The Basics of a Ketogenic Diet

by Mireille Najjar

The ketogenic diet remains one of the most extreme types of low carbohydrate diets, yet its potential role in tumor regression and pediatric epilepsy treatment has become an increasing topic of study among researchers and health professionals worldwide.

What is the Ketogenic Diet?

The ketogenic diet is a low-carbohydrate, moderate-protein, high-fat diet often used to control seizures in children with epilepsy. In such cases, the diet is usually recommended when two or more anti-seizure medications fail to control the seizures or result in harmful side effects. The diet requires careful monitoring by a medical support team, including a pediatrician, a neurologist and a dietitian. After two to three years, a normal diet is reintroduced gradually, depending on the progress of the child. A doctor may also slowly reduce the dosage of medications at this time.

High fat sources common in the ketogenic diet

High fat sources common in the ketogenic diet

Some individuals follow the diet to lose weight and have reported successful short-term weight loss after several months by eating low-carbohydrate, high-fat meals daily. Several studies have also reported unknown or beneficial long-term effects of the diet, particularly in obese patients with high cholesterol. While it can induce rapid weight loss, it is always important to consult a doctor or dietitian before beginning a ketogenic diet.

How Does the Diet Work?

The ketogenic diet works by shifting the body’s energy source from carbohydrates to fat. When the body is in a fasting state, it creates molecules called ketone bodies that build up as the body burns fat for energy—a process called ketosis. The exact reason is unknown, but researchers believe that the high production of ketone bodies improves seizure control in some epileptic children who show no signs of improvement with medication. Some studies, such as a 2010 case report in Nutrition & Metabolism, also show evidence of reduced tumor growth in cancer patients who receive chemotherapy and radiation along with the ketogenic diet.

Characteristics of the Diet

In general, the ratio of fat to carbohydrates and proteins is four to one (4:1) and must be tailored specifically for each individual. This is approximately 60 percent of calories from fat, 35 percent from protein, and 5 percent from carbohydrates. When starting out, it is recommended to limit net carbohydrate intake, which is the amount of carbohydrate in a food that the body is able to use for energy, to 20 grams per day to help the body enter ketosis. Afterwards, it should be limited to less than 50 grams per day. The amount of net carbohydrates per day is dependent on an individual’s own metabolism and activity level.

Many people—particularly adults—find the ketogenic diet difficult to follow since it is very limited in the types and variety of food it allows. The diet is based mostly on fat, protein and vegetables (specifically green leafy vegetables) that provide most of the carbohydrates you eat. Since the diet does not supply sufficient amounts of vitamins and minerals, people usually need to take vitamin and mineral supplements. They must also be completely committed to following the diet for it to work effectively.

Below are some tips on what you should and should not eat, as well as general tips, while on the ketogenic diet:

Foods to Eat

  • Eat plenty of green leafy vegetables like spinach, lettuce, cabbage, broccoli, cauliflower, celery and cucumbers. Limit vegetables like red and yellow peppers, onions and tomatoes, and avoid starchy vegetables like potatoes since they contain higher amounts of carbohydrates.
  • Consume peanut butter, cheese or boiled eggs as a snack. Nuts (with the exception of macadamias and walnuts) should be consumed in moderation since they are rich in inflammatory omega-6 fatty acids.
  • Meat, such as beef, pork and lamb, can be cut or prepared any way you like.
  • Leave the skin on poultry (chicken, turkey, quail, duck, etc.) to increase the fat content. It can also be prepared any way you like.
Beef stir fry, an easy-to-prepare ketogenic meal

Beef stir fry, an easy-to-prepare ketogenic meal

Foods to Avoid

  • Avoid low-fat foods. Since you are getting most of your calories and energy from fat, you need to make sure you are eating enough high-fat products, such as bacon, full-fat dairy (including raw and organic milk products, such as heavy whipping cream, sour cream, cottage cheese, cream cheese, hard and soft cheese, full-fat yogurt, etc.), mayonnaise, oil and butter.
  • If you choose to drink coffee, avoid extra sugar and milk. Instead of sugar, use a sweetener such as Stevia or EZ-Sweetz®. Replace milk with almond milk or heavy cream for a low-carbohydrate alternative.
  • Do not eat fresh, dried or frozen fruit since fruit is high in carbohydrates and fructose, the natural sugar found in fruit. If you choose to eat something sweet, you can eat one or two strawberries, but the fructose might prevent ketosis.
  • Avoid all grains and grain products, juices made from fruit and vegetables, beer, milk (1 percent and skim), beans and lentils, which are all high in carbohydrates.

