WHAT’S ON YOUR PLATE?

 By Marie Dufour RD – Why are health and nutrition news so confusing and, at times, so contradictory? Depending on the investigating body and the financial backer of the study, various foods and their components are alternatively “good” or “bad” for us. Immediately, the hungry media seize the marketing opportunity and feed us at nauseum their re-packaged slugs.

- “Eat nuts,” and the compliant public stashes 1lb-baggies of almonds in their lunch boxes, not realizing that the healthy dose is 7 nuts a day.

- “Eat olive oil,” and we’re now soaking whole slices of bread in plates of olive oil, not even thinking of the total caloric intake of the “healthy snack.”

- “Omega 3, baby!” and we’re popping capsules on top of eating farm-raised salmon, forgetting that there is a healthy balance between omega 3 and omega 6.

Sparking at each diet news like a firecracker on the 4th of july, we do not take the time to look at what really matters: what goes in our plate. I mean, the whole meal, 3 meals a day, 7 days a week, year after year. I bet that if I sent out a survey right now, not even 10% of the responders would tell me that they have their next 3 days meals planned. But their cupboards are filled with food substitutes, their cars littered with fast-food wrappers, and their bathrooms stacked with “xxx Health Magazines.”

To help with re-connecting us to our plates, there are actually a few well-thought and comprehensive websites. One of my favorites is “THE NEW AMERICAN PLATE” by the American Institute for Cancer Research. Check it out at: http://www.aicr.org/site/PageServer?pagename=pub_nap_index_21

ENOUGH of eating out of baggies, on-a-stick, paper-wrapped, walking, driving, on-the-phone! Let’s sit down and eat out of a plate a well-thought and balanced meal.

And don’t whine and tell me it’s hard, because it is a lot harder to eat a well-balanced meal in a hospital bed!

Marie Dufour RD does not have any connection with AICR.

Filed under: diet , cancer nutrition, diet, healthy eating, healthy lifestyle, healthy living, Marie Dufour RD, New American Plate, weight control

Alcohol kills 1 in 25 worldwide

by Marie Dufour, RD – Alcohol consumption is the cause of one in 25 deaths worldwide, one in 10 in Europe. World-average consumption is about 12 drinks per week, but Americans drink 50% more that the average (18/week). Along the Mediterranean, however, the consumption drops to 1.3 drinks per week. And in Asia, consumption is rapidly rising. The world is bingeing itself to death and global action needs to start now.

Health care professionals and consumer advocates need to initiate grass-roots approaches to arouse public awareness regarding the burden of alcohol over-consumption.

Ref: Jürgen Rehm, et al. – “Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders;”  The Lancet, Volume 373, Issue 9682, Pages 2223 – 2233, 27 June 2009
doi:10.1016/S0140-6736(09)60746-7

Filed under: diet , alcohol, healthy living, Marie Dufour RD, Mediterranean Diet, public health

DIET? MEDITERRANEAN!

 By Marie Dufour, RD – Analyzing the data of over 23,000 men and women followed for 8.5 years by European Prospective Investigation into Cancer and Nutrition (EPIC) study, researchers found that mortality dropped with tighter adherence to the Mediterranean diet (13.5% per two-unit increase on a 10-point adherence scale).

They monitored the relative intakes of alcohol intake, meat and meat products, vegetable, high fruit and nut, monounsaturated-to-saturated fat ratio, legumes, cereal and dairy consumption. In my book, that’s 8 components, and a statistical 12.5% chance for individual contribution of each element.

Here is how the micro-analysis of individual contribution to the total effect stacked up:

- Moderate alcohol intake: 23.5%

- Low intake of meat and meat products: 16.6%

- High vegetable intake: 16.2%

- High fruit and nut consumption: 11.2%

 - High monounsaturated-to-saturated fat intake: 10.6%

- High intake of legumes: 9.7%

 - High cereal intake: 6.1%

- Low dairy consumption: 4.5%

Really, these results can be cooked up at any sauce. So, to your saucepans!

- If you eat less meat, you’re going to eat more vegetables: add these ingredients to each other, and they now contribute to 32.8% of the benefits.

