No, I Don’t Care If Kids Eat Candy on Halloween

Letting kids loose on Halloween doesn’t have to mean all hell breaks loose afterwards.

Halloween is a once-a-year occasion.  I’m focused on what kids do the other 364 days of the year.  If they’re eating well on those other days, then there’s absolutely nothing wrong with letting them enjoy Halloween!

Every year around this time I get a ton of questions from parents about what to “allow” kids to eat on Halloween, how much candy to let them collect and keep, and what kind of candy is “best” to give out on Halloween.

Sugar Shakedown

No, sugar won’t make them hyperactive.  They might have a burst of energy, but the whole “sugar-gives-them-a-buzz” thing has been completely dismissed.  The rigorous science just doesn’t show anything.  Actually, a high-sugar snack has even been shown to help keep you on-task.  I’m NOT encouraging more sugar.  It’s not angel food, but not devil’s food, and it’s not a new food, either.  Just keep it real.

Your Homework: Laying the Groundwork

Planning ahead is everything here.  Kids (and adults) don’t like sudden, unexpected changes, especially to their eating habits.  Here are a few tips to help things go smoothly on the big day:

  • Be real about how much you buy. You know how many kids typically visit you, so get enough for THEM.  Buy with an eye to having as few leftovers as possible.
  • If you’ve already bought the candy, let the kids know ahead of time about the plan for leftovers: share with neighbors, you’re bringing them into work for co-workers, making up a bag for a child who couldn’t Trick-or-Treat (a nice thing to do for a child who is ill), and so on.
  • Buy only the smallest portions of candy! No full-sized bars, just the little mini things.  That way even with leftover stuff, the treat is reduced to a bite, not a commitment.

Tricks Before Treats

The idea to reinforce to kids is to “take care of business” first, by spending calories on the foods we need.  If there’s anything left, have a treat and enjoy it.  That’s the eating style I want kids to have 364 days a year.

  • Keep only the “top 10%” – their absolute fave candies. The rest gets donated or shared with others.  Quickly – like, get it out of the house the next day. (Note: For me, candy corn got tossed first thing!  Never could stand the stuff, even as a kid!)
  • Make it social! Halloween is also about dressing up, hanging with friends, and walking the neighborhood. This applies to all holidays or occasions.  It helps them see food and eating in perspective.
  • Never make candy a “reward” for good behavior (save that for training the dog), but see it as a teachable moment. Candy is an “extra”, it provides mostly empty “discretionary calories” so treat it that way.  It’s something to have in a small amount AFTER the rest of needs are met.

“What Does the Research Say”?

Yes, someone actually did a study on whether seeing Michelle Obama’s face (versus other political women’s faces) might influence them to choose a box of raisins or a small name-brand candy bar.  Connecticut home.  Three years of Halloween.  Kids were directed randomly to either of two sides of the porch – one with Michelle Obama’s pic, the other side pics of other political women (Hillary, Ann Romney, or no photo) and asked if they wanted a box of raisins or a small candy bar.  Authors described the community as politically liberal.

Result: The kids on the Obama side were 19% more likely to choose the box of raisins than the candy.

Great, but there was no info on whether the kids then ATE the fruit.  After all, no food can be nutritious until you EAT it.  Ironically, the box of raisins is about the same calories as the small candy.

Cut-To-The-Chase-Nutrition Take-Away

Halloween can be a blast.  It should be.  It’s also over in a day so enjoy it fully.  On other days, it’s about getting what you need first: the fruits, veggies, whole grains and dairy foods FIRST.  Be active, FIRST.  Those are the tricks, before the treats.

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. 

Depressed? Some Fruits and Veggies Might Help!

When I was a kid, and for basically my entire life, having a (huge) slice of watermelon – or two or three, made me happier than eating cake.  Yeah, watermelon made me happy.  But could eating more fruit – and veggies – make you less depressed?  Some new research says that’s not a far-fetched notion.

This review in the American Journal of Clinical Nutrition evaluated the body of studies that investigated the effects of eating fruits and vegetables on various measures of mental health.   The authors wanted to see if an actual causal relationship existed, so they looked at both experimental studies and observational studies.

