nutrition advice that all experts agree: a starting point ... · guideline: sugars intake for...
TRANSCRIPT
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Nutrition Advice That All Experts Agree: A Starting Point For a Vibrantly Healthy Diet
TODAY’S AGENDA:• Introduction & Housekeeping• Speaker Introduction• Presentation• Q&A• Closing
WEBINAR HOST:Keith Hine MS, RDSr. Director of Healthcare & SportsOrgain, Inc.
Become an OrgainAmbassador Today!Request an Orgain Ambassador account today to get access to our on-line sampling portal so you can share Orgain shakes and coupons with your patients or clients.
healthcare.orgain.com
WEBINAR PRESENTER:Dr. Jim Painter, PhD, RDN Adjunct Professor University of Texas, School of Public [email protected]
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Nutrition: Where the Experts Agree!The Starting Place for a Healthy Diet
Jim Painter, PhD, RDN Adjunct Professor, University of Texas -Houston
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Speaker Disclosure •Board Member/Advisory Panel/Consultant● Present–University of Texas, Sun-Maid Raisins, National Dairy Council, United Sorghum Checkoff Board, Dole Food Company, Atkins, Sugarwise.•Past–Eastern Illinois University, University of Illinois –Champaign, Chic-fil-A, American Heart Association Eat Well Task Force, California Raisin Marketing Board, Wonderful Pistachios, White Wave Foods, Davidson’s Safest Choice Eggs, Tree Top Apples, Bush’s Beans,•Honoraria–Honorarium underwritten by Sun-Maid Growers of California–Dietitians of Canada, Exxon Mobil, Frito Lay, Midwest Dairy Council, Pennsylvania Nutrition Network, California Raisin Marketing Board, Alaska Tanker Company, Dairy Max, Texas AND, California AND, Florida AND, MINK, NY AND, South Carolina AND, Iowa AND, Nebraska AND, Manitoba Dairy Farmers, Dairy Farmers of Canada, Davidsons Safest Choice Eggs, National Dairy Council, New Products Conference, the Flavor Experience, BNP Media, and Cooper Vision.
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Speaker Credentials
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Introduction Are you tired of conflicting nutrition data regarding popular diets?
Each diet has peer reviewed studies that show that their diet is effective.
But what are they comparing each diet to?
How should you advise your clients?
Paleo, keto, low fat or vegan, which one is most efficacious for overall health?
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Comparing the Diets
6
Low Fat /High Carb High Fat/Low Carb
Animal Based
Plant Based
Paleo
Vegan
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Introduction Ornish diet: “Animal products are the problem. Eat plants”
Atkins: “Animal products are the answer, Carbs are the problem”
Both claim they are healthy and reduce disease.
Did you know that there is a large area of agreement. What if it is the areas of agreement that are causing the benefit??
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Where All Nutritionists Agree Don’t eat the Standard American Diet (SAD)
1. Eat less added sugar
2. Eat more green leafy vegetables
3. Eat more cruciferous and allium vegetables
4.Herbs and spices
5. Eat the right portion
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Based on data from the United States Department of Agriculture, Courtesy Dr. Joel Fuhrman, author: Eat to Life; Anti-Aging and Wellness Medical( AluvaLife company)
Almost 50% of fruits and vegetables consists of French fries and Ketchup
55%
30%
11%
4%
Standard American Diet (SAD)
Processed foods
Animal Products
Vegetables, fruit, nutsand beansWhole Grains
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“Ultra-processed foods comprised 57.9% of energy intake, and contributed 89.7% of the energy intake from added sugars.”
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Definition of Ultra-Processed Foods
•Flavors, colors, sweeteners, emulsifiers and other additives
•used to imitate sensorial qualities of unprocessed foods, or
•used to disguise undesirable qualities of the final product.
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What To Do?
https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/can-processed-foods-be-healthy-infographic
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What To Do?
https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/can-processed-foods-be-healthy-infographic
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What is The Problem With Added Sugar?What Does Science Say on Added Sugar?
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2014
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Hazard Ratios of CVD Mortality According to Usual % of Calories
from Added Sugar
1 1.09 1.231.49
2.43
0
0.5
1
1.5
2
2.5
3
Adjusted Hazard Ratios of CVD Mortality
7.40%11.40%14.80%18.70%25.20%
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Reduction in Nutrientsas Added Sugar Increases
17Marriott, B. P., Olsho, L., Hadden, L., & Connor, P. (2010). Intake of added sugars and selected nutrients in the united states, national health and nutrition examination survey (nhanes) 2003-2006. Critical Reviews in Food Science and Nutrition,50, 228-258.
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Reduction in Nutrientsas Added Sugar Increases
18Marriott, B. P., Olsho, L., Hadden, L., & Connor, P. (2010). Intake of added sugars and selected nutrients in the united states, national health and nutrition examination survey (nhanes) 2003-2006. Critical Reviews in Food Science and Nutrition,50, 228-258.
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116 115
118
121123
110
115
120
125
>5 5 to >10 10 to >17.5 17.5 to >25 >25
Av. LDL levels for women by % total energy from added sugar
intake
*There were no significant trends in LDL-C levels among men.
