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Sweet News About Sugar Substitutes

August 4, 2010

Clearly, Americans eat too much sugar—some 142 pounds per person per year, by one report. Excess sugar contributes to weight gain and has been linked to increased risk for heart disease, diabetes, and other medical conditions. But are sugar substitutes the solution? The research has been mixed and inconclusive—and thus there are no official recommendations regarding the use of these products for weight control.

Earlier this year, we reported on an animal study that seemed to debunk the idea that artificial sweeteners can aid in weight loss. It found that rats fed saccharin consumed more calories than rats fed sugar, suggesting that artificially sweetened foods offer no weight-loss advantage and may even promote weight gain. Results of a new studyin people—are more promising, however.

Published in the journal Appetite, the latest research compared the effects of two sugar substitutes (aspartame and stevia) and sucrose (table sugar) on subsequent food intake in 19 healthy lean and 12 obese people, ages 18 to 50. On three separate days they were given snacks that contained one of the three sweeteners and then allowed to eat as much or as little food as they wanted at lunch and dinner. Blood samples were taken before and after eating to measure blood sugar levels.

When the participants ate the stevia- and aspartame-sweetened snacks, they consumed significantly fewer calories over the entire day, compared to when they ate the sucrose-sweetened snack. This was largely due to the calorie differences in the snacks, the researchers explained. (The aspartame and stevia-sweetened snacks had about 300 calories versus close to 500 calories in the sucrose-sweetened snack—a 200-calorie-a-day difference.) Moreover, the participants reported feeling just as satisfied and full when they ate the stevia- and aspartame-sweetened snacks, even though they ate fewer total calories. Also significant: the sugar substitutes, particularly stevia, resulted in lower blood sugar levels, compared to the sucrose.

The bottom line: Though the study was small, it found that people who consumed sugar substitutes did not compensate by overeating later on, as some previous studies have suggested. "Using stevia or aspartame in place of sucrose (i.e., sugar) in the diet may be an effective strategy to manage food intake since hunger and satiety levels were similar in all three conditions," the researchers concluded.

Does this mean you can have your artificially-sweetened cake and eat it too, without gaining weight? No way. Cakes, cookies, and other foods that contain sugar substitutes may have fewer calories than their sugary counterparts, but they are not necessarily low in calories. Sugar is a major source of empty calories in our diets, but weight gain occurs when you eat more calories over time from any source—sugars and carbs, fat, and protein—than your body burns. And the only way to lose weight is to eat fewer total calories and/or burn more calories through physical activity.

Source: Anton, Coulon, Cefalu, Geiselman and Williamson. "Effects of Stevia, Aspartame and Sucrose on Food Intake, Satiety and Postprandial Glucose and Insulin Levels." Appetite. 2010 Aug;55(1):37-43.

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A Juicy Sleep Solution?

August 4, 2010

Millions of people deal with insomnia by taking over-the-counter or prescription sleeping pills, which can cause drowsiness that impairs performance the next day, among other side effects. Now, preliminary research from the University of Rochester and University of Pennsylvania suggests there may be a tastier way to get a better night's sleep—if you like tart cherry juice, that is.

It's long been thought that tart cherries have a sleep-inducing effect, primarily due to their relatively high levels of melatonin, a substance naturally produced by the body that helps regulate sleep. This new study, in the Journal of Medicinal Food, is the first to actually test the claim, under controlled conditions. It included 15 older people who had moderate to severe insomnia but were otherwise healthy.

For two weeks, the participants drank two 8-ounce cups of tart cherry juice a day—once in the morning and then again 1 to 2 hours before going to bed. For another two weeks, they drank a placebo beverage, which looked and tasted like cherry juice but lacked the natural substances. Compared to the placebo, the tart cherry juice—which provided the equivalent of about 100 cherries a day—produced significant reductions in insomnia severity (fewer minutes awake after sleep onset)—though no improvements were seen for sleep latency, total sleep time, or sleep efficiency.

The study had limitations. It was small, short in duration, and used self reports (not objective measures) of sleep. The findings, which were limited to begin with, may not generalize to other types of cherry juice or apply to other populations. And the benefits seen—though better than those reported in other studies for valerian (a touted sleep-aid herb)—were not as good as those seen with medication or behavioral changes. Still, the researchers concluded that tart cherry juice "has modest beneficial effects on sleep in older people with insomnia" over two weeks of use. Drinking tart cherry juice is worth a try if you have trouble sleeping. But be aware that if you add two cups a day to your diet, you will get about 250 extra calories and so will have to compensate elsewhere.

Beyond sleep. Even if cherry juice doesn't help you sleep better, there are other good reasons to imbibe—or eat all kinds of whole cherries. Besides melatonin, cherries are rich in antioxidants, particularly anthocyanins, the pigments that give red/blue/purple fruits and vegetables their intense color. Lab studies have shown that cherry anthocyanins inhibit inflammation and reduce oxidative stress implicated in chronic diseases such as arthritis, gout, cardiovascular disease, and diabetes. Pitted sweet cherries (90 calories a cup) are also a good source of vitamin C, potassium, and fiber. Tart cherries have slightly fewer calories and more vitamin C and are much richer in beta carotene and anthocyanins.

Here are other suggestions on how to get a good night's sleep:

  • Limit alcohol. It may make you sleep initially, but alcohol produces unsettled sleep and middle-of-the-night wake-ups.
  • Cut down on caffeine—in coffee, tea, and many sodas—especially in the afternoon and evening.
  • Don't smoke. Nicotine keeps some people awake.
  • Make your bedroom sleep-friendly. Put up darker shades; try earplugs or a "white noise" machine if you sleep in a noisy environment; keep your bedroom cool.
  • Set a regular time to go to bed and wake up, and stick to it, even on weekends.
  • Use your bed only for sleep and sex. Don't bring paperwork or food to bed.
  • Daytime exercise can promote sleep later, but don't exercise strenuously in the evening, since that may have the opposite effect.

Source: Pigeon, Carr, Gorman and Perlis. "Effects of a Tart Cherry Juice Beverage on the Sleep of Older Adults With Insomnia." Journal of Medicinal Food. 2010 Jun;13(3):579-83.

So Long Sugar, Fat & Salt, Say New Guidelines

July 20, 2010

Every five years, the U.S. government unveils updated recommendations for how Americans (over age 2) should be eating for optimal health. The final draft of the 2010 Dietary Guidelines for Americans, as the recommendations are called, are due out at the end of the year.

The recommendations are based on a review of new literature on diet and health, says Joanne L. Slavin, Ph.D., R.D., a member of the 2010 Dietary Guidelines Advisory Committee. And not surprisingly, "the obesity problem, especially in children, was a key focus of our work."

Overall, the guidelines haven't changed much over the last 30 years since they were first issued—they generally encourage Americans to eat less, move more, and make overall smarter food and lifestyle choices.

But here's a sneak preview of some notable changes since the 2005 edition, along with some commentary on them:

  • Limit saturated fat to less than 7% of calories. That's down from 10%. Saturated fat contributes to high blood cholesterol and is linked to an increased risk of heart disease.
    How: Replace saturated fats (which are found predominantly in animal foods, such as whole dairy foods, butter, and meat) with mono- or polyunsaturated fats (as found in vegetables oils such as olive, canola, sunflower, and soy oil).
  • Avoid trans fats created during food processing. This is a key change from the 2005 Guidelines, which advised limiting trans fats, not avoiding them altogether. Trans fats are created when healthful vegetable oils undergo a process called partial hydrogenation. These solid fats are especially harmful because they increase LDL ("bad") cholesterol, decrease HDL ("good") cholesterol, and may contribute to inflammation, which is implicated in heart disease and other illnesses.
    How: If a food label states "zero trans fat," it may contain up to 0.5 grams of trans fat per serving. To avoid industrial trans fat altogether, check the ingredients list. If any "partially hydrogenated" oils are present, the food contains some trans fat. Natural trans fat, present in some animal foods, is not a health concern.
  • Limit sodium to 1,500 milligrams a day, down from 2,300 milligrams. Excess sodium contributes to high blood pressure, which leads to heart disease and strokes, the leading causes of death in America. Previously, only certain people—middle-aged and older adults, African Americans, and those who already have hypertension—were advised to restrict sodium to 1,500 milligrams. But since 70% of Americans fit into those groups, the lower limit is now the recommendation for the general population. More potassium, which helps lower blood pressure, is also recommended.
    How: Cut down on takeout and restaurant meals. At the grocery store, avoid packaged foods that are high in sodium (such as some varieties of canned vegetables, condiments, frozen meals, tomato sauce, soup mixes, etc.). To get more potassium, eat at least 2 cups of fruit and 2½ cups of vegetables a day.
  • Eat at least two servings (a total of 8 ounces) of seafood a week. This will provide an average of 250 milligrams of omega-3 fatty acids a day. According to the committee, there is "moderate evidence" that omega-3s reduce the risk of death from heart disease. Omega-3s are also important for pregnant and nursing women—though they should be especially careful about choosing seafood low in mercury.
    How: Consume fatty fish such as wild salmon, mackerel, herring, and sardines, since they are high in omega-3s.
  • To help in weight control, reduce sugary foods—namely sugar-sweetened beverages (like soda and sweetened bottle tea) and desserts (cakes and cookies). It's unclear, though, whether the final guidelines will specify a limit for added sugars—or just recommend that Americans "choose and prepare foods with little added sugars or caloric sweeteners," as the 2005 guidelines state. Last year, the American Heart Association advised that women consume no more than 25 grams (6 teaspoons or 100 calories' worth) of added sugar a day, and men no more than 37.5 grams (9 teaspoons or 150 calories' worth), despite objection from the sugar industry.
    How: Look at the ingredient list on packaged foods and beverages; if any form of sugar (including high fructose corn syrup, brown sugar, invert sugar, molasses, rice syrup, evaporated cane juice) is at the top or if sugars are listed multiple times throughout, skip them.
  • Get nutrients from food, not pills. "A daily multivitamin/mineral supplement does not offer health benefits to healthy Americans," according to the draft report, and it's no substitute for a healthy diet. "And in some settings, mineral/vitamin supplements have been associated with harmful effects and should be pursued cautiously." For example, some studies have shown that taking beta-carotene in pill form does not decrease the risk of cancer in healthy people and that supplemental beta-carotene, at high doses, may even increase lung cancer risk in some people. Still, some supplements—such as calcium, vitamin D, and iron—are beneficial for people with known deficiencies.

