nutrition

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Nutrition Panel: Cut Down On Sugar To Combat Obesity, Chronic Disease

(Mel B via Compfight)

(Mel B via Compfight)

A U.S. advisory panel on nutrition has issued a sweeping report on the American diet that many of us won’t find earth shattering. One key conclusion: we should eat less sugar.

The 2015 Dietary Guidelines Advisory Committee offered its recommendations to the U.S. Department of Health and Human Services and the Department of Agriculture today as part of a process to develop new national dietary guidelines, which are updated every five years. Public comments are currently being accepted.

As far as sugar goes, the report states that: “Higher consumption of sugar-sweetened foods and beverages as well as refined grains was identified as detrimental in almost all conclusion statements with moderate to strong evidence.”

The report’s authors said they were guided by “two fundamental realities”:

“First, about half of all American adults — 117 million individuals — have one or more preventable, chronic diseases, and about two-thirds of U.S. adults — nearly 155 million individuals — are overweight or obese. These conditions have been highly prevalent for more than two decades. Poor dietary patterns, overconsumption of calories, and physical inactivity directly contribute to these disorders. Second, individual nutrition and physical activity behaviors and other health-related lifestyle behaviors are strongly influenced by personal, social, organizational, and environmental contexts and systems. Positive changes in individual diet and physical activity behaviors, and in the environmental contexts and systems that affect them, could substantially improve health outcomes.

Here’s more about the dietary recommendations:

The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low-or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat;i and low in sugar-sweetened foods and drinks and refined grains. Vegetables and fruit are the only characteristics of the diet that were consistently identified in every conclusion statement across the health outcomes. Whole grains were identified slightly less consistently compared to vegetables and fruits, but were identified in every conclusion with moderate to strong evidence. For studies with limited evidence, grains were not as consistently defined and/or they were not identified as a key characteristic. Low- or non-fat dairy, seafood, legumes, nuts, and alcohol were identified as beneficial characteristics of the diet for some, but not all, outcomes. For conclusions with moderate to strong evidence, higher intake of red and processed meats was identified as detrimental compared to lower intake….

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That Extra Slice: Study Finds When Kids Eat Pizza, They Eat More Calories

Pizza birthday party (Flickr Creative Commons)

Pizza birthday party (Flickr Creative Commons)

By Alvin Tran
Guest contributor

Parents, if you want to prevent your kids from eating too many extra calories, you might want to think twice about letting them have that “just one more” slice of chewy dough, tangy tomato sauce and glistening melted cheese.

In a new study, published Monday in the journal Pediatrics, researchers found that pizza contributed to children and adolescents consuming more calories, saturated fat, and sodium in their usual diet.

“They’re taking in substantially more nutrients we really want to be thinking about limiting,” said Lisa Powell, PhD, a University of Illinois at Chicago professor of health policy and administration and the study’s lead author.

Powell’s study, which analyzed 24-hour dietary recalls of more than 12,000 kids over a 7-year period, found that children between the ages of 2 and 11 consumed an extra 84 calories on the days they ate pizza, while adolescents consumed an extra 230 calories.

It’s not a good idea to eat pizza as a snack.

– Lisa Powell, PhD

They also consumed significantly more sodium and saturated fat, which nutrition and health experts often dub the “bad fat.”

There is a silver lining, however. Children’s overall caloric intake from pizza declined by 25 percent over the course of the study. The study’s adolescent population, which ranged from ages 12 and 19, also demonstrated similar trends: its caloric intake from pizza fell by 22 percent.

But while the number of calories that adolescents consumed dropped, their overall consumption, on average, did not significantly change over the course of the study. According to Powell and her co-authors, this may be due to a slight increase in pizza consumption.

“The average adolescent takes in 620 calories of pizza. By showing that they consume this extra 230 calories, that means that on days they consume pizza, they’re not adequately adjusting the caloric intake and other things they take in that day,” Powell said. “They may be eating pizza but they’re having this additional 230 calories that they’re taking in.”


