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The bugs made me eat it

probioticsGene for gene, you and I are more microbe than human.  In fact, microbial cells that reside within us outnumber our human cells by ten to one! (1)

So in effect, you are never alone… our body contains billions and billions of microbial cells, mostly bacteria, some good and some bad, and according to a new study(2) some of the nasty little buggers within us might be hijacking our mood and our food choices.

Before we delve into the study findings and what you can do about them, allow me to offer a little context first.

Microbes and human health

We have long known that the human body is home to a diverse array of bacteria and other microbes (collectively known as the microbiome).  But fascinating and evolving scientific research is bringing to light the profound impact that these microbes can have on our health, even our mood – and that the wrong or inadequate mix of microbes in our gut can set the stage for disease.

The mix of microbes within us is determined by a complex array of factors beginning from the moment we are born. From a vaginal birth which is our first “inoculation” with good bacteria and being breast-fed which provides prebiotics that support the growth of these good microbes, to our environment, use or misuse of antibiotics, stress,  disease, physical activity or lack thereof, and the foods we eat and don’t eat – all impact the composition of our microbes within.(3-6)  In general, healthful behaviors and healthy dietary choices promote the growth of a more diverse and favorable ecosystem in our gut.(2,3,6)

Studies have shown that damaging alternations to our gut flora can be seen with and/or contribute to diseases as diverse as obesity, diabetes, atherosclerosis, colorectal cancer, nonalcoholic fatty liver disease, and even select mental health conditions including depression, anxiety, and autism.(6-11)

Feeding the bugs within

Most recently, a new review of  the scientific literature completed by Alcock et. al, (2) has suggested that the bugs that reside in our gut may actually influence our mood and our food choices.  It seems they exert this power over us in two key ways:

  1. they generate a craving within us for certain foods that either supports their growth or inhibit the growth of their competitors and
  2. they induce an unsettled feeling within us; a feeling of discomfort or anxiety until we provide them with the food they crave.

That’s right, Alcock and his colleagues reported that these manipulative little buggers inside our belly may influence our satiety and hunger cues by producing toxins that can alter our mood and taste receptors and by triggering the release of hormones that impact our feelings of satiety.  They can even hijack signals between our gut and brain by targeting the connecting nerve called the vagus nerve. (2)

A new accomplice for junk food cravings

It seems that each of the bacterial species within us require specific nutrients to thrive and they compete with one another for survival.  Some may require sugar or carbohydrates, while others need fat, for example.  Some of the bugs have dietary needs that align with our own; others do not. So your cravings for sugar or for the over-consumption of fast foods may now have a legitimate scapegoat – it is no longer just lack of will power that drove you to eat that barrel of ice cream; your bugs made you do it!

Healthy living: the cryptonite for harmful gut microbes

The good news is, we can alter the composition of our gut flora in as little as 24-hours by modifying our lifestyle and food choices.(2) It appears that our gut flora is much like a stock portfolio; diversity is good.   And, by choosing to adhere to a healthful manner of eating and living we can help restore a more diverse population of gut microbes and nurture the survival of beneficial bugs.  A healthy Manner of Living can therefore quiet the nasty little buggers that are sabotaging your health, while magnifying the voice and promoting the growth of the supportive bugs within.

The Bottom Line:

I find this to be a truly fascinating and mind-boggling area of scientific research.  As our understanding of this complex relationship between humans and our bugs within evolves, the implications for human health are staggering.  At this time, there are still more questions then answers about the impact our microbiome has on our health, but what we do know to be true is that we are not powerless against these buggers!

What we choose to eat and how we live our life influences the type of bugs within us.  In addition to adhering to an overall healthy manner of eating, consuming foods sources of probiotics (such as yogurt, kefir, and fermented foods including miso, kimchi, and sauerkraut) and prebiotics (such as apples, asparagus, bananas, oats, and Jerusalem artichokes) can cultivate the growth of a more favorable inner ecosystem.(2,3,6)

So, resist the manipulative cravings and forgo the sugars and overly processed foods.  Instead, choose to eat complex, whole, real, minimally processed foods.  It is win win – you will nurture your own overall health including the survival of the good bugs within and in turn, those good bugs will take care of you.

Curious to learn more?

For more information about the human microbiome, check out the website of the National Institutes of Health, Human Microbiome Project.   Scientists involved in this fascinating project are working to help us better understand the role of microbes in human health and disease. Their findings to date are remarkable.

