Spring Into April with The Sprout

DGAC

It’s April Fool’s day, and in recent days, many people have considered the presence of the Academy of Nutrition and Dietetics’ “Kids Eat Right” logo on Kraft Singles to be a joke. Meanwhile, the Dietary Guidelines Advisory Committee (DGAC) released its advisory report for the 2015 Dietary Guidelines, and the battle over the role of sustainability in shaping the guidelines has proved to be no laughing matter. In this month’s issue of the Sprout, Buki Owoputi tackles that very topic. In addition, Ally Gallop takes another angle examining the DGAC’s changing opinion of cholesterol.

Last week, Friedman hosted the annual Stanley Gershoff Symposium, which featured Allison Aubrey from NPR, James Hamblin of The Atlantic, Jennifer Harris from UConn’s Rudd Center for Food Policy & Obesity, and Douglas Seidner from the Vanderbilt Center for Human Nutrition. Katherine Pett recaps Dr. Hamblin’s talk and his aspirations to be the Jon Stewart of nutrition.

Our writers also continue to look into some of the latest nutrition trends. Emily Finnan breaks down health claims related to the growing “souping” phenomenon and how it compares to the previously popular liquid diet of juicing. Nusheen Orandi contemplates the oft-championed probiotics in yogurt, and Katie Mark concludes her three-part series on the ketogenic diet with a look at C-reactive protein.

If you’re looking for exercise fuel now that the weather might actually be getting nice, Mireille Najjar offers up some tasty pre- and post-workout snacks that may have you replacing your regular protein shake. Finally, Katherine returns with a recipe for a hearty salmon curry dish that will help you mix up your dinners!

Does Sustainability Fit into the Dietary Guidelines?

by Buki Owoputi

EarthSustainability in the food system is not a new topic, yet the Dietary Guidelines Advisory Committee (DGAC) is choosing to finally address the issue full force. Although the DGAC’s report is just a recommendation, the report may influence the new dietary guidelines that are set to come out later this year.

The Yolk is Back in Town: Does Cholesterol Still Matter?

by Ally Gallop

EggMedia headlines have repeatedly echoed the lack of a recommendation surrounding a seemingly new leniency towards cholesterol in the DGAC report. This year, the DGAC points to inadequate evidence linking high dietary cholesterol to high serum cholesterol. So what changed and why should we, as nutrition communicators, care?

Good Sense and Humor

by Katherine Pett

Nsj0uslaWhy someone should give James Hamblin, MD, his own TV show. 

To Juice, to Soup, or to Just Eat

by Emily FinnanPea Soup

Gwyneth Paltrow, Dr. Oz, and future bachelorette Kaitlyn Bristowe are a few embracing the latest weight loss and health solution: souping. Yes, move over juicing—souping is what’s hot.

Probiotics: What Do These Bacteria Do?

by Nusheen Orandi

Danone_ActiviaWhen I’m shopping in the dairy aisle of the grocery store, I stand in front of the yogurt section for a while. When did it get so huge? Greek, Icelandic, Kefir, whole milk, low-fat, non-fat, goat’s milk, and coconut milk are all options. What’s making yogurt so popular? Well, its probiotic nature is one of its claims to fame.

How Does a Ketogenic Diet Affect YOU? Part 3: C-Reactive Protein: A Marker of Inflammation

by Katie Mark

C-Reactive Protein

The latest craze surrounding the ketogenic diet has us further investigating whether or not a high-fat/low-carbohydrate lifestyle might be an appropriate dietary approach for some people. In this 3-part series (click here for part 1 and part 2), we’re evaluating how the ketogenic diet affects biomarkers.

Energizing Pre- and Post-Workout Snacks

by Mireille Najjar

Workout SnacksChoosing what to eat before and after a workout is important to maintain steady energy and to keep your metabolism going. Read on for some simple pre- and post-workout snacks that offer the right balance of carbohydrates, fats and protein to satisfy hunger, fuel workouts and aid in recovery.

Curry Salmon with Cauliflower Rice: A Yummy Way to Get Omega-3s

by Katherine Pett

unnamed-2Having read earlier posts on the benefits of turmeric and hoping to maximize my intake of health omega-3’s, I experimented with a curry recipe for salmon.  After a couple months of tweaking, this is what I came up with!  Try it out and let us know how it goes!

Does Sustainability Fit into the Dietary Guidelines?

by Buki Owoputi

Sustainability in the food system is not a new topic, yet the Dietary Guidelines Advisory Committee (DGAC) is choosing to finally address the issue full force. Although the DGAC’s report is just a recommendation, the report may influence the new dietary guidelines that are set to come out later this year.