Overall, pizza consumption remained highly prevalent across both groups. In 2009 to 2010, 20 percent of children and 23 percent of adolescents consumed pizza on a given day.

Powell and her colleagues also found that consuming pizza as a snack or from fast-food restaurants were the two greatest culprits influencing both children and adolescents’ overall daily calorie intake.

“It’s not a good idea to eat pizza as a snack. That’s one thing that teens and parents should keep in mind,” Powell said. Continue reading

Project Louise: The Project Ends Now … But It Lasts A Lifetime

baby steps, will 668/flickr

baby steps, will 668/flickr

With the end of 2014 comes the end of Project Louise. The official end, that is. My excellent CommonHealth hosts gave me a year of coaching and support to see how much I could improve my health, and that year is now over. But my efforts to keep improving my health will continue, I hope and believe, for the rest of my life.

In part that’s because I haven’t reached all the goals I set for myself a year ago. I lost some weight, but not as much as I hoped; I exercised more, but I still haven’t developed the consistent exercise habit that I know I’ll need in order to make fitness a real and permanent part of my life.

On the other hand, I have made some real changes that I know will last. My diet is much better than it was a year ago – more vegetables, less junk – and, maybe even more important, my relationship with food is less complicated and neurotic. I still sometimes eat “bad” foods, but I don’t hate myself when I do – and that means I don’t go off on a binge.

That change is part of a larger one, one that Coach Allison Rimm urged me to undertake – and one that, frankly, didn’t immediately strike me as relevant to this project. Gently, consistently and with remarkable success, she has encouraged me to speak more kindly to myself, to focus on what I’m doing right rather than what I’m doing wrong.

Gentle Nudging

It turns out that gentle encouragement works much better than relentless criticism – something I knew and practiced in raising my children, yet somehow needed to learn in “raising” myself. In teaching me this lesson, Coach Allison has given me a priceless and lasting gift.

And that newfound sense of patience with myself is connected to the main reason I’ll keep working on this “project,” the single most important thing it has taught me. More than better nutrition, more than motivation for exercise, what Project Louise has shown me is that nothing lasting happens overnight. Change is a continuous process, not an isolated event.

No Overnight Success

We all fantasize about the life-changing moment, the day that divides our imperfect past from our glorious future – isn’t that what New Year’s Eve is all about? But in fact most days are pretty much like most other days; the calendar may change tomorrow, but we all know that Jan. 1 won’t feel much different from Dec. 31. Continue reading

Embrace The Eggnog, And Other Tips To Curb Holiday Eating (And Guilt)

(Theen Moy/Flickr)

(Theen Moy/Flickr)

It’s peak season for overeating — and then beating yourself up for doing it.

Clearly, you’re not the only one treating yourself to pumpkin and pecan pie, egg nog and, yes, fruitcake. Yet it’s no comfort that everyone else and their Weight Watchers’ leader is also riddled with guilt and enduring a personal thrashing for the extra calories and potential weight gain. While this self-flagellation goes on, you’re missing out on enjoying the holidays.

If only there were a better approach to holiday eating, maybe then you’d be able to stop beating yourself up, enjoy eating what you love and savor everything else you really do love about this season.

Happily, you don’t need an emergency gastric bypass to stop the vicious cycle: putting an end to both overeating and self-criticism might be easier than you think. It might be as easy as reviewing some research-based strategies honed from a group training I lead for people with eating issues. It revolves around practicing a variety of mindful eating and self-compassion meditations.

Here are five proven tips for happier, healthier holiday eating:

1. Redefine Holiday Eating

You’ll need a better working definition of “normal holiday eating” if your definition sounds anything like my esteemed colleague and family eating expert Ellyn Satter’s:

Most people get caught up in what they should and shouldn’t eat. They’re anxious and ambivalent about eating. They might try to resist at holiday parties, but the table is laden with ‘forbidden food,’ and they throw away all control and overdo it. Many times they’re over-hungry because they’re trying to restrict themselves and lose weight. So the standard definition of holiday eating becomes eating way too much.

