FAMILY MEALS: ESSENTIAL TO FAMILY HEALTH

September is National Family Meals Month, and it couldn’t come at a more appropriate time than right now, when kids are back at school, yet for many families affected by weather, a family meal can be the most comforting thing ever.  For all families, re-committing to having family meals together is one of the most beneficial things parents can do for their kids and for family life.

The practice of having family meals isn’t dead, but there are signs it’s ailing.   Families still eat together, but according to a Harris poll cited in a 2015 study on family meals, only 3 in 10 families eat together every night.  There’s room for improvement here and there are many reasons to make the effort.

Family Meals: It’s About the ACT As Much As the Meal

A quick research rundown on benefits of frequent family meals:

  • Kids are 12% LESS likely to be overweight
  • Kids are 24% MORE likely to eat healthier foods (and 20% LESS likely to eat unhealthy foods!)
  • Kids are 35% LESS likely to have eating disorders (e.g. have a healthier RELATIONSHIP with food)
  • A separate study found that eating home-cooked meals most often (even if using some frozen or packaged convenience foods) resulted in eating about 130 FEWER calories for the day, compared to people who cook at home less often or not at all. Those families also ate less fat and sugar.

The benefits go beyond nutrition.  Better mental health, social skills and even higher grades In addition to the dietary benefits, research has shown advantages to eating meals together that go beyond nutrients and nutrition but that are every bit as important:

  • A 2015 study: Kids who grow up having regular family meals are more likely to have more desirable social behaviors (such as sharing, respect, fairness) as adults.
  • A 2014 study: have fewer signs of depression, less likely to abuse drugs, less likely to engage in delinquent acts.
  • Strong association between family meals and higher grades, higher self-esteem, less risky behavior.

So…What’s the Barrier to Family Meals?

Check the “Life Happens” folder.  There’s more demanded of everyone today.  Jobs aren’t 9 to 5 anymore.  Technology allows (and encourages) us to check work-related messages outside of typical workday hours.  Pile on the demands of the kids, their academic, extracurricular, and social schedules, plus the demands of just running a household, and family meal seems like an unnecessary expenditure of time.

It’s necessary. As often as you can have it and really make it a priority.   It sends important messages to your kids:

  • A little time spent together every day is important, and
  • You kids are worth my time every day.
  • I want to know what’s happening with you, and

Is there a downside to family meals?  Only if the family relationship isn’t strong.  It’s also another reason to establish the family table early on as a totally neutral zone for parents and kids alike.

How To Enjoy, Not Endure, Family Meals

  • No technology.   If kids – or patents can’t disconnect for the 20-30 minutes it takes for the family meal, then family meals aren’t the problem, family standards are, and it’s time for a reset.  They’ll miss a few texts and posts and they’ll learn the world still spins.
  • Switzerland. The family meal table is a fully demilitarized zone.  No fights, no bickering, no lectures.  Keep it positive.  If social skills need some work, this is the place.  Give some guidance, but always with encouragement, not judgement.  And ALWAYS give some positive feedback.  Kids (and adults) love to be told they’re doing a good job.
  • Table it. Research has associated eating together around the family table, not in front of the TV or in other rooms, with lower body mass index (BMI – a measure of weight-for-height) for kids AND parents. Keep them engaged until everyone is finished – that’s also associated with lower BMIs.
  • Everyone’s an owner. Parents are hungry for prep help! No matter the menu, give age-appropriate tasks for prep and clean-up.  Everyone gets dinner sooner and enjoys it more because they have a personal stake in its prep.  Big note: tell the kids you appreciate their help.  Positive feedback is the ultimate motivator.

Fave Family Meal Story

My friend, Marylou, told me about her former next-door neighbor, a widow with six kids and a huge house to care for.  Marylou visited one Saturday morning to find the widow with a huge pile of laundry to do, yet she was prepping to take all her kids on a picnic.  Marylou was aghast and said, What about all this laundry?!”  The woman said, “I know, but in ten years they won’t remember the laundry.  They’ll remember the picnic we had.”

I love that mom.  And thanks to my own mom, for making great family meals — including breakfasts!

CAN COCOA & CHOCOLATE HELP METABOLIC SYNDROME?

 Cocoa flavanols – those phenom compounds in cocoa that seem to have great health benefits, such as improving blood flow and helping manage blood glucose levels, but some recent research pulls together just how they may be useful in metabolic syndrome.

Let me get through the basics so we can talk about the good stuff.  Metabolic Syndrome constitutes a group of conditions:

  • High triglyceride levels
  • High fasting blood sugar
  • Large waist circumference
  • Low HDL cholesterol (the good type of cholesterol)
  • At least borderline high blood pressure

If you have any three of these, or if you’re taking medication to control three of these, you probably have metabolic syndrome.  You also have lots of company, since 1 in 3 Americans has it, too, according to a 2015 study, although many don’t know it.  Having even one of these conditions increases your risk for common but serious chronic diseases, such as heart disease, type 2 diabetes, and stroke.  These are impacted by diet, so having metabolic syndrome usually means your diet and eating style needs a closer look.  Sounds awful, but it isn’t, and you may get some help where you never expected any.