The purpose of the Dietary Guidelines is to “encourage Americans to focus on eating a healthful diet-one that focuses on foods and beverages that help achieve and maintain a healthy weight, promote health, and prevent disease.” The DGAC recommendations state that it is addressing sustainability to “have alignments and consistency in dietary guidance that promotes health and sustainability.” As the concern for environmental preservation grows, many countries (such as Australia) have addressed this issue by including sustainability in their dietary guidelines. The U.S. has finally decided to get on board and follow the pack.

So what exactly is sustainable diet? The Food and Agriculture Organization (FAO) describes it as “…with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources.”

In other words, sustainable diets focus on preserving the environment and reduce the impact of food production on the planet. While this all sounds wonderful, the question becomes whether the purpose of the dietary guidelines should be to protect the environment or just strictly provide a healthy eating guideline for Americans.

In order to address sustainability, the DGAC has discussed plant-based diets higher in foods such as fruits, vegetables, plant proteins, and whole grains. This also includes decreasing meat consumption. The DGAC also discusses consuming seafood that is wild caught, however it addresses that both farm-raised and wild caught are needed to meet the consumer demand for seafood in the U.S. The DGAC states that it plans to determine if sustainable diets are affordable and accessible, as well as determining the economic impacts of a sustainable diet.

To no surprise, those in the meat industry oppose the committee’s recommendations. For example, Tiffany Ringer of JBS Five Rivers Cattle Feeding writes, “I have read news reports about the recommendations made by the dietary guidelines and I am very concerned. Meat is a part of my family’s diet and always has been because my family knows that it helps our children grow and develop…It seems like this committee is out of touch with everyday Americans.”

However, the DGAC recommendations clearly state that no food group should be eliminated. The focus seems to be increasing fruits and vegetables in the diet.  So far, the feedback from the public has been mostly positive. Many people are happy that the U.S. may finally include sustainability into its recommendations for a healthy diet. For example, Joseph Hayes states, “I absolutely agree that we need to transition to a sustainable, plant based diet. The present standard American diet is unhealthy, extremely cruel to the animals, destructive to the environment, and a terrible waste of resources, especially water…I have been a vegan for 16 years and am in robust health. I love eating exclusively vegan and hope the Dietary guidelines remain strongly in favor of a plant based diet for good health and sustainability.”

There seems to be 2 different arguments that have arisen on the topic of sustainable diets, and it is important to dissect and address both issues separately. The first issue is whether the dietary guidelines should be made with the goal of preserving the environment. Should healthy eating and environmental health be linked together? Almost no one would argue that production of meats and other animal foods increases the carbon emissions and is worse for environmental pollution than producing plant-based foods. But should we be willing to make nutrition and health decisions based on the environment? Would you be willing to adopt a vegan diet to reduce pollution on the environment, even if it was not the best diet nutritionally, preferentially, or culturally appropriate for you? Is it selfish to choose your own wants and needs over those of the environment? While is it easy to say that we all want to do everything we can to limit the impact we have on the environment, is it worth it the sacrifice? Lucky for us, it may be possible to have the best of both worlds. Instead of choosing one extreme or the other, simply limiting animal products may provide a benefit for Americans.

This leads to the second issue that needs of whether adopting a sustainable diet will actually lead to healthier Americans. Many people are arguing that a sustainable diet is a healthier diet and would lead to a decrease in chronic diseases. For example, a study of vegan and vegetarian diets by Tantamango-Bartley et al. found that vegan and vegetarian diets seem to offer some protection against certain types of cancers. Depending on the way the guidelines are stated, this expected decrease in incidence of chronic diseases may not happen. People may choose to replace their meat consumption with foods such as refined grains or animal-based products such as cheese or milk (which are not only still bad for the environment, but may also be linked to obesity). It is difficult enough to get people to follow the existing guidelines, talk less of increasing their already low consumption of fruits and vegetables!

The average American consumes about 2,534 calories, which is more than the recommended 2,000. However, it is important to note this study found that even if people lowered their intake to 2,000 calories, and decreased their meat consumption, the decrease in greenhouse gas emissions still may not be significant. While a decrease in calorie intake and meat consumption might decrease risk of chronic disease and obesity, it might not help the environment in a significant way. These are all issues that should be researched in more depth before any formal guidelines are made.

