February: The Heart Issue

Dear Readers,

This February, we have busy minds and heavy hearts. Not only are some of us beginning to gear up for life after Friedman, but political unrest and uncertainty, social injustices, and–as always–unqualified nutrition claims abound. That’s why The Sprout is back after our winter hiatus to help clear your head and nurture your heart and soul.

So, you went to the Women’s March. That’s great! But there is still work to be done. Sam Hoeffler fills us in on the 10 actions in 100 days movement, and how you can get involved at The Friedman School.

Next, Christine Sinclair and Katelyn Castro warm our souls with delicious recipes. Ever heard of ackee? No? Well you are missing out on this delicious and culturally significant fruit. No worries, Christine has you covered. Then, Katelyn gives us 10 hearty (and heart-healthy) soups that take no time at all. (And are much better than canned.)

And it wouldn’t be Heart Health Month without the temptation of Valentine’s treats (a.k.a. chocolate and sugar, the true heroes of V-day). Jenn Pustz details the mysterious history of how chocolate–and its subsequent partner in crime, sugar–became the commercialized symbols of love and affection. Awwww.

Once you’ve had your fill of treats, Danièle Todorov, Delphine Van Roosebeke, and Julia Sementelli will convince you that proper nutrition is, well, common sense. Danièle and Delphine interview a prominent cardiovascular clinician, getting his take on quick fixes and supplements. Who else comes to mind when you read “supplements?” Right, Dr. Oz. Julia details the state of this epidemic and how the spread of false nutrition information is confusing patients everywhere. And get this: She even interviews the great and powerful Oz himself!

Last but not least, Christina Skonberg and Krissy Scommegna take us on a trip to California to learn about supply chains, and how producers doing good in the world make production decisions.

Cheers,

Micaela & Kathleen

Turning a Moment into a Movementscreen-shot-2017-02-01-at-8-18-13-am

by Sam Hoeffler

Donald Trump is the president of the United States. Now what? Join the movement.

 

Ackee: Jamaica’s Irresistible Delicacy

ackee1by Christine Sinclair

Ever heard of Jamaica? Yes? Ever heard of Bob Marley and Usain Bolt? Yes? Ever heard of ackee? No? Well, just like Jamaica and our international stars, ackee is a star in its own right. You don’t quite know Jamaica until you know ackee. So let me introduce you. Ackee has a rich history dating back to the slave trade. It has a delicious flavor, and a unique texture that you will want to add to your cooking repertoire. 

 

10 Hearty Soups to Make in Less than an Hour

by Katelyn Castrotuscan-kale-and-bean-soup-preventionrd

Fresh almost always tastes better than the canned version, especially when it comes to soup. Having a few hearty soup recipes on hand that you can rely on can be a lifesaver when canned soup just doesn’t cut it. They say soup warms the soul, right?

 

 

The Bittersweet History of Valentine’s Day Sweets

valentine_digitalamherstby Jennifer Pustz

Preparation for Valentine’s Day seems to start earlier every year. The seasonal candy aisle in the local grocery store or pharmacy says goodbye to candy canes and red and green foil-wrapped sweets just in time to make room for heart-shaped boxes of chocolates and the ubiquitous “conversation hearts.” Valentine’s candy has been part of this celebration of love for many decades despite its connection with two ingredients that have very difficult histories: chocolate and sugar.

 

Coming Back to Common Sensepicture1

by Danièle Todorov and Delphine Van Roosebeke

Ever wish the question of what to eat could be, well, simple? In an interview with cardiologist Dr. Jacques Genest, we discuss themes in “common sense nutrition:” the research behind it, the barriers to adherence, and its evolving definition.

 

The Dr. Oz Effect

screen-shot-2017-02-01-at-8-46-41-amby Julia Sementelli

With the beginning of the new year inevitably comes an onslaught of promotions and advertisements for miracle diets, detoxes, and supplements that vow to help you shed pounds, live longer, etc. And when you think of diets and supplements, most likely two words come to mind: “Dr. Oz.”  He is a doctor, but he is also a registered dietitian’s worst nightmare. Read on for the inside scoop of how Dr. Oz further complicates the already messy, ever-changing world of nutrition and health, including an interview with the man himself.

 

Following our Food: A Northern California Supply Chain Adventure

by Christina Skonberg and Krissy Scommegnapicture1

How do people at different points of food production make decisions? As part of a directed study on Sustainable Supply Chain Management, Friedman students Krissy Scommegna and Christina Skonberg spoke with representatives at three different food and beverage businesses in California to learn how producers weigh costs and benefits to yield optimal results.

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Turning a Moment into a Movement

by Sam Hoeffler

Donald Trump is the president of the United States. Now what? Join the movement.

