Thursday, December 26, 2013

State of the Nutritionist 2013

Major Victory. Trans-Fats Go Bye-Bye.
We discussed the FDA's ruling banning trans-fats in-depth. The Museum of Science and Industry turned down our 33 year-old Hostess Cupcake, but are currently trying for the New York Food Museum.

Major Defeat. Eating Habits Getting Worse, Not Better.
Amazingly, Americans' eating habits deteriorated in 2013, as fewer adults report eating healthy all day "yesterday" in every month so far this year compared with the same months in 2012, according to the latest Gallup/Healthways poll. Moreover, healthy eating in most months this year has been at its lowest in Gallup trends since 2008.

In all honesty, it is not that amazing. Whenever we come out of a recession, we tend splurge on many things, including food and drink. However, what it really comes down to is, in order to continued improvement of our eating habits, we need to employ systemic environmental changes.

Our agricultural policy makes unhealthy foods ubiquitous and affordable. To really make an impact, we need to build a food environment where food education can thrive. The perfect example? The FDA removing trans fats from the food supply. You can educate consumers as much as you like, but often the best solution is to get bad foods out of the food supply. That's why policy, food laws and systemic change are so key for the overall health of Americans. Wish we could see the same policy with regard to GMOs, another huge battle that is going on between those for labeling and the corporations who are not.

Americans who report eating five or more servings of fruits and vegetables at least four times a week has dropped in eight out of 10 months so far in 2013. In line with these results, the adult obesity rate so far in 2013 is 27.2%, (up from 26.2% in 2012), and is on pace to surpass all annual average obesity rates since 2008. If fruits and vegetables were given the same subsidies as corn, wheat, soy, and dairy to compete cost-wise, I obesity rates would be half what they are today.

Major Victory. Overtesting and overtreating exposed. 17 medical societies released reports of 90 overused treatments and procedures, many ordered for asymptomatic patients. We have been reporting on this all year long in NCI Well Connect. This is a huge development for the patient. Look up the Choose Wisely campaign on the internet for details.

Major Defeat. New cholesterol guidelines may put billions more on statins worldwide.

Major Victory. The gluten-free trend did not go away as pundits predicted. Why? People feel good when they avoid gluten. It is as simple as that. While I am elated with all the attention being payed to gluten intolerance and celiac disease, I believe the wrong direction for optimum health is a diet based on gluten-free cookies, donuts, pastries, cakes, muffins etc. Hopefully, food manufacturers in 2014 will make gluten-free products healthier, with more whole grains and fortification, not just empty starches and refined grains. This is paramount because the next wave of gluten-free products will be featured in every aisle of the grocery store.
  
The USDA's new threshold for gluten-free labeling will help consumers make better choices when choosing gluten-free.

Major Defeat. Losing the ballot measures in California and Washington for labeling GMOs. However, Hawaii passed a partial ban and many other states (CT, MA, VT) are in the bullpen. It is just a matter of time before labeling happens nationwide.

Major Victory. Obesity is now considered a disease. This will allow insurance to cover well over 12 counseling sessions per year with a licensed health professional.

Major Defeat. The Dr. Oz Effect. His brand is said to be responsible for approximately $1.5 to $2 billion in sales of natural products and supplement in the past year. "America's Doctor" pitched the benefits of weight-management ingredients raspberry ketones and coffee bean extract, which all had ridiculous spikes after mention on his daytime TV show. In many cases, viewers lose because the products do not work and often come with side effects. The problem is that he does not take into account individual needs.

Major Victory. Numerous studies were published this year showing that too much, as well as too little, calcium was detrimental to health. The data supports what we have said forever: in most cases, between 400-800 mg. of absorbable supplemental calcium is ideal. 

Major Defeat. The FDA pulled the rug out from companies like Metagenics by changing what is considered a medical food. For two decades, Metagenics produced incredibly successful medical foods that could be covered by insurance. However, in a snap decision and without warning, the FDA changed what is considered a "medical food," thus acing out companies like Metagenics, who received a warning letter to boot. We believe that Big Pharma saw the medical food category as an emerging trend, was threatened by the success of manufacturers like Metagenics, and suggested changes to the FDA rules on medical foods.