The new dietary recommendations have not yet been finalized—but there's good reason to start following them now. After all, along with getting more exercise, losing weight if you're overweight, and not smoking, a healthful diet may help decrease your risk for major illnesses, such as cardiovascular disease, diabetes, and certain cancers.

To view the 2010 draft report and see the current 2005 Dietary Guidelines, go to:

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Hot Flashes? Weight Loss Might Help

July 20, 2010

If you're a woman going through menopause, you may be experiencing bothersome hot flashes (also called hot flushes or night sweats). Studies have shown that overweight women get them more frequently and severely than their leaner counterparts. So might losing weight help? Recently, a study from U.C. San Francisco sought to answer that question by putting a group of overweight or obese women on a six-month intensive weight loss program.

The study, published in the Archives of Internal Medicine, included 338 women. Women in the "treatment" group, who met weekly with nutrition, exercise, and behavior change specialists, were encouraged to exercise at least 200 minutes a week and limit calories to 1,200 to 1,500 a day with the help of sample meal plans and meal-replacement products. The rest of the study participants served as "controls" and received general information about weight loss and exercise.

Compared to the women in the control group (who lost about 4 pounds, on average), the women in the intensive weight loss group (who lost an average of 17 pounds) were more than twice as likely to report an improvement in hot flashes after six months. And no matter which group the women were in, an association was seen between weight loss and reduced hot flashes.

Why might being overweight increase hot flashes? After all, overweight women have higher circulating estrogen levels, which would be expected to lessen symptoms of menopause, not increase them. On the other hand, excess fat hinders the body's ability to dissipate heat, which may worsen hot flashes. Overweight women may also experience changes in other hormones involved in body heat regulation, the researchers explain—or there may be some social or psychological factors that predispose them to reporting more menopausal symptoms.

The bottom line: Some research has shown that gains in body fat increase menopausal hot flashes. This study is a first to show that losing weight may help. "From a clinical perspective, our findings suggest that women who are overweight or obese and have bothersome hot flushes may be counseled that behavioral weight loss efforts may decrease the burden of their symptoms," the researchers conclude. But it may take several weeks or months to notice an improvement. In the meantime, if you’re bothered by hot flashes, talk to your doctor about other possible treatments.

Source: Archives of Internal Medicine, 170(13), 2010.

Restaurants Take Calorie Counts to the X-treme

June 22, 2010

How many calories does a meal at an American chain restaurant serve up? Far more than you may think. The non-profit Center for Science in the Public Interest recently doled out its 2010 Xtreme Eating Awards, which make McDonald's look like WeightWatchers®. Here's a look at some calorie "winners." To put the numbers into perspective, most people should eat about 2,000 calories and no more than 20 grams of saturated fat a day.

  • The Cheesecake Factory Pasta Carbonara with Chicken: 2,500 calories and 85 grams of saturated fat
  • Chevys Crab & Shrimp Quesadilla: 1,790 calories and 63 grams of saturated fat
  • California Kitchen Tostada Pizza: 1,440 calories and 27 grams of saturated fat
  • Bob Evans Cinnamon Cream Stacked & Stuffed Hotcakes: 1,380 calories and 27 grams of saturated fat
  • Five Guys Bacon Cheeseburger (without toppings): 920 calories and 30 grams of saturated fat

Don't assume that vegetable sides are low in calories, either. The veggies and potatoes that accompany the Outback's Rack of Lamb, for instance, add 520 calories. Not surprisingly, along with high calories comes lots of fat (as much as 85 grams saturated) and salt (as much as 7,690 milligrams).

Yes, these are the extremes. But most restaurant meals still have more calories than most people should eat at one sitting. A regular burger at Five Guys, for instance, has 700 calories—more than a Big Mac (540 calories, with toppings). Pasta dishes and pancakes can easily have 800 to 1,000 calories.

The new health-care legislation will require major chain restaurants to list calories on menus (many already do). This may prompt them to downsize their offerings. In the meantime, if you eat out, you might want to share an entrée with several people.

Source: Center for Science in the Public Interest

Reduce Breast Cancer Risk by 14% With Food

June 22, 2010

The role of diet in preventing breast cancer remains elusive. But a new study suggests that consuming foods rich in lignans, such as flaxseeds, may reduce the risk—at least a little, in older women. Published in the American Journal of Clinical Nutrition, the new research analyzed the data from 21 previous studies.

Higher lignan intake was associated with a 14% reduction in breast cancer risk in postmenopausal women, though no benefit was seen in younger women. Lignans are estrogen-like compounds that may inhibit cancer through various mechanisms that are different from how soy isoflavones (other estrogen-like compounds) may act. In particular, lignans may reduce the formation of new blood vessels to cancer cells, stimulate the death of cancer cells, and have antioxidant and other anti-carcinogenic properties, the researchers say. It's also possible that other constituents in lignan-rich foods, such as the healthy essential fatty acid alpha-linolenic acid, were responsible for the breast cancer protection.

If you want to try flaxseeds, consume them ground—whole flaxseeds simply pass through the body undigested. You can buy flaxseeds already ground or, better yet, buy them whole and grind them yourself—in a food processor, blender, or coffee grinder—just before eating. Keep flaxseeds refrigerated. With their nutty flavor, they can be a tasty addition to yogurt, oatmeal, soups, salads, smoothies, and stir-fries; you can also add them to bread, muffin, and pancake batters. Flaxseed oil is not a good source of lignans, unless it's unfiltered. Other lignan sources include sesame and pumpkin seeds, sprouts, berries, whole grains, and tea.

Source: Buck K, et al. Meta-analyses of lignans and enterolignans in relation to breast cancer risk. American Journal of Clinical Nutrition, 2010 May 12. [Epub ahead of print] doi: 10.3945/ajcn.2009.28573

Not Such a Nutty Idea

May 25, 2010

Looking for a good reason to snack on nuts? A new study in the Archives of Internal Medicine provides the best evidence yet that nuts help lower blood cholesterol and thus may potentially lower the risk of heart disease. That doesn't mean it's okay to eat the whole jar, but an ounce or two of nuts a day may be good preventive medicine.

Studies have consistently linked all kinds of nuts—from almonds to walnuts—to a markedly reduced risk of heart disease, largely because nuts have a favorable effect on blood cholesterol. In the latest analysis, researchers from Loma Linda University in California pooled the data from 25 studies from around the world, involving close to 600 people. Those who consumed 20% of their calories from nuts (that's 2.5 ounces of nuts a day for a 2,000 calorie diet) reduced their LDL ("bad") cholesterol by about 7%, though lower amounts were also effective. The benefits were greatest in people who had higher LDL to begin with and in those who ate a Western diet, compared to a healthier Mediterranean diet. Presumably, nuts have less benefit in people already eating a healthy diet. For unclear reasons, people who were thinner also benefited more.

Why go nuts? Nuts are rich in unsaturated fats, the kind that improve blood cholesterol, especially when eaten in place of animal fats and refined carbohydrates. Nuts are also rich in B vitamins, potassium, copper, magnesium, fiber, arginine (an amino acid that helps relax blood vessels), sterols (which also help lower cholesterol), and other plant substances that may benefit the heart in various ways. The FDA allows the "qualified" health claim that eating 1.5 ounces of nuts a day, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.

But don't go overboard. Nuts have 160 to 200 calories per ounce. Limiting yourself to an ounce or two a day may be enough to get some benefit. How many nuts are in an ounce? The numbers vary, but pistachios offer more nuts per ounce (47) than others, such as cashews (18), pecans (19 halves), and almonds (23).