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58.7 57.5 53.7 51 47.7
010203040506070
>5 5 to >10 10 to >17.5 17.5 to >25 >25
Av. HDL levels by % total energy from added sugar intake
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Added Sugars and Glycemic Index
22
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John Yudkin suggested that sugar was the main causative factor in ischemic heart disease, more so than fat:
“National levels of consumption of fat and of sugar are closely similar. Statistics relating fat intake to … CHD in different populations may therefore express only as an indirect relationship, and the causal relationship may be with sugar”
(Yudkin, 1964).
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...the industry sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD.
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“We urge dietary guidelines to shift focus away from recommendations to reduce saturated fat and toward recommendations to avoid added sugars.”
2016
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Guideline: Sugars intake for adults and children (2015) ‒Reduce intake of free sugars throughout the
lifecourse‒Reduce intake of free sugars to less than 10% of
total energy intake‒A further reduction of the intake of free sugars to
below 5% of total energy intake is beneficialRecommendations do not apply to “intrinsic” sugars
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FDA, What Counts As Added Sugars?
•Definition Includes: –Sugars that are either added during the processing or are packaged as such –Includes sugars (free, mono and disaccharides) and sugars from syrups and honey–Sugars that are added to an ingredient used in a finished food 27
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So what are we to do?- We like sweet- Are there alternatives?- Replace added sugar with intrinsic
sugar
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Adaption In Action: Small Changes, Big Results
INGREDIENTS:• 1 c. almond meal/flour• ½ c. unsweetened coconut• ½ c. cocoa powder• 1 tsp baking soda• ¼ tsp salt• 1 cup raisins• ½ cup pitted dates• ¾ c. water• 3 Eggs• 2 T coconut oil• 2 tsp vanilla
DIRECTIONS:Preheat oven to 325 F. Grease an 8” round cake pan.Mix together almond meal, cocoa powder, baking soda, and salt in a bowl and set aside.In a blender, food processor, or an immersion blender, blend the raisins, dates, and water until smooth.Add the eggs, coconut oil, and vanilla to the blended mixture and mix until smooth.Add the wet ingredients to the dry ingredients and mix just until incorporated. Pour batter into greased cake pan and spread evenly.Bake for 25-30 minutes or until toothpick comes out clean. Let cool 10-15 minutes.
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2. Green Leafy Vegetables This is not a new idea!Genesis 1:29And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in the which is the fruit of a tree yielding seed; to you it shall be food for you.
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Photosynthesis: Powering the Planet!
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Greens are Great Sources of Nutrients
Spinach 1 cup approximately 1 ounce, 7 calories = .4% of calories for the day
● Vitamin K 181%● Beta carotene = Vitamin A 56%● Folate 15%● Vitamin K Vitamin C = 14%● Lutein - prevents Macular degeneration● Magnesium, Iron
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● A diet rich in fruits and vegetables is estimated to reduce:
○ Heart disease (15%), Stroke (27%)
○ Delay cataracts, Prevent asthma, bronchitis, COPD
○ Prevent & treat high blood pressure
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Cancer Associated With Intakes of Selected Nutrients
McCann, S. E. et al. 2005.
0
0.2
0.4
0.6
0.8
1
1.2
Beta Carotene Alpha Carotene Lutein Lycopene
Low Medium High
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Getting Children to Eat Greens • Start the meal with a salad
• Start with the mild flavored greens: leaf lettuce or• spinach over kale• Cooked as greens
• Again use spinach over collard greens• On sandwiches• Blended up in smoothies• Added to soup and stews• Let children make something with it
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3. Cruciferous Vegetables, Broccoli, Cauliflower, Brussel
Sprouts, Cabbage• Cruciferous, Brassica• Allyl isothiocyanate• Phase II enzymes▫ Quinone reductase▫ Glutathione S-transferase
Munday R, Munday CM. Nutr Cancer. 2002;44:52-59.
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Cruciferous Vegetables • Arugula • Bok choi• Broccoli • Brussels sprout • Cabbage• Cauliflower • Chinese broccoli • Chinese cabbage • Collard greens • Horseradish
• Kale • Kohlrabi • Pak choi• Radish• Rutabaga • Wasabi • Watercress
https://www.gardeningknowhow.com/edible/vegetables/vgen/cruciferous-vegetables.htm
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Cruciferous Vegetables
• Consumption has protective effect on development of colorectal cancer• Indole-3-carbinol & sulforaphane• Consumption inversely related to incidence of prostate cancer• 300 g Brussels sprouts per day
Frydoonfar HR, McGrath DR, Spigelman AD. Anx J. Surg. 2003;73:154-156.
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Effect of Sulforaphane on Prostate Cell proliferation
Frydoonfar, H. R., McGrath, D. R., Spigelman, A. D. 2002.
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0 2 4 6 8 10 12
Concentration of Sulforaphane
UV
inte
nsity
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Effect of Indole-3-Carbinol on Prostate Cell Proliferation
Frydoonfar, H. R., McGrath, D. R., Spigelman, A. D. 2002.