This review included studies that reported fruits and vegetables together, as well as those that looked only at intakes of vegetables or fruits.  Being this specific really pared down the pool of eligible studies, but they did find ten that met the criteria, and these included over 33,000 people.

Watermelon may not cure depression, but I am ALWAYS happy when I’m eating it!

The authors concluded that increased fruit and vegetable consumption had a “positive effect on psychological well-being”, with vegetables having somewhat more impact than fruits, in studies that looked at the effects independently.  The effect on mental health however, was less clear. 

Basic Brain Chemistry

There may be some chemical reasons for the improved mental outlook from eating more produce.  Fruits and vegetables are loaded with micronutrients like vitamin C and B-complex vitamins, that influence the formation of neurotransmitters, such as serotonin, dopamine, and norepinephrine in the brain.

Neurotransmitters are known to influence our mood and impact mental health.  Indeed, many medications that treat depression are focused on modulating neurotransmitters like serotonin, to optimize their impact on mental health, depression, and psychological well-being.

Chicken vs. Egg

My first response was, “did the fruit and vegetable consumption improve their psychological well-being, or was their consumption of fruits and vegetables higher just because they had a better sense of well-being in the first place.  The latter would be called “reverse causality”. 

The amount of fruits and vegetables needed for “meaningful changes” varied among studies, ranging from 3.7 servings to 7-8 servings.  Counting a typical “serving” as about ½ cup, you’re looking at from 2-4 cups per day to have an effect.  This is well within recommended amounts by pretty much all global health authorities.

A simple “modified-Mediterranean diet”
seemed to modify depression as well

While this review didn’t include clinical research, a 2017 clinical study looked directly at the impact of increasing adherence to a “modified-Mediterranean” diet, which emphasizes fruit and vegetable consumption, as adjunctive treatment in persons diagnosed with moderate to severe depression.  Scores on the Montgomery–Åsberg Depression Rating Scale (MADRS) were used as a measure of the severity of depression.  This study checked some important boxes for quality of design:

  • Randomized controlled trial.
  • Parallel groups.
  • Some received regular nutrition counseling on a modified Mediterranean diet, others received social support on the same schedule.

Result: The dietary intervention group had significantly improved scores.  Even better, 32% of the dietary intervention group achieved remission of their depression, vs 8% in the social support group, and these results were statistically significant. 

The dietary group also at significantly more:

  • Fruits
  • Dairy foods
  • Fish
  • Pulses (beans, peas)
  • Nuts

They also ate fewer servings of less nutritious items, like sweets and, empty-calorie foods.

The study lasted only 12 weeks, so further research that addresses longer term results and with larger groups, is certainly warranted.  Still, given a relatively simple intervention that just encourages people to eat a diet that’s balanced and includes what they need anyway, it’s hard to dismiss the value of results. 

Cut-to the-Chase Take-Away

Aa clinician, I care mostly about people eating as many of each as possible and I’m less fussy about fruits vs. veggies.  None of them are nutritious unless you eat them and all of them are good for us.  Eat the ones you like and eat them daily.  You’ll certainly be happier with your choices!

Got a Salty Tongue? New Study Says It’s Not So Bad!

Hypertension and “low-sodium diet” seem to go together like two peas in an unsalted pod.  Salt, has been one of the “eat less of” ingredients that dietary guidelines and health organizations have warned us about forever.  We’ve been told of the risks to our blood pressure and heart health in particular.

In the US, we get about 3,500-4000 mg of sodium daily, according to the Centers for Disease Control   (women tend to be on the lower end of this range).  You may exceed these levels if you eat out a lot, as restaurant chefs are known for their generosity with salt.  US Dietary Guidelines recommend a max of 2,300 milligrams, and if you’re at risk for cardiovascular disease, it’s only 1,500 mg.  Even at 2,300 mg, it means cutting out a third of the sodium we eat.

Kimchi: Yes, it’s salty, but it’s OK,
just don’t binge!