Vitamin D: More Is Better

May 25, 2010

It's easy to fall short on vitamin D. Our bodies make vitamin D when we are exposed to sunlight, but it's found in limited foods, including fatty fish and fortified dairy foods and cereals. The government currently recommends 200 to 600 IU a day, depending on your age. But many health experts, including the International Osteoporosis Foundation (IOF), now believe that more is better, especially for older adults.

Vitamin D is essential for healthy bones and muscles. Getting adequate amounts helps prevent osteoporosis-related fractures and helps keep you strong. An increasing number of studies suggests that vitamin D may also help protect against certain cancers, heart disease, diabetes, autoimmune diseases, and other chronic conditions. Blood levels of vitamin D—an indicator of vitamin D status—decline with age, an indicator perhaps that older people need even higher amounts to keep up. As it is, vitamin D insufficiency and deficiency are common in people of all ages.

According to a new position statement from the IOF, written by Dr. Bess Dawson-Hughes at Tufts University and colleagues, older adults (over 60) need 800 to 1,000 IU of vitamin D a day to reach a minimum healthy blood level of the vitamin (30 ng/mL). The researchers reported their "evidence-based" recommendation, in the journal Osteoporosis International, after reviewing a large body of vitamin D science.

Here's what else the report said:

  • Some people may need even more vitamin D—as much as 2,000 IU a day. This group includes people who are obese, already have osteoporosis, have limited sun exposure, or have problems absorbing nutrients.
  • People at high-risk for vitamin D deficiency should have their blood levels tested. What vitamin D dose you need would depend on the results.
  • If you are treated with supplemental vitamin D by your doctor, you should be re-tested after three months to see if the treatment is working.

IOF is not the only health group to call for higher vitamin D intake. The Institute of Medicine, which sets the official nutrient recommendations, is likely to advise higher amounts as well this summer.

Fish Oil Supplements Have Fishy Brain Benefits

April 27, 2010

Fish is brain food, right? Well, sorry Charlie—the largest study to date has found no evidence that taking fish oil supplements improves memory or other cognitive functions in older people. Still, the findings, to be published in the American Journal of Clinical Nutrition, are not the last word on the subject—and there are other good reasons for some people to take fish oil supplements.

Called OPAL (short for the mouthful, "Older People And Omega-3 Long-chain polyunsaturated fatty acids"), the study included 867 "cognitively healthy" older people (ages 70 to 80) in the United Kingdom, who were given either fish oil capsules (700 mgs of omega-3s a day) or a placebo. After two years, those taking the fish oil had increased blood levels of omega-3s, but neither group showed improvements on a battery of cognitive tests that measured verbal and spatial memory, executive functioning, and mental processing speed. On the other hand, the current study may not have been long enough to see a difference, or the dose of fish oil may have been too low, the researchers say.

Fishing for other health benefits. Even if fish oil supplements won't help you remember where you left your keys or the name of an old acquaintance, there's strong evidence that eating fish helps reduce the risk of heart disease and stroke. Omega-3 fats in fish may help prevent arrhythmias (irregular heartbeats) and blood clots, reduce chronic inflammation, and help lower triglycerides and blood pressure. Many health experts recommend eating a variety of fatty fish at least twice a week. Some people—including those with very high triglycerides and those who already have heart disease—may additionally benefit from taking fish oil supplements—but talk to your doctor first.

The Food–Brain Connection

April 27, 2010

Eating a predominantly plant-based diet is good for your heart. And what's good for your heart is good for your brain, too, much research suggests. Now, a new study from Columbia University has found that people who eat a diet rich in certain plant foods, with some fish and poultry, may be better protected against developing Alzheimer's—a disease that affects more than five million Americans.

The study, published in the Archives of Neurology, analyzed the diets of 2,148 healthy older adults (65 and over) every 18 months over four years, during which time 253 of them were diagnosed with Alzheimer's disease. The participants were classified into seven groups based on their dietary patterns. Those who adhered most closely to a particular pattern—one with lots of tomatoes, dark and green leafy vegetables, cruciferous vegetables, fruits, nuts, fish, poultry, and vegetable oils—but low in red meat, organ meats, whole dairy foods, and butter—had a 38% lower risk of Alzheimer's disease.

A combination of nutrients in this dietary pattern—including polyunsaturated fats (omega-6s and omega-3s), vitamin E, and folate—may work together to protect the brain through various pathways, the researchers say. An earlier study by the same researchers found a lower risk of Alzheimer's disease in people eating a Mediterranean-style diet, which is similar in many ways to the dietary pattern identified as protective in the current study.

Putting it into perspective. How we eat is a complex issue, and much research looking at the role of diet and dementia has, not surprisingly, yielded inconsistent results. Moreover, the new study does not prove that following this dietary pattern will keep your mind sharp. But it does offer more evidence that eating a combination of healthy foods, rather than worrying about specific nutrients, is the best way to prevent disease.

The Balancing Act of Calcium and Vitamin D

April 13, 2010

How much calcium do you need to protect your bones from osteoporosis and its debilitating fractures? Though the U.S. government advises that adults get 1,000 to 1,200 milligrams a day, you may be surprised to know that these recommendations are somewhat arbitrary and that they vary from country to country. Moreover, studies haven't always shown that calcium even protects against fractures. Now, a new study from the USDA Human Nutrition Research Center on Aging at Tufts University suggests that you can get by with less calcium as long as you get more of this other critical bone nutrient—vitamin D.

Published in the Journal of Bone and Mineral Research, the study looked at the relationship between dietary calcium intake, vitamin D blood levels, and bone mineral density in 10,000 adults. Among women, higher calcium intake was associated with higher bone mineral density—but only in those who had low vitamin D levels. When vitamin D concentrations were adequate (50 nmol/L or above, according to the authors), consuming more than 566 milligrams of calcium had no further benefit on bone density. And among men, a calcium intake beyond 626 milligrams a day had no additional bone benefit.

Thus, the best way to protect your bones is not necessarily to increase your calcium intake, but to correct a potential vitamin D shortfall. Many experts now recommend 800 to 1,000 IU of vitamin D a day from a supplement. If your doctor tests your blood vitamin D level and finds it deficient, an even higher dose may be recommended.

Eggs Versus Bagels—Which Wins the Breakfast Battle?

April 13, 2010

There's no magic fix for being overweight—no diet pill, supplement, or fad diet. But certain foods may help keep hunger at bay better than others. Foods rich in protein, for example, may provide longer-lasting satiety, compared to foods high in carbohydrates. And a new study in Nutrition Research from the University of Connecticut suggests that eating protein-rich eggs for breakfast, in particular, may be sound diet advice.

The set up: The study, which included 21 men, compared two typical American breakfasts—eggs versus bagels. On one day, in random order, the men ate an egg breakfast (three scrambled eggs and toast) that provided 23% of calories from protein and 22% of calories from carbohydrates. On a second day, they ate a bagel breakfast (a bagel with low-fat cream cheese and six ounces of low-fat yogurt) that provided 72% of calories from carbs and 16% of calories from protein. Both breakfasts had the same number of calories. In the second part of the experiment, the men were given a buffet lunch three hours after breakfast and allowed to eat as much as they wanted until they felt satisfied.

The findings: On the day they ate the egg breakfast, the men ate 112 fewer calories at lunch—and about 400 fewer calories over the rest of the day—compared to when they ate the bagel breakfast. And they reported feeling less hungry and more satisfied three hours after the egg breakfast. Moreover, the egg breakfast kept their blood sugar levels more steady and suppressed ghrelin, a hormone that stimulates hunger. "These results suggest that foods with high-protein...and low in simple carbohydrates may be incorporated into the diet to decrease energy intake by reducing hunger," the paper concluded.

Breakfast ideas: With only about 60 to 80 calories each, eggs are a great high-protein, low-calorie way to start the day. Though an egg yolk contains 210 milligrams of cholesterol, some experts think that most people can consume 500 milligrams of cholesterol a day without it adversely affecting their blood cholesterol—plus, the yolk provides other important nutrients. If you already have high cholesterol, are at high risk for heart disease, or just want to get more protein without extra dietary cholesterol, you can choose egg whites instead of whole eggs or some combination (one whole egg with two egg whites, for example).

Keep in mind that other protein sources besides eggs are likely to have a similar appetite-suppressing effect (not surprisingly, this study was funded by the Egg Nutrition Center, which supports the egg industry). To get more protein at breakfast, you can also scramble up some tofu, spread nut butters on whole-grain bread, add non-fat dry milk powder to oatmeal, or look for dry cereals, milks, and yogurts that are fortified with extra protein.

Art Imitating Life?

March 30, 2010

It's no surprise to many people that portion sizes at restaurants have ballooned in recent years. But an eye-opening study to be published in the April issue of the International Journal of Obesity has found that our plates are getting super-sized in the art world as well—at least when it comes to the depiction of The Last Supper. So if you're watching your weight, here's what you should know before sitting down to your next meal.

