Sprinting Toward Summer

Dear Readers,

We’ve reached the end of another school year. Congratulations, you made it! Now is the time to reflect on what we’ve learned and celebrate the successes of the past year. Whether you’re graduating this month or going off to explore the professional world through an internship, I think we can all agree that we’re looking forward to catching up on fresh air, sunshine and… sleep. Bring it on, summer!

Did you miss the Student Research Conference last month? Fortunately, Jennifer Huang can fill you in on what you missed with her conference recap. (Plus photos!)

It’s often said that “you are what you eat.” Although Friedman students know that that’s a simplistic understanding of how nutrition actually works, Hannah Meier can give you the lowdown on one superfood to fuel your summer activity: sweet potatoes! Try her yummy, power-packed recipes.

But what if  you are what you eat  you are what you grow? Julie Kurtz reflects on her trip to Cuba last winter, and contemplates the lessons the U.S. food system might learn from Cuban agriculture.

Next up, Erin Child does some detective work to get to the bottom of the Pinnertest, a self-administered home test meant to identify all that ails you (a.k.a. food intolerances). Does it work? Erin talked to the experts.

As many of us approach graduation, we’re reflecting on the things we’ll take away from Friedman as we go on to pursue our professional careers. Katelyn Castro shares the lessons she’s learned over the years through her coursework and as a dietetic intern.

And finally, in a world of conflicting messages about nutrition and increasing uncertainty about science, it is often hard to be a persuasive voice for scientific truth. Rachel Baer explores the ways in which nutrition professionals can confront “alternative facts” about food and health.

Before we sign off for this academic year, congratulations are in order! We want to wish our very own co-editor, Micaela Young, a fond farewell as she graduates and moves on and up. Our social media editor and prolific Sprout writer, Julia Sementelli, is also graduating. Best wishes, Micaela and Julia! To take Micaela’s place, Hannah Meier has agreed to join Kathleen as the new Friedman Sprout co-editor for the 2017-18 year. Welcome, Hannah!

This year has been a blast, and we couldn’t have done it without all our fantastic and smart writers and readers. Thank you for a successful year of the Sprout. We look forward to bringing you more writing on food, agriculture and nutrition in the fall.

Happy Summer, everyone!

Kathleen Nay & Micaela Young

In this issue…

Revival of the Student Research Conference

by Jennifer Huang

The 10th Future of Food and Nutrition Graduate Student Research Conference, known fondly within the Friedman community as the SRC, took place on April 7th and 8th. Jennifer Huang gives us a photo-filled recap of this student-led event, where she—and all who attended—were blown away by the amazing capabilities of student presenters and the Friedmanites who worked tirelessly since last November on planning this event

From Soil to Sport: Sweet Potatoes to Power You

by Hannah Meier

As the temperatures slowly, and not so consistently, increase in Boston this spring, more of us will find ourselves out in the field, on the trails, or on the sidewalks soaking in the sunshine and working up a sweat. Even if you aren’t competitive, you have probably noticed the difference in how you feel during, and after, exercise when you are—or are not—properly fueled. Look no further for easy and delicious recipes to power your active spring using the grad student’s pantry staple: The sweet potato!

You Are What You Eat  You Are What You Grow

by Julie Kurtz

Imagine, if you will, that the U.S. was stripped of all its powerful agricultural fertilizers, pesticides and mechanization. Imagine that we were cut off from international trade imports. In Cuba they didnt have to imagine. They lived it. AFE students Julie Kurtz, Tessa Salzman and Jamie Fanous traveled to Cuba in January 2017 to find out what lessons the U.S. food system might learn from Cuba. One surprising lesson? If you want to change American diets, talk to a Midwest corn farmer…

Evaluating the Pinnertest: The Importance of Scientific Evidence

by Erin Child

So, you think you have a food intolerance? What do you do? You could call your doctor and set-up an appointment that is inevitably months away. Then you have a 10-minute meeting in which they only look at their computer and refer you to a specialist, THEN go through more testing, and finally (hopefully!) get some answers. Or, you could order an at-home kit that takes 10 minutes to complete and promises results that will get you feeling better, sooner. Which one do you choose? Read on and decide.

Nutrition in a Nutshell: Lessons Learned as a Dietetic Intern

by Katelyn Castro

I was one of those few teenagers who knew exactly what I wanted to be when I grew up. Now, after four years of college and two years of graduate school combined with a dietetic internship, a career as a registered dietitian is not far out of reach. While my passion for nutrition has never dwindled over these last six years, my approach nutrition has changed significantly.

Finding Common Ground for Nutrition in a World of Alternative Facts

by Rachel Baer

Rachel Baer tackles the implications of the “post-truth” culture for the nutrition profession and poses 3 questions to consider about our response to the unending barrage of nutrition-related “alternative facts.”

