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After posting yesterday "Probiotic Misconceptions", I was pleasantly surprised that today's NY Times had an article (by Jane Brody) raising similar concerns. What was good is that she wrote about supplements not being regulated. She also left out that probiotic beneficial organisms are found in more than the gut. A case in point being the sinuses - because healthy sinuses also have Lactobacillus sakei (according to the Abreu et al study of 2012), and which has been the basis for my family's successful kimchi treatment for sinusitis (see Sinusitis treatment link for the method). From the NY Times:

Probiotic Logic vs. Gut Feelings

The label on my bottle of Nature’s Bounty Advanced Probiotic 10 says it contains 10 probiotic strains and 20 billion live cultures in each two-capsule dose. The supplement provides “advanced support for digestive and intestinal health” and “healthy immune function.” I have no way to know if any of this is true. Like all over-the-counter dietary supplements, probiotics undergo no premarket screening for safety, effectiveness or even truth in packaging. 

To be sure, lay and scientific literature are filled with probiotic promise, and I am hardly the only consumer who has opted to hedge her bets. The global market for probiotic supplements and foods is expected to reach $32.6 billion this year,with a projected annual growth of 20 percent or more.

 Beneficial micro-organisms have since been shown to inhabit three main locations in the digestive tract: the stomach, the lower part of the small intestine and the large intestine. To better understand the current enthusiasm for enhancing the body’s supply of these micro-organisms, some definitions are needed.

Prebiotics are nondigestible carbohydrates that stimulate the growth and activity of beneficial micro-organisms (that is, probiotics) in the gut. They are found naturally in oats, wheat, some fruits and vegetables (bananas, onions, garlic, leeks, asparagus, soybeans, honey and artichokes), and in breast milk, and they are added to some infant formulas.

Probiotics are defined by the World Health Organization as “live micro-organisms which when administered in adequate amounts confer a health benefit on the host.” The ailments that probiotics are said to benefit range from infection-caused diarrhea, inflammatory bowel diseases and irritable bowel syndrome to asthma, allergy and Type 1 diabetes.

Synbiotics are a combination of prebiotics and probiotics. They are found in so-called functional foods like yogurt and kefir, fermented foods like pickles and some cheeses, and in some supplements.

That probiotic organisms are important to health is not questioned. As researchers at the Institute for Immunology at the University of California,Irvine have written intestinal micro-organisms play “an important role in the development of the gut immune system, digestion of food, production of short-chain fatty acids and essential vitamins, and resistance to colonization from pathogenic microorganisms.”

Dr. Walker has explained that probiotics enhance defensive action by the cells that line the gut. When a person takes antibiotics, especially the broad-spectrum antibiotics most often prescribed, many of these beneficial microbes are destroyed along with the disease-causing bacteria. Patients on antibiotics are often told to consume yogurt with active cultures to replenish the beneficial organisms.

In an extensive review of the evidence published in 2010 in the journal Pediatrics, an expert committee concluded that probiotics might limit the course of virus-caused diarrhea in otherwise healthy infants and children. But the committee said there was not sufficient evidence to justify routine use of probiotics to prevent rotavirus-caused diarrhea in child care centers. Nor did the committee endorse taking probiotics during pregnancy and nursing or giving them to infants to prevent allergic disorders in those at risk.

Only a small percentage of probiotic foods and supplements have the backing of peer-reviewed published research. They include Dannon’s Activia yogurt and DanActive drink and the supplements Culturelle and Align. Although kefir contains even more probiotic strains than yogurt, clinical studies have not shown it to be effective in preventing or treating infectious diarrhea.

The challenge in taking probiotics is to get the microbes past the stomach, where most are killed by gastric acid, said Robert Dunn, a biologist at North Carolina State University. Once in the intestines, they must compete effectively with the microbes already present.

Dr. Dunn, author of "The Wild Life of Our Bodies," says there is good reason to remain skeptical of probiotics“There are hundreds of kinds of prebiotics and probiotics in stores,” he said. “As a consumer, it’s almost impossible to figure out what is best. What are the specific species in your intestines, and how will what you take compete with them?” Still, he added, taking them doesn’t seem harmful. 