Important Tips to Consider

  • Check the carbohydrate content of everything you eat. Some foods, such as processed sausages, cheeses, and sauces, contain hidden carbohydrates. For example, added honey and artificial sweeteners in regular low-carbohydrate mustard can increase its carbohydrate content. Be sure to check the carbohydrate content of mayonnaise and oil-based salad dressings, too.
  • Keep track of your daily food and carbohydrate intake. Keep a spreadsheet, use an online food intake tracker, or record the foods you eat in a journal. Write down how you felt each day and any changes you made. If you go off track, you can look back and see what was successful for you.
  • Always choose the lowest carbohydrate options to make sure you do not exceed your daily carbohydrate limit of 50 grams per day. Also, check food labels for net carbohydrates, which are the total carbohydrates minus the amount of fiber.
  • Take a daily multivitamin to replenish the nutrients lost while following the diet.

1-Day Sample Menu (4:1 ratio, approximately 1,884 calories)

Breakfast: Eggs (4 whole eggs, ½ avocado)

Total calories: 419
Fat: 31 g
Protein: 25 g
Net carbohydrates: 5 g

Lunch: Chipotle salad, no dressing (lettuce, chicken, mild salsa, cheese, sour cream and guacamole)

Total calories: 585
Fat: 38 g
Protein: 45 g
Net carbohydrates: 9 g

Snack: Large spinach salad (spinach, olive oil and vinegar dressing)

Total calories: 340
Fat: 32 g
Protein: 4 g
Net carbohydrates: 2 g

Dinner: Cheesy chicken (2 grilled chicken breasts, ½ cup cheese)

Total calories: 380
Fat: 15 g
Protein: 62 g
Net carbohydrates: 4 g

Snack: 24 almonds

Total calories: 160
Fat: 15 g
Protein: 6 g
Net carbohydrates: 3 g

Daily Totals:

Calories: 1,884
Fat: 131 g (63.7% of calories from fat)
Protein: 140 g (30.9% of calories from protein)
Net carbohydrates: 23 g (5.4% of calories from carbohydrates)

Mireille Najjar is a first-year Nutrition Communication student originally from Lebanon. She has a background in nutrition and dietetics and hopes to further strengthen her true passion—writing—here at Friedman.

Recycle your term papers: Don’t just file them away

by M.E. Malone

Another class, another term paper. Another semester’s worth of work destined for a computer folder that will never be opened again. Wait. Stop. Why not ensure all that hard work lives on with the potential to be viewed by hundreds of thousands of others?

On Wikipedia.

me1

Every day, more than 14,000 edits are made to the 4.4 million Wikipedia articles currently available in English. Anyone can write or edit a Wiki page. You need a little expertise, a free account, some patience, and a little Wiki-know-how. Just like school, you won’t be paid for your hard work. Your name won’t be on your article; your efforts will probably not be reflected in your resume. But you can take satisfaction in knowing that you’ve helped a 9th grader in Mississippi or a bureaucrat halfway across the globe to better understand a topic you’ve just spent weeks mastering.

Friedman students are in a unique position to join the collective effort to build an accurate, useful, global, online encyclopedia.

“I had noticed that Wikipedia was weak on food policy topics but impressive on many other topics that I read for fun, such as history, religion, geography, computer technology, pop culture, and board games,” says Parke Wilde, associate professor at Friedman. Not one to assign typical term papers, Wilde asked his Determinants of U.S. Food Policy class to undertake a series of more hands-on projects. One such project was to take a careful look at food policy topics on Wikipedia and propose, develop, revamp, and publish articles for the site.

“Even though it is not perfect, Wikipedia provides insight into the strengths and weaknesses of a non-profit volunteer-centered approach to collaborative information sharing,” Wilde says. “Wikipedia’s writing principles, such as ‘neutral point of view’ and ‘assume good faith,’ are more profound than mere writing guidelines — they are connected to a more fundamental vision about how to learn from each other and thrive in a diverse society when no single opinion can win over all the others.”