Cocoa flavanols to the rescue

Not everyone is aware that cocoa is one of the most, if not the most, concentrated sources of antioxidants in the diets.  We may get a larger quantity of antioxidants from other foods, like tea, coffee, fruits and vegetables, but that’s because we eat larger amounts of them and on a daily basis.

A recent review in the highly respected Journal of Nutritional Biochemistry looked at the ways cocoa may act to be healthful and it may be different than you thought (for those of us “chocolate-science nerds” who even thought about such things).   After looking at over 244 published papers, here’s what the authors concluded about cocoa flavanols and how they lessen metabolic syndrome:

  • Cocoa flavanols appear to slow down the action of digestive enzymes, delaying spikes in blood glucose levels, possibly by limiting or delaying the digestion of starches, and encouraging better insulin response. Nice news: a larger dose seems to be most effective, but it’s way too early to suggest any “more is better” recommendations.
  • Regular cocoa consumption seems to have “pre-biotic” effects, e.g. regularly exposing the gut environment to cocoa flavanols encourages growth of good bacteria that in turn helps the lining of the colon function more effectively. How so? It seems to reduce the absorption of endotoxins (the stuff that’s released when bacteria disintegrate).  Endotoxins that get absorbed into the bloodstream can cause things like plaque buildup and disruption of insulin regulation.  Less of these is better.
  • Cocoa flavanols also help insulin sensitivity in muscles and peripheral tissue. However, they’re not well absorbed. They get broken down by the gut bacteria, but the resulting metabolites (products of the breakdown) do get absorbed and are likely what is doing the good work in the peripheral tissues.

It’s not over

Metabolic syndrome, and especially type 2 diabetes, are associated with chronic low-grade inflammation.  Through a variety of mechanisms, the powerful antioxidant activity of cocoa flavanols may also help reduce this inflammation, and in an enjoyable way.

As a clinician, this is music to my ears: something my patients like hearing and that I like explaining.  Chocolate and cocoa flavanols are a win-win and make me love the power of food.

There’s still much more to know, however.  Many of the studies in humans were of short duration, so it’s not known if observed benefits fade after a few weeks or months.  Dark chocolate is where the flavanols reside, (aim for cocoa powder — the most concentrated source, or 70% bars) but specific doses of cocoa for each condition and best ways to administer cocoa for maximum effect are also unknown.

Cut-to-the-chase

  • There’s excellent news on potential benefits of cocoa and its flavanol compounds, and their potential impact on metabolic syndrome, diabetes, blood glucose control, and other chronic health risks.
  • We still need to remember that the ways in which we consume cocoa – bars, truffles, hot chocolate, etc. provide calories. Too many of those – from ANY source — will contribute to weight gain, one of the hallmark hazards of metabolic syndrome.
  • So it is with chocolate and cocoa as it is with alcohol: eat with your head, not over it. An ounce a day of the darker stuff, or a good scoop of cocoa powder in a drink, is just fine.  NOTE: If the ingredient label says the chocolate is “processed with alkali” or “Dutched”,  the flavanols have been removed. Skip this stuff if you want the benefits.

[Personal note to researchers: please try to avoid concluding that a pill is the best way to get cocoa flavanols!  We’re real people and would be far more likely to get recommended “doses” if they were in the form of edible chocolate and cocoa. Just saying.]

Show Me LESS Money — I’ll Show You a Healthy Mediterranean Diet

A recently published study suggested there were “socioeconomic status (SES) inequities in the cardiovascular protection associated with the traditional Mediterranean Diet.”  Simply put, the Mediterranean diet reduced cardiovascular risk but only in higher socioeconomic groups.  The best benefits came among those who were well educated and had better incomes.  It also suggested that the better health outcome of this richer and more educated bunch happened because they were able to buy higher quality, healthier food.

This may make for great headlines: low-income, less educated people are victims of a cruel society that keeps them powerless and less healthy.  It also bugs me to no end.  I have spent most of my career working with primarily low- and moderate-income populations.  My patients read a headline that says only the wealthy and educated can benefit from a Mediterranean diet and conclude things are just stacked against them because they aren’t wealthy or upper-income people and may never be.

What’s in The Study but Not the Headlines:

Whenever I see conclusions like these I know it’s time to dig in a little deeper. There are other conclusions, perhaps more realistic ones, that could be drawn from this study, even if they wouldn’t grab headlines.