There is growing evidence for the role of the appendix in restoring a healthful balance of microbes in the body. Though long considered an expendable, vestigial organ, the appendix is now being looked at as “a storehouse of good bacteria,” Dr. Dunn said. In a study of recovery rates from Clostridium difficile, which causes a severe form of infectious diarrhea, often following antibiotic therapy, patients whose appendixes had been removed were more likely to have a recurrent infection than those who still had appendixes.

I keep overhearing misguided statements like these all the time: that somehow any and all probiotic (beneficial) bacteria offered for sale, whether in foods such as yogurt, or in probiotic capsules, are wonderful and beneficial, and will reseed your gut as well as do all sorts of miraculous things for your health. And while in reality, there are many, many bacterial species living in a healthy person's gut, it's the same few species that seem to be offered everywhere.

But if you look at the scientific research for even a few minutes, you realize that NO, we actually know very little about the health benefits of these bacteria species now in stores, and that all the claims out there don't have evidence backing them up. Perhaps taking megadoses of certain bacteria even has some negative effects. Yes, Lactobacillus species are generally considered beneficial by scientists. But even in the Lactobacillus family, there are many more types than the few now available in stores. For example. I can not find Lactobacillus sakei (which is found in kimchi and we use to successfully treat sinusitis - see Sinusitis Treatment link) in any store at this time.

Another problem is that sometimes you don't even get the desired bacteria that has been added to the food or cosmetic. For example, this occurs when some Lactobacillus or other bacteria are added to yogurt or some other food, but then the food is pasteurized, which kills off the bacteria. Duh...This is why I liked the following  opinion piece by Julianne Wyrick. From Scientific American:

Are probiotics helping you?

Consuming probiotics – also know as “good” bacteria – via supplements or yogurt has been popularized as a way to maintain gut health. While taking a daily dose of probiotics may not be harming you, it also may not be helping. The idea that every probiotic is good for every disease or condition is oversimplified, according to Catherine Lozupone, an assistant professor of medicine at the University of Colorado School of Medicine.

Lozupone spoke on a panel about the human microbiome, or the bacteria that reside in and on our bodies, that I attended at the Association of Health Care Journalists Conference last month. The panel touched on misconceptions related to probiotics, so I gave Lozupone a call post-conference to learn more.

One misconception Lozupone brought up was the idea that probiotic supplements should be used for “reseeding the good bacteria” missing in a person’s gut. Probiotic supplements often only contain a few species of bacteria, whereas a healthy gut generally has hundreds of species. In addition, the microbes that are abundant in a healthy gut are often different than those found in many supplements. A healthy gut is mostly composed of bacterial species that fall within a two different groups of bacteria: the phyla Bacteroidetes and Firmicutes. One group of bacteria commonly found in probiotics is known as Lactobacillus. While Lactobacillus is a type of Firmicute, it isn’t a type of Firmicute that is typically found in great abundance in a healthy adult gut, according to Lozupone. While Lactobacillus may be helpful for some people in some situations, the idea that everyone needs to repopulate their gut with this “good” bacteria is an overgeneralization.

“I think probiotics have a ton of potential, but different bacteria are going to do different things in different contexts,” Lozupone said. “This notion [of] ‘oh just reseed the good bacteria … they’re good for you’ is definitely very oversimplified.”

But while some general probiotic health claims are ahead of the research, studies do suggest that particular types of probiotic bacteria have potential for specific uses.

For example, Lozupone noted some rodent studies suggest certain microbes might mitigate certain effects of a high-fat diet, which could be helpful to treating obesity and associated health problems.

“There’s just lots of different contexts where the microbiome has been shown to be important,” Lozupone said. Going forward, researchers hope to not only find microbes that have health effects, but also understand why they have these effects. If you’re interested in keeping track of the current research into our body’s bacteria, keep your eye on the NIH’s Human Microbiome Project, an international effort to study the role of the body’s bacteria in our health.

The study found real differences between organic and conventionally grown foods - organic foods have lower levels of pesticides, higher levels of antioxidants, and lower levels of cadmium. From NY Times:

Study of Organic Crops Finds Fewer Pesticides and More Antioxidants

Adding fuel to the debates over the merits of organic fooda comprehensive review of earlier studies found substantially higher levels of antioxidants and lower levels of pesticides in organic fruits, vegetables and grains compared with conventionally grown produce.