Brian Wansink, a professor of consumer behavior at Cornell University, teamed with his brother, Craig Wansink, a professor of religious studies at Virginia Wesleyan College, to analyze the size of the plates and food portions in 52 paintings of The Last Supper dating back 1,000 years. Using state-of-the-art computer technology, they found that the plates have increased in size by 66%, entrees by 69%, and bread by 23%.

The last millennium has seen a rise in the production, safety, availability, and affordability of food—and the art world seems to be reflecting this evolution, the researchers say.

Sit-down message: Brian Wansink's ongoing research clearly shows how environmental cues, such as the size of your plate, can influence how much you eat—and the bigger the plate, the more you tend to eat, without even realizing it. One way, then, to help control your appetite is to use smaller plates (like salad size) for your main meals. You'll eat fewer calories yet will likely feel just as satisfied.

More Good Reason for Women to Get More Omega-3s

March 30, 2010

Low-fat diets have been recommended as a way to protect against endometriosis, a chronic painful condition that affects 10% to 15% of women and can result in infertility. But a large new study suggests that the type of fat matters more than the total amount. In fact, women at risk for endometriosis may want to eat more of a particular kind of fat and less of another.

Researchers from Brigham and Women's Hospital and Harvard Medical School tracked the diet habits of more than 70,000 women enrolled in the Nurses' Health Study over a period of about 10 years, during which time 1,199 women were diagnosed with endometriosis. Those who reported eating the most omega-3s—the type of fat found predominantly in fish—were 22% less likely to develop endometriosis than those who ate the least, after controlling for weight, race, and other factors that may contribute to the disease. And women who consumed the most trans fat—found in many processed and fried foods—increased their risk of endometriosis by 68%. The study, funded by the National Institutes of Health, was published online in the journal Human Reproduction.

The findings need to be confirmed in further research. But until then, there is other good reason to eat more omega-3s and less trans fat: doing so is good for your heart. The best sources of omega-3s are fatty fish such as sardines, mackerel, and salmon. Unhealthy trans fat, formed when vegetable oils are "partially hydrogenated" to make them more stable, is found in many commercial baked goods, snack foods, margarines, frozen dinners, and fried foods. The amount of trans fat must be listed on nutrition facts labels, but the surest way to know if some is present is to check the ingredients list for "partially hydrogenated" oils.

A Sweet Tax

March 17, 2010

No one likes paying more taxes. But a "soda tax" on sugary beverages, first proposed in New York State and now being considered in other states and municipalities, would benefit not just government coffers but also the nation's health, according to a new study from the University of North Carolina (UNC). It estimated just how much weight people stand to lose if they have to pay more for sugary beverages.

Reporting in the Archives of Internal Medicine, UNC researchers looked at the relationship between food prices and the calorie intake and body weight of more than 5,000 people over a 20-year period. Not surprisingly, when the price of a food goes up the less likely people are to consume it. In particular, if an 18% tax were levied on sugary beverages (the amount proposed in New York and the minimal tax being considered elsewhere), young and middle-aged adults would consume about 56 fewer calories a day, which could lead to a five-pound weight loss per person over a year. Higher soda prices were also associated with reduced insulin resistance.

Though the study had some limitations, the findings suggest that government policies that raise the price of sugary beverages and other unhealthy foods may help steer people toward better diets and help reduce long-term weight gain and possibly even diabetes over time, the researchers concluded.

Another tax perk: The revenue generated by a soda tax can be used to fund programs aimed at reducing obesity through education, structural interventions (such as adding more water fountains in schools instead of soda machines), and anti-soda marketing campaigns similar to those used successfully against smoking. A major hurdle to the soda tax, however, is the soda industry.

Crackdown on Food Claims

March 17, 2010

It's not hard to spot foods that make all kinds of nutrition and health claims, such as "high in antioxidants" and "contains zero grams of trans fat," on their labels—or even more bold statements on their websites and in ads that a product can prevent cancer, cure impotence, turn back aging, or have other extraordinary benefits. Late last month, the Food and Drug Administration (FDA) finally took steps to rein in how food companies market their products. It issued warning letters to 17 companies, charging them with making misleading and unapproved health claims on 22 foods, from juice and ice cream to olive oil and nuts.

According to the Center for Science in the Public Interest, "For far too long, manufacturers have exaggerated the healthfulness of their products, or even implied that their products contain special 'functional' ingredients that provide drug-like protection against various diseases." This crackdown is a welcome move by the government, which has long been criticized for failing to take action against such dishonest practices. The companies must take prompt action to correct the violations or they will be subject to further regulatory action.

Among the busts:

  • POM Wonderful, for saying or at least strongly implying on its website and in ads that its pomegranate juice can lower blood pressure, slow progression of prostate cancer, and improve erectile dysfunction, among other supposed benefits—in effect, for making medical claims, which foods cannot do unless the claims have been pre-approved by the FDA.
  • Sunsweet Growers, for describing its dried fruit mixes as "high antioxidant" and "full of nutritious antioxidants." These are unauthorized nutrient content claims because no recommended daily intake value for antioxidants has been established.
  • Dryer's, for highlighting on packages that some of its ice cream products contain no trans fat without providing a disclaimer that they also are high in saturated fat.
  • Spectrum Organic All Vegetable Shortening, for making a cholesterol-free claim when the product contains 6 grams of saturated fat per tablespoon. A food cannot use the term "cholesterol free" on its label if it contains more than 2 grams of saturated fat per serving.
  • Pompeian, for making unauthorized therapeutic claims about its olive oil that establish the product as a drug. The website says, for example, that olive oil protects against a variety of cancers, helps lower LDL ("bad") cholesterol, and protects against blood clots.
  • Diamond Foods, for stating on its walnut packages that "the omega-3 in walnuts can help you get the proper balance of fatty acids your body needs for promoting and maintaining heart health," which suggests that the evidence supporting a relationship between walnuts and heart disease is related to the omega-3 fats in the nuts. "There is not sufficient evidence to identify a biologically active substance in walnuts that reduces the risk of CHD [coronary heart disease]. Therefore, the above statement is an unauthorized health claim," the FDA said.

Keep in mind that many of the foods "busted"—particularly olive oil, walnuts, and pomegranate juice—are certainly healthy foods. But no single food can prevent or cure a disease.

Get Calcium, Live Longer?

March 2, 2010

Many men don't pay much attention to their calcium needs. But a new study offers some food for thought as to why they should—and it has nothing to do with bone health. According to researchers from the Karolinska Institute in Sweden, getting nearly double the recommended daily intake of calcium may, in fact, be a lifesaver for some men.

The study, which will be published in the American Journal of Epidemiology, looked at the food habits of more than 23,000 middle-aged and older men. Those who consumed the most calcium (1,953 milligrams a day from food, not supplements) were 25% less likely to die from all causes than those who consumed the least (990 milligrams), over an average of 10 years. There was also a trend toward reduced risk of death from heart disease, in particular, in men consuming the most calcium. Another mineral, magnesium, was not protective at all. According to the researchers, calcium may have a positive effect on blood pressure, cholesterol, and blood sugar levels.

Your calcium needs: Adults should aim for at least 800 to 1,000 milligrams of calcium a day; adults age 51 and older need at least 1,200 milligrams a day. Calcium not only builds and maintains strong bones, it's also needed for muscle contractions, transmission of nerve impulses, blood clotting, and other body functions. The upper tolerable limit for calcium is 2,500 milligrams a day.

Before you crank up the calcium: This was a population-based study that only observed a relationship between dietary calcium and all-cause mortality—it does not prove that calcium is the reason for the benefit. Also, Swedish men apparently consume a lot of calcium to begin with (even those in the lowest-intake group nearly met the daily recommendation), and it might be something else about their diets or lifestyle that is protective. Keep in mind, too, that the study did not look at calcium supplements—and high-dose supplements may not have the same effect as getting calcium from food. Dairy foods are richest in calcium; leafy greens, broccoli, tofu (processed with calcium), fortified soymilks and cereals, canned salmon (with the bones), and almonds are also good sources.

Trans Fats—Bad for the Brain

March 2, 2010

Trans fats are bad for the heart because they raise LDL ("bad") cholesterol and also lower HDL ("good") cholesterol. Now, new research from the University of North Carolina suggests that these fats—found in some fried foods (such as French fries and donuts), spreads, baked goods (such as crackers and pie crusts), and other processed foods—may also be bad for the brain.

The study, which involved more than 87,000 post-menopausal women participating in the ongoing Women's Health Initiative (WHI) Study, split the women into four groups, based on their fat intake, and followed them for eight years. Those in the top quartile for trans fat intake (7 grams a day, on average) were 30% more likely to suffer a clot-related stroke than women who ate the least (1 gram a day, on average), after controlling for other factors that affect stroke risk, such as age, blood pressure, smoking, physical activity, and fruit and vegetable intake.

Presented at the American Stroke Association's International Stroke Conference 2010, the study is the largest to date to look at the relationship between fat intake and stroke risk in women, and though its findings are preliminary, it offers good reason to cut back or eliminate trans fats from your diet.

