COVID-19: 5 Steps To Make Some Lemonade Of It ALL!

Amid a pandemic like COVID-19, the hysteria seems to build and change by the hour.  Businesses are shut, so are many workplaces and offices.  Gyms, malls, anything even slightly optional, not happening.  We don’t know when things will return to normal but the world isn’t ending either.  In fact, there are some real positives for our lifestyle and our health that can come from all this disruption.

Positives?  From COVID-19?  Yes.  The disruptions are forced upon us, but everyone’s at the same place.  Let’s work it.  Here’s where I see the lemonade from “sheltering in place”:

Everyone. Slows. Down.

Less pressure to get all the errands done and on time.  Indeed, none of us can “do it all,” because so much of “it” has been cancelled!  There is also no rushed commute, no traffic snarls, no morning scramble to get kids to school, no mad dash after work to meet friends or get home to make dinner, and fewer errands to run.

Avoid Going Nuts & Enjoy The Extra Time 

It’s time to get to things you’ve been putting off – especially the “me” things that help clear our heads and bust our anxiety.  Some options to consider: 

  • Move it!   No marathons, just get out and walk.  It’s still OK, even if you’re under “shelter-in-place” orders.  You’re not under house arrest, so get on your sneakers and walk as briskly as you can, staying at least 6 feet from others.  About 100 steps a minute – done outside or inside – is considered a “brisk” pace and that’ll get you a mile for every 20 minutes of walking.  Or ride a bike, dance to a video, or do online yoga!  Exercise is well-known as a great mood lifter. It clears your head, gives you a mental boost, and makes life more manageable.  Make it part of your “me” time.  About that marathon though, check out this story of a guy in France who ran the distance of a marathon on his 23-foot balcony!
  • Give yourself a 30-minute “organizing” task. The task may take longer, but spend 30 minutes a day doing it.  That might be de-cluttering your home office desk (the bane of my existence), cleaning out a closet, gathering clothes and knick-knacks to donate, or going through the pantry to throw out expired condiments and food.  You can do it at a leisurely pace and end up with so much extra room!
  • Do fun stuff. Got a hobby you never seem to have time to do?  It’s time, and make it a priority.  Aim for an hour a day here, too.  I hope you make it a habit you’ll continue, even after this all passes.
  • Family meals are back!  Make these a priority, too, and make them last at least 30 minutes.  No technology at the table, just re-acquaint with conversation and socializing.  Some of the best memories of my childhood were sitting around the dinner table with parents and grandparents.  We’d talk about everything: the meal, friends, goals, you name it, and everyone was welcome to participate.  To me, it’s what a family meal should be, but make your own family meal style you’ll enjoy.
  • Rediscover the joy of cooking!  It’s WAY more enjoyable when you’re not pressured.  You can finally get to making those recipes you’ve collected but never got around to trying.  No cookbooks? No problem.  There are tons of great sites online.  Try www.beefitswhatsfordinner for starters.  It’s my go-to resource for all things beef, and their recipes are excellent and don’t require a degree from Le Cordon Bleu.    Check out Dr. Keith’s Pot Roast recipe.  I’d never cooked one before and adapted a NY Times recipe.  Turned out to be lean and the best pot roast I’d ever eaten!  The prep doesn’t take very long, you just have to be home for a few hours.  And since you’re home anyway, enjoy the aroma and eat the reward – and it stretches for more than one meal!

CHOCOHOLICS REJOICE! It’s Healthy(ish)! Here’s the Evidence!

I love chocolate, particularly dark chocolate.  I make no apologies, and the more I learn about chocolate and the cocoa bean, the more I realize no apologies are needed.  It’s no joke, cocoa has health benefits.  Indeed, if I ruled the world, dark chocolate would be a deductible medical expense. 

Perhaps the science isn’t quite sufficient to justify chocolate as a deductible medical expense, but it ain’t junk food either.  There’s enough info on Theobroma cacao to warrant treating it with respect.  