However, the full findings, to be published next week in the British Journal of Nutrition, stop short of claiming that eating organic produce will lead to better health. Still, the authors note that other studies have suggested some of the antioxidants have been linked to a lower risk of cancer and other diseases.

Organic farming, by and large, eliminates the use of conventional chemical fertilizers and pesticides. Those practices offer ecological benefits like healthier soils but produce less bountiful harvests. 

In the new study, an international team of scientists did not conduct any laboratory or field work of their own. Instead, they compiled a database from 343 previously published studies and performed a statistical procedure known as a meta-analysis, which attempts to ferret robust bits of information from studies of varying designs and quality.

Over all, organic crops contained 17 percent more antioxidants than conventionally grown crops, the new study found. For some classes of antioxidants, the difference was larger. A group of compounds known as flavanones, for example, were 69 percent higher in the organic produce. (At very high quantities, as in some supplements, some antioxidants have been shown to be harmful, but the levels in organic produce were not nearly that high.)

The researchers said they analyzed the data in several different ways, and each time the general results remained robust. Charles M. Benbrook, a professor at Washington State University and another author of the paper, said this analysis improved on earlier reviews, in part because it incorporated recent new studies.

The study also found that organically produced foods, particularly grains, contain lower levels of cadmium, a toxic metal that sometimes contaminates conventional fertilizers. Dr. Benbrook said the researchers were surprised by that finding; there was no difference in other toxic metals like mercury and lead.

This is Part 2 on how lifestyle influences aging. Many recent research reports tell of a link between our lifestyle and how we'll age - whether we'll be active and healthy well into our 80s or in terrible shape and dying young. Mind you, these are not "definites" because nothing can give you a guarantee, but they are ways we can improve our odds in living the long and healthy life that we want. From February 2014 Medscape:

Cancers Caused by Lifestyle Behaviors: Experts Urge Action

In launching the World Cancer Report 2014 earlier this week, the editors emphasized the need for prevention and highlighted lifestyle behaviors that lead to cancer, including smoking tobacco, drinking alcohol, overweight/obesity, and lack of exerciseThe report, issued by the International Agency for Research on Cancer (IACR), contains contributions from more than 250 scientists worldwide, many of them leading experts in their fields. 

In the United States, 1 in 3 cancer deaths is related to obesity, poor nutrition, or physical inactivity, and the problem will only increase as more countries and regions adopt the diet and lifestyles of more economically developed economies."

Tobacco, both smoked and smokeless, remains the world's leading cause of cancer morbidity and mortality, the report notes. The IACR and also the US Surgeon General have concluded that the relationship with smoking is causal for cancers of the nasal and oral cavities, hypopharynx, larynx, trachea, esophagus, lung, bronchus, bone marrow (leukemia), stomach, kidney, pancreas, ureter, uterus, bladder, and cervix. The IACR expands this list to also include paranasal sinuses, liver, colon, rectum, and ovary (mucinous), but says it is unclear if there is a link with breast cancer.

Still under-recognized, and not acted on, is the association between drinking alcohol and cancer. The agency says cancers caused by drinking alcoholic beverages include those of the oral cavity, pharynx, larynx, esophagus, liver, colorectum, and female breast.

Excess body fat increases the risk for cancers of the esophagus, colon, pancreas, endometrium, and kidney, as well as postmenopausal breast cancer. The evidence for obesity increasing the risk for these cancers is "convincing," the agency comments, and there is a dose–response relationship, so being overweight is less risky than being obese.

Regular physical activity reduces the risk for multiple cancers by contributing to weight control, and also reduces the risk for colorectal and breast cancer by additional mechanisms. The general consensus among researchers is that exercise should be of moderate intensity and average at least an hour each day.

High consumption of red meat, especially processed meat, is associated with a risk for colorectal cancer. "A diet high in fruit and vegetables and whole grains does not appear to be as strongly protective against cancer as initially believed," the report notes. "However, this dietary pattern is still advisable because of the benefits for diabetes and cardiovascular diseases, and some possible reductions in cancer incidence."