Major Victory. The State of Supplements
Despite bad press, 85 percent of Americans - including those who don't take supplements - say they are somewhat or very confident in dietary supplements.

Equity capital is flowing into the industry. Large consumer products companies and even pharmaceutical giants are taking notice and some are even doubling down on their investments.

The transition to dietary supplement Good Manufacturing Practices (GMPs), although certainly not inexpensive or without adjustment, has been a relatively smooth one. And by working to understand and comply with these requirements, these firms now have external validation that they are producing well-made, thoroughly tested products that deliver in the bottle what is on the label, consistently made to high-quality standards.

Since the passage of DSHEA nineteen years ago, it has only been amended twice: the adverse event reporting law in 2006 and the Food Safety Modernization Act in 2011 that help ensure the quality of the food supply. However, we are still not doing a good job of weeding out those who do not comply with supplement safety.

Major Defeat. The State of Supplements
In the past five years, FDA has issued warning letters, recalls and seizures for more than 400 products that were marketed as dietary supplements, but according to FDA, contain undisclosed prescription medicines, anabolic steroids, and in some cases, illegal drugs.

We know these are not products represent a tiny part of the industry, but the reality is that many consumers don't know the difference. And when the consumer media report on these incidents, they don't distinguish between the fringe and the mainstream industries. 

We continue to see negative press reporting that dietary supplements don't work, or even worse, that they may hurt you, generated from research studies that, at best, have limitations and weaknesses that don't get discussed-or at worst, the researchers have their own agenda for generating sensational headlines to advance their own careers. Of course, the wonderful research that comes out on a daily basis is rarely reported.
  
Dietary Trending in 2014  
  • Semi- homemade meals made with fresh, high-quality ingredients.
  • Better-for-you snacking
  • Increased focus on high-protein breakfasts
  • Expect dramatic changes from the FDA to the Nutrition Facts Panel seen on food packaging by early 2014.
  • FDA will further define what is and is not considered whole grain.
  • Food Addiction counseling will gain traction among certain segments of the public, but will take several more years to become mainstream.
What's Next after Stevia?
Monk fruit and coconut palm sugar have already made their mark and are growing quickly. However, look out for two new sweeteners in 2014. Details on them are available to NCI Well Connect subscribers.

Dietary Trending in 2014 (continued)  
  • Lemon: used as a main ingredient in juice or preserved form.
  • Tea Leaves: to add a healthy, flavorful twist to dinner, desserts and other products.
  • Middle Eastern seasonings: sumac, za'atar and marash to expand the flavor profile of traditional Mediterranean cuisine.
  • Nut-derived milk: made from cashews, almonds and peanuts for dairy-free flavors in sauces, drinks and dinners.
  • Egg yolk: in place of cheese, dairy and sauces.
  • Poaching and steaming innovations: wine, coffee, beer and smoky liquids to replace water for more flavorful dishes.
  • Seaweed innovations: as a snack, umami-rich seasoning, etc.
  • Pasta innovations: noodles made from alternative flours, seasoned with global spices and formed into new shapes and sizes.
  • Farm-to-table flavors: exotic meat-goat, rabbit and pigeon-raised by small-scale producers for new feel-good protein choices.
  • With the farm to table trend, people are looking for fresh herbs and spices, basil, cilantro, lemongrass, things that are fresh-tasting.
  • The simplification of product formulations, an increasing level of transparency and greater degrees of personalization.
Dietary Trending Beyond 2014
  • Cricket bars. Seriously. Insects will be the new protein source.
  • Matrix 'swapping' uses novel techniques to exchange certain compounds within whole foods to reduce sugar, add bioactives, and input exchanges with key sweeteners. The future will be about delivering the best that cocoa, cranberry, pomegranate, blueberry and so many other whole foods have to offer with extremely low to no sugar.
  • This is the end of the exclusive reign of macronutrients as energy providers and metabolic response modifiers as new non-carb, non-fat, in-between compounds emerge to pare with standard proteins perhaps, or even more interestingly, with amino derivatives and human metabolites.
  • Finally, the one-size-fits-all dietary advice will bow to 'personalized diet discovery' based on the realization that the saying, 'one man's food is another man's poison,' is startlingly more accurate than we currently appreciate. Expect to see the 'special diet' category explode as old dogma and institutional wisdom is blown away by the 'food as information molecule revolution.' A deluge of research will continue to pour out on how food compounds, large and small (molecular weight wise), 'talk' to our systems biology self and interacts with our immune systems in at least three phases: immediate antibody response, delayed antibody response, innate response.

