No, I Don’t Care If Kids Eat Candy on Halloween

Letting kids loose on Halloween doesn’t have to mean all hell breaks loose afterwards.

Halloween is a once-a-year occasion.  I’m focused on what kids do the other 364 days of the year.  If they’re eating well on those other days, then there’s absolutely nothing wrong with letting them enjoy Halloween!

Every year around this time I get a ton of questions from parents about what to “allow” kids to eat on Halloween, how much candy to let them collect and keep, and what kind of candy is “best” to give out on Halloween.

Sugar Shakedown

No, sugar won’t make them hyperactive.  They might have a burst of energy, but the whole “sugar-gives-them-a-buzz” thing has been completely dismissed.  The rigorous science just doesn’t show anything.  Actually, a high-sugar snack has even been shown to help keep you on-task.  I’m NOT encouraging more sugar.  It’s not angel food, but not devil’s food, and it’s not a new food, either.  Just keep it real.

Your Homework: Laying the Groundwork

Planning ahead is everything here.  Kids (and adults) don’t like sudden, unexpected changes, especially to their eating habits.  Here are a few tips to help things go smoothly on the big day:

  • Be real about how much you buy. You know how many kids typically visit you, so get enough for THEM.  Buy with an eye to having as few leftovers as possible.
  • If you’ve already bought the candy, let the kids know ahead of time about the plan for leftovers: share with neighbors, you’re bringing them into work for co-workers, making up a bag for a child who couldn’t Trick-or-Treat (a nice thing to do for a child who is ill), and so on.
  • Buy only the smallest portions of candy! No full-sized bars, just the little mini things.  That way even with leftover stuff, the treat is reduced to a bite, not a commitment.

Tricks Before Treats

The idea to reinforce to kids is to “take care of business” first, by spending calories on the foods we need.  If there’s anything left, have a treat and enjoy it.  That’s the eating style I want kids to have 364 days a year.

  • Keep only the “top 10%” – their absolute fave candies. The rest gets donated or shared with others.  Quickly – like, get it out of the house the next day. (Note: For me, candy corn got tossed first thing!  Never could stand the stuff, even as a kid!)
  • Make it social! Halloween is also about dressing up, hanging with friends, and walking the neighborhood. This applies to all holidays or occasions.  It helps them see food and eating in perspective.
  • Never make candy a “reward” for good behavior (save that for training the dog), but see it as a teachable moment. Candy is an “extra”, it provides mostly empty “discretionary calories” so treat it that way.  It’s something to have in a small amount AFTER the rest of needs are met.

“What Does the Research Say”?

Yes, someone actually did a study on whether seeing Michelle Obama’s face (versus other political women’s faces) might influence them to choose a box of raisins or a small name-brand candy bar.  Connecticut home.  Three years of Halloween.  Kids were directed randomly to either of two sides of the porch – one with Michelle Obama’s pic, the other side pics of other political women (Hillary, Ann Romney, or no photo) and asked if they wanted a box of raisins or a small candy bar.  Authors described the community as politically liberal.

Result: The kids on the Obama side were 19% more likely to choose the box of raisins than the candy.

Great, but there was no info on whether the kids then ATE the fruit.  After all, no food can be nutritious until you EAT it.  Ironically, the box of raisins is about the same calories as the small candy.

Cut-To-The-Chase-Nutrition Take-Away

Halloween can be a blast.  It should be.  It’s also over in a day so enjoy it fully.  On other days, it’s about getting what you need first: the fruits, veggies, whole grains and dairy foods FIRST.  Be active, FIRST.  Those are the tricks, before the treats.

Wanna “Meat Up”? New Research Says Risks Are Lower Than Thought

Well, the meat wars have resumed. When new research suggests that the advice people have heard to eat less meat might have been based on weak evidence, and the New York Times sees fit to make it front page news, you know it’ll be one of the most talked about topics in the food and nutrition world. Pass the popcorn.

It was bound to happen: red meat has been touted as unhealthy, processed meat even worse. Yet lean meat is nutrient-rich and can have a place in your diet if you so desire it.  Several new studies, all published September 30 in the Annals of Internal Medicine, concluded the following:

• “The absolute effects of red and processed meat consumption on cancer mortality and incidence are very small, and the evidence is low to very low”.

• “Low- or very-low-certainty evidence suggests that dietary patterns with less red and processed meat intake may result in very small reductions in adverse cardiometabolic and cancer outcomes.”

• The panel conducting the research made a “weak recommendation” for consumers to continue their consumption of meat, noting that “the desirable effects (a potential lowered risk for cancer and cardiometabolic outcomes) associated with reducing meat consumption probably do not outweigh the undesirable effects (impact on quality of life, burden of modifying cultural and personal meal preparation and eating habits).”