The purpose of the dietary guidelines should not be to preserve the environment, only to provide recommendations for a healthy diet. The Dietary Guidelines were never created with the intent to decrease our carbon footprints. With that being said, adopting a sustainable diet could help decrease the prevalence of obesity and ultimately lower rates of chronic diseases. The focus should be on increasing fresh fruits and vegetables, although animal-products can be part of a healthy diet. Framing the new guidelines in a way that promotes healthy eating instead of preservation of the environment might help reduce push-back from those who oppose including sustainable diets in the dietary guidelines. Helping the environment would just be a plus to enjoying better health!

Buki Owoputi is a first year FPAN and MPH-Epi/Bio student. In her spare time she likes to invent new recipes and read random articles on Wikipedia.

The Yolk is Back in Town: Does Cholesterol Still Matter?

by Ally Gallop, BSc, RDN, CDE

Cherry picking through the Dietary Guidelines Advisory Committee’s (DGAC) February report is a nutrition communicator’s nightmare. Though the report is 571 pages deep, media headlines repeatedly echo the lack of a recommendation surrounding a seemingly new leniency towards cholesterol. This year, the DGAC points to inadequate evidence linking high dietary cholesterol to high serum cholesterol. So what changed? And why should we, as nutrition communicators, care?

The 2015 DGAC’s report recommends withdrawing cholesterol’s longstanding upper limit of 300 milligrams (mg) per day when updating the 2015 dietary guidelines set to occur later this year. Since the federal government’s dietary guidelines were first officially released in 1980, there has always been a focus on cholesterol and saturated fat. The initial guidelines stated to “avoid too much fat, saturated fat, and cholesterol.” It took until the fourth version in 1995 to place a hard number on cholesterol: 300 mg daily for the general population. A stricter 200 mg was advised for those with high cholesterol, at risk of cardiovascular disease (CVD), or diabetes. It also took until 1990 for specific limits on saturated fat to be made: less than 10% total caloric intake from saturated fat (the 2010 goal is now less than 7%).

With the interest and research in nutrition growing over time, our knowledge of nutrition is constantly changing. As far back as the 1990’s, experts began to learn that eating cholesterol does not necessarily parallel large increases in serum cholesterol levels. Back in 1999, the Journal of the American Medical Association found that despite a large egg’s 186 mg cholesterol, daily egg consumption did not increase one’s risk of heart disease*. Harvard’s School of Public Health’s Walter Willett has voiced how although this recommendation was initially based on well-intentioned theory, it was based on and supported by short-term studies with no consistent, hard, and direct evidence. So too, agreed the joint American Heart Association-American College of Cardiology task force in 2013 when it reported that cholesterol’s initial strict limit was based on studies too broad to find a direct link. Even so, the United States remains the only country to include a cholesterol limit within its dietary guidelines. And yet update after update the 300 mg cholesterol guideline was carried forth. How did this happen?

Back in 1980, the dietary guidelines admitted that there was “controversy about what [cholesterol] recommendations are appropriate for healthy Americans.” Produced by the liver, cholesterol has multiple roles within the body. It’s necessary for the production of steroid hormones, is present within the membrane of every cell, and is a requirement for fat absorption due to its role as a precursor for bile acids. In fact, the liver produces upwards of 85% of the body’s total cholesterol levels. Even if a person were to stop eating bacon and eggs, their serum cholesterol likely won’t budge a significant amount. But what’s tricky is that an estimated 15-25% of the population is cholesterol sensitive, but there is no diagnostic test for this.

However, consuming dietary saturated and trans fats increase serum cholesterol to a greater extent than dietary cholesterol itself. As a dietitian, I always explained to patients how cholesterol is like the nagging friend that won’t leave saturated fat alone: foods containing cholesterol tend to also contain saturated fat. This is likely a factor as to why cholesterol was initially limited: when people eat foods high in saturated fat (and cholesterol) their serum cholesterol also increased. Adding to the complexity, eating foods high in cholesterol can increase LDL-cholesterol (the “bad” stuff), but only by a small amount. It also increases HDL-cholesterol (the “good” stuff), thereby maintaining one’s cholesterol ratio.

But guess what? Your dietary advice hasn’t really changed.

The implications surrounding food communicators involve the public’s perception that nutritionists are forever changing their minds as to what’s healthy and what’s not. But taken together with saturated fat, the recommendations don’t really change.

The USDA and the Department of Health and Human Services will be responsible for updating the forthcoming dietary guidelines. If they adopt the DGAC’s recommendations, no longer having a guideline does not mean that foods containing cholesterol should be consumed without restraint. The vehicle that cholesterol is carried in still matters. As mentioned, cholesterol tends to coincide with saturated fat and exists primarily in animal foods, to which the DGAC continues to recommend restricting to no more than 7% of all calories. For instance, items with both high cholesterol and saturated fat include cheese and other high-fat dairy products; pizza; and many cuts of beef, pork, and poultry (with the skin).