Revival of the Student Research Conference

by Jennifer Huang

The 10th Future of Food and Nutrition Graduate Student Research Conference, known fondly within the Friedman community as the SRC, took place on April 7th and 8th. Jennifer Huang gives us a photo-filled recap of this student-led event, where she—and all who attended—were blown away by the amazing capabilities of student presenters and the Friedmanites who worked tirelessly since last November on planning this event.

This year the SRC had its first-ever Poster Slam, where presenters competed against one another to win the prize for the best three-minute talk about their research. A total of 13 presenters from various institutions participated at this Friday evening event where an anomaly at Friedman occurred: Free beer and wine! (And delicious veggies, of course). Some presenters transformed their talks into an entertaining rap or poem, while others presented theirs straight. Topics ranged from food insecurity during and after climate shocks, celebrity marketing to global food supply and demand. Overall, there was just the right amount of (wine-fueled) nerdiness!

On Saturday, Helena Bottemiller Evich, Senior Food and Agriculture Reporter at POLITICO, gave the keynote lecture. While Helena anticipates fewer advancements in agriculture and nutrition policy during the Trump presidency than during the Obama administration, she holds a bit of hope after browsing Ivanka Trump’s Instagram, finding pictures of healthy food and farming. Maybe having Ivanka as an adviser isn’t a terrible thing after all, she mused. Helena also noted that advocates for the National School Lunch Program and other nutrition programs seem to agree as they have already begun to target lobbying efforts in Ivanka’s direction. In addition to Ivanka, Helena also mentioned other key players to follow for agriculture and nutrition issues, such as Chairmen Roberts in the US Senate Committee on Agriculture, Nutrition and Forestry and Chairmen Conaway in the US House Committee on Agriculture.

Helena recounted how she got out of her urban “bubble” before the election and spoke to farmers around the country. As a result, she was one of the few in Washington, D.C. who correctly predicted Trump presidency. She ended her talk by encouraging us all to branch out of our personal networks and engage with others of different mindsets.

Helena Bottemiller Evich gave her keynote speech. Photo: Jeroen Eyckmans.

Helena Bottemiller Evich gave her keynote speech. Photo: Jeroen Eyckmans.

The panel discussion in the afternoon continued the conversation about the future of food and nutrition, and was equally inspiring. The panelists came from various sectors, including Dr. Julian Agyeman, a professor of Urban and Environmental Policy and Planning at Tufts University, Dr. Richard Black, Principal at Quadrant D Consulting who recently served as the VP of Global R&D Nutrition Sciences PepsiCo, Ms. Anne McHugh, the Director of Chronic Disease Prevention and Control Division at the Boston Public Health Commission, and Ms. Sylvia Rowe, President of SR Strategy. Our very own Dr. Parke Wilde moderated the panel.

When discussing the role of scientific evidence across sectors, Ms. Rowe clearly summarized the current social climate when she said, “There is not going to be science for the sake of science anymore, [as] public faith in science is questioned.” On the topic of private and public partnerships, there was consensus among the panelists that it will be critical to “find the synergy of goals,” as stated by Ms. McHugh.

The panel ended on a lighthearted note when a student asked a hypothetical question: Without time and monetary constraints, what questions (not necessarily about food) would the panelists want to ask and solve? The answers ranged from establishing public-private partnerships to combatting obesity, nudging behavioral changes for healthier lifestyle, discovering the role of microbiome in health and disease, to promoting public acceptance of diversity by understanding our personal genomics. Their diverse responses suggest the richness of this multidisciplinary discussion.

Panel discussion on the role of scientific evidence across sectors. Photo: Jeroen Eyckmans.

Panel discussion on the role of scientific evidence across sectors. Photo: Jeroen Eyckmans.

 

Of all the wonderful SRC activities, I personally enjoyed interacting with student presenters the most during the Saturday presentation sessions and poster session. I learned about my fellow classmates’ research, such as alfatoxin exposure in pregnant Nepalese and the minimum grocery delivery order requirement for elderly SNAP participants. I also met people from other institutions who are working on topics I have been learning about in class. When I chatted with an Emory student about her qualitative evaluation of food and nutrition security knowledge and practices in Guatemala and Honduras, I drew my learning from Dr. Jennifer Coates’ NUTR217: Monitoring and Evaluation. When a University of Delaware student presented his regional field experiment on nontraditional irrigation water, I saw how the concepts I have learned in Dr. Sean Cash’s NUTR341: Economics of Agriculture and the Environment are applied. I am excited to cross paths with those students again when we are professionals.

Faculty and student presenters at the poster session. Photo: Jeroen Eyckmans.

Faculty and student presenters at the poster session. Photo: Jeroen Eyckmans.

 

The 10th Future of Food and Nutrition Conference ended with a delightful networking reception at Trade, where conference presenters and participants continued their conversations and deepened their connections with mouthwatering appetizers and refreshing drinks.

Networking reception. Photo: Jeroen Eyckmans.

Networking reception. Photo: Jeroen Eyckmans.

