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.

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

ARE YOU & YOUR KIDS “BACKLOADING” PROTEIN?

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You’ve heard about protein, you know it’s important for building muscle, and you know meat, poultry and fish have a lot of it.

No worries about getting enough protein, either, at least here in the US. But according to research by the US government, we tend to “backload” our protein – meaning we get most of it at dinner. Their stats show that dinner gives us nearly 60% of our daily protein. Breakfast is arguably the most important meal of the day, yet it brings us only about 13% of our protein.

We may be getting enough protein, but do we get it EARLY ENOUGH in the day?

“FRONTLOADING” protein

WHEN you eat protein is important. Kids (and adults) eat most of their protein and calories from after school on, but they NEED most of it earlier, when the demands of their day are greatest, starting at breakfast. Sadly, up to 40% of kids don’t even eat breakfast daily.

Load ‘em up with breakfast protein and they’ll work and feel better all day.­ It’s true. They’ll also be more focused at school and research has shown they also tend to eat less during the rest of the day. Anecdotally, in my practice, I’ve noticed that breakfast-skippers who start eating a good, high-protein breakfast also seem to be less tired after school, allowing them to be more active. It does makes sense, because without breakfast, they run out of energy. Kids shouldn’t want a nap after school, they should want to play, and protein-packed breakfast helps them do just that.

But what KIND of protein?

Meat has good protein but dairy and eggs actually have the highest quality protein, for most efficient use by your body. Most kids would especially benefit from more dairy. Why? The vast majority of kids (and adults!) also don’t get enough calcium, potassium, or vitamin D, and a simple glass of milk is like a cargo truck of these nutrients, and 6 other essential ones as well, so it covers a lot of ground, nutritionally. And, kids LIKE it.

yogurt-smoothieYou might think cereal and milk takes care of the protein at breakfast. For young kids, maybe. But for older kids, especially teens, that’s only about 10 grams of protein. Aim for 20-30 grams and they’ll stay full until lunch. Here are some options and their protein amounts, to help get them to that 20 grams. Combine them as you like:

  • Glass of milk (any percentage of fat, white or flavored): 8 grams (some brands have 9 or 10 grams)
  • Greek yogurt, flavored (a 5.3-oz cup): 12 grams
  • String cheese (2 oz. portion): 12 grams
  • 1 egg, any style: 6 grams
  • 1 oz. cheese (cheddar, Swiss, etc.): 6 grams
  • Cottage cheese, ½ cup: 14 grams
  • Ricotta, low-fat, ¼ cup: 7 grams
  • Peanut butter, 2 Tablespoons: 7 grams (but also about 190 calories, so use wisely if kids are overweight)

Cottage and ricotta cheese for kids? Yes, and they’re perfect in smoothies, as is Greek yogurt.

Keep it COW

To be clear: I’m talking about real milk. The “milk alternatives” like almond, coconut, rice, and other “milk” have almost no protein or naturally occurring calcium. Milk is naturally loaded with good stuff.

Nice add-on: the milk you buy is probably locally produced. Most places in the US are within a few hours’ drive of a dairy farm, even if you live in a big city. Pour a glass and feel good about supporting your local diary people.

Just as nice: milk is one of the best protein buys today. Even at $4.00/gallon, it’s only 25 cents a glass.

Supported by the Milk Processor Education Program

A “Silver Lining” for Those Who Re-gain Lost Weight

regainShows like “The Biggest Loser” where all the contestants lose weight and the big challenge is to lose the most weight, get people all ginned up to see who will win the top spot.  These shows can even get people motivated to make some real dietary and lifestyle changes when they see how contestant’s bodies and mindsets change over the weeks of the TV season.

A recent New York Times article suggests that once the show is over and the smoke clears, some contestants find it a real challenge to keep that weight off.  You might be tempted to think that being overweight is truly a “never ending battle of the bulge”.  A  Not so!  There are plenty of successes!  And people get there a lot more easily, if perhaps more slowly, than the TV contestants.  

Here’s the silver lining: align your eating habits and lifestyle with those who have lost it and kept it off for years.  I talk about a registry of thousands of successes and how you can make gradual, positive changes to your diet, lifestyle, and attitude about food and bring the battle of the bulge to a timely and successful end.  Read more in my blog in  the Huffington Post here.