Currently browsing posts about: Diets

A nutrient profiling system for the (re)formulation of a global food and beverage portfolio.  Antonis Vlassopoulos · Gabriel Masset · Veronique Rheiner Charles ·Cassandra Hoover · Caroline Chesneau‑Guillemont · Fabienne Leroy ·Undine Lehmann · Jörg Spieldenner · E‑Siong Tee · Mike Gibney ·Adam Drewnowski.  Eur J Nutr DOI 0.1007/s00394-016-1161-9.

• Conclusions:  The NNPS sets feasible and yet challenging targets for public health-oriented reformulation of a varied product portfolio; its application was associated with improved nutrient density in eight major food categories in the USA and France.
• Funding: The research presented herein was funded by Nestec Ltd, which is a wholly owned affiliate of Nestlé S.A.  The first eight authors are employed by Nestlé.
• Comment: the paper is the basis of a Nestlé infographic.

Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial.  Heather C Stobaugh, Kelsey N Ryan, Julie A Kennedy, Jennifer B Grise, Audrey H Crocker, Chrissie Thakwalakwa, Patricia E Litkowski, Kenneth M Maleta, Mark J Manary, and Indi Trehan.  Am J Clin Nutr  First published February 10, 2016, doi: 10.3945/​ajcn.115.124636.

• Conclusion: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF [ready-to-use supplemental food], although the whey RUSF supplement provided less total protein and energy than the soy RUSF.
• Funding for this project was provided by the Danish Dairy Research Foundation, Arla Foods Ingredients Group P/S, and the US Dairy Export Council. IT was supported by the Children’s Discovery Institute of Washington University in St. Louis and St. Louis Children’s Hospital…The funders had no role in the design or implementation of the study and no role in the analysis or interpretation of the data.

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK.  L. Claxton, M. Taylor & E. Kay.  British Dental Journal 220, 121 – 127 (2016).  Published online: 12 February 2016 | doi:10.1038/sj.bdj.2016.94

• Conclusion If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year…This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved.
• Declaration: This study and writing support for the manuscript were funded by Wrigley Oral Healthcare Programme.

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base Richard D. Feinman, Wendy K. Pogozelski , Arne Astrup M.D., Richard K. Bernstein M.D., Eugene J. Fine M.S., M.D. , Eric C. Westman M.D., M.H.S.  , Anthony Accurso M.D. , Lynda Frassetto M.D.  , Barbara A. Gower Ph.D.  , Samy I. McFarlane M.D.  , Jörgen Vesti Nielsen M.D.  , Thure Krarup M.D. , Laura Saslow Ph.D. , Karl S. Roth M.D. , Mary C. Vernon M.D. , Jeff S. Volek R.D., Ph.D. , Gilbert B. Wilshire M.D. , Annika Dahlqvist M.D.r , Ralf Sundberg M.D., Ph.D.  , Ann Childers M.D.  , Katharine Morrison M.R.C.G.P.  , Anssi H. Manninen M.H.S.  , Hussain M. Dashti M.D., Ph.D., F.A.C.S.,  F.I.C.S., Richard J. Wood Ph.D., Jay Wortman M.D. , Nicolai Worm Ph.D.  Nutrition. January 2015 Volume 31, Issue 1, Pages 1–13 DOI: http://dx.doi.org/10.1016/j.nut.2014.06.011

• Conclusion: Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1.
• Disclosure: AA is consultant/member of advisory boards for the Dutch Beer Knowledge Institute, NL, Global Dairy Platform, USA, Jenny Craig, USA, McCain Foods Limited, USA, McDonald’s, USA, and Gerson Lehrman Group, USA (ad hoc consultant for clients). He is recipient of honoraria and travel grants as speaker for a wide range of Danish and international concerns. He has conducted research funded by a number of organizations with interests in the food production and marketing sector. RDF writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation. EJF has received grant support from the Veronica and Robert C. Atkins Foundation. TK sits on an advisory board for Eli Lilly and gives lectures for Lilly about the diabetic diet. NW has written popular-audience books on low-carbohydrate diets and is a consultant and promoter for Leberfasten/Hepafast, a specific low-carbohydrate meal replacement program. JW is on the Scientific Advisory Board of Atkins Nutritionals Inc. with paid retainer, honoraria, and travel costs. None of the other authors have anything to declare.
• Comment: The Atkins Diet is low-carbohydrate.

Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial David G. Marrero, PhD, Kelly N. B. Palmer, MHS, Erin O. Phillips, BA, Karen Miller-Kovach, EBMA, MS, Gary D. Foster, PhD, and Chandan K. Saha, PhD. Am J Public Health. Published online ahead of print February 18, 2016: e1–e8. doi:10.2105/AJPH.2015.303035

• Conclusions. A large weight-management program is effective for achieving lifestyle changes associated with diabetes prevention. Such programs could significantly increase the availability of diabetes prevention programs worldwide making an immediate and significant public health impact.
• Funding: This study was funded by Weight Watchers International.

It’s close to a year since I first started collecting these studies.  When the year is up, I will do some analysis.  Until then, the bottom line is that it’s easier to find industry-funded studies with results favorable to the sponsor than it is to find those that are not.

Thanks to Andy Bellatti for noticing this at his local Las Vegas Whole Foods.

This reminds me so much of the Low-Carb craze way back in 2005.

Oh well.  Whatever works.

The Wall Street Journal, hoping to generate some controversy, got me involved in a point/counterpoint about the Paleo Diet: “Is a Paleo diet healthy?”

It can be, but this is a point/counterpoint.  Hence, I took the position “NO: You Lose Too Much Pleasure for Dubious Benefits.”  

Here’s what I said:

Nutritionist that I am, the first questions I have about any diet are: What is it? Is the rationale behind it logical? And does it promote health?

A paleo diet is based on the premise that our genes govern what’s best for us to eat. We evolved to eat whatever could be hunted or gathered. This makes it OK to eat leaves, shoots, roots, seeds, eggs, animals, birds and fish, but not OK to eat grains, legumes, dairy or processed foods.

Why do paleo proponents think the ills of modern society stem from a mismatch between our genetics and today’s typical diets? The cave men, some argue, didn’t suffer from diseases such as obesity, heart disease and diabetes.

The problem with that theory is that we really don’t know what our Paleolithic ancestors ate. As I often argue, determining what people eat is the single most intellectually challenging question in nutrition science. It is extraordinarily difficult to get an accurate idea of what people ate yesterday, let alone 10,000 to a million or more years ago.

In reality, scientists are nowhere near being able to match genes to specific kinds of diets. The reason cave men didn’t have chronic diseases like diabetes is more likely because they didn’t live long enough and lacked antibiotics, rather than because they didn’t eat carbohydrates.

Variety is key

What we know for sure is that the fundamental tenets of nutrition are variety, balance and moderation. The fewer kinds of foods consumed, the greater the chance of nutrient deficiencies. So while it is certainly possible to eat healthfully on a paleo diet, restricting whole groups of relatively unprocessed foods can make this more challenging. It also can take some of the joy out of eating by forcing people to give up foods that they love or that are part of their cultural heritage.

While there is no doubt that highly processed “junk” foods are unhealthy and should be kept to a minimum, grains and legumes are hardly the enemy. Diets that vary enormously—from the traditional high carbohydrate, rice-based cuisines of Asia to those of the Mediterranean rich in grains and olive oil—have been shown to promote health and longevity.

Yes, grains contain glutens, and bread and pasta are caloric, but such foods are also delicious and part of traditional diets in nearly every culture. Yes, legumes contain unpleasant phytochemicals, but these are mostly destroyed by cooking, and beans and peas are excellent sources of vegetable protein. If you eat foods from animal sources, why restrict dairy? Cheese and yogurt are lovely foods, and I, for one, cannot imagine life without an occasional serving of ice cream.

Eating less works

Any restrictive diet helps to reduce calorie intake, so it isn’t surprising that there are studies linking paleo to weight loss, lower blood sugar and a reduced risk of cancers for which obesity is a risk factor. Eating less works every time.

So does eating a largely plant-based diet. Research suggests that we can reduce risks for today’s diseases of affluence by eating more foods from plant sources and balancing calorie intake with expenditure. To the extent the paleo diet achieves these goals, it is a reasonable choice.

But food is so much more than bundles of nutrients. What we eat also nourishes us psychologically and culturally. So while a paleo diet isn’t necessarily bad, why bother? I’d be sad to miss all those delicious forbidden foods.

A reader who prefers his name to go unmentioned writes this in response to yesterday’s post about low-carb v. low-fat diets:

Hi Marion,

It is pretty simple.

1. Calories in, Calories out!

2.  Eat less. I cut out beer and ice cream.

3.  Get a Labrador retriever and walk everyday. If you don’t the dog will drive you crazy and probably destroy your house.

