Wednesday, December 31, 2008

The au natural sweetener?

There's a lot of buzz in the food and nutrition world about a couple of new natural zero-calorie sweeteners, Truvia (from Coca-Cola) and PureVia (from PepsiCo). These two sweeteners contain stevia, an extract from a plant native to South America, and the FDA recently approved the use of these sweeteners as food additives that have been declared GRAS (generally recognized as safe). Some controversy swirls around stevia and stevia-containing sweeteners for several reasons. First, previous studies in animals suggested that high doses could result in male infertility and fewer and smaller offspring for females while other studies suggested potential cancer-causing activity. Critics of this approval also point out the loopholes in the GRAS identification since the testing on safety can be carried out by manufacturers themselves, which creates an obvious potential bias, and the companies can actually self-declare the safety of the additive without actually notifying the FDA or consumers. Therefore, the FDA does not need to review or approve this GRAS declaration of the scientists conducting the studies, and the only way for the FDA to reverse the GRAS classification is through litigation where it would have to prove that the additive is actually unsafe for human consumption. While stevia has been used in foods in countries such as Japan for decades, it has been banned in the European Union, Singapore, and Hong Kong.

What about the other side of the story? Well, the fact remains that stevia-extracts have been used in Japan and Brazil for many years with no reported harm to humans. Other studies have refuted previous trials regarding the physiological effects of stevia. Recent safety studies evaluated the effect of the equivalent of a 150 lb. person consuming 1,000-2,000 daily servings of stevia-sweetened beverages and findings indicated no harmful effects on general health, male or female fertility, and growth or development of adults or their young. Results are mixed on whether or not stevia-containing products may actually have positive effects on health, including blood pressure and blood sugar control in people with type 2 diabetes. In 2006, the World Health Organization (WHO) reported that stevia-extracts were not genotoxic (damaging to cell's genetic material) or cancer-causing based on their own research findings.

Many people are eager to taste the new naturally-sweetened beverages from Coca Cola and Pepsi as these products will likely be rolled out very soon in the U.S. What about you? I must admit that as a foodie, I'm very curious! I've actually tried stevia as a sweetener a long while back although I wasn't a big fan back then. Maybe these new formulations will provide a better taste? After doing my own investigation, I say that moderation is key here as I would with any alternative sweeteners. A possible guide on consumption could come from Australia and New Zealand's acceptable daily intake recommendations of about 4 mg/kg of body weight. For a 150 lb person, this could be the equivalent of about 1.5 cans of a stevia-sweetened beverage daily (and this includes a 100-fold safety cushion). To be honest though, you're probably better off consuming water, low-fat milk, 100% fruit juice or green tea for fluids or other nutrients, antioxidants, or phytochemicals rather than relying on these stevia-sweetened beverages from a nutrition perspective.

Sunday, December 28, 2008

SMART resolutions

It's that time of year again. I'm seeing those commercials revolving around weight loss, exercise, and fitness. I see those reporters interviewing people about their New Year's resolutions. It's always interesting to listen to these. Here are a few examples of resolutions I heard: "I want to be healthier." "I want to exercise more." "I want to eat better." I think the intentions are great, but the execution is going to be a challenge with such resolutions. This is why I'm going to blog about how to set yourself up for success with SMART resolutions!

S - Specific - Make your goal specific. Instead of simply stating "I want to eat better." Be as specific as possible. What is better? Does that mean eating more fruit? More vegetables? Both? Will you incorporate more fish? Less red meat? What does 'eat better' mean for you? Consider the 6 W's - who, what, where, when, which, why? The more specific you are with the goal, the more likely you will be to accomplish it.

M- Measurable - Make your resolution measurable. What does that mean? Involve numbers here. So you decide that you'd like to "Eat more vegetables." Okay, great. What is more? Is that 2 cups/day? 3 cups/day? When you incorporate numbers, you give yourself a specific goal to shoot for and a way to measure your progress in accomplishing that goal.

A - Attainable - Make your resolution attainable or within reach. At the same time, a powerful goal will also stretch you. This will help enhance your attitude, skills, and abilities around achieving your goal. By setting a goal that is both within reach yet challenging, you will build your confidence in accomplishing the goal and create a cycle of success for yourself.

R - Realistic - Make sure your resolution involves something that you are both willing and able to work toward right now. Maybe you'd like to exercise more, so you decide to run a marathon in 6 weeks. Maybe it's something you'd like to do, but do you really have the time to train for it and train well?