As a protester at Trump’s inauguration in D.C. on Friday January 20th, I met many people who did not identify as activists. I encountered people who had never in their lives been motivated to make signs and march in protest. It was inspiring to see so many people in the streets on Friday, and an estimated 3.3 million people across the country marched on Saturday too. Yet in the afterglow of one of the largest demonstrations in national history, we mustn’t forget our reason for protesting: the rise of nationalism and fear mongering that brought Trump to office.

Trump is poised to push our country off a metaphorical ledge, where we would fall into cronyism, oligarchy, denial of science, restraint of the press, and deeper social inequality and unrest. We the people are the only thing holding the country back from that ledge and what lies below. We the people, standing with linked arms and clasped hands, must inch the country back to solid ground. We need to rediscover and reclaim a solid ground where we can come together and fight for the rights of all Americans to live full, healthy lives.

We need to transition from this historic moment of protest to a unified movement that demands change. The moment becomes a movement when we do not simply hold our elected officials back from running the country off a ledge, but when we begin to take action and shape this country with our own hands. We must look downward, at our own feet, at our own hands, at our own communities, and get organized.

The leaders of the Women’s March on Washington are making our transition into the movement easier. They’re offering us a clear way to get engaged, calling for people to take part in 10 Actions in 100 Days. The Friedman Justice League will be facilitating each of the ten collective actions proposed by the Women’s March on Washington organizers. The first action has been published, and it is a call for postcard- and letter-writing to elected officials.

Let’s let our politicians know that we are not going back to sleep. We have been pulled to the streets, and we want to be a part of the positive change that can come after such an outpouring of activism, advocacy, hope, and protest. All Friedman community members—students, staff, and faculty—are welcome to take part in a postcard-writing event this week. FJL will provide the supplies, and even information on certain topics and addresses of elected officials.

This event is a first step in turning this moment into a movement. See you there!

WHEN: Wednesday, February 1st (11:15-12:15) and Thursday February 2nd (12:30-1:15)

WHERE: Jaharis café

WHAT: FJL will have a table with all necessary supplies for postcards and letters

CONTACT: samantha.hoeffler@tufts.edu, caitlin.joseph@tufts.edu

Ackee: Jamaica’s Irresistible Delicacy

by Christine Sinclair

Ever heard of Jamaica? Yes? Ever heard of Bob Marley and Usain Bolt? Yes? Ever heard of ackee? No? Well, just like Jamaica and our international stars, ackee is a star in its own right. You don’t quite know Jamaica until you know ackee. So let me introduce you. Sit back, because you are in for a treat! Ackee has a rich history dating back to the slave trade. It has a delicious flavor, and a unique texture that you will want to add to your cooking repertoire. And the recipe below is Friedman approved, having debuted the recipe below to a group of students with rave reviews.

Ackee is a fruit that grows in clusters of three in a pod on large evergreen trees in tropical climates, namely on the Caribbean island of Jamaica and in other parts of the world, including West African countries, Haiti, and parts of South America. The outer shell of this fist-sized fruit is bright red, with hues of orange and yellow. It has a tough outer skin that protects its delicate inside. As ackee matures and ripens, it naturally opens up to expose its edible contents. This unique and bountiful fruit grows throughout the island and, in fact, is Jamaica’s national fruit and a main ingredient in the national dish, ackee & saltfish.

Ackee has been Jamaica’s national fruit for centuries, having made its way to the island during the 18th century, carried over on slave ships departing West Africa. Its name is derived from the West African Akye fufo and its scientific name, Blighia sapidawas, was coined by a man named Captain William Bligh, and has since become a staple food in the Jamaican diet. The yellow arils are edible, while all other parts of the fruit, including the seeds are discarded.

Ackee fruit by Rik Schuiling

Ackee fruit by Rik Schuiling

Ackee not only has an interesting history, but a unique and potentially dangerous toxic property. Ackee goes through stages of maturation and ripening. During these different stages, ackee has varying levels of a water soluble toxin called Hypoglycin A and B. These toxins produce a symptom called Jamaican Vomiting Syndrome (JVS) aka Toxic Hypoglycemic Syndrome (low blood sugar as low as 3 mg/dL), which can cause severe vomiting, abdominal pain, coma and death. But, wait! Before you run off dismissing this delicate treat, let me explain how ackee can be enjoyed with no toxic effects at all.

In unripe ackee, the concentration of Hypoglycin A is about 1000 parts per million (ppm). As the fruit matures, in addition to its exposure to sunlight, Hypoglycin A is drastically reduced to 0.1 ppm in the mature fruit. Ingestion of immature ackee (a.k.a. ackee not left to properly ripen and naturally open) produces the toxic effect in humans.