If you’d prefer to take fewer bites and ease the anxiety and ambivalence, now’s the time to do the exact the opposite, starting with eating regular meals and snacks. Then, come party-time, permit yourself to eat the foods you enjoy. You’re probably going to eat them anyway, so you might as well as enjoy them, without the guilt and other uncomfortable emotions that predictably fuel emotional eating.

2. Go Easier On Yourself

If, like most dieters, you’re hoping that feeding yourself a steady diet of self-criticism will inspire you to rein in your eating, think again. You’ve actually got it backward. Self-criticism — calling yourself fat, disgusting and other mean, nasty names — is really a recipe for emotional overeating and holiday weight gain. Continue reading

Suit Over ‘100% Natural’ Label On Nature Valley Granola Bars Settled

(AP Photo: Matt Rourke)

(AP Photo: Matt Rourke)

The non-profit Center for Science in the Public Interest has made me a hopeless cynic about the glowing verbiage on food packaging. Among the center’s other work, it acts as a sort of truth squad for food claims, outing many “good for you” labels and ads for the shameless distortions that they are.

“I guess I knew that was too good to be true,” is my usual reaction when I find out that yet another hyper-palatable “healthy” snack or entree is actually packed with sugar or fat or salt.

Now, the center reports the settlement of a suit it brought against General Mills for calling Nature Valley granola bars and other products “100% Natural” even though they contained highly processed sweeteners. (Wait, you mean “high-fructose corn syrup” doesn’t just count as corn?) From it’s press release:

WASHINGTON—A settlement agreement announced today prevents General Mills from claiming that its Nature Valley granola bars, crispy squares, and trail mix bars are “100% Natural” if those products contain high-fructose corn syrup, high-maltose corn syrup, dextrose monohydrate, maltodextrin, soy protein isolate, or several other artificially produced ingredients. The agreement, which is effective immediately and applies to labeling and marketing for 30 Nature Valley products, settles a 2012 lawsuit brought on behalf of consumers by the nonprofit Center for Science in the Public Interest and two law firms.

CSPI privately raised its concern with General Mills over its “100% Natural” claims as early as 2005. The company began phasing out its use of high-fructose corn syrup in some products, but at the time of CSPI’s lawsuit was still using high-maltose corn syrup and maltodextrin. While those ingredients are derived from corn, they are produced by treating corn starch with acids, enzymes, or both before being refined into a substance that does not occur in nature.

The center notes that a bill introduced in Congress in 2013 “would prohibit the use of the word ‘natural’ on a food that includes any synthesized ingredient, or any ingredient that has undergone chemical changes such as corn syrup, high-fructose corn syrup, high-maltose corn syrup, maltodextrin, chemically modified food starch, or alkalized cocoa.”

The Wall Street Journal reports that some Nature Valley packaging had apparently already been changed. Continue reading

The Politics Of Gluten

LaShawn Wiltz/flickr

LaShawn Wiltz/flickr

A close kid relative of mine can die if he eats gluten. Actually, this child is so allergic to gluten that you can’t even cook pasta if he’s in the room or he’ll break out in a rash, or worse. He’s been to emergency rooms, both in the U.S. and abroad, due to his allergies, and it usually happens when someone hands him a so-called “gluten-free” cookie or snack that actually wasn’t.

So gluten is a hot topic in our family. Recently, though, skepticism has been rising about the very notion of gluten allergies, or sensitivities. Exhibit A in this arena is Michael Specter’s latest New Yorker story on the current gluten-free craze, which has enraged more than a few parents whose kids have real and scary reactions to gluten. Specter writes:

While there are no scientific data to demonstrate that millions of people have become allergic or intolerant to gluten (or to other wheat proteins), there is convincing and repeated evidence that dietary self-diagnoses are almost always wrong, particularly when the diagnosis extends to most of society. We still feel more comfortable relying on anecdotes and intuition than on statistics or data.