All studies have weakness and limitations.  Many never make it into the press releases and news articles, however, and that just adds to all the nutrition confusion out there.  This study’s authors acknowledged some of the study’s weaknesses, but there were others that weren’t considered.

  • The authors acknowledged the study’s somewhat short duration, only 4.3 years of follow-up. Fair enough — it is what it is.
  • They noted that dietary information was self-reported and taken only once and only at baseline. A lot can change over 4 years that could impact the value of the study’s findings and conclusions.
  • Average age of the subjects was mid-50’s.  There is no record of their dietary history up to this point.  It’s one of the problems with this type of research – current dietary pattern doesn’t indicate your lifetime dietary history, when many of your health risks were likely determined.
  • Differences in health outcomes were attributed to dietary disparities. That’s a leap.  The outcomes may have had more to do with health care disparities throughout the years prior to the study, rather than whether or not they ate a green vegetable the day before they were interviewed.
  • The study noted that higher SES groups “are more likely to get in line with dietary recommendations”. Very likely, but such groups may also be more likely to afford and seek medical attention, take prescribed medication, follow physician recommendations, and make other positive lifestyle modifications.  This is a huge piece of the puzzle.

Rich and Educated Didn’t Always Do the Smart Thing

Higher income participants actually ate a narrower variety of vegetables than the lower income group and practiced LESS healthful cooking methods for beef, such as grilling and frying.   Does that mean also that eating fewer types of vegetables and doing more frying and grilling of beef is “linked” to a better outcome?  Not likely, although, to be fair and balanced, that’s what the data show, and it’s just as statistically accurate to make such a statement from these data.  This is why describing a behavior as “linked” or “associated” to an outcome doesn’t always tell us much and should certainly never be considered equivalent to “cause-and-effect.”

Observational studies make it easy to cherry-pick what you want to conclude.  All they are really designed to do however, is generate a hypothesis, not a conclusion.

We should be empowering and motivating lower-income people, not treating them as victims.  I don’t have the luxury of telling my low-income patients sorry, but eating better and being healthier are a rich man’s game.  Hello?  They need and deserve help, motivation, and sound nutrition advice, not to hear their health is at risk because they didn’t go to college or make a lot of money.

A Healthy, Economical Mediterranean Diet

Your Mediterranean diet doesn’t have to be populated with lobster and shrimp and washed down with an expensive chardonnay.  For the rest of us, more reasonable options are the way to go, and they can be just as tasty and healthful.  After all, the original Mediterranean diet wasn’t about indulgence, it was about making the best from what was available.

Try these tips for eating a delicious Mediterranean diet.  They’re budget-friendly but they’re smart for any budget:

  • Canned salmon – a treasure. It’s my own go-to for omega-3 fats. Surprise: it’s almost always wild, but without the wild price of the fresh stuff. The edible bones are loaded with calcium and vitamin D, too.
  • Beans, any kind, canned, fresh, or dry: Hummus anyone? Canned kidney or garbanzo beans are great topped with some pasta sauce.
  • Eat in the “C-suite”. Super-nutritious affordable fave veggies: carrots, cabbage, collards, cauliflower, celery. All great choices any time of year.
  • Frozen: peas, green beans are awesome and just as nutritious as fresh, with no prep or waste.
  • Fruits: eat the best of each season. It’ll taste better and be more affordable.  Let it be your sweet treat instead of junk sweets.
  • Extra-virgin Olive oil: You only need a little.  Buy what you can afford and use it where you’ll really taste it — on salads, bread, even on hummus.
  • Dessert, anyone? Try Greek yogurt with fruit, nuts, and a teaspoon of honey. Great for protein when it’s a meatless meal, too.
  • Nuts in bags, not jars. You get more for the money. An ounce a day is enough for benefits.

IT’S HOT OUT THERE! ARE YOU EATING ENOUGH WATER?

 

It’s summer, the hottest time of year, and everywhere you turn you’re hearing about the importance of drinking enough water and fluids.

But how much should we be drinking?  The daily water intake recommendations by the Food and Nutrition Board of the National Academies of Sciences are 13 cups (3.7 liters or about 125 ounces)daily for men, and 10 cups (2.7 liters or about 91 ounces) for women.  These are very general though, as a single recommendation is impossible.  A lot depends on factors like these:

Weight. If you weight more, you usually need to drink more, but it’s not a linear progression.  That is, a 200-lb. person doesn’t need twice the fluid of a 100-lb. person.  The smaller person is more vulnerable to dehydration and overheating because they have a high “surface-to-volume ratio,” the same reason a small child is more vulnerable to overheating.

Gender. Men tend to need more fluid than women.  They tend to weigh more but also have more muscle, which is metabolically active and requires more water to stay hydrated and function properly.

Activity level. But the more active you are in any season, the more you sweat and thus need to rehydrate.

