RSS Feed

It may not be the gluten after all

breadGluten is the thing that makes pizza dough perfectly sticky and freshly baked bread deliciously chewy.  Recently, it has also been vilified as a modern day culinary pariah; the nutritional scapegoat for all that ails you.

But before you feel sorry for this protein and think it is earning an unjustified bad reputation much like dietary fat did back in the day, know that gluten is not entirely innocent.  In fact, many think it has earned this reputation fair and square.  And yet, gluten may also be taking the fall for other accomplices.

Introducing the defendant

Gluten is a protein that is found in whole grains like wheat, barley and rye. Even just a few years back, removing gluten from one’s dietary intake was not an easy or popular task.  This burden was relegated only to those with a gluten allergy or with  celiac disease, a disorder where exposure to any gluten triggers an autoimmune response that can result in very serious health consequences.  Those afflicted have to be remarkably careful and scrutinize every food label and waiter in order to avoid gluten. In the past, finding something – anything without gluten was daunting.

Fast forward to today and now, gluten-free food options abound!  Aisles are dedicated to it in grocery stores, gluten-free chef bloggers are flooding the web with creative recipes and restaurants, even fast food joints are promoting their gluten-free menus. The reason for this gluten-free tsumani of goods is the simple fact that more and more people these days even without celiac disease, are claiming they feel better when they stop eating foods that contain gluten.

So what changed? How did glutenous whole grains go from being a celebrated health food into (for some) a veritable junk food?

The truth is, that while many theories abound, the reason why so many among us seem to have a hard time tolerating this protein remains unclear.

The theories:

Theory #1: The genetic modification of grains has led to what Dr. Mark Hyman famously calls “franken-grains”. These genetically modified grains of today are not the same as the grains of yesterday.  It is this genetically modified glutenous grain that our body is unable to tolerate.

Theory #2: It’s not the gluten per se, but the sheer quantity of gluten we are consuming.  It is in so many processed foods these days and we are eating so much of it that we’ve exceeded the tipping point of the amount of gluten our body can tolerate.

Theory #3: It’s not the gluten but our leaky guts. Our lousy western diet wrought with processed artificial foods and sugar, chronic inflammation and other factors including possibly gluten itself, may have damaged the lining of our gut and thus, there is an an increase in the prevalence of leaky gut syndrome (a condition of increased intestinal permeability). The gluten in franken-grains then adds flames to the fire by triggering further inflammation and symptoms.

Theory #4: It’s not the gluten, but the imbalances in our microbiome (the microbes the reside within us, particularly our gut bacteria).  This theory leads to the question of whether it is the imbalance in our microbiome that makes us less able to tolerate gluten or is the gluten causing the imbalances in our microbiome that is leading to the symptoms?  Whether it is cause or consequence remains to be seen.

Theory #5: It’s not the gluten at all but rather a placebo or nocebo effect. The nocebo effect is a negative placebo effect, where in this case people may experience a negative effect from eating gluten due to their expectations of it being harmful and causing symptoms.

Theory #6: It’s not the gluten at all, it’s the FODMAPs.  say what?? More on this in a moment.

Theory #7:  It is nothing more then a nutritional fad.

At the end of the day, while the reason may remain unclear, the improvements that are reported among many people when they remove gluten from their dietary intake is real.   Furthermore, it is now being taken seriously by the medical community.  In fact, a new term has recently been coined to describe it: Non-Celiac Gluten Sensitivity (NCGS).

So, we blame gluten. Celiac disease or not, many people feel better when they stop eating gluten.  And so, the crusade begins.

Mere correlation or cause?

Irrelevant!

Sole perpetrator or accomplice?

 Immaterial!

The jury has spoken and the verdict on gluten has been declared… GUILTY! 

…..Or is it?

It may not be the gluten after all

Alas, as often occurs in the complex world of nutritional sciences, just when we think we have it all figured out, a recent study has challenged the notion that gluten is the only culprit.

A team of researchers out of Australia investigated a number of patients that were diagnosed with Irritable Bowel Syndrome (IBS).  All the study participants reported finding relief when removing gluten from their diet.  None of the patients had celiac disease.  Instead, they all fit into that elusive category of having Non-Celiac Gluten Sensitivity (NCGS).

This is where it gets interesting.

The researchers set out to determine whether it really was gluten that was causing these people’s symptoms or if it was something else that perhaps many glutenous foods have in common.