Friday, December 20, 2013

Supplement Makers Behind Risky Products.

http://www.usatoday.com/story/news/nation/2013/12/19/dietary-supplements-executives-criminal-records-spiked/4114451/

Bonnie and Steve: We applaud USA Today for outing the criminals who make up a small, but devastating, percentage of the supplement industry. This is exactly why we never, ever, recommend self-prescribing dietary supplements. You need to trust a licensed health professional with knowledge in prescribing high quality, safe dietary supplements. 

However, we do have one question. Will the USA Today ever put this much investigative effort into outing almost every single pharmaceutical manufacturer in the world who have committed criminal acts which have maimed and killed thousands?

The huge settlements and executives who have already been jailed or are up on charges make the news, but not as much as they should for the devastation rendered. Maybe the USA Today would not have enough room in their paper to report on the litany of manufacturers involved in criminal activity?

The supplement industry certainly deserves its share of coverage, but when comparing a 28 billion industry to a one TRILLION industry, the coverage is far from fair and balanced.

Thursday, December 19, 2013

Here's a novel idea for breast cancer prevention: stop eating too much sugar!

According to researchers in the Journal of Investigation, "a dramatic increase in sugar uptake could be a cause of cancer. Furthermore, through a series of painstaking analysis, we have discovered two new pathways through which increased uptake of glucose could itself activate other oncogenic pathways. This discovery provides possible new targets for diagnosis and therapeutics."

They examined the expression of glucose transporter proteins in human breast cells. The focus was on the glucose transporter known as GLUT3, the concentrations of which showed are 400 times greater in malignant than in non-malignant breast cells. Overexpression of GLUT3 in the non-malignant human breast cells activated known oncogenic signaling pathways and led to the loss of tissue polarity and the onset of cancerous growth.

These researchers began exploring the relationship between aerobic glycolysis and malignant cells more than 40 years ago. However, the hypothesis became controversial. Even now the majority view holds that increased sugar uptake in cells is the result of the intense metabolic demands of tumor cells and not a cause of malignant transformation.

The findings help explain why blood sugar disorders in diseases such as obesity and diabetes can raise the risk of breast and other cancers.

Wednesday, December 18, 2013

Vitamins Old, Old Edge

http://www.nytimes.com/2013/12/10/science/vitamins-old-old-edge.html?ref=health

Why balanced meals are so important.

If you were to switch from vegetarianism to meat-eating, or vice-versa, chances are the composition of your gut bacteria would also undergo a big, swift change.

The research, published Dec. 11 in the journal Nature, showed that the number and kinds of bacteria -- and even the way the bacteria behaved -- changed within a day of switching from a normal diet to eating either animal- or plant-based foods exclusively.

Not only were there changes in the abundance of different bacteria, but there were changes in the kinds of genes that they were expressing and their activity.

The study suggests that this bacterial community and its genes -- called the microbiome -- are extraordinarily flexible and capable of responding swiftly to whatever is coming its way.

In the study, participants who switched from their normal diet to eating only animal products, including meat, cheese and eggs, saw their gut bacteria change rapidly within one day.

While the participants were on the animal-based diet, there was an increase within their guts in the types of bacteria that can tolerate bile (a fluid produced by the liver that helps break down fat), and a decrease in bacteria called Firmicutes, which break down plant carbohydrates.

Gut bacteria also tended to express (or "turn on") different genes during the animal-based diet, ones that would allow them to break down protein. In contrast, the gut bacteria of another group of participants who ate a plant-based diet expressed genes that would allow them to ferment carbohydrates.

The differences between the gut bacteria of the people on the plant-only and animal-only diets "mirrored the differences between herbivorous and carnivorous mammals.

