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” REVERSE LOW TEST SCORES & IMPROVE 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!

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.

 

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.]

IT’S HOT OUT THERE! ARE YOU EATING ENOUGH WATER?

 

It’s summer, the hottest time of year, and everywhere you turn you’re hearing about the importance of drinking enough water and fluids.

But how much should we be drinking?  The daily water intake recommendations by the Food and Nutrition Board of the National Academies of Sciences are 13 cups (3.7 liters or about 125 ounces)daily for men, and 10 cups (2.7 liters or about 91 ounces) for women.  These are very general though, as a single recommendation is impossible.  A lot depends on factors like these:

Weight. If you weight more, you usually need to drink more, but it’s not a linear progression.  That is, a 200-lb. person doesn’t need twice the fluid of a 100-lb. person.  The smaller person is more vulnerable to dehydration and overheating because they have a high “surface-to-volume ratio,” the same reason a small child is more vulnerable to overheating.

Gender. Men tend to need more fluid than women.  They tend to weigh more but also have more muscle, which is metabolically active and requires more water to stay hydrated and function properly.

Activity level. But the more active you are in any season, the more you sweat and thus need to rehydrate.

It doesn’t all have to be water and the IOM is clear that all beverages , including coffee, tea, milk, and even juice, so getting those 9 to 13 cups is easier than you think. Liquids aren’t the only place to get water.  You can easily amp up your take from food if you include plenty of high-water fruits and veggies, and there are real advantages to doing this:

  • Flavor! Chilled summer fruits and vegetables are taste powerhouses.
  • Rehydration nutrition: high-water fruits and veggies are loaded with hydrating nutrients like potassium and magnesium. Count milk in here, too.

For highest water content, go for fresh versiuons.  Here’s a list of some of the most common high-water fruits and vegetables (by % weight):

FRUITS

% water

VEGETABLES % water
Watermelon

92

Cucumber, lettuce (iceberg)

96

Strawberries

92

Zucchini, radish, celery

95

Grapefruit

91

Tomato (red)

94

Cantaloupe

90

Tomato (green), cabbage (green)

93

Peach

88

Cabbage (red) cauliflower, eggplant peppers (sweet) spinach 92
Raspberries, pineapple, orange

87

Broccoli 91

Many are more than 90% water, so they really contribute to your total fluid intake for the day.  Plus, they do what a glass of water simply can’t: help you get enough fruits and vegetables for a healthy diet.

Personal fave: watermelon.  I love this stuff.  I have loved watermelon since I was a kid and waited for it to come into season so I could gorge myself on it.  Even now, when I come home on a steamy, sweltering day there is absolutely nothing better to cool me down and get my taste buds dancing than a huge chunk of ice-cold watermelon.  I’m hardcore, too.  I cut off only the outer skin because I love the white part of the rind as well.  It’s not as sweet but that’s OK and it’s still good, kind of like a semi-sweet cucumber.

MORE: Can you be a health-freak AND a smoker?  Get my take in this New York Post article here.

BEEF EARNS ITS PLACE AT THE WEIGHT LOSS TABLE

A solid clinical study by a well-respected team, just published in the July issue of Obesity Science and Practice, showed that eating lean beef, at least four times per week, produced weight loss just as effectively as a non-beef diet.  Even better: there was no negative impact on heart health indicators, like total cholesterol, LDL “bad” cholesterol, or blood pressure.

This research, called the Beef W.I.S.E. Study (Weight Improvement, Satisfaction, Energy) followed 99 overweight and obese adults for 16 weeks.  Everyone did moderate-intensity exercise regularly and ate a higher protein diet, either with beef or without beef.  The beef eating dieters ate beef about 4 times per week, not every day, and they ate plenty of other lean protein foods, like nonfat Greek yogurt, fish, chicken breast, etc. Indeed, some type of lean protein happened at each meal and snack.

The beef-eaters lose just as much weight, preserved just as much lean muscle mass as the non-beef group. “A key finding of this study is that 90 to 95 percent of the weight lost came from fat, not muscle,” said Dr. Drew Sayer, PhD, a co-author of the study. “This shows that lean beef doesn’t have to be restricted in a higher-protein diet and is just as effective as other protein choices in supporting healthy weight loss and leaner bodies.”

And I’d bet they also liked their diet more, because they didn’t have to omit food they liked.  Anytime you have to omit a food on a diet, it can become the one food you want.  According to the Consumer Beef Index, a survey of attitudes about beef, 3 out of 4 people DO like beef as a favorite or a top meal choice.  The dieters in the Beef WISE didn’t eat beef daily, but about five times weekly.  No deprivation there.

That’s exactly why I like this study: no feelings of deprivation.  To be fair, there was no particular advantage to including lean beef, but the W.I.S.E. factors of satisfaction and energy are key to EVERY successful diet, and to maintaining both the lost weight and a healthful eating style.  Whether you’re trying to lose weight or keep it off, YOUR eating style should help you feel energized and satisfied.  The researchers will be following these dieters longer term and satisfaction data is also being analyzed, but the high retention rate suggests the participants liked whichever diet they were eating.