Enter FODMAPs.  An acronym for Fermentable, Oligo-, Di-, Monosaccharides, and Polyols.  these are groups of carbohydrates (including some carbs with and without gluten) that are generally challenging for the body to digest.  They are poorly absorbed and have already been seen to cause abdominal distress in patients with IBS.  

The study took place in a three phases.

First, the participants were on a low-FODMAP diet.  All their symptom scores improved significantly.

Next, the participants were assigned to one of three groups – they either received high gluten, low gluten, or no gluten diets.  They were blinded to the group they were assigned to meaning they did not know which group they were in and neither did the researchers (this blinding helps prevent potential bias when conducting research).

Guess what?

In all three groups the symptoms got worse.  Even in the no gluten group.

MIND BLOWN.

This finding suggests that it was not the gluten, but rather all the hard to digest carbohydrates – the FODMAPs – that were the culprit.

So what are some examples of FODMAPs you may ask?  Sadly, they do include some very healthy foods.

Examples of low and high FODMAP foods include:

Category High FODMAP foods Low FODMAP food alternatives
Vegetables Asparagus, artichokes, onions(all), leek bulb, garlic, legumes, sugar snap peas, onion and garlic salts, beetroot, Savoy cabbage, celery, sweet corn Alfalfa, bean sprouts, green beans, bok choy, bell pepper, carrot, chives, fresh herbs, cucumber, lettuce, tomato, zucchini.
Fruits Apples, pears, mango, nashi pears, watermelon, nectarines, peaches, plums Banana, orange, mandarin, grapes, melon
Milk and dairy Cow’s milk, yogurt, soft cheese, cream, custard, ice cream Lactose-free milk, lactose-free yogurts, hard cheese
Protein sources Legumes Meats, fish, chicken, Tofu, tempeh
Breads and cereal Rye, wheat-containing breads, wheat-based cereals with dried fruit, wheat pasta Gluten-free bread and sourdough spelt bread, rice bubbles, oats, gluten-free pasta, rice, quinoa
Nuts and seeds Cashews, pistachios Almonds (<10 nuts), pumpkin seeds

Additional advice on FODMAPs can be found through Monash University where much of the research of FODMAPs has been completed. Visit their website at:  http://www.med.monash.edu/cecs/gastro/fodmap/

BOTTOM LINE:

We still have a lot to learn about gluten and other potential food sensitivities. In the meantime, whether explainable by science or not, if you feel better when you eliminate gluten and your manner of eating is otherwise nutritionally balanced,  then stop eating gluten (or at least cut back on your intake).  The most important thing is how YOU feel.

If you are eliminating gluten then just make sure you are still getting adequate nutrition from other sources which can easily be accomplished by emphasizing intake of nutrient dense, high fiber, plant foods.

Importantly, avoid (or at least, proceed with caution in) the “gluten-free” isle at the grocery store. Most pre-packaged gluten-free foods are just as unhealthy as any other processed, refined, packaged food.  They often  use many artificial fillers to replace the gluten.  So keep in mind that gluten-free is NOT always synonymous with healthy.

If you have more extensive symptoms (and no other medical reason has been identified) and gluten is not doing the trick, or you have been diagnosed with IBS, consider a trial elimination of FODMAPs under the supervision of your healthcare provider, to see if your sensitivity extends beyond gluten alone.

Even if you don’t have IBS, if you suspect you may have a sensitivity to select foods, look to your gut.  Gut dysbiosis (imbalances between the good and bad bacteria in our gut) may contribute to poor digestive function and FODMAP intolerance.  Talk to your healthcare provider about probiotic and prebiotic food sources and the steps you can take to restore a healthy gut.

References:

  1. Theor Appl Genet. 2010 Nov;121(8):1527-39
  2. J Agric Food Chem. 2013 February 13; 61(6): 1155–1159.
  3. Clin Gastroenterol Hepatol. 2012 October; 10(10): 1096–1100.
  4.  PLoS ONE, 2013; 8 (11): e78687
  5. Annals of Internal Medicine. February 21, 2012 vol. 156 no. 4 309-311.
  6. Nutrients. 2013 October; 5(10): 3839–3853.
  7. Gastroenterology. 2013 Aug;145(2):320-8.e1-3

In defense of the morning coffee ritual

mug1I begin each morning with a hot cup of dark, fair trade certified, organic coffee tempered with a subtle splash (a soupçon) of organic, sugar-free and carageenan-free almond milk.