- Don’t like veggies? Fine, eat less meat and replace it with legumes, and you still get a combined effect of 26.3%

- Don’t like legumes nor veggies, but would rather eat fruit? That’s a combined effect of 27%.

The problem I see with the way researchers presented the results is that they did not account for total food combinations. What is sure, is that the red wine that accompanies the food stands alone from the rest. What is also sure is that a diet low in meat and high in vegetable, fruit, nuts and legumes promotes total health and longevity. As for the word “alcohol” in the result, I understand that it is mostly red wine taken with meals, which denotes a very different lifestyle than a couple scotch downed in a bar.

Based on this study, I wouldn’t advise non-drinkers to go and start drinking but I would advise heavy drinkers to moderate their drinking. But mostly, I would remind all consumers to take such publicized headlines with… a grain of salt!

Reference: Trichopoulou A, et al “Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study” BMJ 2009; 338: b2337.

Filed under: diet , alcohol, diet, healthy eating, healthy lifestyle, Marie Dufour RD, Mediterranean Diet, nutrition, weight control

PANCREATIC CANCER TARGETS OVERWEIGHT YOUNG ADULTS

 By Marie Dufour, RD - Being overweight (body mass index / BMI 25 to 29.9) before the age of 39 increases by 2/3 the risk of developing pancreatic cancer. Being obese (BMI greater than 30) before the age of 39 more than doubles that risk, say researchers from the M.D. Anderson Cancer Center in Houston.

But there is more. In their study of 841 cases, investigators found that obese and overweight individuals past the age of 30 with pancreatic cancer had reduced survival rates, regardless of disease stage. AND… they had an earlier onset of the disease (59 years old, versus 64.)

The odds of getting pancreatic cancer were doubled in smokers, even occasional smokers.

WHY? do we ask. Could insulin dysregulation associated with excess weight be one of the mechanisms for the onset of pancreatic cancer? It would make sense.

Every time we eat, the pancreas is put to work, in great part to produce insulin, but also to produce digestive enzymes that break down carbohydrates, protein and fat. Could repeated –or perhaps excessive– demands on the pancreas create constant irritation and promote cancer in susceptible individuals? It is quite possible.

Although the lifetime risk of developing pancreatic cancer is only 1.31%, it is a very aggressive form of cancer and is the fourth leading cause of cancer death overall. An estimated 42,000 Americans will be diagnosed with this condition in 2009.  Mostly, it is partly preventable by keeping a healthy weight, particularly during young adulthood.

So, watch your waistlines. Women with a waist circumference of 31″ or more, and men with a waist circumference of 37″ or more qualify as overweight and at higher risk for pancreatic cancer.

Reference: Li D, et al “Body mass index and risk, age of onset, and survival in patients with pancreatic cancer” JAMA 2009; 301: 2553-62.

Filed under: diet , cancer nutrition, diet, healthy lifestyle, Marie Dufour RD, nutrition, obesity, pancreatic cancer, weight control

HEALTHY LIFESTYLES ON THE DECLINE

By Marie Dufour, RD – Since the 1980s, we’ve seen an explosion of gyms, nutrition stores, miraculous diets, and a plethora of health magazines, yet only half as many American adults engage in healthy lifestyles as they did two decades ago.

Taking results from NHANES (National Health and Nutrition Examination Survey) 2001-2006, researchers considered five healthy behaviors in their patients ages 40 to 74 and compared them to the 1988-1994 data. The five healthy behaviors were: maintaining a healthy weight, eating fruits and vegetables, drinking alcohol in moderation, exercising, and not smoking .  Twenty years ago, 15% of patients engaged in all five healthy behaviors. Today, only 8% of them do. That’s just a little more than half.

Here is how it breaks down, compared to 1988:

- 36% of the patients are now obese (BMI 30 or greater): 8% more

- 43% are regular exercisers (at least 12 times a month): 10% fewer

- 26% eat five servings or more of fruits and vegetables daily: 16% fewer

- 51% drink alcohol in moderation (1 drink/day for women, 2/day for men): 11% more

- 26.5% are smokers: unchanged.

