Is Butter Better?

by Carole Jackson, Bottom Line Health

For many years, butter was replaced by margarine on the menus of health-conscious consumers. But like many dietary taboos, that’s beginning to change. A little butter is better than the fake stuff, says Daily Health News contributing medical editor Andrew L. Rubman, ND. Butter is a natural food that supports good health, while margarine is a processed product chemically fashioned from refined polyunsaturated oils. Don’t take this as license to drench your vegetables in pools of butter or slather it on your toast with abandon — but unless you have health challenges such as a serious digestive or metabolic disorder, Dr. Rubman says to go ahead and use the real thing!

Butter with Benefits

Butter consists of butterfat and trace amounts of milk proteins and water. You may be surprised to hear that butterfat is butyric acid, which is basically the same substance that mothers produce to nourish their babies, Dr. Rubman explains.

Butter’s beneficial components include…

  • Antioxidants. Beta-carotene, selenium and other antioxidants shield the body from free-radical damage.
  • Butyric acid. This short-chain fatty acid supports colon health.
  • Conjugated linoleic acids. CLAs fight cancer, build muscle and boost immunity.
  • Iodine. Butter is rich in iodine, which is essential to thyroid health.
  • Lauric acid. A medium-chain fatty acid, lauric acid encourages the body’s immune system to fend off yeast and other infections.
  • Lecithin. This phospholipid protects cells from oxidation and may contribute to cholesterol metabolism.
  • Vitamin A. Butter contains the readily absorbable form of vitamin A, which is a must for eye and endocrine health.
  • Vitamin D. This vitamin helps your body absorb calcium to maintain strong bones and plays a role in reducing your risk for chronic diseases such as osteoporosis, heart disease, and colon and other cancers.
  • Vitamin E. Anti-inflammatory vitamin E speeds wound healing, promotes skin health, enhances immunity and may protect against a host of illnesses, including diabetes, heart disease and Alzheimer’s.
  • Vitamin K. Proper blood clotting and bone health are among the benefits offered by fat-soluble vitamin K.

But What About the Fat?

The biggest rap against butter is its high fat content. Butter bashers argue that saturated fat and cholesterol in butter contribute to heart disease, but Dr. Rubman disagrees — and the research bears him out. In a study published in the May 2010 The Lancet, scientists point out that countries with the highest saturated fat consumption have lower cardiac mortality rates than countries that consume the least fat. For example, the French enjoy three times more saturated fat than the Azerbaijanis but have one-eighth the rate of heart disease deaths. The Finns eat half as much fat as the French, but the death rate from heart disease is three times greater in Finland. In research from the UK, 2,000 men with heart disease who cut back on saturated fat for two years had no fewer heart attacks than men who did not cut back.

Saturated fat and cholesterol have been falsely demonized by manufacturers of cholesterol-lowering statin drugs, observes Dr. Rubman, noting that since butter is typically used in small amounts, this can be a good place to get the fat your body needs, not only for optimal health but for life itself. Every cell in your body contains saturated fat and cholesterol, which contribute to proper digestive function, growth and other essential processes. According to Dr. Rubman, for best health, most people should follow a diet that contains approximately 15% to 30% fat, including some saturated fats. How much saturated fat depends on factors such as caloric expenditure and digestive efficiency — the more calories you burn, the more saturated fat you can appropriately consume.

Go with Organic

You are best off with organic butter made from the milk of grass-fed cows, Dr. Rubman notes — since conventional butters often contain dangerous pesticides, antibiotics and added growth hormones. Indeed, the Pesticide Action Network North America ranked non-organic butter as one of the top 10 foods most contaminated with persistent organic pollutants (POPs), toxic chemicals linked with breast cancer, immune system suppression, nervous system disorders, reproductive damage, hormone disruption and more!

Besides containing toxins, non-organic butter also is less nutritious than organic butter… less creamy… and less tasty. Is there any reason to buy any butter that’s not organic? Well, organic butter is more expensive than conventional butter — but the difference in a household’s overall budget is truly small, especially now that national grocery chains, such as Whole Foods and Trader Joe’s, are offering their own organic store brands.

Butter is a staple of the human diet that people have safely and happily consumed for thousands of years, and Dr. Rubman says we should no more ban it from our lives than we should ban mother’s milk. It should be enjoyed in moderation, a pat here and a pat there — but enjoyed it can be… and that’s more than can be said of margarine or other butter substitutes.


Andrew L. Rubman, ND, founder and director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut. <> .