From Science Daily:

Watching too much TV may increase risk of early death: Three hours a day linked to premature death from any cause

Adults who watch TV three hours or more a day may double their risk of premature death from any cause. Researchers suggest adults should consider getting regular exercise, avoiding long sedentary periods and reducing TV viewing to one to two hours a day.

Results of a large study published in the Mayo Clinic Proceedings. From Science Daily:

Large waist linked to poor health, even among those in healthy body mass index ranges

Having a big belly has consequences beyond trouble squeezing into your pants. It’s detrimental to your health, even if you have a healthy body mass index (BMI), a new international collaborative study has found. Men and women with large waist circumferences were more likely to die younger, and were more likely to die from illnesses such as heart disease, respiratory problems, and cancer after accounting for body mass index, smoking, alcohol use and physical activity.

Some good news for those who have to sit for long periods every day at work - being physically fit may help. From Science Daily:

Physical fitness associated with less pronounced effect of sedentary behavior

Physical fitness may buffer some of the adverse health effects of too much sitting, according to a new study. Sedentary behavior has been linked to an increase risk of obesity, metabolic syndrome, type 2 diabetes mellitus, cardiovascular disease, some cancers, and premature death. But previous studies of the association have not taken into account the protective impact of fitness, a strong predictor of cardiovascular disease incidence and mortality.

I've been seeing research report after report looking at how our lifestyle determines how we'll age - whether we'll be active and healthy well into our 80s or in terrible shape and dying young. Mind you, these are not "definites" because nothing can give you a guarantee, but they are ways we can improve our odds in living the long and healthy life that we want. From Medical Xpress:

A healthy lifestyle adds years to life

Live longer thanks to fruit, an active lifestyle, limited alcohol and no cigarettes. This is the conclusion of a study by public health physicians at the University of Zurich who documented for the first time the impact of behavioural factors on life expectancy in numbers. 

...Brian Martin and his colleagues from the Institute of Social and Preventive Medicine (ISPM) at the University of Zurich have examined the effects of these four factors – both individual and combined – on life expectancy. An individual who smokes, drinks a lot, is physically inactive and has an unhealthy diet has 2.5 fold higher mortality risk in epidemiological terms than an individual who looks after his health. Or to put it positively: "A healthy lifestyle can help you stay ten years' younger", comments the lead author Eva Martin-Diener.

"The effect of each individual factor on life expectancy is relatively high", states Eva Martin-Diener. But smoking seems to be the most harmful. Compared with a group of non-smokers, smokers have a 57 percent higher risk of dying prematurely. The impact of an unhealthy diet, not enough sport and alcohol abuse results in an elevated mortality risk of around 15 percent for each factor.

According to Martin an unhealthy lifestyle has above all a long-lasting impact. Whereas high wine consumption, cigarettes, an unhealthy diet and physical inactivity scarcely had any effect on mortality amongst the 45 to 55-year-olds, it does have a visible effect on 65 to 75-year-olds. The probability of a 75-year-old man with none of the four risk factors surviving the next ten years is 67 percent, exactly the same as the risk for a smoker who is ten years younger, doesn't exercise, eats unhealthily and drinks a lot.

From Medical Xpress:

Picking up healthy habits in your 30s and 40s can slash heart disease risk

The heart is more forgiving than you may think—especially to adults who try to take charge of their health, a new Northwestern Medicine study has found. When adults in their 30s and 40s decide to drop unhealthy habits that are harmful to their heart and embrace healthy lifestyle changes, they can control and potentially even reverse the natural progression of , scientists found. On the flip side, scientists also found that if people drop  or pick up more bad habits as they age, there is measurable, detrimental impact on their coronary arteries.

For this paper, scientists examined healthy lifestyle behaviors and coronary artery calcification and thickening among the more than 5,000 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who were assessed at baseline (when participants were ages 18 to 30) and 20 years later.The healthy  assessed were: not being overweight/obese, being a nonsmoker and physically active and having low alcohol intake and a healthy diet. 