In defense of the DGAC, Tufts own Dr. Alice Lichtenstein reports how the average American now consumes between 250 and 350 mg daily. Among other pertinent dietary factors, focusing on cholesterol is no longer of dire concern for the DGAC. However, although dietary cholesterol may not be of concern to the committee, saturated fat still is.

Rather than focusing on specific nutrients, its not enough for food communicators to solely depend on moderation and the importance of whole foods and diets when counseling patients. From experience, they want specific answers. So here’s what you need to know:

  • In 2012 3% of Americans had diabetes, another 86 million were in the prediabetic state, and 1.7 million new cases were diagnosed. In total, 85.6 million Americans suffer from CVD or the aftermath of stroke. Acknowledging that the dietary guidelines are intended for the general population, with numbers this large nutrition communicators need to avoid making broad strokes when advising the public.
  • A daily egg is fine, except for those with diabetes* who should limit their intake to no more than three yolks per week.
  • For those with or at risk for CVD and/or diabetes, continue with a 200 mg restriction.
  • Remain conservative with foods high in saturated fat. For instance, avoid 3-egg omelets with a side of bacon and sausage.
  • Opt for high-fiber foods and whole grains, since refined carbohydrates can lower HDL (nay) and fiber can help lower LDL (yay!).
  • For those pregnant or immune-compromised, cook eggs fully.

And ultimately, Dr. Lichtenstein reminds us how “all bets are off as to what the 2015 [dietary guidelines] will be.” Only time will tell if the 300 mg restriction lives on.

Want to have input on the 2015 dietary guidelines? The public comment period was recently extended until May 8, 2015. Click here to have your voice heard.

*Regarding those with diabetes there was an increased risk. Comparing those consuming more than a daily egg with those less than a weekly egg: adult men RR 2.02 (1.05-3.87; p = 0.04) and adult women RR 1.49 (0.88-2.52; p = 0.008). Those with diabetes have a higher risk for CVD, since sugars in the blood attach to LDL molecules keeping them in the bloodstream longer. Those with diabetes often have lower circulating levels of HDL and higher triglycerides, thereby more so increasing their risk of heart disease and stroke.

Ally Gallop, BSc, RD, CDE is studying towards an MS/MPH focusing in nutrition communication and behavior change. Her favorite egg dish is a scrambled egg, avocado, black beans, sweet potatoes, and Sriracha sauce.

Good Sense and Humor

By Katherine Pett

Why Someone Should Give James Hamblin, MD, a TV Show

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Dr. James Hamblin poses with students at the 2015 Gershoff Symposium

“The formula is simple, to write a bestselling diet book.  I’ll tell you…if you promise not to do it.”

James Hamblin, MD, Senior Health Editor at The Atlantic, paces in front of a giant projection of a man’s head.  Dr. Hamblin is tall, slight, and—as is often noted in profiles of the doc—looks young.  The projected head is slightly orange, suggestive of a spray tan, and belongs to Dr. David Perlmutter, neurologist and bestselling author of the book, Grain Brain, which blames gluten for all chronic diseases.

Hamblin is giving a talk at Tufts’ Friedman School of Nutrition as part of the annual Gershoff Symposium.  This year’s theme is “Nutrition Messages in the Media: Making Sense of the Chaos.” Despite the serious title of his talk, “Evolving Strategies for Effectively Conveying Nutrition Information,” Hamblin keeps the mood light.

A sense of foreboding enters his voice as he describes the recipe for a bestseller.  Starting slowly, voice low, he starts an alarmist “trouble in River City” style rant of a stereotypical Fad Diet Doctor:

“We’re in Danger,” he starts.

“There’s a Serious Problem.

It is threatening us all.

It is going to give us all everything you could possibly be scared of:

People are going to hate you,

You are going to get dementia,

You are going to be fat and have cancer,

AND have hypertension,

And be socially ostracized and every single thing!

You’re going to default on your mortgage!

And it is not your fault! You know it’s not your fault.

It’s the corporations and the government! They have lied to you!”

But luckily Dr. Hamblin’s fake diet book has the solution: a single, simple dietary switch that will save and your family from harm:

“Cut the gluten… You’re gonna see a lifespan triple!  You’re gonna go home and you’re gonna find a new car in your garage!”

