Food as Medicine: Caper (Capparis spinosa, Capparaceae)

The caper (Capparis spinosa, Capparaceae) bush is a small, salt-tolerant shrub with trailing, thorny branches, and thick, fleshy leaves. Caper has a deep root system and trailing vines that grow seven to 10 feet tall.1 The semi-prostrate branches have ovate, petiolate leaves arranged opposite of each other. The flowers are pink or white with three petals and numerous stamens. Caper is a deciduous, dicotyledonous plant that produces distinctive flower buds, which have a lifespan of 24 to 36 hours after opening.1,2

Caper’s edible shoots are considered a vegetable, and its processed buds are considered a culinary herb.1The tender shoots emerge in the spring, while the flower buds are harvested from mid-May to mid-August. Each plant produces hundreds of flowers each season. When pickled in vinegar or brine, the immature flower buds form capric acid, which is responsible for caper’s unique, salty-sour flavor.2,3 Once the flower blooms and is pollinated, it produces a fruit two to three inches in length and one-half to three-quarters of an inch in diameter. Caper fruits start out green but turn purple when ripe. Each fruit contains 200 to 300 seeds.1 The fruit of the caper bush is also harvested, but not commonly used.2

capersCurrently, capers are cultivated commercially in northern Africa, Spain, and Italy. Caper plants in Cyprus, Greece, and Turkey are grown for domestic use and not for export. The United States imports more than $20 million of processed capers annually.1 Caper plants that are two to three years old produce about two pounds of buds in a year, while plants older than four years may produce more than 20 pounds of buds annually.1

Phytochemicals and Constituents

Macronutrients are found in capers in very small amounts. One tablespoon (8.6 grams) of pickled capers has two calories, half a gram of carbohydrates, and minute amounts of protein and fat. An important micronutrient to consider when eating capers is sodium. One tablespoon of capers contains 202 milligrams of sodium, which is 8.5% of the recommended daily intake for a healthy adult.4,5 The flower bud also contains trace amounts of vitamins C and E. The concentration of vitamins can vary from plant to plant. The vitamin C content in capers cultivated in different regions in Tunisia, for example, ranged from 0.3 to 0.5 milligrams per 100 grams of capers.6

A number of bioactive compounds have been isolated from the flower buds of the caper bush. The pickling process has varying effects on the bioavailability of compounds due to different fermentation methods.7 Among the most investigated of these phytochemicals are flavonoids and antioxidants.

Flavonoids from Capers reportedly have cytotoxic, anti-inflammatory, antidiabetic, and antiparasitic properties.7,8 Rutin (quercetin-3-O-rutinoside) is the most abundant flavonoid in fresh and pickled caper buds.7 Simple water extractions high in rutin have been shown to reduce inflammation and arrest cell growth in cancer cells, as well as kill intestinal parasites in animals.8,9 Caper flower buds also contain quercetin-3-O-rhamnosylrutinoside, a derivative of quercetin.6

Quercetin, another well-studied flavonoid, is formed from rutin during the pickling process.7 Quercetin can inhibit inflammation and cancer cell growth in the same way as rutin.9 Quercetin has also shown immune health benefits. Kaempferol 3-O-rhamnosylrutinoside, another flavonoid identified in an aqueous extract, has proven antiparasitic properties.8

The flower bud of the caper bush also contains antioxidants such as carotenoids, tocopherols, ascorbic acid, and a newly identified antioxidant, cappariside, a small organic acid.6,10 Antioxidants eliminate free radicals that cause damage to body tissues and DNA and have been implicated in the prevention of cancer, kidney damage, and heart disease, as well as protection against prescription drug-induced toxicity.11 The antioxidant effects of flower bud preparations have been shown to be more potent than those of the antioxidants in isolation.8

Historical and Commercial Uses

The unopened flower buds of the caper bush are commercially known as capers.2 Capers are used as a condiment in salads and sauces, or with meat or fish. They are also used in cosmetics and medicines.

Archeological evidence for the historical use of capers as a food and medicine exists among many ancient cultures.12 The earliest known evidence of caper consumption was found in the Mesolithic soil layer of an excavation site in Syria, potentially dating back to 9000 BCE. Nearby ancient peoples may have been using capers in 7500 BCE as evidenced by mineralised seeds found in the Franchthi cave, a Stone Age cave in the Greek Peloponnesian peninsula. Dried seeds found in the Nahal Hemar cave in Israel may have been used as early as 6000 BCE. In China, fresh clumps of capers and plant parts were preserved in entombed containers that are almost 3,000 years old. There is also evidence of Egyptian consumption of capers from 275 BCE to 600 CE.