• Regarding reduction of cancer and heart-related diseases, they found “Low- or very-low-certainty evidence suggests that dietary patterns with less red and processed meat intake may result in very small reductions in adverse cardiometabolic and cancer outcomes.”

• Omnivores happen to like eating meat and were averse to changing, even “when faced with potentially undesirable health effects.”

Meat Wars & Culture Wars

None of these latest studies addressed animal welfare or environmental impact of meat consumption. The EAT-Lancet report did however, and looked at an omnivore diet from an environmental and sustainability standpoint, namely that eating meat and all animal foods was unsustainable for the planet. This could be perceived as strategic, as it makes the consumption of animal foods an issue for virtually everyone, not just people interested in health. This “bad-for-the-planet” approach strives to change global dietary culture, almost excluding the consumption of meat and most animal foods.

One thing seldom addressed: meat and animal foods as part of food culture:

• Are the Spanish going to forego their famous Iberian ham, which goes into so many dishes, even diced and added to sautéed vegetables?

• Are the Italians ready to give up their prosciutto and melon?

• Is it realistic to expect cultures to bid farewell to Peking duck? Shish-kebob? Sauerbraten? Sega Wat (Ethiopian beef stew)?  

• Would the French give up omelets?  Cheese, yogurt and milk?

These foods are rooted in centuries of culture and history the world over. As for eating meat, people happen to like it. One of the studies in the Annals concluded that omnivores happen to like eating meat and were averse to changing, even “when faced with potentially undesirable health effects.”

But Are YOU overeating Beef?

Right now, average daily intake of beef is about 2 ounces, or 14 ounces per week. If you keep it to that, and choose the many lean cuts that are available now, you’re probably fine and are also getting the best of the nutrition that beef has to offer. Dairy foods are even more efficiently produced, provide excellent nutrition, and are under-consumed (and underappreciated, IMHO). Make sure to include these, especially low-fat yogurt and milk, if you eat animal foods.

Omnivores can – and should – maintain a plant-based diet, so aim for plenty of fruits, veggies, and beans.

As for the planet, all agriculture in the US generates about 9% of the country’s greenhouse gas, with beef taking up just about 2%. Beef production in this country is amazingly efficient, far more so than in the rest of the world. Indeed, one criticism – a fair one – of the EAT-Lancet report is that it lumped all agriculture together, not focusing on the efficient production of animal foods in more developed countries.

Given the difficulty of changing global food cultures, it may be more useful to help improve the efficiency of global animal agriculture to the level present in developed countries.

Veto The Keto! Here’s Why It ISN’T A Cure-All For Diabetes

“What If They Cured Diabetes And No One Noticed?” is a headline that’s total clickbait. It was published here and well-written by Piper Steele. The purported “cure”? Keto.

“Cure” is a touchy word. Before using it, you’d really better have all your ducks in a row. (Ducks are carb-free, by the way.) “Cure” implies it works and should be the premier treatment for a disease or condition, in this case, diabetes. We speak here of type-2 diabetes, the kind that is usually “acquired”, and that’s by far, the most common in adults.

Keto Isn’t Just “Low-carb”

It takes other low-carb diets like Atkins and “kicks it up a notch”. It’s a high fat diet, to the tune of at least 70% of the calories (often even more) provided by various fat sources. Even protein is limited, so it’s more than just eating high-fat foods like cheese and bacon. Your veggies (mostly green leafies, and even those aren’t unlimited) need added oils and butter.

The premise: the body has difficulty dealing with carbohydrates, so you give it fewer carbs to deal with, substituting fat. The fat is metabolized by the body into “ketones” which can also be used for fuel, even by the brain, even though the body would prefer to use glucose.

Does It “Cure” Diabetes?

According to Steele, it’s a no-brainer. The study she points to makes it look promising. Two groups: the “continuous care intervention” group on the keto diet, and the “usual care” group that just received routine counseling at visits of unspecified frequency. The latter functioned more as a control group.

SURPRISE! The keto group lost more weight and many more came off their insulin meds, compared to the control group. The study went on for two years and the results were sustained.

The Catch – And there Is One

The keto group also received different non-diet intervention. Indeed, they were treated to the following:

• And online app, giving access to “telemedicine communication, online resources and biomarker tracking tools.” The participants were able to upload their body weight, blood glucose levels, and ketone levels.

• The uploaded information allowed for daily feedback and individual instruction to participants. This is intensive intervention, well above that provided to the control group.

• The app facilitated remote communication with a health coach and medical provider, who also recommended modification to diabetic and hypertensive medications.

• Education modules for achieving and maintaining a state of ketosis.

• Clinic-based group meetings, weekly for 3 months, then bi-weekly, then monthly, then quarterly.