Speaking on Here & Now yesterday, Specter reiterated the article’s takeaway that the national gluten-free obsession is mostly just the latest fad diet.

Maybe. But here’s some reaction from a parent who thinks Specter should have taken a broader view:

“My son has gone into anaphylaxis from accidentally ingesting gluten four different times over the course of his life.  Each time we had to administer an emergency Epipen injection and rush him to the ER.  I don’t think he was reacting to a fad…

It is fine to debate the merits of going gluten free as a diet or lifestyle choice for some. But for others it is a clear medical issue, with the most serious consequences. The number of Americans suffering from celiac or severe gluten allergy seems to be growing fast, and that merits substantial funding and research to figure out why and find cures. It would be a mistake if that fact were to be lost amid the current efforts at “de-bunking” the risks of eating gluten for some.”

Confessions Of A Physician Sugar Addict

(Mel B via Compfight)

(Mel B via Compfight)

By Terry L. Schraeder, M.D.
Guest contributor

In medical research, the “n” value is the number of people in a study. If n = 1, it is not generally considered a very powerful study. But when you are the “1” in “n = 1,” it somehow becomes more significant.

It all started with a can of soda disguised as sparkling orange juice. It had become my “go to” treat. My pick-me-up when I was low. In fact, it gave me a rush of energy every time I drank it. One day, I looked at the label to see if it contained caffeine. No caffeine, just added sugar. In fact, it contained 32 grams of sugar — eight teaspoons per can — with sugar second only to water as the largest ingredient. The World Health Organization recommends women not consume more than six teaspoons of added sugar per day — or about 5 percent of total calories as added sugar. Men can have up to nine teaspoons.

How much sugar was I consuming a day? I was also adding honey to my coffee, maple syrup to my oatmeal, consuming corn syrup in my “healthy” flavored yogurt (some brands add as much as 30 grams per serving) and enjoying muffins as a snack and dessert many evenings. Along with my routine stop for a drive-through flavored coffee drink, and occasional cookies or candy, I had officially joined our nation of fellow sugar addicts.

In the US, we are consuming on average 88 grams or 22 teaspoons of added sugar a day. (There are four grams of sugar per teaspoon.) My guess is that I was eating even more. Like many, I needed my fix of high fructose corn syrup or other sugar source every few hours.

For the last several years, there has been an increasing drumbeat of warnings linking sugar to obesity, diabetes, heart disease, cancer and nonalcoholic fatty liver disease from experts such as endocrinologist Dr. Robert H. Lustig at the University of California at San Francisco and media doctor Dr. Sanjay Gupta at CNN. But somehow the message had missed me. I did not think of myself, especially as a physician, as a high sugar consumer.

I have tried to stop the hourly IV drip of added sugar I was consuming throughout the day.

I have passed my 50th birthday and have a normal body weight and exercise regularly. I am not on any medication. My blood pressure and fasting blood glucose are normal. But last year, my triglyceride level was high. One reason might be that the high fructose corn syrup I was consuming is converted to triglycerides in the liver – hence the high level.

There were other concerns. I noticed that I felt shaky and had food cravings two hours after eating. I also noticed an afternoon slump of low energy, a growing bulge of belly fat, and plaque that needed to be vigorously scraped from my teeth every six months. How long had my sugar intake been so high?

Sugar consumption in the US has climbed into the stratosphere in the past three decades. Our added sugar consumption increased by 30 percent from 1977 to 2010, according to a study presented last week at ObesityWeek, a major obesity conference, in Boston. It seems we are slurping, sucking and chewing 300 calories of added sugar daily (up from 228) and far more than the recommended limit of 100 calories of added sugar per day. Continue reading

Studies: It May Be Better For Kids Who Are Overweight Not To Know It

feetonscale

According to the scale, the 18-year-old girl is severely obese. But she doesn’t think so.

