COVID-19 Got You Depressed? Could Probiotics Help?

Whether COVID-19 has you sheltering-in-place, quarantining, or just frustrated by not being able to have your usual life, lots of people seem a little down in the dumps, grumpy, and yes,  even “depressed”.  The “life sucks now” feelings are real, but different from true clinical depression, which can happen for no observable reason. 

Could “Bacteria” Improve Mood?

The right kind of bacteria – probiotics – just might help truly depressed people, even those who on antidepressant medication.  This just-published study reviewed clinical research on the impact probiotic supplements had on people formally diagnosed with clinical depression.  

Probiotics are what give Greek (& regular) yogurt that tangy taste. 

Probiotics are live healthy bacteria, found in cultured foods like yogurt, kimchi, and kefir.  These are different from PRE-biotics, which are various types of dietary fiber found in fruits, vegetables, grains, nuts, and beans.  Prebiotic fiber feeds the growth of probiotic bacteria in the gut.  

What The Results Showed

In the 7 studies that met the criteria for inclusion in the review, all found that probiotic supplementation “demonstrated a significant, quantitatively evident, decrease/improvement of symptoms and/or biochemically relevant measures of anxiety and/or depression for probiotic or combined prebiotic– probiotic use.”  Whether the studies used one strain of probiotics or multiple strains, the results showed improvement in reducing depression symptoms. 

Moreover, in one of the studies that also measured “quality of life”, it increased with supplementation but returned to baseline 8 weeks after the supplementation stopped.

Why Probiotics Helped

If something works, I always want to know WHY, and this paper suggests a mechanism for how probiotics might help depression.

The gut is known to be the center of our immune system, and when probiotics have been found to be useful, as they have with conditions like ulcerative colitis, it’s often because of their ability to reduce inflammation by suppressing the production of some annoying substances, called “cytokines”. 

The gut also is known to connect with the brain via the “gut-brain axis”, part of the central nervous system, so “food and mood”, or the notion that what’s happening in one’s GI tract could impact one’s emotional state has weight behind it.

The “Fine Print” 

It would be great to learn that just by having some yogurt, your mood would soar, but alas, reality must be acknowledged.  These studies looked at persons with diagnosed, measurable depression.  Those who got the probiotic supplements seemed to become less depressed, but those supplements contained higher doses of probiotics than you’d get from a cup of yogurt. 

Tempeh is made from fermented soybeans & contains lots of probiotics, plus protein & fiber!

Probiotic foods and supplements may not be useful mood-boosters if you’re just having a down day, but there are plenty of reasons to eat foods that naturally contain probiotic bacteria, like these:

  • Yogurt, including Greek yogurt
  • Kefir
  • Kombucha
  • Tempeh
  • Miso
  • Kimchi

Look for “Live and Active Cultures” on yogurt and kefir labels, to be sure they contain useful amounts of probiotics. 

“Live & active cultures” guarantees a high amount of probiotic bacteria.

These being dairy foods, they also have a whole lot of essential nutrients we need, especially calcium and potassium, to help fill gaps in most people’s diets.

The main ingredient in kimchi is cabbage, and it’s fermented soybeans in tempeh, so they both have PRE-biotic fiber, too.  Heads up, if you’re sodium-sensitive: Miso and Kimchi can be loaded with sodium.  

Is there a down side to getting probiotic bacteria?   So far, there doesn’t seem to be, especially if you get them from food.  Getting some probiotics daily though, gives you the most benefit, and the study found this as well: depression returned when the probiotics stopped. 

Even if probiotic foods don’t lift your mood, you can definitely feel good about adding some healthy foods to your eating style!

From 9 Top Nutritionists: Positive Take-Aways From COVID-19

In a very short time period, COVID-19 turned how we live upside down.  We’re suddenly living, eating, and shopping differently than perhaps ever before. Has all this impact been negative?  I spoke with 8 nationally-known registered dietitian-nutritionists to get their take on what they think are the POSITIVES that might come out of the current pandemic, what they’ve learned, and a few noted what they’d like to keep from the whole pandemic experience.

Newfound Respect for Some Pantry Standbys

Amy Myrdal Miller hopes people “appreciate the benefits of canned fruits, vegetables, and beans and frozen fruits and vegetables. For too long people have believed ‘fresh is best.’  This points out the reality that canned and frozen foods offer nutrition benefits and convenience.”  If the increased demand for canned and frozen foods is any indication, this appears to be happening.

Neva Cochran agreed, noting that consumers returned to these foods as well as beans, beef, pasta, and others, “that are often mis-characterized as not being healthy or nutritious.”  Since the onset of the pandemic, she continued, “Concerns about buying organic, meat-free, non-GMO, all-natural, no added hormones, antibiotic-free and gluten-free have taken a back seat when people are concerned that there may not be enough food.”

Gratitude was also expressed.  “I’ve never been more grateful for all these non-perishable options – and the farmers who bring them to my table,” said Nicole Rodriguez.  “Whether it’s a simple box of raisins with my daughter during ‘home school’ snack time, cottage cheese topped with a pre-portioned serving of cling peaches, or frozen berries heated up as a makeshift jam,” she said she has a deeper appreciation for fruits in all forms.  As do I, including fresh fruit!  (See my Cut-To-The-Chase Take-Away below for more!)

Isolation – The Good Part

Photo credit: Andrea Piacuadio, pexels.com

Some found appreciations that had nothing to do with food or nutrition.  Chris Mohr’s normal schedule has him on the road constantly.  Being grounded (literally!) has been an unexpectedly positive experience for him, his wife and their two daughters.  “I love the increased level of connection among us.  We’ve each grown closer because we’re not socializing, traveling for work or anything else.  And I will work really hard to keep that up once we are ‘released’ from our homes”.  Probably something we all might focus on.

Having a less structured schedule during isolation has allowed Karen Ansel some freedom.  She’s found that she can do things “at times of day that mimic my body’s natural energy flow instead of when I’m “supposed” to do them.  I’ve been spending a lot of time spinning my wheels trying to be productive at the wrong times of day.” While she realizes all this may change when isolation is relaxed, “normal” life resumes, she does want to maintain take some of this new-realization.  “I do plan to really try to follow my body’s internal energy cues as much as possible.” 

Teachable Moments

If your kids show an interest in cooking, all the at-home time is great for getting into the kitchen with them to practice.   Toby Amidor, author of numerous cookbooks, has found it’s allowed her to, “Cook with my kids in the kitchen and actually see how my girls can cook without me in the kitchen.”  She sees how much they’ve learned from their mom, adding, “Now we are focused on further developing their cooking skills into more complex dishes they want to learn to cook.”  Sounds like “teacher” and her students have both learned something.

Rosanne Rust loves that people are sharing more time with their families in general, but including in the kitchen. “Teaching the kids how to bake, or working together at home, is a win-win for both the parents and the children. Even if at times it seems stressful.”  Good point.  If you’re new to teaching your kids cooking skills, start with goof-proof, entry-level skills: boiling an egg, baking a potato, steaming a vegetable.  Baby steps here!

As a retail dietitian (as in supermarket), Leah McGrath thinks many have gained a new appreciation for how hard supermarkets and restaurants work to make sure there is food available to us.  “Perhaps we won’t forget to take a moment when we’re shopping for groceries or eating out to remember that with a kind word, a smile or, when appropriate, a generous tip.”  Active on social media (@InglesDietitian), she’s using the #QuarantineKitchen hashtag.  “I think many have surprised themselves with their culinary creativity and ingenious substitutions to make meals for themselves and their families.  Necessity is the mother of invention!”

Beyond teaching cooking skills, food has always been part of family culture, too.  Notably, our isolation has occurred during Easter and Passover periods.  Christine Rosenbloom sees this isolation as, “An opportunity for kids and families to learn to cook and bake.  Teaching kids family heritage through foods and sharing treasured recipes,” is something she recommends during all the enforced down time.

I hear that.  Growing up, we celebrated what we called “regular” Easter (the one recognized nationally) and “Greek” Easter (the Eastern Orthodox one, which usually falls on a different Sunday).  This year, I did my part by making this braided Easter bread, like my Greek grandmother made, pictured here. (I hope she’s lenient – I reduced the amount of anise seeds by half and added some nuts – personal preference!)   

Cut -To-The-Chase Take-Away:

I join my colleagues in valuing all those pantry staples people have forgotten or dismissed.  They are – and always were – safe and nutritious to eat.  BUT…SO IS FRESH PRODUCE! 

Moreover, farmers need your help!  Many are plowing under or discarding perfectly good crops because of lower demand by consumers too afraid to handle and purchase fresh fruits and vegetables. 

You CANNOT get COVID-19 from food.  Why?  I explain it to you backed by facts!) in a previous post here.  So, when you do shop, buy fresh, too.  Remember – farmers aren’t “first responders”, they’re CONSTANT responders, through all.

News Flash: Fresh Produce Is Safe To Eat!!!

When I hit the supermarket these days, I’m seeing canned and frozen vegetables and fruits flying off the shelves.  All good, because they’re shelf-stable and many folks are minimizing trips anywhere, including to the supermarket.  Yet the fresh produce section, loaded with colorful, delicious fresh fruits and vegetables, isn’t feeling the love. 

That’s a problem.  There seem to be concerns about buying and eating produce these days, especially if it’s sold in bulk, since other consumers might have handled it.  

Feel Good About Eating Fresh Produce

No reason in the least to avoid eating fresh fruits and vegetables.  Yes, you need to wash it.  You’ve ALWAYS needed to wash it.  You DON’T need to wash it with anything special.  Here are 7 terrific tips, straight from the FDA website, for washing fruits and vegetables so you can eat them with confidence, :

  • Wash your hands for 20 seconds with warm water and soap before and after preparing fresh produce.
  • If damage or bruising occurs before eating or handling, cut away the damaged or bruised areas before preparing or eating.
  • Rinse produce BEFORE you peel it, so dirt and bacteria aren’t transferred from the knife onto the fruit or vegetable.
  • Gently rub produce while holding under plain running water. There’s no need to use soap or a produce wash.
  • Use a clean vegetable brush to scrub firm produce, such as melons and cucumbers.
  • Dry produce with a clean cloth or paper towel to further reduce bacteria that may be present.
  • Remove the outermost leaves of a head of lettuce or cabbage.

COVID-19 note: Your risk of getting it from food is slim to none.  Check This graphic from the University of Georgia Extension.  I love it because it tells you how you WON’T get COVID-19, and you won’t get it from food. 

Your stomach acid HATES this virus as much as you do.  It’s part of our body’s protective barrier.  Stomach acid has a very low pH (meaning it’s a strong acid) and the virus can’t survive that.  Plus, the virus needs to get to you through your respiratory tract, not your GI tract.  The tips on washing your produce however, still holds.  Consider it part of “best practices” on the home front.

 

Long before COVID-19, I wanted to be prudent and remove whatever dirt and such that might have accumulated on the skin.  In our home, we’re eating lots of root vegetables like carrots, beets, and potatoes, especially now, because that’s what’s left in the farmers’ market, and since these veggies grow in the ground, it makes sense to give them a good scrubbing.  (Note, in the photo below there’s also kohlrabi and celery root on the left and right, respectively — other root veggies definitely worth trying!) I do the same for oranges and apples, too, though.  Food safety is not just a farmer’s responsibility, it’s mine and all of ours as well. 

Biggest Pandemic: 9 Out of 10 STILL Don’t Eat Enough Fruits & Veggies!

The latest from the 2020 US Dietary Guidelines Advisory Committee established that average COMBINED intake of fruits and vegetables is just under 2½ cups a day, and that includes 100% fruit juice.  Specifically, average consumption of fruit is 0.9 cups a day of fruit and 1.4 cups of vegetables.  This accounts for all of it – including your 100% juice and the lettuce on your sandwich.  This is about what it’s been for the past 20 years.  Not much progress.

I’m not going to bother you with the Mt. Everest of research about the bennies of eating 5 cups a day of fruits and vegetables.  Unless you’ve been licving under a rock for the past 50 or so years, you know how beneficial eating fruits and vegetables can be for your health – and your taste buds.   I’m just going to say we can do better.

Cut To The Chase Nutrition take-away: I don’t’ split hairs here.  While 2½ cups of vegetables and 1½ cups of fruit are the recommended minimums, don’t obsess.  If your consumption adds up to at least 4 cups a day, in any combo, and regardless of whether they’re fresh, canned, frozen or dried, take a bow.  Keep the juice to a max of 1 cup though, and the dried fruit to 1/4 cup or so if you’re watching calories. 

Otherwise eat up.   

7 Nutrition Myths These Dietitians Are Busting

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

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

Carbo-phobia!

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

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

Plant “Milk” Deserves No Halo

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

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

Stop Kicking The Canned Foods!

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

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

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

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

Don’t Panic If It’s Not Organic

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

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

White Foods Are Bright Foods!

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

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

One Diet DOESN’T For Everyone?  Seriously?

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

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

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

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

Plant-Based Doesn’t Mean Plants-ONLY

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

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

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

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

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

Your “Dream Drug”

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

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

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

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

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

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

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

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

Why I Love This Study

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

Starting Moving

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

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

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

Start “DASH-ing” 

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

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

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

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.