Historical medicinal uses of capers ranged from expelling bad odor spirits in ancient Arabic cultures to treating paralysis in ancient Xinjiang, China.12 In addition to the buds, the root bark, fruit, and aerial parts of the caper bush were used in traditional remedies. Countries in the native range of caper, including Iran, Iraq, and Syria, used every part of the caper bush for a variety of ailments. As the cultivation and use of capers spread, the Greeks, Egyptians, and Chinese incorporated the caper bush into their traditional medicine practices.

Capers contain phytochemicals that can inhibit inflammation, which supports caper’s usages as a cleanser and pain reliever.9,12 In ancient Chinese, Greek, and Arabic cultures, the root bark was mixed with vinegar or honey and applied topically to treat skin conditions such as ulcers and white spots associated with vitiligo.12 Similarly, the root was consumed as a treatment for inflammation and lacerations of the mouth, spleen, stomach, and intestines. In ancient Egypt, the root was used to reduce the pain of a scorpion sting.

In ancient Greece and China, the caper bush was regarded for its drying properties and was used as an expectorant in treating wet cough and asthma.12 Ancient Romans boiled caper root and root bark in oil and used it as an anthelmintic (digestive tract parasitic worm expeller). Likewise, in the 12th century, the Egyptians used the root to cleanse and dry the stomach.

Current medicinal usages are a testament to caper’s efficacy for treating different ailments. In the Middle East, indigenous groups still use capers as a so-called “blood purifier” and diuretic, to relieve stomach discomfort, treat kidney stones, improve liver function, and treat eczema.13 In Ayurveda, one of the traditional medicine systems of India, caper is used to treat paralysis and tremors, as well as edema, gout, and rheumatism.14 The root bark is still used to stimulate the menstrual cycle, as an expectorant, and to treat paralysis, rheumatism, spleen conditions, and toothaches.15

Modern Research

Commercial capers are not frequently studied for their medicinal properties. However, some research has been conducted on the bioactive compounds in the flower buds.

A recent study investigated the antiparasitic effect of a caper bud extract against Haemonchus contortus, a common parasite in cows and sheep. A large number of eggs and short lifespan of H. contortus allows the parasite to adapt quickly to its environment.16 Parasite infestations can result in large economic losses in the animal production industry, and current treatments include chemotherapy and vaccinations, which pose a safety concern.17 Researchers compared the caper extract to a commonly prescribed antiparasitic drug albendazole. The flower bud extract (50 mg/mL) was almost twice as effective as albendazole (1 mg/mL) at killing parasites in sheep and inhibited  the hatching of parasitic eggs more than the leaf extract.8

The caper bud has also been studied for its anti-inflammatory and cytotoxic properties. A recent study investigated the potential of capers to inhibit nuclear factor-kappa B (NF-κB), a transcription factor that controls inflammation and cell growth. Mutations that impact its activation may lead to uncontrolled cell growth, one of the conditions that can cause a proliferation of cancer cells.18 For this reason, NF-κB is a therapeutic target for pancreatic, renal, and thyroid cancer treatments.18-20 In one in vitro study, researchers tested an aqueous extract of the flower bud and leaves, which were selected for their high levels of phenolic compounds, on human adenocarcinoma cells. The caper extract successfully inhibited the inflammation mechanism and arrested cell growth in a dose-dependent manner.9

Additionally, a caper flower bud extract has been studied for its ability to treat liver toxicity in animals. Rats were exposed to two different liver toxins: carbon tetrachloride, a known carcinogen that has been used as a commercial refrigerant, propellant, and solvent; and paracetamol, also known as acetaminophen, a pain-relieving drug that can induce liver failure in sufficiently high doses.21 Compared to control, the caper extract resulted in a significant reduction in carbon tetrachloride-induced and paracetamol-induced liver toxicity.

Nutrient Profile4

Macronutrient Profile: (Per 1 tablespoon pickled capers, drained)

2 calories

0.2 g protein

0.4 g carbohydrate

0.1 g fat

Secondary Metabolites: (Per 1 tablespoon pickled capers, drained)

Provides small amounts of:

Vitamin K: 2.1 mcg (2.6% DV)

Dietary Fiber: 0.3 g (1.2% DV)

Provides trace amounts of:

Magnesium: 3 mg (0.8% DV)

Vitamin C: 0.4 mg (0.7% DV)

Iron: 0.1 mg (0.6% DV)

Riboflavin: 0.01 mg (0.6% DV)

Folate: 2 mcg (0.5% DV)

Vitamin E: 0.1 mg (0.5% DV)

Manganese: 0.007 mg (0.4% DV)

Calcium: 3 mg (0.3% DV)

Niacin: 0.06 mg (0.3% DV)

Vitamin A: 12 IU (0.2% DV)

Phosphorus: 1 mg (0.1% DV)

Potassium: 3 mg (0.1% DV)

Thiamin: 0.002 mg (0.1% DV)

Vitamin B6: 0.002 mg (0.1% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet.