Bonnie: Having all the bacteria at our disposal to break down fats, carbohydrates, and proteins is crucial. This is why going vegan or going strictly paleo is too extreme! Balance is everything. This study also shows us how devastating antibitoics can be because they wipe out ALL bacteria and completely obliterate our microbiome.

Here's a novel idea for flu prevention: minimize sugar!

Reducing glucose metabolism dials down influenza viral infection in laboratory cell cultures, providing an entirely new approach for combating seasonal flu, according to new research in the journal Virology.

While annual flu shots are based on the U.S. Centers for Disease Control's predictions of the viruses that will be in widest circulation each flu season, the new approach targets one metabolic requirement of all influenza viruses: glucose.

Reducing viruses' glucose supply weakens the microbes' ability to infect host cells. To infect cells, the influenza virus is dependent upon the actions of the cell's own proteins, and so another strategy for slowing viral infection would be to target essential viral needs, for example, their dependence on cellular glucose.

When researchers boosted glucose concentrations in the laboratory cell cultures, influenza infection rate concomitantly increased. Treating the viral cells with a chemical that inhibits glucose metabolism significantly decreased viral replication in the lab cultures.

Steve: Influenza viral infection of cells could be increased by giving cells more glucose than normal. Surprised? We're not. The ease with which the researchers could dial viral infection down by controlling glucose levels just shows the need to dramatically reduce our sugar consumption, especially during flu season. However, especially around the holidays, most of us eat more sugar than at any other time of the year!

Tuesday, December 17, 2013

Acidophilus/Bifidus combo we know well shines again

A study to investigate the ability of a unique probiotic formulation to reduce potential gastrointestinal side effects of antibiotic treatment has found significant benefits from a dietary supplementation combination of lactobacillus acidophilus and bifidus.

The triple-blind, dose-response study, published in Vaccine Journal, concludes that the probiotic combination lowered the risk and duration of antibiotic-associated diarrhea (AAD). A decrease in gastrointestinal symptoms – fever, bloating and abdominal pain – also was observed compared to the placebo group.

While the low-dose group clearly experienced fewer antibiotic side effects than the placebo group, the incidence of AAD in the high-dose group was, at 12.5 percent, close to half that of the placebo group (24.6 percent).

The high-dose group similarly had a considerably lower rate of fever and gastrointestinal discomfort. In addition, the study indicates a tendency toward reduced Clostridium difficile associated diarrhea – Clostridium difficile being the pathogen responsible for 10-25 percent of AAD episodes and almost all episodes of antibiotic-induced pseudo-membranous colitis.

Few probiotics, if any, have been shown to reduce the duration and severity of AAD.

Bonnie: We have prescribed these strains of probiotic for over 15 years.

Thursday, December 12, 2013

Dad's to be? Treat your children well.

Mothers get all the attention. But a study led by a McGill researcher suggests that the father's diet before conception may play an equally important role in the health of their offspring. It also raises concerns about the long-term effects of current Western diets and of food insecurity.

The research focused on vitamin B9, also called folate, which is found in a range of green leafy vegetables, cereals, fruit and meats. It is well known that in order to prevent miscarriages and birth defects mothers need to get adequate amounts of folate in their diet. But the way that a father's diet can influence the health and development of their offspring has received almost no attention.

Now research for the first time suggests that the father's folate levels may be just as important to the development and health of their offspring as are those of the mother. Indeed, the study suggests that fathers should pay as much attention to their lifestyle and diet before they set out to conceive a child as mothers do. Fathers who are eating high-fat, fast food diets or who are obese may not be able to use or metabolize folate in the same way as those with adequate levels of the vitamin.

Comparing the offspring of fathers with insufficient folate in their diets with the offspring of fathers whose diets contained sufficient levels of the vitamin, they found that paternal folate deficiency was associated with an increase in birth defects of various kinds in the offspring, compared to the offspring whose fathers were fed a diet with sufficient folate.

There was an almost 30 per cent increase in birth defectsby fathers whose levels of folates were insufficient. While the study was done on mice, they saw some pretty severe skeletal abnormalities that included both cranio-facial and spinal deformities.

The research shows that there are regions of the sperm epigenome that are sensitive to life experience and particularly to diet. And that this information is in turn transferred to a so-called epigenomic map that influences development and may also influence metabolism and disease in the offspring in the long-term. 

