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.

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.

 

 

5 Reasons the Whole30 is Not the Anti-Diet It Claims to Be

by Hannah Meier, RD, LDN

How does the Whole30 Diet hold up from a dietitian’s perspective? Hannah Meier breaks it down.

I’m calling it: 2017 is the year of the non-diet.

As a dietitian who ardently discourages short-term dieting, I was thrilled to read many articles posted around the new year with titles like “Things to Add, Not Take Away in 2017,” and “Why I’m Resolving Not to Change This Year.” Taking a step more powerful than simply abstaining from resolution season, influencers like these authors resolved to embrace the positive, stay present, and not encourage the cycle of self-loathing that the “losing weight” resolutions tend to result in year after year.

Right alongside these posts, though, was an overwhelming amount of press exonerating the Whole30—a 30-day food and beverage “clean eating” diet.

The founders of the Whole30, however, adamantly claim it is not a diet. Even though participants are advised to “cut out all the psychologically unhealthy, hormone-unbalancing, gut-disrupting, inflammatory food groups for a full 30 days” (including legumes, dairy, all grains, sugar, MSG, and additives like carrageenan), followers are encouraged to avoid the scale and focus on learning how food makes them feel rather than how much weight they gain or lose.

But our culture is still hungry for weight loss. The possibility of losing weight ahead of her sister’s wedding was “the deciding factor” for my friend Lucy (name changed for privacy), who read the entire Whole30 book cover to cover, and fought her “sugar dragon” for 30 days in adherence to the Whole30 protocol (only to eat M&M’s on day 31, she admits).

“Whole30 focuses on foods in their whole forms which is positive for people who are learning how to incorporate more unprocessed foods in their diet,” Allison Knott, registered dietitian and Friedman alum (N12) explains. “However, the elimination of certain groups of foods like beans/legumes and grains may have negative health implications if continued over the long-term.”

Diets like these trick consumers into thinking they are forming a healthier relationship with food. Though weight loss is de-emphasized, a trio of restriction, fear, and control are in the driver’s seat and could potentially steer dieters toward a downward, disordered-eating spiral.

I still think 2017 is the year of the non-diet, but before we get there we need to unmask the Whole30 and call it what it is: an unsustainable, unhealthy, fad diet.

1: It is focused on “can” and “cannot”

The Whole30 targets perfectly nutritious foods for most people (grains, beans and legumes, and dairy) as foods to avoid entirely, relegating them to the same level of value as boxed mac and cheese, frozen pizza, and Kool-Aid. And most bodies are perfectly capable of handling these foods. They provide a convenient, affordable, and satisfying means of getting calcium, vitamin D, potassium, phosphorus, and nutrient-dense protein. The Whole30 eliminates almost all the plant-based protein options for vegans and vegetarians. While the point of eliminating these foods, creators Hartwig and Hartwig explain, is to reduce inflammation and improve gut health, nowhere in the book or website do they provide scientific studies that show removing grains, beans and dairy does this for most people. But we’ll get to that later.

The Whole30 also instructs that participants not eat any added sugar or sweeteners (real or artificial), MSG (monosodium glutamate, a flavor enhancer that has been weakly linked to brain and nervous system disruption), or carrageenan (a thickener derived from seaweed and is plentiful in the world of nut milks and frozen desserts; conflicting evidence has both suggested and refuted the possibility that it is associated with cancer and inflammatory diseases), sulfites (like those in wine), or alcohol. Not even a lick, as they are very clear to explain, or you must start the entire 30-day journey from the beginning once more.

“I couldn’t go longer than 30 days without a hit of chocolate,” Lucy told me, explaining why she was dedicated to following the program exactly.

Why take issue with focusing on “good” and “bad,” “can” and “cannot” foods? As soon as a moral value is assigned, the potential for establishing a normal relationship to food and eating is disrupted. “The diet encourages following the restrictive pattern for a solid 30 days. That means if there is a single slip-up, as in you eat peanut butter (for example), then you must start over. I consider this to be a punishment which does not lend itself to developing a healthy relationship with food and may backfire, especially for individuals struggling with underlying disordered eating patterns,” Knott argues.