Recipe: Lemon Capellini with Capers

Adapted from Ina Garten22

Ingredients:

  • 1 pound dried capellini pasta
  • 1/3 cup of extra virgin olive oil
  • Zest and juice of two lemons
  • 1/4 cup capers, drained
  • Salt and pepper to taste

Directions:

  1. Cook pasta according to package directions. Before draining, reserve 1/4 cup of pasta cooking water. Drain pasta and return to pot off the heat.

  2. Toss the cooked pasta with olive oil, lemon juice, salt, and pepper, adding pasta water a tablespoon at a time until

    a thin sauce forms

    . Discard any remaining pasta water.

  3. Add capers and lemon zest and toss once more to combine. Serve immediately.

References

  1. Kontaxis DG. Specialty Crop: Capers. Davis, CA: University of California Cooperative Extension; 2012. Available at: http://sfp.ucdavis.edu/pubs/SFNews/DecJan97-98/capers_148/. Accessed April 17, 2017.
  2. Van Wyk, BE. Food Plants of the World: An Illustrated Guide. Portland, OR: Timber Press; 2005.
  3. National Geographic Society. Edible: An Illustrated Reference to the World’s Food Plants. Washington DC: National Geographic Society; 2008.
  4. Basic Report: 02054, Capers, canned. United States Department of Agriculture Agricultural Research Service website. Available at: https://ndb.nal.usda.gov/ndb/foods/show/303. Accessed April 6, 2017.
  5. Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guidelines Recommendations. In: Dietary Guidelines for Americans 2015-2020. 8th ed. Washington DC: US Department of Health and Human Services and US Department of Agriculture; 2015.
  6. Tlili N, Khaldi A, Triki S, Munné-Bosch S. Phenolic compounds and vitamin antioxidants of caper (Capparis spinosa). Plant Foods Hum Nutr. 2010;65(3):260-265.
  7. Nabavi SF, Maggi F, Daglia M, Habtemariam S, Rastrelli L, Nabavi SM. Pharmacological effects of Capparis spinosa L. Phyother Res. 2016;30:1733-1744.
  8. Akkari H, B’chir F, Hajaji S, et al. Potential anthelmintic effect of Capparis spinosa (Capparidaceae) as related to its polyphenolic content and antioxidant activity. Veterinární Medicína. 2016;61(6):308-316.
  9. Kulisic-Bilusic T, Schmöller I, Schnäbele K, Siracusa L, Ruberto G. The anticarcinogenic potential of essential oil and aqueous infusion from caper (Capparis spinosa L.). Food Chem. 2012;132(1):261-267.
  10. Yang T, Wang C, Liu H, Chou G, Cheng X, Wang Z. A new antioxidant compound from Capparis spinosaPharm Biol. 2010;48(5):589-594.
  11. Kaur CK, Kapoor HC. Antioxidants in fruits and vegetables — the millennium’s health. International Journal of Food Science and Technology. 2001;36(7):703-725.
  12. Jiang HE, Li X, Ferguson DK, Wang YF, Liu CJ, Li CS. The discovery of Capparis spinosa L. (Capparidaceae) in the Yanghai Tombs (2800 years b.p.), NW China, and its medicinal implications. J Ethnopharmacol. 2007;113(3):409-420.
  13. Sher H, AlMutairi K, Mansoor M. Study on the ethnopharmaceutical values and traditional uses of Capparis spinosa L. African Journal of Pharmacy and Pharmacology. 2012;6(16):1255-1259.
  14. Nadkarni K. Indian Materia Medica. Vol 1. Bombay, India: Bombay Popular Prakashan; 1976.
  15. Duke J. Duke’s Handbook of Medicinal Plants of the Bible. Boca Raton, FL: CRC Press; 2008.
  16. Emery DL, Hunt PW, Le Jambre LF. Haemonchus contortus: the then and now, and where to from here? Int J Parasitol. 2016;46(12):755-769.
  17. Kebede B, Sori T, Kumssa B. Review on the current status of vaccines against parasitic diseases of animals. J Veterinar Sci Techno. 2015;7(3):27.
  18. Tunçel D. Role of NF-kappa b in the approach to pancreatic ductal adenocarcinoma. Archives Medical Review Journal. 2015;24(4):565-577.
  19. Li X, Abdel-Mageed AB, Mondal D, Kandil E. The nuclear factor kappa-B signaling pathway as a therapeutic target against thyroid cancers. Thyroid. 2013;23(2):209-218.
  20. Peri S, Devarajan K, Yang DH, Knudson AG, Balachandran S. Meta-analysis identifies NF-kappaB as a therapeutic target in renal cancer. PLoS One. 2013;8(10):e76746.
  21. Chhaya G, Mishra SH. Antihepatotoxic activity of p-methoxy benzoic avid from Capparis spinosaJ Ethnopharmacol. 1999;66:187-192.
  22. Garten I. Lemon capellini with caviar. Food Network Magazine. Available at: www.foodnetwork.com/recipes/ina-garten/lemon-capellini-with-caviar. Accessed April 6, 2017.