What Makes Chocolate “Healthy-ish”?

Chocolate is loaded with antioxidants.  It contains flavonoids, a group of phytochemicals with anti-inflammatory powers and benefits for the immune system.  There are several subgroups of flavonoids, such as anthocyanidins that give foods like Concord grapes and red cabbage their purple color, and flavones, found in celery and bell peppers.  It’s the  flavanols however, that give chocolate (and other foods like tea and blueberries) it’s healthful properties.

So, What’s Chocolate’s Impact On Health?

Improved blood flow: This review of the research studying the combination of eating cocoa flavanols and doing aerobic exercise improved cardiovascular risk factors and vascular function (read: improved blood flow).  Cocoa helps reduce blood pressure by relaxing the walls of the blood vessels, improving blood flow, not only to the heart, but also to the gray matter of the brain.  This doesn’t mean eating a candy bar will make you a genius, but there may be bennies from eating some dark chocolate regularly.

Cholesterol benefits: Cocoa consumption seems to raise the HDL cholesterol (the good form) and reduce the “LDL cholesterol” (the bad one you want less of).  It works best when your total cholesterol levels are high.

Reduces “oxidative stress”: In a just-published systematic review of 48 studies on cocoa, the researchers found that cocoa consumption “plays an important role in the human metabolic pathway through reducing oxidative stress.”  Oh, bring it on.  

What’s oxidative stress?  It’s caused by “free radicals”.  Free radicals in your body can “nick” or damage the cells in arterial walls, making it easy for plaques to adhere and build up, clogging arteries. Cocoa consumption seems to help prevent free radicals from forming.  Ever taste rancid oil or nuts?  You’re tasting “oxidized” food damaged by free radicals.

Adapted from Tuenter, et al.

In the Mood

In this review of studies that looked at chocolate, mood, and cognition, the authors developed a “mood pyramid”.  They placed more general mood benefits from the flavanols at the bottom, since these are benefits associated with flavanols in other foods as well.  Secondary mood benefits appear to come from the caffeine-theobromine combination in chocolate. 

More specific is a possible dopamine effect from a substance in chocolate called salsolinol.  This is emerging research, but the hypothesis is that salsolinol may play a role in the impact of chocolate on mood.  Just how much chocolate you’d need to eat is still unclear. 

The Fine Print

Yes, there is some.  Some of the research found benefits from low intakes of chocolate, as little as 7.5 grams.  Other studies used significantly more however, up to 100 grams a day and produced good results.  (How do I sign up?)

These cocoa flavanols are NOT present in all chocolate foods.  Read labels: if it says, “cocoa processed with alkali” you can pretty much forget getting any flavanols.  This form of cocoa is also known as “Dutch-processed”.  The process makes cocoa appear darker (see photo) and taste a tad less acidic but it blows the antioxidant content to smithereens.  Some chefs and bakers prefer this type of cocoa for recipes.  I do not.  Give me the lighter powder on the right.  I like my flavanols, thanks.

Chocolate isn’t calorie-free.  Solid bars have about 150-170 calories per ounce.  I keep it to a max of 2 ounces a day, but an ounce of good chocolate, at 170 calories, makes for a rich snack or even a lower-calorie dessert.  Fair enough.  Cocoa powder however, is low in calories and the most concentrated source of cocoa flavanols, so use it to make your own hot chocolate.  I sweeten with stevia or a no-cal sweetener to minimize added sugar calories, and often add some cinnamon or other spice (smoked paprika is a favorite of mine).   

Get a high — in percent cocoa.  The most benefits are seen with chocolate that has at least 70% cocoa solids.  Not a problem for me, but it takes getting used to.  Go gradually!