Getting the trans out. The American Heart Association advises consuming no more than 1% of total calories from trans fats (that's less than 2 grams if you eat 2,000 calories a day). Manufacturers have reduced or eliminated these fats from many processed foods, and some fast-food restaurants have taken it out of their fries. But if you see "partially hydrogenated" oils or shortening in the ingredient list on a food package, some trans fat is still present. It's hard to avoid all trans fats, but eat as little as possible—foods that contain them tend not to be the most healthful anyway.

Beer for Bones?

February 17, 2010

If you drink beer regularly, you may be giving your bones a break—a break from osteoporosis, that is. According to new research from the University of California, Davis, beer is a rich source of silicon, a mineral that helps make and keep bones strong. In fact, beer is a major source of silicon in the Western diet, in a form that is readily absorbed by the body. But not all beers are created equal.

Researchers analyzed the raw materials used in beer making and various brewing styles; they then tested 100 commercial beers for their silicon levels. "Beers containing high levels of malted barley and hops are richest in silicon," the paper concludes. Here are some more specific findings of the study, which was published in the February issue of the Journal of the Science of Food and Agriculture:

  • Barley-based beers have more silicon than wheat-based beers. Silicon is concentrated in the husks of barley, which are not affected greatly during brewing.
  • Lighter-colored barley beers have more silicon than darker ones (such as chocolate, roasted barley, and black malt), because they undergo less heat stress during processing.
  • Hops, which are used as flavoring agents, had as much as four times more silicon than is found in malt. But hops are used in much smaller amounts. Still, you can expect "hoppier" beers to have more silicon.
  • On average, Indian Pale Ales (IPAs) had the most silicon, followed by other ales, and then lagers; wheat beers, light lagers, and non-alcoholic beers had the least silicon.
  • Overall, the beers contained 6.4 to 56.5 milligrams of silicon per liter. There's no official recommended daily intake level for silicon, but the average diet supplies about 20 to 50 milligrams a day.

Silicon is an often overlooked mineral that helps promote bone formation and prevent bone loss. A study several years ago found that men and pre-menopausal women with the highest silicon intake had higher bone mineral density at the hip. Other research has shown that people absorb the silicon from beer well.

The flipside of alcohol. Moderate alcohol consumption may be good for bones, and silicon in beer may be one reason why. But the study did not look at whether beer actually boosted bone health or reduced bone fractures caused by osteoporosis. Moreover, a high amount of alcohol is detrimental to bones (and has other harmful effects). Limit yourself to no more than one alcoholic drink a day (that's one 12-ounce beer) if you're a woman, and no more than two a day if you're a man. Other good sources of silicon include whole grains and cereals (such as oat bran and granola), and some fruits and vegetables (such as bananas, dates, and string beans).

Can Tea Take the Pressure Off?

February 17, 2010

If you have pre- or mild hypertension, your doctor has probably advised you to cut back on salt, step up the exercise, and lose weight if you're overweight. Such lifestyle changes are good first steps for getting blood pressure under control. But a new study in The Journal of Nutrition suggests that a spot of tea—hibiscus tea, that is—may help, too.

The study, from the USDA Human Nutrition Research Center on Aging at Tufts University, included 65 people with slightly elevated blood pressure levels. Half consumed three cups of hibiscus tea (H. sabdariffa) a day, an herbal tea different from regular black tea (Camellia senensis); the other half drank a placebo beverage with flavoring and coloring that mimicked hibiscus. After six weeks, the hibiscus tea group had a reduction in systolic blood pressure of 7 points, on average, compared to a 1 point drop in the placebo group, after controlling for diet, age, and other factors that can affect blood pressure. The benefit was greatest in those who started off with the highest blood pressure.

"The potential mechanisms of action for the BP-lowering effect of H. sabdariffa were not determined in our study," the researchers say, but other studies suggest that the herb relaxes blood vessels and has ACE-inhibitor and diuretic effects, similar to the action of anti-hypertension drugs. Polyphenols in the tea may also benefit cardiovascular health.

So is it time for tea? There's no guarantee that hibiscus, found in many herbal tea blends, will lower your blood pressure—more study is needed. But drinking a few cups a day, hot or cold, can be a tasty test.

Sugar-Free Foods: Do They Cause Weight Gain?

February 2, 2010

There's much debate whether non-caloric sweeteners, like saccharin and aspartame, help in weight loss. On the one hand, artificially sweetened foods have fewer calories than their sugary counterparts. But some researchers theorize that they may not be as satisfying, so people may end up consuming more calories elsewhere. Now, a new study (albeit one in rats) offers more evidence that consuming artificially sweetened foods offers no weight-loss advantage—and may even contribute to weight gain.

For the study, which was reported in the journal Physiology & Behavior, researchers fed one group of rats yogurt sweetened with saccharin, and another group yogurt sweetened with glucose (the control group); all the animals were allowed to eat as much of their regular lab chow as they wanted. Over five weeks, the rats who ate the artificially sweetened yogurt consumed about 50 more calories a week than the control group, and they ended up gaining 10 grams more weight (a modest amount for a small rat) and accumulating more body fat.

It's true, of course, that people are not rats. And only one artificial sweetener, saccharin, was tested. But the researchers say it's "plausible, if not probable" that the ability to maintain energy balance—that is, to keep your calorie intake equal to your calorie expenditure—is similarly decreased in humans and rats when sweetened foods do not translate into calories.

The bitter truth: If you're trying to lose weight, do cut down on sugary foods and beverages. But don't assume that replacing them with artificially sweetened products will necessarily result in weight loss. You must still watch your overall calorie intake no matter what.

Two Tasty Memory Enhancers

February 2, 2010

Fruit, overall, is a great source of antioxidants—compounds that help ward off cellular damage and thus may help slow aging and prevent disease. But if you want to boost your memory, you may want to pick blueberries and grape juice, in particular, suggests a pair of studies from the University of Cincinnati.

The studies included older people who were experiencing some memory problems—but not dementia. In the first study, published in the British Journal of Nutrition, those who drank 100% Concord grape juice (about two cups a day) showed significant improvements in verbal learning and verbal and spatial recall after 12 weeks, compared to a control group that drank a placebo beverage that looked and tasted like grape juice but did not contain any real juice. In the second study, reported in the Journal of Agricultural and Food Chemistry, participants who drank about two cups of blueberry juice a day for 12 weeks performed better on paired-learning and word recall tests.

Both blueberries and grape juice are rich in polyphenol pigments, including anthocyanins, which give the fruits their blue and purple colors and act as antioxidants. When consumed, these compounds cross the blood brain barrier and may help stimulate regeneration of brain cells, the researchers say.

Before you juice up: The studies were too small—only 12 and 9 people in each—to provide any definitive conclusions; one didn't even have a proper control group. Large, controlled studies are needed. Moreover, there's no reason to think that other antioxidant-rich fruits, especially other berries, wouldn't have the same potential brain benefits—they just weren't tested. Keep in mind also that fruit juices contain lots of calories (about 150 per cup), which can lead to weight gain if you don't cut calories elsewhere.

An Assault on Salt

January 20, 2010

Mayor Michael Bloomberg, of New York City, admittedly likes salt. But if he has his way, New Yorkers—as well as the rest of the United States—will be eating less salty packaged and restaurant foods in the near future. The National Salt Initiative, announced last week by the NYC Department of Health, will encourage food companies and chain restaurants in New York and across the country to cut the sodium (a component of salt) in their products by 25%, on average, over the next 5 years. The goal of the program—which has the support of more than 40 city, state, and national health organizations—is to lower Americans' salt intake by 20%, in hopes of reducing the prevalence of high blood pressure (hypertension), a major cause of heart attacks and strokes.

The recommended daily limit for sodium is 1,500 milligrams for most adults and 2,300 for younger healthy people. But Americans consume far more—about 4,000 milligrams a day, on average. About 80% of this sodium comes from processed and prepared (including restaurant) foods. Many of these foods, such as bread, cereal, and cookies, don't even taste salty, so you may not realize how much salt you're actually getting. Only a small percent comes from salting food at home.

The National Salt Initiative, which targets the leading sources of sodium in our diets, is a step in the right direction. The sandwich chain Subway has already pledged to commit to the voluntary program. Other companies plan to opt out, but have been making some headway on their own—Campbell's recently reduced the sodium in its V-8 juice and some breads and soups, for example.

The program will set sodium limits for 61 categories of packaged foods and 25 types of restaurant foods. And the cuts in sodium will range from 20–40% of current levels, depending on the food. For example, the sodium in cold cuts would be reduced from 1,084 milligrams (on average, in 3.5 ounces) to no more than 810 milligrams by 2014, and the sodium in pretzels would be lowered from 342 milligrams (an ounce) to no more than 223 milligrams.