My mug selection is almost as important as the coffee itself. Sometimes I may feel nostalgic and reach for my Hello Kitty Eiffel Tower mug; a ridiculously overpriced, irresistible impulse purchase that I picked up many years ago at the Galeries Lafayette department store while I was a student in Paris.  Other mornings I may reach for my black and white mug from Trinity College in Dublin.  A perfectly contoured mug from the university store of Oscar Wilde’s alma mater, that seems to infuse my coffee with the wisdom of the ages.

There is just something about that morning ritual.  In fact, I can’t recall a morning being home when I have forsaken that moment to sit, reflect on my thoughts, and savor that hot cup of coffee.  Even when I have to wake up at an ungodly hour to catch a morning flight or a meeting across town, I set my alarm clock just early enough to ensure I have time for that moment.

That moment

Like you, I too have rode the wave; that ever changing tide of coffee as panacea or poison.   Yet, this was one debate that while I enjoyed to engage in it, the punchline didn’t seem to matter to my ritual.  I have long been convinced that the health benefit of that morning ritual extends far beyond the nutrient value of what was in my cup.  There is just something about taking a moment a midst the joyfully chaotic lives we lead to simply sit still and experience quiet self-reflection.

While the advantages of a moment of mindfulness may seem somewhat obvious, more and more scientific evidence is emerging that elucidates the profound health benefits of practicing mindfulness.  Reported benefits include reducing stress and chronic pain, and improving immune and cognitive function. (1-3)  Remarkably, a 2011 study actually found that among participants regularly practicing mindfulness behaviors, there was an increase in the gray matter density in regions of the brain involved in learning, memory processing and emotion regulation(4)  

Mindfulness is a form of meditation, but it is not about sitting cross-legged on a yoga mat; it is about intentionally becoming an observer of yourself – your thoughts, your feelings and your behaviors – in any moment, and without judgment.  Just observing during relaxation or during activity, and even just for a few moments at a time.

A confession

O.k., I confess… as a doctor, nutritionist, professor and a uber-conscious consumer, as much as I can revel in the ritual and appreciate the ritual for what it is – those of you who know me, know that I would not be letting that coffee touch my lips if I didn’t know about the impact it had on my health.

Coffee caveats

For some, the stimulating effects of caffeine in coffee can lead to stomach upset, insomnia, headaches, irritability, nervousness, even a rapid heart beat or muscle tremors.  Naturally, if you are sensitive to caffeine or if you are under the age of 18, there is no reason to consume coffee.  In such cases, the potential harm likely outweighs any possible benefit.  Additionally, if you are pregnant, over 300 mg of caffeine a day may put the fetus at risk (5) so it is not advised. (NOTE: 300 mg = ~ 2 to 4 cups of brewed coffee)  Furthermore, if you’re the type that will drink coffee all day long, then you are falling into that old dangerous trap of too much of a good thing.  One study has even suggested that over 4 cups a day might increase the risk of death! (6)  Finally, if your idea of coffee is a moca-frappe-double whip-vanilla-choco-latte then you and I are not referring to the same thing. I am talking about a phytonutrient and antioxidant rich bean that has been ground up and brewed in hot water, you are referring to a liquid cake.  Sorry, but the health benefits no longer apply.

The case for coffee

With the caveats in mind, I now get to sing the praises of coffee.  So what makes coffee good?  As mentioned above, it is an abundant source of antioxidants and phytonutrients.  Most famously, it can combat sleepiness and improve alertness.  But the benefits may extend beyond these obvious ones. In fact, your morning coffee may also come with distinct anti-cancer benefits.  For example, a meta-analysis published earlier this year reported that 2-3 cups a day may decrease the risk of liver cancer by up to 50%! (7)

Other chronic diseases may benefit from that cup of joe as well: a 2009 systematic review found that coffee drinkers had a decreased risk of developing type 2 diabetes (8) and other studies have found that coffee consumption may reduce the risk of Parkinson’s and Alzheimer’s disease. (9) It also has been shown to reduce inflammation and boost HDL in people with type 2 diabetes (10) and may even help reduce the risk of gout. (11)

One study has even gone so far as to suggest coffee may be the fountain of youth!  A study of Greek elders attributed their longevity and low risk of cardiovascular disease to coffee consumption. (NOTE: in this study they looked at the consumption of a specific type of boiled Greek coffee) (12)  Other studies have also reported an inverse association between coffee drinking and mortality. (13) 