Turmeric, Red Grape, and Apple Compounds ‘Starve’ Prostate Cancer Cells

An Apple peel compound can halt the growth of prostate cancer cells when combined with compounds from red grapes or turmeric.
What do turmeric, apples, and grapes have in common? According to a new study, they could hold the key to preventing and treating one of the most common cancers in the United States.

Researchers have identified a number of natural compounds that have the potential to “starve” prostate cancer tumors and shrink them.

Compounds present in turmeric, red grapes, and apple peel appear to have the strongest effect, particularly in combination.

Study co-author Stefano Tiziani, of the Department of Nutritional Sciences and the Dell Pediatric Research Institute at the University of Texas at Austin, and colleagues recently reported their findings in the journal Precision Oncology.

After skin cancer, prostate cancer is the most common cancer among men in the U.S. According to the American Cancer Society, there will be 161,360 new cases of prostate cancer diagnosed this year, and around 26,730 men will die from the disease.

Previous studies have identified a number of compounds, particularly found in plant-based foods, that have the potential to reduce the risk of prostate cancer.

For this latest study, Tiziani and colleagues used a novel, high-throughput screening technique to test 142 natural compounds, with the aim of identifying those that are most effective for halting the growth of prostate cancer cells.

Compound combination blocked tumor growth in mice

The compounds were tested on prostate cancer cells derived from mice and humans, individually and in combination.

The team identified three compounds that were most effective for halting prostate cancer cell growth:

  • curcumin, the bright yellow compound in turmeric
  • ursolic acid, found in apple peel
  • resveratrol, found in red grapes and berries

These three compounds were then tested in mouse models of prostate cancer.

The researchers found that when ursolic acid was combined with either curcumin or resveratrol, the natural compounds prevented the uptake of glutamine by prostate cancer cells, which prevented tumor growth in the mice.

Glutamine is an amino acid that prostate cancer cells need in order to grow, so preventing its uptake effectively “starves” the cancer cells to death.

What is more, because ursolic acid, curcumin, and resveratrol are natural compounds, they did not cause any toxic effects in the mice.

However, the researchers note that the concentrations of each of the three compounds were higher than that which is normally consumed through diet. Still, the team believes that the findings show promise for a natural strategy to prevent and treat prostate cancer.

These nutrients have potential anti-cancer properties and are readily available. We only need to increase concentration beyond levels found in a healthy diet for an effect on prostate cancer cells.”

Food as Medicine: Spinach (Spinacia oleracea, Chenopodiaceae)

Spinach (Spinacia oleracea, Chenopodiaceae) is an annual plant that grows up to 23 inches tall (60 cm). Spinach plants produce an edible rosette and toothed fleshy leaves. There are two main types of spinach: crinkled savory leaf spinach and smooth or flat-leaf spinach. Spinach leaves are fleshy, deep green, and rich in essential nutrients and phytochemicals. Spinach requires deep and nitrogen-rich soil to grow, and prefers a cool climate, with spring and autumn being optimal growth seasons for the leaves. The hot weather of summer may cause the spinach to bolt quickly, which causes the leaves to deteriorate. The plant produces greenish-yellow flowers when ready to set seed.

Spinach is native to southwest Asia, in the area of present-day Iran. Spinach cultivation spread to China in 647 BCE and spread across Europe by the 12th century CE. Now, spinach is cultivated throughout the world in temperate climate zones. In the United States, California is the largest producer of spinach, followed by Arizona and New Jersey. The annual per capita consumption of spinach in the United States was estimated to be 1.7 pounds in 2014.

Phytochemicals and Constituents

Spinach is one of the most nutritious leafy vegetables and ranks second behind kale (Brassica oleracea var. acephela, Brassicaceae) in total carotenoids and folate content. Spinach is high in protein and low in carbohydrates and fat.

The plant is a nutrient-dense source of vitamins and minerals and maintains its nutritional value well after cooking. Spinach provides an array of B vitamins, which are important for carbohydrate metabolism, the nervous system, and the brain. Spinach contains other important minerals including calcium, magnesium, zinc, and selenium, and is a significant source of potassium, copper, iodine, and iron. It also contains abundant amounts of vitamins A, K, and C.

The flavonoid, phenolic acid, and carotenoid content of spinach make it a healthy, therapeutic food. These compounds are effective at neutralizing free radicals in the body and are able to protect the body from damage and disease by reducing inflammation.