By young adulthood (at the beginning of the study), less than 10 percent of the CARDIA participants reported all five healthy lifestyle behaviors. At the 20-year mark, about 25 percent of the study participants had added at least one healthy lifestyle behavior. Each increase in healthy lifestyle factors was associated with reduced odds of detectable  and lower intima-media thickness—two major markers of cardiovascular disease that can predict future cardiovascular events. Adulthood is not too late for healthy behavior changes to help the heart."

"That loss of healthy habits had a measurable negative impact on their coronary arteries," Spring said. "Each decrease in healthy lifestyle factors led to greater odds of detectable  calcification and higher intima-media thickness.

Spring said the healthy changes people in the study made are attainable and sustainable. She offers some tips for those who want to embrace a  at any age:Keep a healthy body weight; Don't smoke; Engage in at least 30 minutes of moderate to vigorous activity five times a week; No more than one alcoholic drink a day for women, no more than two for men; Eat a healthy diet, high in fiber, low in sodium with lots of fruit and vegetables.

From Science Daily:

Adults who lose weight at any age could enjoy improved cardiovascular health

Weight loss at any age in adulthood is worthwhile because it could yield long-term heart and vascular benefits, suggests new research. For the first time, the findings indicate that adults who drop a BMI category -- from obese to overweight, or from overweight to normal -- at any time during adult life, even if they regain weight, can reduce these cardiovascular manifestations. The findings are from a study examining the impact of lifelong patterns of weight change on cardiovascular risk factors in a group of British men and women followed since birth in March 1946. 

Lately some articles have been mentioning the amazing possibility of new treatments for psychiatric disorders using bacteria as psychobiotics. Think of probiotics (microorganisms that have beneficial effects when consumed) that affect the brain. Researchers promoting the use of this term define a psychobiotic as "a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness". This new emerging field is just in its infancy. Lots of speculation and anecdotal evidence, and a few tantalizing studies.

I think the following article is a good introduction to this research area of the gut and mind/brain interaction, even though it was published in late 2013. Or you could order the newly published scholarly book "Microbial Endocrinology: The Microbiota-Gut-Brain Axis in Health and Disease" (Editors M.Lyte and J.F.Cryan) with a $189. purchase price (!).  From November 2103 NPR:

Gut Bacteria Might Guide The Workings Of Our Minds

Could the microbes that inhabit our guts help explain that old idea of "gut feelings?" There's growing evidence that gut bacteria really might influence our minds

"I'm always by profession a skeptic," says Dr. Emeran Mayer, a professor of medicine and psychiatry at the University of California, Los Angeles. "But I do believe that our gut microbes affect what goes on in our brains.Mayer thinks the bacteria in our digestive systems may help mold brain structure as we're growing up, and possibly influence our moods, behavior and feelings when we're adults. "It opens up a completely new way of looking at brain function and health and disease," he says.

So Mayer is working on just that, doing MRI scans to look at the brains of thousands of volunteers and then comparing brain structure to the types of bacteria in their guts. He thinks he already has the first clues of a connection, from an analysis of about 60 volunteers. Mayer found that the connections between brain regions differed depending on which species of bacteria dominated a person's gut. 

But other researchers have been trying to figure out a possible connection by looking at gut microbes in mice. There they've found changes in both brain chemistry and behavior. One experiment involved replacing the gut bacteria of anxious mice with bacteria from fearless mice"The mice became less anxious, more gregarious," says Stephen Collins of McMaster University in Hamilton, Ontario, who led a team that conducted the researchIt worked the other way around, too — bold mice became timid when they got the microbes of anxious ones. And aggressive mice calmed down when the scientists altered their microbes by changing their diet, feeding them probiotics or dosing them with antibiotics. 

Scientists also have been working on a really obvious question — how the gut microbes could talk to the brainA big nerve known as the vagus nerve, which runs all the way from the brain to the abdomen, was a prime suspect. And when researchers in Ireland cut the vagus nerve in mice, they no longer saw the brain respond to changes in the gut"The vagus nerve is the highway of communication between what's going on in the gut and what's going on in the brain," says John Cryan of the University College Cork in Ireland, who has collaborated with Collins.