The effort proved to be more time-consuming than we’d thought.

“That kind of work can seem limitless. There’s always more [work] than can be done,” says Kalyn Weber, a second year FPAN/MPH student who undertook a revision of the Wikipedia page on the Supplemental Nutrition Assistance Program (SNAP).
My experience was similar, as I edited the main “Food policy” and “Food politics” pages, and tried to make meaningful additions without trumping someone else’s work.

Wikipedia editors are encouraged to propose new pages or major edits to a page through a “talk” function available on the site to anyone who signs up as a user. Comments or critiques of other’s work are meant to collaborative, not combative. But as several of us working on the project found, there was no response to our proposed changes from other editors on the site.

“My biggest regret in taking on this project was my limited interaction with other wiki contributors,” Weber adds. “Although the SNAP page was highly trafficked, I was unable to facilitate any sort of meaningful collaboration with other ‘Wikipedians.’”

Wikipedia also strives for an encyclopedic tone that is relatively neutral and frowns on “original research,” which means citations are a key component of any work posted on the site. But if you’ve already written the term paper, you’re more than halfway there.

Interested? Go to en.wikiepedia.org. Use the search box on the upper right to see what’s been written about your topic of interest. Does the information look thin? Are there fine points you might add?

Great. Go up to upper-upper right corner and “Create account.” It takes very little time. Once you’ve done that, you can get started as an editor or page creator. All the instructions for joining the Wiki effort are located on the site.

Small edits are relatively easy. Revising a page in its entirety can be daunting, but also worthwhile. “The main reason why I wanted to update the SNAP page was to make it more palatable and informative for individuals who are eligible for SNAP,” she says. “Also, I disagreed with the general negative tone of the page and thought it really undersold the importance of SNAP as a component of the federal safety net.”

Whether you’re interested in policy, humanitarian assistance, nutrition science, or agriculture, there’s likely something on the site that could use some sharpening. Just to give you a flavor of articles Friedman students might help improve, take a look at these articles on Wikipedia.
• Advertising to children
• Behavior change (public health)
• Childhood obesity
• Community-based participatory research
• Environmental impact of agriculture
• FDA Food Safety Modernization Act
• Human Nutrition Research Center on Aging (HNRCA)
• Humanitarian aid
• Let’s Move! (see subheading “Impact”)
• Nutrition program for the elderly
• Nutritional rating systems
• Nutrition transition (see subheading “Case studies”)

Heavy editing sessions on Wikipedia led to a job for Lane Raspberry, whose title is Wikipedian in Residence and Consumer Reports magazine. Speaking in July to students at a summer seminar in Digital Health Strategies, offered through the M.P.H. program, Raspberry said his interest in health topics led him to become engaged in the Wikipedia community. Later, when Consumer Reports magazine decided to launch a health-focused initiative, they found Raspberry and hired him to help with their effort.

Raspberry emphasized that this volunteer-driven project may be the most widely read publication in history and its democratic approach is a sound one. In addition, people looking for information about health topics increasingly turn to Wikipedia.

“There’s no fame. No self-promotion,” he advises. Think of readers and what you can contribute to their experience and their knowledge. Ask yourself: “What do readers really want [to know?]?”

M.E. Malone is a second year MS/MPH student who usually has either food or food policy on the brain. She can be reached at me.malone@tufts.edu.

Alumna Spotlight: Sarah Borron, Researcher at Food & Water Watch

by Janeen Madan

Rajdeep

Alumna Sarah Borron graduated from Friedman in 2007 with a degree in Agriculture, Food and Environment. She is now a researcher on the food team at the DC-based Food & Water Watch. With jobs and internships on everyone’s minds, Sarah has lots of timely advice for Sprout readers. And she’s excited to meet current students at the upcoming Washington D.C. Alumni Networking Trip in March. For more information on attending the trip, contact Sean Devendorf at sean.devendorf@tufts.edu.

The Friedman Sprout: What was your background before attending Friedman?

Sarah Borron: Immediately before Friedman, I worked in Washington, DC, as an Emerson Hunger Fellow and then Policy Associate with the now-defunct Community Food Security Coalition.  I advocated for language in the 2005 Child Nutrition Reauthorization to provide grants for Farm to School programs.

TFS: What did you enjoy most about your time at Friedman?