The learning and the personal connections that this year’s SRC has facilitated for meand for all who attendedare invaluable. The coming together of creative and ingenious students from around the country who are working to make our food and nutrition future better is truly an event you need to see to believe. I am grateful for the SRC team, particularly the SRC chairs, Dianna Bartone and Delphine Van Roosebeke, for leading this wonderful event. I am already looking forward to the 11th Future of Food and Nutrition SRC!

The hardworking team of Friedmanites who made the 10th SRC possible! Photo: Jeroen Eyckmans.

The hardworking team of Friedmanites who made the 10th SRC possible! Photo: Jeroen Eyckmans. 

 

Jennifer Huang is a first-year Food Policy and Applied Nutrition MS student and a registered dietitian. She is interested in econometrics, agricultural trade, and food safety.

From Soil to Sport: Sweet Potatoes to Power You

by Hannah Meier

As the temperatures slowly, and not so consistently, increase in Boston this spring, more of us will find ourselves out in the field, on the trails, or on the sidewalks soaking in the sunshine and working up a sweat. Even if you aren’t competitive, you have probably noticed the difference in how you feel during, and after, exercise when you are—or are not—properly fueled. Look no further for easy and delicious recipes to power your active spring using the grad student’s pantry staple: The sweet potato!

 

Photo: Hannah Meier

Photo: Hannah Meier

Feeling our best, and performing our best (who wants to be that person in a soccer game to miss a pass because you’re too fatigued to run for the ball?) is contingent on having the right amount of fuel to use for energy during activity. Nutrition beforehand is important to power your workout or game, and nutrition afterward is crucial for making physical improvement, gaining strength and replenishing tired tissues. Sure, you may be able to get through a game or a run without thinking about nutrition, but I bet you a million bucks (really) that you’ll make strides with appropriate nutrition.

 

Sweet potatoes come close to what I view as an athlete’s ultimate food. Rich in carbohydrates and easy on the stomach, they provide a spectrum of nutrients that help convert calories to available energy for our cells (ex. B-Vitamins), along with a generous amount of potassium, which is an essential electrolyte for heart and muscle function that can be lost in sweat. One medium (about 5” long) sweet potato provides 10% of the daily value for iron, which is a nutrient of concern for many athletes, especially women. Compared to white potatoes, orange sweet potatoes are rich in Vitamin A as beta-carotene, and provide more of the vitamin than a cup of carrots. Why should athletes or active people care about Vitamin A? During exercise, our tissues can become damaged and more prone to forming free radicals, especially in long, intense endurance training. Beta-carotene, as a powerful antioxidant, combats this free radical formation, keeping cell membranes better intact and less prone to destruction.

What about fiber? While sweet potatoes, like many vegetables, contribute to an adequate fiber intake, the average potato contains about 4 grams of fiber, mostly from the skin. This amount of fiber helps to slow down digestion enough to prevent sharp spikes in blood sugar. This keeps both our hunger and our cells satisfied, with sustained energy for hours. Athletes or competitors looking for a snack to eat less than an hour prior to their event could remove the skin to avoid the digestive slow-down that fiber provides. Many of the nutrients are found in the flesh of the potato, so removing the skin does not take away all the nutritional benefit of the tuber.

Since sweet potatoes offer a powerhouse of beneficial nutrients for exercise, I came up with four ways to dress them up before and after a workout. Feel free to use regular white potatoes or even purple potatoes. All potatoes provide a mix of nutrients valuable for exercise, but the darker the color, the more concentrated the antioxidants you’ll get. These recipes use medium sweet potatoes that were roasted in the oven for about 45 minutes at 375˚F. Just wrap each potato in foil, place on a baking sheet, and throw in a hot oven. They are ready when they are slightly soft to the poke of a fork.

 

Before Exercise

Before exercise, the goal of nutrition is to provide a boost of fuel for your muscles to burn for energy. While glycogen, the stored form of carbohydrate, is typically available, having full stores is crucial if you plan to exercise for longer than 2 hours. Even for shorter events, providing a boost of nutrition leading up to your workout can stimulate better performance. Combining carbohydrate sources with protein increases the satiety factor and provides your body a boost in amino acids to have available for protein re-synthesis.

Pre-Race Burrito

Inspired by many athlete’s favorite pre-race meal, the burrito bowl, this sweet potato highlights traditional burrito ingredients, which happen to be wonderfully rich in carbohydrate. This meal is a bit fiber-heavy thanks to the beans, so should be consumed at least 3 hours before exercise, or the night before an early start. The corn sauce is a recipe adapted from food blogger Pinch of Yum, and breaks down the corn’s fibrous coating so the carbohydrates are more easily available to be absorbed. Peppers and onions contain natural sugars that provide quick energy and delicious sweetness, as well as an additional boost of antioxidants. A little bit of Greek yogurt rounds out the potato with a bit of easily digested protein.