“I know I’m big, but I’m not obese,” she says. “I don’t take up three seats. My weight is high, but no higher than lots of people’s. It’s no problem.”

If you’re her doctor or school nurse or parent, what do you do? Do you bombard her with Body Mass Index charts and warnings of the health risks she faces? Knowledge is power, right? Certainly, that’s the principle behind the “BMI report cards” — colloquially known as “fat letters” — that schools send home in some states.

But research just presented at ObesityWeek, a major conference on obesity, suggests that it may not be wise to persuade that young woman that she has a problem.

One study found that overweight teens who “misperceive” their weight as normal end up gaining less weight over the next decade or so than teens who are overweight and know it. Another study found that those “misperceivers” blind to their extra pounds were also less likely to become depressed in later years.

The findings are at odds with the basic assumption behind BMI report cards, that it is helpful to inform kids and their families of their weight status, says researcher Kendrin Sonneville, an assistant professor at the University of Michigan School of Public Health who is also affiliated with Harvard and the Division of Adolescent/Young Adult Medicine at Boston Children’s Hospital.

Kendrin and IdiaXXX

Dr. Kendrin Sonneville and Dr. Idia Thurston at the Obesity Week conference, where they presented studies that found that weight “report cards” may backfire. (Carey Goldberg/WBUR)

“I think we can say the jury is still out,” she says. “Weight misperception is not something we should assume is harmful, and in the spirit of doing no harm, I think we need to proceed with caution on any type of programming that involves correcting weight misperception.”

The study she led, which followed more than 2700 young people beginning in high school, found that after about a decade, the overweight teens who had perceived their weight accurately gained more than one BMI unit — very roughly about 10 pounds — more than those overweight teens who had falsely believed their weight to be normal.

Why might this be? That’s one of the next avenues of research that need to be explored, but clinical psychologist Idia Thurston, an assistant professor at the University of Memphis, says the key could be the emotional baggage that comes with being told you’re overweight or obese.

More accurate weight perception may translate into more feelings of stigma and lower satisfaction with your own body, she says, “and that could affect your ability to cope — hence, depressive symptoms or hence, engaging in harmful eating behaviors.”

“So when we think about weight report cards and telling kids, ‘This is what your weight status is,’ you really need to think about how that information is being disseminated, and what kinds of protections are put into place, rather than just sending report cards home to kids and not knowing how kids will act on that information.”

Dr. Thurston’s study, also presented at ObesityWeek, found that overweight high-school-aged boys who accurately perceived their own weight as high were significantly more likely to develop depressive symptoms over the next decade or so. (The findings in girls were not statistically significant.) Once again, a false sense of being a normal weight appeared to be protective for overweight young people.

The idea of having schools screen kids for obesity began in 2003 in Arkansas during then-Gov. Mike Huckabee’s anti-obesity efforts, Dr. Sonneville says, and spread around the country without ever having a solid research base on what its effects might actually be.

About one-fourth of states track schoolchildren’s height and weight, and last year U.S. News reported that nine sent weight “report cards” home, including Massachusetts. But last October, facing pushback from nurses, parents and others, the state’s Public Health Council voted to stop sending the letters home, though the schools still gather the information. U.S. News reported that decision under the headline “Massachusetts Schools To Stop Sending ‘Fat Letters:'” Continue reading

Chia Seed Alert: Superfood, Yes, But They Landed One Man In The ER

photo: Rachel Zimmerman/WBUR

photo: Rachel Zimmerman/WBUR

Confession: I eat chia seeds everyday. I feed them to my children. They make me feel full and satisfied and, yes, I’m a sucker for foods touted as “super” even though I know deep down it’s just marketing.