These beef-eaters ate lean beef, but that’s pretty easy.  There are 29 cuts of beef that qualify as lean, meaning they have less than 10 grams of fat per serving and less than 4 ½ grams of saturated fat per 3-oz. cooked serving.  Check out this chart listing 19 popular lean cuts of beef.

CutToTheChase: If you like lean beef, it’s be W.I.S.E. to include it while losing weight. It’s produces the same benefits as a non-beef diet.  Liking your diet is key to staying one it!  Try this lean beef recipe for Grilled Southwestern Steak with Colorful Vegetables (pictured at top).  It’s quick, delicious, and loaded with lean protein.

Note: this study was funded partially by the Beef Checkoff, but also by many additional federal agencies, like the National Heart Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases.  It was registered at https://clinicaltrials.gov. It’s sound science and highly credible. It’s sound science and highly credible. It’s one of the reasons I partnered with the Beef Checkoff program, established by the federal government in 1985. Participation by beef producers is mandatory.

FRUITS & VEGGIES & PESTICIDES, OH MY!

As a kid I waited impatiently for summer. The main reason? The huge variety of fruits.  People think I love fruit because I’m a registered dietitian/nutritionist, but I’ve always been this way.  As a kid,

I remember going berry-picking near the weekend place we had as a kid, in this secluded canyon an hour south of San Francisco.  The blackberries were so sweet in the warm sun that I’d happily get scratched by the bush’s thorns just to reach the branches with the biggest berries. About half of what I picked didn’t make it home — I ate ‘em on the spot.  Yes, I should have washed them and no, I didn’t.  They were wild, but had plenty of dust and dirt.  I lived through it.

As an adult, my produce passion has only expanded.  I never met a grilled, roasted, or even steamed veggie I didn’t like (unless it was overcooked!)

Less is not more

The diet histories I take on all my patients show one constant: a lack of fruits and vegetables.  They’re like most Americans, too, according to the 2015 US Dietary Guidelines. Produce is a powerhouse of nutrients – and taste!  There’s just no substitute nutritionally, so why deprive ourselves?.

What’s the barrier to eating more produce? Check these frequent comments from patients:

  • “They have so many pesticides and organic stuff is too expensive.’
  • “I buy them but nobody eats them so it’s money down the drain.”
  • Fresh is too expensive and frozen and canned don’t have any nutrition left in them.”

A 2016 survey that looked at the attitudes of low-income consumers about organic vs. conventionally grown produce.  If they’d heard about pesticide residues on fruits and vegetables they were more likely to avoid buying them.  They’re definitely misinformed, because their fear is unfounded. Conventionally-grown fruits and vegetables are quite safe to eat.  Let’s look at why that’s so.

Pesticides 101: Testing, testing…

The Environmental Protection Agency (EPA) requires all pesticides to undergo hundreds of health, safety, and environmental tests before they’re approved. They also establish a safe “­reference dose”, or RfD level. To do this, they first establish the maximum amount of the pesticide that, if consumed daily for the rest of one’s life, would cause no harm. They make the RfD is then 1/1000th of that maximum safe dose.  That means that even if you got 1000 times the RfD, every day, you’d still be fine.

Then there’s verification.  The Pesticide Data Program (PDP) maintains the world’s most thorough database of pesticide residues.  It annually tests domestically-grown and imported produce. Over the 20 years of testing that the PDP has done, over 99% of crops have tested below RfD levels.  The vast majority of produce has tested ridiculously low, in fact, often 1/10,000th of acceptable levels – which already have a 1000-fold cushion in them.

Reality check

Carolyn O’Neil, registered dietitian, veteran food & nutrition reporter, author of The Slim Down South cookbook, says, “I have absolute confidence that choosing conventionally grown produce is doing only good things for you and your family.”  She doesn’t believe we have choose between organic or conventional produce.  “Conventionally grown crops are regularly and systemically tested for pesticide residue to ensure that what goes from farm to table is safe to eat. The proper use of pesticides, in both organic and conventionally grown crops, is the expertise of farmers who want to put safest and most nutritious foods on our tables.”

Keep in mind that virtually ALL of the vast research showing huge benefits of eating more fruits and vegetables was done on conventional, not organic, produce.  Avoiding fruits and vegetables just because you can’t afford organic is unnecessary and puts you at risk.  It’s all good.  Buy the produce you can afford and will eat (I’m never without canned garbanzos).  Everyone eats more fruit if there are fewer “competing foods” around, like cookies and cake.

Organic or conventional, wash all fresh fruits and veggies.  I took a risk as a kid by eating some dirt and dust on those berries without washing them!

