‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: Shut your pie hole or, in this case: Put less in your pie hole.

Thursday, December 15, 2016

Pour Some Sugar on Me

If you can't put down your favourite chocolate bar, you may not have to... Or at least, maybe... In a few years... Maybe. Here's what Nestle wants to do about sugar, and what the research says about sugar. Without further ado, let's pour some sugar on this sweet as topic.

When it comes to sugar, there's controversy. Does sugar make you fat, sick, slow your metabolism? Is it all sugar, some sugar, added sugar, no sugar?

One recent review study found that high fructose intakes (150g/day or more) increased insulin resistance and blood lipid levels. These indicators increase the risk of several chronic diseases. The study also found many "side effects" of consuming high sugar/fructose diets, like weight gain and obesity, are a result of energy (calorie) overconsumption, often caused when people consume lots of sugary foods.

Another large review study found fructose-containing sugars do lead to weight gain and increased disease risk if the overall diet provides excessive calories. Wait, déjà vu?

Both articles stress that excessive sugar intake (fructose or otherwise) from sugar sweetened beverages like soda, are associated with weight gain, obesity, and increased risk of chronic diseases like cardiovascular, diabetes, etc.

Both studies also note that people consuming these beverages often consume too many calories, exercise too little, smoke more, and have poorer dietary patterns than people who don't.
Enter Nestle: Touting its new patent-pending sugar structure. The manufacturer compared regular sugar to a shoebox, where the outside and inside are sugar. The new structure is spherical like globe rather than a box, contains sugar on the outside but less sugar inside. Meaning the new sugar should taste as sweet as the regular stuff but contain less sugar, and therefore less calories. Nestle says it will use the new structure to reduce the amount of sugar by up to 40% in its confectionary... In 2018.

What, then, are the take home messages?
  • Even if confectionary has less sugar, that doesn't make it healthy
    • Like when Coke switched from high-fructose corn syrup to sugar... Coke went from being "unhealthy" to "still unhealthy"
  • It pays to play (exercise)
  • Visualise the value of veggies (add more to your meals)
  • Scrap the soda (as much as possible)
  • Curtail the candy (and read the nutrition labels)
Tis the season to make "resolutions". This year why not resolve to eat everything you like in moderation? Here's some fun holiday reading!

Wednesday, November 16, 2016

6 Things to know about FODMAPs

The term "FODMAP" has cropped up several times in recent posts. Today, rather than adding a link where you can read about it yourself, here's a dedicated post about it. So, without further ado, for all the your FODMAP needs, let's get going!

1. WTF is a FODMAP?
Answer: The acronym means: Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols.

2. So again, WTF is a FODMAP?
Answer: They are specific types of carbohydrates: A monosaccharide is a one-sugar unit, disaccharide is a two-sugar unit, polyols are sugar alcohols. These carbohydrates are poorly absorbed by the small intestine, small and osmotically active, and rapidly fermented - see point 4 below.

3. What is a low-FODMAP diet and who's on it?
Answer: This diet isn't a catchy, trendy one, like say... Gluten-free, but there's evidence that a diet low in FODMAPs improves the symptoms of irritable bowel syndrome (IBS). IBS sufferers (about 1 in 7 people!) exhibit recurring GI symptoms including gas, bloating, bowel pain and discomfort, diarrhoea, and/or constipation. A new U.S. study of patients with IBS and diarrhea found greater improvements for those on a low-FODMAP diet. FODMAP research and diet development took place at Monash University in Australia.
4. What do FODMAP foods do?
Answer: People can't absorb FODMAPs, so they move from the small intestine to the large intestine, taking water with them (they are osmotically active). In the large intestine, these carbohydrates meet the resident large intestine bacteria. The bacteria "eat" the carbohydrates, this is called fermentation. A byproduct of fermentation is, you guessed it, gas! People with IBS are very sensitive to the feeling of distention caused by fermentation and gas production.

5. What foods are high in FODMAPs?
Answer: Pretty much every food group has foods within them that are both high and low in FODMAPs. See table below.

