Up-to-date research studies and literature review pearls investigating food and lifestyle behaviors and their impact on our health.

Food & Lifestyle as Medicine Series

*Dental Decay, Cavities & Carbohydrates: Intakes of sweet and starchy foods as they relate to Dental Health*

Sugar + Bacteria in mouth and saliva = Acid Production Acid + Tooth = Dental Decay Sugar + Starch -> activate fast metabolizing bacteria in mouth. During this metabolizing process, fast metabolizing bacteria pulls Calcium from its limited storage form in tooth bacterial biofilm and saliva. This is done in order to address and neutralize changes in Ph caused by the sugar and starch. When too much in quantity, over long periods of times, eventually, these fast-metabolizing bacteria will use up all of the stored calcium in their biofilm and saliva and will start to cause Ca to be leeched from the tooth enamel. This act of leeching Calcium from tooth enamel to neutralize changes in pH in mouth caused by acid production from sugar and starchy foods is what is the initiation of tooth decay hence cavities.

Reference: 1. Lin, Steven. The Dental Diet: The Surprising Link between Your Teeth, Real Food, and Life-Changing Natural Health. Hay House, Inc., 2019.

*Effects of Sleep Hygiene Education on_Sleep Duration_ Cravings for Sweet, Salty foods & Appetite*

Tasali et al, 2014 in his 3-week, home based interventional study assessed the effects of personalized sleep hygiene education on sleep duration and food desires under real life conditions. The participants in the study were overweight individuals who were at risk for obesity. At the end of the intervention period: Mean sleep duration increased by up to 1.6 hrs/ per night. Participants reported: *Being less sleepy *More vigorous *14% decrease in overall appetite *62% decrease in desire for sweet and salty foods. The desire for fruits, vegetables and protein rich nutrients was not affected by the added sleep.

Reference: 1. Tasali, Esra et al. “The effects of extended bedtimes on sleep duration and food desire in overweight young adults: a home-based intervention.” Appetite vol. 80 (2014): 220-4. doi:10.1016/j.appet.2014.05.021

*Sleep & NAFLD *

Yang et al. 2022 Meta- analysis of 15 studies involving a total of 261,554 participants correlated inadequate sleep duration-less than 6-7 hrs/day with an increased risk of developing Non-Alcoholic Associated Fatty Liver Disease (NAFLD)

Suggested Biological Mechanisms of Action:

Inadequate sleep may:

1. Activate brain networks related to reward and result in overeating, craving of sweet and salty foods, upregulate ghrelin which will ultimately cause feeling of constant hunger, and eventually result in obesity.

2. Accelerate Insulin Resistance (IR), increase free fatty acids production (FFA), and increased oxidative stress which may result in liver dysfunction on cellular level.

3. Via increase in inflammation via production of CRP, IL-6 and TNF alpha which ultimately will result in accumulation of fat in liver.

4. via GUT Dysbiosis by affecting natural oscillation of gut microbiota, decrease their richness and alter gut endothelial barrier via promoting leaky gut and causing liver inflammation via bacterial translocation


1. Yang, Jie et al. “Short sleep duration and the risk of nonalcoholic fatty liver disease/metabolic associated fatty liver disease: a systematic review and meta-analysis.” Sleep & breathing = Schlaf & Atmung, 1–12. 22 Dec. 2022, doi:10.1007/s11325-022-02767-z

*8-hrs Time Restricted Eating (TRF) and PCOS*

2021 prospective cohort study published in the Journal of Translational Medicine showed that 8 –hour-Time-Restrictive Feeding (TRF) for 5 weeks in women with an-ovulatory Polycystic Ovary Syndrome (PCOS) contributed to:

->Improvement in menstruation->more than half of participants restored their menstrual cycle;

->Weight Loss: 18% decrease in visceral fat mass

->Improvement in Fasting Insulin Levels: via decrease in Insulin Resistance

->Chronic Inflammation: via decrease in chronic inflammatory markers such as hsCRP, ALT


1. Li, Chunzhu et al. “Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome.” Journal of translational medicine vol. 19,1 148. 13 Apr. 2021, doi:10.1186/s12967-021-02817-2

*Yogurt: Fatty Liver Disease, Insulin resistance and Metabolic Syndrome*

Chen Yang et al in their Randomized, parallel and controlled trial examining the effects of daily conventional yogurt consumption on metabolism parameters in obese women with Non Alcoholic Fatty liver Disease(NAFLD) and Metabolic Syndrome(MetSy) found that 1 cup of yogurt before breakfast over 24 weeks trial improved Insulin resistance(IR), lipid metabolism via decrease in fat mass, liver fat accumulation, decreased levels of serum triglycerides, Cholesterol and TNF alpha likely by regulating inflammation, oxidative stress , lipid metabolism and liver injury via alteration of gut microbiota composition.


