The best beverage in the world, bar none, is water.

You can’t live very long without it, and it’s necessary for almost every metabolic process. But that doesn’t mean there aren’t other beverages that are amazing for your health. There are. And nine of them (ten if you include water) are portrayed in depth in this section of this book.

Given that beverages don’t grow on trees or come out of the ground, every beverage, by definition, is made from something else (like a plant or a fruit). If I may be frank, one of the difficulties in picking foods and beverages for this book had to do with the following dilemma: When does the source of a beverage (for example, apples) get its own entry, when does the juice made from the source (e.g., apple juice) get its own entry, and when do both get their own entries. (Similar dilemmas existed for oils—e.g., olives vs. olive oil—and nuts—e.g., peanuts vs. peanut butter.) Here’s how I tried to solve the problem.

Then there were the exotic berries—noni, acai, and goji. Here the results were inconsistent. Noni berries are impossible to find outside Brazil and taste terrible—but the juice is a nutritional powerhouse. Solution? Noni juice is on the list; the berries are not. Similarly with acai berries. Goji berries, on the other hand, are easy to find in health food stores and are loaded with nutrients. The juice is perfectly good as well, but way overhyped (and overpriced); hence goji berries yes, goji juice, regrettably, no.

So there you have it—the beverage “system.” It’s imperfect, and certainly inelegant, but it’s the one I came up with and seemed the best solution to a difficult problem.

Drink up and enjoy!

Acai Berry Juice

Acai berries grow on an Amazon palm tree and have been prized by Brazilian natives for hundreds of years for their ability to provide a sense of strength and energy and a high nutritional content. The juice tastes like an interesting blend of berries and chocolate.

The acai berry got the best public relations boost any food could possibly hope for when Nicholas Perricone, M.D., picked it as one of his ten top antiaging superfoods and it was subsequently featured on Oprah, giving this little Brazilian native instant celebrity. Does it deserve the hype? The answer is a qualified maybe. I’d never call the acai berry one of the ten top antiaging foods on the planet. But put the acai berry into a search engine and you’ll find no shortage of ringing endorsements and glowing testimonials about its powerful health benefits. Unfortunately, most of these come from companies that are marketing acai berry juice. That doesn’t mean there isn’t great stuff in this berry—there is. But it does mean that you should take the hype with a lot more than a grain or two of salt.

When this book was originally published, there were no human trials on acai, although the test tube research was definitely promising. One study in the Journal of Agricultural and Food Chemistry showed that extracts from acai berries triggered a self-destruct response in up to 86 percent of leukemia cells in a test tube. But the absence of studies showing that the acai antioxidants were actually absorbed in humans was a problem.

That’s no longer the case. Just a year after the original publication of this book, Susanne Talcott and Stephen Talcott, co-researchers at Texas A&M University’s nutrition and food science department, published work showing that the healthful compounds in acai juice and pulp are indeed absorbed by the human body.

“Acai is naturally low in sugar, and the flavor is described as a mixture of red wine and chocolate,” Susanne Talcott told Science Daily, adding “what more would you want from a fruit?”

Aloe Vera Juice

Aloe vera has been recognized for centuries for its remarkable health-enhancing and medicinal properties. It’s used in traditional Indian medicine for constipation, colic, skin diseases, worm infestation, and infections; in Chinese medicine for fungal overgrowth; in Trinidad and Tobago for hypertension; and among Mexican Americans for type 2 diabetes. That doesn’t mean that it’s effective in every one of those situations. But, to my mind, when a substance is believed to have medicinal properties by multiple cultures who have used it for thousands of years, there’s probably something to it.

Although known specifically for external application to the skin, aloe juice is also widely used to help a variety of conditions of the digestive tract. And research shows aloe vera to be beneficial for skin conditions, management of burn and wound healing, constipation, diabetes, and gastrointestinal disorders. Aloe is thought to have originated in the Sudan and the Arabian Peninsula. Today, it’s cultivated and found in the wild in Africa, the Near East, Asia, and the southern Mediterranean. It’s also cultivated in subtropical regions of the United States and Mexico, in the coastal regions of Venezuela, and on the Dutch Antilles.

There are more than 240 species of aloe, and they grow throughout the world. A member of the lily family of plants, aloe has a decided cactuslike appearance. Of the 240 or so species, only four are recognized as having significant nutritional value, with Aloe barbadensis miller being the leader. It is used the most in commercial products today that contain aloe. The aloe leaf contains at least seventy-five nutrients and more than 200 active compounds, including twenty minerals, twenty of the twenty-two necessary amino acids, and twelve vitamins.

Another compound in aloe, aloeride, contains the essential sugars glucose, galactose, and mannose, as well as another sugar called arabinose.

The gel has the active medicinal sugars and other nutrients listed above. Most of the research on aloe vera has been done on the gel, but there’s good reason to suspect that the juice—if it is unrefined or unfiltered—contains a lot of good properties as well. After all, the medicinal part of the plant is the dried juice of the leaves.

Aloe decreases surgical recovery time, according to a report in the Journal of Dermatologic Surgery and Oncology. Eighteen acne patients underwent facial dermabrasion surgery, in which lesions are scraped away. Dressings were applied to their faces, with half of each person’s face receiving the standard dressing coated with surgical gel, and the other half with aloe added to this dressing. The half of the face treated with aloe healed approximately seventy-two hours faster than the other side. Dermatologist James Fulton, M.D., of Newport Beach, California, principal author of the report, uses topical aloe in his practice to speed wound healing. “Any wound we treat, whether it’s suturing a cut or removing a skin cancer, heals better with aloe vera on it,” he states.

Researchers concluded that aloe was able to rebalance the intestines by “regulating gastrointestinal pH while improving gastrointestinal motility, increasing stool specific gravity, and reducing populations of certain fecal microorganisms, including yeast.” Other studies have shown that aloe vera juice helps detoxify the bowel, neutralize stomach acidity, and relieve constipation and gastric ulcers.