Ackee found in the United States is precooked and canned, and has gone through extensive processing checks by the USDA to ensure safe consumption. And these checks seem to work: There have been no known cases of JVS in the United States from canned, imported ackee due to these regulations.

Photo: Ackee stages of maturity

Photo: “Tastes Like Home,” Ackee stages of maturity

What are the health benefits of ackee?

Although there hasn’t been a lot of research on ackee—partly because it isn’t grown in the United States—what little literature we do have suggests that ackee provides many health benefits. People in Jamaica will eat ackee cooked or uncooked. The uncooked version is said to serve as a strong diuretic, helping move the bowels and keep them in good shape. While the uncooked version cannot be found in the United States, the cooked form can be found canned in international markets. And don’t worry, only mature ackee is canned for your eating pleasure!

Ackee in both forms is rich in the monounsaturated fatty acids, oleic acid (55.4%), palmitic acid (25.57%), and stearic acid (12.59%), and is low in calories (about 151 calories per 100g can of ackee). Ackee is also rich in many vitamins and minerals, according to the West Indian Medical Journal.

How is ackee prepared?

When ackee is cooked with different meats and spices, it takes on the flavors of what you pair it with—without losing its own unique taste. Many find it difficult to describe the actual taste of ackee, saying it has the consistency of avocado with a rich buttery flavor. After interviewing a number of people, the verdict is still out. The best way to know? Try it for yourself!

At Ackee Bamboo Restaurant in Los Angeles, CA, owners Marlene and Delroy Beckford prepare this staple dish for customers unfamiliar with ackee’s delicious taste and powerful history. Hoping to give them a true and authentic experience of Jamaica, they give out samples to convince the novice that they are in for a treat. As Marlene said, “If you say you have had ackee [and saltfish] you have been to the island.”

Ackee and Jamaican Culture

Ackee’s uniqueness, beautiful range of colors and its authentic and delicious taste describes the very essence of Jamaica. Ackee is Jamaica! Rooted in a deep history of the slave trade, revolution and liberation, ackee is so much more than a delicious meal. To try and put into words the meaning that this national fruit has is close to impossible. But, if you would like a bite size experience of a rich and powerful history, the next time you spot ackee in your local market or pass by a Jamaican restaurant, be sure to pick up a can or stop in and ask for a plate of ackee and saltfish with dumplings, green banana, yellow yam and callaloo!

Picture: Ackee & saltfish with green banana, yellow yam, boiled dumplings and greens

Picture: “Pinterest,” Ackee & saltfish with green banana, yellow yam, boiled
dumplings and greens

Ackee Recipe

Ingredients – 4 people

1/2 lb saltfish (dried, salted codfish)*

12 fresh ackees or 1 (drained) can of tinned ackee

1 medium onion

1/2 tsp black pepper

3 tbsp of butter or cooking oil

1/2 a hot chili pepper (ideally Scotch Bonnet)

1 bell pepper (red, green or both)

1 chopped tomato

1 sprig fresh thyme or 1 tsp dried thyme

Optional ingredients: 2 cloves of garlic 4 scallion (green onion)

*Eliminate the saltfish to make this recipe vegan

Preparation

  • Cover the saltfish in cold water and let it soak overnight (minimum 8 hours) changing the water several times (this removes most of the salt)
  • Bring a pan of cold water to boil and gently simmer the fish for 20 minutes (until tender)
  • Chop the onion, bell pepper, chili pepper and tomato
  • Remove the fish from the water and allow to it cool
  • Remove all bones and skin then flake the flesh of the fish

Cooking

  • Melt the butter or add oil in a frying pan and stir fry the onion, black pepper, bell pepper, chili and thyme for about 3 minutes
  • Add the tomatoes and flaked fish and stir-fry for another 6 minutes
  • Add the ackee and cook until hot throughout and tender. Stir gently to avoid breaking-up the ackee

Serve with yam, green banana, or fried dumplings

ackee4

Christine Sinclair is a second-semester NICBC student in the dual MS-DPD program whose family is from the beautiful island of Jamaica. She is an avid health enthusiast who loves challenging activities such as boxing, cross-fit, and distance running. If Christine isn’t cooking, she is eating, or talking about food. 

10 Hearty Soups to Make in Less than an Hour

by Katelyn Castro

Fresh almost always tastes better than the canned version, especially when it comes to soup. Having a few hearty soup recipes on hand that you can rely on can be a lifesaver when canned soup just doesn’t cut it. They say soup warms the soul, right?

Snow. Wind. Frigid temperatures. Winters like these usually leave me craving a warm bowl of soup. It’s one of those comfort foods that never really gets old. The problem I have, though, is choosing what soup to eat. 