SB: I enjoyed the people. It’s a rare opportunity to spend your time learning with a lot of people interested in and knowledgeable about food policy, nutrition, and food itself.  Beyond the classroom, I have so many good memories of meals shared, informal field trips and projects, and the student-organized spring break trip to Italy.  I owe a lot of learning to my inspired Friedman friends.

TFS: How has your Friedman education helped you get to where you are today?  Which classes did you find most beneficial?

SB: Collectively, my classes taught me to see issues more critically and deeply than I would have otherwise. Willie Lockeretz and Kathleen Merrigan’s courses in particular led us through the complex relationships between science and policy. In Ray Goldberg’s Agribusiness course at the Harvard Business School, we often analyzed decisions in front of the very CEOs and government officials who made them, a practice that built my confidence advocating to those in power.

TFS: Can you tell me a little bit about your career trajectory after graduating from Friedman?

SB: After graduation, I joined my husband in Las Vegas, not the most conventional geographical choice for an AFE graduate! My timing could not have been better. The food bank there was in the process of a complete organizational overhaul. As a former Emerson fellow, and with my Non-Profit Management concentration from Tufts, I was hired on to rebuild the Agency Relations and Programs departments. We worked with over two hundred agencies to distribute food, started a backpack program serving thousands of kids, joined the USDA Summer Food Service Program, and made advocacy a regular part of the food bank’s work.

I always had the goal to return to full-time food policy work and joined Food & Water Watch shortly after our return to Washington, DC, in early 2010.

TFS: What is your current role as a food researcher for Food & Water Watch?

SB: As a researcher, I research and write reports, issue briefs, blogs, and other documents to support our campaigns. I track regulations and regularly write public comments on behalf of the organization. I also serve as a knowledge base for any organizational questions on my areas of focus. I primarily focus on issues related to the industrialization of livestock agriculture, as well as food marketing to children and some related nutrition issues.

TFS: What is the most rewarding and most challenging aspect of your job?

SB: On a regular basis, my job is rewarding simply because I find these topics so interesting.   On a much less frequent basis, we see a real change for the better on our issues. Those moments are rare, so, as an advocate, it’s certainly important to also enjoy the process. Perhaps the most challenging aspect of my job is that so much of what we do depends on what Congress and the Administration do.

TFS: Do you have any advice for current Friedman students, both those graduating this spring and those gearing up for summer internships?

SB: Take a hard look at available courses and consider what will be most useful to you in your career, but also more broadly about what intellectual itches you’d like to scratch before you leave the world of full-time student life.

Make as many connections as you can, and don’t hesitate to reach out to those connections and to Friedman alums as you look for internships and jobs. I look forward to meeting some of you during the DC Student and Alumni Networking Trip in March.

Janeen Madan is a first-year FPAN student by day and a kitchen fanatic by night. She is interested in international nutrition programs, is addicted to clementines and enjoys collecting old maps. Read more about her at our Meet Our Writers page.

FDA’s Proposed Trans Fat Ban and Potential Environmental Impacts

by Barbara Patterson

Last month, the Food and Drug Administration made a substantial first step at banning partially hydrogenated oils– the primary source of industrially produced fats. FDA has made a tentative decision that partially hydrogenated oils are no longer recognized as safe in foods. If finalized after the 60-day comment period, the decision would mean that food manufacturers would no longer be permitted to sell partially hydrogenated oils or use them as ingredients without prior approval from FDA for use as a food additive.

Under an amendment to the Federal Food, Drug, and Cosmetic Act, in 1958, any substance that is intentionally added to a food is classified as a food additive and is subsequently subject to pre-market review and approval by FDA unless it is generally recognized as safe, or GRAS as its commonly referred as.  A food substance may be GRAS through either scientific procedures or through experience based on common use in food for substances used prior to 1958.  Partially hydrogenated oils have been used widespread commercially due to their ability to increase shelf life and inexpensive cost since the 1940s and have been considered GRAS by the food industry due to the pre-1958 use of partially hydrogenated oils.

FDA admits that trans fat consumption has declined tremendously since mandated nutrition labeling for all trans fats fully went into effect in 2008, based on the 2003 ruling from FDA.  Yet the Administration recognizes that certain populations still consume high levels of trans fats.   Those populations still consuming high amounts of foods containing trans fats face the risk of adverse effects on blood cholesterol levels and increased risk for coronary heart disease.  Trans fats are the worst offending fats because they raise LDL cholesterol, the “bad cholesterol,” and lower HDL, the “good cholesterol.”

