Judith C. Thalheimer, RD, LDN, executive editor of Tufts Health & Nutrition Letter, answers: “Microwave ovens bombard food with electromagnetic waves. This makes water molecules inside the food vibrate, which produces heat and cooks the food from the inside out. This may sound concerning, but it is safe. Whereas ionizing radiation (the type of radiation used in x-rays) affects atoms in living things and can damage the DNA in genes, potentially leading to cancer-causing mutations, electromagnetic waves, otherwise referred to as electromagnetic radiation, is non-ionizing. In addition to microwaves, non-ionizing radiation is around us every day in the form of light and radio waves.

As for the first part of your question, microwaves do change food at the molecular level by heating it, but so does every other method of cooking food. Heat causes proteins to change shape (denature). It can also degrade some vitamins, primarily vitamin C. Microwave ovens tend to preserve the nutrients in food better than other cooking methods because they heat food quickly, and shorter heating time means less time for nutrients to break down.

The most important thing to keep in mind when using a microwave oven is safety. Handle hot items with care, and make sure meats are fully cooked. Microwave ovens are more likely to leave cold spots in food than other cooking methods, so it is important to use a food thermometer to check the temperature of microwaved meat products in several spots to ensure there are no raw areas that could transmit foodborne microbes. For mixed dishes, it is a good idea to stir midway through the heating cycle, especially when reheating.

When used correctly, microwaves are generally an efficient and safe way of reheating and cooking food, and minimally alter food at the molecular level.”

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Body mass index (BMI) is a ratio of weight to height that has long been used to assess whether people are tipping the scales into the overweight or obese category. There are numerous online BMI calculators (the Centers for Disease Control and Prevention has one at http://tiny.cc/cdcbmicalc). A BMI below 18.5 is categorized as underweight, 18.5 to 24.9 is normal, 25 to 29.9 counts as overweight, and 30 and higher is categorized as obese. For younger people, maintaining a normal BMI is associated with better cardiovascular health and a lower risk of death—however, studies have suggested that older people who fall into the overweight category (or are even mildly obese) live longer than those whose BMI is considered normal. BMI increases for some older people because their height tends to decrease, and there is ongoing debate about whether to use a person’s adult height or their current height when calculating an older adult’s BMI. If the latter is used, BMI will increase. I tell my patients not to worry too much if they are overweight according to their BMI. However, if you reach the point where excess weight may be increasing your risk of chronic illness and disability, I recommend working with your doctor to manage weight gain.

Rosanne M. Leipzig, MD, PhD

Geriatric Medicine

I made the mistake of overusing a nasal decongestant spray a couple of years ago during a bad cold. I’m now having to use it all the time, because my nose is so stuffy without it. What can I do to stop using the spray?

Colds, the flu, COVID-19, and seasonal allergies cause the blood vessels in the nasal membranes to swell up, which manifests as a stuffy nose. Decongestant sprays clear the stuffiness by shrinking swollen blood vessels; however, it is very important to limit their use to the two or three days recommended on the medication leaflet or you may suffer from rebound congestion. The sprays that are most likely to cause this are those containing oxymetazaline (for example, Afrin®) or phenylephrine (Neosynephrine®). Long-term use of these sprays also can damage the septum (the wall between your nasal passages). You may be able to wean yourself off the spray by using it in just one nostril for as long as it takes the other side to stay clear, and then not using it in the second nostril. Using a saline spray on the untreated side may help you avoid severe congestion while your nasal blood vessels get back to normal. A vapor inhaler stick or a few drops of Olbas oil (available at pharmacies) sprinkled on a tissue also may help. If these strategies don’t make a difference, ask your doctor if it is safe for you to switch to using a steroid nasal spray instead, since these are not associated with rebound congestion. Steroid sprays take time to start working, so you’ll need to be patient.

Patricia Bloom, MD

Geriatric Medicine

I’m due for my first colonoscopy, and I have a question. Every diagram I’ve seen of the colon shows that it curves in several places. How does the colonoscope negotiate the curves?

The colon curves to the left just beyond the rectum into a section called the sigmoid colon and curves again to continue upward (a section called the descending colon). It then curves right into a horizontal section (the transverse colon) before making a final turn into a section we call the ascending colon. Rest assured that gastroenterologists receive a great deal of practical training to help them negotiate these curves with the colonoscope. The colonoscope itself is very flexible, so it can bend easily—there also is a knob at the control section of the colonoscope that your doctor uses to change the direction of the tip up/ down and left/right. Your doctor also may have a nurse press on your stomach or slightly change your position during the procedure if needed to help maneuver the colonoscope. You won’t be aware of this activity or feel any discomfort, since you will be sedated.