Canned soup is always easy. Just crack open the can, pour it into a bowl, zap it in the microwave, and violà! You’re done. But, in the end, I’m usually not satisfied with canned soup. Either the meat isn’t fresh, the broth is way too salty, or it just doesn’t fill me up.

Homemade soup, on the other hand, almost never disappoints me. Making soup from scratch can seem tedious though, especially when it involves a slow cooker, a food processor, hours of your time, and 20+ ingredients. Finding simple yet tasty soup recipes can be hard, which is why I put together this delightful list. These soups made the cut because they:

  • Take less than 50 minutes to make
  • Require 15 ingredients or less
  • Are filling, with enough protein and fiber
  • Are delicious, with a variety of flavors and cuisines (a.k.a. not just your typical chicken noodle soup)
  1. TURKEY CHILI

This turkey chili is perfectly spiced and hearty with a mix of ground turkey, kidney beans and corn—you won’t even miss the beef! And it’s a quick recipe to make for game day eats.

  1. TUSCAN KALE AND BEAN SOUP

If you’re in the mood for something Italian, try this savory Tuscan soup. The blend of vegetables, beans, and herbs brings me back to when I was eating my way through Italy. Add a sprinkle of Parmesan cheese on top and you’re good to go!

  1. HAM AND POTATO SOUP

Now, if you’re more of a meat-and-potatoes kind of person, this creamy ham and potato soup is for just you. Bonus: It’s gluten-free and dairy-free for those with allergies or intolerances.

  1. TOMATO LENTIL SOUP

Most lentil soups that I’ve tried kind of just taste blahh. It seems like there is always something missing! This lentil soup is different, though. With tomatoes, peppers, chilis, and a mix of spices, it has the right boost of flavor.

Source: Wholefully

Source: Wholefully

  1. ITALIAN WEDDING SOUP WITH QUINOA

This one’s a twist on your traditional Italian wedding soup, but it’s equally delicious. Plus, with all the meatballs, quinoa, and veggies, it’s loaded with protein and fiber to keep you full.

Source: Love & Zest

Source: Love & Zest

  1. SPINACH ARTICHOKE PESTO TORTELLINI SOUP

If you’re looking for something a little more carb-y, then try this tortellini soup. It’s like spinach artichoke dip, but better. With just 9 ingredients and 15 minutes of cooking time, it’s also quick and easy to make.

  1. CREAMY CHICKEN NOODLE SOUP

Campbell’s chicken noodle soup is great and all, but when you use fresh chicken, noodles, and veggies to make soup from scratch it’s hard to go back to the canned version. Plus, the creaminess of this soup makes it soup-er satisfying.

Source: Well Plated

Source: Well Plated

  1. GINGER TOFU AND VEGETABLE SOUP

Looking for a soup with more of a savory, umami flavor? With a blend of ginger, garlic, soy sauce, and bok choy, this Asian noodle soup is the perfect choice. To all the tofu skeptics out there: Give it a try!

  1. CHICKEN AND RICE FAJITA SOUP

Like the turkey chili, this soup definitely has a kick to it. Luckily the rice and beans are there to help you handle the spiciness a little better. Bonus: You only need one pot and 25 minutes for cooking time.

  1. CHICKPEA FARRO TOMATO SOUP

Farro is one of those whole grains that tends to stay under the radar. If you’ve never tried it before, now is your chance!  Cooked similarly to rice, farro’s nutty flavor makes it a tasty alternative to more common whole grains—especially in this soup.

Katelyn Castro is a second-year student in the DI/MS Nutrition Program at the Friedman School. She is a food science geek who loves experimenting with simple, flavorful recipes in the kitchen and forcing her friends and family to try her healthy concoctions.

The Bittersweet History of Valentine’s Day Sweets

by Jennifer Pustz

Preparation for Valentine’s Day seems to start earlier every year. The seasonal candy aisle in the local grocery store or pharmacy says goodbye to candy canes and red and green foil-wrapped sweets just in time to make room for heart-shaped boxes of chocolates and the ubiquitous “conversation hearts.” Valentine’s candy has been part of this celebration of love for many decades despite its connection with two ingredients that have very difficult histories: chocolate and sugar.

Europeans discovered chocolate during their conquest of the Americas, and its story—like any good love story—has been complex since this first encounter. The Aztecs consumed chocolate as a beverage and this preparation was transferred, along with shipments of cacao beans, across the ocean to Spanish royalty and ultimately throughout Europe. The love of chocolate made a return trip across the ocean when European colonists brought the practice of drinking chocolate with them to places like Boston, where consuming chocolate became a mark of high social status. The Museum of Fine Arts in Boston has several examples in its collection of eighteenth-century silver chocolate pots and porcelain mugs made specifically for the preparation and drinking of chocolate.