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0 0.2 0.4 0.6 0.8 1
Groups
UV
inte
nsity
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Effect of Sulforaphane on Colon Cell Proliferation
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0 0.01 0.02 0.03 0.04 0.05 0.06 0.07
Groups
UV
inte
nsity
Frydoonfar, H. R., McGrath, D. R., Spigelman, A. D. 2002.
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Cruciferous Vegetables
•Consumption has protective effect on development of colorectal cancer
•Sulforaphane
•Consumption inversely related to incidence of Colon cancer
Frydoonfar HR, McGrath DR, Spigelman AD. Colorectal Dis. 2004;6:28-31.
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The Challenge!!! Getting Children to Eat Cruciferous Vegetables
● Use the milder ones, not horseradish ● Serve as finger food
Serve a dip, ranch, Italian, French● Add to other cooked veggies● Covered with a cheese sauce● Grate cauliflower use as a pizza crust● Mash cooked cauliflower like potatoes● Cabbage in coleslaw● Don’t try juicing!!!!
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Allium Vegetables: Onions, Garlic, Leeks
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Garlic• Garlic has been used in traditional and folk medicine for
over 4,000 years• Garlic contains sulfur compounds• Eating one clove of garlic per day may help decrease blood
cholesterol levels
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Most Notable Health Benefits of Garlic
• Antimicrobial
• Anticarcinogenic
• Cancer prevention
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Component Responsible • Allicin, a sulfur compound
• Diallyl Diasulfide = breakdown product
• Volatile sulfur compounds are not present in intact cells
• Release by:
–chopping
–steaming
–crushing
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Effect of Diallyl Disulfide on Growth Suppression of Prostate Cancer Cells
Arunkumar et al 2005.
• In vitro test • Of aged garlic at various levels• Prostate cancer cells• Growth suppression• As measured by Thymidine uptake
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Effect of Diallyl Disulfide on Growth Suppression of Prostate Cancer Cells
Arunkumar et al 2005.
0
20
40
60
80
100
120
Control 10 25 50 100
Upt
ake
UM concentration
24 hr 48 hr
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How Much Garlic?• Experts still researching optimal dose• Conservative estimate = 1-3 cloves per day
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Getting Children to Eat Allium Vegetables
• In spaghetti sauce• Background flavor in general
cooking• Added to soups and sauces • Minced onion on salads• Topping for hot dogs, hot dogs
pizza• Onions on sandwiches• Grilled sweet onions on fajitas• Grilled sweet onions as a base for
any sauce
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4. Herbs and Spices.
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Rosemary (Rosmarinus officinalis)
•Leaves are used as a spice •Contains antioxidants• Used commercially as a antioxidant•Prevents oxidation in vegetable oil•Potency comparable to BHT & BHA
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Percent of Mice With Tumors
0%
100%
Weeks 5 10 15
control
1.2 mg rosemary
3.6 mg rosemary
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Turmeric:• Used as a yellow food coloring and spice.• A principal ingredient in curry
powder(28%).• Contains three major curcuminoids, which
are responsible for the yellow color of the herb.
• Curcumin (diferuloylmethane) is the most significant curcuminoid.
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Effect of Turmeric on Lung Cancer in Mice. Percentage that Developed Cancer
0 10 20 30 40 50 60 70 80 90 100
Placebo
Taxol
Curcumin
Curcumin & Taxol
Percentage Mice that Developed Cancer
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Turmeric Meta-analysis
Conclusions:Average dose 500mg/d.Mixed results for turmeric’s anti-inflammatory activity. More studies need to be done.
Di Lorenzo, C, et al, 2013
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5. Eat the right portion
- Portion size me- Visual cues, Soup study- Proximity of food, candy study
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Portion Size Me Documentaries
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CBS Morning Show –Portion Size Me
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Soup Study
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0
50
100
150
200
250
300
Normal Soup Bowl Refilling Soup Bowl
Estimated Calories Consumed Actual Calories Consumed
Wansink, B., Painter, JE., North, J. 2005. Bottomless Bowls: Why Visual Cues of Portion Size May Influence Intake. Obesity Research, 13,1, 93-100.
Refillable Soup Bowls Increase Consumption, But Not Perception of Consumption
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Visibility Intervention Closed candy container containing 30 Hershey kisses replenished daily
Three conditions:•on top of the desk (visible & convenient)• in a desk drawer (not visible & convenient)•away from desk (inconvenient)
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02468
10
On Desk In Desk 2 Meters fromDesk
# of Candies Consumed
Amount of Candy Consumption According to Condition
Painter, J., Wansink, B., Hieggelki, J. (2002). How Visibility and Convenience Influence Candy Consumption. Appetite 38, 237-238.
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Conclusion
- Don’t eat the Standard American Diet (SAD)
- Eat less added sugar
- Eat more green leafy vegetables
- Eat more cruciferous and allium vegetables
- Eat more herbs and spices
- Eat the right portion
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WEBINAR HOST:Keith Hine MS, RDSr. Director of Healthcare & [email protected]
GENERAL INQUIRIES OR TO REQUEST SAMPLES:[email protected]
WEBINAR PRESENTER:Dr. Jim Painter, PhD, RDN Adjunct Professor University of Texas, School of Public [email protected]