The audience is laughing, but the topic is a pressing one. How do doctors, scientists, and nutritionists defend against sweeping assertions made by health gurus with fewer scruples about bending the truth? A headline saying that Mediterranean diets may or may not improve risk factors for cardiovascular disease is a lot less catchy than “one weird trick” that promises effortless weight loss.

Doctors like James Hamblin and David Perlmutter trade on their MDs; their medical content knowledge informs their prominent careers in media. While Perlmutter has leveraged his MD into a massive brand, fad diet book, and YouTube channel around his name and tagline, “empowering neurology” (draw Dr. Oz comparison here), Hamblin has taken what one could call a more measured approach. And though he isn’t interested in writing the next diet bestseller, his long-term aspirations are not modest.

Leaving his unfulfilling residency in radiology after year three of five years, Hamblin joined The Atlantic when the staff created a health segment for the online magazine. In the more creative essay style of The Atlantic, Hamblin uses his writing talent and self-deprecating sense of humor to take objective, approachable stances on divisive health issues. His work often requires him to interview the creators of fad diets and purveyors of pseudoscience, such as Vani Hari (The Food Babe) and Dr. David Perlmutter, who likens eating gluten to pouring gasoline on oneself.

Dr. Hamblin stars in The Atlantic’s popular video series “If Our Bodies Could Talk,” where he sheds light on awkward health situations like how to get a friend to quit smoking, or how to empower women to ask their doctors about orgasms. He’s also purchased (legal) THC laced candy…for science.

Hamblin’s accessible comedic style in “If Our Bodies Could Talk” make it easy to see him as a potential John Oliver or Stephen Colbert of health and nutrition, and Hamblin feels he’s headed in that direction.

“I want to entertain people, and I want it to be substantive; why don’t I do it about the thing I know and care about like health? John Oliver and Daily Show and Colbert, they set out primarily to entertain. And I really like that, I think that’s more my path.”

Blending health and comedy may be the ideal way to combat nonsense that floats around the Internet and daytime TV (Dr. Perlmutter has a 90-minute Grain Brain special that airs on PBS). And there’s no mistaking the powerful combination of common sense and jokes in YouTube clips that can easily be shared on Facebook, the major source of news for at least one third of Americans.

Perhaps getting people to laugh about the absurdity of gluten as the root of all evil, like a recent episode of South Park did, is the key to dispelling nutrition myths that can’t be combated through reasoning alone.

While Dr. James Hamblin doesn’t have any concrete plans yet, he’s open to the idea. As we spoke the day after his talk, he threw out the possibility.

“Yeah I’d love to have a TV show, and if you know anyone I could talk to…”

Katherine Pett is a first-year student in the Biochemical and Molecular Nutrition program at The Friedman School.  She can be reached at katherine.docimo@tufts.edu and on Twitter @smarfdoc.

To Juice, to Soup, or to Just Eat

by Emily Finnan, RD, LDN

Gwyneth Paltrow, Dr. Oz, and future bachelorette Kaitlyn Bristowe are a few embracing the latest weight loss and health solution: souping. Yes, move over juicing—souping is what’s hot.

The Soup CleansePea Soup

A soup cleanse doesn’t mean alternating between minestrone and clam chowder for a week. The soups are akin to smoothie, made of blended fruits and vegetables. Soupure, kitskitchen, and Real Food Works are a few companies offering soup cleanses. Some soups are served hot, others cold. There’s a romaine lettuce and tomatillo soup, strawberry sprouted cashew soup, and one of the few animal based soups: curried chicken.

The premise is simple. For one to five days, you eat only the soup shipped to you.  For about $60 a day you’ll get between four and six soups. Some companies offer additional flavored water and broths as part of their cleanse package.

The Juice Cleanse

Souping and juicing are the same concept. In juicing, for one to five days you drink only water or tea and five to six fruit and/or vegetable juice blends. Pressed Juicery and Suja offer juice cleanses between $55 and $72 a day.  Joe Cross, the star of Fat, Sick, and Nearly Dead, is the founder of Reboot with Joe. This company provides free recipe plans for a juice cleanse; accompanied by juicer and personal coaching marketing.

Health Claims

Souping and juicing boast similar health claims; including, detoxing from said built-up toxins, weight loss, energy boost, rest for your gastrointestinal tract, and a host of other claims. Some cleanse diets also instruct people to undergo periods of fasting or laxative use.

Studies on juicing or souping are limited. In one German study, participants drank 150-300 Calories of juice per day for about a week. They found some favorable changes in blood fat levels.  However, a week later, all levels were back to where they’d started. This speaks to the fact that any type of diet, followed only in the short-term, will have likely have little overall impact. This applies to weight loss claims too. A person could potentially lose weight on these low-Calorie cleanses, but if they switch back to their high-Calorie habitual diet, the weight will surely return.

