Balance, Variety, and Moderation: What Do They Really Mean?

by Katelyn Castro

Balance, variety, and moderation have been referenced in the Dietary Guidelines for Americans for decades. Yet overtime, the ambiguity of these terms has clouded their importance and left their meaning open for interpretation—often misinterpretation.

“Everything in moderation.”

“It’s all about balance.”

“I eat a variety of foods… well, a variety of ice-cream flavors!”

These words are often used to justify our food choices or to make us feel better when our diet is not 100% nutritious. Not anymore! Instead of using these words to rationalize our eating habits (which is completely unnecessary and counterproductive), let’s talk about how these nutrition concepts can be interpreted with a more intuitive approach to healthy eating.

Variety

Fruits and vegetables are usually the food groups that we focus on when we talk about variety in our diet. However, variety is encouraged within all the major food groups and among the food groups.

Besides making meals more colorful, eating a variety of fruits, vegetables, dairy, proteins, and grains provides a wider range of vitamins, minerals, antioxidants, prebiotics, and probiotics—keeping our heart, mind, skin, eyes, and gut functioning optimally. Varying protein with a combination of eggs, dairy, legumes, grains, and nuts is especially important for vegetarians to receive adequate amounts of all essential amino acids.

In addition to the benefits of variety at the biochemical level, a varied diet can also make eating more satisfying and flexible. While it can be easy to rely on your food staples for meals, introducing new ingredients can bring attention back to the flavor and enjoyment of eating, preventing you from eating on autopilot. Swap out an apple for a grapefruit or peach; have turkey or fish in place of chicken; substitute barley or quinoa for pasta. Choosing local and seasonal foods will also keep your diet varied diet throughout the year. Giving yourself permission to eat a variety of foods within all food groups can be freeing, helping to overcome rigid eating habits and food rules and appreciate the range of foods that satisfy your hunger and cravings.

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Moderation

Sweets, fatty meats, fried food, fast food, soda… these are all foods recommended to “eat in moderation,” or limit, in some cases. Whether it is unwanted weight gain or increased risk of type 2 diabetes, the negative health effects of eating excess added sugars and solid fats have been identified in the literature. However, cutting out sugary and fatty foods completely can be just as damaging for our emotional health, leaving us disconnected from friends and family and preoccupied with thoughts about food. Food is a huge part of our culture; it’s social, celebratory, and meant to be enjoyed in good company. That’s why moderation—not restriction or overindulgence—is the secret to healthy, happy eating habits.

But, what does moderation really mean? Technically, the most recent dietary guidelines recommend limiting added sugars to less than 10% of total calories per day, saturated fat to less than 10% of total calories per day, and trans fat to as little as possible. Realistically, this may translate into having more added sugars one day (i.e. when you’re eating cake at a family birthday party), and having more saturated fat another day (i.e. when you eat pizza with friends on a weekend).

Moderation is about being open to day-to-day variations in your diet depending on your appetite, cravings, and activity level. Sometimes a big bowl of ice-cream is just want you need to satisfy your sweet tooth, other times a small square of chocolate may be enough to keep sweet cravings at bay. Savoring the flavor of sugary and fatty foods and becoming aware of how your body responds can help you determine what “eating in moderation” means for you.

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Balance

Out of all three of these terms, balance probably has the most interpretations. A balanced diet is often defined as a balance of protein, carbohydrates, and fat within the Acceptable Macronutrient Distribution Ranges set by the Institute of Medicine. A balanced meal, on the other hand, refers to a balance of food groups consistent with MyPlate or Harvard’s Healthy Eating Plate: fill half your plate with fruits and vegetables, one fourth with lean protein, and one fourth with whole grains. Together, creating a balance of food groups and macronutrients can make meals and snacks more filling (from protein and fiber) and provide more sustained energy (from carbohydrates in whole grains, beans, fruits, and vegetables).

Beyond balance within our food choices, energy balance looks more broadly at the balance between energy intake (calories from food) and energy expenditure (calories used for exercise and metabolic processes). Energy balance is associated with weight maintenance, while energy imbalance can contribute to weight loss or weight gain. However, this concept is often oversimplified because energy expenditure cannot be precisely calculated since many factors like the stress, hormones, genetics, and gut microbiota (bacteria in our digestive tract) can alter our metabolism. For example, chronic stress can lead to high levels of cortisol, which signal the body to store fat, contributing to weight gain. In contrast, a diverse composition of gut microbiota may enhance metabolism and promote weight loss, according to preliminary research.