According to juice authority Steve Meyerowitz, aloe vera juice contains a wealth of vitamins, minerals, and nutrients including B₁, B₂, B₃, B₆, C, choline, calcium, copper, manganese, potassium, silicon, and others. But, also according to Meyerowitz, the real uniqueness of the juice lies in its wealth of phytochemicals such as the organic acids chrysophanic, salicylic, succinic, and uric; polysaccharides such as acemannen; enzymes such as glutathione peroxidase; and various resins.

Here are four steps that should help you when you shop for a good-quality aloe vera juice:

Avoid products that put aloe vera through unnecessary and damaging processes such as heating, boiling, freeze-drying, etc.

Look for the International Aloe Science Council seal of approval. Check its website at www.iasc.org to make sure the product is not carrying the seal fraudulently—sad to say, many companies do just that. Make sure the label says the product is a juice or a gel—together with the seal this tells you the product is 95 percent or more aloe vera.

Check the ingredients to make sure aloe vera is the first ingredient, not water or a sugary filler.

Look at the color. It should be similar to fresh-squeezed grapefruit juice.

Coffee

Coffee is one of the entries in the first edition of this book that I decided to re-evaluate this edition. It wasn’t so much the substantial amount of research that’s been done on coffee in the last ten years, though that was certainly a part of it. It was because coffee is such a good example of how small, incremental changes in our knowledge can slowly increase and deepen our understanding and change the conventional wisdom on a given food.

Back in 2007, coffee was still lumped with alcohol, sugar, and saturated fat as one of the things in our diet we would all be better off without. To this day, you still hear people talking about “detoxing” from caffeine and alcohol. And back in 2007, there weren’t many of us defending America’s most popular drug. New Scientist magazine reported that 90 percent of North Americans consume caffeine on a daily basis, making coffee officially the most widely used legal, psychoactive substance in the world.

So here’s how I started the entry on coffee for the original edition of The 150 Healthiest Foods on Earth :

If you’re surprised to find coffee on the list of the world’s healthiest foods, you’re not alone. To tell you the truth, so was I.

I went on to say that while I had always suspected that coffee wasn’t all that bad for you, I was happy to see that it was actually on the top ten lists of a few of my very forward-thinking experts. And that the research on coffee was promising.

I pointed out that there were things about coffee that I found troubling—like the well-known ability of caffeine to cause nervousness and jitters and interfere with sleep. There was even a study or two showing an association with higher blood pressure.

But that was then.

Now consider this, the opening paragraph of an article about coffee in the June 15, 2016, New York Times, almost ten years to the day from when I first submitted the original manuscript:

An influential panel of experts convened by the World Health Organization concluded on Wednesday that regularly drinking coffee could protect against at least two types of cancer, a decision that followed decades of research pointing to the beverage’s many health benefits.

Coffee is one of those iconic foods—like butter, or eggs—that nutritionists always seem to be changing their minds about. How often do you read articles that bemoan the fickleness of my profession with statements like, “First they said coffee (or eggs, or butter) was good, then they said it was bad, then they said it was good again—why can’t they make up their minds?”

Why indeed. Let’s take a look at what’s happened with coffee over the past decade or so.

“I’m detoxing from caffeine, alcohol, and sugar… ”

Although many people lump caffeine in with all the bad stuff they have to detox from, the emerging and extensive research on coffee suggests that our favorite morning drink may have gotten a bad rap. One study shows that those drinking six or more cups a day are significantly less likely to have diabetes. Studies show that folks who drink the most coffee have significantly lower risk of getting the disease, with risk reduction ranging from 23 percent to a whopping 67 percent.

A study—in the 2006 Journal of Cardiac Failure—showed that caffeine increases exercise tolerance in patients with heart failure. Other studies have shown it increases alertness and improves mental and physical performance in the short run. According to the Nurses’ Health Study, two or three cups a day may lower the incidence of Parkinson’s and decrease gallstone formation in men. A study in the Archives of Internal Medicine showed that coffee may protect against alcoholic liver disease—for every cup (235 ml) of java (up to four a day) the study charted about a 20 percent reduction in risk of alcoholic cirrhosis.

And if all that weren’t enough, there are studies showing that coffee drinkers have a lower risk for Alzheimer’s than non-coffee drinkers. Plus, of course, the aforementioned findings of the World Health Organization that regular coffee drinking protects against at least two types of cancer, a finding that echoed the World Cancer Research Fund International finding that coffee protects against multiple types of cancer.

When you use caffeine to mask your exhaustion, that’s not a good thing. Not everyone does that—at least not to the point where it would cause problems. A lot of studies show that coffee helps memory, mood, reaction time, and even athletic performance.

And for those who still remain skeptical, consider this: coffee helps you burn fat. At least two studies show that caffeine can boost your metabolic rate by between 3 to 11 percent, and other studies show that caffeine increases fat burning by up to 10 percent in obese folks and an even more impressive 29 percent in lean people. The caffeine actually makes your fat cells break down fat, releasing fatty acids into the bloodstream to be used for energy. Of course, if you’re just sitting around all day, those fatty acids won’t do you much good, but if you’re exercising, the availability of that fat for fuel is a good thing.

Meanwhile, a study published in 2006 consisting of a cohort of 41,836 postmenopausal women concluded that “consumption of coffee, a major source of dietary antioxidants, may inhibit inflammation and therefore reduce the risk of cardiovascular disease and other inflammatory diseases in postmenopausal women.” Of course, that study was on a specific subgroup of the population—postmenopausal women—and caution would dictate that we shouldn’t necessarily extrapolate the results to the general population. Still, taken as a whole, the evidence for the antioxidant capacity of coffee is compelling at the very least.

Two of the antioxidants responsible for coffee’s health benefits are chlorogenic acid and caffeic acid. Both are strong antioxidants, and coffee beans are one of the richest dietary sources of chlorogenic acid in the world. It’s been estimated that coffee drinkers might ingest as much as 1 g of chlorogenic acid and 500 mg of caffeic acid on a daily basis. For many people, coffee supplies as much as 70 percent of the total amount of their dietary intake of these important antioxidants.