The two major carotenoids present in spinach leaves are lutein and beta-carotene, and they compose more than 65% of the total carotenoids content. Lutein may help prevent vision loss from age-related degenerative disorders such as macular degeneration and cataracts. A yellow pigment, lutein is found in high amounts in the retina and absorbs blue light emitted by back-lit devices such as smartphones and computer screens. Other carotenoids in spinach include violaxanthin and neoxanthin.

The carotenoids in spinach are very delicate and highly susceptible to degradation over time. Post-harvest handling of spinach from a field to freezer does alter the phytochemical profile of the leaves. In one study, storing fresh spinach leaves for 24 hours at 39°F (4°C) did not impact the carotenoids content in fresh spinach. However, storing fresh spinach for 72 hours at the same temperature resulted in a reduction of the carotenoids content by almost 15%. Blanching fresh leaves for two minutes at 212°F (100°C) followed by freezing effectively preserved the carotenoid content of spinach.

Historical and Commercial Uses

Historically, spinach leaves have been used as a laxative, diuretic, antidote against poison or infection, and as a treatment for asthma and other breathing difficulties, sore throat, and kidney stones. Spinach also has potential effects against hyperglycemia and inflammation. The seeds were used to control fever, to address back pain, and as a diuretic. In the Indian traditional medicine, the plant is known as palak and was used to treat liver injury or infection and jaundice. Spinach was prescribed and used in traditional Iranian medicine as an antidepressant. Due to its high iron and chlorophyll content, spinach often is used as a therapeutic food for patients with anemia.

Spinach leaves are available commercially fresh, frozen, or canned. Depending on the spinach cultivar and method of preservation, the nutrients and phytochemical profile of spinach may vary. Spinach leaves can be eaten fresh or cooked. Several popular spinach-based dishes are said to be prepared “a la Florentine,” supposedly in honor of Catherine de Medici (1519-1589), who was born in Florence and introduced the vegetable to the French court upon her marriage to King Henry II.

Modern Research

There are limited data regarding the effect of whole spinach leaves on diseases, metabolic pathways, and conditions. Most of the available literature reports the effects of leaf extracts or specific isolated phytonutrient components.

Oxidative Damage and Inflammation

The antioxidant content of spinach leaf, which contains high amounts of vitamins A and C, suggests protective effects against damage from cellular oxidation. A mouse study found that supplementation with 1,100 mg/kg per day of methanolic spinach leaf extract significantly decreased radiation-induced lipid peroxidation in the liver. This study further demonstrated that the leaf extract decreased the negative impact of radiation on glutathione levels.

A 2017 rat study used a different methanolic spinach leaf extract with high levels of lutein, luteolin, quercetin, and coumarin. High-performance liquid chromatography analysis of the extract confirmed the presence of these compounds in active amounts. The study reported that intraperitoneal injection of the extract showed a protective anti-inflammatory effect in mice that were given isoproterenol to induce a heart attack. Spinach extract intake led to changes in activities of multiple enzymes, including paraoxonase, lecithin-cholesterol acyltransferase, C-reactive protein, myeloperoxidase, and caspase-3. Furthermore, the levels of pro-inflammatory cytokines in the heart tissue were significantly lower in mice pretreated with spinach extract than the control group. These results indicate the potential protective effects of spinach against inflammation and atherogenesis (the formation of abnormal fatty masses in arterial walls) when used as a concentrated leaf extract.

Cancer Chemoprevention

An in vitro study demonstrated that neoxanthin significantly suppressed inflammation and proliferation of prostate cancer cells. Additionally, in a bacteria-based model, flavonoids found in spinach leaves showed antimutagenic potential.

A study in mice reported that the antioxidants extracted from spinach leaves have protective effects against benign epithelial tumors. The potential mechanism of action was linked to the direct and indirect abilities of antioxidant compounds in spinach leaves to act as free-radical scavengers that inhibit the progression of carcinogenesis.

The abundant glycolipids in spinach leaves were found to possess inhibitory effects on the gastric cancer cell and promyelocytic leukemia cell proliferation in vitro. These findings are considered positive, but preliminary, results of the potential therapeutic effects of spinach glycolipids to prevent cancer proliferation.

Cardiovascular Disease

In a semi-randomized crossover study in humans, the consumption of a fortified spinach beverage resulted in a significant increase in plasma nitrate concentration, which correlated with lower diastolic blood pressure within 150 minutes post-consumption and persisted for five hours thereafter. This study suggests the possible therapeutic uses of spinach as a safe alternative and effective carrier for nitrate medications.