Even the most long held rumor about coffee has recently been debunked.  Scientists out of England published a paper suggesting that the dehydrating effect of coffee is a myth.  In fact, they claim that based on their findings coffee may be as hydrating as water! (14) 

The Bottom Line:

While coffee has certainly been the subject of much controversy over the years, so far it has withstood its critics.  It seems that for many of us, the benefits appear to outweigh the risks.  As reported by O’Keefe et al., “(up to) 2 to 3 cups (a day) appears to be safe and is associated with neutral to beneficial effects”. (15) Overall, I have enough confidence in its safety and the prospect of its potential goodness to rest-assured that not only is my morning coffee ritual satisfying, but it also appears to support my well-being for  reasons beyond the calm, comforting, mindfulness it grants me.

So, that is how I start my day.

In fact, that is also how I end my day.  In the evening  the ritual is similar, except the coffee is now replaced with a hot cup of my favorite caffeine-free, herbal, Ayurvedic, organic, ginger tea; the brand with the inspirational quote on each packet.

The big question that remains is…

I wonder which mug I will reach for tonight?

A final word: Much of the of the research on coffee’s impact on our health comes from observational studies and not randomized controlled trials. It is therefore important to keep in mind that an association, while encouraging – does not prove cause. Time will tell if coffee is truly a “fountain of youth” or just a benign, neutral beverage that seem to be enjoyed by otherwise healthy people.

References:

  1. Psychological Science May 2013 vol 24 no. 5 776
  2. BMC Med Educ. 2013 Aug 13;13(1):107
  3. Journal of Evidence-Based Complementary & Alternative Medicine October 2013 vol. 18 no. 4 243-247
  4. Psychiatry Research: Neuroimaging. 2011 Jan 30; 191 (1): 36-43
  5. BMC Medicine 2013, 11:42
  6. http://www.medicalnewstoday.com/articles/264778.php
  7. Clinical Gastronenterology and Hepatology, Published 22 October 2013.
  8.  Arch Intern Med. 2009;169(22):2053-2063.
  9. Crit Rev Food Sci Nutr. 2011 Apr;51(4):363-73.
  10. Am J Clin Nutr. 2010 Apr;91(4):950-7
  11. Arthritis Rheum. 2007 Jun;56(6):2049-55
  12. Vasc Med March 18, 2013 doi: 10.1177/1358863X13480258
  13. N Engl J Med. 2012 May 17;366(20):1891-904
  14. PLoS ONE 9(1): e84154. doi:10.1371/journal.pone.0084154
  15. J Am Coll Cardiol. 2013 Sep 17;62(12):1043-51

It is OK to be a little uncomfortable once in a while

genakadar.177 - Copy POSTThere were weekends when I passed on the nights out with friends and instead, stayed home diligently preparing for my high school biology and history exams.

There were parties that I missed when I chose to spend late nights at the McGill University library struggling to grasp the complexities of physics and organic chemistry.

There was sleep lost with that all-nighter I pulled preparing for my gross anatomy final exam.

I’ve opted to spend the day cleaning and doing laundry not because it gave me pleasure, but so I could be proud of my home when the guests arrived.

We all make choices in our life where we sacrifice transient comfort for a greater goal.  Somehow this seems acceptable in most aspects of our life, except when it comes to what we eat.

  • Why do we prioritize flavor over health promoting nourishment at nearly every meal?
  • Why do we judge a meal’s value by the portion size and not by it’s nutritional quality?
  • Why does a transient taste sensation override the desire to support our health with what we eat?

Consider this:

You do not need to derive pleasure from every meal you eat.  Sometimes, it is OK to eat something just because it is good for you.

Don’t get me wrong, I do not think that the joy of eating should be sacrificed in the name of good health.  Food is one of life’s great pleasures!  I have always told my Clinical Nutrition students that when working to improve a patient’s dietary intake, never make healthy eating synonymous with deprivation.  Instead, demonstrate how eating health-promoting, real food can taste great!  But, as we all know, when we are transitioning away from artificial food products towards whole real foods, at first the flavors may in comparison, seem a little muted; not as salty, rich, or sweet.

Artificial, processed foods are often and notoriously bolder in the flavors of sweetness, saltiness, and richness.  Food manufacturers enhance flavors to make their products seem more satisfying but as we know, this satisfaction comes at a cost.