Although it has been known for some time that there is a massive erasure and re-establishment that takes place in the epigenome as the sperm develops, this study now shows that along with the developmental map, the sperm also carries a memory of the father's environment and possibly even of his diet and lifestyle choices.

Bonnie: As we have said incessantly, fathers need to think about what they put in their mouths, what they smoke and what they drink and remember they are caretakers of generations to come. We don't need a mouse study to tell us this. It has and will continue to occur until parents-to-be prepare themselves optimally for fertility.

Sugar and endometrial cancer in women

http://cebp.aacrjournals.org/content/early/2013/11/13/1055-9965.EPI-13-0636.abstract

Wednesday, December 11, 2013

Reflux drugs create serious B12 deficiency

Not like any of you should be surprised, but it is nice to see headlines bringing the seriousness of this issue to the forefront. I just wish they would have also mentioned the FDA's warning of serious magnesium deficiency as well.

http://www.reuters.com/article/2013/12/10/us-stomach-acid-drugs-vitamin-d-idUSBRE9B914Y20131210

Monday, December 09, 2013

Healthy diets cost $1.50 more per day

This should not surprise us. The system is rigged for cheap, empty caloric fare. Until the fundamentals of our food system are altered to make it a level playing field, this will continue. That said, it is possible to sacrifice certain lifestyle choices that would allow most of us to free up an extra $1.50 per day for healthier food.

For example, how about eliminating soda, juice, and/or any other empty caloric beverage? What about losing the foo-foo coffee drink and instead, choose simple black coffee. Not only will you benefit from lowering caloric content and sugar, but with black coffee, you are gaining a healthful food. Any other suggestions out there?

http://news.harvard.edu/gazette/story/2013/12/pinpointing-the-higher-cost-of-a-healthy-diet/

Friday, December 06, 2013

Allergy Shots a Thing of the Past?

For most of you who have followed us for years, this should not be surprising. For others, allergy drops are a thrilling upgrade!
http://www.nytimes.com/2013/12/06/business/treating-allergies-with-pills-or-drops-instead-of-shots.html?ref=health

A little education can go a long way.

The knowledge and skills required to change poor nutrition and health behavior choices are often unavailable to those living with financial limitations. Competing demands on time and resources may pose obstacles to their achieving better diets. However, two researchers at the University of Minnesota recently completed a study that looked at the effects that three educational sessions might have on knowledge and behaviors of low-income women of ethnically diverse backgrounds.

The researchers developed and taught three classes to lower income women of predominantly American Indian, African American, and white ethnicities. They used a holistic approach and experiential learning, as well as providing clear sets of instructions. The first class covered the "nuts and bolts" of nutrition, including shopping, budgeting, and basics of macro- and micro-nutrients. In the second class, cooking techniques were emphasized, and in the third, participants learned about resources to increase food security, which included gardening.

After participating in the three classes, the women had increased vegetable intake, decreased fast food intake, and read labels more often. Data indicated that there were nine behaviors that improved after the session, as well as measures of knowledge. Increased knowledge and behavioral changes in a low-income population of women may help narrow inequalities in health, based on socioeconomic status.

Thursday, December 05, 2013

Red Meat Increases Inflammation, Glucose Imbalance in Women

A study appearing in the February 2014 issue of American Journal of Clinical Nutrition examined diabetes-free female participants in the Nurses’ Health Study for consumption total, unprocessed, and processed red meat intakes with plasma C-reactive protein (CRP), ferritin, adiponectin, fasting insulin, and hemoglobin A1c (HbA1c). All of these markers indicate glucose imbalance and inflammation.

Greater total, unprocessed, and processed red meat intakes were associated with detrimental effects on all plasma markers except adiponectin. The takeaway? If you eat red meat one or twice weekly maximum, and it is not a necessity, make sure it is grass-fed. Grass-fed beef greatly reduces the inflammatory properties because that fat has a higher omega-3 concentration.

Vitamin combo slows HIV progression

http://www.bloomberg.com/news/2013-11-26/vitamin-combination-with-supplement-slows-hiv-progress.html