Many of the affluent men and women enjoying this beverage became wealthy due to their role in the sweetening of chocolate. Sugar shares its history with the slave trade, the economic growth of the North American colonies, and many New England families who owned and operated sugar plantations in the Caribbean islands. One family, that of Isaac Royall, Sr., lived in an opulent Georgian mansion less than a mile from Tufts University’s Medford campus. (In fact, a portion of the Tufts campus was at one time part of the Royall estate.) Royall owned a sugar plantation on the island of Antigua and following a series of slave revolts, droughts, and other natural disasters, decided to bring his family back to their Massachusetts home. Among the fragments retrieved during an archaeological dig were pieces of porcelain chocolate mugs.

It wasn’t until many decades later that chocolate emerged as a more widely-consumed beverage, became available in bars and other shapes, and was seen as a symbol of love presented in a heart-shaped box. Milton Hershey is widely recognized as the genius behind mass-produced commercial chocolate. He founded the Hershey Chocolate Company in 1894 and introduced the Hershey’s Kiss in 1907. As for the marriage of chocolate and Valentine’s Day? This has been attributed to the British chocolatier Richard Cadbury, who began selling the now ubiquitous heart-shaped boxes of chocolate in the 1860s.

In addition to sweetening bitter chocolate for consumption in truffles and Kisses, sugar is the base of many other popular Valentine’s Day sweets. In 1902, the New England Confectionary Company of Cambridge, Massachusetts, known as Necco, sold its first “conversation hearts.” These sweet and tart little candies were printed with a variety of messages, from the fairly innocent “BE MINE” to a more suggestive “KISS ME.” More than one hundred years later, Necco still manufactures the candy, but has updated some of the messages to include “LOL” and “YOU ROCK.”

As those of us who study at the Friedman School are well aware, chocolate and sugar continue to be controversial foods. The chocolate industry is fraught with issues like deforestation and unfair labor practices, and sugar is under attack from all sides due to its likely role in the obesity epidemic, as evident in the title of Gary Taubes’ new book What Not to Eat: The Case Against Sugar. Despite their associations with difficult social issues, chocolate and sugar continue to tempt us, but today’s world does provide us with choices. From fair trade chocolate to lower-sugar options, we can still indulge our Valentine’s Day traditions—even when we are aware of the long and bittersweet history of these favorite sweets.

Jennifer Pustz is a first-year NICBC student in the dual MS-MPH program. A public historian by training, she is also on the Board of Directors of the Royall House and Slave Quarters in Medford, Massachusetts, which is open to the public for tours between the end of May through the end of October.

Coming Back to Common Sense

by Danièle Todorov and Delphine Van Roosebeke

Ever wish the question of what to eat could be, well, simple? In an interview with cardiologist Dr. Jacques Genest, we discuss themes in “common sense nutrition:” the research behind it, the barriers to adherence, and its evolving definition.

New trends in popular nutrition seem to pop up every day. This fervor for novelty has distracted us from what Dr. Jacques Genest simply calls “common sense nutrition.” Dr. Genest is a clinician in cardiovascular disease at The Research Institute of the McGill University Health Centre and a former researcher at the HNRCA. We had the pleasure of speaking with him last November during the 5th International Symposium on Chylomicrons in Disease. (For brevity and clarity, the questions from our original interview have been paraphrased.)

picture1

From left to right: Delphine, Dr. Genest, & Danièle

Q: Supplements are immensely popular and it looks like they are here to stay. Is this frustrating to you as a practitioner?

I’m old enough to have given up. What I tell my patients is that I have no trouble with vitamin supplements, but nutrition will be far more imperative. I tell my patients to purchase [fish oils] in the original container. In other words: Eat fish. And to have a good diet as recommended by a food guide—fruits, vegetables, and no added salt. They are simple recommendations people love to forget.

Q: Such as?

Take a 46 year-old, blue-collar working male. He comes home and he will tell you that a nice piece of meat with a potato, brown gravy, and salt is like the elixir of the gods. If you put in front of him a regular salad with endives, he will not like that. So how do you change a mindset in which the palatability of food gives so much pleasure?

Q: As we have seen in the course Macronutrients [NUTR 370], there is a link between the carbohydrate intake and lipogenesis [the metabolic formation of fat]; however, there are still many people who put emphasis on minimizing dietary fat. Do you agree?

From a public health perspective, I think maybe it’s not as relevant as caloric intake. I have some patients that come back from France and they apologize because they’ve been eating some Camembert and some foie gras. I say, look, your lipids have never looked better. I think its portion size far more than anything else. Compare a steak that you would get in Europe—you’d get about a 3 oz. steak.  Here, you’d get basically a quarter of a brontosaurus. Now, I’m a huge believer in no saturated fat. I tell my patients, if you want to eat meat, eat meat that flies and that swims.