The problem?  People HATE low-salt diets and they love salty food!   Even excluding French fries, these foods also figure into our love of salty savories:

  • Grandma’s chicken soup (and most canned or homemade soups)
  • Cured meat, fish (smoked salmon!) and cold cuts
  • Most condiments, from Worcestershire sauce to anchovy paste
  • Most ethnic dishes and restaurant meals
  • Almost everything savory that‘s canned or jarred (pasta sauces, tomato sauce, baked beans, and on)

S.O.S.: Save Our Sodium?

This study looked at just how bad the present intake of sodium is for our health and it turns out sodium may be a minor player. 

The study estimated sodium intake by assessing sodium in the urine (where 90% of our sodium ends up) and divided the groups into low, medium, and high excretion groups and followed them for about 8 years, looking at risk for cardiovascular events and death.

Interestingly, the groups at the most risk had both the highest and the LOWEST intakes of sodium, but only when they also had a low intake of potassium. 

The group with the LOWEST risk for death and cardiovascular events?  They had a moderate sodium diet (3.000-5,000 mg/day) but diets that were highest in potassium. 

D.A.S.H.-ing Through the Clutter

A diet that’s moderate in sodium but high in potassium.  That’s pretty much the DASH diet: “Dietary Approaches to Stop Hypertension”.  It works and it’s simple.  Just eating more fruits, vegetables, and low-fat and fat-free dairy foods (milk is an astoundingly good source of potassium) does the trick, and it’s what most people’s diets need more of anyway.  Here’s why I like the DASH approach:

  • It’s not regimented or prescriptive. It’s an eating style that works with all cuisines.
  • Plenty of delicious foods are also loaded with potassium. Eat your favorites and eat them daily. 
  • Bonus: eating more fruits, veggies and low-fat dairy foods will probably push out some of the higher-salt foods people eat now, especially for snacks.

ALL fruits and vegetables are good sources of potassium, but here are some superstars:

  • All melons and berries
  • All citrus fruits and juices (100% juice, please)
  • All potatoes, squash, pumpkin
  • All leafy greens (lettuce, spinach, kale, the whole lot)
  • Beets (don’t laugh – beets are the new “in” veggie for 2019!)
  • MILK!  Whole, 2%, 1% and fat-free, also yogurt are the top non-plant sources of potassium – and calcium.

Reality: It Doesn’t Have to Bite

High-potassium foods are a “must-have.” More important than “low-sodium”!

People in the free-living world aren’t going to stop eating their favorite savory foods and they shouldn’t have to.  It’s time we accepted that and focused on encouraging everyone to eat more high-potassium foods. This latest study suggests it may be more effective anyway.

While the research continues, make sure your favorite savories keep better company:

  • Ham sandwich?  Instead of the chips and soda, try an apple or banana and some iced tea.
  • Going out to dinner?  Start with a salad – dressing on the side so you stay in charge.  Have a nice baked potato – sour cream has no sodium! 
  • Soup’s on?  Add some beans and greens for good measure.
  • Bacon and eggs?  Lox and bagels?  Have a fruit and yogurt parfait along with it.  Or at least a glass of OJ or a banana.
  • Get the herbs and spices into everything: soups, salads, meat, fish, even yogurt!  Dried or fresh, herbs and spices are loaded with antioxidants and replace the need for some of the salt.

There’s no requirement for a specific fruit or veggie to be healthy.  Just eating more fruits, veggies and dairy foods is a start and a good one.  It’s a super-tasty way to get healthier all-around – and just by eating, because these foods also fill nutrient gaps.  The benefits go way past getting more potassium. 

Your Headphones Won’t Mask the “Noise” In New Egg-Heart Disease Study

For years, all you heard about eggs was that they were “linked with” heart disease.  Keep consumption to a few eggs per week and dietary cholesterol to less than 300 mg. per day. Since one egg has about 185 mg of cholesterol, you really had to be careful how you spent those 300 mg. 

Then, research found saturated fat to be riskier for heart disease than dietary cholesterol, but the egg damage was done.  Finally, the 2015 US Dietary Guideline for Americans finally dropped it’s 300 mg/day cholesterol limit.   

Eureka!  Progress!  Eggs Are Back!

Give up omelets? Say it ain’t so!