It doesn’t all have to be water and the IOM is clear that all beverages , including coffee, tea, milk, and even juice, so getting those 9 to 13 cups is easier than you think. Liquids aren’t the only place to get water.  You can easily amp up your take from food if you include plenty of high-water fruits and veggies, and there are real advantages to doing this:

  • Flavor! Chilled summer fruits and vegetables are taste powerhouses.
  • Rehydration nutrition: high-water fruits and veggies are loaded with hydrating nutrients like potassium and magnesium. Count milk in here, too.

For highest water content, go for fresh versiuons.  Here’s a list of some of the most common high-water fruits and vegetables (by % weight):

FRUITS

% water

VEGETABLES % water
Watermelon

92

Cucumber, lettuce (iceberg)

96

Strawberries

92

Zucchini, radish, celery

95

Grapefruit

91

Tomato (red)

94

Cantaloupe

90

Tomato (green), cabbage (green)

93

Peach

88

Cabbage (red) cauliflower, eggplant peppers (sweet) spinach 92
Raspberries, pineapple, orange

87

Broccoli 91

Many are more than 90% water, so they really contribute to your total fluid intake for the day.  Plus, they do what a glass of water simply can’t: help you get enough fruits and vegetables for a healthy diet.

Personal fave: watermelon.  I love this stuff.  I have loved watermelon since I was a kid and waited for it to come into season so I could gorge myself on it.  Even now, when I come home on a steamy, sweltering day there is absolutely nothing better to cool me down and get my taste buds dancing than a huge chunk of ice-cold watermelon.  I’m hardcore, too.  I cut off only the outer skin because I love the white part of the rind as well.  It’s not as sweet but that’s OK and it’s still good, kind of like a semi-sweet cucumber.

MORE: Can you be a health-freak AND a smoker?  Get my take in this New York Post article here.

BEEF EARNS ITS PLACE AT THE WEIGHT LOSS TABLE

A solid clinical study by a well-respected team, just published in the July issue of Obesity Science and Practice, showed that eating lean beef, at least four times per week, produced weight loss just as effectively as a non-beef diet.  Even better: there was no negative impact on heart health indicators, like total cholesterol, LDL “bad” cholesterol, or blood pressure.

This research, called the Beef W.I.S.E. Study (Weight Improvement, Satisfaction, Energy) followed 99 overweight and obese adults for 16 weeks.  Everyone did moderate-intensity exercise regularly and ate a higher protein diet, either with beef or without beef.  The beef eating dieters ate beef about 4 times per week, not every day, and they ate plenty of other lean protein foods, like nonfat Greek yogurt, fish, chicken breast, etc. Indeed, some type of lean protein happened at each meal and snack.

The beef-eaters lose just as much weight, preserved just as much lean muscle mass as the non-beef group. “A key finding of this study is that 90 to 95 percent of the weight lost came from fat, not muscle,” said Dr. Drew Sayer, PhD, a co-author of the study. “This shows that lean beef doesn’t have to be restricted in a higher-protein diet and is just as effective as other protein choices in supporting healthy weight loss and leaner bodies.”

And I’d bet they also liked their diet more, because they didn’t have to omit food they liked.  Anytime you have to omit a food on a diet, it can become the one food you want.  According to the Consumer Beef Index, a survey of attitudes about beef, 3 out of 4 people DO like beef as a favorite or a top meal choice.  The dieters in the Beef WISE didn’t eat beef daily, but about five times weekly.  No deprivation there.

That’s exactly why I like this study: no feelings of deprivation.  To be fair, there was no particular advantage to including lean beef, but the W.I.S.E. factors of satisfaction and energy are key to EVERY successful diet, and to maintaining both the lost weight and a healthful eating style.  Whether you’re trying to lose weight or keep it off, YOUR eating style should help you feel energized and satisfied.  The researchers will be following these dieters longer term and satisfaction data is also being analyzed, but the high retention rate suggests the participants liked whichever diet they were eating.

These beef-eaters ate lean beef, but that’s pretty easy.  There are 29 cuts of beef that qualify as lean, meaning they have less than 10 grams of fat per serving and less than 4 ½ grams of saturated fat per 3-oz. cooked serving.  Check out this chart listing 19 popular lean cuts of beef.

CutToTheChase: If you like lean beef, it’s be W.I.S.E. to include it while losing weight. It’s produces the same benefits as a non-beef diet.  Liking your diet is key to staying one it!  Try this lean beef recipe for Grilled Southwestern Steak with Colorful Vegetables (pictured at top).  It’s quick, delicious, and loaded with lean protein.

Note: this study was funded partially by the Beef Checkoff, but also by many additional federal agencies, like the National Heart Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases.  It was registered at https://clinicaltrials.gov. It’s sound science and highly credible. It’s sound science and highly credible. It’s one of the reasons I partnered with the Beef Checkoff program, established by the federal government in 1985. Participation by beef producers is mandatory.

How YOU View Food & Health: “And the Survey Says…”

 

…you’re confused!

The International Food Information Council (IFIC) recently released its 2017 “Food & Health Survey: A Healthy Perspective: Understanding American Food Values” all about consumers’ beliefs and behaviors around food.

To “cut-to-the-chase,” consumers are confused!  How confused are they?  Here are some highlights:

  • 4 in 5 admit finding conflicting information about food and nutrition.
  • Over half say this confusion gives them doubts about their food choices (maybe agita, too?)
  • 24 out of 25 people do seek out health benefits form the foods they choose, but less than half of those people could identify even one food or nutrient linked to those benefits!

Friends & Family: The New “Nutritionists”

More than 3 in 4 consumers actually rely on the people closest to them for at least some of their nutrition advice.  They’re skeptical about it, though.  About 7 in 10 don’t exactly have high trust in these folks for nutrition and food safety info.   Friends and family mean well and don’t speak “nutrition-ese”, so they’re easy to listen to.  Things change however, according to Tony Flood, senior director of food safety at IFIC, who noted, “For concerns such as foodborne illness and chemicals in food, news articles tend to be the top source to influence consumer opinion.”

Smart, because the “hallway advice” from friend and family, has a downside: inaccurate or incomplete information fuels food and nutrition myths.  No one wants to make food decisions and purchases based on flawed assumptions.  Here’s what the IFIC survey had to say about that:

  • If a food costs $2, you are more likely to think it’s healthier than an IDENTICAL food that costs 99 cents.
  • You’re four times as likely to think fresh food is healthier than frozen
  • You’re five times as likely to think fresh is healthier than canned

Let’s at least clear some confusion about the above points:

  • Higher price – for the exact same item – is no indication of healthfulness.
  • Frozen can actually be higher in nutrients. Nowadays, frozen produce is quick frozen right on the field as it’s harvested.  That helps it retain nutrients that can be lost during the time it takes for the fresh version to go from farm to store, to your refrigerator – where you may wait a few days to prepare and eat it.
  • Canned foods vs. fresh? It depends.  Canned garbanzo and kidney beans?  Super nutritious.  I always keep them around.  Canned tomato paste is just condensed, concentrated tomatoes, and cooking tomatoes makes more of the antioxidant lycopene available.  Two thumbs up.  Canned fruit with lots of syrup?  Fresh or frozen fruit is a better choice most of the time, and it does have more fiber. Of course, context is everything: a canned peach with some vanilla Greek yogurt will have way fewer calories and more protein than a slice of cheesecake.

Let’s Clear the Air

As a clinician of over 30 years, I try every which way to make certain that a patient in my office leaves with clarity, not confusion.  Why? Because a confident patient/consumer is motivated to make positive changes!  A confused consumer says, “no” and stays put.  Exactly what I don’t want. Eating is more than just nutrition.  It’s about enjoyment.  If you’re confused or conflicted, where’s the fun?

Resolving conflict

Consumers said they trusted health professionals, especially registered dietitian/nutritionists (RDN), the most, even if they didn’t go to them as often as other sources.  It might be worth it to have a chat with an RDN.  It’ll help stop your confusion about food and get you more confident about the choices you make. As my colleague Carolyn O’Neil says, “The more you know, the more you can eat.”

Another way to clear the confusion? Sign up for my newsletter.  That’s an easy, positive change right there.

 

FRUITS & VEGGIES & PESTICIDES, OH MY!

As a kid I waited impatiently for summer. The main reason? The huge variety of fruits.  People think I love fruit because I’m a registered dietitian/nutritionist, but I’ve always been this way.  As a kid,

I remember going berry-picking near the weekend place we had as a kid, in this secluded canyon an hour south of San Francisco.  The blackberries were so sweet in the warm sun that I’d happily get scratched by the bush’s thorns just to reach the branches with the biggest berries. About half of what I picked didn’t make it home — I ate ‘em on the spot.  Yes, I should have washed them and no, I didn’t.  They were wild, but had plenty of dust and dirt.  I lived through it.

As an adult, my produce passion has only expanded.  I never met a grilled, roasted, or even steamed veggie I didn’t like (unless it was overcooked!)

Less is not more

The diet histories I take on all my patients show one constant: a lack of fruits and vegetables.  They’re like most Americans, too, according to the 2015 US Dietary Guidelines. Produce is a powerhouse of nutrients – and taste!  There’s just no substitute nutritionally, so why deprive ourselves?.

What’s the barrier to eating more produce? Check these frequent comments from patients:

  • “They have so many pesticides and organic stuff is too expensive.’
  • “I buy them but nobody eats them so it’s money down the drain.”
  • Fresh is too expensive and frozen and canned don’t have any nutrition left in them.”

A 2016 survey that looked at the attitudes of low-income consumers about organic vs. conventionally grown produce.  If they’d heard about pesticide residues on fruits and vegetables they were more likely to avoid buying them.  They’re definitely misinformed, because their fear is unfounded. Conventionally-grown fruits and vegetables are quite safe to eat.  Let’s look at why that’s so.

Pesticides 101: Testing, testing…

The Environmental Protection Agency (EPA) requires all pesticides to undergo hundreds of health, safety, and environmental tests before they’re approved. They also establish a safe “­reference dose”, or RfD level. To do this, they first establish the maximum amount of the pesticide that, if consumed daily for the rest of one’s life, would cause no harm. They make the RfD is then 1/1000th of that maximum safe dose.  That means that even if you got 1000 times the RfD, every day, you’d still be fine.

Then there’s verification.  The Pesticide Data Program (PDP) maintains the world’s most thorough database of pesticide residues.  It annually tests domestically-grown and imported produce. Over the 20 years of testing that the PDP has done, over 99% of crops have tested below RfD levels.  The vast majority of produce has tested ridiculously low, in fact, often 1/10,000th of acceptable levels – which already have a 1000-fold cushion in them.

Reality check

Carolyn O’Neil, registered dietitian, veteran food & nutrition reporter, author of The Slim Down South cookbook, says, “I have absolute confidence that choosing conventionally grown produce is doing only good things for you and your family.”  She doesn’t believe we have choose between organic or conventional produce.  “Conventionally grown crops are regularly and systemically tested for pesticide residue to ensure that what goes from farm to table is safe to eat. The proper use of pesticides, in both organic and conventionally grown crops, is the expertise of farmers who want to put safest and most nutritious foods on our tables.”

Keep in mind that virtually ALL of the vast research showing huge benefits of eating more fruits and vegetables was done on conventional, not organic, produce.  Avoiding fruits and vegetables just because you can’t afford organic is unnecessary and puts you at risk.  It’s all good.  Buy the produce you can afford and will eat (I’m never without canned garbanzos).  Everyone eats more fruit if there are fewer “competing foods” around, like cookies and cake.

Organic or conventional, wash all fresh fruits and veggies.  I took a risk as a kid by eating some dirt and dust on those berries without washing them!

Cut-to-the-Chase

Strong safeguards ensure our food supply is the safest you’ll find anywhere.  Our fruits and vegetables are healthy even if they didn’t come from our own yard.

I work with kids and families.  Their safety and food budgets are important.   I eat conventionally grown produce daily, organic if it’s a good buy.  Eat the ones you enjoy and eat them every day.

PROCESSING THOUGHTS ABOUT “PROCESSED FOOD”

You can’t hear any conversation about food these days without hearing about “processed foods”.  Nutrition experts, medical experts, and those who talk about food a lot all seem to be saying the same thing: processed foods are to be avoided or at least minimized to the greatest extent possible.

It’s easy to join the pile-on but as with everything in life, the processed food issue is not black and white.  Why?

News flash: ALL FOOD IS PROCESSED  

Unless you bite an apple off the tree, it’s probably been processed.  Indeed, the act of washing your fruits and vegetables is a form of processing them.  Peeling, chopping, drying, and cooking are all ways of “processing” food.

Processed food has a spectrum, and a group or researchers based at the University of Sao Paulo, in Brazil developed a system is called “NOVA” that classifies all foods into four groups.  In a nutshell:

  • Group 1: Unprocessed or minimally processed foods.

o   Whole fruits and vegetables, whole or sliced fresh meat and fish,

o   dried fruit and nuts

o   combinations of foods in this category, like granola if made with no added sugars. It also includes enriched white rice.  Fair enough.

  • Group 2: Processed ingredients

o   Iodized salt, vinegar, lard, salted butter, etc.

o   Ingredients used in home and restaurant kitchens to prepare “hand-made” dishes.

  • Group 3: “Processed foods”

o   Canned fish, vegetables, and fruits (including fruit in syrup), cured meats,

o   Cheeses

o   “Unpackaged and freshly made breads.”

o   “Most processed foods have 2 or 3 ingredients.”

o   Beer, cider, wine.

  • Group 4: “Ultra-processed food and drink products.”

o   Yogurt sweetened with sugar or a sugar substitute.

o   “Mass-produced packaged breads”

o   Frozen dinners and pre-prepared, ready-to-heat dishes, savory or sweet.

o   Breakfast cereals (sweetened or not)

o   Candy, desserts, pastries, soda.

o   Infant formula

o   Distilled spirits.

o   Foods with “cosmetic or sensory intensifying additives”,

The authors’ advise avoiding category 4 foods altogether, as they, “damage culture, social life, and the environment.”