Considering the multiple factors influencing our metabolism, listening to our bodies’ hunger and fullness cues can often guide food intake better than relying on calculated formulas and food trackers. Creating balance, variety, and moderation in our diets can help us meet our nutritional needs and achieve energy balance, while preserving the joy and connection that food brings to our lives.

Photo credit: https://stocksnap.io

Katelyn Castro is a second-year student in the DI/MS Nutrition program at the Friedman School. She’s a foodie, runner, and part-time yogi on a mission to make healthy eating easy, sustainable, and enjoyable. You can find her thoughts on all things relating to food and nutrition at nutritionservedsimply.com

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!).

 

 

Microalgae: Do They Have a Place in Your Diet or Should They Be Left in the Pond?

by Julia Sementelli

If you have an Instagram account, chances are you’ve seen a slew of blue-green smoothies pop up on your feed. That vibrant color comes from adding some form of powdered algae to the smoothie. High in antioxidants, healthy fats, and protein, microalgae are the latest superfood to take over the nutrition world. The most popular types of algae include chlorella, spirulina, Aphanizomenon flos-aquae (AFA), Blue Majik…the list goes on. Microalgae are claimed to boost your energy, decrease stress, and reduce your risk for diabetes and heart disease. The question, of course, is whether these microalgae have any science-based health benefits beyond the nutrients they provide. I’ve asked consumers, health food companies, and nutrition experts to weigh in on whether algae should be added to your daily regimen or if they’re better off as fish food.

What are algae?  And why are we eating them?

Microalgae are very small photosynthetic plants rich in chlorophyll, which is where the green comes from (hello flashbacks to high school biology class). According to research, algae types differ in the nutrients they provide but all share one characteristic: they are high in antioxidants.  (See “Get To Know Your Blue-Green Algae” in the sidebar to learn more about individual microalgae). While some microalgae have been on the market for years, they have just recently risen to fame in the nutrition world as social media, blogs, and magazines advertise the purported benefits. One microalga in particular, spirulina, has received a significant amount of attention.  Companies have jumped on the microalgae bandwagon by adding spirulina to their products and even selling it in pure form. Abby Schulman, vegan and nutrition enthusiast, says that her fascination with superfood culture generally led to hearing about microalgae, in particular spirulina.  “It is sort of billed as this amazing nutrient-dense secret pill,” she states. “I was actually concerned about my iron levels and nutrition generally when I first started using it, since it was right when I transitioned to veganism. It felt like a good way of packing in some vitamins was to try the spirulina.” As a vegan who eats a diet rich in fresh produce, Abby states that adding spirulina to her diet is “ a more shelf stable way of getting in greens at the level I eat them than having to buy huge tubs of greens all the time.”

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Photo credit: Julia Sementelli

Microalgae’s time in the sun

 Blue-green microalgae have become a nutritional celebrity thanks to their prevalence in popular health food spots across the United States. Juice Generation, a national juice and smoothie chain, has jumped on the algae bandwagon by selling products that tout its supposed benefits. Products range from “Holy Water,” which contains Blue Majik, tulsi, coconut water, and pineapple, to concentrated shots of E3Live. These products claim to boost energy, enhance focus, and balance blood sugar. However, research to support these claims is lacking.

Infographic credit: Julia Sementelli

Infographic credit: Julia Sementelli

Health food businesses that use social media and blogs to advertise their products have also played a significant role in making microalgae famous. Sun Potion, an online medicinal plants and superfoods company, sells a slew of supplements, including chlorella. Sky Serge, Sun Potion spokesperson, is a big proponent of the power of chlorella. “Sun Potion chlorella is a single-celled green algae that is different than others, and is grown indoors and processed using an advanced sound frequency technology to crack the cell wall, making its many nutrients available for us to enjoy,” she explains. She says that she enjoys consuming chlorella in a glass of spring water each morning. “I have personally felt its detoxification benefits and have noticed healthier skin, better digestion and overall, a better wellbeing. Whether I am drinking it in my water in the morning or adding it to a salad dressing, I try and want to consume it every day!”

To further bolster Sun Potion’s belief in the power of its chlorella, founder, Scott Linde claims that chlorella “contains all eight essential amino acids, which could allow a person to live solely on chlorella and clean drinking water.” Not surprisingly, he too consumes chlorella daily. “Upon waking in the morning, I enjoy an eight ounce glass of water with a teaspoon of chlorella mixed in,” he says. “This simple action can punctuate the start of a great day. The body is slightly dehydrated after sleep, meaning the nutrients from the chlorella are absorbed almost immediately into the blood stream.” When asked about the nutrition benefits of chlorella, Linde claims that drinking chlorella offers much more than just antioxidants. “It helps to oxygenate the blood, waking up the brain; nourish the organs; aid in healthy elimination; and assist the body in moving toxins out of the system.” Not only have Serge and Linde experienced excellent results, but their customers have as well. “At Sun Potion, we have actually had customers tell us that they have forgotten to make their coffee in the morning because they were feeling so good from their morning chlorella ritual. This is perfect example of potent nutrition and best quality plant materials helping to saturate the body with positive influence, leading to looking, feeling, and operating at one’s best.”

