Dieary patterns are more important to health than fad diets

The Hottest New Diet Isn’t a Diet at All

Meet the dietary pattern, a style of eating with a proven record of success.

This post was originally written as a guest blog for Health.USNews.com

Diets are out; dietary patterns are in – at least, that’s what the 2015-2020 Dietary Guidelines for Americans seems to say.

That’s big news for those of us who like to incorporate the report’s nutrition advice into our personal eating habits when it comes out every five years. This time, the government suggests we abandon diets that glorify or shun single foods and nutrients (think butter, eggs, fat and fiber – past years’ targets) and shift our attention to overall eating patterns, or the sum total of what, how often and how much we eat, as well as what we eat it with.

Why the move away from “good food/bad food” diets? For one, nutrition science is continually evolving and we are learning from our mistakes. Back in the 1980s, for instance, the guidelines told us to cut back on “bad fats” to lower our risk of heart disease – the No. 1 cause of death for Americans. But people who followed that recommendation filled the void on their plates with simple carbohydrates, such as pasta, bagels and fat-free cookies. In time, we learned those foods weren’t any better for our hearts (or waistlines) than the high-fat fare they replaced.

So in 2000, we tried again. The guidelines issued that year redeemed fats – as long as they were “good fats.” This recommendation was based on newer research linking populations that regularly ate olive oil, avocados and almonds with a lower incidence of heart disease. We followed suit, dipping our bread in olive oil, adding sliced avocado to our burgers and making almonds our go-to snack. But so far, the only thing that has improved is sales of those foods. Our single-minded pursuit of the perfect food (or fat) to fight heart disease has kept us from seeing everything else that contributes to its lower rates in people with different dietary patterns.

Now, after spending more than two decades rationing just three eggs into our weekly menus, we’re being told cholesterol isn’t as bad for us as we once thought. Does that mean it’s time to order the broiled lobster tail with drawn butter to celebrate?

Not so fast.

What it means is precisely what the latest Dietary Guidelines concluded: When it comes to diet, the whole is greater than the sum of its parts. Put another way, when you eat foods together, their health benefits are greater than a single food could produce on its own. For example, eating eggs every day can lower your risk of heart disease if you are also eating plenty of vegetables, beans, nuts, seeds, fruits, whole grains, fish and olive oil. On the other hand, eating eggs every day along with regular servings of fatty meats, refined grains and excess sodium from highly-processed foods can increase that risk. That’s because the connection to heart disease isn’t just about the eggs – it’s also about everything else we consume with them.

Another advantage of adopting a healthy dietary pattern is that the benefits are cumulative, like compounded interest. So, people who have been eating a Mediterranean-style pattern all their lives, for instance, get an immediate return on investment by meeting their nutritional needs early in life to support optimal growth and development. Later, they receive a long-term dividend by preventing, or greatly reducing, their risk of suffering from the noncommunicable diseases of adulthood, such as arthritis, osteoporosis, macular degeneration and the ubiquitous heart disease. But this payoff requires making consistent contributions to your healthy eating plan, just like building retirement wealth depends on making consistent contributions to your 401K. Both are more effective the sooner you get started.

Choosing a healthy dietary pattern over a diet also leaves more room for the occasional holiday food exemption. (Sorry, but weekends don’t count as “occasional.”) That approach is different from the can-eat-can’t-eat diet style, in which we’re open to every loophole that might give us a free pass. Have you ever rushed off to work without eating breakfast so you feel entitled to partake in the office pastries? How about arriving home from work too tired to chop vegetables, so you eat pizza (without a salad) for dinner? What about the Sunday you finally get the whole family together for brunch and end up eating eggs benedict and a Belgian waffle to celebrate? You get the picture: Food choices can change with the seasons, but a dietary pattern remains the same.

Convinced yet? If so, the highly regarded Mediterranean and DASH  plans are a great place  to start. Those patterns offer the best of what is known about the food-health connection when put together right, so you won’t have to upgrade to something new in another five years. You also won’t have to worry about getting caught up in the next fad diet that promises to solve all your health and weight issues because history has shown us they don’t work in the long term. Think gluten-free, low-glycemic index, high-protein, low-carb, antioxidant-rich, paleo and probiotic diets, to name a few. It’s time to move on something more sustainable.

You can start transitioning to a healthier pattern by following some of these simple tips. The goal is to make the right choice a habit so it becomes your default option.

  • Eat at least one piece of whole fruit daily.
  • Order “whole wheat” as your bread choice for sandwiches, toast and pizza crust.
  • Choose fish over meat or poultry for an entree at least once a week.
  • Drink one full glass of water with each meal.
  • Add a layer of fresh or grilled vegetables to every sandwich.
  • Use nuts or seeds instead of croutons on salad.
  • Make chili with more beans and less (or no) meat.
  • Have brown rice with all Chinese takeout.
  • Include some vegetables whenever you grill.
  • Use Greek yogurt instead of sour cream in cooking and baking.
  • Make your meat portions no larger than the palm of your hand.
  • Choose vegetables to top pizza, fill an omelet, stuff a potato or stretch a soup.
  • Keep hummus, salsa and sliced vegetables on hand as your go-to snack.
  • Be more inclusive of fruits and vegetables by including fresh, frozen, canned and dried varieties in your repertoire.