Evidence is emerging to suggest that these artificially enhanced food products are not only nutritionally void and damaging to our heath, but they also appear to be addictive.

In a recent 2013 study, researchers at Harvard set out to demonstrate that not all calories are created equal.  They found that compared to consuming the same number of calories from complex whole food, consumption of lower quality high sugar, processed foods leads to:

  • Greater increases in blood sugar
  • Increased hunger
  • Activation of the same regions of the brain associated with reward and craving that are activated in response to addictive substances like alcohol and drugs

Exposure to these poor quality foods therefore makes us crave them even more.  This can make passing on the packaged cookies and choosing the apple feel uncomfortable and less satisfying…  in the moment.

Nobody likes putting time towards studying.  Yet, it is an important means to an end.   Regular studying enhances knowledge and may also lead to a degree, a satisfying job, and a stable income.

Choosing daily to have water or unsweetened ice tea instead of cola (diet or regular) may not be most satisfying to your palate, but it too is a means to an end; helping to prevent of type 2 diabetes and weight gain.

Choosing to eat less of the food on your plate may lead to a little less satisfaction in the moment, but when you look in the mirror and feel great you don’t think about those extra bites that were left behind.

Choosing not to give in to that late night snack craving and instead going to bed a little unsatisfied will be an non-issue when you have enough energy to play with your children.

You don’t lament passing on the fries and choosing the roasted vegetables when you are dancing at your grandchild’s wedding.

Choosing to eat well during most meals: whole, real food and not too much – will help you achieve far greater and more meaningful goals than a transient pleasure sensation in your mouth.  It also makes the occasional special indulgence in fresh ice cream sprinkled with almonds all the more sweeter, and the occasional savoring of a Kobe beef burger all the more delightful.

Life is all about choices, but we need to pause, and be mindful when it comes to deciding what and how much we eat.  By defining a bigger goal – a healthy body composition, less pain, more energy, enhanced vitality and longevity – choosing the wild salmon filet and roasted vegetables instead of the double cheese burger and fries becomes no different than studying for the high school history exam.

Time to re-think the “kids’ meal”

Little ChefsI never really understood the idea of a kids menu at restaurants.  Don’t get me wrong, as a child I too succumbed to the irresistible seduction of the “prize inside” phenomenon that accompanied foods designated for the under 8 crowd.  I understand the draw of the gifts, but why the need for special “kids meals” to accompany them?

Growing up in Canada the product of worldly Eastern European parents, my brother and I ate some foods that may seem bizarre to the typical North American child’s palate.  Bone marrow, (yes, bone marrow!) sardines, herring, toltott paprika (Hungarian stuffed peppers) and goulash (a hearty Hungarian stew) were all a part of my regular dining repertoire.  Not because they came with a prize, but because that was the food my parents ate.   I was so detached from “conventional” children’s foods that my first memory of a peanut butter and jelly sandwich is not until my 20’s.

I never got the memo, nor did my parents, that children were only able to eat special foods designated as “kids meals”.  I never knew as a child that instead of eating the same paprikás csirke (a Hungarian dish made with chicken and paprika) as my parents, that my poultry was supposed to be processed into the shape of a dinosaur.  I never knew that instead of  fruit, my snack foods should come in boxes with cartoon characters upon them.  Well contrary to the trend these days, they’re not.

Think about it: many children around the world deprived of the ‘luxury’ (sarcasm intended) of processed children’s foods are instead out of necessity, growing up eating the foods common to their culture.  This unintentional (or in some cases, intentional) rejection of catering special foods to kids, leads to children worldwide being reared on foods that may seem too complex and grown-up for the typical North American child’s lunch box.   Indian curries, Vietnamese pho, Spanish paella, delicious French ratatouille, Ethiopian wat, or Korean bibimbap, etc.  Vibrant spices and diverse flavors; healthful, whole REAL foods consumed by children across the world – and yet, we think North American kids can only eat processed foods with Sponge Bob Square Pants on the box? Really??  Why are North American children so different?

Clearly, they are not.  And, we need to stop treating them as if they are.

We need to stop allowing food manufacturers and clever marketing teams to dictate what our children should eat.  It’s time to ditch the idea of a kids meal.