Keep in mind that the target sodium limits are still not low. A fast-food burger with 1,200 milligrams of sodium (the limit set for 2014) is still a salty burger. And the program is voluntary—there will be no fines or other penalties if the companies do not reach the goals. Still, it doesn’t take a big reduction in salt to see big health gains. According to New York City health officials, if Americans reduce their sodium intake by just 20%, overall, "this will save tens of thousands of lives each year and billions of dollars in health care costs."

The High-Calorie Truth Behind Food Labels

January 20, 2010

An increasing number of restaurants provide calorie information, which can be helpful if you're watching your weight. But just how accurate are these numbers? To find out, Tufts University researchers measured the calorie counts of 29 meals and side dishes from national fast-food and sit-down restaurant and compared them to the calories published on the restaurants' menus and websites. They specifically chose items with lower posted calories, since these are the ones that people watching their weight are more likely to order. The researchers also analyzed 10 frozen meals bought from local supermarkets.

Here are some of the findings of the study, which was published in the January issue of the Journal of the American Dietetic Association:

  • Calorie counts provided by vendors and manufacturers were often inaccurate. And when they were off, they tended to err on the side of under-reporting calories.
  • On average, restaurant dishes had 18% more calories than the calories posted. Some dishes contained twice as many calories as stated.
  • Part of the discrepancy was due to over-sized portions at restaurants. That is, the amount of food actually served exceeded the listed portion sizes, which automatically means more calories.
  • Some restaurants provide free side dishes with entrees, but the calories from them were not included in the total calorie count of the meal. And these side dishes had even more calories, on average (471 calories), than the entrées themselves (443 calories).
  • The frozen-food products had an average of 8% more calories than what their labels listed; one had 31% more calories, but another had 10% fewer calories. The Food and Drug Administration (FDA) allows packaged foods to exceed their stated calorie counts by up to 20% without penalty; no such regulations exist for restaurant meals, which may be why those calorie counts were more inaccurate.

The difference between, say, a 400-calorie meal (what the menu may state) and a 472-calorie meal (what you may really be getting) may not sound so big, but it contributes to inadvertent overeating. "Discrepancies of this magnitude, if widespread, are likely to substantially hamper efforts to control weight by individuals self-monitoring their energy intake," and could lead to a weight gain of many pounds a year, the paper concludes.

What to do: The study included a relatively small sample of foods, which makes it hard to generalize the results. But if you're watching your weight, it's probably wise to always assume that the calorie counts at restaurants—and even on packaged foods—are not 100% accurate and are likely higher than what's listed. When dining out, order a smaller size portion if possible, or split an entrée. Don't assume side dishes included with an entrée are calorie-freebies. And remember, you don't have to clean your plate—you can take leftovers home for another meal.

Ginkgo: An Herb to Forget?

January 6, 2010

Many people take the herbal supplement ginkgo (Ginkgo biloba) in hopes that it will sharpen their memory and concentration. But research over the years has been conflicting as to whether or not it does the brain any good—and the largest study to date, in 2008, found that ginkgo did not reduce Alzheimer's disease or other dementias. Now, a further analysis of the data from that study, just published in the Journal of the American Medical Association, suggests more reason to forget about ginkgo.

The Ginkgo Evaluation of Memory (GEM) study followed more than 3,000 healthy older people (ages 72 to 96) for an average of six years. Half took a standardized ginkgo extract (120 milligrams) twice a day, while the other half took look-alike placebo pills. Every six months to a year, they were given a battery of memory and other cognitive tests. But the results were disappointing. According to the researchers, there was no evidence that ginkgo had any effect on either global cognitive change or within specific cognitive domains, such as memory, visual-spatial construction, language, attention, or psychomotor speed—even after controlling for age, education, and other factors. That is, ginkgo proved no better than a placebo in slowing normal age-related cognitive decline in older adults.

Still, proponents of ginkgo argue that the study had flaws and that this is not the last word on the herb. Lab studies suggest that compounds in ginkgo, including flavonoids and terpenoids, may improve blood flow, reduce blood clotting, and have anti-inflammatory, antioxidant, and neuro-protective effects. We’ll keep you updated.

Pass the Reindeer Meat?

January 6, 2010

The "Mediterranean Diet," which is based on the cuisines of southern Europe, made lots of headlines over the last 10 years as a healthful way to eat. But if a group of researchers have their way, instead of tomatoes, olive oil, and red wine, you'll be passing the cabbage and herring, along with other northern European foods, in the next decade.

The researchers, from the University of Copenhagen in Denmark, are developing this new food concept, called the "New Nordic Diet," based on the traditional cuisine and culture of Scandinavian countries. The diet emphasizes cabbage (and other cruciferous vegetables, such as Brussels sprouts), wild native berries (blueberries, cowberries, and cloudberries), herring (and other oily fish, such as salmon, trout, and cod), grains (oats, rye, and barley), rapeseed oil (also known as canola oil), and lean game meats (elk and reindeer). The diet will be tested on about 1,600 school children to see if it improves their health.

Some caveats. Most people living in Scandinavia do not actually eat such a healthy Nordic diet anymore—if ever. And obesity rates there are not necessarily low. So until studies are published, it's not known if this diet has the potential to lower the risk of heart disease and other illnesses, as the Mediterranean diet seems to.

In the meantime, though, it won't hurt to include some "New Nordic Diet" foods in your own diet. Besides a range of nutrients and fiber, cruciferous vegetables contain plant compounds called indoles, which may have cancer-protective properties. Berries (all kinds) are rich in antioxidants. Herring and other fatty fish are the top sources of heart-healthy omega-3 fatty acids. Oats and barley are particularly rich in soluble fiber. And canola oil, rich in monounsaturated fats, is a good and less expensive alternative to olive oil.

How Safe is Your Chicken?

December 22, 2009

Despite increased attention on food safety issues, fresh store-bought chicken is more contaminated with bacteria today than six years ago, according to the latest round of independent testing by Consumer Reports. Of 382 raw whole chickens from more than 100 nationwide stores, 66% harbored Campylobacter and/or Salmonella—bacteria that can make you sick if you eat the poultry undercooked. That means that only 34% of the birds were "clean," compared to 51% in 2003. Believe it or not, though, this is an improvement since 2007, when 80% of supermarket chickens were found to be infected with bacteria.

According to the Centers for Disease Control and Prevention (CDC), 3.4 million Americans are sickened by Salmonella and Campylobacter every year; 25,500 are hospitalized, and 500 die. More people likely go undiagnosed.

The new study looked at major name brand chickens, as well as store brands—and both organic and non-organic birds. They were bought from supermarkets, gourmet and natural-food stores, and mass merchandisers in 22 states and were tested by an outside lab.

Campylobacter was detected in 62% of the samples, Salmonella in 14%, and both bacteria in 9%. The most contaminated birds were from Tyson and Foster Farms, with more than 80% testing positive for one or both bacteria. Perdue birds fared better—56% were bacteria free. The "cleanest" were those labeled "air-chilled." In air chilling, the carcasses are hung and chilled after slaughter in a cold chamber, rather than dunked in a cold chlorinated bath. Incidentally, all of the air-chilled birds were organic, though not all organic birds were air-chilled.

Not surprisingly, the National Chicken Council questioned the testing methods used and issued the following statement: "Chicken is safe. Like all fresh foods, raw chicken may have some microorganisms present, but these are destroyed by the heat of normal cooking. Consumers are encouraged to follow the safe handling and cooking instructions printed on every package of fresh meat and poultry sold in this country."

As we've said before, although the real fix must come from government and industry, the responsibility for food safety still ultimately rests with consumers. The bottom line with poultry is that you must cook it to at least 165°F and make sure that no raw juices come in contact with other foods.

Santa's Naughty Habits

December 22, 2009

With Christmas just a couple of days away, you (and your children) might be eagerly anticipating the arrival of St. Nicholas. You may have made extra attempts this year to be good—perhaps lose some weight and get more exercise. But how good has Santa been himself? Ironically, he is hardly a ringing endorsement of good health habits, points out an article in the latest issue of the British Medical Journal, by Dr. Nathan Grills, a public health doctor from Monash University in Australia.

Today's image of Santa—which originated from 1930’s Coca-Cola advertising—promotes obesity, an inactive lifestyle, and other unhealthy behaviors. "Santa is a late adopter of evidence based behaviour change and continues to sport a rotound sedentary image," says Dr. Grills. Moreover, Santa is even more recognizable than Ronald McDonald, another popular fictional (sorry) character who doesn't set the best example for good eating habits, either.

According to the article, countries that celebrate the full-figured Santa have higher rates of childhood obesity. We can't directly blame Santa for this association, of course, but this image promotes the false message "that obesity is synonymous with cheerfulness and joviality." That's not all. The tradition of leaving Santa some brandy means that he could potentially drink millions (if not billions) of cups by night's end. Even if his reindeers are pulling the sleigh, Santa is still in the driver's seat—and this would put him over the legal blood alcohol level. He doesn't wear a seat belt, either. And though Santa is not allowed in many countries to overtly advertise cigarettes anymore, as he once did, you may also still see his image on cards and drawings happily puffing away on a pipe.