Just when consumers were getting comfortable having an omelet again, here comes a new study in the Journal of the American Medical Association that claims an “association” between egg consumption and heart disease.  At first glance, the study seems impressive:

  • They looked at 6 different populations or “cohorts”, covering a 17-year period, on average.
  • They calculated hazard ratios (HR) and absolute risk difference (ARD) for cardiovascular-related deaths and all-cause mortality.
  • They adjusted for “demographic, socioeconomic, and behavioral factors.”

Here’s what they concluded

“Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner.”

They say that, for every 300 mg of cholesterol you eat, your chances of dying from heart disease in 17 years (assuming you’re over 50) are increased by about 17% and your chances of dying of anything at all are increased by about 18%.

But the average consumption of both eggs and dietary cholesterol was modest.  Even the cohort with the highest consumption of eggs ate only 0.42 eggs/day – less than 3 eggs per week!  Average dietary cholesterol intake was: 240 mg/day – well under the previously recommended 300 mg/day.

Turns out that, in this study, cholesterol become the issue, not eggs, but even when you just look at cholesterol, it’s important to hear the study’s “noise”.

The “Noise”, a.k.a. Weaknesses & Limitations 

It’s problems, plural, and the authors acknowledged some of them, but still felt entitled to make some strong conclusions (and I feel entitled to strongly disagree with them):

  • “Associations” and “linked-to” don’t CAUSE anything.  Anytime, and I mean ANYTIME you hear about a study that shows a food is “linked to” or “associated with” a disease or condition, it does NOT indicate the food CAUSES that condition, yet journalists often don’t get this concept.  These “Observational” studies are incapable of doing anything more than generating a hypothesis.
  • All the dietary data came from a SINGLE dietary report, and a self-report at that.  That’s like asking thousands of people about their diets on one day, and track how many die in 17 years.  Then draw conclusions about their deaths based on what they ate on that single day.  
  • Different dietary survey methods were used, so there was no uniformity of measurement.  To deal with that, the authors use a lot of statistical methods that “harmonize” the data and supposedly give you a better picture.  All methods still involved self-reports however.
  • Poorly surveying a large number of people doesn’t make data more reliable, no matter how you “harmonize” the data.  In this study, it still means 29,000 people were poorly surveyed.    
  • This study assumes a stable diet and lifestyle for 17 years, and that’s unrealistic.  No matter how many statistical tests you do, or how much “statistical significance” you find, no one – but no one – has that kind of stability for 17 years. 

Who knows what other lifestyle factors that evolved during the 17-years after the original dietary data were taken?  The authors do not, and the study cannot tell anything about what influence such factors might have had.

Yes, they’re STILL incredible…
….even for your heart!

Cut-To-The-Chase-Nutrition Reality Check

The egg has nourished people for thousands of years.  It has the highest quality protein of any food (it’s neck-and-neck with dairy), and critical, hard-to-get nutrients like vitamin D and choline.  Eggs also have the antioxidants lutein and zeaxanthin, known to help reduce the risk of age-related macular degeneration.  And they’re actually low in saturated fat. 

  • Pair your eggs with other good foods.  Scramble or fry them in olive oil, have them with fresh fruit and whole-grain toast.  It’s breakfast, but also lunch or dinner.
  • Balance it!  Greek yogurt with that fruit will round out the meal, or combine them in a smoothie as a beverage with those eggs.   
  • I keep hard-cooked eggs in my fridge as a high-protein snack.  Spread them with some Dijon mustard or hummus and keep hunger pangs away. 

The Easter bunny can rest easily.

Wanna Eat Healthy? Get Your Nitrates!

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

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

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

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

Where the Real Nitrates Are

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

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

Are Nitrates in Fruits and Veggies a Problem?

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

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

Nitrates & Their Cousins: Nitrites and Nitrosamines

Here are the basics you need to know about these:

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

“Nitrate-Free” Cured Meat?

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

Celery: Fine wherever you find it

Nitrates: The Boil-Down

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

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

Cut-To-The-Chase-Advice

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

Learn From a Baby About New Year’s Resolutions

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

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

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

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

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

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

Ready, S.M.A.R.T., Go!  –Anytime

Learn from these guys

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

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

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

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

Baby steps & persistence!

Babies Have Vitamin “P”

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