What will replace trans fats in foods?  Likely other saturated fats will replace trans fat in the diet, resulting in increased use of palm or coconut oils.  If demand switches to palm oil, it may have devastating environmental impacts.  Indonesia, for example, has lost tremendous rainforest acreage due to the production of palm oil.  From 2009 to 2011, Indonesia lost 1.24 million hectares of forest, largely driven by increased palm oil production.  Indonesia has one of the world’s largest rainforest, and the depleted forests have made the country a significant contributor to global climate change.

Critics of FDA’s initial attempt to ban trans fat argue that the ban is no longer necessary since the labeling requirements prompted the removal of the majority of trans fats in processed foods.  The American Soybean Association stated in a press release, “We have concerns that if the FDA were to finalize this determination, food processor may be pressured to replace remaining partially hydrogenated oils with those high in saturated fat such as palm or coconut oils, which would not be a good outcome for consumers.”

If you would like to comment on the proposed removal of GRAS status for partially hydrogenated oils, you can submit a written comment on regulations.gov or mail a hard copy to FDA by the deadline, January 7, 2014.

Barbara Patterson is a 2nd year FPAN/AFE student focused on federal policy.  She loves bourbon, Michigan and her dog, Daisy. To learn more about her, please visit our Meet Our Writers page.

Nutrition News: Filters, Fantasy Football, and Freezers

by Sheryl Carvajal

There are several factors that play into our behaviors surrounding nutrition, from beliefs about food choices to outside factors dealing with the subconscious.  Sometimes, even random and unexpected things can influence how we see, choose, and eat food.

We can't get no satisfaction/S. Carvajal

We can’t get no satisfaction/S. Carvajal

Instagram
We live in a generation where social media is ever-present and has the power to reach across countries and oceans.  We can see the effects of the growing popularity of platforms like Twitter and Instagram; “selfie,” a word used to describe a photo taken of oneself has taken social media by storm, and has even become the Oxford Dictionaries 2013 word of the year.

Instagram is a photo-sharing smartphone app that you can use to apply filters to enhance the most ordinary of pictures, and often times a hashtag is assigned to increase traffic to your photo.  In addition to the selfie, it isn’t uncommon to see pictures of rainbows, animals, and steaming cups of cappuccino on your feed.  But one particular category of pictures that is filling the cyber photo book is pictures of delicious meals, which many label as #foodporn.  From intricately dressed salads to decadent desserts, taking and looking at these pictures can actually affect one’s appetite.

A study conducted by researchers at Brigham Young University suggests that looking at too many pictures of appetizing meals and treats can make eating less enjoyable.   Overexposure to these foods gives the viewer a sense of satisfaction and satiation without actually eating the food.  Essentially, it suggests that with the heightened sense of sight, you’ve already experienced the food, thereby causing the sense of taste to decrease.

While some restaurants have been known to ban patrons from taking pictures of their plates, maybe we should follow the example and save the food for our mouths instead of our eyes.

Food and Football
Whether you’re a lifelong fan of your hometown’s team, you’ve adopted the New England way and cheer on the Patriots every Sunday, or you’re just hoping for another win for your Fantasy team, football is often surrounded by food.  Tailgate food, finger food, and a fridge or cooler full of beer is often the go-to for diehard fans and casual viewers alike.

As college football Bowl Games and the National Championship draw near, and we gear up for Super Bowl Sunday, eating habits may not only be influenced during game time.  A study published in Psychological Science found that NFL fans whose teams lost on Sunday are more likely to consume extra fat and sugar the following Monday.  Compared to their usual consumption, fans of losing teams consumed an average of a 16% more saturated fat; for those whose team won, there was a decrease of about 9% in saturated fat compared to usual consumption.

Football fanatics might lose-eat/S. Carvajal

Football fanatics might lose-eat/S. Carvajal

Though there still may be other factors to consider in eating patterns and behaviors following a win or loss for one’s football team, it may be a good idea to try to be more conscious of your Monday diet, regardless of whether the Patriots (or your favorite team) come out with a “W.”

