium and Vitamin E Cancer Prevention Trial.” Nutrients. (2013). 17. “Bioactivity of selenium from Brazil nut for cancer prevention and selenoenzyme maintenance.” Nutr Cancer. (1994). 18. “Pistachio nuts: composition and potential health benefits.” Nutr Rev. (2012). 19. “Cashew.” (2016). 20. “Macadamia Nut Consumption Modulates Favourably Risk Factors for Coronary Artery Disease in Hypercholesterolemic Subjects.” Lipids. (2007). 21. “A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women.” J Nutr. (2008). 22. “Chocolate Nut Bark.” (2010).


for the love of chocolate by sydnie bui |design by kandice tsoi

total wellness ▪ summer 2016

Whether enjoyed in batches during the holidays or as an occasional indulgence, chocolate is an American favorite. The average American consumes 9.5 pounds of chocolate per year. But that’s nothing compared to the average Swiss, who consumes around 20 pounds of chocolate per year!1 In this article, you’ll learn all about chocolate—how it is made, how it affects our health, and why we love it so much.


what is chocolate?

the process: from pods to the supermarket

The word “chocolate” comes from xocolatl, the Nahuatl word for “bitter water.” Xocolatl was a spiced drink that was consumed by the Mayans and the Aztecs.2 The basic ingredients of today’s chocolates are cocoa (or chocolate) liquor, additional cocoa butter, and a sweetener such as sugar. Cocoa liquor is pure cocoa in liquid form. It contains both cocoa powder and cocoa butter. Other ingredients can be added to chocolate, including flavorants, preservatives, and milk solids.2 Milk solids are the components of milk after the water has been removed. These include proteins, minerals, vitamins, and sugars.

How are plain cacao beans transformed into tantalizing, beautifully wrapped bars of chocolate? The process includes more than simply harvesting, grinding, and mixing ingredients. Here’s a step-by-step guide to chocolate-making:

total wellness ▪ summer 2016

The two words sound similar, but they are not the same! You can think of cacao as nature’s raw chocolate chip. Cacao comes from the cacao tree, which is grown in tropical, humid climates. It is made from beans found in cacao pods, each pod containing about 30 to 45 beans. The beans are usually hand-harvested to avoid damaging them.2 Cacao butter is white and buttery and is the raw fatty part from the cacao fruit. Cocoa, along with its related products like powder and butter, is the heated form of cacao. You can buy it as Dutch-processed or regular. Dutch-processed cocoa powder is processed using an alkaline solution, making it taste richer and less acidic. Regular cocoa powder is more acidic.3 Cocoa butter is composed primarily of three major fatty acids: palmitic acid, stearic acid, and oleic acid. The amount of each fatty acid can be adjusted to change the melting temperature of chocolate. Ideally, chocolate should melt only in your mouth.2 Although cacao and cocoa are technically different, chocolatiers and chocolate-lovers use the terms interchangeably.


2. Ferment: Microorganisms like yeast and bacteria and heat generated from fermentation help break down the cell walls of the beans and chemical reactions occur to enhance the flavor 3. Dry and ship: Beans are dried in the sun to preserve flavor and shipped to chocolate manufacturers 4. Clean and winnow: Dirt and other debris are removed by air flow, the shells are removed, and the beans are saved 5. Roast: The beans are heated to develop flavor 6. Grind: The cracked beans are called nibs, which are further ground into a liquid (cocoa liquor) 7. Mix: Chocolate liquor, additional cocoa butter, sugar, and other ingredients such as milk and flavorants (vanilla, spices) are combined 8. Conche: Ingredients are slowly mixed and ground under heat for several hours to develop flavor and smooth out the texture, using a machine called a conche 9. Temper: The chocolate is melted and cooled so that once it solidifies, it is shiny and easily snaps—this is the step that you may have seen at chocolate shops where the liquid chocolate is poured over a flat surface and smoothed 10. Cast: The chocolate is molded into desired forms2,4

cover: jackmac34/pixabay left: dio5050/istock; right: istockphoto back: istockphoto

cacao vs. cocoa

1. Harvest: The cacao beans are removed from the pods

a sweet comparison

milk chocolate The most popular type of chocolate in the U.S. is milk chocolate.5 According to the FDA, milk chocolate contains no less than a 10% concentration of cocoa liquor. It also contains sugar and no less than 12% milk solids by weight.6

dark chocolate The FDA has no official definition of dark chocolate. Typically, dark chocolate contains a cocoa percentage of as low as 40% to as high as 100% along with sugar and cocoa butter. It may contain little or no milk solids.4

white chocolate White chocolate is a mixture of cocoa butter, milk solids, and sugar.6 Because it doesn’t contain cocoa powder, some people might not even consider white chocolate to be real chocolate.