  

Photo: Hannah Meier

Photo: Hannah Meier

 

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 2 Tablespoons corn sauce (recipe below)
  • 1/4 Cup black beans, cooked or canned
  • ¼ Medium red pepper, sliced
  • ¼ Medium Onion, sliced
  • Salsa
  • Plain Greek yogurt of choice

Total Time (after baking potato) 10 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • In a pan with a little oil, sauté the pepper and onion slices on medium heat until desired softness.
  • Top sweet potato with onions and peppers, black beans, corn sauce, salsa and Greek yogurt.
  • Enjoy!

CORN SAUCE RECIPE

Inspired by Pinch of Yum

Makes about 8 Servings (2 tablespoons each)

INGREDIENTS

  • 1 cup corn kernels, from fresh or frozen (I used Trader Joe’s frozen Fire Roasted Corn)
  • 1 tablespoon fresh garlic
  • 1/2 cup water, milk, or broth (I used almond milk)
  • 1 tablespoon butter or olive oil

Total Time: 15 minutes

DIRECTIONS

  • Heat the butter or olive oil in a pan over medium heat.
  • Sauté garlic until fragrant. Add the milk and stir to form a creamy mixture.
  • Add corn kernels and sauté for another 5-10 minutes until very soft.
  • Transfer to a blender or food processor and puree until very smooth.

 

After Exercise

After exercise, along with hydration, the primary goals with nutrition are to provide your muscle cells with a replenishing dose of carbohydrate to store as glycogen, and amino acids from protein to aid in muscle tissue repair and growth. The post-exercise meal is also a chance to load up on vitamins and minerals that keep body processes functioning normally at the higher intensity that exercise demands.

Sweet Recovery

For those with more of a sweet tooth, sweet potatoes are a nourishing way to satisfy it. This sweet potato is topped with dark berries, rich in polyphenol antioxidants and natural sugars to reach muscles quickly. Almond butter provides a bit of protein and salt, which is an electrolyte athletes need to replace after very sweaty workouts. Full fat ricotta cheese rounds out the potato with easily digested dairy protein and a bit of satiating fat, without the overpowering taste and extra sugar that yogurt provides. Feel free to substitute more nuts and seeds for the cheese to make this vegan.

Photo: Hannah Meier

Photo: Hannah Meier

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 1/2 cup mixed berries of choice (aim for dark, bright colors; I used a frozen berry blend, thawed)
  • 1 tablespoon salted almond butter
  • 2 tablespoons ricotta cheese

Total Time (after baking potato): 5 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • Top with berries, almond butter and ricotta cheese.
  • Enjoy!

 

Savory Recovery

For those of us who don’t crave sweet things post-workout, a sweet potato can still provide a canvas for a savory meal. This potato provides a rich carbohydrate base to refuel muscles and serves as the base for protein powerhouse eggs and hemp seeds, plus red cabbage and carrots for extra antioxidants and avocado for healthy fats. Top with hot sauce if desired—especially if you got sweaty and need to replace lost sodium.

Photo: Hannah Meier

Photo: Hannah Meier

 

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 1 large egg
  • 1/2 – 1 cup shredded red cabbage (I used a Trader Joe’s bagged mix)
  • 1/3 of a medium avocado, sliced or mashed
  • 1 tablespoon hemp seeds (or sunflower seeds)

Total Time (after baking potato): 10 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • Whisk the egg well in a bowl, making sure to incorporate lots of air for a fluffier texture.
  • In a pan with a little oil over medium heat, sauté the cabbage until soft. When cooked, push cabbage to the side of pan to make room for the scrambled egg.
  • Spray the pan with a bit of cooking spray to prevent sticking, and add the whisked egg to the pan. Scramble the egg until cooked through.
  • Top sweet potato with cooked cabbage and scrambled egg, avocado, and hemp seeds.
  • Enjoy!

 

Rest Day

Everyone needs a day off to let the body truly recover, fully top off glycogen stores, and repair damaged tissues. Despite being often overlooked in terms of sports nutrition, rest days are an important opportunity to supply your body with nutrients in high-demand. So do some yoga stretching, cook up this Buddha Bowl inspired potato and go to bed early—your body needs it!

Yoga Night Buddha

This is a meal full of plant-based power. As always, the potato is a base rich in Vitamin A and is topped with a trio of steamed broccoli, carrots and edamame that provide their own chorus of plant chemicals (phytochemicals), vitamins, minerals, and even protein (broccoli and edamame are some of the higher-protein vegetables). Tempeh (fermented soy) is the primary protein source of the meal, and is ideal for rest days when quick digestion is not necessarily the goal. Likewise, plant proteins are broken down more slowly in our bodies than animal proteins and reach muscles at a slower rate. Finally, a delicious peanut sauce brings the dish together with the unsaturated fat our body needs to absorb many of the ingredients’ fat-soluble nutrients.