What Really Causes Dementia

by Carole Jackson, Bottom Line Health

What really causes dementia? What a relief it would be to know the answer, since practically everyone I know worries about whether the occasional “senior moment” or “brain fog” is a sign that something more serious is going on. With the incidence of dementia rising worldwide, scientists are studying this issue from every possible angle, trying to learn what illnesses, lifestyle habits and environmental factors are at play — but, to be honest, as yet no one knows for sure.

Making this particular challenge even more difficult (or rewarding, I suppose, depending on your perspective) is that dementia researchers seem to find new associations with every rock they turn over. Having a big head? Exposure to bright lights? Both may be protective. Living a sedentary lifestyle, smoking and having high cholesterol at midlife? Trouble lies ahead.

What We Do Know…

Let’s take a quick trip through some of the more recent research findings so that you can see what I mean:

Healthy habits that seem to protect against dementia…

Using your brain, living a full life. A study of 951 older, dementia-free patients found that those who reported having a purpose in life at the study’s start were half as likely to have Alzheimer’s disease seven years later… while numerous studies showed that engaging in mentally stimulating activities, such as doing crossword puzzles, playing cards and attending movies and plays, holds back development of dementia.

Good nutrition — including taking tea. A four-year study of 2,258 dementia-free New Yorkers found 40% lower risk for Alzheimer’s among those who followed the Mediterranean diet (lots of fruit, vegetables, fish, olive oil, legumes and cereals and moderate alcohol intake) than for those whose diets weren’t as healthy. Studies have also found that drinking tea regularly is protective — for instance, one 14-year study found that tea drinkers were 37% less likely to develop dementia than those who don’t drink tea.

Exercise. A vast body of research finds regular exercise is protective. For instance, one study found that those who engage in active exercise, such as doing yard work or biking, had a 29% lower risk for dementia than people who got little or no exercise.

Meanwhile, signs that point to increased risk for other health problems are also associated with a higher risk for dementia…

Vitamin D deficiency. An international group that assessed cognitive decline of 858 seniors over six years found that people deficient in vitamin D were more than 60% more likely to have experienced significant cognitive decline and 31% more likely to have problems with executive function (which includes thinking, learning and memory) than those with healthy levels of vitamin D.

Cardiovascular risk factors. One large study that followed almost 10,000 people over age 40 found that even marginally high cholesterol (200 mg/dL to 239 mg/dL) at middle age increased risk for late-life dementia by about 50%, while other studies have correlated high blood pressure with dementia.

First- and secondhand smoking. Beyond the countless studies linking smoking and cognitive impairment, a six-year study of almost 5,000 nonsmoking adults by researchers from the Universities of Cambridge and Michigan found that those who reported long-term exposure (30 years or more) to secondhand tobacco smoke were about 30% more likely to develop dementia than those who reported no regular exposure.

And if you already have certain diseases, odds are higher that you’ll get dementia, too…

Diabetes. Substantial research has found diabetes is a risk factor for dementia. For example, a new study by London’s Institute of Psychiatry found that participants with diabetes were nearly three times as likely as nondiabetics to develop dementia.

Depression. Several studies find depression increases dementia risk. Of nearly 1,000 elderly participants from the 62-year Framingham Heart Study, those who were depressed when first examined had almost double the risk for dementia 17 years later.

Is There a Theme Here?

I called Peter Rabins, MD, MPH, Richman Family Professor for Alzheimer’s and Related Diseases at the Johns Hopkins University School of Medicine, to ask his opinion. He told me that it makes sense, in practical terms, to summarize risk factors for dementia as being pretty much inclusive of everything that we already know is bad for your heart. But when it comes to prevention, he added — frustratingly — the massive amount of research has so far produced “no strong evidence that we can ‘prevent’ dementia by doing anything in particular.”

A major problem is that most of the studies have some basic limitation or flaw in research design, Dr. Rabins told me. For instance, most of the existing research compares people who develop dementia with those who don’t… but new research indicates that dementia may be present decades before symptoms are noticeable enough to make a diagnosis, so it may be that some of those patients weren’t actually dementia-free. Another flaw: Healthier people tend to take better care of themselves, so it’s hard to tease out which factors or habits are responsible for cognitive health.

In the Meantime…

What scientific advice can we offer, based on what we know at this point? I asked Dr. Rabins this question. He pointed out that when it comes to preventing dementia, the odds clearly favor those who live a healthy lifestyle. For instance, since 10% to 20% of dementia in the US is known to have vascular causes, we can infer that eating a healthy diet, exercising and managing stress are beneficial. The fact that only 30% to 60% of dementia risk is thought to be genetic means that there is plenty of reason to do all you can to reduce environmental risk — another argument for health-promoting habits and choices.