the pros and cons of chocolate pros: antioxidants According to a 2008 review of 28 chocolate studies published in the British Journal of Nutrition, chocolate may have some health benefits as a result of its antioxidants. The antioxidants in chocolate, known as flavanols, come from the cocoa liquor. However, milk chocolate contains less cocoa liquor than dark chocolate, and white chocolate contains no cocoa liquor. In addition, heat processing and fermentation are known to destroy some of the antioxidant content in the cacao bean. In fact, from harvesting to the final product, antioxidant content goes from approximately 7% to 1%.7 In vitro studies have implicated that the antioxidants in chocolate may work in inhibiting inflammatory pathways, though scientists have studied only the short-term effects.5

cons: sugar Chocolate often contains added fat and sugar. The fatty acids in chocolate, such as stearic, palmitic, and oleic acids, do not appear to raise blood cholesterol levels.5 However, chocolate, especially milk and white, may have high levels of sugar, which can negatively impact dental health if eaten in large amounts.5 The sugar is a food source for bacteria, which eat the sugar and produce acids as a byproduct. The acids eat away at tooth enamel. High sugar consumption can also increase the risk of type II diabetes.5

Cacao and cocoa by themselves have lower fat and sugar content, so these less processed products could be healthier alternatives to chocolate.5 Despite the promising evidence of chocolate’s benefits, a majority of studies on chocolate have been either fully or partially funded by industries, or at least the subjects were supplied with chocolate by industries. Other limitations include small sample sizes (ranging from 4 to 49 participants) and varying controls (including white chocolate and water, which makes it difficult to compare and ascertain the target compound at work).5


total wellness â–Ş summer 2016

on the other hand

why do we crave chocolate? Some studies have attempted to find psychoactive ingredients that may contribute to chocolate cravings. A few candidate ingredients include the stimulants caffeine and phenylethylamine. However, the concentrations of these psychoactives are too low to have a significant effect—the concentrations are actually higher in noncraved foods than in chocolate. Additionally, most people prefer milk chocolate; if psychoactive compounds were the culprits, then dark chocolate or cocoa powder would be preferred, because they have more caffeine and phenylethylamine.

does drinking milk reduce antioxidant absorption? Does drinking milk actually interfere with the absorption of antioxidants? According to a 2003 study in Nature, when 12 healthy participants were given a cocoa beverage prepared with whole milk or water, milk did not seem to interfere with the absorption of antioxidants or its activity.8 Other similar studies found supporting evidence for this claim.9-10

does chocolate exacerbate my acne?

total wellness ▪ summer 2016

Perhaps you’ve heard that eating chocolate makes acne worse. According to a 2015 study published in The International Society of Dermatology, acne-prone males who consumed 25 g of 99% dark chocolate daily for 4 weeks experienced more acne afterwards. Because previous studies had found a link between milk and acne, researchers chose to minimize the amount of milk in their chocolate by using 99% dark chocolate. Although the acne-causing mechanisms of chocolate were not pinpointed, the researchers proposed that cocoa butter, which is present in chocolate, might be the culprit. In animal models, the oleic acid in cocoa butter caused blocked hair follicles. Please note, however, that the human study did not have a control group.11 A placebo-controlled study published in the Journal of Clinical and Aesthetic Dermatology in 2014 found comparable results: acne-prone males who consumed capsules of 100% cocoa for 7 days developed more acne than those who had the placebo or combination pills.12 Other studies analyzed in a 2009 review in the International Journal of Dermatology that examined the effects of chocolate on acne were inconclusive.13 References 1. “The World’s Biggest Chocolate Consumers.” (2015). 2. “MIT Laboratory for Chocolate Science.” (n.d.). 3. “Cacao vs. Cocoa: What You Need to Know.” (2014). 4. “Clinical Benefit and Preservation of Flavanols in Dark Chocolate Manufacturing.” Nutr Rev. (2008). 5. “Cocoa and Health: A Decade of Research.” Br J Nutr. (2008). 6. “Title 21; Part 163: Cacao Products.” (2015). 7. “Chocolate, Lifestyle, and Health.” Crit Rev Food Sci Nutr. (2009). 8. “Nutrition: Milk and Adsorption of Dietary Flavanols.” Nature. (2003). 9. “Milk Does Not Affect the Bioavailability of Cocoa Powder Flavonoid in Healthy Human.” Ann Nutr Metab. (2007). 10. “The Effect of Milk Protein on the Bioavailability of Cocoa Polyphenols.” J Food Sci. (2007). 11. “Dark Chocolate Exacerbates Acne.” Int J Dermatol. (2015). 12. “Double-blind, Placebo-controlled Study Assessing the Effect of Chocolate Consumption in Subjects with a History of Acne Vulgaris.” J Clin Aesthet Dermatol. (2014). 13. “Diet and Acne: A Review of the Evidence.” Int J Dermatol. (2009). 14. “Mood State Effects of Chocolate.” J Affect Disord. (2006).