Fresh vs Frozen debate
As nutrition students, many of us love the idea of cooking with and eating fresh produce.  We hear phrases like “fresh is best” and try to limit pre-packaged foods.  I don’t know about you, but being in this field for so long, whenever I hear the word ‘frozen’ I have a knee-jerk response to associate it with processed foods, though that is not always correct.

It turns out that frozen fruits and vegetables might sometimes be more nutritionally valuable when compared with their fresh counterparts, according to a study done at the University of Georgia in collaboration with the Frozen Food Foundation.  The reason for this is that often times, the produce that you find at the grocery store isn’t at its nutritional peak.  Produce is picked before it is ripe so it can ripen during the transit from the farm to the shelves.

Especially for those items that are out of season, it may be a good idea to take to the freezers at the store, as they are frozen right after harvesting, which locks in the nutritional content.

Of course this isn’t the case if you grow your own fruits and vegetables, or you shop at your local farmer’s market or Community Supported Agriculture (CSA), as they don’t lose their nutritional value from a long transit.  However, if you do happen to shop at big name supermarkets, you may want to think twice before overlooking the frozen produce aisle.

Sheryl Lynn Carvajal is an avid Instagram-er and Fantasy Football “coach.”  Though her hometown NFL team is currently and sadly the worst team in the league, she can’t wait to watch Florida State play in the National Championship game! To learn more about her, please visit our Meet Our Writers page.

When it comes to heart disease, could carnitine be the culprit?

By Natalie Obermeyer

Research

A recent study published in Nature Medicine led by Stanley Hazen of the Cleveland Clinic has found another explanation for why red meat contributes to heart disease: red meat is rich in the amino-acid carnitine. The researchers demonstrated that when carnitine is ingested, bacteria in the small intestine convert it to trimethylamine (TMA), which is further converted to trimethylamine-N-oxide (TMAO). TMAO is believed to be responsible for accelerating atherosclerosis contributing to heart disease.

The link between red meat consumption and heart disease has been well established. Epidemiologic studies show that vegans and vegetarians have a significantly decreased risk of heart disease compared to omnivores. A combined analysis on data from the Nurses’ Health Study and Health Professionals Follow-up study on over 120,000 people estimates that eating just 1 serving (100 grams) of red meat per day increases the risk of cardiovascular death by 18%. Historically, people primarily blamed meat’s saturated fat and cholesterol content; however, we now recognize that saturated fat and cholesterol do not explain all of the increased heart disease risk. Carnitine, which is metabolized to TMAO, may play a vital role.Meat1

The researchers found that when people eat red meat, their blood levels of both carnitine and TMAO increase. And after looking at the blood levels of carnitine and TMAO in about 2,600 men and women, the researchers found that increased carnitine and TMAO levels were associated with increased risk of heart disease and major adverse cardiac events (such as heart attacks, strokes, and death) in a dose-dependent manner. These associations remained after the traditional heart disease risk factors, such as smoking, high blood pressure, and cholesterol, were removed. The researchers also found that meat eaters have much higher levels of carnitine in their blood than do vegetarians.

Interestingly, when vegetarians are given meat to eat they produce less TMAO than omnivores. Vegetarians do not have as much of the bacteria in their intestines that are responsible for metabolizing carnitine into TMAO. The regular consumption of carnitine-containing foods (such as meat) promotes the growth of the bacteria that metabolize carnitine into TMAO.

The researchers also found that feeding mice carnitine caused them to develop atherosclerosis. However, when the mice were given antibiotics that blocked the production of TMAO from carnitine, they no longer developed atherosclerosis. Therefore, the authors concluded that TMAO is the molecule responsible for the increase in heart disease. The researchers theorize that TMAO both inhibits the body from excreting excess cholesterol and increases the ability of cholesterol to become lodged in the arterial walls, leading to the build up of atherosclerotic plaque.

Carnitine is found primarily in animal products, especially red meat. Carnitine, like carnivore, is derived from the Latin word carnis, which means meat. Dairy, fish, and chicken also contain smaller amounts of carnitine.