WHOA!  Absolutely no scientific evidence for that.

The NOVA system: Science or Ideology?

The system seems based more on politics, philosophy, and ideology than science. Examples:

  • “Common attributes of the Category 4 ultra-processed products are hyper-palatability, sophisticated and attractive packaging, multi-media and other aggressive marketing to children and adolescents, health claims, high profitability, and branding and ownership by transnational corporations.”
  • The “freshly made” white bread loaf from the corner bakery is “processed” but the one that’s “pre-packaged” is “ultra-processed” and should be avoided.
  • Fruit canned in syrup is “processed”, which is OK but you should avoid sweetened yogurt and whole-grain cereal because they’re “ultra-processed”?

The scale of production seems more important than what’s in the food itself. Science doesn’t support this. Large-scale production is the only way you’re going to feed hundreds of millions of people every day.  Foods like packaged whole-grain bread and sweetened yogurt, Greek or conventional, can be a terrific part of a very healthful diet.

This tool will probably be idolized but the developers seem to be speaking to an elitist audience that is disconnected from the realities of the people they need to reach.

Avoid the word “avoid”

As a practicing clinician and registered dietitian for over 30 years, whole grain breakfast cereal is a lot more nutritious than candy.  These foods should be far apart from each other when speaking about nutrition.  It’s also unnecessary to “avoid” any food (unless you’re allergic).  Eat less candy and empty-calorie drinks, yes, but I’d like people to eat more whole-grain cereal and yogurt – sweetened or not.  These are nutrient-rich foods that are underconsumed.  There’s no reason to feel guilty about eating them.

People eat food, not philosophy.  After all, it doesn’t’ become “nutrition” until someone eats it.  My philosophy? I’d argue that the cell phone — or “personal device” – has done more damage to our eating habits and lifestyle than breakfast cereal and sweetened yogurt.

Cut-To-The-Chase Nutrition’s bottom line:

  • Nearly all our food is “processed” in some manner. Processing is fine – it’s what makes many foods edible and safe to eat.
  • There are plenty of healthful, “mass-produced” foods.
  • Down with demonizing food and making people feel guilty, especially when the science isn’t there.
  • “Mass production” also brings us standards that ensure the safety and consistency of our food supply. Food is only nutritious if it’s affordable and accessible.
  • There’s a place for nutrition philosophy, but science, should drive nutrition policy.

IS BUTTER BACK? NO, BUT FULL-FAT DAIRY IS!

Do you shy away from drinking milk and yogurt because you don’t like the low-fat/fat-free stuff but also avoid cheese because of the saturated fat?

Well, have a slice of cheese and read on.  And while you’re at it, scoop some full-fat yogurt on some fruit, too.  Your cardiologist probably won’t cringe, either, and may even give you a high-5.  That’s because several recent studies, both randomized clinical trials, (considered the “gold standard” of research), and observational studies that look at tens of thousands of people and are less rigorous, suggest that full-fat dairy foods — but not butter — may be better for us than we thought.

Dietary guidelines have traditionally advised us to reduce our consumption of saturated fat, and full-fat dairy foods are a significant source of it.  These newer studies are suggesting that saturated fat isn’t all the same, shouldn’t all be under one big umbrella.  Dairy fat, in particular, may behave differently than other saturated fats.

Cheese vs. butter

The fat in these two foods have similar levels of saturated and unsaturated fat.  Makes sense, as they both contain dairy fat from milk.  Butter is simply isolated from the milk, whereas cheese has the fat as well as protein and even a small amount of carbohydrate, depending on how long it was cultured.   Since the fats are of similar type, you could also reason that similar amounts of saturated fat from butter and cheese would behave the same way in the body.

That doesn’t seem to be the case, at least not in this study that reviewed randomized controlled trials, — the gold standard of research – to compare the effects of cheese and butter on blood lipids.  Here’s what they concluded from the studies they reviewed:

  • Compared with butter, cheese reduced both LDL-cholesterol (the bad stuff) by 6.5% and HDL-cholesterol (the good stuff) by 3.9%. Note that the more hazardous LDL dropped much more than the desirable HDL.
  • Cheese intake had no effect on triglycerides.
  • When compared to tofu or reduced-fat cheese, full-fat cheese increased LDL cholesterol.

Foods vs. nutrients

Just as not all saturated fat is the same, it may be a mistake to see all dairy fat as the same, even though it all has the same origin and composition.  Why? Because we’re learning that there’s more to food than just its nutrients.  (You may think, “duh” but in the nutrition world, it’s always been just about nutrients!)

In this 2016 synopsis of several symposia that looked at 131 studies, the research did not show any increased risk for cardiovascular disease from the consumption of full-fat dairy foods.  Moreover, for weight gain, there was actually an inverse relationship with weight gain and obesity risk, meaning that higher consumption of full-fat dairy foods was associated with less obesity and weight gain.