Brijen J. Shah, MD

Gastroenterology

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Annals of Internal Medicine, June 2024

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A: A food matrix refers to the complex physical and chemical structure of a food. It includes the way nutrients and other compounds are organized and may interact within the food. This overall structure impacts how nutrients are digested, absorbed, and metabolized by the body. For example, the matrix found in whole foods (like fruits and vegetables) is often more complex than in processed foods, affecting the release and the availability of nutrients.

The food matrix can also impact the sensory traits of food, including texture, flavor, and appearance, which in turn may influence consumer preferences and eating behaviors. The matrix also affects food processing and preservation, as the matrix may influence how foods respond to cooking, drying, or freezing.

It is important to understand the food matrix because it provides insight into how different foods may exert varying health effects, even though their nutritional content may be similar.

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What is a Low Carbon Diet? A low carbon diet focuses on reducing the carbon dioxide (CO2) emissions associated with the production, transportation, and consumption of food. Food production is a significant contributor to greenhouse gas emissions, with agriculture alone accounting for about 10 percent of total emissions in the U.S. A low carbon diet aims to lower these emissions by choosing foods that have a smaller environmental impact.

Key Components of a Low Carbon Diet:

Plant-Based Foods. These are generally less resource-intensive to produce than animal-based foods. Fruits, vegetables, grains, nuts, and seeds typically have lower carbon footprints.

Local and Seasonal Foods. Foods grown locally and in season require less transportation and energy for storage, thus reducing emissions.

Minimized Food Waste. Reducing food waste can significantly decrease the carbon footprint associated with food disposal and production.

Sustainable Farming Practices. Supporting organic and sustainably farmed products can lower the environmental impact of food production.

Benefits of a Low Carbon Diet

Environmental Impact. Adopting a low carbon diet can substantially reduce your personal carbon footprint. According to a study published in Environmental Research Letters, shifting to a plant-based diet can reduce food-related greenhouse gas emissions by up to 73 percent per person. This reduction helps mitigate climate change and its associated impacts.

Health Benefits. A low carbon diet often aligns with dietary recommendations for health. Plant-based diets are linked to lower risks of heart disease, hypertension, diabetes, and certain cancers. Emphasizing fruits, vegetables, and whole grains can improve overall health and longevity.

Economic Savings. By focusing on seasonal and locally produced foods, you can often save on grocery bills. Additionally, reducing food waste means you get more value, as less food ends up in the trash.

Supporting Biodiversity. Choosing foods from sustainable sources helps protect ecosystems and supports biodiversity. Sustainable farming practices preserve soil health and protect natural habitats, supporting a healthier planet.

How to Follow a Low Carbon Diet

1.Increase Plant-Based Meals. One of the most effective ways to reduce your carbon footprint is by eating more plant-based meals. This doesn’t mean you have to become vegetarian or vegan overnight. Start by incorporating a few meatless meals each week, focusing on legumes, grains, and vegetables.

Try it! Prepare a vegetable stir-fry with tofu or a hearty lentil soup as alternatives to meat-based dishes.

2. Choose Local and Seasonal Foods. Shopping at local farmers’ markets or joining a community-supported agriculture (CSA) program ensures that you’re consuming foods with a lower carbon footprint. These options reduce the distance food travels and support local farmers.

Try it! In the summer, enjoy fresh tomatoes, cucumbers, and berries from nearby farms instead of imported produce.

3.Minimize Food Waste. Plan your meals to use all the ingredients you purchase. Store foods properly to extend their shelf life, and consider composting food scraps to reduce waste.

Try it! Keep a list of meals for the week to avoid overbuying and use leftovers creatively, like turning roasted vegetables into a soup.

4.Opt for Sustainable Seafood. If you consume seafood, choose options that are sustainably sourced. Look for certifications like the Marine Stewardship Council (MSC) label, which ensures that the fish was caught responsibly.

Try it! Enjoy sardines or mussels, which generally have lower carbon footprints than larger fish or shrimp.

5. Reduce Processed Foods. Processed and packaged foods often require more energy for production and packaging, leading to higher emissions. Focus on whole foods that require minimal processing.

Try it! Choose whole oats over instant oatmeal packets and fresh fruit over fruit-flavored snacks.

6. Grow Your Own Food. If possible, consider growing your own vegetables and herbs. This not only reduces your carbon footprint but also provides fresh produce at your fingertips.

Try it! Start with easy-to-grow plants like tomatoes, herbs, and leafy greens in your backyard or on a balcony.

7. Be Mindful of Packaging. Reduce your use of single-use plastics and packaging by buying in bulk and using reusable bags and containers.

Try it! Bring your own bags to the grocery store and choose bulk bins for grains and nuts.

The Bottom Line. A low carbon diet offers a simple way to support a healthier environment while also reaping personal health benefits. By focusing on plant-based foods, choosing local and seasonal produce, minimizing food waste, and supporting sustainable practices, you can make a significant impact. Small changes in eating habits can lead to a healthier planet and a healthier you. Adopting a low carbon diet is not only a personal choice but also a step toward global responsibility.