Santa needs an image makeover. Santa needs to slim down and trade some bad habits for good ones, says Dr. Grills and other health authorities. Rather than leaving out cookies, pies, or brandy this year, you could set a good example for your kids (and yourself) by offering him a snack of carrots and celery sticks (the reindeers would appreciate this too) and nonfat milk instead of whole milk. And though this would undoubtedly make him (very) late in his deliveries, Santa should also get off his sleigh and ride a bike or walk or jog.

Getting the Most Bang for Your Vitamin Buck

December 9, 2009

The best way to get the nutrients you need for good health and disease prevention is to choose a wide variety of healthy foods, rather than take dietary supplements. That's the bottom line of a newly released position paper from the American Dietetic Association (ADA). Still, the ADA and other health experts acknowledge that supplements can benefit some people by filling in dietary shortfalls.

Talk to your doctor or a registered dietitian about what extra nutrients you may need and how to take them safely. Here are some tips from a recent New York Times article on how to get the best supplements for your money:

  • Take only the vitamins and minerals you need. More is not only risky, it's a waste of money. It's often better to take a single supplement—such as vitamin D—rather than a pricier formula that contains other nutrients that you don't need.
  • Generic and store brand supplements are likely to be as good as name brands. That's because most manufacturers use the same ingredient sources. Yet generic and store brands cost far less.
  • But don't go too cheap. Buy from reputable retailers—those that do a brisk business and restock their inventory regularly. Check the expiration dates, but be aware that supplements that are not stored properly (at or below room temperature) can degrade sooner.
  • Look for certification symbols. The seals from two nonprofit organizations—U.S. Pharmacopeia (USP) and NSF International—provide some assurance that the supplement is pure and of good quality, and that you are getting what the label indicates. But because the approval processes are voluntary, supplements that do not carry these seals are not necessarily of poorer quality—they just haven't been submitted for testing. You can also go to for listings of supplements that have passed muster.

Keep in mind that the Food and Drug Administration (FDA) does not test supplements for quality, effectiveness, or safety, and most supplements don't do what marketers say they do—plus, they can have harmful effects. Supplements do not take the place of standard medical care, either. Investing in a nutrient-rich diet with lots of fresh whole foods will go farther in safeguarding your health than investing in dietary supplements.

Take Vitamin C—See Worse?

December 9, 2009

If a little vitamin C is good for you, more must be better, right? That's what a lot of people think—or hope for—when they take high doses of vitamin C. But a new study in the American Journal of Clinical Nutrition suggests that increased intake of vitamin C may contribute to age-related cataracts—at least in women.

In the study, which included nearly 25,000 Swedish women aged 49 to 83, those who took about 1,000 milligrams of vitamin C a day had a 25% increased risk of having cataract surgery over eight years, compared to women not taking supplements. In further analyses, high-dose vitamin C was associated with even greater cataract risk among women aged 65 and over and in women also taking hormone replacement therapy (HRT) or corticosteroids. The researchers hypothesize that large doses of vitamin C, an antioxidant, may, in certain situations, act as a pro-oxidant and promote cataract formation.

Not the last word. This is hardly the final word on high-dose vitamin C and cataracts. Previous studies, which have looked at combinations of vitamin C with other nutrients, have had conflicting results, and the new study is an observational study, which does not prove cause and effect. Still, there's no reason to take large amounts of vitamin C. You need not worry about the vitamin C in your multivitamin (the Swedish study found no increased risk from multis containing 60 milligrams of vitamin C), or about the vitamin C in your diet. In fact, some researchers think that vitamin C in fruits and vegetables may help prevent cataracts.

Cataracts, characterized by a progressive clouding of the eye, are a common cause of vision loss in older people. According to the Mayo Clinic, more than half of all Americans over age 65 have some clouding of the lens, and up to 70% of Americans over 75 have cataracts severe enough to impair vision.

Movie Theater Popcorn: Two Big Thumbs Down

November 25, 2009

Popcorn can be a healthy snack—full of fiber and, as a recent study found, unexpectedly rich in antioxidants. But when it comes to movie theater popcorn—well, that's still a real horror show. Fifteen years after exposing the colossal calorie and fat content of movie theater popcorn, the non-profit Center for Science in the Public Interest (CSPI) has found that little has changed.

In this follow-up study, CSPI sent popcorn samples from the nation's three largest movie chains—Regal, AMC, and Cinemark—to an independent lab for testing. Here are some of the findings:

  • Popcorn calories range from 370 to 1,200, depending on the chain and the serving size. And that's without the "buttery" topping, which adds another 120 to 260 calories.
  • The medium and large popcorns at Regal theaters have the most calories—1,200. Both sizes hold 20 cups of popcorn, but the large just looks bigger because it comes in a wide tub instead of a bag. The chain, however, lists the calories for a medium at 720, and a large at 960. As CSPI says, "oopsy-daisy."
  • Order Regal's medium popcorn and soda combo and you'll get 1,610 calories and 60 grams of saturated fat (three days' worth)—the equivalent of eating three McDonald's Quarter Pounders® with 12 pats of butter.
  • None of the theaters still use hydrogenated oils, which contain unhealthy trans fats. Two switched to coconut oil, which, though free of trans fats, is about 90% saturated fat. Cinemark got kudos from CSPI for switching to non-hydrogenated canola oil, which is much lower in saturated fat.
  • Movie popcorn isn't the only calorie buster. Sodas, from 16 to 54 ounces, have 150 to 500 calories, all from sugar. And candy, sold in oversize packages not meant as single servings, have 300 (Sour Jacks) to 1,160 (Reese's Pieces) calories. Most movie candy falls in the 400 to 500 calorie range.

A better scene: You don't need to eat at the movies at all (it's a bad habit we have accepted as normal). But if you can't go without, bring your own air-popped or low-fat microwave popcorn, or other healthy low-calorie snacks, like carrot sticks or apple wedges.

Vitamin D—A Good Life Insurance Plan?

November 25, 2009

If you want to live longer, boosting your vitamin D levels may be a good insurance plan. A new study in Nutrition Research found that older women who had the lowest vitamin D blood levels (below 15.3 ng/mL) were 150% more likely to die from heart disease, cancer, or other causes than women with the highest levels (above 27 ng/mL). Previous research has also linked low vitamin D to increased mortality.

The study divided 714 women, ages 70 to 79, into four groups (quartiles) based on their vitamin D levels. After six years of follow-up, 19% of the women in the lowest vitamin D group had died, compared to only 8% of those in the highest vitamin D group. Overall, women with the lowest vitamin D levels had "significantly worse survival" than those with the highest levels, after adjusting for age, weight, smoking, cholesterol, and other factors.

It's easy to fall short on vitamin D. Our bodies make it when we are exposed to sunlight, and it's found in some foods, such as fatty fish and fortified cereals and dairy foods. The recommended intake is 200 to 600 IU a day, depending on your age, but many experts now recommend 800 to 1000 IU—or even more—a day. The only way to get that much on a regular basis is with a supplement. You may also want to talk to your doctor about getting your vitamin D blood level measured.

Slow Eaters Win the Weight Race

November 14, 2009

It may seem obvious, but the faster you eat the more likely you are to overeat. Some observational studies support this notion. And you may know this—too well—from personal experience. A study, to appear in the Journal of Clinical Endocrinology & Metabolism, explains why eating fast may cause overeating. It has to do with hormones that act on the brain.

Eating is known to trigger the release of gut hormones, including peptide YY (PYY) and glucagon-like peptide 1 (GLP-1), which act on the hypothalamus in the brain to regulate appetite. This new study, by researchers from Greece and the U.K., however, is the first to look at how the speed at which you eat influences the release of these appetite-regulating hormones.

The study included 17 healthy people who, on one day, ate a big bowl of ice cream (the "test meal") quickly (within five minutes), after fasting overnight. On a second day, they ate the ice cream slowly (within 30 minutes). Blood samples were taken before eating and then every 30 minutes after, for about three hours, to measure changes in hormone levels. As expected, the subjects had higher PYY and GLP-1 levels, and some reported feeling more full, when they ate slowly, compared to when they ate quickly. This generally held true in both normal-weight and overweight people.

The bottom line. The findings don't guarantee that if you eat slowly you will eat less or lose weight (the researchers did not test this). Actually, many people who overeat do so in response to environmental, social, and/or psychological factors, not because they are hungry. Still, as the authors conclude, "The warning that we were given as children that 'wolfing down your food will make you fat' may in fact have a physiological explanation."

Can Chewing Gum Really Help You Lose Weight?

November 14, 2009

Can something as simple as chewing gum help you eat less and lose weight? It sounds too good to be true—and for the most part is. But preliminary research from the University of Rhode Island suggests that gum chewing may curb hunger—at least a little. In the study, volunteers who chewed sugar-free gum for a total of one hour in the morning (in three 20-minute bouts) consumed about 70 fewer calories at lunch (where they were allowed to eat as much as they wanted), compared to when they didn't chew gum. And they didn't make up the calories later in the day.