Consider the findings from a new study from the University of Edinburgh.  Scottish researchers looked at over 2,000 5-year-old children.  They found that when it comes to children’s health, eating together as a family was “far less important”  than the young children being fed the same food as their parents (and keep in mind haggis – a savory pudding made with sheep innards – is a Scottish staple).

The researchers found that youngsters who ate the same meals as their parents ate more fruit and vegetables, less fatty and salty foods and less snack foods then their “kids menu” counterparts.

What’s more, when the researchers evaluated other variables, they found that eating the same food as grown-ups had the greatest impact on a young child’s health.

As a nutritionist, this finding is not surprising.  The nutritional quality (or lack thereof) of most “kids meals” is atrocious.  Not only are they lacking in nutrients relative to similar adult foods, (a 2013 report from the Center for Science in the Public Interest found that about  97% of nearly 3,500 “kids meals” analyzed did not meet basic nutritional standards)  but they are also loaded with questionable additives that in the best case have no benefit to human health, and in the worst case are tremendously harmful - especially to children.  How ironic.  (For more info on select food additives refer to my post: Where’s the fruit?)

Bottom Line:

1) Next time you eat out with children, ditch the kids menu and order from the real menu.  Bring the left-overs home, or enjoy the entrée family style – share it!

2) No time for a daily family meal? No need to stress!  According to this new research, just setting aside for your children the same food that you eat is even more valuable to your child from a health perspective.  Although, I must add that despite what the researchers say, ideally you should do both.

Eating together as a family offers additional health benefits that the researchers did not focus on in this particular study.  At the very least it gets the child away from the TV and allows an opportunity for the family to connect, even if only for a few moments.  Consider a 2010 study that found children who regularly ate a family meal, got adequate sleep and watched less TV were nearly 40% less likely to be obese than children who did not have these routines.  There are other benefits too.  Personally, growing up I learned more about contemporary events, debate and discussion around the dining table than I did in the classroom.

3) Lastly, when at the grocery store, simply avoid purchasing packaged and processed foods marketed to kids.

NOTE: If your child is a picky eater, and you need help transitioning your child away from the junk food marketed to children, check out the section in my book (slated for release this October!) entitled “Raising a Healthy Eater”.

References:

1.  Skafida, V. (2013), The family meal panacea: exploring how different aspects of family meal occurrence, meal habits and meal enjoyment relate to young children’s diets. Sociology of Health & Illness, 35: 906–923. doi: 10.1111/1467-9566.12007

2.  Center for Science in the Public Interest (2013) Kids’ Meals II: Obesity and Poor Nutrition on the Menu. Available from:  http://cspinet.org/new/pdf/cspi-kids-meals-2013.pdf

3.  Anderson SE, Whitaker RC . (2010), Household routines and obesity in US preschool-aged children. Pediatrics. Mar;125(3):420-8. doi: 10.1542/peds.2009-0417.

Where’s the Fruit?

If you’re a child of the 80′s, the image of the three old ladies asking “where’s the beef?” is forever ingrained in your mind.  Today, as I walked the aisles of my local grocery store it appeared to me that in 2013, we now have a new question to ask:

“Where’s the fruit?”

You see, as I glanced at the labels of some new food products as I often tend to do, I saw fruit at the bottom yogurt, but now made with Greek yogurt! I saw fruit juices, but now with added vitamin D! I even saw fruit lunch snacks for children that were not only gluten free, they were also organic!  Yet, aside from their attempt to hitch their wagon to the latest food trends, you know what else all these ‘fruit based’ food products had in common?

Not one contained ANY actual fruit.

I’m not joking.

Instead of fruit, the ingredient list indicated the presence of “pear flavor”, “cranberry flavor”, innumerable amounts of sweeteners, and a rainbow of artificial dyes to mimic the vibrant colors of the apples, berries, and pomegranates that are colorfully depicted on the front of the packages.  But alas, it seems these two dimensional print images of fruit is the closest thing that any of these products have to real fruit.

With all these fruit flavored delights (sarcasm intended) available in the market these days, I must give the prize to “Kellog’s® Blueberry Mini Wheats Cereal”.

It seems Kellogg’s® idea of a blueberry is as follows:

Ingredients: “Whole grain wheat, sugar, contains 2% or less of milled corn, brown rice syrup, corn syrup, natural and artificial flavor, modified corn starch, gelatin, soybean oil, glycerin, sorbitol, blue 2 lake, red 40 lake, red 40, BHT for freshness.”