7 Nutrition Myths These Dietitians Are Busting

When people learn I’m a registered dietitian/nutritionist (RDN), they almost immediately start venting their frustrations about food issues. “Every day it’s another thing you can’t do or eat.  One day a food is good for you, the next day it’s bad for you.”  Since confused consumers make no changes, I always try to bust their myths and misinformation.

While consumers may be confused about food fads, RDNs are not.  They’re fed up with them.  They’re trained to spot hype, fads, and myths around a blind corner and it annoys them to no end. I asked some RDNs who have particularly good communications skills to tell me which popular nutrition fads really grind at them.  Here’s what they said:

Carbo-phobia!

Mindy Hermann, MBA, RDN, said straight up, “I wish people would stop thinking carbs are the devil.”  She’s had it with a near universal demonizing of these essential macros. 

Sure, most people eat too much added sugar, but she’s right that all carbs seem to be lumped together, whether it’s whole wheat bread or soda.  “Today it’s keto, yesterday it was Paleo, so many others before,” she said.  “I’m tired of all the iterations of high-protein, restricted carbs.”

Plant “Milk” Deserves No Halo

Nutritionally, plant-based diary alternatives just can’t hold a candle to the nutrition in real milk, according to Salge Blake, EdD, RDN, FADN, professor of nutrition at Boston University and the host of the hit health and wellness podcast, SpotOn! In addition to being a dynamite protein source, “Cow’s milk is chock full of vitamin D, calcium, and potassium, three nutrients that many Americans are falling short of in their diets.”  Dairy alternatives only have these nutrients if they’re added, and they often aren’t.  Unfortunately, says Salge Blake, “plant-based milks may also contain added sugars, adding calories and no additional nutrition to your glass.” 

Salge Blake also sees the affordability of real milk as a win-win.  “When it comes to your wallet, plant-based milks can be at least twice the price of cow’s milk.  For the nutrients and the money per gulp, you can’t beat low fat or skim dairy milk.”  If you’re allergic or vegan, soy is the closest alternative.  Be prepared to pay though.

Stop Kicking The Canned Foods!

Shari Steinbach, MS, RDN, spent years working directly with consumers as a retail dietitian in supermarkets, is fed up with canned foods getting dissed when they offer so many advantages:

  • Sustainability: “90% of cans are recycled and they can be recycled indefinitely.” Linings are safe, with 90% containing none of the controversial BPA.
  • Convenience: They have a long shelf life and that helps prevent wasted food and wasted food dollars.
  • Nutrition: “You can cut 40% of the sodium in canned beans and veggies just by rinsing and draining them,” Steinbach says. Since 9 in 10 people don’t eat enough vegetables, “Canned beans and tomatoes count,” towards scoring enough of this critical food group, and are a, “convenient, nutritious way to balance your diet.”

Want her recipe for quick, veggie-loaded, chili using canned ingredients?  “Here’s a favorite simple chili recipe that I made this week”:

  1. Brown 1 pound of lean ground beef;
  2. Drain and add 2 cans of chili-seasoned beans and 2 cans of undrained diced tomatoes.
  3. Season to taste with cumin or chili powder. “Serve with a green salad and whole grain crackers. Enjoy!”

Don’t Panic If It’s Not Organic

That’s advice from Leslie Bonci, MS, RDN Owner of Active Eating Advice, who is fed up with food elitism.  I see her point.  I spent decades working with low-income families who will never be able to afford organic food.  They shouldn’t worry.  They can still put delicious, nutritious food on the table. 

“What do we even mean when we say clean?” Bonci says, because “clean eating” has no definition.  That leaves every definition up to whomever is spewing it and that’s a perfect recipe for consumer confusion, fear, and doubt.  Instead, Bonci favors creating “an enabled table where foods of all price points have a place.”

White Foods Are Bright Foods!

Liz Ward, MS, RDN, Author of Better is the New Perfect is bugged by all the attention given to putting “only the most colorful fruits and vegetables on your plate.”  Forget colors, she says.  “Instead of worrying about what types of produce are “best,” simply include the types you like, no matter how pale,” Ward advises.  Besides, white, brown, and tan produce, such as mushrooms, cauliflower, potatoes, and bananas, are just as worthy as their brighter counterparts,” are loaded with nutrition.

“And while we’re at it, can we stop shaming starchy vegetables, such as corn, potatoes and peas? They are packed with nutrition and starch is a form of energy.”  It’s true, these foods are hugely important to so many food cultures and have sustained people for thousands of years.  Empty calories they most certainly are not. 

One Diet DOESN’T For Everyone?  Seriously?

“The nutrition belief that I hope goes to its final resting place in 2020 is that a single diet plan, or way of eating, is right for everyone,” declares food anthropologist and nutrition communications consultant Robyn Flipse, MS, MA, RDN.  Looking ahead, Flipse feels personalized nutrition, not fad dieting, holds the most promise in the years ahead.  

Leah McGrath, MS, RDN, corporate dietitian for Ingles Supermarkets, couldn’t agree more.  “It seems like every year we have a new ‘hot’ diet,” she says.  “However, just like our fingerprints,  we should want to and  deserve to individualize our eating plans.” 

Flipse continued, “The one thing we’ve learned from the decades of fad diet trends we’ve endured is that none of them have delivered on what they promised because they have all overlooked our metabolic differences.”  They also tend to be extreme, which is probably why people burn out on them. 

Flipse admits that we still lack the scientific tools to allow us to tailor nutrition to each person’s needs.  Unfortunately, when consumer demand gets ahead of the science, charlatans see an opportunity to market all kinds of pseudo-scientific gimmicks.

Plant-Based Doesn’t Mean Plants-ONLY

This one is mine.  I’ve written about it before and everyone in 2019 seemed to be jumping on this bandwagon.  Thing is, there’s no universal definition of “plant-based!” 

What it DOESN’T mean is vegan.  Eating a plant-based diet doesn’t automatically guarantee your diet is balanced or healthful, either.  Living on soda and chips is a fully “plant-based”, vegan diet.  And it ain’t balanced.  A huge salad with 10 different veggies, some nuts, and crumbled feta or parmesan cheese or a couple of ounces of beef or salmon is not vegan – but it IS plant-based.  Flipse put it best, “I tell people if 50% or more of what they eat is plants, then they have a ‘plant-based’ diet.”

Foodie Alert! Finding New Fruits & Veggies At NY Produce Show

If you want to know what brings out the “food nerd” in this registered dietitian/nutritionist, watch me at the New York Produce Show and Conference.  It’s the “trade show” for growers and distributors of all kinds of produce from all over the country and I jump for joy to attend. 

It’s all fruits and vegetables, but you get a preview of what will be happening for consumers in the months ahead, including many of the new varieties of fruits and vegetables that either haven’t hit the market yet or that are readying for national distribution.  It also give me a chance to speak with the growers themselves and learn what they’re hearing from consumers. 

A few highlights (not compensated — these thoughts are my own):

Convenience Rules 

Consumers like fruits and veggies but they don’t’ want to prep, slice, or peel it.  They want turn-key food, and produce folks realized they had to get on this bandwagon if they were going to get, and keep, people interested in buying and eating fresh produce. 

Everywhere in the exhibit halls were display cases featuring pre-cut “ingredients” like cleaned and ready-to-roast cauliflower and Brussels sprouts, chopped onions and peppers and of all manner of “stringy” veggies (think zoodles but with both winter and summer squash varieties).   

Then there were the new ready-to-eat “finger foods”, mostly cut fruits but there were some surprises.  “Watermelon stix”?  That’s right – watermelon cut in the shape and size of thick French fries!  No knives needed and ready for kids (and adults) to grab from the fridge.  I tasted them and was amazed at how crisp they were.  This owes to the value of plant breeding – new varieties are bred to lose less water when they’re cut and maintain the firmness of the flesh but still have the sweetness you’d expect from ripe watermelon..  They’ll come in both the traditional red and the newer golden varieties, both seedless.

