Author: Nia Stephanopolous-Chichura, MD

Summer 2016 in Kansas City, Dr. Nia is scheduling patients for the Riordan Clinic’s new site and planning to write her Health Hunters article. She goes home and is in the kitchen cooking supper for her family with a well-seasoned, black cast iron skillet. After a tasty meal, she washes the skillet but suddenly is distracted by the sound of her toddler giggling. She quickly turns to find him taking a bite out of every apple in the fridge. In an attempt to save the apples from browning and play with her toddler, she forgets to dry the skillet. Dr. Nia then comes back 20 minutes later to find a red rusty skillet… Fiddlesticks!

You have probably encountered rust sometime in your life. It happens when iron oxidizes. Oxidation is what causes that shiny new piece of iron metal to turn dull and red. Oxidation can happen to other metals too and it can even occur in our bodies. In fact, oxidation is occurring constantly, and our body has ways to balance it through antioxidants.

If you look up anything about the process of oxidation, you may find that it takes place by means of something called ‘free radicals.’ Free radicals are like a fire. Many of the free radicals arise from the fire within us, called metabolism. Much of the metabolism of our cells takes place in the mitochondria. You can think of mitochondria as little power plants that power a city. They work day and night to convert energy to usable forms so that you can have the energy to think, walk, talk and be you. All of our cells make free radicals during metabolism in the mitochondria and they have a purpose, just as the power of fire can be harnessed and used as a tool for heat or light. However, if that fire gets out of hand it can cause excessive oxidative stress which breaks down our bodies quickly and we begin to age or rust inside.

We keep this fire in balance with anti-oxidants. The great news is that antioxidants can come from whole food sources! In fact, the U.S. Department of Agriculture has a rating scale, available to the public, comparing the antioxidant power of various foods. It is called the ORAC scoring system (Oxygen Radical Absorbance Capacity) and you may have seen this term with a number next to it on some of the fruit and vegetable labels in grocery stores. The higher the number, the more antioxidant capacity the food has and the more it can keep the fire of free radicals in check (meaning keeping you youthful and healthy). (10)

To give you some examples:
Rosehips 96,150
Raw Strawberries 4,302
Watermelon 142
Sprouted Raw Alfalfa Seeds 1,510
Raw Broccoli 1,510
Boiled Broccoli 2,160
Frozen Broccoli spears, unprepared 496
Raw Garlic 5,708
Portabella Mushrooms 968
Raw Parsley 1,301
Avocado, Hass, Raw 1,922
Lemon Juice, Raw 1,225
Raw Pomegranate 4,479
Raw Spinach 1,513
Sweet potato Baked in Skin 2,115
Sweet Potato cooked, boiled without skin 766
Sweet Potato Raw 902
Pecans 17,940
Baking Chocolate unsweetened squares 49,944
Cocoa Dry Powder, unsweetened 55,653
Acai fruit/pulp, skin, powder 102,700
Dried Rosemary 165,280
Spices turmeric, ground 127,068 (10)

Some common trends arise in perusing the ORAC values. The majority of spices rate extremely high. Many medicinal herbs produce some of the highest ORAC ratings known. We also begin to see what are known as “superfoods” such as cacao and acai berries which rank very highly. Superfoods tend to be very colorful and much of their antioxidant capacity is due to the colorful pigments they produce. Always remember to eat colorful foods and do not forget the spices! (8)

You may be thinking that’s great, Dr.Nia, antioxidants can combat too much oxidative stress, but what is the purpose of having oxidation and anti-oxidation taking place in our cells anyway? Why would we have oxidation and free radicals at all if they can do damage? (6)

The answer lies in a term called ‘hormesis.’ Hormesis says that a little bit of stress can make us stronger, but too much stress causes us damage. (5) You may have encountered the concept of hormesis when starting to work out for the first time in a long time. A little walk, a few weights to lift and you feel great the next day. A 3-hour session at the gym and you cannot move the next day. Scientists are finding that hormesis is occurring in our cells when we have just enough oxidation to trigger our cells to respond, get stronger, and heal more quickly. Scientists are finding that a key step in the process of getting our mitochondria and cells to multiply and maintain health is a pathway called NRF-2, which stands for nuclear factor erythroid-derived 2. You can think of NRF-2 as a thermostat inside the cell. If the fire from oxidation is getting too hot, the thermostat kicks in to cool it off. Basically, a little stress turns on the NRF-2 pathway in our cells and, once it is turned on, we generate many more antioxidants than ever before. We increase our cellular detoxification systems such as glutathione, we activate antiinflammatory cascades, and we activate cell survival genes. All of these mechanisms combat chronic and acute diseases at their core, from heart disease, Parkinson’s disease, sepsis to autism to cancer, just to name a few. (1,2,4,7,9,11)