How will a person feel on day 31, adding brown rice alongside their salmon and spinach salad after having restricted it for a month? Likely not neutral. Restrictive dietary patterns tend to lead to overconsumption down the road, and it is not uncommon for people to fall back in to old habits, like my friend Lucy. “People often do several Whole30 repetitions to reinforce healthier eating habits,” she explained.

Knott relates the diet to other time-bound, trendy cleanses. “There’s little science to support the need for a “cleansing diet,” she says. “Unless there is a food intolerance, allergy, or other medical reason for eliminating food groups then it’s best to learn how to incorporate a balance of foods in the diet in a sustainable, individualized way.”

While no one is arguing that consuming less sugar, MSG and alcohol are unsound health goals, making the message one of hard-and-fast, black-and-white, “absolutely don’t go near or even think about touching that” is an unsustainable, unhealthy, and inflexible way to relate to food for a lifetime.

2: It requires a lot of brainpower

After eight years of existence, the Whole30 now comes with a pretty widespread social-media support system. There is plenty of research to back up social support in any major lifestyle change as a major key to success. Thanks to this, more people than ever before (like my friend Lucy, who participated alongside her engaged sister) can make it through the 30 days without “failing.”

But the Whole30 turns the concept of moderation and balance on its head. Perfection is necessary and preparation is key. Having an endless supply of chopped vegetables, stocks for soups, meat, and eggs by the pound and meals planned and prepared for the week, if not longer, is pretty much required if you don’t want to make a mistake and start over. The Whole30 discourages between-meal snacking, (why?) and cutting out sugar, grains, and dairy eliminates many grab-and-go emergency options that come in handy on busy days. So, dieters better be ready when hunger hits.

Should the average Joe looking to improve his nutrition need to scour the internet for “compliant” recipes and plan every meal of every day in advance? While the Whole30 may help those unfamiliar with cooking wholesome, unprocessed meals at home jumpstart a healthy habit, learning about cooking, especially for beginners, should be flexible. It doesn’t have to come with a rule book. In fact, I think that’s inviting entirely too much brain power that could be used in so many other unique and fulfilling ways to be spent thinking, worrying, and obsessing about food. Food is important, but it is only one facet of wellness. The Whole30 seems to brush aside the intractable and significant influence of stress in favor of a “perfect” diet, which may or may not be nutritionally adequate, anyway.

The language used by Whole30 creators to rationalize the rigidity of the diet could make anyone feel like a chastised puppy in the corner. “It’s not hard,” they say, and then proceed to compare its difficulty to losing a child or a parent. Okay, sure, compared to a major life stressor, altering one’s diet is a walk in the park. But changing habits is hard work that requires mental energy every single day. Eating, and choosing what to eat, is a constant battle for many people and it doesn’t have to be. Life is hard enough without diet rules. The last thing anyone needs is to transform a natural and fulfilling component of it (read: food) into a mental war zone with contrived rules and harsh consequences.

3: It is elitist

When was the last time you overheard a stranger complain about healthy eating being expensive? Most likely, the protester was envisioning a diet akin to the Whole30. Grass-fed beef, free-range chicken, clarified butter, organic produce…no dry staples like beans, rice or peanut butter. Healthy eating does not exist on a pedestal. It does not have to be expensive, but it certainly can be depending on where you choose to (or can) shop. Let’s set a few things straight: You don’t need grass-fed gelatin powder in your smoothies to be healthy. You don’t need organic coconut oil to be healthy. You don’t need exotic fruits and free-range eggs to be healthy. Maybe these foods mean more than just nutrition, signifying important changes to be made within our food system. But it terms of nutrition, sometimes the best a person can do for himself and his family is buy conventional produce, whole grains in bulk, and Perdue chicken breast on sale because otherwise they would be running to the drive thru or microwaving a packet of ramen noodles for dinner. A diet like the Whole30, which emphasizes foods of the “highest quality,” does nothing more than shame and isolate those who can’t sustain the standard it imposes, further cementing their belief that healthy eating is unattainable.