References:

  1. American Society for Microbiology. (2008, June 5). Humans Have Ten Times More Bacteria Than Human Cells: How Do Microbial Communities Affect Human Health?. ScienceDaily. Retrieved August 24, 2014 from http://www.sciencedaily.com/releases/2008/06/080603085914.htm
  2. Alcock, J., Maley, C. C. and Aktipis, C. A. (2014), Is eating behavior manipulated by the gastrointestinal microbiota? Evolutionary pressures and potential mechanisms. Bioessays. doi: 10.1002/bies.201400071
  3. Hawrelak JA, Myers SP., The causes of intestinal dysbiosis: a review. Altern Med Rev. 2004 Jun;9(2):180-97.
  4. Sekirov I., Russell S., Caetano L., Antunes M., Finlay B.B. Gut microbiota in health and disease. Am. Physiol. Soc. 2010;90:859–904.
  5.  E, Cosola C, Dalfino G, Daidone G, De Angelis M, Gobbetti M, Gesualdo L., What Would You Like to Eat, Mr CKD Microbiota? A Mediterranean Diet, please! Kidney Blood Press Res. 2014 Jul 29;39(2-3):114-123.
  6. Guarner F, Malagelada JR.Gut flora in health and disease. Lancet. 2003 Feb 8;361(9356):512-9.
  7. Chan YK, Estaki M, Gibson DL.Clinical consequences of diet-induced dysbiosis. Ann Nutr Metab. 2013;63 Suppl 2:28-40.
  8. Power SE, O’Toole PW, Stanton C, Ross RP, Fitzgerald GF, Intestinal microbiota, diet and health. Br J Nutr. 2014 Feb;111(3):387-402.
  9. Rescigno M., Intestinal microbiota and its effects on the immune system. Cell Microbiol. 2014 Jul;16(7):1004-13.
  10. Petrof EO, Claud EC, Gloor GB, Allen-Vercoe E., Microbial ecosystems therapeutics: a new paradigm in medicine? Benef Microbes. 2013 Mar 1;4(1):53-65.
  11. Bested AC, Logan AC, Selhub EM., Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: Part II – contemporary contextual research. Gut Pathog. 2013 Mar 14;5(1):3.

The religion of food and why I choose dietary atheism

genakadar 156 - CopyA rule of etiquette in business and in general company at the dinner table is to “never talk about religion or politics.” I propose we also add “diets” to that list of topics off limits in polite conversation.

Adhering to a diet these days is no longer merely a way to eat; it has become a calling card that has emerged as a polarizing part of our identity. Much like our religion or politics, many of us identify ourselves these day by what we eat: “I’m Paleo”, “I’m gluten-free”, “I’m vegan”, “I’ll pass on the eggs; I’m a fruititarian herbivore.”

Like religious or political beliefs, our dietary proclivities can be divisive: “oh, he’s not Paleo” or provoke aggressive judgment: “I can’t believe you eat meat!”  It can also inspire ignorant attempts at claiming expertise: “You’ve gone vegan? But, where will you get your protein?” Don’t forget the condescending sarcasm: “You’re Paleo?  Oh, I didn’t realize paleolithic man had access to Whole Foods and Trader Joe’s.” And of course, there is also the arrogant annoyance: (to be read in a Valley Girl circa 1982 accent) “O-M-G. You’re gluten- free?  Do you even know what gluten is?”  Finally, there is also the sanctimonious proclamation often made by diet zealots to those around them who do not adhere to their same beliefs: “I can’t believe your gonna eat that.”

The truth is, the way I hear people talk about their diet these days and their judgment of the diet of others, you would think they are talking about the conflict in the Middle East or American politics.  You would also think they know what they are talking about.  P.S. Just because a celebrity lost her baby weight in record time does not  make her a diet expert.

So, what’s my take?

I do not follow a religion of food.

I do not worship a diet deity; I am a dietary atheist.

I am not Paleo, nor am I vegan. I do not possess a fear of all things carbohydrates.

I do not adhere to any particular “diet”.  In fact, as I explain in my forthcoming book A Manner of Living, I make every attempt to avoid even using the word “diet” anymore.

I am a professor of clinical nutrition.  I have studied clinical nutrition for well over a decade and I read countless scientific articles on nutrition each and every week.  Based on my review of the best available scientific evidence to date, I have concluded the following:

Unless you have a particular food allergy, sensitivity, or medical condition, there is no single, prescriptive, one-size-fits-all “diet” that universally, we all should adhere to.

Instead, there are simply smart choices, based on reliable evidence, that we can make when it comes to what we eat to harness the health-promoting potential of food, without compromising the pleasure of eating.  It is this understanding that informs my own daily food choices.

I choose not to eat meat; I eat mostly vegetables and other plant based-foods, and I do enjoy fish but I do not like to label myself a pescatarian.  I am inspired by the health benefits of the Mediterranean dietary pattern and delight in many foods from that region and from other culinary traditions across the globe.

I avoid highly processed foods that contain artificial ingredients or fillers. I choose organic foods when reasonable.

I eat food.  Whole, real, minimally-processed, delicious, satisfying food. I also aim to prepare food in a manner that preserves nutrients and enhances palatability, and I savor and delight in the pleasure of eating.

I do not judge those that choose to eat differently than I do, unless they impose their beliefs on me or others. (For the record, I take the same approach to religion and politics.)  Nor do I impose my preferences on others, but I am delighted to respond to questions or share my opinions and expertise whenever asked.

The Bottom Line:

What we eat has a profound effect on our health, but like religion and politics there are no easy answers.  At the end of the day, if you become informed of the broader context, seek unbiased and quality research, avoid shortsightedness, trends, and succumbing to manipulative media soundbites and headlines (not to mention propagandistic Facebook posts) – then on all three fronts: religion, politics, and what you eat – you will be more inclined to make wise decisions that are right for you.  Just think twice before mentioning that decision while in mixed company at the next office dinner party.

Amen.

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.

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