So if you’re someone who can’t sleep soundly through the night because you’re too wired, you should probably cut back on coffee, or stop drinking it in the early afternoon. But if you’re someone who does just fine with caffeine, there’s no reason whatsoever to cut it out. Not only does it give you a nice little legal buzz of alertness, but it has multiple health benefits.

Cranberry Juice

Ann Louise Gittleman, Ph.D., C.N.S., is one of our best-known nutritionists and the author of more than a dozen books. In fact, she’s fondly known in America as “the first lady of nutrition.” Anyone who’s read her work knows that she’s a huge fan of unsweetened cranberry juice. Her famous Fat Flush plan relies on copious amounts of cran-water, which is a mix of the unsweetened juice diluted with fresh water in a 1:8 ratio. Fat Flushers drink this stuff all day long.

Gittleman’s top ten list of favorite foods appears shown here and, of course, it includes unsweetened cranberry juice. She has it on her list because cranberry juice is a rich source of phytonutrients such as anthocyanins, catechins, lutein, and quercetin. These powerful phytonutrients act as antioxidants and provide nutritional support for the detoxification pathways in the body.

Gittleman is certainly right about the rich phytonutrient content of both cranberries and cranberry juice. In one study, biochemist Yuegang Zuo, Ph.D., from the University of Massachusetts–Dartmouth, showed cranberry juice cocktail had the highest total phenol content of the twenty fruit juices tested. Phenolic compounds are natural antioxidants that help neutralize harmful free radicals in the body that are thought to be linked to most chronic diseases, including cancer, heart disease, and diabetes. The researchers state that “cranberry has the highest radical-scavenging capacity among these different fruits studied.” In a second study, Catherine Neto, Ph.D., assistant professor at the University of Massachusetts–Dartmouth, isolated several bioactive compounds from whole cranberries and found that the flavonoids showed strong antioxidant activity, and newly discovered compounds in the berries were toxic to a variety of cancer tumor cells. “The tumor cell lines that these compounds inhibited most in our assays included lung, cervical, prostate, breast, and leukemia,” according to Neto.

According to a study by Amy Howell, Ph.D., research scientist at the Marucci Center for Blueberry & Cranberry Research at Rutgers University, and Jess Reed, Ph.D., professor of nutrition at the University of Wisconsin–Madison, an 8-ounce (235 ml) serving of cranberry juice cocktail—but not the equivalent single servings of grape juice, apple juice, green tea, or chocolate—prevented E. coli (the bacteria responsible for the majority of UTIs) from adhering to bladder cells in the urine of six volunteers. (UTIs occur when bacteria in the urine bind to cells of the urinary tract wall.)

In addition, the researchers analyzed the chemical composition of the proanthocyanidins in these foods. According to Howell, “the cranberry’s proanthocyanidins are structurally different than the proanthocyanidins found in the other plant foods tested, which may explain why cranberry has unique bacterial antiadhesion activity and helps to maintain urinary tract health.”

Fresh Vegetable (and Fruit) Juice

Consider how many times you’ve felt frustrated by conflicting advice about food, health, weight loss, supplements, and exercise. One day margarine is good, the next day it’s terrible. One day eggs are bad, the next day they’re good (actually, they’ve always been good, but that’s another story). Medical and nutritional information seems to change as often as the celebrities on the cover of People magazine. So if there was one thing that virtually every expert agreed on, and continued to agree on year in and year out, decade in and decade out, that would be a big deal, right? And worth listening to, correct?

Well, there is. One thing everyone agrees on, that is. And it’s this: Eat more vegetables. And while you’re at it, eat some fruit. Sorry, but this is the biggest no-brainer in the history of nutrition, for all the dozens of reasons discussed in the of this book. Let’s review: Vegetables and fruits provide fiber. Antioxidants. Phytochemicals. They help control weight, diabetes, and blood sugar. They help fight or prevent cancer. They contain multiple compounds that act as anti-inflammatories. They’re associated with significantly lower rates of cardiovascular disease and stroke. They lower blood pressure. They contain compounds such as carotenoids that support the eyes and protect against macular degeneration. Other compounds in vegetables and fruits may help prevent brain aging, dementia, and Alzheimer’s.

There is compelling evidence that a diet rich in fruits and vegetables can lower the risk of heart disease and stroke. The largest and longest study to date, done as part of the Harvard-based Nurses’ Health Study and Health Professionals Follow-up Study, included almost 110,000 men and women whose health and dietary habits were followed for fourteen years. The higher the average daily intake of fruits and vegetables, the lower the chances of developing cardiovascular disease. Compared with those in the lowest category of fruit and vegetable intake (less than 1.5 servings a day), those who averaged eight or more servings a day were 30 percent less likely to have had a heart attack or stroke. Increasing fruit and vegetable intake by as little as one serving per day can have a real impact on heart disease risk. In the two Harvard studies, for every extra serving of fruits and vegetables that participants added to their diets, their risk of heart disease dropped by 4 percent.

It’s called juicing.

I juice almost every single day—or as often as I can manage it. I honestly believe it’s one of the best, most life-enriching health habits I’ve ever developed. And my decision to include freshly made juices on this list was largely influenced by how strongly I believe in the health benefits of juicing and how much I’d like to see as many people as possible adapt the same habit I’ve learned to love.

And it doesn’t take much work to learn to love it. Juices are absolutely delicious. The best thing about them is that you can disguise almost anything in a juice and still make it taste great. For example, I know a lot of people who just don’t like broccoli, but give me a juicer and a few ingredients, and I can mix broccoli’s cancer-fighting indoles into a sweet apple-flavored drink faster than you can say, “What’s in this thing, anyway?” Listen, if I can fool the teenager in our house into drinking it without grimacing, I can fool anyone.

So, you might be asking, what about sugar? I’ve warned about the high-sugar fruit juices that I consider to be a scourge on society so many times in the past—how can I be recommending juices made of fruit?

Well, it’s like this: Commercial fruit juices are largely flavored sugar water. Homemade, freshly squeezed juices are vitamin powerhouses. Yes, they contain some natural sugar, but you can also modify that by intelligent mixing of low-sugar vegetables (which should constitute the bulk of the ingredients) and some carefully chosen fruits for flavor and additional nutrients. And for all but the most sugar sensitive—or diabetics—the results should be fine.

One year, I gave my three best friends juicers for Christmas. They all asked me how to use them. I told them what I’m about to tell you: Use them any way you want! Have fun! Throw absolutely anything from the produce section into them in any combination!

Any of the following are terrific ingredients for a juice. Experiment and have fun!

JONNY’S FAVORITES (All make two to four servings, depending on how thirsty you are.)

• Green Giant: 6 ribs celery/1 pear/ginger

• Green Giant Deluxe: 2 cups spinach/4 ribs celery/2 stalks broccoli/2 apples/ginger

• Spinach Sweetness: 2 cups spinach/1 apple/2 to 3 carrots/ginger (variation: add 1 beet with greens)

• Mixed Sensations: 1/2 of a large red bell pepper/2 to 3 stalks broccoli/3 ribs celery/1 apple/1 pear/ginger

• Roots of Health: 3 parsnips/2 stalks broccoli/3 ribs celery/2 large carrots/1 pear/1 apple/ginger

• Red Juice Deluxe: 2 sticks rhubarb/1/2 of a red bell pepper/1 pear/1 apple/3 carrots/ginger

• Red Delight: 1 large beet with greens/1/2 of a large red bell pepper/1 apple/2 to 3 carrots/ginger

Noni Juice

Okay, let me be perfectly honest. I hate multilevel marketing, and I hate “magical” products that claim to cure everything from acne to cancer. The trifecta of my pet peeves is when the they combine, i.e., a multilevel marketing company selling a “magical” product that claims to cure everything. Even when the product isn’t bad—which does happen—the multilevel marketers send their salespeople out with such hype and hoopla, quoting “scientific” studies and making claims that are so outrageous and unfounded, that I get turned off before I even try the product.

So I was ready to dislike noni juice. And acai berries, and goji berries, and all the other berries that have been promoted in the last few years—some of them honestly and carefully, some of them outrageously.

But truth be told, marketing gimmicks and practices aside, many of these berries are amazing foods. Especially noni berries.

I ignore the “science” that the companies write about in their brochures because many of the “studies” that they boast about are questionable, biased, unpublished, or, worst-case scenario, made up. I go right to the National Institute of Medicine library, and look for what I can find on my own. And what I found about noni juice was pretty impressive.

You’ve seen me mention sulforaphane several times in this book. It’s a phytochemical that has significant anticancer properties, largely because it increases the production of certain enzymes known as phase-2 enzymes, which can “disarm” damaging free radicals and help fight cancer-causing carcinogens. But a study from the College of Pharmacy at the University of Illinois at Chicago found that a compound in noni fruit was forty times more potent than sulforaphane. If that turns out to be true, that would mean that authentic noni (and noni juice) could have an astonishing amount of cancer-fighting potential.

At least two studies have been published demonstrating that an extract from the Morinda citrifolia fruit (noni) has been found to have an antiproliferative effect on tumor cells. One report in the Annals of the New York Academy of Science, titled “Cancer-preventive effect of Morinda citrifolia (noni),” compared the antioxidant activity of noni juice to vitamin C, grape seed powder, and pycnogenol—all very powerful antioxidants. The researchers presented preliminary data showing that Tahitian noni juice mixed in drinking water for one week was able to prevent carcinogen-DNA adduct formation and suggested that the antioxidant activity of noni juice may contribute to its cancer-preventive effect.

As with many fruits, juices, and foods that have been used medicinally for centuries in a variety of cultures, the rigorous scientific study of noni is still emerging. It’s likely that the health claims may outpace the evidence for a while. Nonetheless, there’s enough solid science—not to mention a long history of folk tradition—to support the inclusion of noni juice on this list. Remember, the taste is off-putting—the best companies making it produce a pure juice that has to be diluted with water or taken in 1-ounce (30 ml) servings.

Pomegranate Juice

Only a decade or so ago, pomegranate juice was practically unknown in the US. But in a relatively short time, it’s been the subject of a ton of research, and the results have been so impressive that even mainstream medicine is paying attention. It’s listed on the Memorial Sloan Kettering Cancer Center website in the integrative medicine section, complete with research references showing that it suppresses inflammation, inhibits tumor growth and breast cancer cell proliferation, and benefits patients with everything from carotid artery stenosis to those with moderate erectile dysfunction.

I’m not kidding about that last benefit. Research published in the Journal of Urology actually examined the effect of long-term intake of pomegranate juice on erectile dysfunction. They established two things: One, that free radicals—rogue molecules that do terrific damage to just about everything in your body from your DNA on down—have a profound effect on erectile dysfunction in an animal model. And two, that pomegranate juice actually helps modulate this effect because it’s been found to contain powerful antioxidants that actually fight free radicals and the damage they do. Because of this, pomegranate juice is sometimes called a “natural Viagra.”

Controversy exists about whether pomegranate extract in pill form works as well as the juice. The bulk of the research has been on the juice itself, and some wonder if the same benefits apply to the extract in supplement form. No one really knows the answer to that, but it’s reasonable to assume that supplements of pomegranate extract are also very beneficial.

The excellent website GreenMedInfo assembled 158 scientific abstracts of studies related to pomegranate, including (but not limited to) studies that investigated the effect of pomegranate on oxidative stress, inflammation, atherosclerosis, prostate cancer, and hypertension. For the most part, the studies are uniformly positive. Pomegranate fruit extract contains polyphenols, which are plant chemicals that have the ability to help protect cells from damage and the ability to lower inflammation.

According to the University of Maryland Medical Center website, pomegranates have been used as medicine for thousands of years. In Asia and in the Middle East, they use the bark, root, fruit and rind of the pomegranate tree as medicine, but in the West, most of the research has been done on the fruit and its juice.

One review article “Potent Health Effects of Pomegranate,” published in 2014 in the Journal of Advanced Biomedical Research, concluded that pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammation. The researchers noted that the antioxidant potential of pomegranate juice is more than that of red wine and green tea. Pomegranate fruit extract prevents cell growth and induces apoptosis—a kind of programmed death for cells that are no longer needed or are a threat to the organism. It’s this ability which may be responsible for pomegranate’s anticancer effects.

Pomegranate also seems to protect LDL cholesterol from oxidative damage, which is critical because cholesterol is only a problem when it’s oxidized. In one animal study, pomegranate juice slowed the growth of plaque. In other research, it slowed the growth of prostate cancer cells in the lab. Preliminary evidence suggests that the juice may help lower blood pressure, improve cardiovascular risk factors, and enhance immunity. There’s even research suggesting that pomegranate’s ability to fight inflammation just might stall the progression of Alzheimer’s disease, and might have a preventive role in obesity.

How much should you drink? There’s no perfect answer to that question. The best advice is to just put pomegranate seeds and pomegranate juice in heavy rotation in your diet. Eat the fruit or drink the juice (or both). Israeli scientists showed blood pressure reduction from drinking as little as two ounces (60 ml) of pomegranate juice daily (Dornfeld, 2001), probably due to decreased activity of angiotensin converting enzyme (ACE). This is worth noting for people who might want a more natural alternative to ACE inhibitors, drugs commonly given for hypertension.

When the first edition of this book came out, pomegranate seeds were not particularly popular, although the juice was getting a fair amount of attention in the nutrition press. Now many supermarkets carry pomegranate seeds in little plastic packages, much like those that contain fresh blueberries or strawberries. They do the tedious work of removing the seeds from the pomegranate for you, so it’s now possible to buy the very tasty seeds ready to eat; no muss, no fuss. Just be aware that you’ll pay a premium for having the work done for you—a container of pomegranate seeds can be pricey.

Research on pomegranate tends to concentrate on the juice or an extract given in pill form. You don’t see too many research reports on pomegranate seeds themselves, though it seems reasonable to assume that many of the same benefits found in the juice would also be available from an equivalent amount of the seeds.

Red Wine

Plato may have been on to something when he said, “nothing more excellent or valuable than wine was ever granted by the gods to man.” Red wine has received a ton of press for its health-promoting abilities and has even been credited for something called the French Paradox. The truth—as always—is more complicated.

The French Paradox is the term used to describe the well-known fact that the French have less heart disease than Americans, despite the fact that they eat far more high-fat foods, such as cheese.

If you buy into the fact that fat alone is responsible for heart disease (I do not), this indeed looks like a paradox. But, as most nutritionists are now aware, the “fat causes heart disease” paradigm is woefully out of date. Nonetheless, for years it was believed that the reason the French could “get away” with such supposedly unhealthy fare is that they consumed liberal amounts of heart-healthy red wine, which contains numerous compounds that protect the heart and support health. This isn’t the place to go into the fallacies of the French Paradox. (There are many.) But it is the place to go into the heart-healthy, life-extending compounds that are in red wine. And the best place to start is with the superstar compound that many consider the number-one antiaging supplement in the world—resveratrol.

Antioxidants like resveratrol are beneficial in preventing harmful elements in the body from attacking healthy cells. The antioxidant properties of resveratrol also offer certain health benefits in the prevention of heart disease and the reduction of lung tissue inflammation in chronic obstructive pulmonary disease (COPD). An animal study in Journal of Agricultural and Food Chemistry (volume 54, 2006) suggested that resveratrol can improve blood flow in the brain by 30 percent, thereby reducing the risk of stroke.

Resveratrol also has anticancer activity. Writing in the journal Anticancer Research in 2004, researchers from the University of Texas M.D. Anderson Cancer Center reviewed dozens of studies on resveratrol and concluded that it exhibited anticancer properties against a wide range of tumor cells, including lymphoid and myeloid cancers, multiple myeloma, cancers of the breast, prostate, stomach, colon, pancreas, and thyroid, melanoma, head and neck squamous cell carcinoma, ovarian carcinoma, and cervical carcinoma. The researchers concluded that “resveratrol appears to exhibit therapeutic effects against cancer.”

The research on resveratrol has been steadily growing over the past ten years, revealing a picture that is even better than we thought when the first edition of this book was published. In 2010, there was a Resveratrol Conference in Denmark. Almost 3,700 published studies on resveratrol were analyzed and the findings were profound. Experts identified twelve mechanisms of action by which resveratrol may act to combat the diseases of aging and to protect the body against the five leading causes of death among Americans. Among the mechanisms cited:

Resveratrol lowers inflammation.

Resveratrol is a powerful antioxidant.

Resveratrol can prevent damage to DNA.

Resveratrol can stimulate bone formation.

Resveratrol can lower the incidence of hypertension.

Resveratrol is neuroprotective.

Resveratrol has been shown in studies to inhibit the growth of several cancer cell lines and tumors. It’s a powerful antioxidant and anti-inflammatory. It ramps up detoxification enzymes in the liver making it easier for your body to get rid of carcinogens, and it protects the heart. It also protects neurons (brain cells). And animal studies show that it slows the accumulation of fat.

When calories are scarcer, SIRT genes get turned on.

So if you want to turn on your longevity genes, all you’ve got to do is eat about one-third less food than you’re eating now. How does that sound?

That’s what I thought. Not so great. That’s why the research of David Sinclair Ph.D., assistant professor of pathology at Harvard University Medical School, generated so much excitement.

Sinclair discovered that there was a molecule found in red wine that actually turned on those same SIRT genes that were turned on by calorie restriction. The molecule was called resveratrol. If there was a way to isolate that molecule and create a drug (or supplement, in this case), one could theoretically get a lot of the benefits of calorie restriction without the angst.

Resveratrol may be one of the best antiaging substances around. And red wine is an excellent way to get resveratrol into your diet.

Besides resveratrol, there are other health-promoting polyphenols in red wine, and many of these are heart protective. Studies investigating the benefits of red wine suggest that a moderate amount of red wine (one drink a day for women and two drinks a day for men) lowers the risk of heart attack for people in middle age by 30 to 50 percent. It is also suggested that alcohol, such as red wine, may prevent additional heart attacks if you have already suffered one.

Other studies have indicated that red wine can raise HDL (“good”) cholesterol. Red wine may help prevent blood clots and reduce the blood vessel damage caused by fat deposits. Indeed, studies showed that people from the Mediterranean region who regularly drink red wine have lower risks of heart disease.

Some years back, the British Medical Journal published a famous paper on the “polymeal” in which researchers proposed a perfect meal that, if eaten daily, would substantially reduce the risk for heart disease as much as or more than many medications. Wine was a part of it. In fact, the authors calculated that based on the available research, about 5 ounces (150 ml) of wine a day would likely result in a 23 to 41 percent reduction in risk for coronary heart disease.

My follow-up book to this one (The Healthiest Meals on Earth, co-written with the Clean Food Coach, Jeannette Bessinger) is based on the polymeal concept—the meals and recipes provide as many of the nutrients found in the seven basic foods (including wine) that made up the original polymeal.

In general, alcohol does appear to increase the risk of breast cancer in women. The Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment’s Non-Technical Summary concludes, “The new research estimates that a woman drinking an average of two units (drinks) of alcohol per day has a lifetime risk of developing breast cancer 8 percent higher than a woman who drinks an average of one unit of alcohol per day. The risk of breast cancer further increases with each additional drink consumed per day.”

Both the National Cancer Institute and Walter Willett, M.D., Dr. P.H., professor of epidemiology and nutrition at Harvard’s School of Public Health put the increased risk for breast cancer at about 20 to 25 percent for women drinking two drinks a day. This doesn’t mean that 20 to 25 percent of women who have two drinks a day will get breast cancer—it means that drinking would increase the risk from about 12 out of 100 women getting breast cancer (the national average) to 14 to 15 per 100. This is a small increase, but no comfort if you’re one of those extra two or three people.

If you’re able to handle it, and if you’re consuming it in moderation, red wine can be part of a wonderful healthy lifestyle. The trick is to know when enough is enough.

Or when even a little is too much.

So red wine is antioxidant rich, loaded with healthy polyphenols, and a major dietary source of the anticancer, antiaging compound resveratrol. On the other hand, wine—and alcohol in general—is one of those substances where God truly is in the details, and the dosage makes the poison. Moderate intake of red wine: good. Too much alcohol, especially for those with addictive personalities: unmitigated disaster. Alcohol can raise triglycerides, increase blood pressure, and lead to weight gain. And it’s not possible to predict in which people alcohol will lead to alcoholism.

Tea

(green, black, white)

After water, tea is probably the most consumed beverage in the world. Not counting water, it’s also probably the healthiest.

The key to the health benefits of tea can be found in a large group of protective plant-based chemicals generally known as phenolic compounds, or polyphenols.

First, some clarifications. All four kinds of nonherbal tea—green, black, white, and oolong (red)—come from the same plant, a warm-weather evergreen known as Camellia sinensis. The leaves of this plant contain many chemicals from a general class of compounds called polyphenols.

Polyphenols are powerful antioxidants, many of which have anticancer activity (more about that in a moment). There are more than 4,000 of these compounds, and they fall into many classes and subclasses, including flavonoids, anthrocyanins, and isoflavones. Polyphenols, like other antioxidants, help protect cells from the normal, but damaging, physiological process known as oxidative stress. Although oxygen is vital to life, it’s also incorporated into reactive substances called free radicals. These can damage the cells in our body, and they have been implicated in the slow chain reaction of damage leading to heart disease and cancer. Many studies have demonstrated the anticancer properties of polyphenols. They can stop the damage that free radicals do to cells, neutralize enzymes essential for tumor growth, and deactivate cancer promoters.

White tea is the only one of the four made from immature tea leaves, leaves that are picked right before the buds have fully opened. Silver fuzz still covers the buds, and the silver fuzz turns to white when the tea is dried (hence its name). Depending on the variety of white tea, the exact ratio of buds to leaves can vary—for example, White Peony contains one bud for every two leaves; Silver Needles—which can be expensive—is made entirely from buds picked within a short period in early spring.

Being the least processed of the bunch, white tea in general is highest in polyphenols. Research has found that “certain green and white tea types have comparable levels of catechins with potential health promoting qualities,” (according to a study in the Journal of Food Science) The take-home point is that there isn’t a hierarchy of teas—all teas have benefits.

Green, oolong, and black tea all start with mature leaves that are then “withered” or air-dried. After that, the process differs slightly. To make green tea, the withered leaves are then steamed or panfried, and then dried again. To make oolong (red) tea, the withered leaves are first bruised, then partially fermented, then panfried and dried. And to make black tea, the withered leaves are first rolled, then fully fermented, and then panfried and dried. Black tea represents 78 percent of the total consumed tea in the world, whereas green tea accounts for approximately 20 percent.

Not so.

We now know that the very fermentation process that deactivates the catechin in green tea creates a whole other set of powerful antioxidants that are present in black tea. Black tea actually contains more complex polyphenols than green tea. The fermentation process needed for the production of black tea produces some unique antioxidants called biflavonols, thearubigens, and especially theaflavins.

Studies show the theaflavins in black tea have just as much antioxidant activity—if not more—than the compounds in green tea. A research report in the Journal of Nutrition in 2001 showed that the theaflavins in black tea and the catechins in green tea are equally effective as antioxidants, and a study by the Netherlands National Institute of Public Health and the Environment found a connection between drinking black tea regularly and reducing the risk of stroke. Researchers looked at data from a study examining the health benefits of foods that are high in flavonoids and phytonutrients with antioxidant benefits. Although some of the flavonoids were obtained from fruits and vegetables, 70 percent came from black tea. The study looked at 552 men over a fifteen-year period and found that men who drank more than four cups (940 ml) of black tea per day had a significantly lower risk of stroke than men who drank only two to three cups (470 to 705 ml) per day.

Finally, a study in Cancer found that among 109 Polish women, high black tea consumption was associated with diminished salivary levels of 17 beta-estradiol, the most potent mammalian estrogenic hormone and one that can be carcinogenic in hormone-related cancers. (Lower levels of the hormone were also reported when women consumed high amounts of the catechins found in green tea as well.) In writing about the study, the medical/nutritional newsletter Clinical Pearls said the study “suggested that tea consumption may provide a relatively easy dietary intervention for reducing hormone-related cancer risk.”

I’ve spent this much time on black tea only because it’s so often overlooked, living in the shadow of its big brother, green tea. But wonderful health benefits of black tea aside, green tea fully deserves its primary place in the sun. It is one of the world’s superfoods and has been acknowledged as such by virtually every nutritionist I know. It has anticancer activity. It’s helpful in weight loss. It lowers cholesterol. It’s associated with significantly lower levels of heart disease. And it has components in it that are helpful with depression and anxiety.

Of the hundreds and hundreds of green tea experiments that have been conducted, about 10 percent have directly involved humans, and many more have involved observations of populations that drink large amounts of green tea. It’s now fairly established that green tea may help prevent the following types of cancers in humans: bladder, colon, esophagus, pancreas, rectum, and stomach.

The studies showing the anticancer and antioxidant effects of catechins in green tea are numerous. Just for example, one particularly exciting study done at the Cancer Chemotherapy Center in Tokyo, Japan, and using leukemia and colon cancer cell cultures, demonstrated that “epigallocatechin gallate (EGCG) strongly and directly inhibits telomerase.” Telomerase is the enzyme that “immortalizes” cancer cells by maintaining the end portions of the tumor cell chromosomes. Inhibition of telomerase could be one of the main anticarcinogenic mechanisms of catechins.

Green tea may be helpful for anyone who wants to lose weight. In one study, in the American Journal of Clinical Nutrition, men who were given green tea burned more calories than men who were given a similar drink without the green tea, even after allowing for the possible effect of caffeine. The late great nutritionist Shari Lieberman, Ph.D., C.N.S., used to say that green tea stimulates the metabolism way more than caffeine alone. While studies of weight loss using green tea supplements have shown mixed results, in several animal studies, green tea demonstrated the ability to lower blood sugar.

Since the first edition of this book, there’s been even more research on tea, and the evidence is overwhelmingly positive. In 2014, a Chinese group of researchers led by Shoude Zhang published a complete analysis of the multiple bioactivities of green tea, and found that green tea polyphenols affect two hundred target genes in humans, including those involved in inflammation, diabetes, neurodegenerative diseases, diabetes, and cardiovascular disease. At least two studies have shown that green tea protects against DNA damage while at the same time promoting DNA repair. Large epidemiological studies show that those who are regular green tea drinkers have a significantly reduced risk for heart disease and stroke. And a 2015 study in Molecular Nutrition & Food Research from Penn State University found that green tea kills oral cancer cells.

Finally, numerous studies have cited the connection between inflammation, oxidation, and Alzheimer’s disease. Antioxidants have a potent role in the prevention of neurodegenerative diseases. One study, “A review of antioxidants and Alzheimer’s disease,” in the Annals of Clinical Psychiatry in 2005 reviewed all the research published to date to draw conclusions about the usefulness (or lack thereof) of specific antioxidants in the prevention of Alzheimer’s. Researchers scanned more than 300 articles and concluded that there were eight agents that showed promise in helping prevent Alzheimer’s. Green tea was one of the eight (the other seven were aged garlic, curcumin, melatonin, resveratrol, Gingko biloba, vitamin C, and vitamin E). And a paper in the Journal of Nutritional Biochemistry (September 2004) examined the neuroprotective mechanisms of green tea polyphenols—especially EGCG—on Alzheimer’s and Parkinson’s disease.

Matcha literally means “powdered tea.” It’s what’s used in the famous Japanese tea ceremony. The tea plants used for matcha are covered with shade cloths for about three weeks, which creates large thin leaves with better texture and flavor. Tea farmers hand select the tea leaves, and steam them lightly (to stop fermentation). Then they’re dried and aged in cold storage, which deepens the flavor even more. The “finished” leaves are then ground into a fine, emerald green powder. That’s matcha.

Besides the specialness of the leaves used to make it, the main difference between standard teas and matcha is in how they’re consumed. With regular tea, you steep the leaves in hot water and then discard them. With matcha, you actually consume the whole tea leaves in the form of the finely ground powder made from them. Nothing is discarded. You’re actually drinking the leaves themselves. Not only that, the leaves themselves are the best of the bunch, having been hand-selected and specially processed. The result is a tea that has everything green tea has only in higher concentrations. One study indicated that the concentration of EGCG (epigallocatechin gallate)—the catechin in green tea responsible for much of its anticancer activity—is 137 times greater than the amount of EGCG available from China Green Tips green tea, and at least three times higher than the largest value studied for other green teas.

To prepare matcha, sift 1 to 2 teaspoons of the matcha powder into a cup or bowl and add about 2 ounces (60 ml) of hot (not boiling) water. Whisk it with a bamboo brush until the mixture froths.

Although purists would probably frown on it, you can make a match latte by preparing the matcha as described above and, once it is well mixed (no clumps), add your desired milk or milk substitute.