• Online peer social support with fellow participants.

If the “usual care” group was also treated to the same, would the outcome have been different? That is, are the outcomes strictly the result of the diet or did the continuous care intervention play a role? My guess is the latter is true, or else why use it for this group only?

Are we seeing the results of weight loss alone? If the control group had experienced similar weight loss, would the metabolic results have been similar?

Are Carbs the real “Devil’s Food?”

It’s ridiculous to place all carbs into one bucket. Dismissing foods such as beans, whole grains, and high-fiber vegetables and fruits is to dismiss some of the healthiest foods known. Their health benefits are indisputable. A diet that lacks these nutrient-rich, anti-inflammatory foods has to be viewed cautiously, especially if adopted on a permanent basis.

Steele doesn’t think caution is warranted here. She writes, “The publication of this study should be enough for doctors and the medical associations to recommend a ketogenic diet for diabetics.” Huh? A responsible practitioner would NEVER recommend a permanent dietary change on the basis of a single study.  Indeed, this recent study advises caution, when “enthusiasm outpaces evidence,” especially when a true keto diet may have long-term side effects, given the avoidance of so many nutrient-rich foods.  

Cut-To-The-Chase-Nutrition Advice

A keto diet for treating diabetics might be one way up the mountain, but it’s not the only way and it may still not be the best way. A more varied, nutritionally rich eating style, low in “empty-calorie” carbs, that includes daily physical activity consistent with one’s abilities – an absolute must in my book.  And get support, ideally from a certified diabetes educator, or “C.D.E.“, trained specifically to help diabetics. You may find such efforts are more sustainable (and enjoyable!) over the long-term – and with excellent results.  

I’ve seen people get off insulin after over two decades of daily injections, just by losing enough weight on a balanced, low-calorie diet with regular exercise.   

Why Population Studies Are “Associated” With Limitations

Sigh…another week, another population study “linking” a food with a health consequence. This just-published study involved 70,000+ participants in the Japan Public Health Center–based Prospective Cohort looked at the “association” between plant and animal protein intake and mortality from heart disease, cancer, and “all-cause” mortality (a.k.a. “death from any reason”). 

Here’s what it concluded:

  • Higher intakes of plant protein were “associated” with lower cardiovascular-related and all-cause mortality.
  • Animal protein, per se, was NOT associated with any of these mortalities.
  • If red and processed meat was replaced with plant protein, it was “associated” with lower mortality from cancer, cardiovascular disease, and all-cause mortality — according to their statistical models, which did include some assumptions.

These population or “epidemiological” studies typically recruit thousands of people, use a questionnaire to get their dietary pattern – usually only at the study’s start, then check their health status 20+ years down the road.  The researchers then conclude that what participants ate when they filled out that food questionnaire was “associated” with their health outcome two decades later. 

Essentially, it gets a lot of statistics and draws a lot of conclusions based on what these people ate on a Tuesday 20+ years ago. 

When you see it laid out like that it’s almost comical.  That’s fine, but too often it’s given more credit than it deserves.

Plant protein is great. But it’s not the only way to ensure good health.
(Photo: pixabay.com)

Some Fine Print

This study took a single dietary assessment at the start and never again. Would it be fair to base your current health status on what you ate on a Tuesday 20 years ago? Eating habits change, as do activity levels. These factors may actually skew the results toward less dramatic differences, but again, it’s unknown. To be fair, the authors acknowledge that the possibility for “residual confounding in the association between plant protein and mortality remains.”

Some other potentially confounding variables:

• The high plant protein eaters also ate at least 300 FEWER calories than those eating more animal protein.
• High consumers of plant protein ate more fruits and vegetables in general, compared with the high consumers of animal protein.

Mortality from various causes has so many variables.  It’s hazardous to attribute it all to diet.  In commenting on yet another population study, Frank Mitloehner, professor of Animal Science at the University of California, Davis, who specializes in agricultural productivity and environmental sustainability, felt, “The correction for confounders is near impossible. It is difficult to know what the relative risk of one such variable is on morbidity and mortality.”  He actually gives “little credence” to these nutrition population studies.

When Statistics Aren’t Reality

These studies produce tons of numbers that are “statistically significant”.  The problem, too often, is that they may not be “clinically” significant. 

Example: take two empty Olympic-sized swimming pools.  Put a drop of water into one, and three drops into the other.  The second pool has THREE TIMES the water that the first one has.  Easy to show this statistically.  The problem: the statistics are meaningless because no one should dive into either pool.

Population Studies CAN’T Show Cause-and-Effect

They’re only designed to generate a hypothesis that should then be tested by clinical research.  This is an important distinction, because many times the hypotheses don’t pan out.  We’ve seen this happen many times in nutritional epidemiology studies over the years.  Recall two of the big mishaps:

  • Eggs being demonized because of their cholesterol content. 
  • All fat was considered bad.  Fat-free was better. 