The good, the bad, and the blue-green

Although many health claims about microalgae, such as increasing energy and regulating blood sugar, are not supported by science, research has shown some promising, more realistic benefits. A 2013 study showed that adding 3600 milligrams per day of chlorella to the diets of 38 chronic smokers for six weeks helped to improve their antioxidant status and reduce their risk of developing cancer. Another study found that daily intake of 5 grams of chlorella reduced cholesterol and triglyceride levels in patients with high cholesterol. Research has even found that supplementing chlorella can improve the symptoms of depression, when used in conjunction with antidepressant therapy. Still, many of these studies are the first of their kind and more evidence is needed regarding the long-term effects on cholesterol, cancer prevention, and depression, in addition to other conditions microalgae are claimed to help to alleviate.

While the supposed benefits of microalgae typically receive all of the attention, microalgae also have their own list of caveats. According to New York City-based registered dietitian, Willow Jarosh, “Some people can have allergic reactions to both spirulina and chlorella, so take that into consideration when trying. In addition, spirulina can accumulate heavy metals from contaminated waters.” She also states that microalgae can actually be too high in certain nutrients. “If you have high iron levels, have gone through menopause, or are a man, be aware of the high iron levels in microalgae—especially if you use them regularly.”

So what’s the verdict?

While there is certainly a lot of hype surrounding microalgae in the media, from companies that sell products containing them to preliminary supporting research, when it comes to recommending adding chlorella to your daily diet, experts are hesitant.

According to Jarosh, “There are some really major health claims, with very little scientific evidence/research to back up the claims, for both chlorella and spirulina.” As the co-owner of a nutrition consulting business, C&J Nutrition, she finds that her clients are frequently asking her about her thoughts on microalgae. “We’re always reluctant to recommend taking something when the long-term safety is unknown,” Jarosh says. “And since there’s not much research in humans to provide strong reasons to take these supplements (yet!), and the long-term research is also lacking, we’d recommend not using either on a regular basis.”

Microalgae are packed with antioxidants and those are always a good addition to your daily eats. Although the colors of microalgae appear supernatural and their effects often advertised as having the ability to give you superpowers, research is currently inadequate to say whether microalgae have more benefits than other antioxidant-rich foods. If you do decide to try it based on its antioxidant content, make sure that it does not replace other fruits and vegetables in your diet. Remember: Whole foods are always better than a powder.

Julia Sementelli is a second-year Nutrition Communication & Behavior Change student and registered dietitian.  Follow her on Instagram at @julia.the.rd.eats

 

 

 

 

 

 

What to Eat? It Depends Who You Ask

by Hannah Packman

The question of what to eat perplexes many Americans. We’re constantly barraged by conflicting dietary advice, much of which does not fit within our personal preferences or cultural practices. To help navigate this rocky territory, seven Friedman professors offer their take on the matter.

“What should I eat?”

As a food and agriculture student, I am frequently asked this by friends and relatives. It’s a question rife with controversy and complexity, one that I don’t generally feel comfortable answering, despite having a relatively comprehensive background in nutrition. There are countless contingencies that can influence dietary needs and preferences – religion, cultural practices, family tradition, ethical values, and personal biology and psychology, among many others. While my own diet – mostly vegan, mostly unprocessed, with plenty of chocolate and coffee – works for me, I would be remiss to universally recommend it, as it would inevitably dissatisfy a great number of people. So rather than address this question myself, I’ve asked seven Friedman professors to share their own thoughts on this quintessential dietary dilemma.

What do you eat on a normal day?

Sean Cash
Breakfast is typically berries, a toasted whole grain bagel with some sort of protein on it, and a few cups of tea. At work, I bring a big pile of fruits and veggies in, some leftovers from the night before or a sandwich, and graze throughout much of the day, usually at my desk or in meetings. My favorite afternoon snacks include almonds (the alleged villainous nut du jour!), Belvita crackers, and bananas. In the evening, anything goes: sushi and other fish dishes are favorites for meals out, but favorite meals at home lately include salads, pastas, homemade pizzas, oven-roasted chicken, and lots of broccoli and squash side dishes, washed down with a glass or two of barley juice.