Translation: Blueberries = sugar, starch, oil, syrup, with added food dyes.

I can’t make this stuff up.

I also can’t let them get away that easy, without taking a moment to highlight the dyes used in this cereal, particularly red 40.

Red 40, is one of a number of food dyes that (while commonly used in many food products marketed to children) have been linked to hyperactivity and ADHD.[1] [2] Several of these dyes have also been linked to anxiety, migraines, and even cancer.[3]  For this reason, many European countries have banned their use altogether or have mandated strict warning labels for products that contain them.[4]  Yet, their use is still permitted by the FDA, and here they are in morning breakfast cereal… impersonating blueberries.

Remember that final ingredient BHT that is included “for freshness”?  Studies have raised concerns that excessive consumption of BHT may be carcinogenic. [5] [6] 

If only there is a better way to achieve freshness…

Wait! I have an idea!  What about eating real, fresh blueberries for breakfast?

The Bottom Line: Buyer beware.  If you purchase packaged foods, do not purchase another product without turning the box around to read the ingredient list, so you can find out what is really in there.   Better yet, to avoid this deception in the first place, choose to enjoy fresh, real fruit instead.

[1] McCann D., Barrett A., Cooper A., Crumpler D., Dalen L., Grimshaw K., Kitchin E., Stevenson J. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial (2007)  Lancet,  370  (9598) , pp. 1560-1567.

[2] Pelsser L.M., Frankena K., Toorman J., Savelkoul H.F., Dubois A.E., Pereira R.R., Haagen T.A., Buitelaar J.K. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): A randomised controlled trial (2011)  The Lancet,  377  (9764) , pp. 494-503.

[3] CSPI. Food Dyes: A Rainbow of Risks. Washington, DC: Center for Science in the Public Interest; 2010.

[4] Food Standards Agency. Compulsory Warnings on Colours in Food and Drink [press release] London: Food Standards Agency; Jul 22, 2010.

[5] EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS); Scientific Opinion on the re-evaluation of Butylated hydroxytoluene BHT (E 321) as a food additive. EFSA Journal 2012;10(3):2588. [43 pp.] Available online: www.efsa.europa.eu/efsajournal.htm

[6] UNEP and OECD, 2,6-di-tert-butyl-p-cresol (BHT) Screening Information Data Set: Initial Assessment Report (Paris: OECD, 2002), Available online: http://www.inchem.org/documents/sids/sids/128370.pdf.

The health “halo effect”: how one color can change our perception of candy

candy labelHave you noticed the green colored nutrition labels that have been showing up on candy bar wrappers?  That color choice was not a random call.

In a response to industry demand motivated by the increasing prevalence of obesity and diet-related diseases, more and more food products are now bearing “front-of-package” nutrition labels that highlight some of the key nutrients within those foods.  The intent is to help consumers have an easier time making decisions regarding what they eat. These new labels generally include: calories, fat, sodium, fiber and/or sugar content.

While these new labels can be a benefit to the consumer, to the manufacturer of unhealthy packaged “foods” they pose  a problem.  Why would you want to make it easier for consumers to determine how unhealthy your food product is??

To solve that problem, the manufacturer of select candy bars came up with a clever solution – color that new label green.  Problem solved.

You may wonder- why would merely adding the color green to a label have any impact on this problem??

I’m glad you asked!

This brings us to two fascinating new studies conducted at Cornell University.  (Published Feb 27, 2013)

Study 1:

“participants perceived a candy bar as healthier when it bore a green rather than a red calorie label, despite the fact that the labels conveyed the same calorie content.”

Study 2:

“examined the perceived healthfulness of a candy bar bearing a green versus white calorie label”  “Overall, results suggest that green labels increase perceived healthfulness, especially among consumers who place high importance on healthy eating.”

The researchers suggest that most likely the green implies “go” in the mind of consumers.

One can also consider this reaction a health “halo effect” of sorts, whereby when one component of the label is associated with health (the color green means healthy!) it influences our perception of the entire food - through it’s association with the color green, we think the candy bar must be healthy as well.  

This leads us to the next question: how do food manufacturers get away with this obviously deceptive tactic?

The simple truth is that unlike the nutrition fact panel on foods, these new “front-of-the-package” food labels are not closely monitored by the Food and Drug Administration (FDA). And even though the FDA has issued warnings to 17 food companies for deceptive labeling, and even though articles have appeared including one in the Journal of the American Medical Association (JAMA) calling this tactic a “breach of consumer trust” - these practices still continue among select food manufacturers.