Gut microbes may also communicate with the brain in other ways, scientists say, by modulating the immune system or by producing their own versions of neurotransmitters"I'm actually seeing new neurochemicals that have not been described before being produced by certain bacteria," says Mark Lyte of the Texas Tech University Health Sciences Center in Abilene, who studies how microbes affect the endocrine system. "These bacteria are, in effect, mind-altering microorganisms."

This research raises the possibility that scientists could someday create drugs that mimic the signals being sent from the gut to the brain, or just give people the good bacteria — probiotics — to prevent or treat problems involving the brain. Experiments to test whether changing gut microbes in humans could affect the brain are only just beginning. 

One team of researchers in Baltimore is testing a probiotic to see if it can help prevent relapses of mania among patients suffering from bipolar disorder."The idea is that these probiotic treatments may alter what we call the microbiome and then may contribute to an improvement of psychiatric symptoms," says Faith Dickerson, director of psychology at the Sheppard Pratt Health System.

Mayer also has been studying the effects of probiotics on the brain in humans. Along with his colleague Kirsten Tillisch, Mayer gave healthy women yogurt containing a probiotic and then scanned their brains. He found subtle signs that the brain circuits involved in anxiety were less reactive, according to a paper published in the journal Gastroenterology.

But Mayer and others stress that a lot more work will be needed to know whether that probiotic — or any others — really could help people feel less anxious or help solve other problems involving the brain. He says, "We're really in the early stages."

Overall, this is further evidence that eating natural, real foods  (in moderation) and avoiding supplements is best for health. Don't want to feed any cancers. From Science Daily:

How antioxidants can accelerate cancers, and why they don't protect against them

For decades, health-conscious people around the globe have taken antioxidant supplements and eaten foods rich in antioxidants, figuring this was one of the paths to good health and a long life.Yet clinical trials of antioxidant supplements have repeatedly dashed the hopes of consumers who take them hoping to reduce their cancer risk. Virtually all such trials have failed to show any protective effect against cancer. In fact, in several trials antioxidant supplementation has been linked with increased rates of certain cancers. In one trial, smokers taking extra beta carotene had higher, not lower, rates of lung cancer.

Two cancer researchers have proposed why antioxidant supplements might not be working to reduce cancer development, and why they may actually do more harm than good. Their insights are based on recent advances in the understanding of the system in our cells that establishes a natural balance between oxidizing and anti-oxidizing compounds. These compounds are involved in so-called redox (reduction and oxidation) reactions essential to cellular chemistry.

Drs. Tuveson and Chandel propose that taking antioxidant pills or eating vast quantities of foods rich in antioxidants may be failing to show a beneficial effect against cancer because they do not act at the critical site in cells where tumor-promoting ROS (reactive oxygen species) are produced -- at cellular energy factories called mitochondria. Rather, supplements and dietary antioxidants tend to accumulate at scattered distant sites in the cell, "leaving tumor-promoting ROS relatively unperturbed," the researchers say.

Quantities of both ROS and natural antioxidants are higher in cancer cells -- the paradoxically higher levels of antioxidants being a natural defense by cancer cells to keep their higher levels of oxidants in check, so growth can continue. In fact, say Tuveson and Chandel, therapies that raise the levels of oxidants in cells may be beneficial, whereas those that act as antioxidants may further stimulate the cancer cells. Interestingly, radiation therapy kills cancer cells by dramatically raising levels of oxidants. The same is true of chemotherapeutic drugs -- they kill tumor cells via oxidation.

Some good foods to eat for their health benefits. The following articles are from Science Daily:

Almonds reduce the risk of heart disease, research shows

Eating almonds can reduce the risk of heart disease by keeping blood vessels healthy, research has shown. Research found that they significantly increase the amount of antioxidants in the blood stream, reduce blood pressure and improve blood flow. These findings add weight to the theory that Mediterranean diets with lots of nuts have big health benefits... "Our study confirms that almonds are a superfood. Previous studies have shown that they keep your heart healthy, but our research proves that it isn't too late to introduce them into your diet -- adding even a handful (around 50g) every day for a short period can help.

Could grapefruit be good for your kidneys?

A natural product found in grapefruit can prevent kidney cysts from forming, new research indicates. Naringenin, which is also present in other citrus fruits, has been found to successfully block the formation of kidney cysts, an effect that occurs in polycystic kidney disease, by regulating the PKD2 protein responsible for the condition. With few treatments currently available, symptoms include high blood pressure and loss of kidney function, and lead to the need for dialysis.