I may be crazy, but I’m also trendy: chia seeds are everywhere, in energy bars and smoothies, atop yogurt parfaits and at the core of crunchy kid snacks. Good Morning America called chia seeds the “it” food of 2013.

And they really are good for you: “a rich source of fiber, protein and heart-healthy omega-3 fatty acids,” according to an NIH publication.

But this week, my chia euphoria took a hit. “Despite potential health benefits, chia seeds may pose a risk if they are not consumed properly, according to new research,” said the Medline headline.

A case report presented by a North Carolina GI doctor describes a scary case of chia seeds gone bad: a 39-year-old man spent several hours in the emergency room under anesthesia after eating no more than a tablespoon of dry chia seeds followed by a glass of water.

The seeds, which can absorb up to 27 times their weight in water, apparently expanded post-ingestion and completely blocked the man’s esophagus, according to the doctor who handled the case, Rebecca Rawl, MD, MPH, a gastroenterology fellow at Carolinas Medical Center in Charlotte, North Carolina.

I spoke to Rawl, and she told me the story of the chia seed blockage — believed to be the first report of its kind. She presented her poster, titled “Watch It Grow: Esophageal Impaction With Chia Seeds,” earlier this week at the American College of Gastroenterology’s annual meeting in Philadelphia. It began innocently enough, she said:

The man arrived at the hospital and said he had this feeling of pain at the top of his stomach and couldn’t swallow anything — “not even his own saliva.” Hospital staff took him in for an upper endoscopy and the imaging clearly showed the culprit: puffed up chia seeds.

What did it look like?

Rawl said:

It was a gel of these seeds, the consistency was similar to Playdoh — not solid, but not a liquid. Continue reading

Good Potato, Bad Potato: War Over Starchy Spud Rages On

Hideya HAMANO/flickr

Hideya HAMANO/flickr

By Alvin Tran
Guest Contributor

Potatoes, it turns out, are political.

At least in the cutthroat world of food and nutrition where, increasingly, what we eat is a highly partisan, hotly debated and frustratingly gridlocked battle pitting health policy types against one another.

Here’s where the potatoes come in:

On one side of the battle, you’ll find politicians, farmers and advocates lobbying for potatoes to become a part of the federal Special Supplemental Nutrition Program for Women, Infants, and Children, saying they are cheap and potentially nutritious. On the other, you’ll find researchers, including many doctors from the Institute of Medicine, steering patients away from potatoes and saying that Americans are currently consuming too much of the starchy vegetable.

As a doctoral student in nutrition, I often find myself caught in the crossfire of such food battles, whether they’re over the health benefits of dark chocolate, red wine, coffee or my current fixation: potatoes. All too often, friends, family members and even strangers on the bus beg for a little simplicity: they just want to know if certain foods are “good” or “bad.”

Unfortunately, things are rarely so simple and, like many foods that have become mired in controversy, nuances around the relative benefits or ills of potatoes have been obscured in the rhetoric.

Some specifics:

For starters, potatoes contain a large amount of carbohydrates and they have a high glycemic load – meaning they are quickly digested. Foods that have high glycemic loads generally cause blood sugar and insulin levels to rapidly spike and may cause a person to feel hungry again shortly after eating a meal.

According to The Nutrition Source, a publication of the Harvard School of Public Health that acts as a source of research-based nutrition information, previous research studies have linked diets high in potatoes and other rapidly digested carbs to chronic health outcomes, including diabetes and heart disease.

The findings from a new study, published in early September, suggested that a low-carb diet, compared to one that is low-fat, may be more effective for weight loss and in reducing the risk of heart-related health problems.

Nutrition researchers, however, have raised concerns over the study’s findings. For example, in a recent opinion piece in The New York Times, David L. Katz, a nutritionist and the founding director of the Yale University Prevention Research Center, is quoted saying that diets focused on eliminating solely one item, such as carbs, aren’t always good and can actually be harmful: “Our fixation on a particular nutrient at a time has been backfiring for decades…”
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