Cut-to-the-Chase

Strong safeguards ensure our food supply is the safest you’ll find anywhere.  Our fruits and vegetables are healthy even if they didn’t come from our own yard.

I work with kids and families.  Their safety and food budgets are important.   I eat conventionally grown produce daily, organic if it’s a good buy.  Eat the ones you enjoy and eat them every day.

PROCESSING THOUGHTS ABOUT “PROCESSED FOOD”

You can’t hear any conversation about food these days without hearing about “processed foods”.  Nutrition experts, medical experts, and those who talk about food a lot all seem to be saying the same thing: processed foods are to be avoided or at least minimized to the greatest extent possible.

It’s easy to join the pile-on but as with everything in life, the processed food issue is not black and white.  Why?

News flash: ALL FOOD IS PROCESSED  

Unless you bite an apple off the tree, it’s probably been processed.  Indeed, the act of washing your fruits and vegetables is a form of processing them.  Peeling, chopping, drying, and cooking are all ways of “processing” food.

Processed food has a spectrum, and a group or researchers based at the University of Sao Paulo, in Brazil developed a system is called “NOVA” that classifies all foods into four groups.  In a nutshell:

  • Group 1: Unprocessed or minimally processed foods.

o   Whole fruits and vegetables, whole or sliced fresh meat and fish,

o   dried fruit and nuts

o   combinations of foods in this category, like granola if made with no added sugars. It also includes enriched white rice.  Fair enough.

  • Group 2: Processed ingredients

o   Iodized salt, vinegar, lard, salted butter, etc.

o   Ingredients used in home and restaurant kitchens to prepare “hand-made” dishes.

  • Group 3: “Processed foods”

o   Canned fish, vegetables, and fruits (including fruit in syrup), cured meats,

o   Cheeses

o   “Unpackaged and freshly made breads.”

o   “Most processed foods have 2 or 3 ingredients.”

o   Beer, cider, wine.

  • Group 4: “Ultra-processed food and drink products.”

o   Yogurt sweetened with sugar or a sugar substitute.

o   “Mass-produced packaged breads”

o   Frozen dinners and pre-prepared, ready-to-heat dishes, savory or sweet.

o   Breakfast cereals (sweetened or not)

o   Candy, desserts, pastries, soda.

o   Infant formula

o   Distilled spirits.

o   Foods with “cosmetic or sensory intensifying additives”,

The authors’ advise avoiding category 4 foods altogether, as they, “damage culture, social life, and the environment.”

WHOA!  Absolutely no scientific evidence for that.

The NOVA system: Science or Ideology?

The system seems based more on politics, philosophy, and ideology than science. Examples:

  • “Common attributes of the Category 4 ultra-processed products are hyper-palatability, sophisticated and attractive packaging, multi-media and other aggressive marketing to children and adolescents, health claims, high profitability, and branding and ownership by transnational corporations.”
  • The “freshly made” white bread loaf from the corner bakery is “processed” but the one that’s “pre-packaged” is “ultra-processed” and should be avoided.
  • Fruit canned in syrup is “processed”, which is OK but you should avoid sweetened yogurt and whole-grain cereal because they’re “ultra-processed”?

The scale of production seems more important than what’s in the food itself. Science doesn’t support this. Large-scale production is the only way you’re going to feed hundreds of millions of people every day.  Foods like packaged whole-grain bread and sweetened yogurt, Greek or conventional, can be a terrific part of a very healthful diet.

This tool will probably be idolized but the developers seem to be speaking to an elitist audience that is disconnected from the realities of the people they need to reach.

Avoid the word “avoid”

As a practicing clinician and registered dietitian for over 30 years, whole grain breakfast cereal is a lot more nutritious than candy.  These foods should be far apart from each other when speaking about nutrition.  It’s also unnecessary to “avoid” any food (unless you’re allergic).  Eat less candy and empty-calorie drinks, yes, but I’d like people to eat more whole-grain cereal and yogurt – sweetened or not.  These are nutrient-rich foods that are underconsumed.  There’s no reason to feel guilty about eating them.

People eat food, not philosophy.  After all, it doesn’t’ become “nutrition” until someone eats it.  My philosophy? I’d argue that the cell phone — or “personal device” – has done more damage to our eating habits and lifestyle than breakfast cereal and sweetened yogurt.

Cut-To-The-Chase Nutrition’s bottom line:

  • Nearly all our food is “processed” in some manner. Processing is fine – it’s what makes many foods edible and safe to eat.
  • There are plenty of healthful, “mass-produced” foods.
  • Down with demonizing food and making people feel guilty, especially when the science isn’t there.
  • “Mass production” also brings us standards that ensure the safety and consistency of our food supply. Food is only nutritious if it’s affordable and accessible.
  • There’s a place for nutrition philosophy, but science, should drive nutrition policy.

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

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

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

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

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

Science for chocolate nerds

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

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

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

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

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

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

How to do chocolate right

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

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

Chocolate caveat

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

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

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