Another explanation involves our daily calorie intake. If we simply crave chocolate because we haven’t consumed enough calories in a day, then we should like milk and white chocolate equally, but we don’t. There’s also a difference between chocolate craving and carbohydrate craving. A release of the neurotransmitter dopamine followed by a pleasurable hedonic sensory experience drives our chocolate cravings. In contrast, carbohydrate cravings, which characterize emotional eating, are driven by the mood-enhancing, comforting effects of opioids (like endorphins produced by the body). When craving carbohydrates, typically any sweet food, including chocolate, will help to alleviate negative mood states temporarily. So why do we crave chocolate? The sweetness and smooth texture of chocolate contribute to its palatability and hedonic appeal. Furthermore, it has a distinctive aroma and flavor. Therefore, it seems that we crave chocolate because it gives us a unique sensory experience.14

bottom line Milk, white, or dark—this luxurious, sweet treat is irresistible, but there are still health effects to keep in mind. Chocolate that is higher in cocoa liquor, namely dark chocolate, has more flavanol antioxidants and so may have greater benefits. But in general, heat destroys most of the antioxidants that were present in the cacao prior to processing. Furthermore, added sugar and fat limit chocolate’s health-food claim credibility. Scientists have found it difficult to isolate the compounds and mechanisms responsible for the supposed benefits of chocolate. Raw cacao or even cocoa may be healthier alternatives, but these items aren’t as popular. In the meantime, it’s alright to indulge in a piece of chocolate here and there because when you’re craving chocolate, only chocolate will suffice. t w

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myths about chocolate





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total wellness

a ucla student wellness commission publication

fall 2016 recruitment! Love what we do? Join us! We will be recruiting new members for our writing, design, marketing, and finance teams in the fall. Follow us on social media to stay tuned! total wellness â&#x2013;Ş summer 2016


Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Office of Residential Life

super fruits for a super you!

credits We would like to acknowledge the following people for their contributions to this edition. We would also like to make special mention of the following UCLA physicians, professors, and faculty members who donated their time and expertise to ensuring the accuracy of content published in the following articles:

Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Office of Residential Life

it’s kale! it’s it’s red wine vinegar!

Dolores Hernandez, MA, RD, Nutrition Education Coordinator, UCLA Dining Services

your ultimate yogurt guide

Alicia Yang, RDN, Registered Dietitian Nutritionist, UCLA Center for Human

food addiction: when the craving consumes you

Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Office of Residential Life

going nuts!

Alicia Yang, RDN, Registered Dietitian Nutritionist, UCLA Center for Human Nutrition

for the love of chocolate

Eve Lahijani, MS, RD, Nutrition Health Educator, UCLA Office of Residential Life

copy-edits and review


Payam Mirfendereski, Omid Mirfendereski, Christopher Phan, Nancy Vu

hung up on alcohol

layout revisions

Rena Orenstein, MPH, Director of Student Health Education/Promotion, UCLA Arthur Ashe Student Health & Wellness Center

total wellness ▪ summer 2016

coke vs. diet coke

Alison Jeng

cover & table of contents

Designed by Alison Jeng, Nancy Vu

coffee: its perks and reasons to be bitter Behnaz Esther Behmanesh, DO, Physician, UCLA Arthur Ashe Student Health & Wellness Center







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total wellness â&#x2013;ª summer 2016

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Food for Thought  

Summer 2016. Volume 16, Issue 3. Produced by UCLA's Student Wellness Commission.

Food for Thought  

Summer 2016. Volume 16, Issue 3. Produced by UCLA's Student Wellness Commission.