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(JACC: CardioOncology, July 2024)

• Midlife Diet Impacts Later Quality of Life. People eating a healthy diet from midlife and later can increase the likelihood of healthy aging, according to researchers. Data going back to 1986 from more than 106,000 adults aged 39 and older, and free of chronic diseases at the outset of the study, showed that following a healthy diet from their 40s and beyond were 43-84 percent more likely to be well-functioning physically and mentally at age 70 compared to people who did not follow a healthy diet. Researchers noted a healthy diet is rich in fruits, vegetables, whole grains, and healthy fats. 

(Presented at American Society for Nutrition annual meeting, June 2024)

• Beans Fill Nutrient Shortfalls. Adding more beans to a typical U.S. dietary pattern can lead to a higher intake of shortfall nutrients and improved overall diet quality, according to researchers. The study used data from the U.S. National Health and Nutrition Examination Survey to model the addition of one to two servings of canned or dried kidney beans, black beans, chickpeas, or pinto beans to younger and older adult diets. One to two servings of beans resulted in significant increases in several shortfall nutrients, including dietary fiber, potassium, magnesium, iron, folate, and choline, and increased overall diet quality as measured by the Healthy Eating Index.

(Maturitas, August 2024)

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In this Q&A, Dana Hunnes, RD, MPH, PhD, Senior Dietitian Supervisor, UCLA Medical Center, provides insights on dietary choices that can help us potentially live longer and also live better.

What does the phrase “food is medicine” mean?

“This phrase means that what we eat has the ability to protect our health, as medicine can,” explains Hunnes. “When we use food to protect our health, we are eating in a way that lowers our risk for chronic conditions. Or if we already have chronic conditions, eating healthfully may help manage them or control them better. If we are fortunate, a heathy diet can possibly reverse them.”

For example, research published in the Journal of Clinical Endocrinology & Metabolism found that study participants who followed an intermittent fasting regimen achieved complete diabetes remission, defined as maintaining an HbA1c level of less than 6.5% for at least a year without diabetes medication.

Why is eating whole foods so beneficial?

“There are many nutrients in whole foods that work synergistically with each other that make the “whole” greater than the sum of its parts,” says Hunnes. “By that I mean, we reap so many more benefits from eating a whole raspberry with all of its fiber and seeds. We gain more antioxidants, anthocyanins, micronutrients, and other anti-inflammatory compounds than we can ever get from eating one isolated nutrient extracted from said raspberry. When we eat ultra-processed foods or isolated nutrients, we are not getting that synergy. We are only getting single nutrients that likely don’t have the same effects.”

A good example of this is taking fish oil supplements for heart health. Numerous studies have shown that fish oil supplementation makes little to no difference in reducing the risk for heart attacks and stroke. But eating fish high in omega-3 fats may reduce risk of heart disease.

Why the  buzz around adhering to a mostly plant-based diet?

“Whole plant foods are filling, lower in calories, nutrient dense, and are associated with lower risk for disease and disability. That doesn’t mean no risk. It just means reduced risk,” she explains. “Plants have naturally occurring compounds that protect them against disease and pests which are also healthful to humans. For example, there are bitter compounds in sulphorphane vegetables (e.g., broccoli, Brussels sprouts, cauliflower) that protect them against pests, but are extremely anti-inflammatory and healthful to humans. Fiber also helps clean out the toxins from our digestive tracts, which is good. We don’t want to keep too much waste in our digestive tracts for long periods of time.”

Though eating these veggies raw provides the most nutrients, not everyone enjoys them raw. Steaming for a minute or two, lightly sautéing or even blanching helps maintain nutrients. Definitely avoid boiling because that method destroys valuable nutrients.

Can foods replace medicines and even cure diseases?

“While I’ve heard of these so-called miracles, they are relatively few and far between,” says Hunnes. “Certain chronic conditions such as diabetes or heart disease can be relieved, reduced, and possibly even reversed (sort-of like cured) by an extremely healthy diet. Other diseases, such as certain types of cancer, far less so, though (again) not impossible. With that said, it’s much easier to decrease the risk of ever developing these diseases, which are food/diet associated, than it is to try to correct/treat them after you have them. Healthy diet is always to our benefit.”

What are some simple ways to incorporate heathy foods daily?

“For easy snacks, keep sliced jicama, carrots, bell peppers, or other favorite veggies with hummus or pureed beans in the fridge,” she suggests. “For sweet treats, make your own trail mix of dried fruits and nuts, or enjoy fresh fruit such as blueberries, raspberries, or other blackberries with walnuts or almonds.”

Another strategy Hunnes suggests is to have a variety of whole and minimally processed foods in your kitchen. Also, be sure to stock canned and frozen healthy foods to ensure that you always have nutrient-rich foods available, regardless of the season. Leave the ultra-processed foods at the store and make rich desserts something you go out for as a special treat. 

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