T - Time-sensitive - Put a time frame on when you'd like to achieve that goal. Will it be by the end of next week? Next month? The next 3 months? This will provide a sense of urgency around the goal so that you continue to take the necessary steps toward achieving it.

Finally...write down your goals. I heard somewhere that some of THE most successful people in the world often write down their goals. This truly works. Put your goals in writing, make them SMART, and see what you accomplish!

Happy and Healthy New Year to you!

Tuesday, December 23, 2008

Need a perc up?

My caffeine habit started several years ago. I never liked coffee, but suddenly I found myself in the midst of a very busy and tiring time in life (aka, dietetic internship), and those around me swore by their brain-boosting juice, coffee. I didn't like it at first, but it grew on me. Here I am today, still sipping on my morning cup of Joe. Many people turn to caffeinated beverages or food (or even candies and lipsticks now!) for that extra jolt of 'energy'. So, if someone needs that energetic boost, do I tell them to reach for a cup of Joe? Not necessarily. Believe it or not, caffeine is not actually a source of energy. The major sources of energy in the diet are carbohydrate, fat, and protein. These nutrients provide fuel for the body to function each day. Caffeine does not provide energy.

So, when someone feels the need to reboot the brain, why does s/he take a quick stroll through the nearest Starbucks? Well, caffeine is a stimulant. Even in small doses, it stimulates the central nervous system causing an increase in heart rate and mental alertness among other things. In fact, studies show that caffeine does improve mental performance by enhancing alertness and reaction time, and this happens whether someone is a caffeine addict or a newbie. Caffeine consumption in moderate doses may also temporarily enhance mood, especially for those who are sensitive or don't consume much.

One thing to note is that caffeine does disrupt normal sleep patterns for most people if consumed too close to bedtime. First, it makes it harder for one to fall asleep, and once one is asleep, it can result in temporary awakenings throughout the night. So, if you have problems with sleep, I suggest limiting caffeine consumption within 3-5 hours of bedtime. Otherwise, you may find yourself in a cycle of: caffeine consumption close to bedtime, limited/interrupted sleep, and the need for more caffeine the next day to offset the effects of disrupted sleep.

You may have heard that caffeine is a diuretic, right? Well, it does have a mild diuretic effect; however, given that coffee accounts for about 75% of the caffeine that most people consume, there's no need to worry about dehydration anytime soon. The amount of caffeine contained in most caffeinated-beverages is not enough to have a major diuretic effect. In addition, the fluid from the beverage contributes to a person's fluid needs.

So, what is my advice? Moderate consumption, which is up to about 300 mg/day (or ~2-3 cups of coffee), is okay for most people. I say most because there are some exceptions. While some recommendations suggest that moderate caffeine consumption during pregnancy is okay, I err on the side of caution here, especially in the first trimester. A recent study indicated that pregnant women who consumed at least 200 mg/day experienced more miscarriages than those who consumed less than 200 mg/day during the first trimester. If possible, I suggest avoiding caffeine or limiting intake to <200 mg/day during the first trimester especially. Moms who breastfeed may also want to avoid/limit consumption to no more than 300 mg/day because higher intakes have been associated with increased wakefulness, irritability, and poor feeding for the baby. None of which any new parent really wants, right? Caffeine may also perpetuate problems for people with migraines, so it's best for those with a genetic predisposition for migraines to limit their intake. There are also certain medications, such as Ritalin, or nutrients, such as iron, that can be affected by caffeine, so always speak with a doctor, pharmacist, or RD regarding potential drug-nutrient interactions. Lastly, I advise parents/caregivers to moderate their child's caffeine consumption. It has the same effect in children and it tends to occur more quickly and last for longer than for adults. Plus, some of the major sources of caffeine in the child's diet aren't necessarily the most nutritious either (i.e., sodas, energy drinks, candy).


Tuesday, December 16, 2008

The WHAT and WHEN of feeding a toddler

I've entered an interesting phase in the feeding of my little 1 1/2 year old (though if you've seen her, you'd realize she's not really so 'little'). My once enthusiastic eater who tried anything and everything now shows a little more skepticism about food. Oh yes, and sometimes instead of eating it she likes to wear it! Hence the photo above (a la PB in hair). Ah toddlerhood! Her suspicions about unfamiliar foods can sometimes create a little anxiety for me. However, I find comfort in knowing that as long as I fall back on the division of responsibility in feeding developed by Ellyn Satter, my daughter and I will be fine! So, here's my reminder about that division of responsibility:
1) Parents/caregivers are responsible for what, when, and where a child eats.
2) The child is responsible for how much and whether to eat.