4: It is socially isolating

Imagine with me: I am participating in the Whole30 and doing great for the first week eating fully compliant meals. Then comes the weekend, and “oh no” it’s a football weekend and all I want to do is relax with my friends like I love to do. For me, that typically involves a beer or two, shared appetizers (even some carrots and celery!) and lots of laughs. The Whole30 creators would likely laugh in my face and tell me to suck it up for my own good and just munch on the veggies and maybe some meatballs. (“But are those grass-fed and did you use jarred sauce to make them? I bet there’s a gram of sugar hiding in there somewhere.”)

But it is just a month—certainly anyone can abstain from these type of events for a mere 30 days (remember, “it’s not hard”)—but then what? Do you just return to your normal patterns? Or do you, more likely, go back to them feeling so cheated from a month of restraint that you drink and eat so much more than you might have if you’d maintained a sense of moderation?

Of course, there are people comfortable with declining the food-centric aspect of social life, for whom turning down a glass of wine with cheese in favor of seltzer and crudités is no big deal. And perhaps our social events have become a bit too food centric, anyway. Either way, using food rules to isolate one’s self from friends and family sounds an awful lot like the pathway to an eating disorder, and the sense of deprivation most people likely feel in these situations can snowball into chronic stress that overshadows any short-term, nutrition-related “win.”

Although, maybe we should get all our friends to drink seltzer water and eat crudités at football games.

5: It is not scientifically sound

Most of The Whole30’s success has come from word of mouth, stories, and endorsements from those who successfully made it through the program and felt “better” afterwards. The website, dismayingly, does not house a single citation or study referenced in creation of the diet.

It’s important to note that the Whole30 did not exist 20 years ago. The Whole30 is not a pattern of eating that is replicated in any society on earth, and it doesn’t seem to be based off any research suggesting that it is indeed a superior choice. At the end of the day, this is a business, created by Sports Nutritionists (a credential anyone can get by taking an online test, regardless of one’s background in nutrition—which neither of them has) part of the multi-billion-dollar diet industry. Pinpointing three major food groups as causing inflammation and hormonal imbalance is quite an extreme statement to make without any research to back it up.

What does the science actually show? Knott, who counsels clients in her Tennessee-based private practice reminds us that, “consuming a plant-based diet, including grains and beans/legumes, is known to contribute to a lower risk for chronic disease like heart disease, cancer, and diabetes. Grains and beans/legumes are a source of fiber, protein, and B vitamins such as folate. They’re also a source of phytochemicals which may play a role in cancer prevention.”

The Whole30 proposes eliminating grains because they contain phytates, plant chemicals that reduce the absorbability of nutrients like magnesium and zinc in our bodies. While it’s true that both grains and legumes contain phytates, so do certain nuts and some vegetables allowed on the diet, like almonds. It is possible to reduce the amount of phytates in an eaten food by soaking, sprouting, or fermenting grains and legumes, but research from within the last 20 years suggests that phytates may actually play a key role as antioxidants. In a diverse and balanced diet, phytates in foods like grains and legumes do not present a major micronutrient threat. Further, new findings from Tufts scientists provide more evidence that whole grains in particular improve immune and inflammatory markers related to the microbiome.

Legumes in the Whole30 are eliminated because some of their carbohydrates aren’t as well-digested and absorbed in the small intestine. Some people are highly sensitive to these types of carbohydrates, and may experience severe digestive irritation like excessive gas, bloating, constipation, etc. Strategies such as the FODMAP approach are used with these folks under professional supervision to ensure they continue to get high-quality, well-tolerated fiber in their diets, and only eliminate those foods which cause distress. For others, elimination of these types of carbohydrates is unsound. Undigested fibers like those in legumes are also known as prebiotics, and help to feed the healthy bacteria in our gut. Eliminating this beneficial food group to improve gut health goes directly against the growing base of scientific evidence surrounding the microbiota.

Dairy, for those without an allergy or intolerance, has been shown to provide many benefits when incorporated into a balanced and varied diet, including weight stabilization and blood sugar control. The diet also fails to recognize the important health benefits associated with fermented dairy products like yogurt.

In terms of the diet’s long-term sustainability, Knott adds, “There’s plenty of research to support that restrictive diets fail. Many who adopt this way of eating will likely lose weight only to see it return after the diet ends.”