New Varieties of Old (and not-so-old) Favorites

Koru Apples

Developed in New Zealand, grown domestically in upstate New York.  Jim Allen of New York Apple Sales explained that the Koru apple hits the trifecta – it’s good raw, cooked, or baked –yet holds its crispness without turning mushy or “floury”.

I’m a die-hard apple lover and I put this one to the test.  Jim gave me a Koru to take home and I kept it in my backpack for four days to see how it would hold up. When I bit into it I found it amazingly crisp.  A tart, yet sweet flavor with no astringency.  Thumbs up.  Bonus: the Koru has a smaller core, so you can eat more of it with less waste.

They’re available from October through March.  If you see them in your market, grab them. 

 

Honey persimmon

People have strong feelings about persimmons, especially the Hachiya persimmon, shaped like a huge acorn. It’s tricky to eat because it tastes best when it’s really soft, but some people are turned off by the almost gelatinous texture.  Eat it before then, when it’s firm, and it’ll pucker your mouth.  The Fuyu persimmon can be eaten hard, like an apple (it’s one of my favorite fruits and I’ve written about it here). 

At the show I tasted a “Honey persimmon”, a Hachiya variety from Brandt Farms in Reedley, California, that looks much like a traditional Hachiya but doesn’t require softening to eat it.  It’s absolutely delicious.  Dave Maddux of Brandt Farms described it as having a lot of mango notes with a hint of cinnamon and he was spot on.  Production was minor this year but Maddux said 2020 the honey persimmon will be busting out nationwide.  They’re a winter fruit, full of nutrients and antioxidants like potassium, vitamin C and carotene, have fiber and add some great variety to the usual winter fruits.  Don’t pass this one up.  Since they look like the regular Hachiyas, the Honeys will be bagged and labeled.

Brandt Farms also grows the Fuyu persimmon – also known as a “Sharon fruit” and – full disclosure – he gave me a bag of them.  We sliced them crosswise, thinly, spread them with goat cheese, topped with another slice, then rolled the sides in chopped almonds.  Guests at our holiday party went crazy for them.  Thanks, Dave! 

Eating the Dragon

Dragon fruit has been around for years in markets but a big push is on by growers to make them more mainstream.  Dragon fruit is related to the cactus family and the outside betrays a sweet, white flesh inside, studded with tiny seeds.  The taste and texture might remind you of a kiwi-pear hybrid.  Most common are the red ones, but now they share space with a yellow variety.  Nutritionally, it’s got game: a reasonable source of calcium, good fiber, and antioxidants (the red fruit has the same pigment that gives beets their color).  The only drawback: they’re a bit pricey.  But hey, they’re definitely worth trying.  I did, and I liked them.   

 

Holidays, Eating, & Why Everyone Needs This “Drug”!

NO ONE wants to hear about health stuff this month.  Save that for January!  We want our “once-a-year-foods”, so stay out of the way or we’ll squash you like a grape!  And why not?  Food that’s around once a year should be eaten and enjoyed.  I’ll even join you.

But holidays can be challenging.  There are always more things to do than time in which to do them: buying gifts, heading to social occasions, hosting them, cooking foods you have only once a year (how did I cook that last year?), and on.  All on top of the usual stuff called “life.” 

Your “Dream Drug”

If you could invent a drug for this time of year, you’d probably want it to:

  • Burn excess calories
  • Act like a statin to lower your cholesterol
  • Improve your heart’s health
  • Lower your fasting blood glucose
  • Help you cut stress
  • Give you a “mood lift”
  • Improve your sleep
  • Add some lean muscle
  • Help you think more clearly

If you could patent this drug and market it, you’d be richer than Jeff Bezos, who would be begging you to sell it on Amazon.