Photo: Hannah Meier

Photo: Hannah Meier

 

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 1/2 Cup Broccoli, steamed
  • 1 small carrots, sliced or shredded (about 1/4 cup)
  • 1/4 Cup edamame, fresh or frozen
  • 1/4 Block Tempeh, sliced
  • Peanut sauce (recipe below)

Total time (after baking potato, including peanut sauce): 15 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • In a steamer or pan with just enough water to cover the bottom, add broccoli, carrots, and edamame and steam until cooked through to desired softness.
  • In a pan with a little oil over medium heat, sear tempeh slices for ~2 minutes on each side, until cooked through.
  • Meanwhile, make peanut sauce (recipe below).
  • Top potato with steamed veggies, edamame, and peanut sauce.
  • Enjoy!

Makes 1 Serving

PEANUT SAUCE INGREDIENTS

  • 1 Tablespoon peanut butter
  • 1 Teaspoon rice vinegar
  • 1 Teaspoon reduced sodium soy sauce or liquid aminos
  • 1 Teaspoon water
  • ½ Tablespoon honey
  • Optional additions: ground ginger, red pepper flakes, garlic powder

DIRECTIONS

  • In a liquid measuring cup or bowl, whisk ingredients together until well blended. If the peanut butter is very thick, you may need to add more water to thin out the mixture.
  • Season to your taste. Add ginger for a bit of sweetness, red pepper flakes for heat, or garlic powder to make it more savory.

 

Hannah Meier is a registered dietitian and second-year student in the Nutrition Interventions, Communication and Behavior Change program at Friedman. She works one-on-one with undergraduate Jumbo athletes and sports teams at Tufts University, educating them on fueling for their best performance and mastering the fundamentals of nutrition for an active life.

Evaluating the Pinnertest: The Importance of Scientific Evidence

by Erin Child

So, you think you have a food intolerance? What do you do? You could call your doctor and set-up an appointment that is inevitably months away. Then you have a 10-minute meeting in which they only look at their computer and refer you to a specialist, THEN go through more testing, and finally (hopefully!) get some answers. Or, you could order an at-home kit that takes 10 minutes to complete and promises results that will get you feeling better, sooner. Which one do you choose? Read on and decide.

In our current world of food intolerances and hypersensitivities in which the best path to treatment is often a conundrum, the Pinnertest promises an easy solution to any dietary woes.  A few months ago, I started noticing ads for this new test popping up on social media. The Pinnertest is an over-the-counter food intolerance testing kit that uses microarray technology to test for IgG (Immunoglobulin G) mediated sensitivities for 200 common foods.

The classic manifestations of true food allergies (hives, oral discomfort, trouble breathing, anaphylaxis, etc) are mediated by overproduction of IgE antibodies. Like IgE, IgG is a type of antibody. And IgG is the most common antibody in the human body. (The immune system releases five types of antibodies: IgA, IgE, IgG, IgD, and IgM.) Instead of testing IgE mediated allergies, the Pinnertest producers claim that the microarray technology allows them to test for IgG mediated intolerances to 200 different foods—including lettuce, quail, and baking powder—using only a few drops of blood. It sounds scientific, but also seemed too good to be true. Was it?

I started my research by reaching out to the Pinnertest folks directly. My goal? To score a pro-bono test to try it out myself and see the results first hand. I was thrilled when a friendly representative at Pinner immediately reached out to set up a phone interview (calendar evite and everything). When the day came, I called—and was sent to voicemail. Twenty minutes and five tries later, I knew I had been ghosted. My subsequent emails were ignored, and my quest to learn first-hand about the scientific evidence backing their product was squashed.

So, I began researching on my own. The Pinnertest website sports a cluttered page of medical study citations that cover work on food allergies, intolerances and Celiac Disease—but none of which provide any evidence of using IgG testing for food intolerances.  My own PubMed search [IgG + food intolerance; Immunoglobulin G + food intolerance] yielded little, but did include one recently retracted 2016 article linking IgG testing to food allergies. The rest of the Pinnertest website leads you down a rabbit-hole of B-list celebrity endorsements and every Friedman student’s favorite—Dr. Oz videos! Interestingly, nowhere on the site does it tell you the cost of the test. To find out pricing, you must first enter your information (“Hi, my name is Newt Trition”) before you discover that the test will run you a whopping $490.

To further explore if this test has any scientific merit, and is worth the hefty price tag, I reached out the Boston Food Allergy Center (BFAC). Dr. John Leung, MD, the founder and CEO of the BFAC, and the Director of the Food Allergy Center at Tufts Medical Center and Co-Director of the Food Allergy Center at Floating Hospital for Children, took some time out of his day to answer my questions. Dr. Leung said, “We have patients coming into our office on a weekly basis with that kind of report [IgG], who pay out of pocket no matter what insurance they have. [Insurance doesn’t cover the test] because there is a statement from both the American and European Societies for Allergy saying that this test has no clinical significance.”

This is something to consider in any area of medicine—if a test is not covered by insurance, it may be the first sign that clinical significance could be lacking.