High and low-FODMAP foods. http://www.med.monash.edu/cecs/gastro/fodmap/low-high.html

6. Do low-FODMAP diets help people other than those with IBS?
Answer: There is some research suggesting people who think they have a gluten or wheat "sensitivity" may actually have IBS or similar symptoms to those suffering from IBS. Research shows people with these "sensitivities" would actually benefit from a low-FODMAP diet rather than the trendier "gluten-free" diet (1, 2, 3).

So, there you have it. What FODMAPs are, what a low-FODMAP diet is, and who benefits from being on such a diet.

Should you want to try a low-FODMAP diet, I strongly advise seeking an accredited dietitian who specialises in such diets (see links below.) These dietitians will ensure your diet continues to provide you with sufficient nutrients, vitamin, and minerals, monitor your progress, and guide you through adding back potential FODMAP foods.

In Australia, find an accredited dietitian here: http://daa.asn.au/for-the-public/find-an-apd/
In the USA, find a registered dietitian here: http://www.eatright.org/find-an-expert

Wednesday, October 12, 2016

Gluten-Free Superfoods for the Gluten Intolerant?

The "gluten-free" craze of "superfoods" continues to rear its ugly head. But there's a relatively new player in the medical world, and that's "gluten intolerance" or "non-celiac gluten sensitivity" (NCGS). It's a mouthful to be sure, but what is it?

The number of people following a gluten-free diet (or think they are) has increased since 2009, but the number of people diagnosed with celiac disease remains about the same. Basically, more people are jumping on the gluten-free bandwagon without an actual celiac disease diagnosis, probably because it's trendy and falsely "healthy" (you can probably sense my eye roll and see my air quotes).

Pie Hole devotees will recall several celiac-related articles tackling what it is, how it's diagnosed, and how it's not diagnosed. One such article discussed NCGS and its lack of medical biomarkers, making it difficult to test for and identify.

A new study found subjects with NCGS had:
  • Systemic (widespread) immune activation
  • Different intestinal markers compared to people with celiac disease
In contrast to people with celiac disease, these findings suggest that people with NCGS have intestinal cell damage, and a weakened intestinal barrier. Think of it as a nightclub with a bouncer who lets in the riffraff.

People with celiac disease do not exhibit this systemic immune response, rather, it's strictly localised to the intestine. Think of this where the bouncer does his job and keeps the riffraff out.

The systemic response observed in NCGS subjects is likely due to microbial components that are released from the gut into circulation. This doesn't occur in celiac patients because the intestinal immune response is able to neutralise these microbes and prevent them passing through the intestinal barrier.

The study found immune activation and biomarkers returned to normal after dietary restriction of gluten. The potential mechanism, or trigger molecules responsible for intestinal barrier weakening is currently unknown, hence a great potential for more research.
Some food for thought, though, another recent study investigating NCGS found participant's symptoms significantly improved when following a low FODMAPs diet. Gluten-specific effects were only seen in 8% of participants. FODMAPs predominantly trigger gut symptoms, and many foods that contain gluten (eg: cereals) also contain one or more FODMAPs. So, going gluten-free to keep on point with food trends may be totally useless. And if you think you have NCGS, you might want to tone down the FODMAPs first.

The take home points:
  • Being gluten-free isn't a healthier way to live unless you've been properly diagnosed with celiac disease (which requires more than a blood test)
  • NCGS may be triggered by gluten, but in a different way than celiac disease
  • More research is needed to identify what causes the weakened intestinal barrier seen in people with NCGS
  • It may very well be FODMAPs, rather than gluten, that triggers gut symptoms in people who think they have celiac disease or NCGS
  • FODMAPs needs its own article... Coming soon

Wednesday, August 17, 2016

Healthy, Happy Eating: No Helicopter Parents Needed

What if I told you that forcing your kids to eat is a bad idea? What if you could improve your family's health by making a couple of simple changes? Parents, you're all over this, so let's get down to it!

August is Kids Eat Right Month, which inspired me as a new mum to write this article based on a bunch of new studies about kid's health.

Contrary to many parent's beliefs and actions, children shouldn't be forced or pressured to eat anything (including veggies). What whaaat? Seriously, this latest study is just adding to the body of research showing these results. Read 'em and weep:
  • Children who had more control over food-related decisions were more likely to enjoy eating healthy foods
  • Urging a child to eat increases food neophobia (fear of new foods)
  • Offering new foods reduces food neophobia
  • Children with high neophobia scores tended to like fewer foods
Translation - You, the parent, should present an array of healthy foods to your child and let them decide how much of it to eat. Your child doesn't need to be urged, coaxed, or tricked into eating more.