And, surprisingly, patients with hypertension, diabetes, or cardiovascular disease are no more likely to adopt healthy lifestyle than those without these conditions.

What’s going on? We drink more, exercise less, eat less fruit and vegetables, get thicker around the waist, and WE DON’T CARE if it makes us sick.

Are we not caring about our health any more? Are we just dreaming that technology and pills are going to get us magically well? Are we thinking that watching Dancing With the Stars on Blue Ray will count as our cardiovascular workout? Is Emeril or The Iron Chef migrating in our kitchens and making us forget about basic healthy nutrition? And are we simply hoping that the latest fat-burning pill or restrictive diet will keep us away from obesity? At the grocery store, did we substitute the stop at the produce department for a run through the nutritional supplement aisle?

Being healthy doesn’t come in a pill, nor can it be infused from the TV screen. A healthy lifestyle takes dedication and planning. How do you start? A walk around the block is a good debut. If that’s not feasible, an old Jane Fonda video will do!

Reference: King DE, et al “Adherence to healthy lifestyle habits in U.S. adults, 1988-2006″ Am J Med 2009; 122: 528-34.

Filed under: diet , alcohol, diet, healthy lifestyle, Marie Dufour RD, nutrition, obesity, public health

Atkins’ Green Twist

By marie Dufour, RD  – Dr. Atkins is long gone, but his marketing machine lives.  Propelled by the soy and almond industries, a new study heralds the weight-loss benefit of a plant protein-based diet.  But should we go all out on textured soy protein yet and keep loading up on almonds?  Hold your shopping carts! 

- During a four-week period, researchers fed 47 overweight men and women only 60% of their caloric needs.  One group was fed the “Eco-Atkins” diet, with 26% of calories from carbohydrates, 31% from protein, and 43% from fat (26/31/43).  All from plant foods.

The other group was fed a high-carbohydrate vegetarian diet with low-fat dairy and whole-grain products, which included 58% of the calories from carbohydrates, 16% from protein, and 25% from fat (58/16/25).

Both groups lost a similar amount of weight and both groups improved their lipid profiles, although the “Eco-Atkins” showed a slightly greater reduction in LDL (20.4% vs. 12.3%).

The “Greentwist” on the Atkins diet advocates proteins from gluten, soy, nuts, fruits, vegetables, cereals, and vegetable oils, and is all looks oh-so-good for you!  But there are really 3 issues here:

- Anyone who eats 60% of their caloric needs is going to lose weight. PERIOD!  By the same token, the lipid profile will improve.  And anyone can follow any kind of restrictive diet for four weeks. 

- As demonstrated over and over, the long-term sustainability of an Atkins-type restrictive diet is dubious, and after one year there has been no shown difference in weight loss between Atkins and other dieters.  The lack of palatability and the restricted choices are an issue with Atkins-type diets.

- The Eco-Atkins nutritional balance is still out of whack: too high in fat (and unbalanced fatty acid distribution) and way too low in carbohydrates (75g for a 1200 Kcal diet.)

While the soy and almond industries are drumming up yet another consumer hype, let’s remember that, when it comes to weight loss, it’s all about calories.  When it comes to sustained weight loss, it’s about calories and palatability.  And when it comes to healthy life-long weight control, it’s about calories, palatability, and balance.

 

Reference: Jenkins D, et al “The effect of a plant-based low-carbohydrate (“Eco-Atkins”) diet on body weight and blood lipid concentrations in hyperlipidemic subjects” Arch Intern Med 2009;169: 1046-54

Filed under: diet , Atkins, diet, healthy eating, healthy lifestyle, low-carb diet, Marie Dufour RD, nutrition, obesity, weight control, weight loss

Curbside Produce to Curb Obesity

This morning’s story comes to us from Canada where investigators found that people were 25% less likely to be obese if they lived in an area with fewer fast-food outlets than supermarkets, “The proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity.”

Would you agree that, as a specie, we’ll get our nutritional needs where the least effort is required?  Why would we expand energy to then have to refuel?  It’s counter-nature (unless, of course, we want to lose weight.)  In the Canadian study, researchers drew the line at 800 meters. What is that?  Half a block or so?  I draw the line at curbside. 