The search for the cause or cure will certainly continue, but reviewing what we already do know says quite a lot. Living well and with joy seems to boost the odds that you will remain cognitively intact, whereas all those things that are bad for you… are bad for you.

Peter V. Rabins, MD, MPH, Richman Family Professor for Alzheimer’s and Related Diseases, vice-chair for academic affairs, department of psychiatry and behavioral sciences, Johns Hopkins University School of Medicine, Baltimore, and coauthor of The 36 Hour Day (The Johns Hopkins University Press).

Healthy Maple Syrup

by Carole Jackson, Bottom Line Health

Here’s a sappy story about a sweet breakfast treat that you don’t have to feel guilty about enjoying (unless you have diabetes) — maple syrup, which I love to drizzle onto my morning oatmeal. With a few nuts and some raisins or dried cranberries sprinkled on top, it’s my go-to breakfast for weekday mornings in cool weather. I called nutritionist Jane Kirby, RD, CD, CCP, author of Eat Great, Lose Weight and founder of Vermont Grain Mills in Charlotte, Vermont, for both the details on the health benefits of maple syrup and to get some ideas on different ways to enjoy it.

Unlike the many processed products that try to imitate it, real maple syrup contains significant amounts of both zinc (1.6 mg per ounce), an immune supporter and helpful to male reproductive health, and manganese (1.2 mg per ounce), which is good for bone health.

Also, Kirby points out that maple syrup is a healthier sweetener than table sugar for a variety of reasons…

  • The sugars in maple syrup are absorbed more slowly by the body than refined sugar.
  • There is no chemical processing involved, so it’s completely natural.
  • Maple syrup has some nutrients, while sugar has none.

buy the real thing

Most of what you’ll find in the “syrup” section of your supermarket contains exactly 0% real maple syrup. Therefore you have to check the package carefully to find “pure maple syrup,” which is USDA-graded according to color and intensity of flavor. Here’s how real maple syrups differ from each other…

  • Grade A Light Amber or Vermont Fancy usually is made early in the season and has a mild, delicate flavor. It’s often used for maple candies.
  • Grade A Medium Amber is darker and has a more robust maple flavor. It’s typically used for pancakes and waffles.
  • Grade A Dark Amber, darker still, has strong maple and caramel-like flavors. It can be used for pancakes if you like a more intense flavor, as well as for cooking.
  • Grade B is very dark and has the strongest flavor, mostly maple but also with hints of caramel. It’s the best choice for cooking.

The differences among these grades relate to variances in weather, growing conditions and time of harvest, but all grades are nutritionally equal.

Now You’re Cooking! (With Maple Syrup)

Kirby told me that she often substitutes maple syrup for sugar in recipes — she recommends a one-to-one replacement, using Grade B (or cooking grade) syrup because it works best. Note: Decrease the amount of other liquid in your recipes by three tablespoons per cup since the syrup adds liquid.

She shared some of her favorite easy ways to use maple syrup in the kitchen…

  • Fizzy maple. Drizzle maple syrup in a glass of carbonated water, with a lime wedge squeezed and dropped in.
  • Maple carrots. Shred carrots in a food processor, pile on a plate, drizzle with a bit of olive oil and maple syrup, sprinkle with salt, pepper and grated fresh ginger. Microwave, covered, two to three minutes until carrots begin to soften.
  • Maple glaze. Grade B (cooking-grade) maple syrup is thick, like molasses, and serves as a delicious glaze to be slathered on before roasting a chicken or ham.

And let’s not forget about the classic — maple syrup on pancakes! Kirby suggests warming Grade A Light or Dark Amber syrup slightly before pouring it onto a fresh, hot stack. This, by the way, is what we enjoy at my house on the more leisurely weekend mornings — with a swallow of fresh-squeezed orange juice to counter the sweetness, I can’t think of a better way to start the day!

Jane Kirby, RD, CD, CCP, author of Eat Great, Lose Weight: Tried and True Recipes from Real Weight-Loss Winners (Rodale) and founder of Vermont Grain Mills in Charlotte, Vermont.