Supplementation

Spinach, like most dark, leafy greens, contains a high amount of folate: 100 grams of raw spinach provides almost half of an average person’s daily recommended intake. Daily intake of spinach for three weeks showed a significant increase in plasma folate concentrations, and processing spinach leaves did not affect the bioavailability of folate when compared to fresh whole-leaf spinach. Frozen whole-leaf spinach, minced spinach, and liquefied spinach have similar effects in terms of increasing plasma folate concentration.

Researchers currently are examining the potential benefits of fortifying flour with dehydrated spinach, with a goal to improve total folate content in bread.21 Fortification of white bread and whole grain bread with spinach (40 g spinach per 100 g of other ingredients) increased the total folate content, despite the effect of processing factors such as kneading and baking.

Diabetes

Spinach leaves contain many beneficial compounds such as vitamin C, iron, zinc, folic acid, polyphenols, and fatty acids. These compounds have protective effects topically as well as internally. In a study, diabetic rats were fed an aqueous spinach leaf extract to determine its effects on wound healing. The results showed that the spinach group had better wound-healing outcomes as indicated by significant improvements in epithelial and granulation tissue formation and blood vessels. These results indicate the potential beneficial effects of supplementation with spinach juice or other types of spinach extracts to treat wounds and ulcers in patients with diabetes.

Consumer Considerations

In August 2008, The US Food and Drug Administration (FDA) announced that it would allow the irradiation of spinach in order to kill the harmful bacteria Escherichia coli and Salmonella after numerous outbreaks of foodborne illness. Strains of E. coli have the ability to survive and multiply in the absence of an animal host when soil, water, and plants become contaminated. Pathogenic bacteria can grow inside the leaf tissues of spinach, rendering typical antimicrobial surface treatments ineffective. Uniformity of crop management practices as well as environmental factors not only impact the vegetable quality, but also the survival rate of E. coli in the soil and on the leaf crops. There are concerns, however, about the irradiation of food crops. Research indicates that the process generates harmful reactive oxygen species and decreases the phytonutrient content of the food in the process of eliminating foodborne pathogens.

The primary source of spinach leaf contamination with heavy metals is from pesticides containing lead arsenate, environmental pollution, contaminated irrigation water and rainwater, and runoff from nearby areas treated with plant pesticides and fertilizers. Leaf crops are most sensitive to lead contamination and bioaccumulation. Commercially farmed spinach is most susceptible to heavy metal and pathogen contamination due to the reliance on pesticides and poor land management techniques such as continual replanting in contaminated soil.

Caution with spinach consumption may be warranted in populations susceptible to kidney stones. Spinach is one of a number of foods that naturally contains oxalates. The oxalate content in spinach is estimated to be about 0.77 mg/100 g. Oxalates bind to many minerals, including calcium, zinc, and magnesium, inhibiting their absorption. Approximately 80% of kidney stones contain calcium and predominately consist of calcium oxalate. High levels of urinary oxalate are a major risk factor and precursor to the formation of calcium oxalate kidney stones. Observational data indicate an inverse relationship between dietary calcium and the risk of kidney stone formation, since dietary calcium may bind to oxalates in the gut, and thereby limit the absorption of intestinal oxalates and subsequent excretion of urinary oxalates. However, a study of three diverse populations noted only a small association between oxalate and spinach consumption and the risk of kidney stone formation.

Nutrient Profile

Macronutrient Profile: (Per 100 grams raw spinach)

23 calories

2.9 g protein

3.6 g carbohydrate

0.4 g fat

Secondary Metabolites: (Per 100 grams raw spinach)

Excellent source of:

Vitamin K: 482.9 mcg (603.6% DV)

Vitamin A: 9377 IU (187.5% DV)

Folate: 194 mcg (48.5% DV)

Vitamin C: 28.1 mg (46.8% DV)

Manganese: 0.9 mg (45% DV)

Magnesium: 79 mg (19.8% DV)

Potassium: 558 mg (15.9% DV)

Iron: 2.7 mg (15% DV)

Very good source of:

Riboflavin: 0.19 mg (11.2% DV)

Vitamin E: 2.03 mg (10.1% DV)

Vitamin B6: 0.2 mg (10% DV)

Calcium: 99 mg (9.9% DV)

Dietary Fiber: 2.2 g (8.8% DV)

Good source of:

Thiamin: 0.08 mg (5.3% DV)

Also, provides:

Phosphorus: 49 mg (4.9% DV)

Niacin: 0.72 mg (3.6% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet.