I was driving my clunky car through the chaotic stone-paved streets of Asuncion (Paraguay) this morning when I came across a stand at roadside.  I rolled down my window and the stand attendant started to load my canvas bag with his merchandise: bananas, pears, apples, white lettuce, baby carrots, red onions, yellow peppers, eggs from the farm and fresh cilantro.  And I thought how lucky I was to work in a third-world country where you could still buy fresh produce at curbside.  Not that the big marketing machines are absent.  At the next big light, I was assailed by the soda vendor, the chip peddler, and the candyman but I did not roll down my window. 

So I say, bring back the fruit-and-veggie stand at the street corner, at the school gate, at the baseball field.  Let’s have cities issue inexpensive food cart licenses, provided that the carts only carry pre-approved healthy merchandise.  It could help us hunt and gather close to home and help us keep that so-called obesity “epidemic” in check.

reference: Spence JC, et al “Relation between local food environments and obesity among adults” BMC Public Health 2009; DOI: 10.1186/1471-2458-9-192. 

Filed under: diet , community nutrition, diet, nutrition, obesity, public health, weight control, weight loss

Calcium Diet Bites the Dust

by Marie Dufour, RD.  Calcium diet bites the dust… but don’t toss your yogurt out the window yet!

 A recent study reported that calcium supplementation (1,500 mg of calcium carbonate daily) was “unlikely to have clinically significant efficacy as a preventive measure against weight gain in patients who are already overweight or obese.” Perhaps the results would have been different if the researchers had used calcium citrate, better absorbed. But I doubt it. But, why the research in the first place?

Back in 2000, Dr. Michael Zemel published a bombshell paper stating that three or four daily servings of low-fat dairy products can help us lose fat and get thinner. Dr. Zemel and his fellow researchers proposed metabolic pathways for fat burning inside our fat cells that were novel and attractive. Calcium acted as a fat-burning machine. The more calcium was stored in a fat cell, the more fat would be burnt. Genial for fat loss. Genial for weigh loss. Genial for Dr. Zemel and the entire dairy industry. We all went on the 2-to-3-non-fat-yogurt-a-day-diet. And yes, we lost weight (ah, we also watched our calories…) Dr. Zemel’s theory seemed to work. Thinking of it, it has not been disproved yet.

What has been proved, however, is that calcium pills, as supplement, do not have the same effect. Why is that? We really don’t know. It seems that MILK SOLIDS have a role to play in calcium metabolism, but that role has not been explained yet.

But don’t throw away your calcium pills either. Calcium citrate, taken between meals, is a good supplementation if you don’t drink milk or don’t eat yogurt. However, calcium pills won’t make you skinny.

So, if you want to lose weight, eat less, move more (ouch, I said it again!) and enjoy your 3 to 34servings of non-fat (sugarless) dairy (milk or yogurt) a day.

reference: Yanovski JA, et al “Effects of calcium supplementation on body weight and adiposity in overweight and obese adults” Ann Intern Med 2009; 150: 821-29.

Filed under: diet , calcium diet, dairy products, healthy eating, nutrition, obesity, weight loss

Is Moderate Drinking good for you?

by Marie Dufour, RD - More than 100 studies link moderate drinking to heart health, as alcohol has been found to increase the “good” cholesterol (HDL) and to have anti-clotting effects. Based on these studies, the 2005 Dietary Guidelines state that alcohol may have beneficial effects when consumed in moderation (one to two drinks per day.) In other words, one would be better off drinking moderately than abstaining from drinking. Or, re-stated, not drinking may be a health danger. The media have taken a hold of this message and, pushed by the marketing machine of the alcohol industry, are just short of promoting moderate drinking as heart disease prevention.

It is true that observational studies have shown that abstainers, as a group, have a higher overall mortality risk than moderate drinkers. But can those two groups even be compared? Does moderate drinking make people healthy, or is moderate drinking something healthy people do? The answer, I think, lay with the populations’ socio-economic strata.