My conversation with Dr. Leung was brisk, informative, and confirmed my gut reaction that this test was too good to be true. Furthermore, there is a body of literature providing evidence that IgG mediated reactions are a sign that a food intolerance does not exist, not the other way around. In a 2008 European Academy of Allergy and Clinical (EAACI) Task Force Report, the authors wrote, “food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components.” Simply put, IgG evidence can show that you’ve been eating that food, not that you are intolerant to it. The EAACI has been joined by their Canadian, American, and South African counterparts in clear statements that research does not support the use of IgG mediated testing for food intolerances at this time.

Having shadowed Dr. Leung at the BFAC, I know that he takes patients’ claims of food intolerances seriously, and is invested in using the best clinical practices and scientific evidence available to make the diagnosis. Concerning IgG mediated testing, he stated, “There is so little research, so from a clinical view it is not very useful, it doesn’t mean much. It is not diagnostic.” And yet, the Pinnertest website claims that the“Pinnertest is a common procedure in most European countries. In many cases, dietitians and nutritionists will ask for their client’s Pinnertest results before creating any kind of diet plan.” Since this approach directly contradicts the current EAACI recommendation, that’s highly unlikely.

I also had the opportunity to speak with Rachel Wilkinson, MS, RD, LDN, and Practice Manager of the BFAC. Rachel explained, “If patients come in concerned about food intolerances, we can do the hydrogen breath test for lactose, fructose or fructan [found in some vegetables, fruits and grains]. These are the three main ones [food intolerances] we can test for, because we actually have tests for those.” She went on to state, “What was interesting to me about the Pinnertest, was how they say they can specify one specific food–so not just a category. I honestly don’t understand how they would pinpoint a specific food. It makes more sense to me to listen to patient’s histories and to look at how their intestines are able to break down that particular group of sugars. So, I really would love to know how they [Pinnertest] are coming up with this.”

It is important to note that the Pinnertest is not just marketing itself as a food intolerance test. It is also presenting itself as a weight loss tool. Current Frances Stern Dietetic Intern and Masters Candidate Jocelyn Brault, interning at BFAC, indicated her concern: “I think this is also being marketed for weight loss, which you can see throughout their website. This is usually a good sign that we should dig deeper. Is this a proven weight loss method? This claim seemed out of nowhere to me.” Indeed, directly on the Pinnertest box it reads, “Discover which foods are making you sick or overweight.” If taken seriously, this test will result in unnecessary diet restrictions, and potential malnutrition if too many foods are unnecessarily eliminated. Rachel Wilkinson, RD noted, “if you’re going to be avoiding certain types of foods, you need to make sure your diet is still adequate. We do not want to see people over-restricting foods for no reason.”

Over the course of my research and conversations with Dr. Leung, Rachel, and Jocelyn, I confirmed that my initial gut reaction was correct: too good to be true. And here’s the kicker, so does The Pinnertest. In a tiny disclaimer at the bottom of their website, they write: “Quantification of specific IgE antibodies to foods and inhalants is an FDA-accepted diagnostic procedure for the assessment of allergies. However, the assessment of human IgG antibodies specific for individual food and inhalant antigens is not an FDA-recognized diagnostic indicator of allergy.”

It is a noble task to try to design an allergy test that does not require you to doctor hop, or wait months for an appointment, but the scientific evidence needed to back up the Pinnertest is lacking. Perhaps one day this will shift, and the body of evidence will improve. In the meantime, however, anyone who thinks they might have a food intolerance (or food allergy) is best served by going to their clinician (and then a dietitian). This at-home kit promises a quick fix, but is really just an expensive, dangerous distraction.

Erin Child is a second-semester NICBC student in the dual MS-DPD program. She is fascinated by the science of food allergy and intolerances, and will probably keep writing about them until someone tells her to stop.  With two weeks left in the semester, she would really like a nap. Like right now.

Nutrition in a Nutshell: Lessons Learned as a Dietetic Intern

by Katelyn Castro

I was one of those few teenagers who knew exactly what I wanted to be when I grew up. Now, after four years of college and two years of graduate school combined with a dietetic internship, a career as a registered dietitian is not far out of reach. While my passion for nutrition has never dwindled over these last six years, my approach nutrition has changed significantly.

Nutrition tips on the sidebar of Self magazine, an over-simplified nutrition lesson in a health class in middle school, and a quick nutrition lecture from my pediatrician, summed up my understanding of nutrition before entering college. Now­—six years of coursework and 2000+ hours of dietetic rotations later—I not only know the nitty-gritty details of nutrition science, but I also have learned some larger truths about nutrition that are not always talked about.

Beyond what you may read as you thumb through your social media feed, or even what you may learn from an introductory nutrition textbook, here are some of the lessons that I have acquired about nutrition along the way:

1- Nutrition is an evolving science.