You may be asking, what can activate the NRF-2 pathway? Exercise, Sulforaphane and isothiocyanates from cruciferous veggies like broccoli sprouts, resveratrol from berries and grape seeds, catechins found in green tea, cacao and dark chocolate, ozone, even our natural lactobacilli bacteria can activate the NRF-2 pathway! (3) Science is just beginning to scratch the surface on the NRF-2 pathway, along with Oxidative Medicine, finding ways the bacteria and our mitochondria are actually talking with one another, and fostering communication among all of our cells for the health of our bodies. Much of the research up to this point has been conducted in sterile environments and has not taken into account the microbiome or good bacteria normally found in and on the surface of the human body. There is so much more to be discovered and applied to humans for healing. We are living in very exciting and hopeful times, despite what much of the world may be telling us. Remain hopeful and truth seeking co-learners. I look forward to our next chat together!

Until then, I want to welcome you all to our new clinic office location in Kansas City, Kansas, as well as our campuses in Wichita and Hays. I will leave you with an adapted antioxidant-loaded chocolate recipe from author David Wolfe. Warm Regards, Dr. Nia

Cacao Kapow!

Serves 2 | Adapted from the book Superfoods by David Wolfe p.55

2 oranges
14 dried apricots, soaked in water 4 to 6 hours
½ cup almonds, dry (could substitute cashews, pecans, walnuts, hazelnuts, macadamia nuts)
1 heaping teaspoon of raw cacao nibs
2 tablespoons of raw cacao powder

Directions: Juice the oranges. Blend the orange juice with 10 of the apricots and place in 2 glasses. Blend the remaining apricots with almonds , cacao nibs, and chocolate powder. Keep it still slightly crunchy. Spoon this on top of the orange and apricot blend. You may also top this with some honey or other natural sweetener and orange zest Enjoy! (8)

Article Sources:

1.) Bai, Yang et al. Sulforaphane protects against cardiovascular Disease via Nrf2 activation. Oxid Med Cell Longev. October 25, 2015: 407580.
2.) Chen, Pei-Chun et al. Nrf2-mediated neuroprotection in the MPTP mouse model of Parkinson’s disease: critical role for the astrocyte. Proceedings of the National Academy of Sciences of the United States of America (PNAS) . vol 106 no.8 2933-2938.
3.) Jones, Rheinalt M. Lactobacilli modulate epithelial cytoprotection through the Nrf2 pathway.Cell Reports 12, 1217–1225, August 25,
4.) Lau, Alexander et al. Dual roles of Nrf2 in cancer. Pharmacological Research Vol 58, Issue 5-6, Nov-Dec 2008, 262-270
5.) Mattson, Mark P.Hormesis Defined. Aging Research reviews. 7 (2008) 1-7
6.) Rahman, Khalid. Studies on free radicals; antioxidants, and co-factors.. Clin Interv Aging. 2007 Jun; 2(2): 219–236.
7.) Singh, Kanwalit et al. Sulforaphane treatment of autism spectrum disorder (ASD)Proceedings of the National Academy of Sciences of the United States of America (PNAS) vol. 111 no. 43
8.) Superfoods . David Wolfe. North Atlantic Books. Berkeley. 2009 p. 55
9.) Thimmulappa, RK et al. Nrf2 is a critical regulator of the innate immune response and survival during experimental sepsis. J Clin Invest 2006 Apr 116 (4) 984-95.
10.) USDA Database for the Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods, Release 2 Prepared by David B. Haytowitz and Seema Bhagwat May 2010 http://www.orac-info-portal.de/download/ORAC_R2.pdf
11.) http://www.nrf2science.com/studies/