Eat The “Dirty Dozen” Fruits & Veggies & Be Healthier For It

It’s that time of year again – spring – when the Environmental Working Group (EWG) publishes it’s “Dirty Dozen” list of fruits and vegetables with the most pesticide residue. It’s also when I’m reminded that fear sells and facts are more boring (but more essential!).

Many fruits and veggies on this list are popular favorites:

1. Strawberries                                 7. Cherries
2. Spinach                                          8. Pears
3. Nectarines                                     9. Tomatoes
4. Apples                                           10. Celery
5. Grapes                                           11. Potatoes
6. Peaches                                         12. Sweet Bell Peppers

This list always gets a ton of media attention (probably why the EWG keeps issuing it) but it fails miserably at giving context, and that’s unconscionable for an issue that’s so important.

As a practicing clinician of some 33 years, what concerns me most about this list is that it can put already confused consumers off of eating produce. It’s exactly what shouldn’t happen, but research suggests it’s exactly what DOES happen. This study – not industry-funded, please note – found that:

“Messages naming specific FV with pesticides shifted participants toward

‘less likely’ to purchase any type of FV regardless whether organically or conventionally grown.”

Exactly what no responsible health professional wants.  The amount of solid, scientific evidence indicating the health benefits of eating more fruits and vegetables is overwhelming and indisputable.  That research – all of it – was carried out with conventionally grown produce.

Pesticide Residues: Perspective & Context

The issue of pesticide residues has been scrutinized by the feds for ages. The EPA is extremely conservative in setting allowed levels of pesticides. Indeed, many countries follow our lead on this.
Strawberries were ranked #1 on the Dirty Dozen list. Yet, EPA has found that a typical 3½-oz portion of strawberries had maximum residues that were about 1/100th of allowed levels.

Cutting to the chase: You’d have to eat about 22 pounds of strawberries daily – for life – to reach the EPA threshold levels.

Another perspective: Take two Olympic-sized swimming pools, both bone-dry. You throw a drop of water into pool A and 100 drops of water into pool B. You can accurately say:

• Pool B actually has 100 times more water than pool A.

Now, in context:

• You won’t drown in either pool.
• You won’t even get wet in either pool.

Organic ≠ Pesticide-Free

Reality bites: pesticides are allowed on organic crops.  If you like eating organic and can afford it, go for it, but know it’s still not pesticide-free — and that’s OK.  Some other facts about organic that most people don’t know:

• There are several HUNDRED “natural” pesticides that USDA approves for organic farming.

• Even some synthetic pesticides are allowed on organic crops. Check the feds’ complete list here.

• Pesticide residues on organic crops aren’t monitored as thoroughly as they are on conventionally grown crops. The National Organic Standards Board has 15 people. Only one is a scientist.

ALL produce deserves cheers, not fears. So read the Dirty Dozen list if you like. When you know the facts, you won’t worry. You’ll do what I do: yawn — and grab an apple.

MORE: Want to know if corn is a vegetable? Do Beans count as veggies, too?  Want about canned/dried/frozen fruit?  I have you covered.  Get the answers here.

DRINK BEER, LIVE LONGER, MORE OR LESS

But maybe a little less than you thought.  Lots of people see holidays like St. Patrick’s Day as the a day when getting drunk doesn’t seem so awful, because:

a) it’s tradition to do it,
b) people almost EXPECT to do it, and
c) you feel almost left out if you DON’T do it.

I had a patient once who recalled his family’s St. Patrick’s Day tradition, “it’s a rule: you go to the parade, then you come home and abuse yourself.” A case of beer PER PERSON (that’s four 6-packs or 24 cans) during the course of the day was not unusual, “and that wasn’t the only stuff we drank, either.”

Moderate drinking seems to be fine (see below) but there’s no way this kind of drinking is moderate and certainly not healthy, even if it’s “typical” for some St. Patrick’s Day.

What’s “moderate drinking”? There really are definite numbers here. The feds describe “moderate drinking” as: 2 drinks for a man, one for a woman. What’s “one drink”?