Next up, family meals. There are numerous researched benefits to families eating meals together:
  • They significantly increase the amount of fruit and veggies kids eat
  • They are significantly associated with BMI z-scores (more family meals equals healthier BMI)
  • They are associated with overall higher diet quality (see a review of earlier studies here, along with tips for fun, fast family meals)
But wait, the fun doesn't stop there... New research shows parent and child food intakes are closely related across various metrics of diet quality including energy intake (total calories). This is most likely due to shared food environments, shared meals, and parental modeling.

If you, the parents, are eating at Mc Donald's (environment), your child is likely with you and either sharing your meal or getting their own Mc Donald's meal (shared food). This is due to you, the parent, modeling the consumption of that particular food. This example is, of course, a negative one.

Finally, the take home messages:
  1. No healthy child self-starves
  2. The less of a fuss you make about your kids eating, the better time you'll have and the healthier food habits your children will have
  3. Eat with your kids (and be a role model: Eat your veggies!)
  4. Make the time, watching your favourite show on Netflix can wait
I happened upon this article whilst writing the above. How to get kids involved in prepping their lunches:

Wednesday, July 13, 2016

Gimme Some (Added) Sugar

Thanks for returning to Pie Hole! I'm back from "maternity leave" and will continue posting articles every month rather than every two weeks. This blog is like my baby and I want to ensure the ongoing quality of work, research, and love that goes into each article, as well as devote time to my actual beautiful new baby girl!

Following on from the insane excitement that was the release of the new Dietary Guidelines for Americans comes the new-look nutrition facts panel (NFP), coming to food packaging near you. The new NFPs boast several changes, which Pie Hole groupies will recall from the article "Label Warfare", back in 2015 when the proposed changes were announced. Let's zero-in on one particularly provocative permutation: Added sugars.
Every American not living in a cave knows we're eating too much sugar. The new Dietary Guidelines oh-so boldly and balls-ily broadcast a new guideline relating to sugar: Out of one's total daily calorie 'bank', <10% of calories should come from added sugars. Pie Hole enthusiasts will recall that from the earlier article "Dietary Guidelines: Better Late than Never".
Figure 1: FDA new proposed food label
So it seems like a great idea to add an "added sugars" item to the new NFP... Right? Well, not really, and here's why: A new study found that people who read food labels actually misinterpreted the meaning of the new "added sugars" line... Because that's what people need, a more complex food label.
Added Sugars on the label
Take a look at the new food label (figure 1). Locate the "added sugars" line (highlighted in yellow). Now, that line is indented under "total carbs", meaning that this product has 37g of carbs per serve and of that 37g, 12g are sugars (see "total sugars") and 10g of those 12g are added sugars.

Study findings 
Study participants, and I suspect many other shoppers, misinterpreted the "added sugar" line as needing to be added to the total carbs number. Who can blame them? The rules of addition are that the "total" goes at the bottom, not the top.

How to correctly interpret "added sugars"
"Added sugars" are a component of the total carbs (just like fiber and total sugars.) In other words, this product has 37g of carbs total, and of that 37g:
- 4g are fiber
- 12g are sugars
- Of the 12g that are sugar, 10g (that's 10g out of 12g) are added to this product

The bottom line (Get it? Because "added sugar" is the bottom line under carbs... You love it!)
  • It's not complicated, you don't need to do addition when reading the label (yay)
  • For the most part, avoid products with a lot of sugar and added sugar (just like trans fat)

The good news is the aforementioned study found 78% of participants reported actually reading the NFP when buying or eating food. With a little help (like this fabulous article, for example), everyone can easily and accurately decode the new label.
Additional resources: 

Thursday, March 17, 2016

Popular Posts to Pique Your Interest

It's official, I'm putting myself on "Pie Hole maternity blog leave". I've put together a list of top 10 articles... And a few extras. These are a mix of most popular reads, and my personal favourites.

1. Lunch Boxes For Picky Pie Holes - Make school lunches your kids will love eating (works for big kids, and kids in adult bodies)

2. We Came, We Snacked, We Conquered: A Big Day Out - All you need to know about snacks and how to get healthy ones into your pie hole. More on snacks here.