1.        1. Chen, Yang et al. “Yogurt improves insulin resistance and liver fat in obese women with nonalcoholic fatty liver disease and metabolic syndrome: a randomized controlled trial.” The American journal of clinical nutrition vol. 109,6 (2019): 1611-1619. doi:10.1093/ajcn/nqy358


Riboli et al : EPIC Study : an ongoing prospective cohort study designed to investigate the relationship between nutrition, cancer and potentially other diseases showed that incorporating 4 foundational behaviors:

1.No Smoking

2. Physical Activity of 3 1/2 hrs Weekly

3. Healthy Diet

4. Healthy Weight

—> Results In: Reduced risk of developing:

93%  Diabetes

81%  Heart Disease

50% Stroke

36% reduced risk of developing Cancer.


1. Hyman, Mark. The Pegan Diet: 21 Practical Principles for Reclaiming Your Health in a Nutritionally Confusing World. Little, Brown Spark, a Hachette Book Group, 2021.
2. Riboli, E et al. “European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection.” Public health nutrition vol. 5,6B (2002): 1113-24. doi:10.1079/PHN2002394

*Added Sugar*

Per 2017–2018 NHANES report, the average daily intake of added sugars for children & young adults aged 2 to 19 years was staggering 17 teaspoons per day.
Added sugars include fructose, sucrose, dextrose, table sugar, syrups, honey and sugars from concentrated fruit or vegetable juices.
Added sugar is different than natural sugar found in fruits and vegetable for it has a different metabolic pathway of conversion to energy and impacts body systems.
Consuming too much added sugars may contribute to weight gain, obesity, type 2 diabetes, and heart disease.
Per CDC National Center for Health Statistics data brief, 42.4 % of the US population through the years of 2017-2018 was found to be obese.
12.2 % of adults in the USA are found to be metabolically healthy per 2019 report published by The National Library of Medicine.

So, you may:

Start reading labels of the products you purchase. Always, always look at the added sugar column, and aim for no added sugar options, and or <5 g per serving. Remember, regarding food choices, simple is better, color and variety even more so, moderation is the key. Try to do your grocery shopping around the store where fresh foods are and stray away from the middle aisles where all prepackaged foods with added preservatives are. Choose options that contain fewer ingredients, and ingredients you can pronounce. Go for dark chocolate, simple ingredients options with a label of ingredients that do not look like you must have master’s in chemistry to understand what it means. That way you may satisfy your sweet craving while eating potent antioxidants and polyphenols found in cocoa. Food Is Medicine.


“Get the Facts: Added Sugars.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 May 2021, www.cdc.gov/nutrition/data-statistics/added-sugars.html.

*Mediterranean Diet Principles*
Emphasis on:
Whole foods such as fruits and vegetables with low glycemic index and glycemic load, whole grains, nuts, legumes, dairy, EVOO, spices, modest amount of poultry and fish, low amounts of red meat and red wine.
Reviews of studies on the Mediterranean diet show improvements in the following parameters of metabolic syndrome: waist circumference, HDL cholesterol, blood fats, blood pressure, blood sugar.
1. Esposito, Katherine et al. “Mediterranean diet and the metabolic syndrome.” Molecular nutrition & food research vol. 51,10 (2007): 1268-74. doi:10.1002/mnfr.200600297
2.Georgoulis, Michael et al. “Mediterranean diet and diabetes: prevention and treatment.” Nutrients vol. 6,4 1406-23. 4 Apr. 2014, doi:10.3390/nu6041406


Pre-Biotic fiber is “food for GUT microbiome”. It has the ability to stimulate growth of specific gut microbiota. By eating prebiotic food sources, we feed/stimulate growth of beneficial microbiota, and may starve the pathogenic ones.

Prebiotic fiber food sources:

Allium Vegetable family: garlic, onion, leeks and chives

Green Color vegetables: asparagus, Jerusalem artichoke, peas, soybeans

Legumes->bean, peas, chickpea, lentil, peanut and soybean.

Fruits-> such as bananas, apples, and berries

Honey-> prebiotic(food) for beneficial strains due to prebiotic oligiosacharides (2)

The products of pre-biotic degradation are mainly SCFA`s.

Some of the protective effects of these SCFA include:

Improvement in blood lipid profiles->Decrease of Total Chol & LDL

Immune S-m: Improve: antibody response to vaccines, Natural killer cells function to fight off viruses

CNS: Improve general cognition, learning, mood , recall and memory, slow down dementia process.

Bones: Improve Calcium Absorption

Skin: decrease risk of atopic dermatitis, erythema

1.     Lux, Stefanie et al. “In vitro fermented nuts exhibit chemopreventive effects in HT29 colon cancer cells.” The British journal of nutrition vol. 108,7 (2012): 1177-86. doi:10.1017/S0007114511006647
2.     “Functional Nutrition and Lifestyle Strategies to Promote Microbiome Health during & after Antibiotic Therapy.” Project of Health, 11 Nov. 2020, projectofhealth.com/functional-nutrition-and-lifestyle-strategies-to-promote-microbiome-health-during-after-antibiotic-therapy/.
3.     Davani-Davari, Dorna et al. “Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications.” Foods (Basel, Switzerland) vol. 8,3 92. 9 Mar. 2019, doi:10.3390/foods8030092