L-Carnitine Content of Selected Foods

Food Serving L-Carnitine (mg)
Beef steak 3 ounces 81
Ground beef 3 ounces 80
Pork 3 ounces 24
Canadian bacon 3 ounces 20
Milk (whole) 8 fluid ounces (1 cup) 8
Fish (cod) 3 ounces 5
Chicken breast 3 ounces 3
Ice cream 4 ounces (1/2 cup) 3
American cheese 1 ounce 1
Whole-wheat bread 2 slices 0.2
Asparagus 6 spears (1/2 cup) 0.2

Source: http://lpi.oregonstate.edu/infocenter/othernuts/carnitine/

This study has many implications. First, eating less meat can reduce heart disease risk. Fortunately, according to the USDA, beef consumption in the US peaked in 2002 and has has continued to fall since then. (See a post by Professor Parke Wilde in his U.S. Food Policy blog). However, Americans still eat much more red meat than is considered healthy, and it is recommended that we decrease our consumption.

Additionally, a number of supplements and sports drinks on the market contain carnitine. Body builders and athletes take carnitine because they assume it builds stronger muscles and increases fat metabolism. However, after the recent research on carnitine, consumers should think twice about ingesting the potentially toxic molecule.Meat2

Finally, some have suggested that rather than limiting meat consumption, researchers should look for antibiotics that might kill the bacteria that metabolize carnitine into TMAO. However, this direction of research is not very promising. An antibiotic would need to be found that only kills this one type of intestinal bacteria and not the others. Our gut hosts numerous different bacteria which maintain intestinal health, support the immune system, and activate nutrients and vitamins; certain bacteria may even play a role in regulating insulin and body weight. Rather than researching how to kill bacteria to stop TMAO synthesis, efforts should be focused on decreasing our overall meat consumption. In doing so, not only will we avoid the carnitine, we will also avoid the saturated fat and cholesterol.

 Natalie Obermeyer is a first year student in the Nutrition Communication and Masters of Public Health programs. When she is not studying, reading, or writing, she loves to run, hike, ski, play outdoors in the sunshine, and experiment in the kitchen

Eating earlier in the day may help you lose weight

By Natalie Obermeyer

Research

We constantly receive information on what and how much to eat. But, have you ever thought about when we should eat? A recent study by researchers of the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University suggests that eating your main meal earlier in the day may facilitate more weight loss than eating the meal later in the day.timing

Jose Ordovas of the HNRCA’s Nutritional Genomics Laboratory collaborated with researchers from Brigham and Women’s Hospital and the University of Murcia in Spain to track the weight of 420 men and women in Spain who were enrolled in a weight loss program. They found that people who ate their main meal earlier in the day lost 2.3% more body weight (21.8 lbs as compared to 16.9 lbs). Even though both early-eaters and late-eaters had equivalent calorie intakes, energy expenditures, and ate similar foods, the early-eaters lost more weight.

Interestingly, the researchers found no significant associations between timing of smaller meals and weight loss. The predictor of weight loss differences was the timing of the main meal, which in Spain is lunch and provides approximately 40% of daily energy intake. However, late-lunch eaters generally ate less for breakfast or were more likely to skip it altogether. Thus, eating a nutritious breakfast may also play a role.

This study was the first prospective, longitudinal study to show that timing of meals predicts weight loss effectiveness in humans. However, multiple animal studies have shown that timing of food intake predicts weight gain. For example, feeding nocturnal mice a high-fat diet during the day (when they usually sleep) causes them to gain more weight than feeding the mice a high-fat diet during the night, even though the mice’s calorie consumption and activity levels are the same.

Additionally, there is evidence emerging that adipose (fat) tissue contains a circadian clock inside it. For example, certain genes in fat tissue are expressed at certain times of the day. The temporal expression of these genes may cause the cells to be more susceptible to storing or mobilizing fat at certain times. Thus, eating a large meal when adipose tissue is in a more fat-storing mode may increase weight gain.

Finally, it is important to realize this was an observational study. While the study found a significant association between timing of food intake and weight loss, this does not necessarily mean that eating meals earlier in the day directly causes more weight loss. The association is novel and important, but more studies need to be done to determine if meal timing does indeed play a causal role in weight loss. Nevertheless, the study certainly suggests that it is important to factor in meal timing, in addition to food content, when planning weight-loss strategies.

Natalie Obermeyer is a first year student in the Nutrition Communication and Masters of Public Health programs. When she is not studying, reading, or writing, she loves to run, hike, ski, play outdoors in the sunshine, and experiment in the kitchen

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