Let’s not forget its few redeeming qualities

For everything wrong with the Whole30, there are a few aspects of the diet that should stick. The concept of getting more in touch with food beyond a label, reducing added sugars, and alcohol is a good one and something that everyone should be encouraged to do. Focusing on cooking more from scratch, relying less on processed foods, and learning about how food influences your mood and energy levels are habits everyone should work to incorporate into a healthy life.

Knott agrees, adding, “I do like that the diet emphasizes the importance of not weighing yourself. We know that weight is a minor piece to the puzzle and other metrics are more appropriate for measuring health such as fitness, lean muscle mass, and biometric screenings.”

Improving the nutritional quality of your diet should not eliminate whole food groups like dairy, grains, and legumes. It should not have a time stamp on its end date, and rather, should be a lifelong journey focusing on flexibility, moderation, and balance. Lower your intake of processed foods, sugars, and alcohol and increase the variety of whole foods. Et voilà! A healthy diet that won’t yell at you for screwing up.

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Thanks to Allison Knott MS, RDN, LDN for contributing expertise. Knott is a private practice dietitian and owner of ANEWtrition, LLC based in Tennessee. She graduated from the Nutrition Communications program at Friedman in 2012.

 

Hannah Meier is a second-year, part-time Nutrition Interventions, Communication & Behavior Change student and registered dietitian interested in learning more about non-diet approaches to wellness. She aspires to make proper nutrition a simple, accessible and fulfilling part of life for people in all walks of life. You can find her on Instagram documenting food, fitness and fun @abalancepaceRD, as well as on her (budding) blog of the same title: http://www.abalancedpace.wordpress.com

Putting a Pause on Peanut Butter Panic: New Guidelines Seek to Reduce Peanut Allergy Risk

by Erin Child

Do you like peanut butter? So do I. I’m kind of obsessed. Perhaps you add it to your smoothie bowl, drizzle it artfully on your Instagram worthy oatmeal, or, if you’re in grad school, it’s part of your PB&J. After all, that is the cheapest, easiest thing to make. But what if you had to take the PB out of the PB&J, and eliminate it from your diet and your life? This is a growing reality for many in the United States, with outdated, misinformed guidelines being blamed for the recent spike in peanut allergies. Read on to explore the revolutionary research that has spurred the creation of new guidelines, and why Americans need to change how we handle peanut exposure in childhood.

I recently stopped eating peanut butter in any way that could be deemed pretty or practical. Instead, you can find me in my room, with the door shut, maniacally shoveling peanut butter into my mouth with a plastic spoon.

This all started at the beginning of 2017. No, it is not some bizarre New Year’s resolution or diet trend. Rather, a new roommate moved in. She’s a great girl – kind, thoughtful, willing to learn how to properly load a dishwasher – and massively, catastrophically allergic to peanuts. She is also allergic to tree nuts and soy, but peanuts are THE BIG BAD. They are the reason why I spent the week before her arrival scrubbing my kitchen from top to bottom and running every dish and utensil (even the wooden ones, to my chagrin) through the dishwasher. And there is now an EpiPen® in our kitchen. Just as they are on some airlines, peanuts are now banned from the general living areas of my house, and thus I & my beloved jar of peanut butter have been sequestered to my room.

Many of you have probably dealt with peanut-free schools or day cares, or been informed to not consume any peanut products on your flight. Peanut allergy rates in children in the United States have quadrupled from the late 1990s (less than 0.5%) to about 2% today, and are the leading cause of anaphylaxis or death from food allergies. Thanks to my new-found awareness, I have become extremely self-conscious about eating peanut butter in public spaces. On the bus the other day some peanut butter dripped from my sandwich to the seat. I panicked, thinking “What is the chance this spill is going to wind up hurting some little kid?” (I hope they are not licking the seats on the bus, but still.)

Coupled with my new roommate’s arrival, I was fascinated to find that peanut allergies have been back in the news. On January 5th, 2017, the National Institute of Allergy and Infectious Disease (NIAID) published new guidelines for practitioners about when to introduce peanuts to high-risk, medium-risk, and low-risk infants. High-risk infants with severe eczema and/or an egg allergy should be introduced to peanuts between 4 to 6 months. Medium-risk infants with mild eczema should be introduced to peanuts by 6 months, and low-risk infants without eczema or other allergies can be introduced to peanuts any time after they have been introduced to solid foods.