Recipe: Savory Spinach-Onion Pastry

Courtesy of Mariam Alhado

Ingredients:

  • 3 cups frozen chopped spinach, thawed
  • 1 yellow onion, thinly sliced
  • 1/4 cup freshly-squeezed lemon juice
  • 1 tablespoon extra-virgin olive oil
  • 1 tablespoon ground sumac or za’atar spice blend
  • Salt to taste
  • 1 package frozen puff pastry

Directions:

  1. Heat oven to 350°F. Using several layers of paper towels, squeeze as much excess water from the frozen spinach as possible.
  2. In a large bowl, combine spinach, onion, lemon juice, olive oil, sumac, and salt and form a uniform mixture.
  3. Roll out the pastry until it is smooth and of even thickness. Divide into three-inch squares. Add a few tablespoons of the spinach mixture into the center of each square, then fold the corners in and press to seal.
  4. Arrange the pastries on a baking sheet and bake for 15-20 minutes, until golden brown and heated through.

Life Changing Foods

In our world today, it can feel impossible to figure out what to feed yourself and your family. You want to eat healthfully, though not to the point of deprivation—you don’t want to forfeit the soul-soothing comfort of a delicious meal. You want to pick the “right” foods, though just what those are isn’t always clear. Out of so much advice about which foods are supposed to be beneficial and which to avoid, how do you make sense of what it means for you? After all, you and your loved ones are special. You’ve faced specific symptoms and illnesses, suffered distinct injuries (emotional and otherwise), and have your own unique hopes and dreams.
What if you knew the exact foods to add to your life—foods to protect you, foods you could trust, foods that were tailored to your goals and your needs? Enter the life-changing foods.

All of the life-changing foods are amazing for overall health. Each one also has specialized properties so you can select what to eat based on your particular needs, whether on a physical, emotional, or spiritual level. One food, for example, can help you put an end to mystery infertility, combat autoimmune disease, stave off Alzheimer’s, ease ADHD, boost your immune system at bedtime, connect you back to your true self, and help you hold on to good memories—and that’s just for starters. (That food is raw honey; more on its other amazing attributes soon.)

When you discover these answers, you welcome healing knowledge that has the power to change everything. When you know what a fruit, vegetable, herb, spice, or wild food has to offer, and when you focus on eating more of it on a regular basis, you get to let go of the massive food confusion. Instead of living in fear and struggling to keep up with each day, you give your mind and body the fuel they need to adapt to our changing times. You finally get to take control of your life and to guide the ones you love to health and happiness.

Why Is Drinking Water Important?

Most people take drinking water for granted, but keeping hydrated has a huge impact on overall health. Despite how crucial water is, a significant number of people fail to consume recommended levels of fluids each day.

Around 70 percent of the body is comprised of water, and around 71 percent of the planet’s surface is covered by water. Perhaps it is the ubiquitous nature of water that means drinking enough each day is not at the top of many people’s lists of priorities.

Fast facts on drinking water

Here are some key points about drinking water. More detail and supporting information is in the main article.

  • Humans are 70 percent water, and our blood is 90 percent water
  • There is no universally agreed quantity of water that must be consumed daily
  • Water is essential for the kidneys to function
  • When dehydrated, the skin can become more vulnerable to skin disorders and wrinkling
  • In a CDC questionnaire, 7 percent of respondents reported drinking no water at all daily

Why do we need to drink water?

Woman drinking water.
The Institute of Medicine recommends that men achieve a daily fluid intake of around 3 liters and that women take in 2.2 liters.

To function properly, all the cells and organs of the body need water. It is also used to lubricate the joints, protect the spinal cord and other sensitive tissues, regulate body temperature, and assist the passage of food through the intestines.

Although some of the water required by the body is obtained through foods with a high water content – soups, tomatoes, oranges – the majority is gained through drinking water and other beverages.

During everyday functioning, water is lost by the body, and this needs to be replaced. It is noticeable that we lose water through activities such as sweating and urination, but water is even lost when breathing.

Drinking water, be it from the tap or a bottle, is the best source of fluid for the body. Beverages such as milk and juices are also decent sources of fluid, but beverages containing alcohol and caffeine, such as soft drinks, coffee, and beer, are not ideal because they often contain empty calories.

It was previously thought that caffeinated beverages had diuretic properties, meaning that they cause the body to release water. However, studies show that fluid loss because of caffeinated drinks is minimal.

How much water should you drink?

The recommended amount of water to be drunk per day varies from person to person, depending on factors such as how active they are and how much they sweat. There is no universally agreed upon amount of water that must be consumed daily, but there is a general level of consensus as to what a healthy amount is. According to the Institute of Medicine (IOM), an adequate intake for men is approximately 13 cups (3 liters) a day. For women, an adequate intake is around 9 cups (2.2 liters).

Many people will have heard the phrase, “drink eight 8-ounce glasses of water a day,” which works out at around 1.9 liters and is close to the IOM’s recommendation for women. Drinking “8 by 8” is an easy-to-remember amount that can put people on the right track regarding water consumption. Remember, all non-alcoholic fluid counts towards this recommendation.