Who are the non-drinkers? Are they are people who stopped drinking because they already had heart disease or another chronic illness? People whose self-imposed restrictive diets present nutritional deficiencies and cause illnesses? Older people who have stopped drinking as they aged and whose overall mortality rate is higher? A social stratum that is economically disadvantaged, consequently with restricted access to health care and at higher risk for disease? Could it be that the non-drinkers are simply an adverse-selection population and that their higher mortality has nothing to do with alcohol consumption?

And who are the moderate drinkers? A study from the CDC found that moderate drinkers were wealthier, more educated, had better health care. They were found more likely to eat right and exercise, and even to have all of their teeth, a marker of well-being. Could it be, then, that moderate drinkers represent a socially advantaged stratum and their lower mortality has nothing to do with their alcohol consumption?

The two groups are so different that they shouldn’t be compared, and suggesting that abstaining from drinking increases one’s disease risk is a fallacy. In addition, no study has shown a cause-to effect relationship between moderate drinking and lower risk of death — only that the two often co-exist.

The most recent studies link drinking, even in moderation, to stomach and pancreatic cancers. It is unwise, therefore, to recommend non-drinkers to start drinking in order to protect their health, and moderate drinkers should weight the benefits of possibly higher HDL and anti-clotting effects against the danger of cancer and liver disease.

In that regard, why not study the benefits of eating fish and exercising daily compared to drinking alcohol daily? We might just get the same benefits without the risks.

Filed under: diet , alcohol, drinking, dufour, health, healthy lifestyle, nutrition

Of TV, Screens, Autism & Weight Control

In today’s medical news, researchers found that the more time young children spend in front of the TV, the less exposure they have to adult voices and the less likely they are to speak themselves _(1).  This echoed a 2006 Cornell University study where researchers found that the more time toddlers spent in front of the television, the more likely they were to exhibit symptoms of autism disorders.₍₂₎

This caught my attention because children on the autistic spectrum have specific nutritional needs.  But since this morning’s report also mentioned the correlation between the hours of passive screen exposure (TV, computers, videogames) and childhood overweight, let’s look at the effect of passive screen time in young children.

Literature on the subject abounds.  For example, in a review of 31 possible early-life risk factors, television viewing was associated with increased risk of overweight at age seven. Incidentally, the presence of a television set in the bedroom outweighed the impact of hours of TV alone. High amounts of TV were shown to have a number of other negative outcomes: poor scholastic performance, poorer food choices, less sleep
, less play and limited social interaction.
₍₃₎

We cannot deny that, over the last 50 years, the advent of “screens” has drastically altered our behaviours.  TV, of course, but also computers, video games, up to the latest iPhones and Blackberries, have generated a plugged-in society that passively feeds on images, craves instantaneous data and often suffers from information indigestion and facts intolerance.

 That we, insatiable adult consumers, should end up with leaner pocketbooks and fatter waistlines, is our personal choice.  But that we should blissfully expose our younger generations to well-known health and developmental risks is irresponsible.

It is utopia, however, to think of eliminating screen time.  Therefore, parents and educators have a duty to properly manage exposure to limit risks. 

- Turn the TV off and physically play. Hide-and-go-seek is a good start. Plastic bottles make for a great indoor bowling alley.  Small paper plates become indoor freesbees.  

- Cook with the kids.  I you don’t know how to cook, learn!  If kids are to eat well, parents need to teach them.  No one else will.

- Eat at the table, family style.  That’s right, even a family of two can sit together, eating and talking, with the TV off, the phones off, and no video game at the table.

It’s not too late to redress the odds and make sure that the younger generations do not, as reported, have a shorter life expectancy than their parents.

References:

1 – Christakis D, et al “Audible television and decreased adult words, infant vocalizations, and conversational turns” Arch Pediatr Adolesc Med 2009; 163: 554-58.

2 – Waldman & al, “Does television cause autism?” Cornell University 2006

3 – Gibbons K, “Interventions for childhood overweight and obesity: a place for parenting skills” 2007 Jour. Dietitians Assoc. Australia 

Filed under: Lifestyle, diet , healthy lifestyle