3. Pregnancy: 10 Things to Think About When You're "Eating for Two..." - Self explanatory... When you're eating for two, you're not feeding a garbage disposal.

4. The Rules Are... There Ain't No Rules - Why "diets" don't work, here's what does!

5. Applications of MSG: From Unsavoury to Flavoury - The various, little thought of applications for MSG.

6. Quit Wheat Belly Aching (Pt II) - Everything you need to know about the current state of research regarding gluten, wheat, and real science. You can click back to pt I here.

7. Artificial Sweeteners: Not So Sweet After All - Some bacteria-laden research regarding how fake sugars aren't all things nice.

8. Coffee & Tea-ter Tottering Over Caffeine - Tea and coffee (and caffeine) a review of all three.

9. Coffee: For Better or For Worse? - For all the caffeine-addicts, a review of everything you want to know about caffeine.

10. Udder Confusion: Are Your Kids Having a Cow Over Milk? - Kids fighting you on drinking their milk? Your guide book is in this article. If you love dairy as much as me, check out this article too.

And a few extras... Because I loved writing them.

Highfalutin Gluten - What is gluten and should you go "gluten-free"?

Highfalutin Gluten (part II) - Thinking "gluten-free" through... Critically

What Ails and Cures - Why cured meat gives you colon cancer (or to quote my husband "ass-cancer"... Sorry)

Should You Steer Clear of Beer? - Everyone's talking about wine, here's cheers to beer (and there's a photo of my dog in this one!)

Juicing: Healthy Habit or Half-Witted Hypothesis? - For those on the juicing bandwagon

Juicing: Healthy Habit or Half-Witted Hypothesis? Pt II - More for those on the juicing bandwagon

Choc-It-Up to Chocolate - Who doesn't love chocolate? We can't be friends. Science says we should love chocolate.

Overeating: Unsustainable - For the millennials like me, why "plant-based" is great for us and the earth

Does this Protein Bar Make Me Look Fat - Protein-pounding gym-junkies... Here's the truth about protein

Does this Protein Bar Make Me Look Fat pt II - As above

There will be more soon. In the meantime, enjoy these!

Wednesday, February 24, 2016

Grass-Fed Beef: An Environmental No No

The always popular, always controversial discussion of beef resurfaced recently and I figured, why not chew the fat a little? Let's talk grass-fed vs conventionally raised beef, let's talk beef and nutrition. Let's steak a claim!

First off, allow me to remind readers that herein doesn't lie my opinion. If you're morally opposed to biting into Bessie the Cow, I understand, I'm purely sharing scientific findings. Feel free to moo'v along.

A new meta analysis based on 67 articles compared the nutritional composition of organic vs conventional meat. Here are the main points:
  • Organic meat has less saturated fat (the artery clogging kind) and also less monounsaturated fat (one of the "good" fats)
  • Total polyunsaturated fats ("good" fats) and omega 3 fats (also good) were estimated 23% and 47% higher in organic meat, respectively
The likely reason for the difference in fat composition is due to grazing/forage-based diets in organic animals.

So you're thinking, "we're done, that settles it, I'm only going to buy Bessie if she grew up organic and foraged". But wait, there's another aspect worth considering... The environment.
Contrary to popular belief, conventional beef has the lowest environmental impact across several parameters, and the lowest carbon footprint.
Am I crazy? Everyone and their dog says the opposite: Grass-fed is best, right? Not right, and I'm not crazy (well, maybe a little).
A pretty landmark study assessed the conventional (CON) system, compared it to the natural (NAT) system and the grass-fed (GF) system. Here's a summary of findings:
  • Days from birth to slaughter:
    • CON system - 444 days
    • NAT system - 464 days
    • GF system - 679 days (a conservative estimate on the lower end of the "finishing age" range which is actually 671-915 days)
    • See the implications of this below
  • A larger population is required in the GF system and NAT system to produce the same amount of beef as the CON system:
    • Pop size in the NAT system is 17.1% larger than CON
    • Pop size in the GF system is 77.5% larger than CON
  • More land is needed to support larger populations:
    • If all the beef produced in 2010 was by the GF system, the additional land needed would've been equivalent to 75% of Texas
  • Water consumption:
    • In the NAT system uses 17% more than the CON system
    • In the GF system uses a whopping 302% higher than the CON system
  • Carbon footprint (the big one!):
    • The NAT system's carbon footprint was 17.4% greater than the CON system
    • The GF system's carbon footprint was 67.5% higher than the CON system
So really, what the above boils down to is that the GF system and, to a lesser extent, the NAT system requires animals to live longer before being slaughtered. That means more feed, more water, more land, more grazing for those extra days. All that contributes to the greater carbon footprint seen above. To recap, the GF system is the least environmentally friendly system.
But I'm a dietitian, shouldn't I tell you to eat grass-fed beef because some research shows it's marginally healthier? I'm not that type of dietitian. There are some things that are bigger and more important than us, the environment is one of them.
Ideally westerners would eat much less meat and beef. Can I change the world? No. We need a societal/cultural shift to occur: Eat less meat, more plants, plant-based. If we all jump on that bandwagon, perhaps we could all eat grass-fed beef.
Well, I'd say "eat more leaf, less beef"