• 12-ounce can or bottle of beer
• 5-ounce glass of wine
• 1.5 ounces of distilled spirits

So that case of beer should have last about 12 days for a man, and 3-1/2 weeks for a woman. That’s the bad news for beer drinkers. For wine drinkers, you may want to check your pour. Five ounces is likely less than you think – it means 5 drinks per average bottle or white or red.

Booze: The good news

Moderate drinking, as defined above, seems to be associated with a longer life. The 90+ study was initiated in 2003 to study the common factors about people who live to be 90 years and older. There’s reason for this study – the nonagenarians are a fast-growing group. Baby boomers will likely contribute to their expansion in the years to come.

The 90+ year-old folks who have one or two drinks per day tended to live longer than those who abstained. Ditto for moderate coffee drinking, which has been defined as two to three cups daily. As for why moderate drinkers live longer, that’s till up for grabs.

This is an “association” study – it cannot show that moderated drinking of booze or coffee CAUSE you to live longer. Studies like these can only generate a hypothesis. Still, at least drinking moderately isn’t associated with negatives like earlier death.

It could be that people who drink moderately also aren’t taking take medication that is incompatible with alcohol. Therefore, the alcohol consumption acts as a screener or “marker” of people who are healthier to start. Same with coffee drinking. If you have high blood pressure, you may be told to stay away from caffeine, associating abstainers with poorer health.

“Beer-Bank”? It’s No-Deposit, No Return 

With booze, unfortunately there is no “banking” your beers ahead of time so you can enjoy a big blast on St. Patrick’s Day – or on any random Friday night. It’s two drinks per day, use them or lose them. If you know you’re going to drink more than that, keep it to no more than one drink per hour. The liver just can’t metabolize alcohol more quickly than that. Even at that rate, you may still not pass a breathalyzer, so don’t drink and drive. Period.  And please, holiday or not, legal drinking only, not for kids.

By the way, plenty of other factors were also associated with longer life, including daily exercise and working on hobbies of interest. Sounds like those who are enjoying themselves more also tend to live longer.

Silver lining for moderate drinkers/teetotalers

Keep your drinking sensible and instead of kissing the Blarney Stone, you’ll kiss hangovers good-bye and feel great the next day.  Cheers!

BEST DIETS: THESE 2 TIED FOR GOLD

It’s January, and that means US News has issued its “Best Diets” rankings. Out of the 40 diets ranked, both the DASH diet and the Mediterranean Diet tied for first place – again.

Why? They have the most research behind them and they’re both great for your health. The DASH diet (Dietary Approaches to Stop Hypertension) was created to reduce high blood pressure and the Med diet is intended for heart health – two very common health conditions.

Both diets emphasize plenty of fruits and vegetables. The main difference is that DASH also emphasizes at least 2 to 3 servings of low-fat dairy foods daily. The Med diet is strong on heart-healthy fats like olive oil, nuts, and fish, like salmon, because of its high omega-3 fat content. The Med diet can be a bit low on calcium, due to the modest intake of dairy foods.

“Flexibility” Gets a Bronze!

The Flexitarian Diet approaches vegetarianism but not obsessively so. I like this approach. It takes the best from the vegetarian diets but the only thing it banishes is the absoluteness. You don’t have to choose a camp here. For many people, veg is fine – but not all the time. This diet , and so supports this thinking, and so do I. Plus, it’s actually very healthful.
What I love about the DASH, Mediterranean, and Flexitarian diets is that they’re basically eating styles. You can lose weight on them, but they can be a way of eating for the whole family, even the kids. This is ideal for families where one person is trying to lose weight, but doesn’t want to make, or eat, different food from the rest of the family. These diets are all about healthy (and tasty) eating. They also take no special work, don’t require exotic food, and have enough options for everyone.