This 2010 Sprout article examined the controversy surrounding detox diets. The “detoxing” concept, to put it plainly, doesn’t make sense. Juices and soups do not eliminate toxic compounds from the body. The only things that can do this are your liver, kidneys, intestines, and lungs. Life-long healthy habits, including a good diet, are important to keep these organs in good shape.

Soup and juice cleanse makers do not – as they should – recommend following their diets long-term. Doing so, as will be discussed in this article, would certainly be unfavorable in terms of health.

Souping vs. Juicing

Soups can satisfy

Soups may provide more satiety, or feeling of fullness, than juices. One study found that participants felt significantly less hungry after eating apple soup or an apple compared to apple juice. In another study, participants ate the same amounts of an apple, applesauce, or apple juice. Like the previous study, the apple and applesauce group felt significantly less hungry. They were then offered lunch 25 minutes later. They found that that the apple and applesauce group ate significantly less Calories at lunch than the juice groups. The apple group ate the least. Some soups in soup cleanses are served cold, sort of like applesauce.

The side-by-side

For easy comparison, one day of a soup cleanse, one day of a juice cleanse, and the dietary guidelines’ nutrient composition are lined up in the table below. I chose one day of a Reboot with Joe plan and one day of Soupure’s soup cleanse. The companies provided the nutrient information. The 2010 US dietary guidelines shown are based on a moderately active woman who is 31 to 50 years old.

Juice Soup DGs

*percentages do not sum to 100% as Calorie information was calculated from rounded gram values
**WHO 2002 recommendation

Juicing, compared to souping, has more sugar and carbohydrates, with less protein, fiber, and very little fat.  Both met guidelines for sodium intake and were low in calories. Souping is slightly above the US saturated fat goal.

Super sugary

The juice diet doesn’t meet recommendations for fiber and is very high in carbohydrates and sugar. More than half of the calories come from sugar! High-sugar diets are linked to unhealthy levels of insulin and triglycerides, but also more serious conditions, like non-alcoholic fatty liver disease and heart disease.

Juice diets are devoid of the nutrient-rich pulp and fiber-rich skin of fruits and vegetables. Pro-juicers typically claim that juicing “compacts” nutrients as it take several whole fruits or vegetables to make just one cup of juice. It is true that some nutrients may be present in higher levels, but so is sugar. Other vitamins and minerals that reside in the pulp would be lost. Furthermore, unlike whole fruit that has more fiber, the sugar in juice is in a liquid package.  Liquid sugar is absorbed more quickly and raises blood sugar to a higher level.  Below is a table comparing a cup of raw apple slices to a cup of apple juice.

Apple NF

Source: USDA Nutrient Database

As you can see, in the juice you’re getting more calories, more sugar, and less fiber. The juice does supply more potassium, but less vitamin C and folate.

Few fats

The juice diet provides very little fat.  An American Heart Association science advisory panel, led by Tufts University’s Dr. Alice Lichtenstein, examined diets less than 15% fat. They cautioned, in the short-term, these diets can lead to an unhealthy triglyceride level and decreased HDL or “good” cholesterol .

This juice diet is actually so low in fat that an essential fatty acid deficiency (EFAD) could be a concern. Your body can make some of the fats it needs for normal function, but others – essential fats – you must eat. EFAD is normally only seen in people receiving parenteral, or IV, nutrition who get too little fat. In parenteral nutrition, a minimum of 2-5% of Calories from fat are needed to prevent EFAD. It isn’t known, in food, what the minimum level is. Deficiency did occur in one man who ate a diet less than 7% fat for several months.

The Verdict

Variety is an essential part of a healthy diet. Many souping and juicing plans eliminate entire beneficial food groups like whole grains, lean meats, seafood, eggs, and dairy. This puts you at risk for nutritional inadequacies. It is clear that both souping and juicing don’t measure up as a long-term healthy diet.

If you are a healthy adult, there are (probably) no negative health effects of cleanse diets in the short term. If you are searching for a cleanse, it does appear that souping beats juicing. Souping offers a more ideal provision of sugar, carbohydrates, fats, fiber, and protein in terms of health.

Emily Finnan is a pediatric dietitian and a first year biochemical and molecular nutrition master’s student. While she does enjoy a good soup, she’ll stick to eating her fruits and veggies with a fork.