Wednesday, February 10, 2016

Pregnancy: 10 Things to Think About When You're "Eating for Two..."

Sorry in advance for the click-baity title. However, since becoming pregnant myself, this article's been brewing inside me... Just like my future baby. I'm soo sick of hearing "oh, you can eat that, you're pregnant" when it comes to all manner of things like chocolate, cake, fried food, you name it. So here's why you might want to rethink that thought.

First, allow me to repaint this image for you: Your pregnant wife, daughter, daughter-in-law, best friend, etc, is growing a new life. They're feeding a developing brain and human, not a garbage disposal.
This idea that pregnancy is a free pass to eat whatever the hell you want is bull. I'm calling it. There's enough evidence to show that smoking and drinking are bad for pregnant women, right? Well, you know what? Here's some evidence that shoving copious amounts of cake, candies, caramels, corn dogs, and cookies down your pie hole whilst pregnant isn't all that different.

A recent CDC report stated that 47% of pregnant women in the US gain too much weight whilst pregnant. Ok, so here are the 10 things you should think about when you're reaching for your 6th Snickers bar with the convenient excuse of "it's fine, I'm pregnant"...

Thing 1
Research shows gaining too much weight during pregnancy (or being obese prior to becoming pregnant) increases your child's risk of obesity. No one wants to predispose their child to obesity and the slew of health problems that accompany it like high blood pressure, heart disease, cancer, sleep apnea, diabetes, high cholesterol, etc, etc.

Thing 2
Along that same vein, high total fat and/or visceral fat in mothers in their first trimester is an independent predictor of dysglycemia (abnormal levels of sugar in the blood that can lead to gestational diabetes). No, that doesn't mean your baby will be extra sweet.

Thing 3
Following on quite nicely is that a combination of pre-pregnancy obesity and maternal diabetes showed an increased risk of autism and other intellectual disabilities in children. Yes, you are building and feeding a human brain, take some responsibility.

Thing 4
Women with gestational diabetes (a condition during pregnancy where blood glucose levels are abnormally high) were more likely to have a larger baby at birth, and that baby is at greater risk of being overweight/obese at 7 years old. No, a big baby doesn't mean a healthy, well nourished baby... Read thing 5.

Thing 5
Women who are overweight or obese during pregnancy have increased risk of depression and delivery complications. Given what you just read in thing 4, this is because overweight/obese mums are more likely to develop gestational diabetes, which leads to larger babies at birth. Larger babies are more difficult to deliver vaginally (1, 2) - think: Large basketball, small hoop (I know you loved that analogy.)

Thing 6
High blood glucose levels/gestational diabetes during pregnancy are also associated with heart defects in babies. Good news: A healthy diet during pregnancy reduces risk of heart defects. More good news: Gestational diabetes and elevated blood sugar levels are easily prevented and managed.

Thing 7
Research shows a woman's diet while pregnant impacts her baby's body composition at birth and later in life. Meaning, a poor diet during pregnancy may lead offspring to carry more visceral fat (the dangerous abdominal kind) and again, be predisposed to the chronic diseases listed in thing 1.