These guidelines fit in with the dual-allergen exposure hypothesis. This suggests that children are first exposed to food particles through their skin as infants. This exposure primes their immune systems to treat the food proteins like invaders and build up defenses against it. If the food is eaten years later, the child has an acute allergic reaction because their immune system had ample time to prepare. Children with eczema have weakened skin barriers and are much more likely to experience repeated skin exposure to food allergens. This leads to an increased chance of an allergic reaction once they eat the food. Current research now supports this hypothesis, and also suggests that by shortening the time between skin exposure and ingestion, we will reduce the number of acute allergic reactions. The sooner an infant starts eating an allergen, the more likely the body will adjust to it without having time to bsuild up strong defenses against it.

These new guidelines on peanut exposure from NIAID seek to correct for guidelines set by the American Academy of Pediatrics in 2000. The 2000 guidelines were based on only a few tests done on hypoallergenic infant formula feeding, yet conclusively recommended that infants at high-risk for peanut allergies wait until 3 years of age to first try peanuts. Based on the newest findings, it appears that this advice was ill advised. My roommate, n=1, was born in the mid-1990s when delaying peanut exposure was coming into vogue. She had severe eczema an infant, and following doctors’ recommendations, wasn’t introduced to peanuts until somewhere between 18-24 months old. She is equally fascinated with the new research, and wishes there was some way to know if the outcome would have been different had she tried them at a younger age.

Peanut allergies are more common in the US, UK, and Australia, which are also the countries that have historically had the most stringent recommendations around peanut introduction. As doctors and researchers sought to figure out why peanut allergies were ballooning, they looked to countries with very low peanut allergy rates, like Israel, where infants are introduced to peanuts at early ages. In Israel, instead of Cheerios, infants are given a peanut based snack, called Bamba, as one of their first foods. In other developing countries, infants are exposed to peanuts early on—both in their environment and in their food. These other countries also have much lower allergy rates.

In 2015, NIAID funded the Learning Early About Peanut Allergy (LEAP) study to determine whether early exposure to peanuts would decrease the incidence of peanut allergies. The UK study was a randomized controlled trial including 640 infants between 4 and 11 months of age with severe eczema and/or egg allergy. The infants were split into two groups (based on skin prick test results for peanuts) and then randomized to either eat or avoid peanuts until 60 months old (5 years). For infants in the negative skin prick test group, 13.7% of those who avoided peanuts had developed an allergy and only 1.9% of those who ate peanuts developed an allergy (P<0.001). For infants in the positive skin prick test group, 35.3% who of those who avoided peanuts had developed an allergy and 10.6% of those who ate peanuts developed an allergy (P=0.004). These results were significant and stunning, prompting the formulation of the current NIAID guidelines.

So, should we all start slathering our babies in peanut butter? Maybe. (As always, talk to your pediatrician). Food allergy science is an evolving field, and what is true today may not hold true a decade down the line. But based on the significance of the current research and the lower peanut allergy rates in cultures and countries that do not limit peanut exposure, the evidence strongly indicates that parents in the United States should change their approach.

Only 20% of children diagnosed with peanut allergies will grow out of them. The vast majority, like my roommate, are allergic for life. For now, research on reducing peanut allergies in adults is limited, making it unlikely that we will be eliminating any allergies anytime soon. So for now, I will continue to eat my peanut butter in my room. Alone.

Erin Child is a second semester NICBC student in the dual MS-DPD program and this is her first article for the Sprout. She loves cooking (usually with Friends or Parks & Rec on in the background). She hates brownies. (Seriously.) As the Logistics Co-Chair for the Student Research Conference, she looks forward to seeing everyone there on April 8th!

WIC at the Crossroads of the Opioid Epidemic

by Danièle Todorov

The complexity and pervasiveness of the opioid epidemic has forced government agencies to be innovative with their resources. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in a prime position to care for pregnant women affected by the epidemic and has stepped up to the plate.

In January of 2016, then Secretary of Agriculture Tom Vilsack was appointed by President Obama to lead an interagency taskforce to address the opioid epidemic in rural America. Secretary Vilsack, who’s been outspoken about his own mother’s struggle with prescription drug addiction, knew that compassion and collaboration would be vital. His agency, the USDA, has unique resources and relationships in rural areas, putting it in a prime position to address the epidemic.

