Dear Tom Brady: You Won, Your Nutrition “Beliefs” Don’t

Tom Brady is a multiple Super Bowl winner.  He’s also a businessman, and he’s glommed onto the formula for marketing a diet regimen:

  • Be a celebrity, preferably a sports celebrity, because they’re instantly believable.  Not credible, but no one cares about credibility or facts, just that you’re believable.
  • Look good, have a killer bod.  People will think your diet is the reason. Hey, sexy sells.
  • Have an equally hot spouse or significant other who can endorse you. And when you say you get to bed early every night, no one would doubt you. 
  • Talk about nutrition “beliefs” and “philosophy”.  Facts aren’t good for business.
  • Exclude all the standard food commodities. They’re not elite enough (see below).
  • Have all the trendy “free-froms”:
    • No gluten.
    • No red meat.
    • No dairy.  
    • No white potatoes or any other nightshade vegetables either, like peppers, eggplant, or tomatoes.  They’re “inflammatory”. 
    • No GMOs.
  • Keep it as green as possible.  Heavy on leafy foods, but he also includes beans – I do like this part.
  • Go against the grains – at least the common ones, like wheat and corn – again, those commodity foods the masses eat, because you aren’t most people.
  • Have expensive “uniquely formulated” products to sell – only available from your web site.  It’s critical to eat like a wealthy, elite athlete, not a commoner.
  • ELECTROLYTES!  The ones he sells in particular — the TB12 electrolytes.  They’re part of his “alkalinizing” the body, a must for health in his book.  (NO science supporting this – none).  A 20-serving, 1.7-ounce bottle sells for $15 (plus shipping).  That’s 71 cents per serving.  A serving of milk gives you three times more potassium, plus protein, sodium, calcium, and other nutrients you  need after a workout, for one-third the price. This from someone who chastises food companies about “brainwashing” consumers.  Shame on you, Tom. 
  • WHEY PROTEIN POWDER?!  This dairy food is OK – IF it’s TB’s specially formulated one.  It’s $50 for 21 servings, or $2.38 per serving.  To get the same amount of protein from real milk would set you back only about 65 cents, and you’d get all the other nutrients in milk to boot. 

Keep Edgy: Diss the Mediterranean Diet!

Sweet red pepper: One of many superfoods
NOT allowed on TB’s diet!

No cooking with olive oil!  Swap it for coconut oil.  No scientific basis for this – coconut oil is way more saturated than any animal fat.

No yogurt, eggplant, tomatoes, or peppers!  No cheese!  Nutrient-rich foods that have fed and sustained Italians and Greeks for thousands of years have no place in this winner’s diet.  Fish only if it’s wild-caught.  Farmed salmon, while quite healthy and affordable, but probably not exclusive, elite, or expensive enough.

You’re Busted, Tom. Ditching Dairy Is Dumb.

Dairy foods – from milk to yogurt to cheese – have unparalleled qualities.  If you know your nutrition, this isn’t debatable.  It might be boring, but facts often are. 

He writes, “When I was a kid, the dairy industry rolled out lots of campaigns urging people to drink lots of milk.  But research today is pretty clear that we should consume dairy in more limited amounts. Our belief [there’s that word again] at TB12 is that dairy products are high in calories and lower in nutritional value than other foods.”

I don’t know what “research” he’s talking about (I’d bet he doesn’t either), but there is no drink that can match a glass of milk for nutritional value and affordability.  None.  Furthermore, a mountain of solid science verifies the benefits of dairy foods, including that a glass of low-fat chocolate milk after a workout is BETTER than sports drinks for repairing muscle mass and improving endurance in subsequent workouts.   Why? Probably a great carb-to-protein ratio and a great electrolyte balance, plus vitamins and minerals.  Of course, milk is a commodity, so it has to be out. 

No GMOs?

Tom seems to disagree with over 100 Nobel prize winning scientists who have attested to the safety and nutritional value of foods produced with genetic engineering. I wonder what he knows?

Cut-To-The-Chase-Advice

Nutrition advice should be grounded in science and facts, not beliefs or philosophies.  Using the word “belief” shouldn’t give you a pass to propagate nutrition myths and misinformation. 

Most of us don’t have personal chefs to cook our meals (and clean up afterwards).  Tom’s diet may not be harmful to the average person, but the DASH and the Mediterranean diets have far more science behind them and are solid, affordable, and sustainable paths up the mountain towards good health.  They don’t require expensive “website” foods and supplements or forbid foods either – it’s a matter of how much and how often.  Not sexy, just solid.  For my health, I’ll go there.  Sorry, TB.

Food Fashions: Full-Frontal & Fickle!

It’s coming up on Fashion Week in New York and while that’s all about styles of clothes, foods come into – and go out of – fashion, too.  A previous post dealt with foods that nutritionists never thought would become popular, yet they did just that. 

Now think of the foods that were “in” — for a while.  I actually heard or read these comments recently:

  • “I’m so over kale, already.”  I read this comment by a former editor of a prominent food magazine. (Cauliflower is the new kale, if you’re wondering, but beets are gaining.)  
  • “Cottage cheese? What are you, like, 80?”  (This was said to me and no, I’m not 80 — but hey, nothing wrong with 80!)
  • “A baked potato?  A white one? Are you serious?”
  • “I don’t’ do bread.  All that gluten.  Quinoa is my thing.”
  • “She wants a Cosmo? No one drinks those anymore.”

All the above foods (excluding the Cosmo) are delicious and healthful.  They’re also “out of fashion” (including the Cosmo).  If this sounds a little ridiculous, read on.

Food Fashions Fade, Food Value Doesn’t

People may be “done” with kale, but is it less healthful than it was when it was “in”?  Of course not. It’s a superfood.  A baked potato is one of the best sources of potassium, even better than a banana, and has as much vitamin C as a tomato!  It always has!  Even so, all the buzz is that white potatoes are bad and sweet potatoes are a little better, but still a “starchy vegetable” to be eaten in minimal amounts. (Thanks, Harvard.)  

Fashion eating aside, the nutritional qualities of these foods have ALWAYS been there.  Whether it’s kale or cauliflower, or They’re as nutritious today as when they were first “discovered” by food fashionistas. 

Consider the following:

A healthful Russet Burbank white potato grown in Idaho!
  • Kale is every bit as good for you now as it was when you first tasted it.  It may even taste better now, since all that attention motivated chefs to develop inventive ways of eating kale.  Bravo.
  • White potatoes. Before you were told of their “horrors”, they were a staple food for millions of people from Paris to Poughkeepsie to Peru.  The nutrition they had is the nutrition they still have.  (Check out www.potatogoodness.com for a ridiculous number of facts and recipes. 
  • Bread?  It takes a hit for having “carbs” and gluten, which celebrities tell us are both bad (proof you should never get nutrition advice from celebrities).  Yet, it’s been a staple, indeed, the “staff of life” in many cultures throughout history.  Made with whole grains, it’s also loaded with fiber, vitamins and minerals.  It’s versatile, oh, and people like it. 
  • Cottage cheese?  PLEASE!  If you think it’s only for elderly ladies who lunch, experts disagree. registered dietitian nutritionist and exercise physiologist Jim White is one guy trying to set the facts straight about the value of cottage cheese. “If your goal is to increase lean muscle, mass try cottage cheese with a serving of your favorite fruit after a hard earned workout,” he says. He educates clients that a typical cup of low-fat cottage cheese boasts a walloping 27 grams of protein for those muscles, plus 200 mg of calcium to support bone health.

Sometimes fashionable eating can have benefits.  I love anything that gets people eating more veggies, yogurt, and whole grains of any kind.   But I get concerned that people strop eating these foods when the trend fades and the benefits also go missing from their diets, especially if they replace them with something less healthful.  (Example: plant-based “milks” are more hype than benefit.)

Cut-To-The-Chase Advice

Work it.  Let food fashions motivate you to try a new food.  If you like it, keep eating it!    If it’s nutritious and out of fashion, it’s still just as good for you as it was when everyone else was eating it to be “in.”  Never be intimidated about eating healthy food you like.

Wanna Eat Healthy? Get Your Nitrates!

Think nitrates in your food and eating healthy don’t go together? What’s this gorgeous spinach salad have to do with nitrates? Read on, but let’s start at the beginning.

You’re not going vegan but you want to eat better and you’ll start with baby steps, like I talked about in my previous post.  OK, and here are some popular intentions:

  • Try and eat more leafy green stuff.
  • Definitely cut the hot dogs, ham, bacon, the deli stuff, and “processed” meat, even if it’s lean.  Everyone knows that stuff is “bad” because it has nitrates, right?

Swapping out hot dogs and ham for spinach and beets (the new “in” veggie for 2019, as I mentioned here) would at least cut back on the nitrates, right?  Wrong. 

Where the Real Nitrates Are

Indeed, a bunch of healthy, nutrient-rich veggies like beets, spinach, celery, even iceberg lettuce and broccoli, have more nitrates than that hot dog you snuck in for lunch last week.  Check out this chart from a 2012 report of the nitrate content in foods.  Amounts are in “parts per million” (ppm):

This image has an empty alt attribute; its file name is mushrooms-417101_1280-2.jpg
More nitrates than a hot dog — & it’s healthy food!
  • Beets: 2797 ppm
  • Spinach: 2333 ppm
  • Celery: 1496
  • Mushrooms: 590 ppm
  • Broccoli: 394 ppm
  • Strawberries: 173 ppm
  • Cured sausage (hot dog), cooked: 32 ppm

Are Nitrates in Fruits and Veggies a Problem?

No, and not in other foods either, according to Melissa Joy Dobbins MS, RDN, CDE and known as The Guilt-Free® RD.   “This is a great example of how misinformation can create a “fear factor” when it comes to food. I think most people who are concerned about nitrates/nitrites would be surprised to learn that the majority of these nutrients in our diet are not from cured meats, but from plant foods, namely a variety of vegetables.”

Dobbins’ statement is evidence-based and reflects the conclusion of this 2015 meta-analysis of many studies on dietary nitrates, nitrites, and nitrosamines, which found nitrates associated with a decreased risk of gastric cancer.  The slight increased risk associated with increased nitrite intake was considered weak, and tended to come from weak or poorly-designed studies, which muddied their findings.  Even then, spinach still has more nitrites than cured sausage.

Nitrates & Their Cousins: Nitrites and Nitrosamines

Here are the basics you need to know about these:

  • Nitrates are naturally present in lots of different foods. 
  • Nitrites are also naturally present in foods but most are formed when bacteria in your saliva convert nitrates to nitrites. 
  • Nitrosamines are not naturally present in food but can form in food through several pathways.  Cooking at a high temperature, such as frying cured meat, or when an acid (like stomach acid) is present.  If there’s any concern, it’s with the formation of nitrosamines.  Even then, conversion from nitrite to nitrosamine can be inhibited or stopped by the addition of compounds like ascorbic acid, or “vitamin C”.  Seriously – check the ingredient label of many cured foods like hot dogs and you’ll find “ascorbic acid” is often present. 

“Nitrate-Free” Cured Meat?

There are cured meats labeled “no added nitrates.”  What they add instead is celery powder.  As you’ll see from the table above, celery is loaded with natural nitrate.  There’s no evidence that there’s any difference between the nitrate in celery powder and the nitrate added to “nitrated” cured meat. 

Celery: Fine wherever you find it

Nitrates: The Boil-Down

It’s ironic to know that someone eating a spinach salad is probably getting 10 times more nitrates than the person eating the ham sandwich, but Dobbins noted, “Does that mean we should be afraid of eating vegetables? No. It means we should look at the overall nutrients a food provides and try to consume more nutrient-rich foods and fewer empty-calorie foods.”

It may be that the folks who eat lots of cured meat may also have a less-healthy lifestyle overall.  They may be less likely to engage in regular physical activity, and less likely to eat a lot of veggies and fruits, and may drink more soda or eat more junk snacks.

Cut-To-The-Chase-Advice

Eat all the spinach, beets, mushrooms, celery and broccoli you can fit into your diet.  As for cured meat, I like Dobbins’ approach. Nitrates may not be an issue but balance still is, so don’t go crazy at a cold-cut buffet.  If you like cured meats, make them leaner cuts, like ham, instead of sausage.  And have that ham with lots of veggies – even high-nitrate ones like spinach and broccoli.  A meal loaded with nitrates can, and should, still be healthy.  0000000000000

Learn From a Baby About New Year’s Resolutions

Even a baby who hasn’t seen his/her first New Year can teach us something about making resolutions.  Babies may not think about their health, but this poll done in the UK found the top 3 resolutions for adults:

  1. Lose weight
  2. Get fitter
  3. Eat more healthy

Wisely, the poll also followed up with these people.  Nearly two out of three who made resolutions keep them and more than 4 in 10 broke a resolution within the first month.  Only 1 in 3 kept going for more than a month. 

Resolutions: They’re FOR the Year, so TAKE All Year

Imagine if a baby stopped trying to walk after falling?  Every single human would be immobile.  A broken resolution isn’t a failed resolution!  I wouldn’t even call it broken – just “in progress.”  The flip side is to expect 100% perfection 100% of the time, right from the start.  Ridiculous.  You get up, look at where you tripped up, and move on. 

This study found successful “resolvers” used more behavioral strategies, which, by nature, require more time, because behaviors change slowly.  Every road has a pothole or two, so if you encounter one on your journey, you’re typical and on schedule.  Keep it moving.

Ready, S.M.A.R.T., Go!  –Anytime

Learn from these guys

Never mind January 1, whenever you’re ready, the calendar will support it.  Just see a resolution as its own project.  Give it priority and treaty it with some respect.  This is you, after all.

S.M.A.R.T. is just an acronym for the components of successful goals and objectives, whether in the workplace or your personal space.   The letters have stood for different things over the years, but here’s where they stand now:

  • Specific: keep it simple, something you KNOW you can achieve. “I’m going to eat healthier” isn’t specific.  “I’m going to eat 1 cup of fruit and a cup of vegetables at least 3 days a week” is more specific.
  • Measurable: Note how far you walked, how many vegetables you ate, or whatever your specific objective is. Forget obsessing about every detail.  Again, simple is key here.
  • Achievable: Specific and achievable are two sides of the same coin.  THINK LIKE A BABY here.  Take baby steps!  Set a goal you think is achievable and then reduce the goal by 50% or more.    You can inch up later. 
  • Realistic: Meet yourself where you live.  If you can’t spare a whole hour a day for exercise – or if you’re not in shape yet for that – it’s OK.  I don’t care if you start walking for 5 minutes a day.  You’ll be at this the whole year and you’ll get where you need to go.  An easy goal is the best kind when you’re starting out. If you want to lose 10 pounds of body fat in 3 days, that’s specific but not realistic. 
  • Time-bound: TAKE THE WHOLE YEAR but set small time goals for the baby steps.  You’re building a habit here, and habits take time to become established. 

We want everything done immediately and easily sustained forever.  Let that concept go, because it’ll never happen – for anyone.  Most importantly, THAT’S OK. 

Baby steps & persistence!

Babies Have Vitamin “P”

Back to babies.  They’re loaded with vitamin P – persistence and patience!  Even better – they LOVE the journey and what they accomplish along the way!  Have you ever seen a baby’s expression when they crawl farther, learn to hold a spoon, or stand for the first time?   Give yourself a little credit for taking those baby steps.  They’re the best kind!

The Top 3 Diets: Why Do They Always Win?

WINNERS AGAIN – according to US News’ annual ranking of diets, the Mediterranean diet, the DASH diet, and the Flexitarian diet were the best diets of 2018. They’re likely top be the best of 2019, too, since they’ve been tops forsome time now.  This is NOT news to thoseof us in the field – they’re widely accepted as terrific examples of healthfuleating styles.

These diets are notable for two things:

  • The science about their healthfulness, and
  • They all push plant foods: fruits, veggies, whole grains, nuts

What else I love about them?  They don’t push out any foods.   You can include anything; the only issue is how much and how often.  My kind of eating style, because it’s realistic. 

DASH to delicious!

DASH details:

So, what’s different about them? 

-Low-fat and fat-free dairy are featured

-Add AT LEAST one fruit or vegetable to each meal, but preferably more.

-WALK!  Just a little, about 15 minutes after lunch or dinner (do it anytime you can, but aim for at least 30 minutes a day).

Mmmmediterranean!

Mediterranean Momentum:

  • Olive oil is the fat for cooking and salads.  Canola is also good, but butter is rare. 
  • It’s nuts. Almonds, hazelnuts, pistachios are typical.  An ounce several times a week.  What’s an ounce?  Small handful – think “nibble” not ”shovel”. 
  • Something fishy? Yup.  Twice a week, and make it fatty – think salmon more than sole. (Hint for economy: canned salmon is a superfood and by comparison to fresh, it’s super-economical). 
  • Low in red meat – BUT, for red meat lovers, you CAN eat red meat on this diet and there’s good research to say so.  I have the details here.
Approaches vegetarian, but room for all

Flexitarian Features: 

  • Includes more vegetarian meals, especially plant-based proteins. 
  • Dairy and eggs? Both OK!  The diet just emphasizes including the plant-proteins, as well.
  • Meat?  Nota feature, but more of an, “it’s OK sometimes, too” approach. 
  • It’s not about strict anything, or it wouldn’t be “flex”.  You’re in charge about how far to take it.

Together is better

If there’s a downside to the Med diet, it’s the low-calcium content.  The 2015 US Dietary Guidelinesfor Americans endorsed both the Med diet and the DASH diet as excellent eatingstyles, but they acknowledged that the Med diet didn’t fully meet calcium needs.  The majority of people have diets deficientin calcium – the reason calcium is a “nutrient of concern”.  What to do?

Breaking New Research: The “MedDairy Diet.” 

An Australian study, just published, looked at the cardiovascular health markers of a Med diet, supplemented with four servings of dairy — one serving of low-fat milk; 40-120 grams hard or semisoft cheese; 200 grams low-fat Greek yogurt or 200 grams tzatziki dip.  Here’s what they discovered about the Med-Dairy diet’s effects:

The Med-Dairy diet improved cardiovascular health markers:

  • LOWERED blood pressure (both the top and bottom numbers)
  • LOWERED triglycerides
  • RAISED HDL-cholesterol levels (the good kind of cholesterol)

Talk about an example of “We’re better when we work together”! 

What I especially liked about this study was that it included full-fat cheese, a favorite of many, and it actually included a fair amount of it – about 1.5 to 4 ounces daily, depending on calorie needs. 

But RED meat…?

Yes, you can still have lean, unprocessed red meat on a MedDiet.  Indeed, this Purdue University study, blinded to even the investigators, found that eating up to 18 ounces of leanred meat was not only OK, but it was MORE effective than a Med diet thatlimited lean red meat to only 7 ounces per week.  Red meat lover?  You’re OK, within the context of a Med diet.

As for the WORST-rated diets?  Those that are super-trendy, alsosuper-restrictive (Keto, Dukan, and Whole-30 lead this pack).  Entire food groups excluded, rigid rules, demonizedfoods, and little science to support them – a red flag.  Don’t hate them, but give them a big hug andlet them go. 

Why I Try To Be “Over 30” Every Day

Dee is an inspiration to me.  She has cerebral palsy and is confined to a motorized wheelchair. She has only minimal use of each hand, just enough to move her chair and use a phone if it’s placed into her hand. She’s not only cognitively intact, she’s pretty smart.

I’m lucky. I worked for 33 years with people with special needs, people like Dee.  It’s emotionally difficult work sometimes, but I always got more than I could ever give them. One powerful lesson they taught me was how lucky I was to be physically able-bodied.

She told me once she was fed up hearing what a nuisance people thought it was to take the stairs, walk the dog, or park farther away from your destination to get in a few extra steps. “They sit down all day long but they have a choice. I don’t. If I could walk I’d never want to sit down.”

When we think of chores, she thinks of abilities. Big wake-up call here.

Everyone Needs To Be Over 30

I speak not of years, but of minutes. Thirty minutes of physical activity for at least five days of the week is what’s recommended by the US Physical Activity Guidelines for Americans. How much do we get? The feds survey this info regularly and the latest data show 1 in 4 of us get NO leisure physical activity at all. None. That’s self-reported data, and it may be higher, as people do tend to enhance the amount of physical activity they do.

Flipping the Script on Activity

Many of us cringe when we’re told to be more active. So how about baby steps? How about focusing on being less INACTIVE?

If it’s too overwhelming to go to a gym (I speak not of “joining” because that doesn’t ensure “going”) or if you have little leisure time, then it makes sense to build some activity into your day, a little bit here and there, whenever you can.

Enter the “Exercise Snack”

A food snack is something less than a meal. An exercise snack is something less than a workout. It can take many forms and be done pretty much anywhere. It doesn’t have a minimum time, it just requires moving – anyway you can, and anywhere you can. You don’t need to develop a twitch, just think of doing what some of my physically disabled patients would LOVE to do:

Deliver it.  Why email a memo to someone close by, when you can walk down the hall to speak with them? Follow-up with a memo for the record.

Think glass,  not bottle.  Have one glass of water at a time, rather than brining a bottle to your desk. When you want more, you’ll get up and get it.

DIY: Make a photocopy yourself, get the staples from the supply closet, give the home floor an extra quick vacuuming. It’ll get done your way and it’s another exercise snack.

TV? A 30-minute sitcom only has about 22-23 minutes of actual programming. That’s about 7 minutes of time – in 2 or 3-minute intervals – for exercise snacking.  Get the playing cards, charge your phone, lay out your clothes for the next day, or even fold a few clothes.

Tidy up!  Not a deep clean, just clear the coffee table, run the dishwasher, or hang that coat that’s been there since you got home.

Remember, these are exercise snacks, not workouts, so you’re done after a couple of minutes, but do them several times a day and you’re on your way top getting that 30 minutes. Better still, you’re preventing your metabolism from slowing down. Remember – it’s not about being more active – just less INACTIVE.

It’s an easier goal to achieve and these exercise snacks might lead to bigger things, like “exer-meals”. And if you need motivation, remember: Dee would happily trade places with you.

As for motivation, check this video out of a 4-year-old girl with cerebral palsy, taking her first steps by herself.  You’ll cheer her on as loudly as I did.  Then get up off your chair or the sofa — just because you can!

Believing Junk Is Even Worse Than Eating Junk

If you’re of a “certain age” you’ll remember “Vacupants.” You hook up a vacuum to the hole in the special “pants” and the fat melts off.  The idea was that it somehow “vacuumed” away the extra weight.

You might think this could never happen in the age of digital media but you’d be wrong.  It happens plenty, just differently.

The food, nutrition, and diet world is loaded with sensational and extreme headlines and promises.  We gravitate towards the sensational. The promise of a quick fix has a magical way of grabbing your attention and won’t let go.

It’s the modern-day version of the “snake-oil” sales pitch.  You’ve probably seen headlines touting:

• “Lose 10 pounds in 3 days without doing exercise or changing your diet!” (Similar to the Vacupants claim — see how much things have changed?)

• “Lose all the weight you want eating junk food!”

• “This miracle food speeds up metabolism!”

Most common now are diets that spout the total avoidance of a food or even entire food groups. Think about carb- and sugar-phobia that lumps empty-calorie foods together with great foods like beans and fresh fruit. Or the keto diets that demonize most carbs, including whole grains and most fruits and vegetables, and hold the state of ketosis on a pedestal. In truth, ketosis is something that should generally be prevented, not promoted.

Then there’s the scare-tactic approach:

  • “10 Foods You Should Never Eat”
  • “Your Body Can’t Process These 3 Foods”
  • “5 Foods That Cause Belly Fat”

“Absolute” Exploitation

These sensational promises, extreme claims, and headline-grabbers exploit people who are vulnerable, undereducated or just misinformed. Someone with a health issue, including someone trying to lose weight, is vulnerable, even desperate for a solution, making them easy prey for junk science purveyors.  Health issues are sensitive, lots of emotions are involved, making them vulnerable to quick-fixes, magic bullets, and instant cures – just the type of stuff that makes up fad dieting.

Educated people aren’t insulated either. “Vacupants” was marketed as a quick weight loss method.  Laugh if you must, I once had a patient, an educated woman, who admitted she’d bought this gizmo. No, they didn’t work. She’d have been better of if she’d put on some actual sweats and gone walking for half an hour a day instead.

We all like being told something that fits with our values or what we’d LIKE to be true.  Eating junk can be over in a flash but believing junk can continue for years.

10 Red Flags of Junk Science

Tufts University does a nice job of explaining these in detail, but this is the Cuttothechase version:
1. Promises of a quick fix. File “miracle foods” under this one, too.
2. Danger warnings of a single food.
3. Claims that sound to good to be true. Hint: they are too good to be true.
4. Simple conclusions from a complex study. Oversimplifying often indicates taking results out of context or omitting caveats.
5. Recommendations based on a single study. If it cannot be replicated, it’s probably bogus or at least cherry-picked. Pass.
6. Statements refuted by reputable health organizations. If they’re reputable, they require solid evidence. Key word: solid. If they pass on the claim, you should, too.
7. Lists of “good” and “bad” foods. #ridiculous
8. Recommendations made to help sell a product or supplement. This doesn’t mean it’s junk, but if it’s good, check for lots of evidence and organizations that agree.
9. Research that is not peer reviewed. Big red flag for research that’s badly done.
10. Recommendations from studies that ignore differences among individuals or groups. There can be differences between genders, smokers vs. non-smokers, young and old age groups, the works.

Could Losing Weight Make You Richer?

Well, yes and no. It won’t automatically add to your bank account, but according to this study you’ll probably spend less on health care. Reducing weight reduces health risks – and what they cost you.

The authors studied data between years 2001-2015 from the Medical Expenditure Panel Survey (MEPS), an annual survey that uses a nationally representative sample of adult civilians. They looked at the additional cost of being obese, compared to a non-obese person with the same condition.

They combined the costs for obesity-related illness from all “third-party payers”, including Medicare, Medicaid, private insurance plans, and patient “out-of-pocket” spending, other than for over-the-counter medicines. The results are worrisome – and costly.

Price Per Pound

Out of the 334,000 adults surveyed, 30%, or 99,000, had a body mass index (BMI) over 30, indicating obesity. This is no surprise, as other national surveys have shown similar percentages. This percentage would double if they had included people who were merely overweight, with BMI values between 25-29.9.

After adjusting for inflation to 2015 dollars, here’s the change in the percentage of medical costs associated with obesity:

• 2001: 6.13% of medical expenditures
• 2015: 7.91% of medical expenditures

That might not seem like a huge change, but it amounts to a 29% increase, compared to someone with the same condition who is not obese. Some states, such as Ohio and Wisconsin, fared even worse, with increases over 40%.
The cost of obesity isn’t just born by third-party payers. Consumers often have plans with high deductibles. If your visits require a co-pay, the more visits you need, the more money out-of-pocket costs you have. Consumers now average nearly 5% of their own medical costs to treat obesity, with consumers in many states far exceeding this percentage. The study also noted that 13% of prescription drug costs are to treat obesity

Weighing Down Your Earnings?

The authors quoted several studies that suggest associated a higher BMI with lower wages, but for women only, not men. Weight-related discrimination in the workplace has also been documented. Indeed, there is less chance of being hired because of weight. Then there are the issues of obesity-related health problems causing more missed days due to illness, more physician visits, more medication costs.

When you add it all up, shedding a few pounds starts to make financial sense, not just healthy sense. Who wouldn’t rather put that money to better use if they could – and you can.

Going Positive – a 5% solution

This study showed national averages but you’re not a population, you’re you. Everyone is different. You can’t change national numbers but you can impact your own. Losing 100 pounds is not necessary to be healthier and reduce obesity-related risks. This review of weight research studies documented that even losing 5% of your body weight will produce health benefits. Weigh 200 pounds? That means if you release 10 pounds you’re healthier. Hold that for a year and I’m your biggest cheerleader.

Take It Easy To Save More

I wouldn’t care if you made one small positive change to your diet or lifestyle each month. Just do what you can commit to and know it’s moving you in the right direction, health-wise, and money-wise. In fact, if you’re making changes you notice quickly, you’re probably making too drastic a change. OK to slow down, take a year to lose 12 pounds – a pound a month. If that gets you to the 5% solution, you’re already saving money on health care costs.

BTW — This is a pic of a huge California peach on a “smiling” dessert plate.  It WAS dessert, amazingly delicious all on its own.  

Direct & “Indirect” Food Additives: Issues Or Non-Issues?

The American Academy of Pediatrics recently released a policy statement on food additives — the direct food additives like nitrates, and indirect ones, like plastic containers that come into contact with food. Their bottom line is that the FDA’s regulatory process doesn’t properly vet food additives and cannot assure us that all of these 10,000 “chemicals” [emphasis mine] are 100% safe.

I like the AAP – really I do – but in this case I wonder if they’re presenting a balanced view of the total body of science on food additives. For example, the statement references studies where additives are “linked” to conditions like impaired thyroid function and immune responses to vaccines, even increased risk for obesity. Yet, many of the referenced studies also admit that such “link” may not be one of cause-and-effect. Moreover, numerous studies not referenced validate the safety of these additives. Getting approval of a new food additive just isn’t easy – nor should it be.

Is ANYTHING 100% Safe?

Not likely, and that includes prescribed medications, but that doesn’t mean we shouldn’t use them when necessary. It would be easy to get suspicious of everything we eat: Are healthy foods like beans 100% safe for everyone?

It’s more useful to me and my patients to put this issue perspective, and to that end I think the AAP statement could have done that better. We DO have the most advanced food delivery system in the world and our FDA is a guide post for similar organizations in other countries.

The AAP’s issue with nitrates is one I don’t get, for example. Nitrates and “processed meats” are buzz words, true. But a food label saying “no nitrates added” doesn’t mean the meat has no nitrates. Celery powder is often a substitute, because celery is a source of natural nitrate, along with green beans, carrots, spinach and collards. Of course, celery powder is also a “food additive.”

If someone is eating processed meat frequently, I’d be more concerned with what it’s replacing in the diet, rather than nitrates per se. Let’s balance the diet and the nitrates become a non-issue.

The Big Picture

As a pediatric nutritionist for over 30 years, I’d love it if we lived in a world without a need for anything “additive”. But we don’t, and in some cases that’s a good thing. After all, food additives have provided some of the best public health interventions. I’m glad I don’t have to see children with neural tube defects anymore, now that folic acid – a food additive – is added to enriched grains. My own mother remembers her grandmother having a goiter and to this day she will only use iodized salt. No fancy sea salt, not even Kosher salt, for her. “You never had to see anyone with a goiter,” she says.

The AAP calls for the FDA to re-examine the regulatory process for approval of food additives, including those additives on the “GRAS” (generally regarded as safe) list. They also note that low-income children are at increased risk, as higher consumers of packaged foods.

Food Additives & Food Budgets

As for affordability, I like that the AAP recommends practitioners “develop a list of low-cost sources of fruits and vegetables.” I’ve worked my entire career with low income patients and helping patients stretch their food dollars goes hand-in-hand with good medical nutrition therapy. Nothing is nutritious until people eat it.

I don’t have the luxury of telling parents that their family’s health is at risk until the feds beef up their regulatory process. I also think there’s a lot that you can do at ANY income level to reduce exposure to additives. The AAP does give some recommendations in the interim, but frankly, they’re the same ones I’ve been giving to my patients on for years, just for general health:

• Make fresh fruits and veggies a big priority in the home eating environment. (Uh, it helps if parents eat them, too, and in front of the kids).

• When microwaving food, put it onto a plate or in a glass container instead of plastic. It just saves worrying about whether the container is microwave-safe to begin with. Also, no plastic wrap when microwaving. Too hot and the stuff melts. Ick.

• Forget the dishwasher for plastic containers. Just wash them by hand. Done.
Finally, if you’re doing these things anyway, then you’re also already minimizing your exposure to food additives. Then the feds can take all the time they want. You’re doing your job and that’s plenty safe.

 

 

 

Lean Red Meat in a Mediterranean Diet? Oh, Yes You Can!

This post is a collaboration with Beef. It’s What’s for Dinner., on behalf of the Beef Checkoff, as part of my role as a member of the Beef Expert Bureau.

In my previous EdibleRx column, I discussed the PREDIMED study, a 2013 landmark multi-center trial that showed how following a Mediterranean diet could reduce the risk of heart attack, stroke, and cardiovascular disease, but that was recently retracted due to flawed methodology. The re-analyzed and republished data showed good, but less dramatic results, than when first published.

Among the hallmarks of a traditional Med diet, one that the typical Greek farmer ate, are the inclusion of olive oil as the preferred fat in cooking, lots of fish, fruits, vegetables, and minimal red meat. Oh, and the glass of red wine.
Red meat? That Mediterranean farmer didn’t eat much because not much was available. Cows were expensive and sheep worked better on the arid land, plus they gave wool and milk to make feta. All based on pragmatism, not fashion. Red meat (usually lamb) was a celebratory dish. My Greek grandfather loved roasting the lamb heads at Easter (knock it, but farmers waste nothing).

Better Med With Red

A new study asks the question: What would happen to cardiovascular risk factors if you ate a Med diet but compensated/replaced some (up to 18 oz/week) of the poultry with lean red meat, keeping consumption of fish, extra-virgin olive oil (EVOO), nuts, and the rest of the Med diet the same?

This study, in the American Journal of Clinical Nutrition, has some credibility.  It’s small, but well done, and it’s a “cross-over” design, so that every participant followed both the Med diet limited in red meat and the Med diet that included red meat (i.e. Med-Red) for 5 weeks each, with about a month in between each phase.
Following both Mediterranean-style diets produced lower total cholesterol levels, but here’s the difference:

• The Med-Red diet lowered total cholesterol significantly more than the Med diet limited in red meat.

• The Med-Red diet lowered LDL-cholesterol, but the Med diet limited in red meat did not.

Blood pressure improved in both groups, regardless of red meat intake. HDL-cholesterol, glucose levels, and insulin were similar and unchanged for both groups.

Revised Results = New Questions

• Is the advice to reduce red meat intake in a Med diet misguided?

• What about lean forms of deli meat (beef and pork)?

From this study, the answer would be “yes” to the first question, but the second cannot yet be answered because it hasn’t yet been tested. It’s possible that processed, lean deli meats (beef and pork) may be able to be included with similar results to the Med-Red diet. “To be continued…”

Interestingly, when I looked at the revised PREDIMED data, specifically the questionnaire that scored the adherence to the Med and control diets, at the 1-year, 3-year, and 5-year follow-up marks, there were no differences in consumption of red or processed meats between the Med diet groups and the control groups, even though the Med diet groups had a lower risk of stroke. Maybe it’s not the red meat that makes the difference here.

Limitations? ALL studies have them. This study was smaller and didn’t last as long as the PREDIMED study, which had a 5-year follow-up.

The study was funded partially by the Beef Checkoff and the Pork Checkoff, but before you make pre-judgements, it was also funded by the National Institute of Health’s Ingestive Behavior Research Center at Purdue University and NIH’s Institute of Health’s Indiana Clinical and Translational Sciences Institute, all reputable organizations. Regardless, the funding organizations had “no role in the design or conduct of the study; collection, analysis, or interpretation of the data; or writing of the manuscript.” The study was fully peer-reviewed.

Cut-To-The-Chase Recommendations

• Stop worrying about “red meat” and focus more on leanness and freshness (i.e. unprocessed).

• Beef in particular has a lot to offer nutritionally, especially nutrients like zinc and iron, but also conjugated linoleic acid, B-vitamins, and more.

• Keep meat lean, keep portions real (4 or 5 ounces are enough, downing a 12-oz. portion doesn’t prove masculinity and your body can’t use all that protein at one meal anyway. Good news is that this study showed you can enjoy up to 18 ounces of lean red meat per week as part of this eating pattern and still see a positive impact on heart health)

• Make sure you have it with plenty of veggies and some whole grains, dressed with a drizzle of EVOO.

If you want a great lean beef recipe I made, check out my recipe for an easy, lean, tasty pot roast here, or for many more check out Beef-It’s What’s for Dinner and this infographic on the Med Diet. The site is loaded with great, heart-healthy recipes.