About thirty years ago, we went from a fat-diet to recommending a switch to carbohydrates. My personal impression is that this has been a huge mistake. The insulinemia you get with a high-carb diet is probably deleterious. Whereas a protein-rich, fat-rich diet is much more slowly absorbed, doesn’t produce hyperinsulinemia, and probably gives a better sense of satiety. I think we’ll look back and say that this might have been one of the biggest nutrition errors in the late 20th century.

We had forgotten about the covariates that come with a low-fat diet. Move to Japan where there is a relatively low-fat diet but you also have an incredibly good lifestyle. If you turn to more northern populations where you need the fat for some reason, you don’t necessarily correlate fat intake with cardiovascular disease. You don’t correlate caloric intake with cardiovascular disease.

Q: When you see patients, would you first talk about diet rather than prescribing medication?

My primary prevention patient—the 46-year-old man—I will often give up to two years to fix his bad habits. [If there is no lifestyle change in that time], then he is middle-aged, has high blood pressure, high cholesterol, and high blood glucose. He’ll need two pills for blood pressure, two pills for diabetes, a pill for cholesterol… Five pills when he’s 46; imagine how many pills he’s going to have when he’s really sick. And my success rate is probably less than 10%. The biggest threat [to long term health] is the insulin needle. It’s not having a heart attack, it’s going on the needle.

Q: What is the biggest gap in our knowledge that’s impairing how patients are treated?

You’re again a 46-year-old man. You have a bit of hypertension and your cholesterol is high. I put you on a statin and a blood pressure lower. At your next visit, your blood pressure is extremely normal and your cholesterol is extremely low. Why should you stay on an exercise program and a diet? The perverse effect of our outstanding medication may be that we’re not making the lifestyle effort to treat ourselves naturally.

Authors’ note: We can’t quite explain how we got onto this tangent about low-density lipoprotein (LDL), but it has been fascinating to think about and it would be a shame to exclude it.

What was your diet [50,000 years ago]? Tuberous vegetables, berries, and very little meat. Then something happens to you—you started domesticating animals. You got something you never had in your diet before, two things you rarely found in nature—cholesterol and saturated fats. It takes about a million years to change your genes through evolution. In 50,000 years, we haven’t had time to adapt to a huge influx of saturated fat and cholesterol.

How many animals do you think have LDL? Zero. Maybe the hamster if you feed it an extreme Western-style diet. But animals do not make LDL. In times of starvation, we developed the VLDL [very low-density lipoprotein] system. In my view, VLDL is unidirectional. [After removal of triglycerides by lipases], the particle should be completely taken up by the liver with no cholesterol on it. Where does the cholesterol go? It should go to HDL [high-density lipoprotein], which is the main source of cholesterol for most cells, rather than making or incorporating it. It might not be such a bad thing to say that we’re not meant to have LDL and that any technique to prevent it will be good, especially lifestyle nutrition.

Bottom Line

Surprisingly, there is a lot standing in the way of ‘common sense nutrition’. Adding a supplement or a medication is relatively easy compared to changing deep-rooted eating behaviors like food preferences and portion size. Recommendations around fat intake have changed dramatically and are still being hotly debated. The inclusion of animal products in these recommendations is even questionable from an evolutionary point of view. Dietitians and clinicians certainly have their work cut out for them.

A big thank you to Dr. Genest for taking the time to speak with us! It was a fascinating conversation and hopefully an equally enjoyable read.

Danièle Todorov is a first-year student in Nutritional Epidemiology with a focus on maternal nutrition and a minor obsession with lipid metabolism, a holdover from her biochemistry days.

Delphine Van Roosebeke is a master’s graduate in the Biochemical and Molecular Nutrition program with a background in biochemical engineering. Delphine has a crush on nutrients and the magic they perform in our body, and loves to share her knowledge with anyone who wants to hear it in a fun and approachable way! 

The Dr. Oz Effect

by Julia Sementelli

With the beginning of the new year inevitably comes an onslaught of promotions and advertisements for miracle diets, detoxes, and supplements that vow to help you shed pounds, live longer, etc. And when you think of diets and supplements, most likely two words come to mind: “Dr. Oz.”  He is a doctor, but he is also a registered dietitian’s worst nightmare. While dietitians are out there teaching patients and clients that weight loss cannot be healthfully achieved in a pill or in a 2 week “cleanse,” Dr. Oz is preaching the opposite. Read on for the inside scoop of how Dr. Oz further complicates the already messy, ever-changing world of nutrition and health, including an interview with the man himself.