>>>Cut-to-the-Chase Eating Style: A “MediterDASHean Diet”<<<
Here’s my short-order combo of the DASH and Med diets:
• All fruits and veggies – and 5 portions of them (at least!) daily.
• Low-fat dairy foods of the DASH diet Aim for 3 servings but at least 2 (that’s still an improvement for most).
• Extra-virgin olive oil, fatty fish, nuts, and sure, a glass of wine (if you drink).
Basically a Med diet with more low-fat dairy foods. More inclusive, flexible, less limiting – IOMO.
Up next: The Worst Diets (NOTE: this could get ugly)

COULD “REVERSE RECESS” IMPROVE BOTH TEST SCORES & DIETS?

I’ve said forever that kids who eat breakfast do better in school. A growing pile of research also suggests that “reverse recess”, that is, having some physical activity before – not after – lunch, may also contribute to better test scores.  This reverse recess also seems to help0 kids want to eat more of what they need.

The latest study  included 1350 students in Texas elementary schools and looked at the differences in intake and test scores when schools scheduled recess before or after lunch.

Simple changes, big results

I love research like this. It’s simple and shows real results.

When students (third, fourth, and fifth grade students) had recess before lunch, they scored higher on the “3Rs” – reading, writing, and arithmetic. Not all grades scored higher on all measures, but the results were enough to impress school principals enough to consider changing the school’s recess schedule for next year.

There were nutritional implications here, too. In the schools with recess before lunch, students ate more of all lunch components: the entrée, fruit, milk, and even the veggies. Two things may be happening here to produce the results:

• The kids were hungrier after being active, so they had a better appetite for their lunch
• Having just actively “let off steam”, they were a bit more calm and more ready to eat, and with play time done for a while, they could devote more time to eating and socializing.

Another thing I love about his study is that it looked at “plate waste”. This is messy research, because it requires the investigators to look at how much food was actually eaten. It’s a dirty job, but I’m glad they did it, because the results are more informative than some other studies that look only at how much food is chosen, not necessarily eaten. That’s significant, because it’s not nutritious until they eat it.

More than nutrition: BEHAVIOR benefits, too?

A 2014 study done in an Oregon community however, found that the students having recess before lunch drank significantly more milk and were 20% more likely to drink the entire 8-oz. carton of milk than were the students having recess after lunch.

Even better: the teachers reported that having recess before lunch resulted in better classroom behavior and greater readiness to concentrate on academics after the lunch period.

What I love about these studies is that they really didn’t change the curriculum or even the offerings of the school lunch program. Only the scheduling changed, so that kids were given more activity right before they sat down to lunch. Easy fixes for nearly all schools, and most certainly worth a try, especially because virtually none of the schools offering recess before lunch noted any misgivings or negatives.

Finally, remember that kids like to eat stuff that tastes good, but we adults can stand to learn a thing or two about what we assume kids will eat. The kids in the 2014 Oregon school study ate the most fruit when pineapple and cottage cheese was served. Wake-up call here!

Eat Well During Holidays Without Crossing Over to the “Dark Side”

Healthy holiday eating and enjoyment are not mutually exclusive, IF you know the right tricks. Having a healthy eating style doesn’t have an “on-off” switch and. It’s not about choosing between living in a healthy food monastery, or crossing over to the dark side, where all enjoyment happens.

Being healthy is being on a food journey, not on a diet. On a journey, there’s room for everything.  Extreme, overly restrictive eating styles aren’t sustainable and most people wouldn’t want to sustain them either. I wouldn’t. But I think of holidays as just another opportunity to hone a better eating style. Keep in mind, my own eating style has evolved over the years. Give yourself permission to evolve a little, too.

Think about the reasons why our usual eating styles get “disrupted”:

• “…the kids were off from school this week”.
• “…it was the (fill in the holiday)”
• “…we had a party at the house this weekend.”
• “…we had family in from out of town.”
• “…we were doing a lot of socializing.”

Making holidays work FOR you, not AGAINST you

File all these reasons under “stuff happens” but they happen all year long, so make life’s little disruptions amount to nothing more than a minor nuisance. They may even open a new dimension to your eating style or give you different “routines” for each situation.