Nutrition epidemiology studies produced those conclusions but such studies simply cannot get granular enough to produce real insight. Clinical research proved them to be inaccurate. 

Clinical research has already shown that lean red meat can not only be healthful but useful.  The BOLD study (Beef in an Optimal Lean Diet) showed that lean beef – about 4 oz daily, you don’t need any more than that – found that LDL-cholesterol was lowered as much as by the DASH (Dietary Approaches to Stop Hypertension) diet that offered only an ounce of beef daily. 

A more recent study showed a greater reduction in LDL-cholesterol on a Med diet that contained MORE lean beef than the one with less lean beef. 

Proteins from plants AND animals have a lot of nutritional value. Regardless of the source, it’s best to keep ALL portions reasonable.  Three or 4 ounces of animal protein (or the plant-equivalent) per meal is all that’s needed. Then fill out with fruits, veggies, and whole grains on your plate.

Cut-to-the-Chase-Nutrition Take-Away

You’ll never stop seeing these population studies.  They’re easy to do, they generate huge databases and they give researchers the ability to publish papers for years.  Just see them with some healthy skepticism and know they aren’t capable of producing ANY cause-and-effect conclusions – no matter what the headline might imply.  Solid, clinical studies usually give a better picture that’s far more likely to be meaningful in the real world.  IMHO.

Like Diversity? So Does Your Gut: FOUR Eating Styles to Help Out

I can’t count the times people have said to me, “this is the way everyone should be eating.” RIDICULOUS. The world is round. And there IS more than one eating style that’s good for your health.

This study looked at four eating styles known for their healthfulness: 

• The Healthy Eating Index 2010 (HEI 2010), is based on the 2010 US Dietary Guidelines for Americans. It focuses on fruits, veggies, legumes, whole grains, low-fat dairy foods and lean meats and other proteins.

This image has an empty alt attribute; its file name is MED-diet-ideal.jpg
“Alternative” Mediterranean diet:
Less credit for red & processed meat

• The Alternative Healthy Eating Index (aHEI), based on HEI-2010 but de-emphasizes meat and dairy foods.

• The Alternative Mediterranean Diet (aMED) focuses specifically on markers of inflammation and cardiovascular health. Its score does not consider dairy intake or potatoes and gives credit for less consumption of red and processed meats.

• Dietary Approaches to Stop Hypertension (DASH diet), developed to reduce hypertension with diet, it encourages plenty of fruits, vegetables and low-fat/fat-free dairy foods but nothing is excluded.

The researchers wanted to compare each eating style’s impact on the gut and the diversity of healthy gut bacteria.

Drum Roll…The Results Showed…

If you REALLY build it,
the good gut bugs will come

ALL four eating styles benefitted the gut – and in mostly similar ways The authors found the results showed “strikingly consistent patterns.”  People with higher scores on all four eating styles had less “bad” bacteria – the ones associated with inflammatory diseases like irritable bowel syndrome, diabetes, even colon cancer. 

Interestingly, the HEI-2010 – the more moderate of the eating styles studied and the one based on the 2010 Dietary Guidelines, was the only one of the four eating styles associated with lower amounts of harmful Escherichia-Shigella and Enterobacter, two species associated with diet-related conditions linked to systemic inflammation.

Higher scores on all the eating indices were also associated with a greater richness of beneficial fiber-fermenting bacteria in the gut.

For gut-geeks like myself, this study is incredibly interesting.  To consumers and “normal” people, here’s what it really means:

  • A healthy diet rules.  But not a single healthy diet.
  • There are at least four ways up the mountain to a healthy eating style.
  • It’s more about what you include than what you exclude!  Fruits, vegetables, beans and whole grains help grow the most beneficial bacteria, because they’re loaded with fermentable fiber. 

Why I like this study

  • It looks at diverse eating styles and their impact on gut diversity.  That is, how these eating styles positively or negatively impact our gut bacteria. 
  • The study used subjects with diverse ethnicities: Japanese American, Latino, Native Hawaiian, and African American, who were part of the Multiethnic Cohort Study
  • These were also senior citizens, average age: 69 years.

The study was long: subjects were enrolled between 1993-1996 and their gut bacteria were studied as of 2013-2015.

Study Weaknesses: 

All studies have limitations, but this one has fewer than most. Most observational studies like this look only at initial dietary intake and then analyze outcomes a decade or more later, not knowing if diets changed during the interim.  This study took dietary intake at the enrollment and also during a return visit in 2013-2015, at which time the subjecfts also provided a stool sample.

Cut-To-The-Chase Recommendations

The least “restrictive” of these four eating styles is a split between DASH and the regular HEI.  They don’t exclude anything, emphasize balance and are probably the easiest to follow. Best of all, they produce good gut health. 

When Did “Plant-based” Become “Plants ONLY”?

When the New York State Assembly said so.  They recently passed A04072,, requiring all hospitals to – upon request – offer  “a plant-based food option as an alternative to every meal or  snack  offered  in  food service  to  the patient.”  In addition, all the hospital’s written material describing food offerings must now include the availability of a plant-based food option.

They take it a step further by defining “plant-based” as plants-only:

  • “Plant-based food option” means a food or beverage that is free of animal products and that has nutritional value comparable to the non-plant-based food option that it replaces.
  • “Animal product” means meat, poultry, seafood, dairy, eggs, honey, and any derivative thereof.

“Basically they are saying “plant-based” equals vegan,” said Toby Amidor, a NY-based registered dietitian nutritionist and best-selling cookbook author. “Those are two separate entities. [The State Assembly] is defining it as they wish.” 

Historically, “plant-based diet” has always meant plant  dominant, whereas vegan diets are exclusively from plants.  By the NY Assembly’s definition, even honey is excluded (bees are tiny but they’re animals).   

“Comparable Nutritional Value”? No Such Animal

Add a sprinkle of grated parmesan?
Oops! Then won’t be “plant-based”!


As for the bill’s requirement that the “plant-based” meals and snacks have a “nutritional value comparable to the non-plant-based food option that it replaces”, this is a huge ask.  “It might sound good on paper but it’s not truly possible,” according to registered dietitian nutritionist and certified diabetes educator Melissa Joy Dobbins.  “Offering plant-based options is one thing, but requiring them to be nutritionally comparable is problematic.” 

Nature just doesn’t work like that – there just isn’t always an ideal plant-based counterpart for an animal food, nor vice-versa.  Milk and yogurt are perfect examples.  There are plant-based alternatives, but none is nutritionally equivalent.  This is the whole premise of eating a varied diet.  The more food groups you exclude, the more nutritional risks you take. 

Dobbins added, “Implying that it’s a simple swap is misguided at best, and has the potential to contribute to nutritional deficits in an already compromised patient population.”  Hospital patients often have poor appetites, yet their protein needs can be higher than normal, due to the stress of surgery and illness.  Elderly patients at bedrest for an extended period lose muscle mass faster than younger counterparts, and may benefit from a diet that contains extra protein of the highest quality, such as in meat, dairy foods and eggs, and in less volume than a vegan diet would need to provide the same protein.

A “Solution” In Search of a Problem

What did hospitalized vegans do BEFORE this legislation?  “Accommodating vegan patients is standard,” according to Jessie Pavlinac, a chief clinical dietitian at the Oregon Health and Science University hospital in Portland and past president of the Academy of Nutrition and Dietetics. 

Pavlinac noted that hospitals would be cited by accreditation bodies for not having options for vegetarians and vegans.  

Cut-To-The-Chase Nutrition Advice

Dairy foods — and meat — can be in
YOUR plant-based diet, and for good reasons!

As consumers muddle through this “plant-based/plants-only” forest, there are a few facts – not hype – to remember about these terms:

  • “Plant-based” and “vegan” are NOT health claims.
  • Neither term indicates dietary quality.
  • These terms are simply descriptive, nothing more.

Defining plant-based to mean “excludes all animal foods” is incorrect and confusing.  Does the delicious salad pictured being “plant-based” if you sprinkle some parmesan over it?  Of course not, and no law should say otherwise — IMHO.

My guess is that the “nutrition-naïve” legislators were strongly influenced by lobbyists with a vegan agenda.  The bill still has significant hurdles in the Senate and the governor’s office before it could become law, but a similar bill was signed into law by California’s Governor Jerry Brown.  

Featured image courtesy of www.inkmedia.eu

Got a Salty Tongue? New Study Says It’s Not So Bad!

Hypertension and “low-sodium diet” seem to go together like two peas in an unsalted pod.  Salt, has been one of the “eat less of” ingredients that dietary guidelines and health organizations have warned us about forever.  We’ve been told of the risks to our blood pressure and heart health in particular.

In the US, we get about 3,500-4000 mg of sodium daily, according to the Centers for Disease Control   (women tend to be on the lower end of this range).  You may exceed these levels if you eat out a lot, as restaurant chefs are known for their generosity with salt.  US Dietary Guidelines recommend a max of 2,300 milligrams, and if you’re at risk for cardiovascular disease, it’s only 1,500 mg.  Even at 2,300 mg, it means cutting out a third of the sodium we eat.

Kimchi: Yes, it’s salty, but it’s OK,
just don’t binge!

The problem?  People HATE low-salt diets and they love salty food!   Even excluding French fries, these foods also figure into our love of salty savories:

  • Grandma’s chicken soup (and most canned or homemade soups)
  • Cured meat, fish (smoked salmon!) and cold cuts
  • Most condiments, from Worcestershire sauce to anchovy paste
  • Most ethnic dishes and restaurant meals
  • Almost everything savory that‘s canned or jarred (pasta sauces, tomato sauce, baked beans, and on)

S.O.S.: Save Our Sodium?

This study looked at just how bad the present intake of sodium is for our health and it turns out sodium may be a minor player. 

The study estimated sodium intake by assessing sodium in the urine (where 90% of our sodium ends up) and divided the groups into low, medium, and high excretion groups and followed them for about 8 years, looking at risk for cardiovascular events and death.

Interestingly, the groups at the most risk had both the highest and the LOWEST intakes of sodium, but only when they also had a low intake of potassium. 

The group with the LOWEST risk for death and cardiovascular events?  They had a moderate sodium diet (3.000-5,000 mg/day) but diets that were highest in potassium. 

D.A.S.H.-ing Through the Clutter

A diet that’s moderate in sodium but high in potassium.  That’s pretty much the DASH diet: “Dietary Approaches to Stop Hypertension”.  It works and it’s simple.  Just eating more fruits, vegetables, and low-fat and fat-free dairy foods (milk is an astoundingly good source of potassium) does the trick, and it’s what most people’s diets need more of anyway.  Here’s why I like the DASH approach:

  • It’s not regimented or prescriptive. It’s an eating style that works with all cuisines.
  • Plenty of delicious foods are also loaded with potassium. Eat your favorites and eat them daily. 
  • Bonus: eating more fruits, veggies and low-fat dairy foods will probably push out some of the higher-salt foods people eat now, especially for snacks.

ALL fruits and vegetables are good sources of potassium, but here are some superstars:

  • All melons and berries
  • All citrus fruits and juices (100% juice, please)
  • All potatoes, squash, pumpkin
  • All leafy greens (lettuce, spinach, kale, the whole lot)
  • Beets (don’t laugh – beets are the new “in” veggie for 2019!)
  • MILK!  Whole, 2%, 1% and fat-free, also yogurt are the top non-plant sources of potassium – and calcium.

Reality: It Doesn’t Have to Bite

High-potassium foods are a “must-have.” More important than “low-sodium”!

People in the free-living world aren’t going to stop eating their favorite savory foods and they shouldn’t have to.  It’s time we accepted that and focused on encouraging everyone to eat more high-potassium foods. This latest study suggests it may be more effective anyway.

While the research continues, make sure your favorite savories keep better company:

  • Ham sandwich?  Instead of the chips and soda, try an apple or banana and some iced tea.
  • Going out to dinner?  Start with a salad – dressing on the side so you stay in charge.  Have a nice baked potato – sour cream has no sodium! 
  • Soup’s on?  Add some beans and greens for good measure.
  • Bacon and eggs?  Lox and bagels?  Have a fruit and yogurt parfait along with it.  Or at least a glass of OJ or a banana.
  • Get the herbs and spices into everything: soups, salads, meat, fish, even yogurt!  Dried or fresh, herbs and spices are loaded with antioxidants and replace the need for some of the salt.

There’s no requirement for a specific fruit or veggie to be healthy.  Just eating more fruits, veggies and dairy foods is a start and a good one.  It’s a super-tasty way to get healthier all-around – and just by eating, because these foods also fill nutrient gaps.  The benefits go way past getting more potassium. 

Your Headphones Won’t Mask the “Noise” In New Egg-Heart Disease Study

For years, all you heard about eggs was that they were “linked with” heart disease.  Keep consumption to a few eggs per week and dietary cholesterol to less than 300 mg. per day. Since one egg has about 185 mg of cholesterol, you really had to be careful how you spent those 300 mg. 

Then, research found saturated fat to be riskier for heart disease than dietary cholesterol, but the egg damage was done.  Finally, the 2015 US Dietary Guideline for Americans finally dropped it’s 300 mg/day cholesterol limit.   

Eureka!  Progress!  Eggs Are Back!

Give up omelets? Say it ain’t so!

Just when consumers were getting comfortable having an omelet again, here comes a new study in the Journal of the American Medical Association that claims an “association” between egg consumption and heart disease.  At first glance, the study seems impressive:

  • They looked at 6 different populations or “cohorts”, covering a 17-year period, on average.
  • They calculated hazard ratios (HR) and absolute risk difference (ARD) for cardiovascular-related deaths and all-cause mortality.
  • They adjusted for “demographic, socioeconomic, and behavioral factors.”

Here’s what they concluded

“Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner.”

They say that, for every 300 mg of cholesterol you eat, your chances of dying from heart disease in 17 years (assuming you’re over 50) are increased by about 17% and your chances of dying of anything at all are increased by about 18%.

But the average consumption of both eggs and dietary cholesterol was modest.  Even the cohort with the highest consumption of eggs ate only 0.42 eggs/day – less than 3 eggs per week!  Average dietary cholesterol intake was: 240 mg/day – well under the previously recommended 300 mg/day.

Turns out that, in this study, cholesterol become the issue, not eggs, but even when you just look at cholesterol, it’s important to hear the study’s “noise”.

The “Noise”, a.k.a. Weaknesses & Limitations 

It’s problems, plural, and the authors acknowledged some of them, but still felt entitled to make some strong conclusions (and I feel entitled to strongly disagree with them):

  • “Associations” and “linked-to” don’t CAUSE anything.  Anytime, and I mean ANYTIME you hear about a study that shows a food is “linked to” or “associated with” a disease or condition, it does NOT indicate the food CAUSES that condition, yet journalists often don’t get this concept.  These “Observational” studies are incapable of doing anything more than generating a hypothesis.
  • All the dietary data came from a SINGLE dietary report, and a self-report at that.  That’s like asking thousands of people about their diets on one day, and track how many die in 17 years.  Then draw conclusions about their deaths based on what they ate on that single day.  
  • Different dietary survey methods were used, so there was no uniformity of measurement.  To deal with that, the authors use a lot of statistical methods that “harmonize” the data and supposedly give you a better picture.  All methods still involved self-reports however.
  • Poorly surveying a large number of people doesn’t make data more reliable, no matter how you “harmonize” the data.  In this study, it still means 29,000 people were poorly surveyed.    
  • This study assumes a stable diet and lifestyle for 17 years, and that’s unrealistic.  No matter how many statistical tests you do, or how much “statistical significance” you find, no one – but no one – has that kind of stability for 17 years. 

Who knows what other lifestyle factors that evolved during the 17-years after the original dietary data were taken?  The authors do not, and the study cannot tell anything about what influence such factors might have had.

Yes, they’re STILL incredible…
….even for your heart!

Cut-To-The-Chase-Nutrition Reality Check

The egg has nourished people for thousands of years.  It has the highest quality protein of any food (it’s neck-and-neck with dairy), and critical, hard-to-get nutrients like vitamin D and choline.  Eggs also have the antioxidants lutein and zeaxanthin, known to help reduce the risk of age-related macular degeneration.  And they’re actually low in saturated fat. 

  • Pair your eggs with other good foods.  Scramble or fry them in olive oil, have them with fresh fruit and whole-grain toast.  It’s breakfast, but also lunch or dinner.
  • Balance it!  Greek yogurt with that fruit will round out the meal, or combine them in a smoothie as a beverage with those eggs.   
  • I keep hard-cooked eggs in my fridge as a high-protein snack.  Spread them with some Dijon mustard or hummus and keep hunger pangs away. 

The Easter bunny can rest easily.

Did Your Child Eat 90 Cups of Strawberries This Morning?

If that happened, then be concerned with pesticide residues.  Everyone else can forget about the Environmental Working Group’s annual “Dirty Dozen” list.  

I can always tell it’s spring — that’s when the EWG issues it’s list of fruits and veggies with pesticide residues, just when people are looking forward to spring and produce.  The EWG’s message is always the same:  Avoid the Dirty Dozen.  And the failures of their message are also the same:


AGAIN, the EWG fails to put pesticide use into context and AGAIN, that’s irresponsible. (Example: even a child would have to eat 181 servings (about 90 cups) of strawberries, the #1 food on Dirty Dozen list, to exceed safe levels. An adult male would need to eat 635 servings (about 317 cups) of strawberries. 

AGAIN, the EWG doesn’t mention the pesticides used in organic agriculture.  There are hundreds of them, and even a few dozen synthetic ones that are allowed under certain circumstances – while still allowing the food to carry an “organic” label.

AGAIN, consumers should be reminded that the feds have been looking at this for decades, through its Pesticide Data Program.

The “Villains”

Kale: The new addition to the “Dirty Dozen”
  1. Strawberries
  2. Spinach
  3. Kale
  4. Nectarines
  5. Apples
  6. Grapes
  7. Peaches
  8. Cherries
  9. Pears
  10. Tomatoes
  11. Celery
  12. Potatoes

It Really Is ALL Good

You’ve heard that “the dose makes the poison.”  It’s true, but the dose also brings the benefit.  Let’s remember: ALL the research proving the healthfulness of eating plenty of fruits and vegetables – fresh, canned, frozen, dried – throughout our lives, was done using CONVENTIONALLY grown produce, not organic. 

Organic is just another choice.  If buying organic gets you eating more fruits and vegetables, then terrific!  But if you can’t find them, can’t afford them, or simply want to eat healthful food that’s also more economical, then the conventionally-grown option is fine.  I eat organic produce sometimes, when it’s convenient and reasonably priced.  I also eat ALL the conventionally-grown produce on the “dirty” list. 

No, I Won’t Peel My Apples

Eat the peels! There’s good stuff there!

That may remove pesticide residues but it’s probably healthier to eat the edible peels and skins on produce – they’re loaded with antioxidants and prebiotic fiber.  The research supporting eating fiber outweighs the near-non-existent negative research on pesticides on our food.  It’s also a huge waste to throw away these edible portions.


My EdibleRx about LAST YEAR’s Dirty Dozen holds as true today as it did then, except that kale made this year’s list, bumping off sweet bell peppers. Yawn.  If you hate kale, you’re thrilled.  But if you like it, then it won’t kale you to keep eating it without concern.  

Still Have Doubts?

Get the facts.  This cool tool calculates how many servings of one of the Dirty Dozen a man, woman or child would have to eat before pesticides could become a concern.  It’s from the Alliance for Food and Farming – a non-profit organization of BOTH organic and conventional growers of fruits and vegetables on all sizes of farms.

Organic: The Answer To Cancer Prevention?

If anyone tells you they have the definitive answer, they’re misleading you.

Growing foods conventionally usually – but not always – involves the use of some pesticides when there’s a need to control harmful bugs, plant viruses, fungi, etc. that damage either the whole plant or the edible portion of it.  These compounds are expensive, so farmers tend not to use them unless absolutely necessary, and then in the least amount possible for the needed benefit. 

Organic crops are thought to be grown without pesticides, but there are hundreds of pesticides approved for use on organic crops.  Most are organic ones, but in certain circumstances, as with a particularly difficult to control pest, USDA has rules in place to allow limited use of a few dozen synthetic pesticides is allowed, and the food produced can still be labeled “organic”. 

But Is Organic Food Healthier?

Twice the price,
but twice the benefit?

“Healthier” has no formal definition, but let’s say it means you have a lower risk of developing cancer, since that’s a highly desirable outcome by everyone.  Would eating organic food make you less likely to develop cancer?

This recent study wanted to find out.  It was a prospective study – meaning that it went on for years before results were determined.  As part of a large study involving 68,946 French participants, all volunteers “self-reported” the frequency of consumption of organic foods.  Responses about consumption were multiple choice and ranged from 1 (“most of the time”) to 7 (“never”), with an option for “I don’t know”.  Demographic information was also gathered, including about household income.  This was interesting, because the top household income bracket was US $3,100, hardly “upper income” even in 2009, when the study launched.

The Good News: Organic Eaters Had Less Cancer

More frequently eating organic foods was “associated” with lower your cancer risk.   Key word, “associated”.  It’s the bane of my existence because it is often interpreted as “cause-and-effect,” a very wrong assumption. 

Why?  This study was “observational”.  These types of studies aren’t designed to evaluate cause-and-effect.  They can only generate a hypothesis that clinical studies could then evaluate for more direct conclusions.  This study is incapable of making such conclusions.

Photo: www.inkmedia.eu

The not-so-good news: the benefit of eating organic was minimal, at best.  The risk of getting cancer went down only 0.6% — that’s 6/10ths of one percent, and only for the most frequent eaters of organic food.  Even then, the benefit may be less than reported. Read on… 

Limitations of the Study, A.K.A. the “Fine Print”

The authors responsibly called out a fairly lengthy list of limitations of this study, and why the results need to be seen with caution:

  1. The participants were volunteers who were “likely particularly health conscious individuals”, therefore limiting the application of the results to the general public.
  2. The questionnaire used asked about frequency of consumption but not quantity.    Also, possible misclassification of organic foods, “cannot be excluded.”
  3. Follow-up time was short – an average of only about 4½ years.  Cancer can take many years to develop and it’s unclear what the diets of these participants were prior to participation.
  4. Possible “residual confounding resulting from unmeasured factors or inaccuracy in the assessment of some covariates cannot be totally excluded.”  This means there is a lot they didn’t measure or that they couldn’t measure accurately. 
  5. They could not exclude the non-detection of some cancers. 

Cut-To-The-Chase-Nutrition Takeaways

  • Will eating organic food help prevent cancer? Not based on this study.
  • Organic food is expensive, and thus out of reach of many, even if they can find it.
  • Organic doesn’t mean pesticide-free. 
  • Focus on this: A mountain of research showing the health benefits (including cancer risk reduction) of eating plenty of fruits, vegetables, beans and whole grains, was done using conventional foods!