First, let’s be clear that nutrition is a science that relies on concepts from biology, chemistry, anatomy, physiology, and epidemiology to study how nutrients impact health and disease outcomes. Understanding how diabetes alters carbohydrate metabolism allows people with diabetes to live without fear of dying from diabetic ketoacidosis or seizures due to unsafe blood glucose levels. Understanding how ulcerative colitis impacts mineral absorption and increases protein losses helps those with the condition manage nutrient deficiencies with adequate nutrition supplementation. These are only a few examples of the many ways our knowledge of nutrition science makes it possible to improve individuals’ health outcomes.

However, the more I learn about nutrition, the more I realize that the research still holds many unanswered questions. For example, previous nutrition guidelines, like when to introduce hypoallergenic food to children, are being disproven and questioned by more recent studies. On the other hand, research on the gut microbiota is just beginning to uncover how one’s diet interacts with their gut microbiota through hormonal and neural signaling. Staying up-to-date on the latest research and analyzing study results with a critical eye has been crucial as new scientific discoveries challenge our understanding of nutrition and physiology.

Who would have thought a career in nutrition would require so much detective work?

 2- Food is medicine, but it can’t cure everything.

The fact that half of the leading causes of death in the U.S. can be influenced by diet and physical activity highlights the importance of nutrition for long-term health. Using medical nutrition therapy for patients with variety of health problems, ranging from cancer and cardiovascular disease to cystic fibrosis and end-stage renal disease, has also allowed me to see nutrition powerfully impact the management and treatment of many health conditions. High cholesterol? Avoid trans fat and limit saturated fat in foods. Type 2 diabetes? Adjust the timing and type of carbohydrates eaten.

While making simple changes to eating habits can improve lab values and overall health, nutrition is often only one component of treatment accompanied by medication, surgery, therapy, sleep, and/or stress management. Interacting with patients of all ages and health problems, and working with health professionals from a range of disciplines has forced me to step out of my nutrition bubble and take a more comprehensive approach to patient care: Improving quality of life and overall health and wellbeing is always going to be more important than striving for a perfect nutrition plan.

3- Nutrition is political and nutrition messages can be misleading.

Back when the Academy of Nutrition and Dietetics was one of many health organizations sponsored by Coca-Cola and PepsiCo, I realized how much influence large food industries have on food advertising, marketing, and lobbying. With known health consequences of drinking too many sugary beverages, the concept of health organizations being sponsored by soda companies was perplexing to me. Learning more about the black box process of developing the government dietary guidelines has also made me more cognizant of government-related conflicts of interest with industries that can color the way nutrition recommendations are presented to the public.

Industry-funded nutrition research raises another issue with nutrition messaging. For example, only recently a study revealed that the sugar industry’s funded research 50 years ago downplayed the risks of sugar, influencing the debate over the relative risks of sugar in the years following. Unfortunately, industry-sponsored nutrition research continues to bias study results, highlighting positive outcomes, leaving out negative ones, or simply using poor study designs.  While sponsorships from big companies can provide a generous source of funding for research, as both a nutrition professional and a consumer, I’ve learned to take a closer look at the motives and potential bias of any industry-funded nutrition information.           

4- Nutrition is not as glamorous as it sounds, but it’s always exciting.

When the media is flooded with nutrition tips for healthy skin, food for a healthy gut, or nutrients to boost mood, the topic of nutrition can seem light and fluffy. With new diets and “superfoods” taking the spotlight in health magazines and websites, it’s easy to think of nutrition as nothing more than a trend.

However, any nutrition student or dietitian will prove you otherwise. In the words of one of my preceptors, “my job [as a dietitian nutritionist] is not as glamorous and sexy as it sounds.” Throughout my dietetic rotations, my conversations with patients and clients have gone into much more depth than just aesthetics and trendy nutrition topics. If I’m working with a patient with Irritable Bowel Syndrome, bowel movements (a.k.a poop) may dominate the conversation. If I’m counseling someone who has been yo-yo dieting, I may be crushing their expectations of fad diets while encouraging more realistic, sustainable healthy goals. If I’m speaking with a group of teenagers with eating disorders, I may not talk about nutrition at all and focus more on challenging unhealthy thoughts and behaviors about food. It is these conversations, discussing what really matters when it comes to food, nutrition, and overall health that make a career in nutrition ever-changing and always exciting.

Katelyn Castro is a second-year student graduating this May from the DI/MS Nutrition program at the Friedman School. She hopes to take advantage of her experiences at Tufts to make positive impact on individuals’ health and wellbeing through community nutrition outreach. You can follow on her journey as she blogs on all things relating to food and nutrition at nutritionservedsimply.com.

 

 

Finding Common Ground for Nutrition in a World of Alternative Facts

by Rachel Baer

Rachel Baer tackles the implications of the “post-truth” culture for the nutrition profession and poses 3 questions to consider about our response to the unending barrage of nutrition-related “alternative facts.”