As the lead researcher, Dr. Kathleen J. Melanson, explains, "the act of chewing stimulates nerves in the muscles of the jaw, which may send signals to the part of the brain linked to satiety, thereby reducing hunger. Based on these initial results, one could hypothesize that gum chewing may be a useful adjunct to a weight management program."

Some sticking points: The study was short term, so it's not known if the small appetite-suppressing effect observed would last. Moreover, not all studies have shown that gum chewing reduces appetite. An earlier study actually found it increased appetite. Not surprisingly, the study was funded by the Wrigley Science Institute (as in Wrigley's gum) and has not been published.

Chewing gum does burn some calories—about 11 an hour by one estimate. But you'd have to chew (sugarless) gum for 10 to 12 hours a day for a month to lose about a pound. One thing is for sure—gum has fewer calories than a candy bar. Be aware, though, that some sugary gums have 20 or more calories per stick, which adds up if you chew a lot—and can override the small calorie-burning effect of chewing it.

Eating Less of These Foods May Help the Environment

November 2, 2009

Many of us have begun paying attention to our personal "carbon footprints"—that is, the impact that our lifestyle choices have on the environment in terms of greenhouse gas emissions—in hopes of reducing global warming and lessening our dependence on oil. We can trade our gas guzzlers for hybrids, buy energy-efficient light bulbs, weatherize our homes, and unplug appliances when not in use. Some new companies even offer (for a price) to offset our carbon emissions for us, by planting trees.

But we can also look at our food choices. According to a new report from the World Watch Institute, cutting back on meat and dairy foods, in particular, can go a long way in cutting our carbon emissions. Raising cows, pigs, chickens, and other animals for food produces even more carbon dioxide and other greenhouse gases (GHGs) than burning oil, gas, and coal, the report says—and far more than previously estimated by the United Nations. Though difficult to measure precisely, World Watch blames at least half of all human-caused GHG emissions—at least 32,000 tons of carbon dioxide released a year—on livestock. If this figure is correct, then going meatless would be the best way to reverse global warming.

Why blame animals raised for food? Greenhouse gases are produced when forests are cleared to make way for livestock to graze (trees release stored carbon into the atmosphere when cut down), in the production of animal feed, and in transporting and processing the animals. Farm animals release tons of carbon dioxide and methane into the air from breathing and belching. And the problem is increasing as livestock numbers rise worldwide. In contrast, meat and dairy analogs (such as soy burgers and soy milk) "clearly generate a small fraction of the GHGs attributable to livestock products"—and are also healthy, easy to prepare, and less expensive than meat products.

What you can do: You don't have to become vegetarian, but going meatless a few nights a week is a small step that can make a difference. An earlier study from Carnegie Mellon University found that skipping red meat and dairy products just one night a week for a year saves the equivalent in greenhouse gas emissions of driving 760 miles.

In place of beef, pork, and chicken, try protein-rich soy and seitan (wheat gluten) products; many are good-tasting substitutes, especially if you incorporate them into other dishes (for example, use soy crumbles instead of ground beef in pasta sauce). In place of dairy, try calcium-fortified soy, rice, or hemp milk, and soy or rice cheeses. Legumes (beans and lentils) and nuts also provide good protein—along with fiber, which animal foods lack, and healthy unsaturated fats.

The Mediterranean Diet & Breast Cancer Risk

November 2, 2009

Many population studies have linked the so-called "Mediterranean diet"—a diet with lots of fresh fruits, vegetables, legumes, grains, fish, olive oil, and red wine—to a lower risk of cardiovascular disease, diabetes, cancer, and other illnesses, as well as longer life. Now, a new study in the American Journal of Clinical Epidemiology suggests that a Mediterranean-type diet—without the alcohol, though—may also lower a woman's risk of breast cancer.

Researchers analyzed the diets of more than 65,000 French women and identified two main patterns: One, the "healthy/Mediterranean," rich in vegetables, fruits, seafood, and olive/sunflower oils; the other, the "alcohol/Western," with processed meat, fries, rice/pasta, potatoes, eggs, cakes, mayonnaise, butter, cream, and alcohol. After controlling for other risk factors, such as age, weight, and family history of breast cancer, the higher the women scored on the Mediterranean dietary pattern, the lower their risk of breast cancer—though the benefits were seen only in women who didn't overconsume calories or eat large amounts of "unhealthy" foods. In contrast, higher scores on the Western pattern were associated with an increased risk of breast cancer—though only in women of normal weight (being overweight may outweigh any specific diet effect).

"It is difficult to determine which components of the Mediterranean pattern explain the inverse association with breast cancer risk," the researchers say. In general, studies have failed to identify specific foods that affect breast cancer risk. This study suggests that it's the whole dietary pattern that may be protective—or harmful.

It's relatively easy to adopt a Mediterranean-type diet. You probably eat at least some of the key foods already. Center your meals around vegetables, grains, and legumes (beans and lentils); aim for small amounts of a variety of fish at least twice a week; and limit red meat to small portions, no more than a few times a month. Eat fruit for dessert; snack on nuts and seeds. Use vegetable oils—including olive oil—in place of (not in addition to) butter and margarine.

A word about alcohol: While wine is a key component of traditional Mediterranean diets, alcohol has been associated with increased breast cancer risk. It's not proven that alcohol causes breast cancer, but to be on the safe side, if you choose to drink, keep it moderate—no more than one drink a day for women. If you are at high risk for breast cancer or have had breast cancer, not drinking at all or drinking only on occasion may be a good idea. Discuss your breast cancer risk factors with your doctor.

Risky Business

October 14, 2009

What do leafy greens, eggs, oysters, tomatoes, and berries have in common—besides that they are all good for you? They are among the top ten foods regulated by the Food and Drug Administration (FDA) that are most likely to harbor bacteria that can make you sick, according to a new report from the from the nonprofit watchdog group, Center for Science in the Public Interest (CSPI). Also singled out as "risky" are tuna, potatoes, cheese, ice cream, and sprouts. The list does not include meat or poultry, which pose an even greater risk of foodborne illness (that is, food poisoning) but are regulated by the U.S. Department of Agriculture, not the FDA. The FDA oversees produce (vegetables and fruits), eggs, dairy products (milk, cheese, and butter, for example), seafood, and most packaged foods.

Between 1990 and 2006, the "FDA Top Ten" foods accounted for nearly 1,500 food poisoning outbreaks across the United States, involving almost 50,000 reported cases of illness—about 40% of all foodborne outbreaks linked to FDA-regulated foods. You may be surprised to know that Salmonella and E. coli, which caused many of these outbreaks, are not just a problem in burgers and chicken Leafy greens accounted for 24% of the outbreaks (363 outbreaks and 13,568 illnesses), while berries, at the bottom of the list, sickened 4,000 people. And these numbers are “only the tip of the iceberg,” as many more cases of foodborne illness go unreported.

As CSPI explains, "A complex, globalized food system, archaic food-safety laws, and the rise of large-scale production and processing have combined to create a perfect storm of unsafe food. Unfortunately, the hazards now come from all areas of the food supply: not only high-risk products, like meat and dairy, but also the must-eat components of a healthy diet, like fruits and vegetables."

What to do: Don't give up these healthy foods, but do take care when handling, preparing, and storing them. Wash all produce well—leafy greens, in particular, including bagged spinach and salad mixes (not such a "convenience" anymore); cook foods, including seafood and eggs (as well as meat and poultry, of course) to proper temperature or otherwise done. Pregnant women, young children, the elderly, and people with compromised immunity or in frail health should especially avoid raw milk products, raw seafood (including raw oysters), raw sprouts, and runny eggs. While the real fix must come from government and industry, the responsibility for food safety still ultimately rests with consumers.

Here's Looking at You, Omega-3s

October 14, 2009

Omega-3 fats, the kind found in oily fish, have received a lot of attention for their heart benefits. Now, a new study from the National Eye Institute and George Washington University, reported in the American Journal of Clinical Nutrition, links consumption of these fats to a reduced risk of vision loss from age-related macular degeneration (AMD), a chronic eye disease that affects more than 10 million Americans.

Of more than 1,800 people at moderate-to-high risk for advanced AMD, those who reported the highest omega-3 intake (mostly from seafood) were about 30% less likely to show a worsening of disease over a 12-year period than those with the lowest omega-3 intake. The association held true for the two types of macular degeneration—wet and dry. Omega-3 fats in fish may reduce inflammation associated with age-related macular degeneration, the authors note. Previous research has also linked omega-3s with reduced risk of AMD.

The study, however, does not prove that omega-3s caused the observed benefits (eating more omega-3s may be a marker of a healthier lifestyle in general), and the findings need to be confirmed. But this research offers one more reason, besides heart health, to eat fish—especially considering that current treatments for AMD are invasive, limited, and expensive, and can have serious side effects. Aim for at least two servings a week of fatty fish, such as wild salmon, sardines, and mackerel. The study did not look at the effects of fish oil supplements.

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