Addressing the epidemic is no simple task. According to the CDC, 91 Americans died daily from opioid overdose in 2015. Nearly half of these deaths involved a prescription opioid, used in the treatment of pain. In a town hall meeting in Missouri last July, Secretary Vilsack stated that due to “the devastating toll that opioid misuse has taken on our communities, and particularly rural areas, I have tasked USDA with creatively using all of the resources at our disposal to stem the tide of this epidemic” [1]. Interestingly, Secretary Vilsack highlighted WIC as a resource that could be creatively used. “For many women”, he stated, “WIC is their first point of entry into the healthcare system, and we have an opportunity to intercept and potentially prevent dangerous health outcomes for both the mother and the child” [1].

Pain management is an important part of pregnancy care. The prescription of opioids for pain in pregnancy is increasingly common; 1 in 5 Medicaid-enrolled women were prescribed an opioid at some point during their pregnancy in 2014 [2]. However, the effect of opioids on birth outcomes is understudied. In utero opioid exposure may be associated with preterm delivery and low birth weight [3]. Exposed neonates may develop withdrawal symptoms, a condition known as neonatal abstinence syndrome, which is associated with increased risk of seizures and breathing difficulties [3]. Similarly understudied are the rates of opioid abuse during pregnancy. We do know that pregnant women with substance abuse problems are particularly vulnerable to food and job insecurities and unstable housing, which exacerbate potential health complications [4].

The healthcare system often stigmatizes and underserves pregnant women with substance abuse problems. However, WIC is increasing its ability to engage them in care. WIC’s mission is to promote the health of low-income women and their children by providing nutritious food, health education, and referrals. Starting in 2014, WIC agencies have increased staff training surrounding substance abuse [1]. Staff are better equipped to notice potential substance abuse, to educate WIC participants about the dangers of substance abuse during pregnancy and breastfeeding, and to connect them with local resources. These expanded roles align with WIC’s mission, not only because they aim to protect the health of the women they serve, but because WIC “acknowledges that substance use is incompatible with good nutrition” [5].

WIC is forming relationships with women at a promising point in time in their lives. In their staff training guide, WIC cites a study showing that women are “more motivated to improve their lifestyle and health habits during periods when they make the transition from one life situation or role to another… WIC participants are a natural target audience for substance use information because they are, by definition, in the life transition stage of pregnancy and new motherhood” [5].

WIC is playing an important part in the collaborative response to the epidemic. As the director of the USDA, Secretary Vilsack understood that a holistic response was the only effective solution and embraced President Obama’s mandate. “This disease isn’t a personal choice,” says Secretary Vilsack, “and it can’t be cured by willpower alone. It requires responses from whole communities, access to medical treatment, and an incredible amount of support. To me, our mandate is clear: don’t judge, just help” [6]. Secretary Vilsack’s endorsement of his replacement as Secretary of Agriculture, nominee Sonny Perdue, gives hope that the USDA will continue this vital endeavor.

Sources

  1. Agriculture Secretary Vilsack Announces Substance Misuse Prevention Resources for Low Income Pregnant Women and Mothers In Order to Battle the Opioid Epidemic, U. Office of Communications, Editor. 2016.
  2. Desai, R.J., et al., Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstetrics and gynecology, 2014. 123(5): p. 997.
  3. Patrick, S.W., et al., Prescription opioid epidemic and infant outcomes. Pediatrics, 2015. 135(5): p. 842-850.
  4. Sutter, M.B., S. Gopman, and L. Leeman, Patient-centered Care to Address Barriers for Pregnant Women with Opioid Dependence. Obstetrics and Gynecology Clinics of North America, 2017. 44(1): p. 95-107.
  5. Substance Use Prevention: Screening, Education, and Referral Resource Guide for Local WIC Agencies, F.a.N.S. U.S. Department of Agriculture, Editor. 2013.
  6. USDA. Addressing the Heroin and Prescription Opioid Epidemic. 2016 02/17/17].

Danièle Todorov is a first-year nutritional epidemiology student with a focus on pregnancy nutrition and birth outcomes.

 

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.)

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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!).