Upon the request of a blog-reader and friend, I decided to address the what and when aspect of feeding a toddler this week.

Some find it amazing that children actually need more calories and protein per pound of body weight than adults! The average 1-3 year old needs roughly 990-1050 calories per day; however, don't start tallying up those calories yet! Starting around the age of one a child's growth begins to slow in comparison to that first year of life, and if you have a toddler or have ever been around one during meal times, you will know that their food intake can seem quite sporadic. That's because they go through periods of rapid growth and slower growth. You've also probably noticed that those little ones can be quite active at times! The great thing about children is that they are very intuitive eaters. That is, they can feed themselves very well depending on their hunger and satiety cues. So being overly concerned about the how much part of a toddler's eating can actually do more harm than good, and counting calories is not necessary.

With that said, let's dig into this what part. You may or may not be surprised to know that what a child needs to eat is really not that different from what an adult needs. Although the portion sizes are scaled down quite a bit. We can take some cues from the Food Guide Pyramid for Young Children. This suggests: 6 servings of grains, 3 servings of vegetables, 2 servings of fruit, 2 servings of milk, and 2 servings of meat each day. So, how do I know what a serving is, you ask? Well, a good rule of thumb is to offer about 1-2 T of food per year of life. That would be appropriate for foods like meat, fish, poultry, pasta, rice, vegetables, and fruit. As for milk, about 1/4-1/3 cup is appropriate. (1/4-1/3 of an adult portion is a good start on other food items, such as bread or eggs). Keep in mind that these are amounts that you can start with; however, depending upon your child's appetite, s/he may eat more or less.

I haven't mentioned the dread F word...FAT! For children, fat should not be a bad word or nutrient. Children actually need a greater proportion of their calories from fat than adults. One benefit of fat in the child's diet is that it provides a concentrated source of energy. Consider those tiny little tummies. They can only hold so much food, and as long as children have some fat in their diets, they can more readily meet their energy needs. There are also some special types of fats, essential fatty acids, that our bodies must obtain from the diet. These essential fatty acids are important for the proper development of the nerve, eye and other tissues. In fact, the American Academy of Pediatrics advises against fat restriction in children ages 2 and under. After the age of 2, high fat intakes may increase the risk for childhood obesity and cardiovascular disease. At this point, it's okay for children to gradually consume fewer high-fat foods (i.e., whole milk) and consume more grain products, fruits, vegetables, low-fat dairy products, lean meats, and other protein-rich foods. Slide 10

Now let's get to the when of feeding those tiny tots. If I've learned anything important about children, it is that they thrive on structure and routine. Throw that off, and you could have one rattled child on your hands! The same goes for feeding times. Children do well with about three meals and planned snacks in between (mid-morning and mid-afternoon are appropriate). Somewhere between 2-4 hours between meals/snacks works fine, and it's okay to schedule it at a time that works for your family. Let's revisit the whole tiny tummy thing again. Our little munchkins can't usually eat a large quantity of food at one time, so they often feel hungry before the next main meal. This helps the little ones maintain adequate energy sources throughout the day. It can also help mom, dad, or caregiver not feel so bad or worried if a child declines to eat what's offered at a previous meal because s/he knows that another meal/snack is coming down the pipeline soon enough and the child might be more willing to eat what is offered later, too.

So that's it in a least for now. This is another topic that I could expand upon, but I'll save that for another blog post.

Here's to a happy and healthy little one!

Wednesday, December 3, 2008

Supplements - Did you know...