A recent client of mine, Mark (name changed for privacy), eats a fairly healthy diet: Greek yogurt and berries for breakfast, a salad with lean protein for lunch, and something from the Whole Foods salad bar for dinner (he doesn’t like to cook).  He says that his major downfalls are cookies and beer. Mark’s goal is to lose 30 pounds and improve his overall health given his family history of heart disease. “Give me a meal plan and I will follow it,” says Mark. I can work with that. He is actually a dietitian’s dream—someone who already doesn’t mind eating well and is motivated to lose weight. I thought his meal plan would be a breeze, until he said “Oh—I should tell you about my supplements.” I had expected a multivitamin and some daily vitamin D, but my hopes were dashed as Mark rattled off more than 15 supplements that he is currently taking, only one of them being a multivitamin. Among these supplements were resveratrol, an antioxidant found in red grape skins that he claims sheds years off of your life, and Conjugated Linoleic Acid (CLA), which apparently melts body fat. When I asked Mark where he learned about all of these supplements, he said “Dr. Oz.”

No two words can send angry chills up a dietitian’s spine quicker than Dr. Oz. While I am a fairly green registered dietitian, I have interacted with enough patients to see firsthand the power of Dr. Oz. Dr. Mehmet Oz started out as the resident expert on “The Oprah Winfrey Show” for five years before he was given his own spotlight, “The Dr. Oz Show.” He holds three degrees: a B.S. in biology from Harvard and an M.D. and M.B.A. from the University of Pennsylvania. He is vice-chairman of the department of surgery at the Columbia University College of Physicians and Surgeons in New York. He is also likeable. Consequently, he has become one of the most trusted doctors in the world and yet he uses words like “magical” and “miraculous” to promote supplements that promise to burn fat or prevent cancer. However, what the public may not understand is that a pill is not a miracle cure for anything. According to Stephanie Clarke, registered dietitian and co-owner of C&J Nutrition in New York City: “Most MDs get very little (or zero) nutrition education and background—so it’s a frustrating when they dole out nutrition advice or research without enough details or without thinking about how their messages will be interpreted by the public and related to real life eating.” But Americans continue to believe in the power of nutritional supplements recommended by a doctor that (most likely) has had minimal nutrition education and, more surprisingly, continue to buy them.  In fact, Americans spent more than $21 billion on vitamins and herbal supplements in 2015.  According to analyses, just the mention of a product on the Dr. Oz Show causes a surge in sales.

This phenomenon has been coined as “The Dr. Oz Effect.” Combine charismatic with a few letters after his name and you have someone who is more believable than the thousands of nutrition professionals that use science, not pseudoscience, to back up their recommendations. Even my own father, who has type 2 diabetes, an affinity for soy sauce (read: sodium), and meets my attempts to improve his diet with stubbornness, listens to Dr. Oz. Meanwhile, I have gone through four years of undergraduate education in nutrition, applying for competitive dietetic internships (50% acceptance rate), a one year unpaid dietetic internship, studying for and passing a comprehensive exam, and an additional two years of graduate work to get to where I am. And yet I still don’t have the influence that Dr. Oz does to change my father’s food behaviors.

As a dietitian, I strongly believe in balance. It is my goal to reduce the all-or-nothing thinking that surrounds eating and exercise. The media and people like Dr. Oz perpetuate this mindset, capitalizing on the public’s obsession with weight loss and diets by highlighting drastic regimens and alleged cure-all supplements. Diets do not work because they typically deprive a person of entire food groups, fats or carbohydrates, for example, and eventually the individual gives in and eats those food groups in excess since they have been denying themselves of them for so long.

The demonization of food, another spawn of the media, is the belief that particular foods are good or bad. It has resulted in mass confusion and further damage to peoples’ relationship with food. One of the most infuriating examples of this demonization is fruit. Yes, fruit. “I heard that the sugar in fruit is bad for you” or “I was told not to eat pineapple because it is high in sugar” are actual quotes that I have heard from clients. And not surprisingly, both clients attributed their beliefs to Dr. Oz. After some research, I discovered that, lo and behold, Dr. Oz did a segment titled “Can the Sugar in Fruit Make You Fat?” that most likely influenced these beliefs. Aside from vegetables, fruit is one of the most wholesome food groups, packed with fiber, antioxidants, vitamins, and minerals. Yet fruit cannot even avoid falling victim to the war on food. Conundrums like this exist for nearly every food: eggs, fish, coffee, potatoes…the list goes on. The only way to try to reverse the damage is to tell people that no food is off limits and remind them that there is no replacement for good eating and regular exercise. The only way that I have seen weight loss occur is with gradual and sustainable changes over time. And anyone that promises anything different is lying or worse, using pseudoscience to make outrageous claims.