Parke Wilde
Breakfast at the kitchen counter at home: coffee and Cheerios with granola sprinkled on the cereal.

Lunch at my desk: two peanut butter and jelly sandwiches and an apple from home, with a chocolate chip cookie and a coffee from Au Bon Pain.

Supper: pasta and pesto, with a big plate of salad, and some bean soup brought over by a friend who works in food service at a Waldorf school and who is passionate about never seeing food wasted.
Beverages during the day: water, coffee, and a beer or wine around 9 p.m. when early evening work or trip to gym is done.

Will Masters
Weekday breakfast is black coffee and toast with peanut butter and jam. Weekend breakfasts vary a lot, but lately I’m liking French toast. The lunch bag that I bring to Jaharis has leftovers from dinner, plus fruit, yogurt, muesli, and other stuff that I eat a couple of times during the day, maybe around 11 and again at 3 or 4. I often have peanut butter in the office that I eat with a spoon.

My wife loves to cook, so dinner is her choice: always a lot of cooked vegetables, and always a salad, often with beans or lentils and blue cheese or goat cheese, sometimes fish or meat. It usually includes pasta or rice or potatoes only when we have guests, and even then sometimes not.

Caloric beverages are pretty rare and alcohol triggers migraines, so I only drink when necessary.

Dariush Mozaffarian
Usual breakfast: whole-fat plain yogurt, almonds, blueberries, raisins, glass of OJ.  Weekends: eggs/veggie/cheese scramble, lox, or homemade whole-wheat blueberry pancakes with fresh walnuts and berries.

Usual lunches: sushi; tuna in oil and a cheese Panini with olive oil, carrots and hummus.

Typical dinners: big mixed salad with walnuts, cheese, avocado, olive oil; salmon, asparagus, mixed veggie quinoa; mozzarella and beef tomato salad.

Desserts: dark chocolate (65%+) almost every day; daily espresso; frequent fresh fruit; occasionally Ben & Jerry’s ice cream (Colbert’s Americone Dream is a favorite).

Diane McKay
Well, breakfast is usually a bowl of cut-up fruit with non-fat milk and a little granola sprinkled on top. Lunch is a salad with beans and a grain (usually chick peas and corn) with a little olive oil-based dressing.  My afternoon snack is either an apple, popcorn, or a few pretzel crackers with spinach hummus. Dinner is more varied. My favorite is grilled salmon with some brown rice and a big serving of fresh vegetables – all paired with a lovely pinot noir. Dessert is usually some type of cut up melon or grapes.

Bea Rogers
I ALWAYS start the day with coffee! That’s the one constant. In the summer my standard breakfast is berries or peaches with milk and a sprinkle of cheerios.  I’m much more varied in the winter: whole grain bread with gjetost (brown goat cheese) is one of my favorites, but whole grain toast with peanut or almond butter is another. I eat berries and milk in the winter too, if anything looks decent at the supermarket. Or fruit and (plain) yogurt.

My standard lunch on weekdays is salad with my homemade dressing, some cut up cheese and a cut-up half-apple or pear.
I cook dinner most night. Meat, chicken, or fish…with a couple of vegetables (always).  I make hearty soups for dinner fairly frequently.

I keep nuts in my office for snacks, and I also keep nuts in my car for the same purpose.  I don’t dare admit I usually have cookies in my office too, which I share at meetings.

Christian Peters
I generally eat three meals plus one to two snacks. Breakfast and dinner are the most regular, eaten at home around 7 a.m. and 6:30 p.m., respectively. I eat lunch daily, but the timing varies depending on the day’s schedule and my appetite. I often have a snack in the late afternoon, sometimes dessert in the evening.

What do I eat? All over the map in terms of cuisine. Here are some typical meals:

Breakfast: yogurt with fruit, toast with peanut butter and jam, coffee.

Lunch: leftovers from previous night’s dinner.

Dinner: ranges widely, but includes vegetables, grains, and a protein source.

Snack: coffee or tea and a cookie.

What do you prioritize most when eating – sustainability, ethics, nutrition, taste, or some combination?

Sean Cash
I favor nutrition and taste, but also pay attention to sustainability and price. I’m fortunate that I enjoy eating things that I also think are fairly good for me and honestly prefer savory to sweet, but don’t sweat it much when I want an indulgence. When I do, it’s usually a donut or more barley juice.

Parke Wilde
We enjoy food greatly and arrive at a meal pattern that is healthy, sustainable, inexpensive, and personally meaningful, without worrying much about any of those goals.