As a registered dietitian, I can tell you this: Nutrition professionals know a thing or two about alternative facts. We spend our careers with textbooks and scientific journals in hand, waiting for the next misinformed food fad to go viral. We fight to defend the facts because we have always believed that if we could show people what is true, we could convince them that we have the best answers for their nutrition-related questions. But the concept of truth is losing popularity.

The Oxford English Dictionary declared the term “post-truth” to be the 2016 word-of-the-year. Post-truth is defined as “related to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.” Let that sink in for a moment: emotional appeals are more influential than objective facts. While this concept is alarming on many levels, I am particularly concerned about its implications for health professionals who rely on scientific truths as the basis of their credibility.

Don’t get me wrong. I understand the frustration people feel as they watch seemingly contradictory nutrition headlines emerge at the very hint of new research findings. One day people are told to limit egg consumption to 3 yolks per week, the next, the one-yolk-per-day allowance is back. However, as nutrition professionals, we have a certain appreciation for the fact that science is ever-evolving. We hold our recommendations lightly because we believe in a scientific community that is always growing, and that new discoveries only sharpen our understanding of nutrition and physiology. The public, on the other hand, does not always share this appreciation.

Confusion over wavering nutrition claims is exacerbated by the inundation of un-credentialed, unschooled voices clamoring for attention in popular media. Social media has provided a proverbial soapbox for anyone with a passionate message to share, regardless of qualifications. Simultaneously, dietitians tend to hold back on making bold retorts, often waiting for consensus to catch up with the fads so that our recommendations are supported with the latest research. This seeming imbalance of voices alongside the emergence of the post-truth culture only perpetuates the proliferation of unfounded claims, or “alternative facts,” as they have become popularly known.

I have no easy answers for this predicament, but here are 3 questions that we could benefit from exploring as nutrition professionals:

1. How do we remain experts while also being compelling?

Dietitians have long been referred to as the “food police.” While I resent this reputation, it highlights a worthy question: Do nutrition professionals present information in a way that is relatable, realistic, and winsome to the people whose respect we want to gain?

We can no longer depend solely on the letters after our names to gain an audience with the public, particularly when we are pitted against wayward blog and media influencers using sensationalized language to win over vast groups of people who blindly follow their passionate advice. The internet is full of examples of people preferring to follow the advice of a persuasive friend or influencer over the advice of a knowing professional. While this situation is endlessly frustrating to those of us who see through their hyperbolic messages, is there anything we can learn from these blog/media personalities that may help us reach the audience they seem to have hooked? How do we successfully build rapport with the public while maintaining good science?

2. How do we talk about fundamentals in a world that wants controversy?

Let’s face it. Fundamentals don’t make great headlines. For decades, consensus research has revealed that a diet full of minimally-processed fruits, vegetables, whole grains, nuts/seeds, lean proteins, and healthy fats is unequivocally and unanimously the best diet for human health. Yet, people still search elsewhere looking for the latest and greatest weight-loss, risk-reducing, and health-enhancing diets. Could it be that balance is more challenging than we thought? Perhaps avoiding certain food groups or food ingredients altogether is easier than the amorphous concept of moderation? Our greatest challenge is not getting more people to consume health information, it is finding new and compelling ways to deliver the information we’ve known for decades, and this is no small task.

3. How do we overcome differences within the nutrition profession to present a united front to people lost in the sea of alternative facts?

In 2014, David Katz and Walter Willet co-chaired a conference sponsored by the non-profit Oldways*, titled “Finding Common Ground.” Oldways and the co-chairs assembled what they referred to as “the dream team of nutrition experts,” including Friedman’s own, Dariush Mozaffarian, as well as Dean Ornish, creator of the Ornish Diet; David Jenkins, founder of the glycemic index; Boyd Eaton, originator of the Paleolithic diet; Collin Campbell, author of The China Study; and a myriad of others. Known most commonly for their differences, this group of scientists gathered together for the sole purpose of coming to a consensus on the basic tenants of a healthy diet. In the end, the group agreed on 11 common denominators of the widely differing philosophies they espouse. The topics ranged from fruit and vegetable consumption, to sustainability, to food literacy.

Following the conference, David Katz published an article in Forbes where he said “…it is the controversies at the edge of what we know that interest experts most, but ask [experts] about the fundamentals, and the vast expanse of common ground is suddenly revealed.” The Common Ground committee’s decision to gather around a table, invite open dialogue, and pursue unity is something we could all learn a lesson from. Alternative facts will always provide fodder for hucksters and peddlers of over-simplified nutrition information, but the scientific community has a vast body of research that unites us. As nutrition professionals, we cannot forget that our voices will always be more powerful together than they ever will apart.

Rachel Baer is a registered dietitian and a first-year in the NICBC program at Friedman. Her favorite foods are Brussels sprouts and brownies, and she loves nothing more than cooking great meals and gathering people around a table.

*Editor’s Note, 5/1/17  2:09 PM: An earlier version of this article incorrectly spelled the name of the organization, “OldWays.” The correct spelling is Oldways, and the change has been made above.