Pseudoscience, the basis upon which Dr. Oz has constructed his lucrative empire, involves exaggerated and often contradictory claims that are not supported by reputable research. The media is also a culprit of using pseudoscience, composing articles and news stories from press releases of studies with small sample sizes or that use mice as their subjects. Just because it is effective or safe for mice, does not mean it will be safe for humans. Many writers for tabloids and mainstream magazines are stretched for time and are more concerned with quantity rather than quality given that their main goal is to make headlines that sell papers and magazines. Unfortunately, such writers and apparent health experts like Dr. Oz produce the majority of what the general public sees and uses to shape its food choices. However, according to a study published in the BMJ in 2014: “Consumers should be skeptical about any recommendations provided on television medical talk shows, as details are limited and only a third to one half of recommendations are based on believable or somewhat believable evidence.” That’s right—more than half of what Dr. Oz claims on his show regarding nutrition is not based on science. While the show has seen a dip in ratings, currently 1.8 million still tune into the Dr. Oz Show and are consequently exposed to information that is incorrect 50-67% of the time according to the 2014 study in the BMJ.

Dr. Oz has been criticized by a slew of medical professionals for his scam marketing, most notably in 2015 when ten physicians wrote a letter to the dean of health sciences at Columbia University requesting that Dr. Oz be removed as a faculty member due to his “egregious lack of integrity” on his TV show. Dr. Oz defends what he tells the public by claiming that “it’s not a medical show,” despite the fact that the show is titled The Dr. Oz show. Dr. Oz says that freedom of speech gives him the right to say what he wants to. But it is difficult to respect this freedom when he is a faculty member at a prestigious university that makes false claims on TV.

I reached out to the Dr. Oz team and received a response from Oz himself. When asked where he finds his nutrition information he said, “We obtain nutrition information from a wide variety of sources. We rely heavily on literature published in scientific journals as well as textbooks. In addition we consult a wide variety of experts including medical doctors and nutritionists. Our research staff is made up of myself a physician trained in preventive medicine as well as 3 medical students who take a year off to work with us. We evaluate all of the content on our show to ensure that viewers are getting accurate information. One of our researchers this year has a master’s degree in nutrition as well.” I am not sure which scientific journals Dr. Oz and his team are using, but when I researched “curcumin” and “oil of oregano,” two of the supplements that Dr. Oz has promoted on his show and that Mark, my client, is currently taking, the conclusion was that “the existing scientific evidence is insufficient to recommend their safe use.” In our interview, Dr. Oz said: “We also reach out to the Friedman school when we have difficult questions. I spent a day up at the school this summer meeting with a number of your faculty. Most recently I have spoken to an expert about fiber fortified foods and to your Dean about the current opinions on dietary fats.” He included a note that says that he and his team welcome interns to join them every month from September to June and students from Friedman are welcome to apply. *Insert eye roll*

When I asked about Dr. Oz and his team’s stance on nutritional supplements, he replied: “In general we believe that many have a place in people’s life to enhance nutrition. We always love to see more and better studies conducted on the utility of supplements in promoting health.” This is a nice response but when I begrudgingly watched a clip from the Dr. Oz show in which he says that Conjugated Linoleic Acid (CLA) can help to burn body fat, even without diet and exercise, I realized that what he says and what he does do not match. And aside from empty promises and putting people at risk with questionable pills, he is encouraging people to waste their money. This is what I told Mark in an effort curb his daily supplement cocktail. If the risk of taking his favorite “fat-melting” supplement won’t stop him, maybe the opportunity to save money will.

Dr. Oz is frustrating for many reasons, but for nutrition professionals it is the fact he uses his credentials as a physician to get away with promoting pseudoscience. Being a dietitian no longer involves simply telling people what to eat. It is trying to untangle the web of misinformation surrounding nutrition that clients have woven over the course of their lives and re-teach them what a healthy relationship with food should look like. While turning to supplements can seem like an easy fix, science shows that eating a diet based on whole foods like fruits, vegetables, whole grains, lean protein, and healthy fats, is the ideal diet. Science does not show that a pill is the secret to losing those last five pounds that keep hanging on. If scientists really found a cure for obesity, we would not be hearing about it at 4pm on a Tuesday afternoon. And unfortunately, the supplement industry is not going anywhere. The FDA and FTC regulate the supplement industry, but not very well. So it is up to trained and licensed nutritional professionals (i.e. registered dietitians) to educate the public about the dangers of supplements and listening to people who are simply “health experts.”

Julia Sementelli is a second-year Nutrition Communication & Behavior Change student and Boston-based registered dietitian who works in a local hospital and also counsels private clients.  You can find her on Instagram (@julia.the.rd.eats- Follow her!) where she strives to intercept confusing nutrition messages from self-proclaimed health experts with expert nutrition advice and tips (as well as some beautiful food photos if she does say so herself!).