For an innocuous and common beverage that costs next to nothing, that’s a pretty powerful résumé.

Water

Okay, consider the following: You’re walking in the woods and you come upon a pond. The pond hasn’t seen life in ages. There’s a brown scummy film floating on it. The water is brown and dirty. It looks stagnant, and there are flies and mosquitos buzzing around it. Now imagine you’re on that same walk in the woods and you come upon a mountain glacier. The water is flowing freely down the rocks, with the light of the sun sparkling through, the water looks clean and clear and crisp, and you stand for a moment to admire it as it gushes down the mountain.

Which water would you rather have in your body? Well if you’re not drinking enough clean, pure water, the water in your body is more analogous to the pond than the glacier.

So doesn’t it make sense to constantly replenish that body of yours with the equivalent of the gorgeous clean mountain stream, rather than to let all that water just sit in your body and recycle like the stagnant pond?

Of course it does.

Water can improve energy, increase mental and physical performance, remove toxins and waste from your body, keep your skin healthy and glowing, and may even help you lose weight. If you’re dehydrated—and some experts think that most of us are at the very least underhydrated—your blood is thicker and your body has to work that much harder to cause it to circulate. As a result, your brain becomes less active, it’s harder to concentrate, and you feel fatigued.

Water is one of the fluids that lubricates and cushions your joints and muscles, protecting them from shock and damage. If the body is dehydrated, it may become more susceptible to ailments. Also, before, during, and after exercise, drinking proper amounts of water can help reduce cramping of the muscles and early onset of fatigue.

And there are health benefits to water beyond the fact that it keeps us alive. Dehydration can elevate at least four independent risk factors for coronary heart disease: whole blood viscosity, plasma viscosity, hematocrit, and fibrinogen. In one landmark study in the May 1, 2002, American Journal of Epidemiology, researchers from the School of Public Health at Loma Linda University examined more than 20,000 relatively healthy people over six years. High daily intakes of water (five or more glasses) were associated with significantly lower risk for fatal coronary heart disease events, even after adjusting for smoking, hypertension, and body mass index.

I say phooey. You wouldn’t wash your clothes in soda, would you? And though there may not be scientific confirmation on exactly how many glasses a day we need, based on the trillions of cells in the body that need water to function, I’m going to continue to go with the assumption that when it comes to water, more is better. Sure you can go overboard if you drink massive amounts resulting in possible hyponatremia (extreme loss or dilution of sodium) or even water intoxication. But these are rare. Most of us would benefit from more water, not less.

My brother—like many intelligent, well-informed people—argues that the tap water in many parts of America is among the safest in the world and has been deemed perfectly acceptable for drinking purposes. He gently suggests that folks like me who spend all this money on bottled water might be being, well, a bit silly.

Here’s my answer.

Some years ago, fifteen-year-old West Virginia high school student Ashley Mulroy set out to conduct tests for antibiotics in the water supply as a school project; she wound up winning the prestigious Stockholm Junior Water Prize for her essay detailing the extent of antibiotic contamination of American waterways. You think it ends with antibiotics? I don’t.

I’m also not confident that all the government standards are particularly up to date, largely because I see how behind the times large agencies and organizations are on other health recommendations. From time to time the government realizes that the amount of a toxin previously considered safe was way too high—whoops! In 2001, for example, the U.S. Environmental Protection Agency lowered the maximum level of arsenic permitted in drinking water from 50 mcg per liter to 10. That means they were previously allowing 400 percent the amount they now know to be “okay.” Who knows how many other toxins are currently in our water at levels now considered safe that will later be found to be much too high?

Update: Since this book was written, water safety has become a national issue when lead in the drinking water of Flint, Michigan, caused a mammoth health crisis leading the president of the United States to declare a federal state of emergency. Though I’d like to believe this awful situation was an anomaly, it does not strengthen my faith in the ability of various government agencies to ensure the safety of our water supply.

So for all these reasons, I’m leaving tap water alone. I’ll take my chances with filtered water or bottled water. Are there unscrupulous companies selling stuff that’s probably no better or worse than tap? Sure. Is the good stuff expensive? Yup. But compared to a drink at an upscale bar or hotel, or a day’s worth of lattes at the local coffee emporium, the best bottle of water in the world is cheap.

Doubly so for the peace of mind it buys me.

THE EXPERTS’ TOP TEN LISTS

Fred Pescatore, M.D.

Fred Pescatore ’s New York Times ’ best-selling books, The Hamptons Diet and The Hamptons Diet Cookbook, combine the Mediterranean lifestyle with the preferences of Americans, emphasizing a whole-food approach to health and weight management.

1. Macadamia nut oil: This is the heart-healthiest fat with a high smoke point and no oxidation or trans-fatty acids.

2. Avocado: This is rich in heart-healthy monounsaturated fat.

3. Alaskan sockeye salmon: Responsibly caught salmon is high in omega-3 fatty acids. Its mercury and PCB content are either low or nonexistent.

4. Red/yellow/orange peppers: These are rich in antioxidants, B vitamins, and flavonoids that are not generally consumed.

5. Kale: This green is rich in well-absorbed calcium and vitamin K.

6. Lean, organic red meat: Genetically perfect for carnivores and one of the only sources of CLA, this kind of fat that helps people lose weight.

7. Sea vegetables: These often-overlooked foods contain iodine and protein and are perfect for vegetarians.

8. Lentils and beans: Fiber-rich legumes contain many naturally occurring B vitamins and protein for those who wish to consume less animal protein.

9. Alcohol: Every study around the world tells us the same thing: Drinking alcohol in moderation is good for you. Those who drink the least and those who drink the most have the worst health profiles, but those who drink in moderation can lower their risk for heart disease, stroke, and cancer.

10. Whole foods of any kind: These are foods that have not been touched by humans or at the very least, minimally processed. They help speed up our metabolism and keep our appetite low, therefore keeping us at our healthiest.