More evidence that dark chocolate is good for you. From Science Daily:

Polyphenols could yield small benefit for people with PAD

In a small study, people with artery problems in their legs (peripheral artery disease) walked a little longer and farther when they ate dark chocolate -- a food rich in polyphenols.The authors suggest that compounds found in cocoa -- polyphenols -- may reduce oxidative stress and improve blood flow in peripheral arteries....Many other polyphenol-rich foods would offer less added sugar, saturated fats, and calories than dark chocolate, such as cloves, dried peppermint, celery seed, capers, and hazelnuts, to name a few.

But I wonder if the results would be different if the only processed meat (cold cuts, salami, prosciutto) you ate came from antibiotic, hormone, additive, and nitrate-free meat. From Science Daily:

Processed red meat linked to higher risk of heart failure, death in men

Men who regularly eat moderate amounts of processed red meat such as cold cuts (ham/salami) and sausage may have an increased risk of heart failure incidence and a greater risk of death from heart failure. 

Processed meats are preserved by smoking, curing, salting or adding preservatives. Examples include cold cuts (ham, salami), sausage, bacon and hot dogs."Processed red meat commonly contains sodium, nitrates, phosphates and other food additives, and smoked and grilled meats also contain polycyclic aromatic hydrocarbons, all of which may contribute to the increased heart failure risk," said Alicja Wolk, D.M.Sc., senior author of the study and professor in the Division of Nutritional Epidemiology at the Institute of Environmental Medicine, Karolinska Institutet in Stockholm, Sweden. "Unprocessed meat is free from food additives and usually has a lower amount of sodium."

The Cohort of Swedish Men study -- the first to examine the effects of processed red meat separately from unprocessed red meat -- included 37,035 men 45-79 years old with no history of heart failure, ischemic heart disease or cancer. 

After almost 12 years of follow-up, researchers found:  - Men who ate the most processed red meat had more than a 2-fold increased risk of death from heart failure compared to men in the lowest category. - For each 50 gram (e.g. 1-2 slices of ham) increase in daily consumption of processed meat, the risk of heart failure incidence increased by 8 percent and the risk of death from heart failure by 38 percent. - The risk of heart failure or death among those who ate unprocessed red meat didn't increase.

"To reduce your risk of heart failure and other cardiovascular diseases, we suggest avoiding processed red meat in your diet, and limiting the amount of unprocessed red meat to one to two servings per week or less," said Joanna Kaluza, Ph.D., study lead author and assistant professor in the Department of Human Nutrition at Warsaw University of Life Sciences in Poland. "Instead, eat a diet rich in fruit, vegetables, whole grain products, nuts and increase your servings of fish."

The reduced risk of stroke was from only a modest 20 grams of protein per day. From Science Daily:

Diet higher in protein may be linked to lower risk of stroke

People with diets higher in protein, especially from fish, may be less likely to have a stroke than those with diets lower in protein, according to a meta-analysis. The meta-analysis looked at all of the available research on the relationship between protein in the diet and the risk of stroke. Seven studies with a total of 254,489 participants who were followed for an average of 14 years were included in the analysis.

"The amount of protein that led to the reduced risk was moderate -- equal to 20 grams per day," said study author Xinfeng Liu, MD, PhD, of Nanjing University School of Medicine in Nanjing, China. 

Overall, the participants with the highest amount of protein in their diets were 20 percent less likely to develop a stroke than those with the lowest amount of protein in their diets. The results accounted for other factors that could affect the risk of stroke, such as smoking and high cholesterol. For every additional 20 grams per day of protein that people ate, their risk of stroke decreased by 26 percent.

Liu noted that the analysis does not support increased consumption of red meat, which has been associated with increased stroke risk. Two of the studies were conducted in Japan, where people eat less red meat than westerners do and more fish, which has been associated with decreased risk of stroke. 

The reduced risk of stroke was stronger for animal protein than vegetable protein. Protein has the effect of lowering blood pressure, which may play a role in reducing stroke risk, Liu said.