Here are some positive ways to help yourself during “disruptions”:

• MOVE MORE! Just make it a part of the fun. Activity is a total ace in the hole. The more you move, the more calories you burn, for sure, but the more fun you can have, too. Moving kicks in your brain’s “feel-good” chemicals called “endorphins” that lift your mood. Walk through decorated neighborhoods, go ice skating, and make sure you dance at all the holiday parties! Feel the fun, not the burn!
• Workday “me” time: take 30 minutes of your lunch hour and walk briskly. THEN have a modest lunch and you’ll deserve a little indulgence. Or bank it for tomorrow’s indulgence!
• Splurge on some delicious, healthful foods you like but usually deny yourself: smoked salmon and pre-seeded pomegranates, (where all the work is done for you) are two of my faves. Keep grapes and clementines on the counter for a tasty impulse-bite. Gift yourself the convenience of salad-in-a-bag to make sure you and your family have an easy way to get plenty of low-calorie, nutritious foods (throw in some of those pomegranate seeds!). It’s also an easy way to get kids started in the kitchen with simple prep. Try some high-end balsamic vinegar and you’ll need less oil.
• Expect the unexpected. If a disruption is likely to happen, keep the rest of your day’s eating smart. Leave 200 or so calories for something unexpected. That way it doesn’t set you back.

MEAT AND TYPE 2 DIABETES? CALM DOWN — LET’S BOIL IT DOWN

Just when people are at feeling (justifiably) entitled to feel OK about eating meat again, out comes a study that “associates” consumption of meat with type 2 diabetes.  It was published in the American Journal of Epidemiology and was part of the Singapore Chinese Health Study.  Here’s the gist:

Over 63,000 Chinese adults, ages 45-74 years

There were two interviews during follow-up of just under 11 years to determine type 2 diabetes

Dietary pattern determined only once – at the start, by a food-frequency questionnaire

The variables: intake of poultry, red meat, seafood and incidence of type 2 diabetes upon follow-up.

They divided the subjects into four groups based on intake of shellfish, poultry, and red meat.  Then they compared the groups with the lowest intake of meat/poultry/shellfish with groups that had the highest intakes.

Here’s where things get interesting, but first:

Iron 101

There are two ways iron exists in food.  Iron is either part of hemoglobin (called “heme iron”), as in the case of animals, or it’s bound to other compounds (called “non-heme iron”), as with plants.  Compounds like phytates in plants bind to iron to make it less absorbable.  Eating plant iron with an acid, like having spinach with a vinaigrette dressing, will help liberate some of the iron, but in general, heme iron is more available to the body.

How much iron do we need each day?  Adults need 12 mg/day and women of child-bearing age need 18 mg/day, because they lose iron each month they menstruate.

The study data are “noisy”

This means the study has limitations that prevent drawing strong conclusions. To be fair, he study’s authors were pretty responsible in pointing out some of the limitations of their study. Most notably:

  • Dietary pattern was taken at the beginning and never again. So, what you had for dinner on a  Tuesday night 11 years ago predicts your health now?  You might be able to get statistics from this data, but drawing any realistic conclusions is making a Grand Canyon leap.  People’s diets change over 11 years!
  • Activity patterns were also assessed only once, at the beginning of the study.
  • Those who ate the most red meat ate averaged only about 53 grams daily – less than two ounces! And they still ate more seafood than meat.
  • Those who ate the most seafood also averaged about 33 grams of red meat daily — a little over an ounce! So differences between the HIGHEST and LOWEST consumption of red meat was only 20 grams – about 2/3 of an ounce.
  • Different meat types were assessed (beef, pork, lamb, etc.), but not cuts of meat, or parts of poultry (legs have more heme iron than breast) or dietary fat.  Pork belly has lots more fat than pork loin, for instance.

With the difference between the highest fish-eaters and the highest meat eaters being only 20 grams of meat, the difference may be statistically significant but not clinically (“real life”) significant.  The “associations” these studies talk about don’t mean “cause-and-effect” but consumers don’t often understand that. and the headlines don’t help much. To get the facts you usually have to read beyond headlines.

My take-away from this study? Not a whole lot.    

And the authors pretty much agree with me, noting, “We do not perceive any reason for meat intake to be related to the likelihood of disease diagnosis in our study population.”  Simply put, this study failed to connect meat intake with type 2 diabetes.  Game over.