 Will Masters
An overriding goal is to find a mix that suits the whole family without too much waste of time or money or other resources, including packaging and food waste as such. I generally find no conflict at all between nutrition and taste: for the many unhealthy things that I find delicious, like Nutella (palm oil!) and all kinds of charcuterie, they’re most delicious in small quantities so there’s no real compromise involved.

The harder goals for me are ethics and sustainability. In my experience working on various types of farms, any use of animals other than as pets involves some degree of cruelty. So I just limit animal-sourced foods as much as possible. I believe that eating eggs and milk and fish probably does somewhat less violence to the world than eating meat, and I believe that beef does a bit less violence than poultry or pork, but none of it seems benign to me.

In general I expect that my priorities are fairly typical of the Friedman community, except maybe regarding sustainability: I don’t aim to reduce food miles and I don’t credit organic certification for much, because my reading of the evidence is that these don’t actually help regarding climate change or biodiversity or anything else I really care about.

Dariush Mozaffarian
Taste and how it makes me feel, that day and over the week. Fortunately, both of these criteria match nearly perfectly with good health. It’s a marketing- and modern-culture-driven myth that good food tastes worse, or is much more expensive.

Diane McKay
Taste, nutrition, and health issues are the reasons why I choose most foods.

Bea Rogers
I always think about taste, nutritional quality, and calories. Pretty much all at once.  I think about issues of sustainability and ethics, of course (given where I work), but it’s not really front and center when I go to the supermarket. I guess I choose organic when there’s a choice. I buy all my produce at the local farmers market during the season. I really do prioritize fresh and local when available, mostly because it just tastes better.

Christian Peters
All of these factor in, albeit imperfectly.

Do you have any rules of thumb or general guiding principles when deciding what to eat?

Sean Cash
I don’t eat red meat beyond a taste from a friend’s plate, and a few years ago I started finding that fried foods and dairy bothered my stomach so I avoid them most of the time.

I love donuts and when I lived in Alberta I walked by three Tim Horton’s donut shops between home and work. I put myself on a “once per week” rule as I was afraid it might become my regular breakfast, and have kept to that after returning to the land of Dunkin’ Donuts.

Parke Wilde
Real food. Low cost. Little or no meat (but not vegetarian).

Will Masters
My overall rule of thumb is to eat low on the value-added food chain. Those are things grown mostly by hand, without too much water or fuel use, so consuming them might help pull up farmers’ earnings and limit natural-resource use.

In general, if you want to know how big the environmental footprint of something is, you can start with its price tag–that gives you a rough approximation of the total amount of economic activity embedded in it. Then you can guess at the share of that activity which is just labor, and among the rest you can guess at the product’s degree of energy-intensity and other major sources of externality burden on other people.

About nutrition, a guiding principle is that I generally believe the results of careful meta-analyses of big cohort studies. Since I can’t do epidemiology myself I have to trust what I read about which dietary patterns are associated with healthy outcomes. Eventually there might be enough randomized trials in various settings to have experimental evidence, but for now I’ll continue with yogurt and tree nuts and fruits and vegetables because of observational data. For things I can observe myself, like my own energy levels and weight gain/loss, I do a lot of self-experimentation to see how different things feel — but for long-term health I have to follow what works in the cohort studies.

My final rule is not to take any particular rule too seriously — I think what’s dangerous for diets, as for many things in life, is self-certainty. The Internet worsens our tendency to live in information bubbles.  In my experience, the key to healthy living is an open mind.

Dariush Mozaffarian
I eat what tastes good and makes me feel good – energy for my body, mind, and soul.

Diane McKay
I eat mostly vegetarian, including dairy, but try to include fish three times a week. I try to stick with organic dairy products, and for produce I choose whatever looks good or is in season at my local market. My beverage of choice these days is water; no more espresso or diet Coke.

Bea Rogers
I never drink soda! I don’t believe in wasting calories on drinks… that includes soda and fruit juice. (But not coffee.) I try to keep low-carb (that is, I avoid refined grains and sugar, pasta and potatoes) and eat mostly whole grain (bread, pasta, rice) and eat lots of fruit and vegetables. I can go without meat at dinner, but not without vegetables. But since I cook for myself and my husband, generally we have a meat/poultry/fish protein source at dinner.

Christian Peters
I seek to eat meals that have a balance of flavors and textures and that constitute a complete meal. Nutritionally, my meals almost always include grains, vegetables and/or fruit, dairy and/or protein. In terms of taste, meals usually contain a mix of sweet, salty, sour, bitter, and pungent flavors. At home, we typically cook meat (or fish) 1-2 times per week, though this may get included in multiple meals. The rest of the meals rely on eggs, beans, tofu, cheese, yogurt, or nuts for protein. I drink coffee or tea in the morning and in the afternoon, otherwise water is my drink of choice.

Hannah Packman is a second year student in the Agriculture, Food and Environment masters program. When she isn’t busy filling her head with food-related facts, she enjoys filling her stomach with food-related objects.

CitySprouts: Gardens with a Mission

by Katherine Pett

We know the benefits of providing schools with computers, books, and gluesticks, but should schools come with gardens, too? Katherine Pett visited The Haggerty School in Cambridge to see their school garden in action.

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Sign welcoming visitors to the Haggerty School Garden

I met up with Greg Beach, AKA “Gardener Greg,” on Monday, September 21, on a sunny fall day at the Haggerty Elementary School in Cambridge. Greg is a garden coordinator for CitySprouts, a non-profit organization that provides and maintains schoolyard gardens and teaches classes for students from pre-school through the 8th grade. Greg, who has been with the organization for 3 years, manages 4 gardens for 5 Cambridge schools. I was visiting the Haggerty to see a class’ first planting day.

CitySprouts was founded 2001 when the organization’s founder, Jane Hirschi, and other parents and teachers decided their children didn’t have enough access to the natural world as part of their education. The group banded together and created gardens for two schools in Cambridge to fill that need. Today, CitySprouts is at every public school in Cambridge and at 6 Boston schools.

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“Gardener Greg” does some maintenance before class starts

In addition to utilizing the gardens for lessons on food production and nature, CitySprouts founders wanted the gardens to be a good source for lessons in reading, science, math, and art, not to mention nutrition. Part of their mission statement reads:

“In an era of increasing disease caused by poor diet, especially for children in under-resourced communities, school gardens are an effective means to set children on a path toward life-long healthy food choices.”

Tiny and rambunctious, the class of 20, attended by their teacher and two assistant teachers, was visibly excited. A few students prompted Greg to remember them, “from kindergarten!” one exclaimed.

The class was split into two, and half the class was given sketchbooks and crayons. They were then released into the garden to find inspiring plants to sketch. The other half followed Greg into the garden beds. He gave each student a handful of tiny lettuce seeds.

“Normally, we dig holes and bury seeds in the ground,” Greg explained to the students, “but these are so small, we can just sprinkle them over the dirt.”

After planting, students worked in pairs to carry heavy watering cans across the garden to water their newly planted seeds. The work combined physical exertion with teamwork as students shared the heavy load and then traded off watering.

Students relished the chance to move around after their long day inside. A few jumped from stepping stone to stepping stone yelling, “Parkour!” Another student took a break from planting to approach me and describe her memories of CitySprouts. Last year, she said, they made apple juice!

Different corn allowed to cross pollinate in the gardens.

Different corn allowed to cross pollinate in the gardens.

CitySprouts’ programs run not just during the school year, but into and through summer break. Even during the summer, CitySprouts incorporates academic topics into gardening. Greg explained CitySprouts’ work with The Ancient Grains Project:

“The Ancient Grains Project is a community collaboration. The students learn about the social and historical significance of grain, plant heirloom winter wheat seeds and seedlings, measure their growth and, in the summer, harvest the seeds and turn the grain into food. This summer, we ground the grain, which we used in pizza dough. We also save the best seeds, so that we can grow another crop of wheat the following season.”

Despite all the ways CitySprouts makes the natural world available for education, the students’ enthusiasm is its strongest recommendation. At the end of the first planting session, ten tiny farmers gathered around Greg for a chance to taste mustard spinach. Every child received a bite-sized piece and a wave of reactions flooded the garden. “It’s bitter,” “I like it!” “I hate it!” “I want more!” sounded at once as students nibbled.

One boy had found a different plant he was interested in eating. “Kale,” he said, staring at the greenery, “I LOVE raw kale.” I am impressed. I had never seen or heard of kale before college.

From a single visit to the Haggerty School, the value of schoolyard gardens is evident. Gardens provide outdoor time, a green space, a chance to move around, and unlimited opportunities to tie classroom learning to the natural world.photo 2

After class had finished and the first-graders had lined up returned inside, a woman approached Greg. “My daughter was just given a spot at this school,” she said looking around.

“That’s great,” Greg replied, “It’s a good school.”

The woman explained that her daughter was currently at a school down the road.

“Also a good school,” Greg replied diplomatically.

“Yes,” she replied, “but they don’t have this garden.”

Katherine Pett is a second-year student in the BMN program.  She has still never tried mustard spinach. 

Good Sense and Humor

By Katherine Pett

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

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

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

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

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

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

“We’re in Danger,” he starts.

“There’s a Serious Problem.

It is threatening us all.

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

People are going to hate you,

You are going to get dementia,

You are going to be fat and have cancer,

AND have hypertension,

And be socially ostracized and every single thing!

You’re going to default on your mortgage!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Bulletproof Coffee: the Breakfast of Champions?

by Ally Gallop, BSc, RD, CDE

Imagine waking up in the morning to a breakfast of butter, oil, and coffee. Better known as Bulletproof Coffee, it’s the new rage in the diet world. With proponents noting marked improvements in alertness, hunger suppression, and weight loss, bulletproof coffee and its creator are altering the morning routine. But navigating through these claims, the science doesn’t align.

After a trip to Tibet in 2004, Silicon Valley businessman Dave Asprey tasted Tibetan Yak Butter Tea: a concoction of brewed tea, salt, and yak butter. Upon returning to the U.S., Asprey devised his own version. Now marketed as bulletproof coffee (or BPC), it pairs well with his newly released book The Bulletproof Diet. Advocates for BPC include U.S. Olympic marathoner Ryan Hall, Divergent actor Shailene Woodley, and singer/songwriter Ed Sheeran. BPC is said to be creamier than a latte, prevent hunger before lunch, increase alertness, and be loaded with vitamins A, E, and K2 alongside omega-3 fatty acids. Yet the most enticing reason in opting for this drink is because it seemingly causes weight loss without having to exercise.

The recipe for BPC is simple. In a blender combine many of Asprey’s own products:629px-Bulletproof_Coffee_Starter_Kit

  • At least 2 tablespoons of unsalted grass-fed butter,
  • 1-2 tablespoons of Brain Octane™ Oil, and
  • Bulletproof® Upgraded™ brewed coffee beans.

Keep in mind, BPC is meant as a breakfast replacement. So let’s compare the BPC nutritional content to that of a typical breakfast: two scrambled eggs, an apple, black coffee, and a slice of whole grain toast with a tablespoon of peanut butter.

Typical Breakfast BPC *Unable to find specific nutrient data for grass-fed butter and omega-3 content.**The USDA Foods List only lists information for vitamin K1.
Calories (calories) 491 461
Total Fat (g) 23 51
Saturated Fat (g) 4 43
Omega-3 Fatty Acids (mg) < 1 n/a*
Total Carbohydrates (g) 48 0
Total Fiber (g) 10.4 0
Protein (g) 24 0
Vitamin A (IU) 803 400
Vitamin E (mg) 1.88 0.4
Vitamin K1 (μg) 9.5 0.8
Vitamin K2 (μg) n/a** n/a**
Caffeine (mg) 142 142

Starting the day off with a high-fat brew that shuns hunger and enhances alertness sounds like a great idea. Losing weight is easier when your stomach isn’t grumbling. High-fat BPC in the gut slows the rate of stomach emptying, suppresses ghrelin (the “eat more” hormone), and reduces the amount of calories consumed at subsequent snacks and meals. Since fat takes the longest to leave the stomach and be digested, even in its liquid form, Asprey’s claim makes some sense.

But Asprey’s claims regarding omega-3s and vitamins A, E, and K2 are cloudier. The amount of these nutrients in grass-fed versus conventionally grain-fed beef is higher. Yet only 60% of studies found a statistically significant difference. Further, no research exists on the amount of omega-3 fatty acids in butter- all the research comparing omega-3 contents is in types of beef, not dairy.

Recently, I contacted Kerrygold, a popular brand of grass-fed butter, and asked them to elaborate on the omega-3 content their product. They responded by saying that they have no research on omega-3’s present in butter. While grass-fed dairy may be a wiser nutritional source, there is currently no research that supports Asprey’s supposition that it has more omega-3s.

The caffeine content of BPC is likely the source of increased alertness drinkers report. It’s also possible that if the coffee truly does have a higher omega-3 content, those omega-3s could give the brain extra power.

Asprey’s line of Bulletproof® Upgraded™ coffee beans are touted as being free of mycotoxins (i.e., mold), which he claims are pervasive components of every other coffee on the market. However, coffee producers like Starbucks and Dunkin Donuts have long known about these mycotoxins. That’s why coffee beans are wet-processed, which means that the beans are washed to eliminate the mold. So the upgraded brew is no better than the rest.

But what really stands out about BPC? How about its fat content: the brew fulfills 23% of both your daily total caloric and fat intake. The Institute of Medicine (IOM) recommends 25-35% of daily total calories should come from fat. BPC fulfills that quota on its own. The Canadian Society of Intestinal Research also reminds us how fat is a stimulant for the intestines. Higher intakes may result in abdominal cramping, diarrhea, and floating stools. But that’s never advertised.

Being so high in calories, how can BPC help weight loss? If, like with any diet, fewer calories are consumed, then weight loss may occur. Asprey’s book recommends following a low-carbohydrate diet as to induce ketosis. And food restriction generally leads to weight loss.

In an interview with Runner’s World, University of California Davis’ director of sports nutrition Liz Applegate debunks Asprey’s idea behind Brain Octane™ oil, which is made of medium-chain triglycerides (MCTs). Asprey believes that the oil increases the body’s ability to burn calories because it is processed differently than other fats. Unlike long-chain triglycerides, MCTs pass directly from the gut into the bloodstream and are immediately available to be burned for energy. However, Applegate notes that there is no scientific evidence to support MCTs’ ability to increase metabolism and promote weight loss. If consumed in amounts that surpass the body’s immediate needs, MCTs will still be converted to and stored as fat.

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Breakfast of Champions?

Ultimately, this article wouldn’t be complete without attempting BPC myself. I found it odd watching butter dissolve into my morning cup. The oil slick on top was definitely unsettling. Using coconut oil and regular coffee in place of Asprey’s oil and beans, the concoction was creamy with a subtle hint of coconut. My hunger was suppressed the rest of the day, cravings for carbs were reduced, and I was able to forgo my mid-morning snack. In comparison to my normal routine of breakfast and a snack, I likely saved 120 calories. But due to an injury, I was unable to exercise. Would this daily pattern of high-fat BPC power me through morning exercise sessions?

Should YOU add BPC to your diet?

The typical breakfast provides protein and fiber, long having been touted as essentials for their hunger-suppressing properties. But choose BPC, and neither exist. The idea is you can’t have both food and BPC.

For those who already eat breakfast, replacing it with BPC on a short-term basis or intermittently could be all right. The BPC’s calories are appropriate for a morning meal. Caloric intake may even be less, depending on what one would normally eat. However, the habit of drinking coffee alongside breakfast may return, thereby increasing total calories consumed. In a recent article, Chris Gayomali, a journalist for Fast Company, tried BPC for two weeks. By the end, he was adding toast in addition to his BPC. After two weeks he ditched BPC completely because he missed eating solids.

Diet trends tend to fail due to deprivation. Given that all other meals and snacks consumed throughout the day remain constant, having BPC and food in the morning could lead to weight gain since it is so high in calories.

If you’re adamant about BPC, doing so every-other-day and ensuring intake of higher fiber and protein foods is advised. That way you can indulge while still limiting saturated fat intakes, promoting gut health with fiber, and sparing protein. Following the IOM guidelines, you wouldn’t require any additional fat on a BPC day. On those days opt for vegetable-dishes, lean protein, and unsaturated fats, like those from nuts, plant oils, and avocados.

For those who don’t typically eat breakfast, adding almost 500 calories of BPC in addition to your usual food consumption could lead to significant weight gain.

So what’s the final consensus?

When it comes to Bulletproof Coffee, the science is lacking. Egregious claims that the oil supplies “fast energy for the brain,” “reduces brain fog,” and is responsible for “rebalancing…yeast in the gut” are stated on Asprey’s website. Yet they lack any footnotes for supporting literature.

We also can’t look at foods in isolation. Rather, the whole diet matters. Asprey’s BPC argument focuses on the nutrients in two items: butter and oil. Humans are encouraged to seek variety in the foods we eat. The typical breakfast I detailed above already contains all of the nutrients advertised as part of BPC and more. If for an entire month one were to replace their breakfast with solely BPC they would be missing out on vital nutrients that variety would fulfill.

Like any other diet, BPC is supposedly “universal.” It’s meant to meet the needs of all of its followers. For me, I felt full. Others may be starving after just a couple hours.

And ultimately, Dave Asprey is a businessman. His empire includes a line of pricey oil and coffee beans in addition to travel mugs, T-shirts, and anti-aging skin creams. With a booming business plan, book, and BPC shops in the works, Asprey is raking it in when you drink his breakfast of champions.

Ally Gallop, BSc, RD is a Certified Diabetes Educator and is studying towards an MS/MPH focusing in health communication and epidemiology. She continues to drink black coffee alongside her high-fiber and scrambled egg breakfast.