Probiotics: What Do These Bacteria Do?

by Nusheen Orandi

When I’m shopping in the dairy aisle of the grocery store, I stand in front of the yogurt section for a while. When did it get so huge? Greek, Icelandic, Kefir, whole milk, low-fat, non-fat, goat’s milk, and coconut milk are all options. What’s making yogurt so popular? Well, its probiotic nature is one of its claims to fame.

What does probiotic mean?

“Probiotic” describes anything that stimulates the growth of microorganisms in large enough numbers to enhance health. With food, this involves bacteria and yeast that ferment products we love, like beer, yogurt, and cheese. With health, the primary interest lies with gut microflora. Gut microflora affects health and digestion in a number of ways including food intolerances, food allergies, and other forms of gastrointestinal discomfort. This not only sparks nutrition research interests but food industry interests as well, who try to market the “functional foods” that could enhance health.

What makes yogurt so special?

The making of yogurt involves probiotic bacteria. Starter cultures begin the process of fermenting hot pasteurized milk to make yogurt. These starter cultures are bacteria not found in the intestinal tract that include Streptococcus thermophilus and L. delbrueckii ssp. Bulgaricus. However, other bacteria used in yogurt-making are found in the intestinal tract, such as members of the Lactobacillus and Bifidobacterium species. Because these bacteria are also found in the intestinal tract, they are known as “dietary adjuncts.” The bacteria in yogurt produce lactic acid, which reacts with milk protein to give it the creamy texture and tart taste. These bacteria’s ability to be produced in high amounts, withstand long shelf life, and benefit human health give yogurt’s its probiotic reputation.

What are the health benefits of probiotics?

Should we eat another bowl of yogurt or a second pint of Guinness? Microbiology experts think so. Scientific evidence points to many health benefits including anti-microbial activity, anti-diarrheal function, enhanced immune function, and improved lactose intolerance and gastrointestinal function.

Anti-microbial activity

Probiotic bacteria produce organic acids that suppress the multiplication of pathogenic bacteria like E.coli and salmonella, which can make us sick. The increased acidity of the intestinal tract enables this function.

Lactose Intolerance

People who experience discomfort from dairy products due to lactose intolerance can sometimes tolerate yogurt due to the probiotic bacteria. People with lactose intolerance lack sufficient amounts of the enzyme lactase in their intestine. Without enough lactase, people inadequately digest the milk sugar. The probiotic bacteria in yogurt contain an enzyme called b-D-galactosidase that partially digests the lactose in yogurt, making it easier for lactose intolerant people to eat yogurt comfortably.  Research also suggests that probiotic bacteria can enhance lactase activity.

Anti-diarrheal Function

Pathogenic bacteria and antibiotic use can cause diarrhea. Probiotic bacteria compete with diarrhea- causing pathogenic bacteria on epithelial cells in your intestine, which reduces the likelihood of diarrhea. Probiotic bacteria especially help people required to take a lot of antibiotics. The antibiotics reduce the amount of “good” microorganisms in your intestine, which can causes diarrhea symptoms. Probiotics help re-colonize the intestine with these “good” bacteria to improve intestinal movement. Hospitalized people who take a variety of medications may benefit from certain probiotic bacteria.

If probiotic bacteria are so good, should we add more to foods?

Because of the noted benefits of probiotic bacteria, debate surrounds the idea of adding more probiotic bacteria in addition to the ones found in traditionally made yogurt and other fermented products. One example is Activia brand yogurt. Probiotic bacteria are available in powders, capsules, and tablets. However the type, amount, and ratio of added probiotic bacteria remain unclear. Clinical trials raised discussion about whether probiotic bacteria given to infants could decrease food allergies later in life. However, further studies provided inconclusive evidence.

Probiotic bacteria not only help make the food we love, but help our bodies know what to do with it! Although those with dietary restrictions or illness may benefit from added probiotic bacteria, the probiotic bacteria found in our foods may be enough to give the rest of us the potential benefits. It just gives us another reason to maintain a well-balanced diet.

Nusheen Orandi is a first-year student from California in the Nutrition Communication program and likes to spend her time tea-shop hunting, tensely watching the Tottenham Hotspurs, and cooking and eating with friends and family.

How Does a Ketogenic Diet Affect YOU? Part 3: C-Reactive Protein: A Marker of Inflammation

by Katie Mark

The latest craze surrounding the ketogenic diet has us further investigating whether or not a high-fat/low-carbohydrate lifestyle might be an appropriate dietary approach for some people. In this 3-part series (click here for part 1 and part 2), we’re evaluating how the ketogenic diet affects biomarkers.

