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.