Did you know that...
  • while the Food and Drug Administration (FDA) regulates the dietary supplement industry, supplements are not held to the same regulatory standards as food or drugs? Essentially, dietary supplement manufacturers do not have to guarantee their dietary supplement safe and effective before placing it in the marketplace. In contrast, pharmaceuticals undergo several phases of study from animals to humans before they can be approved for use in the general population. In addition, the FDA provides oversight for supplements only after they are on the store shelves, if safety is called into question. More recently, some additional regulations were set in place to improve safety by establishing improved manufacturing practices and to ensure that the product contains what it claims to contain and nothing that could be harmful (i.e., lead). Unfortunately, even recent reports evaluating the content of certain supplements revealed that many of them either do not contain the ingredient(s) or contain less than what's claimed on the label. Even though the new guidelines were set in place to enhance supplement safety, I question how tight the monitoring will be. Plus, there is still no guarantee that the supplements are safe and effective.
  • dietary supplements are also not standardized as prescription drugs are? What does this mean? Well, standardization involves following practices that ensure batch-to-batch consistency of a product or a high quality product. So, the contents of the supplement you bought six months ago will be consistent with the contents of the same product on the shelf today.
  • just because a supplement contains naturally occurring ingredients does not mean it's safe? Natural does not = safe. Mushrooms are natural, but some contain natural toxins that are harmful. Arsenic, lead, mercury...these are all naturally occurring elements, but it doesn't mean that they're necessarily safe either.
  • more isn't necessarily better? For one, when some nutrients, such as water-soluble vitamins like vitamin C or B vitamins, are consumed in excess of the body's needs, most excesses are excreted in the urine rather than stored in the body. Plus, higher levels may contribute to harmful toxicity disorders.
  • depending on the ingredients and dosage, they may have negative interactions with other nutrients, foods, medications, or processes in the body? Symptoms of toxicity for nutrients most often occur from consumption of dietary supplements rather than foods. For example, high doses of iron can result in reduced absorption of copper and zinc and vice versa. Some dietary supplements can result in increased or decreased absorption or increased or decreased function of medications and vice versa.
  • so far the only diseases or conditions that supplements, such as vitamins or minerals, cure are the ones caused by a deficiency of that nutrient? For instance, vitamin C does not cure the common cold, but it can cure scurvy, the vitamin C deficiency disorder. Even though we often see media clips about how a new research study shows that nutrients, such as vitamins of minerals, can help prevent or treat some condition, it doesn't necessarily mean that a supplement will do the same. In fact, several recent studies have shown that consumption of nutrients in supplement form may actually do more harm than good. For example, a study conducted some years ago found that beta-carotene (a form of vitamin A and weak antioxidant) in supplement form can actually increase lung cancer risk in smokers! More recent studies show that the antioxidant supplements of vitamin A, E, and beta carotene may actually slightly increase the risk of death.
  • just because the person in the ad or a family member or friend says s/he took a supplement that helped with X, Y, or Z doesn't mean that it is actually a safe and effective treatment? Testimonials or anecdotal evidence are a great way to sell products, but they prove nothing.
  • just because the product label or ad says the supplement does X, Y, and Z does not mean that the product is safe and works? Of course the company is going to tell you their product works, but don't you think they might have a biased opinion?
So, am I against supplements? No. I believe that there definitely are certain situations in which a dietary supplement can be helpful, and I believe that it's important for people to make informed decisions when deciding whether or not to take a supplement.

So, what do you do? Here are my quick tips:
  • Consider buying recognized brands from well-established companies. These companies generally have more at stake because they want to be around for a long time, so they work harder to ensure a higher quality product.
  • Scan the shelves for standardized products. How will you know? Look for the USP symbol. USP stands for the United States Pharmacopeia. This agency provides standards for the quality, purity, strength, and consistency of dietary supplements and conducts tests verifying the product ingredients, integrity, purity, and potency. Some other organizations or programs that provide similar standards or testing include: the Dietary Supplement Verification Program (DSVP), ide 82 and NSF International.
  • Read the Supplement Facts Panel. It's best to stick with supplements that provide no more than 100% of the Daily Value (DV), especially those that are considered more potentially harmful such as vitamin A, D, or iron.
  • If the claims sound too good to be true, then they probably are. I always tell students and clients that if I knew of a product out there that really was the MIRACLE pill for weight loss or enhanced performance, etc. I certainly wouldn't want to keep that a secret.
  • Run the dietary supplements by your healthcare provider before using them. In fact, I always ask my clients to bring their supplement containers with them to our visits so that I can help them evaluate these products.
  • Remain skeptical of the latest headlines. They make good stories, but the sound nutrition or health advice is typically based on a broad body of research and not a single study. Who were they studying? How many people were in the study? How long was the study? There are many factors to consider, and one study alone does not mean the results are generalizable to the population at large or to you specifically.
  • Finally, lots of research powerfully indicates that foods, not supplements, are the best source of nutrients.
Have a healthy one!
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