I got my first Lab in 2002 and weighed 240.  I am on my second Lab and now continue to weigh about 210 after having lost 35 pounds by 2006, and have crept up about 5 pounds.

It ain’t complicated!

He could make a fortune.  Just think: the “Get a Lab” diet—a guaranteed success!

To my great surprise, a new clinical trial finding that low-carbohydrate diets help people lose weight has been getting a lot of press. Its conclusion:

The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

This is news?

The trial, conducted by authors who previously published a meta-analysis that came to the same conclusion, told people to eat either a low-carbohydrate diet of less than 40 grams a day (the amount of sugar in one 12-ounce soda) or a “low-fat” diet of 30% of calories from fat or less.

They didn’t do either, of course (for one critic’s analysis, see examine.com).

I put quotes around “low-fat” because 30% of calories is not exactly what I would call low—lower, for sure, but not low. After a year, the low-carb dieters lost about 3.5 kg more than did the “low-fat” dieters.  They also showed greater improvements in their risk factors for cardiovascular disease.

As I told Andy Bellatti

The folks eating the low carbohydrate diet…were eating less, and probably a lot less.  It’s easier for some people to lose weight if they cut out whole categories of food, in this case, carbohydrates.  But is this a long-term solution?  For that, we need to see results for several years.   Studies that examine the effects of different kinds of diets—and there have been many—typically find that all work to the extent that they cut calories, but that people have trouble sticking to extreme diets, which the low-carb one was in this study.  Personally, I like carbs and would rather cut my calories some other way, but that’s just me.  The bottom line: if you want to lose weight and are having trouble doing it, you need to eat less.

This profoundly boring conclusion, discussed at length in my book with Malden Nesheim, Why Calories Count: From Science to Politics, has just been confirmed by yet another meta-analysis.  This one doesn’t seem to be getting much press, however.

It reports significant weight loss with any low-carbohydrate or low-fat diet.

Weight loss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.

An accompanying editoria,  “A Diet by Any Other Name Is Still About Energy,” points out that study investigators only rarely analyze for how well participants in these studies actually adhere to the different diets, and for how long.

This makes it impossible for readers to figure out whether the weight loss was due to the specific components excluded from the diet or to the level of adherence.

In other words, whatever helps you eat less, helps you lose weight.  Go for it.

Thanks to Deborah Szekeley for forwarding this link to an evening in the 1950s when Sid Caesar, who died last week, went to dinner with Imogene Coca at a health food restaurant in New York.

Perhaps it is still open?

Yoni Freedhoff.  The Diet Fix: Why Diets Fail and How to Make Yours Work.  Harmony Books, 2014.

Ordinarily I don’t pay much attention to diet books but this one comes from the Canadian obesity physician, Dr. Yoni Freedhoff, whose Weighty Matters blog is fun to read and well worth following.

The key to healthy dieting, he says, is to avoid dieting’s seven deadly sins: hunger, sacrifice, willpower, restriction, sweat, perfectionism, and denial.

This sounds hopeful.

Instead, you are to reset your relationship with food forever, starting with a 10-day preliminary experiment in which you get ready, keep a diary, banish hunger, cook, think, exercise, indulge, eat out, and set goals.  Then you move forward, one day at a time.

“You absolutely CAN do this,” he says.

This is a seriously mindful weight-loss program that works well for his patients.  It ought to.

Give it a try?

The book even comes with recipes.

Can it really be this easy?  Morrison’s, a grocery chain in the U.K., put cardboard cutouts of doctors near the produce section.

A new pilot scheme in a Morrisons store in Salford, using cardboard cut-outs of local GPs in the fresh produce aisles delivered a 20% rise in the sales of fresh fruit and a 30% uplift for frozen fruit.

All of this is part of Great Britain’s Public Health “Responsibility Deal,” which aims to enlist businesses to voluntarily promote health objectives.

The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.

Organisations signing up to the Responsibility Deal commit to taking action voluntarily to improve public health through their responsibilities as employers, as well as through their commercial actions and their community activities. Organisations can sign up to be either national partners or local partners.

The principles and ambitions of the Responsibility Deal are set out in its core commitments and supporting pledges.

This is all it takes?  Really?

Why do I think this won’t work nearly as well in America?  We have a long way to go, says the USDA.

What might work?  Celebrities?  Sports figures?  Political figures?