Secretly Salty Foods

by Carole Jackson, Bottom Line Health

If you live in the US, the odds are nine to one that you ingest too much sodium, according to new research from the Centers for Disease Control and Prevention (CDC). That doesn’t mean just a bit too much — for many, the excessive salt intake is enough to kick off high blood pressure, heart disease, stroke and/or kidney disease. In fact, dialing sodium intake back to the right amount could save 120,000 Americans from heart disease and 66,000 from strokes each year, researchers said.

However, the story behind the story is that consuming this “right” amount of salt will never be possible for people who don’t know exactly where all their dietary sodium lurks — and the hiding places are likely to surprise you.

According to the CDC report, the food group where most Americans are getting the highest amount of sodium is grains! This includes bread (even the healthy whole-grain kind), pasta and pizza crust (the tomato sauce and cheese add yet more sodium). Second-highest is meats — not only the lunch meat and sausage you’d expect, the report also specifically cited prepared chicken dinners and other prepared and packaged meats. And third is “processed vegetables” including vegetable-based soups and sauces and canned vegetables, not to mention the unsurprising potato products such as chips and fries.

Early Morning Peril?

According to Mark Houston, MD, head of the Hypertension Institute in Nashville and associate clinical professor of Medicine at Vanderbilt University School of Medicine, the sodium-loaded surprises don’t stop there. Dr. Houston said that he was taken aback to see that the report barely mentioned other foods that contain sodium in plentiful amounts, including the all-American classic (and seemingly healthful) breakfast of milk (107 mg in one cup of low-fat milk) and cereal (200 mg in one cup of cornflakes). Most people don’t realize these contain any sodium at all!

We can’t just take a pass on sodium. We need it to help our nerves function properly, to aid nutrient absorption and for maintaining the right balance of water and minerals in our bodies. But, said Dr. Houston, most healthy adults require only 500 mg to 1,000 mg of sodium/day, and no one should ingest more than 2,300 mg. Some people should go lower still, setting 1,500 mg/day as the upper limit. This includes…

People with high blood pressure, diabetes or kidney disease.

African-Americans, who are genetically predisposed to high blood pressure.

People over age 50, who also are considered at higher risk for hypertension.

People who are “salt sensitive,” which describes about one-third of the adult population. Such individuals are extraordinarily reactive and will experience a rise in blood pressure after eating just a small amount of sodium.


Since you can’t rely on your taste buds to identify foods and beverages high in sodium, Dr. Houston made the following recommendations:

Read every label. You may be surprised to learn that one slice of whole-wheat bread typically contains about 100 mg of sodium and one ounce of cheddar cheese contains 180 mg. There are 390 mg of sodium in a half-cup serving of canned sweet peas, 709 mg in two ounces of turkey breast lunch meat and 780 mg in one cup of canned vegetable beef soup. Other surprisingly high sources of sodium: Four large black olives contain 150 mg of sodium… a one-ounce dill pickle has 260 mg… and two teaspoons of yellow mustard contain 115 mg.

Be mindful when adding salt. You may not realize that one-half teaspoon of salt (about what’s used in a pan of homemade lasagna or a batch of chocolate chip cookies) contains about 1,160 mg of sodium. A quick dash of salt (such as what you’d sprinkle on grilled fish or corn on the cob) contains 290 mg of sodium. Be aware that for the average American, about 70% of daily sodium intake is in prepared, packaged or processed foods, and the remaining 30% comes from the saltshaker.

Perk up your food without sodium. If you eat foods that are inherently more flavorful, you’ll be less likely to want to add salt. Try making salads with arugula, for example — it has a more intense flavor than more commonly used lettuces such as romaine or iceberg. Another idea: Add cilantro or ginger (both of which also have nutritional value) to salads and other dishes. Fresh lemon juice, peppermint, basil and vinegar are other zesty sources of flavor that add taste but contain virtually no sodium.

Eat lots of fresh fruits and vegetables — meat and poultry, too. These are naturally very low in sodium.

Dr. Houston has one more piece of advice for those of us trying to reduce salt intake — go slow. He suggests cutting back gradually, by about 150 mg/day to 250 mg/day to reach your goal of 2,000 mg/day unless you are in a high-risk group, in which case it should be 1,500 mg/day. Not only will this help you feel less deprived, you’ll also learn to appreciate the true flavors of foods that had been masked by salt and other unhealthful condiments. Such an approach also helps your body adjust to and properly balance sodium concentrations. This is good advice that should not be taken with a grain of salt!


Mark Houston, MD, is the director of the Hypertension Institute in Nashville and an associate clinical professor of medicine at Vanderbilt University School of Medicine. He is the author of What Your Doctor May Not Tell You About Hypertension (Grand Central).