The thought is that when dairy fat exists in foods, it’s bound to a complex matrix that includes milk proteins (chiefly casein and whey) as well as minerals and even bacterial cultures, in the case of cheese and yogurt.  These along with the compounds of digestion, may reduce the absorption of some of the cholesterol and/or saturated fats.

I actually like this type of research because it helps me work with patients who couldn’t care less about the biochemistry of it all, they just want to know how to eat a healthy diet that also tastes good.

Cut-to-the-Chase take-aways:

  • Overall, good news here about cheese and full-fat dairy foods.
  • Keep eating the fatty fish and olive oil!  But it’s OK to replace butter and fattier cuts of meat with cheese and full-fat dairy.
  • IF you like fat-free yogurt and you’re used to 1% or fat-free milk, keep at it!
  • If your diet is short of calcium and vitamin D because you don’t care for low-fat or fat-free diary, and including more full-fat dairy foods would help correct that
  • Spend wisely: Full-fat dairy foods have more calories than lower-fat versions, so be sure you balance calories elsewhere in your diet.

US NEWS’s BEST & WORST DIETS: Get my take & stop building a shelf of diet books

US News started 2017 with their ratings of popular diets.  What stands out?  The sheer quantity!  They rated 38 – count ‘em – 38 diets, and had a panel rate them on many factors, including health, weight loss, and overall.  They also classified them into such categories as best “commercial” diet, most heart-healthy, best diet for diabetics, and on.

What stood out to me? Let’s look at the top 3 diets:

  1. DASH diet: Long-standing winner year after year. It’s a simple concept: lots of fruits and vegetables, low-fat and fat-free dairy every day (some full-fat, too) and cut back on sodium. Developed to lower blood pressure, DASH stands for: Dietary Approaches to Stop Hypertension.
  2. Mediterranean Diet: Focus is on heart health. Like, DASH, the concepts are simple: lots of fruits and vegetables, not much red meat, plenty of fish and daily olive oil and/or nuts like almonds, hazelnuts and walnuts.  Focus here is on olive oil and omega-3 fats.  Another annual favorite.
  3. The MIND Diet: This combines some concepts from the top two diets but gets a bit more specific about certain foods to cut risk for Alzheimer’s disease. Specific fruits and vegetables include green leafy veggies and berries, two foods associated with reduced Alzheimer’s risk.  Fish at least once a week, and low intakes of fatty meat, butter, and empty-calorie desserts and fried foods.

Why I love the top 3 diets

I love that they’re not really diets, just “eating styles”.  There are no absolutes, no rigid “my-way-or-the-highway” rules.  Nothing is prohibited forever, but there are specific to include, but enough variety to allow for favorites within each group.

And there’s solid science behind these eating styles.  The research even indicates a beneficial trajectory.  That is, even if people ate a diet that made some changes, even if not enough to count as a true Mediterranean or DASH diet, but approaching those, they saw reduced risk for developing Alzheimer’s.  You can sustain all three of these eating styles and strong research says you’ll be healthier if you do.

Honorable Mention: #4: The Flexitarian Diet

This diet tied with several others for fourth place but I like it.  It’s healthful, varied and “mostly vegetarian” but recognizes that the world is round.  If you want an occasional burger or taco on this diet, it doesn’t mean you’ve “crossed over to the dark side.” High time.

What about the bottom 3?

  1. Paleo Diet: Despite the popularity, especially among males who want to eat like the hunter-gatherer of 10,000 years ago, this diet ranked last for weight loss, last for fast weight loss, and was considered among the most difficult to follow in modern times. Let’s not forget that 10,000 years ago the life span was short.  The average 40-year-old has been dead a while.
  2. The Dukan Diet: This diet offers an “all-you-can-eat” theme – but only of the allowed foods. It’s big on protein. Really big, and carbs and fats are quite limited.  As with most high-protein, low-carb diets, you’ll lose a lot of weight in the first week or two, but this one got low ratings for being easy to follow and maintain.  Low ratings for healthfulness, too.  The maintenance phase has similarities to other diets: moderation, nothing is off limits except large portions and binges.  Maybe best to start with that?
  3. The Whole30 Diet: Bottom of the heap and I’d agree. Super-restrictive and there are absolutes. Deviations are not allowed.  It only lasts 30 days and is intended so designed to push your body’s re-set button but also to fix dysfunctional relationships with food.  Big claims made here and there’s no research behind this diet (Red flag of junk science – NO science).  I’m against temporary diets.  You’ll be in your body after 30 days but this dietary pattern probably won’t.  And probably shouldn’t.

Edible Rx take-away: Choose one of the top 3 diets that you’re most comfortable with.  Take all of 2017 to gradually move in that direction.