Thing 8
The amount and ratio of omega 3 vs omega 6 fatty acids plays an important role in brain development. A recent mouse study found that both diets high in omega 6, and low in omega 3 fatty acids caused abnormal brain development and lasting effects on an offspring's mental state (eg: anxiety). More research is needed, but ladies... think "hook, line, and sinker"...Eat fish! More on that here and here.

Thing 9
A diet high in junk food during pregnancy changes a baby's brain chemistry. It decreases sensitivity to the joys of fatty/sugary foods, meaning those kids need to consume more of those foods to feel satisfied. More junk food means more calories, means more weight gain... Chronic illnesses listed in thing 1.
Thing 10
Women who ate high junk food/high fat diets during pregnancy had higher instances of children with behavioural problems.

So to recap:
  • Lots of junk food during pregnancy predisposes your baby to a slew of health issues
  • If you're eating a lot of junk food, you're missing out on important nutrients that help grow and nourish a human
    • No, you cannot fix everything by taking your prenatal vitamin
    • We've talked about vitamins a-plenty, and yes, while they are necessary to supplement certain nutrients during your pregnancy, they do not "make up" for or "reverse" your crappy diet
Now you're wondering how much weight you should gain? These recommendations are given by pre-pregnancy BMI:
  • Underweight (BMI <18.5) gain 28-40lbs
  • Healthy/normal weight (BMI 18.5-24.9) gain 25-35lbs
  • Overweight (BMI 25-29.9) gain 15-25lbs
  • Obese (BMI >30) gain 11-20lbs
Final parting message from one preggo to another: Look at pregnancy as a reason to better yourself and your diet, not an excuse.

Thursday, January 21, 2016

Gluten-Free: Not Guilt-Free

It's no longer the season to overeat and be merry. But many people have this problem year-round, followed by the oh-so familiar guilty feeling. That's when folks turn to fancy advertising claims to make themselves feel better. What am I talking about? The crowd buying into the "fat-free", "sugar-free", "gluten-free", "wheat-free", "all natural", "science-free" jibber jabber.

new study found that a significant number of people believed that a product with a "free-from" claim on it (especially "gluten-free") was healthier than the conventional counterpart that sported no such claims. That's good news for no one, unless of course you're the company pocketing the (gluten-free) dough... Get it? You know you chuckled.

People who "identified" as gluten intolerant, or unsure about gluten intolerance, were significantly more likely to choose the "gluten-free" product and rate it "healthier" than the conventional alternative. So, by that logic the "gluten-free" chocolate chip cookies are healthier than regular chocolate chip cookies. Same, I guess with gluten-free chips, pretzels, or lard...

There are really two issues here: The psychology behind people making these choices, and the people who "identified" as gluten-free. Let's discuss the latter.

"Identifying" as gluten free
This statement in and of itself is flawed. One does not "identify" as having Parkinson's or dementia or cancer until one is actually diagnosed with it. Celiac disease is no different. But many "identify" (AKA they self-diagnosed themselves) as gluten intolerant.

Gluten intolerance is yet to have a clinical definition or clinical diagnosis (1, 2, 3). But Celiac disease (aka someone who MUST be gluten free) does have a definition (read more here and here).

"Gluten intolerance", or non-celiac gluten sensitivity (NCGS) is a relatively new condition. And since there's no diagnostic criteria, it's currently diagnosed based on excluding other illnesses/condition like wheat allergy or actual celiac disease. This is because NCGS has a lack of viable biomarkers (things that show up on blood tests) to accurately determine a person has NCGS (1, 2, 3, 4, 5, 6).

But no. You shouldn't use this as an excuse to say that you have NCGS and therefore need to follow a gluten free diet. That remains controversial in the scientific community due to insufficient evidence that a gluten free diet is effective (1, 2.)
In fact, one study found that NCGS patients significantly decreased their gastrointestinal (GI) symptoms when put on a low FODMAPs* diet. Further, when gluten was introduced it only caused GI upset in 8% of participants. Another study also found that FODMAPs, rather than gluten, were the cause of GI symptoms in NCGS patients.

* What's a FODMAP? That's a whole other article. In the meantime, you can read about it here and here.
What did we learn?
  • A self-diagnosis (or non-medical diagnosis) doesn't make you gluten intolerant
  • Buying a product that touts itself as gluten free or free from other things, doesn't make it healthier than the conventional version... Just more expensive

Thursday, January 7, 2016

Dietary Guidelines: Better Late than Never

The highly anticipated revised Dietary Guidelines for Americans are finally available. Who cares that they're titled 2015, even though it's not anymore?! And happy new year to all the readers, btw!

After reading about the dismal state of our nation's nutritional needs, I'm wet-my-pants excited to translate the fascinating, and frankly feeble, feeding figures for you. So let's get down to business! Here are the discussion points:
  1. What are we eating and why does it suck? A breakdown of the food groups.
  2. What's new in the guidelines? (Hint: It's a not-so-sweet surprise)
  3. What about cholesterol?
  4. What about red and processed meat?
What are we eating and why does it suck?
Americans, I know it's hard to hear the truth... But we collectively suck at eating fruit and veggies. Across both sexes and all ages groups, we're not meeting the vegetable recommendations. Even starchy veg like corn and potatoes.

Fruit: In the early years, young children meet the fruit recommendations (three cheers.) But once you're over 8 years old, it's all downhill (even earlier for boys).

Grains: Collectively, we are meeting the recommendations for grains. But wait. Don't get excited. Nutritionally, not all grains are equal. There are whole grains and there are refined grains. At least half our daily grains should be whole grains.

Bingo, that's where we're mucking it up. All age groups across both sexes are above the recommendation of refined grains and below the recommendation for whole grains (fig 1). That's a whole lotta not good.
Fig 1: Average intake of whole vs refined grains compared to daily recommendations. Adapted from: http://health.gov/dietaryguidelines/2015/guidelines/chapter-2/a-closer-look-at-current-intakes-and-recommended-shifts/
Dairy: We're doing great at this... Well, the 4 years and under crowd is. Older kids, teens, parents, and oldies, they're not in the game... At all. We force our youngsters to kick back the cow juice, and then we forget that we all actually need dairy, till death do us part... Or till a diagnosis of osteoporosis to get our attention.

Protein: Not an issue for most. We have no problem meeting, and often exceeding the recommendations for protein (especially men.) If we break it down to where we get out protein, we get above the recommended amount from meat, poultry, and eggs. But no one is meeting the recommendations for fish and seafood.

Oils and fats: We are faring a little better here. As an average, we're close to meeting the lower end of the recommendations for oils. The bad news is that we're still eating too much solid fat (the stuff that contains the dreaded, artery-clogging saturated fat.)

What's new in the guidelines?
As expected, there's a guideline for limiting added sugar to <10% of your total calories... Which, (surprise surprise!) we really stink at (fig 2).
Fig 2: Average intake of added sugar compared with the new recommendation of <10% calories from added sugar. Adapted from: http://health.gov/dietaryguidelines/2015/guidelines/chapter-2/a-closer-look-at-current-intakes-and-recommended-shifts/
Where's all the sugar coming from? Good question:
  • 47% is from beverages
    • Of this: 25% comes from soft drinks, 11% from fruit drinks, 7% from tea/coffee, 3% from sport/energy drinks, 1% from alcohol
    • Wow, we are a thirsty nation
  • 31% from snacks and sweets
What about cholesterol?
An interesting one. The previous recommendation limited cholesterol to <300mg/d. This is no more (cue doom music.) Actually, cue applause and whooping.

There's a large body of evidence that shows dietary cholesterol doesn't increase blood cholesterol*. Trans and saturated fat do that. So the guidelines finally reflect the research.

*A little disclaimer: It was controversial to remove this guideline because many foods that contain high amounts of cholesterol (red meat, full fat dairy, baked goods, and processed foods) also contain high amounts of saturated and/or trans fat. So bear in mind, the updated cholesterol guideline is not a green light to eat those foods. Which brings us to...

Red meat, and processed meat.
Controversial indeed. Both these meats were recently revamped by the media as causing butt (colon) cancer (and other cancers.) However, more research is needed to know at what "dose" these meats have the highest butt (colon) cancer-causing potential. This is probably why it didn't get its own guideline.

These meats, particularly processed/cured meats, are ones to limit - especially due to their high salt content.

Well folks, that's the breakdown of the new guidelines. We've got our work cut out for us. It is a new year, maybe this is the year  our "be healthy" resolutions will stick... Fingers crossed.