This “drug” isn’t in a bottle.  It’s in your shoes: physical activity.  It does ALL the things listed above and you can get all those benefits.

Registered dietitian nutritionist, Leslie Bonci, should know, as the owner/founder of www.activeeatingadvice.com, she says, “Exercise is the gift that gives your body the lift it needs during the holidays.”  This isn’t just an opinion, either.  Read on.

Hot Off the Research Press: Thinking Won’t Help You Exercise, But Exercise Helps You Think

This study, just out, looked at the cognitive outcomes of four older adult groups: those who did moderate physical activity three days a week (walking or biking), ate a DASH diet (Dietary Approaches to Stop Hypertension), those who did both and a control group that received only dietary education.

Best neurocognitive improvement at 1 year?  The group that did BOTH aerobic activity and the DASH eating style.  Second best was the aerobics-only group.  No surprise to Bonci.  “Getting moving helps to circulate blood to the brain,” she says.  

Why I Love This Study

  • The participants were at least 55 years old. If these folks can do it, it can be done by most people. 
  • The activity wasn’t extreme. No marathons, no sweating until exhaustion, just walking or stationary biking for 35 minutes, thrice weekly. Just move, then move on. 
  • DASH eating style? Also easy-peasy: It’s 2½ cups of fruits and veggies and two servings of dairy foods – what we should be doing anyway!   

Starting Moving

Baby steps here.  Registered dietitian Liz Ward’s philosophy says it all. “My mantra is that any movement is better than none to relieve tension and help you sleep better.”  Even her website is called “BetterIsTheNewPerfect

No time to do that walk?  Try doing it for half your lunch hour, so it doesn’t use any valuable “off” time.  FYI: a “brisk walk” is about 100 steps a minute.

This time of year, Ward admits her workouts may be shorter or even less frequent, but she knows the benefits go way beyond calorie-burning.  “I try to exercise as much as my schedule allows because physical activity is a huge stress-buster for me.”

Start “DASH-ing” 

Getting those 2½ cups (total) of fruits and veggies and two servings of dairy is easier than you think.  No specific fruits or vegetables here, and it’s cooked or raw, so choices are up to you.  For dairy, even some cheese is fine (an ounce per serving), but mix it up.  Examples:

  • Dairy: a cup of REAL milk on your cereal
  • Greek yogurt at breakfast, lunch, or for a snack or even dessert (with some of that fruit!).
  • Fill a pint plastic container (the kind that holds the won-ton soup form Chinese take-out) with any combo of fruits and veggies – that’s 4 servings right there – so you’re almost done for the day.

Cut to the Chase Bonus: Start now and you’re (literally) miles ahead of everyone else come New Years! 

15 Tips: Prevent G.E.R.D. From Being “Thanksgiving’s Revenge”

“National G.E.R.D. Awareness Week” is November 18-24 this year — a week BEFORE Thanksgiving, but maybe that’s good.  Being aware of this annoying condition can help you avoid it.

What’s “GERD”? It stands for “gastro-esophageal reflux disease”.  Back in the day, it was commonly known as “heartburn.”   It happens when the acid from your stomach backs up into your esophagus and it burns the hell out of it.  Your stomach is well-equipped to handle the stomach acids it produces to aid digestion, but the esophagus is much more sensitive.  When stomach acid gurgles up into the esophagus, it’s painful. 

A big Thanksgiving meal can trigger GERD even if you rarely experience heartburn.  Why?  Your stomach is only so big.  When you eat more than the stomach can handle, the sphincter muscle between the stomach and the esophagus may not close completely (see the graphic).  When stomach acid is released to start digestion in the stomach, some of that acid bubbles up and you feel a burning sensation. 