Seafood absolutely is great food, but meat and poultry are also nutrient-rich.  Some tips for eating meat and poultry well:

  • Go leaner whenever possible.
  • Keep portions real. Even 4 ounces of lean meat is going to be loaded with enough protein for your meal.
  • Keep half your plate veggies and fruits.
  • Include a whole grain or a starchy vegetable.
  • Keep added fat reasonable. Olive oil or canola are good choices, rather than butter or coconut oil.

 

Paleo-Inspired Baby Food? Sorry, They Need ALL Food Groups

In the EdibleRx, I like to keep things informative and simple.  I’m not a fan of demonizing foods or food groups.  Balance is key, and I believe in making recommendations based on sound evidence – as good as it exists.

Food trends come and go – witness the plethora of extreme diet books that have populated bookshelves (maybe even your own) and spurred endless conversations and discussions.  When a trend becomes potentially harmful to a vulnerable group, however, I cannot let that slip by.  Having spent most of my career working with children and families with special needs, it makes my blood boil when food trends and fads get visited on vulnerable groups.

Case in point: Back around 2004 I was called to testify before the House Energy & Commerce Committee, which was examining two companies in particular that were marketing diet pills and supplements for children.  One supplement actually used herbs that were contraindicated in anyone under age twelve years.  I pulled no punches and spoke the science, the facts, and also my outrage.  When you get the ear of Congress people, believe me, it’s not about keeping quiet.  It’s about using a professional voice to speak the truth, and making sure it is heard by those who can make changes.  That supplement website was shut down, fortunately.

I was interviewed September 18th for an ABC News story about a company making Paleo-inspired baby food: free from grains, dairy, and fruit, centered around meat and vegetables.  Beef, chicken and veggies are great foods and fine for a meal, but promoting a diet free from dairy, grains, and fruit for infants and toddlers is not. Young children this age need balance and variety from all five food groups.  Simple, basic foods from these groups are a nutrient-rich package and round out a balanced diet.

Their reasoning?  From their website:

“We were shocked by the amount of sugar in most baby foods, because sugar (even from fruit) creates inflammation which leads to health problems and can make a baby fussy from the blood sugar crash.”

In 30+ years as a pediatric nutritionist/dietitian working with children with special needs of all forms, I have yet to see an infant/toddler who had a “sugar crash” from eating strained pears.  Period. 

As for their food, it comes in three different flavors, “free-range chicken, “all grass-fed beef” or “uncured bacon”, each mixed with vegetables and each with either 4 or 5 grams of protein – less than what you’d get from about an ounce of edible beef or chicken (both typically contain about 7 grams of protein per ounce).   Squeeze pouches only, sold online in 6-packs.  Each pouch is 4-oz. or ½ cup.

Baby Nutrition 101: Mixed dishes are not first foods

They call these products “first foods to feel good about” but these are all mixed dishes.    You never want to introduce more than one new food at a time.  If there’s an allergic reaction, you won’t know which food is causing it.

Meat and vegetables are great foods for babies – but not JUST meat and vegetables.  While they shun dairy, I hope they’re OK with breast milk – it has even more “sugar” than cow’s milk.  (For the record, cow’s milk doesn’t replace breast milk or formula until at least 12 months.)

“Ridiculous” Costs

Cost per 6-pack: $26.95, or about $4.50 PER SERVING!  For $26.95 you can buy enough healthful beef, chicken and veggies – and grains, fruit, and dairy – and feed your toddler for days, or even buy wholesome prepared baby food.  An infant/toddler diet that excludes grains, dairy, and fruit isn’t serenity.  It’s insanity.  And $26.95 for 3 cups of meat and veggies?  Unnecessary food elitism.  Good baby food — store-bought or homemade — should be, and IS, far more affordable than this.

And even if you buy baby food in pouches, feed it to baby with a spoon.  Stay involved.  It’s the start of having family meals — one of the BEST ways to feed kids of all ages.  Hey, it’s Family Meals Month.  Make it happen in your family. THAT make healthier kids.

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!