The ketogenic diet is a very low-carbohydrate (<10% of total calories), moderate protein and high-fat (>70% of total calories) diet. After at least two weeks of keto-adaptation, the body’s energy source switches from glucose to fat.

In part one of “How Does a Ketogenic Diet Affect YOU?” we found studies suggesting that nutritional ketosis lowers fasting glucose and insulin levels and possibly increases insulin sensitivity. In part two, we investigated the impact of ketosis on cortisol. We found that a high-fat, carbohydrate-restricted diet may increase certain forms of cortisol, but blood cortisol levels are only half the story. Further research is needed to clarify the relationship between ketosis and an increase in certain forms of cortisol: the active form (cortisol), the inactive form (cortisone) and metabolites of cortisol from enzymatic breakdown.

Now let’s evaluate how the ketogenic diet affects C-reactive protein (CRP).

Increased CRP: Is there a need to worry?

C-Reactive Protein

C-Reactive Protein Model

CRP is considered a marker of inflammation. The liver makes CRP when inflammation in the body is present. High levels of CRP are influenced by genetics, high stress, exposure to environmental toxins and a sedentary lifestyle. Diet can also impact CRP levels, especially diets high in refined and processed foods.

There are two blood tests to measure CRP. The non-specific test indicates acute CRP levels that result from general inflammation in the body. The more sensitive measure is the highly sensitive CRP (hs-CRP) test, which accurately measures basal levels of CRP by measuring inflammation in blood vessels. The hs-CRP test is the accepted measure to determine the risk for cardiovascular disease (CVD).

Higher CRP levels signify a higher risk for developing CVD and abdominal obesity. Weight loss is known to decrease markers of inflammation such as CRP.

It is believed that a high saturated fat and very low carbohydrate diet (VLCARB) increases the risk for CVD. A study published in Nutrition Metabolism (London) compared a VLCARB diet to two low saturated fat, high carbohydrate diets to determine their effect on body composition and CVD risk. The isocaloric (similar calorie composition) diets were: very low fat (CHO:fat:protein; %SF 70:10:20), high unsaturated fat (50:30:20; 6%) and VLCARB (4:61:35, 20%). The study concluded that weight loss resulted in a reduction of CRP regardless of the dietary macronutrient composition. Yet, it is uncertain whether or not the macronutrient composition of a diet influences inflammation.

A study published in The Journal of American College of Nutrition found an increase in CRP in overweight women who followed a short-term low carbohydrate, high-fat weight loss diet. The study reported that an increase in CRP might have resulted from the oxidative stress caused by this type of diet.

Another study published in Obesity (Silver Spring) looked into the inflammatory response caused by a high-fat, low-carbohydrate weight loss diet (HF) by randomly assigning 19 overweight men and women to either an antioxidant (AS) or placebo (P) supplement. The objective was to see if the antioxidants vitamins C and E could decrease the inflammation reported in a HF diet.

CRP decreased 32% in the AS group and increased 50% for the P group; however, this was statistically insignificant. The HF diet did not decrease CRP within the short-term 7-day study even though other markers of inflammation decreased.

The study could not confirm if oxidative stress was causing the inflammation. It was concluded that further research is needed to determine the different CRP responses over the long term, especially while using antioxidant supplements. This is important considering most fruits and vegetables, which are low in fat, contain antioxidants.

The Verdict

A ketogenic diet may increase CRP levels, but weight loss reduces CRP levels. The reason for the increase in CRP is unclear. One plausible explanation is that low intakes of magnesium, vitamin C and other nutrients while on a ketogenic diet may lead to this effect. When magnesium is low, CRP increases. It has been reported that increased vitamin C intake may reduce high CRP levels.

An imbalance between anti-inflammatory fats (omega-3 fatty acids) and pro-inflammatory fats (omega-6 fatty acids) is another possible explanation. Polyunsaturated vegetable oils primarily contain the pro-inflammatory omega-6 fatty acids. Eating less grain-fed meats and chicken and more grass-fed meats and free-range chicken is also important to consider. Grain-fed animals have higher omega-6s whereas grass-fed animals have higher omega-3s. Omega-3s are anti-inflammatory and important for normal body functions, including regulating blood clotting and building cell membranes in the brain. Omega-3s are also suggested to protect against heart disease.

An elevated CRP level is never a good thing. If you are opting for a ketogenic diet, increasing magnesium and vitamin C intake as well as choosing grass-fed products may reduce CRP levels.

Katie Mark is a first year Nutrition Communication/Master of Public Health student who enjoys road cycling and traveling.

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