How to prevent GERD and Enjoy Your Thanksgiving Meal

The International Foundation for Gastrointestinal Disorders (IFFGD) put out this great graphic with 15 tips for avoiding GERD.  I’ll explain each one:

  1. Eat the meal earlier. It gives you more time to digest your food.  Having a big dinner in the the evening is a sure-fire way to get heartburn. 
  2. Serve (and eat) light appetizers. The Thanksgiving meal is an important tradition.  Save valuable tummy space and spend calories on the meal, instead of on typical nibbles.  A couple of bites of something and leave it at that.
  3. Stay active! Keeping moving helps your stomach empty itself a little sooner.  No marathons or vigorous exercise here, but any movement more than sitting down is a good idea.
  4. Don’t smoke. Add “heartburn irritant” to the list of reasons to avoid smoking.  Enough said.
  5. Nix the juice. The acid in fruit juice is much tamer than stomach acid, but can still bother the esophagus. Fruit nectar fares better, but if you must have juice, dilute it at least 1:1 with water.
  6. Limit the drinks. Alcohol is a known trigger for reflux.  It relaxes the esophageal sphincter, allowing stomach contents to back its way into the esophagus, but it can aggravate tender tissue on the way down, too.  Another trigger drink: regular coffee.  Keep it to decaf.
  7. Season lightly. This is individual, but some known irritants are things like chili peppers, tabasco, and hot sauces like salsa. They may not like you as much as you like them.
  8. Pass on deep-frying your turkey. I’d add, “and anything else.”  Fried foods trigger GERD symptoms in many folks, so be warned.  If you must eat them, think “taste” or a bite instead of a portion.
  9. Use smaller plates. It’s amazing how well this works.  If you’re int the habit of having seconds, try using a salad plate.  Then a second helping doesn’t have to mean overeating.
  10. Trade the soda for water. Bubbly stuff creates gas.  Gas puts upward pressure on that sphincter again and risks blowing acidic stomach contents into the esophagus. 
  11. Watch the desserts. Two reasons: 1) They’re heavy, just at the time your stomach is probably already full.  2) They’re usually really fatty (pie crust especially, but cake as well).  Best bet? Eat the filling in a small portion of pumpkin pie.  Hold the whipped cream and the a-la-mode.
  12. Skip the after-dinner mint. Peppermint oil – the flavoring – isn’t a “spice” but it’s just as irritating to the stomach and the esophagus.  It’s NOT a “digestive”. 
  13. SLOW DOWN! Make that salad plate-sized portion last at least 20 minutes – the amount of time it takes for your brain to register fullness, so don’t get there before the brain does!  Then ask yourself if you even want any more.  And remember, this is a time to get social.  Try and say something to everyone at the table.
  14. Stay awake. And upright.  People can feel comatose after a big meal (another reason to eat less).  Laying down after eating just makes it easier for stomach contents to back its way up into your esophagus and give you GERD symptoms.  Empty stomachs are better sleep companions.
  15. Talk to your doctor. Get relief!  There are medications available if you suffer from GERD symptoms frequently. 

Above all, may you enjoy the day, remember to be thankful.  My very best to you and your family.

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

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

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

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

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

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

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

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

Meat Wars & Culture Wars

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

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

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

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

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

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

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

But Are YOU overeating Beef?

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

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

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

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

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

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

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

Keto Isn’t Just “Low-carb”

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

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

Does It “Cure” Diabetes?

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

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

The Catch – And there Is One

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

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

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

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

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

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

• Online peer social support with fellow participants.

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

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

Are Carbs the real “Devil’s Food?”

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

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

Cut-To-The-Chase-Nutrition Advice

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

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

Why Population Studies Are “Associated” With Limitations

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

Here’s what it concluded:

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

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

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

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

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

Some Fine Print

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

Some other potentially confounding variables:

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

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

When Statistics Aren’t Reality

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

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

Population Studies CAN’T Show Cause-and-Effect

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Drum Roll…The Results Showed…

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

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

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

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

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

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

Why I like this study

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

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

Study Weaknesses: 

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

Cut-To-The-Chase Recommendations

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