My 2 cents: it is sad that an initiative designed to help consumers make more informed decision regarding the food they purchase, has been manipulated by some manufacturers to take advantage of human instinct and essentially, trick consumers into purchasing their products.

In my opinion, as consumers we need to take a stand and vote with our fork.  Let’s stop supporting manufacturers that are intentionally manipulating our fellow consumers.  If you must satisfy a candy craving, bypass these green labels and instead, choose a product from a manufacturer that has a little more respect for you and I.

Better yet, to satisfy a sweet craving consider reaching for a warm cup of tea and a high quality, antioxidant and phytonutrient rich piece of dark chocolate (with a 70% or greater cacao content), a few almonds to add to the satiety and lower the glycemic load of the snack and then… savor it.

Fruit smoothie or… cleverly packaged candy?

sugarshocker44This week in my Clinical Nutrition course, I had my students participate in an interesting activity. Each student brought in a food item along with the equivalent amount of sugar or salt that the item contained to illustrate the deceptively large quantity of these ingredients in certain foods.  The visual impact was impressive.

Some of the surprising culprits included a salad dressings with more sugar per serving than you’d expect could fit into the entire bottle, and old favorites like ketchup and Nutella that are simply laden with sugar.   But the greatest/most shocking culprit?  The fruit smoothie.

Pop quiz! Which of the following has 80 grams of sugar in one serving?

  1. A bag of Skittles
  2. A Snickers chocolate bar
  3. Six Oreo cookies
  4. A  24 oz. fruit smoothie

If you selected option 4 – congratulations, you’re right!

If you selected option 4 for your morning breakfast with the intent of enjoying a “healthy” start to your day… ouch.

That fruit smoothie has almost double the amount of sugar as a can of Coke, more sugar then a Cinnabon Cinnamon Roll, and about three times the amount of sugar as a bowl of Captain Crunch cereal.

To offer some perspective, The American Heart Association recommends women limit added sugars to no more than 100 calories/day (about 6 tsp) and for men, no more than 150 calories/day (about 9 tsp).

One teaspoon of sugar has about 4 grams of sugar and 16 calories.

Juices are notoriously deceptive sources of sugar.  Even a 16 ounce bottle of Minute Maid orange juice has 48 grams of sugar; a 16 ounce bottle of Apple Juice? A whopping 52 grams of sugar!  A can of Coca Cola? “Only” 39 grams of sugar.

You would never start the day off with a Coke or give your child 12 tsp of sugar with their breakfast –  perhaps it’s time to think twice about that juice as well.

To replace that glass of O.J., here are a few thirst quenching options to enjoy instead:

  • Unsweetened iced tea
  • Warm herbal tea
  • Naturally infused water: add mint leaves, berries, orange, watermelon  or cucumber slices to water
  • Natural flavored seltzer water
  • Ice coffee without the sugar
  • If you miss the juice and/or soda – add a splash of juice to seltzer water

While fruit juices do have nutritional benefits including essential vitamins and phyto-nutrients, you are better off eating these calories from the whole fruit – that also offers satisfying fiber – than gulping them down in a glass.

Eating whole foods as opposed to drinking down calories appears to have some additional advantages when it comes to preventing weight gain.

A few years ago, a group of researchers did what has been referred to as the jelly bean vs. soda study.  In addition to their typical daily food intake, the researchers had the study participants consume a snack each day.  There were two study groups and each was provided a different snack but with an identical amount of calories.  One group consumed the snack calories as edible solid food – jelly beans; the other group as liquid calories – soda.  Again, the amount of calories  was the same (450 kcals), and the snack nutrient quality (or lack thereof) was also the same.

So what did the researchers find?  Those consuming the liquid calories gained weight after only 4 weeks; those on the solid foods – no weight gain.  It seems participants subconsciously reduced their daily calorie intake commensurate with the number of calories provided by the jelly beans, but not when drinking the soda.

To clarify, this study is not to advocating for, or justifying a jelly bean diet!  It is simply illustrating another good reason too eat our calories from solid foods instead of drinking them.

The Bottom Line: Whether it is soda, juice or that now infamous fruit smoothie – if it has sugar on the label… think before you drink.

Follow

Get every new post delivered to your Inbox.

Join 181 other followers

%d bloggers like this: