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.]

ARE SMARTPHONES HELPING OR HURTING TEENS’ LIFESTYLES

A recent article in The Atlantic, written by Jean M. Twenge, a professor of psychology at San Diego State University, painted a bleak statistical picture of the “iPhone” generation – basically pre-teens and teens, as does her recent book on the subject.  Here’s a snapshot of what’s happening with kids today since the debut of the iPhone, much of which is drawn from data collected by Monitoring the Future:

  • Less going out without their parents.
  • Less likely to get at least 7 hours of sleep: By 2015, 41% of teens failed to get at least 7 hours of sleep nightly, up from 34% in 2007.
  • Nearly 1 in 4 teens admits to being online “almost constantly”.
  • More likely to feel lonely: In 2015 nearly 1 in 3 teens said they felt lonely, up from 1 in 5 in 2007.

Almost 9 in 10 teens have smartphones now, and they use them.  According to a study by the Pew research center, the typical teen in 2015 sent and received about 30 texts per day, versus none in 2007.  More than 7 in 10 teens use multiple social network platforms.

What’s the addiction to smartphones?

All humans learned to survive by monitoring any changes in their environment.  Social networks change every second of every day.  It’s easy to see how teens (and adults, let’s face it) can’t help feeling that they’re missing out if not constantly monitoring various social platforms.

Teens may be “super-connected” but are they “communicating”?  Their increasing feelings of loneliness suggest that they’re not.

Disturbing thought: kids can now be “socially” active without leaving their homes, without leaving their rooms, and even without leaving their beds.  Nothing physical required for this “social activity” except thumbs in motion. Even if they do physical activity in school, the more they’re using their smartphones, the more they’re essentially at bedrest.

What does this have to do with health?

A lot.  Staying at home more, going out less, feeling lonely, and getting less sleep, are all negative trends for developing teens. Add that to the lack of physical activity that’s enabled by this online, sedentary life, and it doesn’t bode well for their health.

According to the Centers for Disease Control, all kids ages 6-17 years should get at least 60 minutes of physical activity daily. Nationally, only 1 in 4 said they met this goal in 2015, according to CDC statistics.  Nearly 3 in 10 did as recently as 2011.  That also means 75% of teens are not active enough.

Former Surgeon General David Satcher, in his 2001 landmark “Call to Action to Prevent and Decrease Overweight And Obesity”, emphasized more physical activity, but also “fewer sedentary activities.”  That means an hour of exercise followed by 23 hours of laying around, doesn’t cut it.

Back to school is a perfect time to build a better routine, one that gives teens a lifestyle that’s not only healthier, but happier.  If feelings of loneliness are increasing, they often go hand-in-hand with low self-esteem, already too common in teens.  Behavior changes that help shift self-esteem positively deserve some attention.

Calories and Social Media Time: 2 Things to Spend Wisely

Here are three big triggers for mindless eating: feeling lonely, being tired, and staring at any screen.  If your teen thinks a smartphone is an umbilical cord to the world, cutting it off seems tyrannical and isn’t necessary.  Still, these tips can help them towards healthier behaviors, positive attitudes, and lead them to healthier eating:

  • Media diet: NEVER at the table and insist the meal last 30 minutes. Family dinners aren’t just about food, they’re about communicating and connecting.  If this requires some getting used to, it’s a red flag that it’s overdue.
  • Kitchen help. Assign them some part of the meal prep – it builds responsibility but it also keeps them off the smartphone a little longer.  If it’s preparing part of the meal, give them some freedom to make decisions about what vegetable to cook or what ingredients to include in the salad.
  • TELL THEM YOU APPRECIATE WHAT THEY DID and mean it. There’s never been a better motivator than that.
  • Keep ALL “screen time” to a max of 2 hours daily, but also support non-screen activities that interest them.
  • Shut down all media (and snacking) at least an hour before bedtime. Two hours is even better.

Silver lining: by 2015 teens were also far less likely to have a driver’s license and have sex than were teens in 2007 – but there have to be better ways to prevent driving accidents and teen sex than keeping them home, hypnotized by a screen!

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.

CHOCOLATE ON VALENTINE’S DAY? NO, EVERY DAY!

A National Confectioners Association survey recently revealed that 94% of Americans reported wanting chocolate on Valentine’s Day.  I didn’t participate in the study but you can count me among them.  I want it every day.  I’m health conscious.  Read on.

For hundreds of years however, Europeans felt chocolate was heart healthy and even aided the liver and one’s digestion, among other benefits.

Chocolate in this country has traditionally been an indulgence, where the expectation is merely good taste and satisfaction – with some calories and fat.

That’s changing.  A lot of research during the past 20 years or so is telling us that chocolate can be heart-healthy, and via a variety of mechanisms.

Science for chocolate nerds

Two components in chocolate seem to be giving the benefits: antioxidants and the fat.

Eating foods rich in antioxidants, such as fruits, vegetables, beans, and whole grains, has long been associated with numerous measures of health benefits and reduced health risks, including lower risk for cardiovascular disease, diabetes, and hypertension.

Chocolate is rich in a subclass of antioxidants called “flavonoids”.  Catechins, epicatechins, and procyanidins are the main flavonoids in chocolate and they’re present in higher concentrations than in most other plant foods, even tea and red wine on a per-serving basis.  Dark chocolate is the third largest contributor of antioxidants to the American diet, after fruits and vegetables.

The fat in cocoa is mostly saturated – usually something we advise reducing in the diet. But not all saturated fats are created equally, and the primary one in chocolate is stearic acid, which seems to have more neutral, not harmful, effects.

Here are some of the benefits studies have consistently shown for chocolate:

  • Lower blood pressure: The reduction isn’t huge, but it seems to lower both the top number (systolic) by about 5 points and the bottom number (diastolic) by about 3 points. Not huge, but better than for most “treat” foods!
  • Improved markers of cardiovascular health: It seems to reduce LDL-cholesterol (the bad one) and raise HDL-cholesterol (good one) – at least when it replaces butter. It doesn’t top olive oil in this respect, but swapping a pastry for some chocolate makes sense.
  • Reduced “platelet aggregation”: This is beneficial because it helps prevent plaque build-up in your arteries.

How to do chocolate right

Yes, chocolate can fit into a healthy diet.  It might even be a good thing, in the right amount.  Here are a few tips if you want to have chocolate regularly:

  • Go dark. Really dark.  The benefits come when the cocoa content is 70% of higher.
  • Take 1.  Figure 1 ounce a day (about 30 grams). It’s only about 160 calories, so it’s lower in calories than most desserts!
  • Swap right. Use your daily chocolate to replace lower-quality foods. This usually means junk snacks.  You’ll find that an ounce of dark chocolate is satisfying.
  • No chewing allowed! Bite a small piece, notice the crackle of the bar, and let it melt in your mouth. Why rush?
  • Take a powder.  Leverage the flavor of cocoa powder! Hot chocolate, smoothies, on Greek yogurt!  Even shake it onto sliced apples or added it to coffee.  It’s almost calorie-free.  Trader Joe’s and Ghirardelli both have great cocoa powder.
  • Don’t “go Dutch”.  Cocoa labeled as “processed with alkali”, or “Dutched cocoa”, has lost most of the antioxidants. I avoid this kind of chocolate. It’s not harmful, just has no antioxidants.

Chocolate caveat

If you have reflux or heartburn, chocolate can irritate the stomach and stimulate acid production.  Chocolate doesn’t have much caffeine, but dark chocolate has more than milk chocolate, and it does have theobromine, which can also get you buzzy if you have it before bedtime.  Also, the antioxidant activity can vary, based on origin and handling methods.

Finally, file this under “nice-to-know”: Mondelez, the huge mega candy company, has a goal of 200,000 cocoa farmers participating in its “Cocoa Life” sustainable cocoa farming program, by year 2020.  They recently announced that they are nearly halfway there, with participation nearly doubling in the year 2015 alone.  Props to Mondelez.

Chocolate on Valentine’s Day.  Call it a gift from the heart, and for the heart!

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.

YES! KIDS WHO EAT BREAKFAST DO BETTER IN SCHOOL

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You’ve heard it forever: “breakfast is the most important meal of the day.”  Sounds exactly like something you’d hear from picture-perfect TV moms like June Cleaver on “Leave It To Beaver, or Mrs. Cunningham on “Happy Days.”

Well, it’s really true, according to the latest research – and a lot of studies that preceded it.  This study involved 698 students, average age was about 7½ years, so primary grade school kids.  Just before they were given a standard achievement test, they completed a recall of what they’d eaten for breakfast.

The kids who ate breakfast before taking the test scored significantly higher than those who had not eaten breakfast.  One review looked at breakfast eaters among urban minority youth and the conclusions were horrifying:

  • The prevalence of skipping breakfast was “highly and disproportionately prevalent among urban minority children.”
  • Breakfast skipping negatively impacted academic achievement.
  • Was associated with increased absenteeism.
  • Despite the availability of school breakfast programs, not enough vulnerable children take advantage of them.

But What KIND of Breakfast Works?

berries-1851148_1280glass-of-milk-being-pouredwhole-grain-cereal-bowl-with-spoonBreakfast is a true opportunity for filling the gaps in kids’ diets that probably won’t be filled if they skip breakfast.  Here are the food groups of particular concern that most kids’ (and adults’) diets are lacking:

  • Low-fat/fat free dairy,
  • Fruits & vegetables,
  • Whole grains.

Breakfast is an ideal meal for getting all three of the food groups of concern. A simple serving of whole grain cereal, milk, and fruit covers so much nutritional ground.  These are foods they need multiple times during the day, and when kids miss breakfast, they don’t eat more of them later to compensate, they just miss out.  When they make a habit of skipping breakfast, it’s a lifestyle with a nutritional concern.

The US Dietary Guidelines for Americans points out 4 “nutrients of concern” so named because over half the population is falling short:

  • Calcium
  • Vitamin D
  • Potassium
  • Fiber

Indeed, at least 60% of kids (up to 90% of teen girls) don’t get enough calcium, yet a simple glass of milk – real milk, not a “milk alternative” – is a top source of three of those 4 nutrients of concern: calcium, potassium, and vitamin D.  The fresh fruit and whole grain cereal both have fiber, so you can see how that simple bowl of cereal, fruit and milk adds up to so much.  And kids like it!  Of course, for older kids, you can do some add-ons, too.  milk-ricotta-cheese-on-breadAdding some yogurt (Greek yogurt, too) or an egg, or some string cheese, just ups the protein and nutrition further, keeping them full and better able to focus until lunchtime.

Doing School Breakfast Smarter

The above review also called for a universal breakfast program that allows kids to actually have their breakfast in their own classrooms.  This is becoming more popular but it’s still in its early stages and needs to be greatly expanded because it has to be one of the best ideas yet about how to give kids breakfast at school and ensure they have it every day.  Here’s how it works:

  • Kids pick up their breakfast in a package as they enter their classroom.
  • They eat at their seat during the first 10 minutes or so of the school day, while announcements are made.
  • Remaining trash is collected, the kids continue with class, ready to learn.

I like this idea for a few reasons:

  • It always includes milk & fruit – two groups kids need more of.
  • Kids get a structured meal that’s balanced and meets federal nutrition standards.
  • They eat with their friends in a familiar place.
  • They get nourished when they need to concentrate.
  • Convenience! No having to go to the cafeteria, just go to class and it’s there.

The best part of breakfast in the classroom is that eating breakfast becomes part of their regular routine.  Breakfast is a meal of habit, and a good habit is one they can keep forever.

This column was supported by the Milk Processor Education Program