Water also helps dissolve minerals and nutrients so that they are more accessible to the body, as well as helping transport waste products out of the body. It is these two functions that make water so vital to the kidneys.

How does not drinking enough affect the kidneys?

Cross-section of the kidneys.
The role of the kidneys in keeping the body healthy may be underrated in relation to the heart and lungs.

Every day, the kidneys filter around 120-150 quarts of fluid. Of these, approximately 1-2 quarts are removed from the body in the form of urine, and 198 are recovered by the bloodstream. Water is essential for the kidneys to function.

If the kidneys do not function properly, waste products and excess fluid can build up inside the body.

Untreated, chronic kidney disease can lead to kidney failure, whereby the organs stop working, and either dialysis or kidney transplantation is required.

Urinary tract infections (UTIs) are the second most common type of infection in the body and account for around 8.1 million visits to health care providers in the U.S. every year.

If infections spread to the upper urinary tract, including the kidneys, permanent damage can be caused. Sudden kidney infections (acute) can be life-threatening, particularly if septicemia occurs.

Drinking plenty of water is one of the simplest ways to reduce the risk of developing a UTI and is also recommended to those who have already developed a UTI.

Kidney stones interfere with how the kidneys work and, when present, can complicate UTIs. These complicated UTIs tend to require longer periods of antibiotics to treat them, typically lasting 7-14 days.

The leading cause of kidney stones is a lack of water; they are commonly reported in people who do not drink the recommended daily amount of water. As well as complicating UTIs, research has suggested that kidney stones also increase the risk of chronic kidney disease.

In November 2014, the American College of Physicians issued new guidelines for people who have previously developed kidney stones, stating that increasing fluid intake to enable 2 liters of urination a day could decrease the risk of stone recurrence by at least half with no side effects.

Dehydration – using and losing more water than the body takes in – can also lead to an imbalance in the body’s electrolytes. Electrolytes, such as potassium, phosphate, and sodium, help carry electrical signals between cells. The levels of electrolytes in the body are kept stable by properly functioning kidneys.

When the kidneys are unable to maintain a balance in the levels of electrolytes, these electrical signals become mixed up, which can lead to seizures, involving involuntary muscle movements and loss of consciousness.

In severe cases, dehydration can also result in kidney failure, a potentially life-threatening outcome. Possible complications of chronic kidney failure include anemia, damage to the central nervous system, heart failure, and a compromised immune system.

Effects on other organs

Of course, it is not just the kidneys that are affected by a lack of water; below is a small sample of the other negative consequences dehydration can bring:

  • Blood is more than 90 percent water, therefore, if water is in short supply, blood can become thicker and increase blood pressure.
  • When dehydrated, airways are restricted by the body in an effort to minimize water loss, potentially making asthma and allergies worse.
  • The skin can become more vulnerable to skin disorders and premature wrinkling.
  • The bowel needs water to function correctly. If dehydrated, digestive problems and constipation can become an issue. Dehydration can lead to an overly acidic stomach which makes heartburn more common and can encourage the development of stomach ulcers.
  • Cartilage, found in joints and the disks of the spine, contain around 80 percent water. If dehydration is ongoing, joints can become less good at shock absorption, which leads to joint pain.
  • Dehydration can affect brain structure and function. If dehydration is prolonged, cognitive ability is impaired.

Does the U.S. drink enough water?

A study carried out by the Centers for Disease Control and Prevention (CDC) in 2013 analyzed data from the National Cancer Institute’s 2007 Food Attitudes and Behaviors Survey.

Out of a sample of 3,397 adults, the researchers found the following:

  • 7 percent of adults reported no daily consumption of drinking water
  • 36 percent of adults reported drinking 1-3 cups of drinking water a day
  • 35 percent of adults reported drinking 4-7 cups of drinking water a day
  • 22 percent of adults reported drinking 8 cups or more a day

People were more likely to drink less than 4 cups of drinking water daily if they consumed 1 cup or less of fruits or vegetables a day.

The study only measured the intake of drinking water and, of course, fluid can be gained from other beverages. However, water is the ideal source of fluid because it is calorie-free, caffeine-free, and alcohol-free.

Because 7 percent of respondents reported drinking no water at all daily, and those who drank a low volume of water also consumed less fruit and vegetables, it suggests that there is a certain number of people who are risking their health by not getting enough fluid.

Even if the respondents reporting low levels of water intake were obtaining enough fluid, it is likely that they would be obtaining it from sources that could potentially compromise their health in other ways.

“The biologic requirement for water may be met with plain water or via foods and other beverages,” write the study authors. “Results from previous epidemiologic studies indicate that water intake may be inversely related to the volume of calorically sweetened beverages and other fluid intakes.”