Robyn Flipse, MS, MA, RDN, is a registered dietitian nutritionist and cultural anthropologist who has spent her 30-plus year career counseling, teaching and writing about food, nutrition and health. Her passion is communicating practical nutrition information that empowers people to make the best food choices possible in their everyday lives. You can read her blog at www.EverydayRD.com and follow her on Twitter at@EverydayRD.

Heart Healthy Foods You May Have Missed

Some Heart Healthy Foods You May Have Missed

LOOK FOR THESE HEART HEALTHY FOODS THAT DON’T GET THE ATTENTION THEY DESERVE

This blog was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated in July 2013, but you can read the original post here.

When looking for foods that can improve your heart health, many of the ones most often recommended are either expensive, not easy to find, or are foods you don’t like. That doesn’t mean you have no chance of lowering your risk factors for heart disease through diet. The same attributes in those commonly named “heart-healthy” foods are found in many other more palatable options.

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Sardines – Salmon gets all the attention when it comes to fatty fish, but sardines are one of the most concentrated sources of the omega-3 fats DHA and EPA you can get, and at a much lower price all year round. The oils in fatty fish help lower triglycerides in the blood and reduce blood pressure and irregular heart rhythms. A 3-ounce serving eaten twice a week is all you need.

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Black beans – Oatmeal is recognized as being good for your heart, but dry beans, like black beans, have the same benefits and are far more versatile in the diet. Beans are a good source of soluble fiber, which binds cholesterol and keeps it from being absorbed. They are also rich in phytonutrients, like flavonoids, that can inhibit the clumping of platelets in the blood. Eating ½ cup a day can make a difference.

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Raisins –Like blueberries, raisins are rich in antioxidants that help reduce cardiovascular risk factors, such as blood pressure, total cholesterol, LDL-cholesterol, and markers for inflammation. Unlike blueberries, raisins are convenient to have on hand no matter what the season. Enjoy ¼ cup as a fruit serving daily.

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Popcorn – Whole grains don’t just in the form of breads and cereals. Popcorn is a whole grain and a good source of polyphenols, a naturally occurring antioxidant, that improves heart health. It’s very budget friendly and a satisfying snack as long as it’s prepared without excess salt and oil.

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Milk– Most often associated with calcium, milk is also high in potassium which is maintain the fluid balance in the body and help the kidneys eliminate excess sodium. With as much potassium as a medium banana, every 8 ounce glass of fat free milk you drink is a great way to keep your heart strong.

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Plant Stanols and Sterols – These compounds are found in very small amounts in fruits, vegetables, and grains. They help block the absorption of cholesterol, but there is not enough of them in foods to get the 2 grams a day needed for cholesterol-lowering benefits. Daily use of foods fortified with stanols and sterols, such as Minute Maid Heart Wise Orange juice and Benecol spread, is an valuable way to supplement a heart-healthy diet.

Woman on table having abdomen examined by physician

Crash Diets and Gallstone Attacks

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can read the post here.

STONES IN THE BILE DUCT CAN CAUSE GALLBLADDER ATTACKS IN PEOPLE ON VERY LOW CALORIE DIETS

If you want to reduce your weight, lowering your caloric intake is an option. If you want to reduce your risk of gallbladder attacks while losing weight, don’t lower your caloric level too far.

Crash diets have been proven to increase gallstone attacks.

Crash Diets and Gallstones

A new study from researchers in Sweden followed 6,640 people for one year who were losing weight on diets with different caloric levels. The “crash diet” included liquid meals providing 500 calories a day for six to 10 weeks. After that phase, those dieters gradually resumed eating solid food and followed a maintenance diet for nine months with an exercise regimen.

The other dieters followed a “low calorie diet” with between 1200 and 1500 calories a day for the first three months. It also included two liquid meals a day, then transitioned to a weight maintenance diet of all solid food for the next nine months.

As reported in the International Journal of Obesity, 48 people on the crash diet developed gallstones requiring hospital treatment while only 16 people in the low calorie group did.

One reason offered for this difference in gallstone attacks is that the people on the crash diet lost more weight. They had an average loss of 30 pounds at three months compared to 17 pounds for the low calorie group and an average loss of 24.5 pounds at the end of one year compared to 18 pounds for the others.

Even though obesity is a risk factor for gallstones, losing weight too quickly just makes the problem worse.

What Causes Gallbladder Attacks?

The gallbladder’s function is to hold bile, a liquid made in the liver, and release it during digestion when needed to help breakdown fats. Bile contains water, bile salts, protein, bilirubin (a waste product), cholesterol and fat.

The most common type of gallstones is made from cholesterol. When there is too much cholesterol in the bile it can harden into small pebble-like substances – or stones.

During rapid weight loss the liver secrets extra cholesterol into the bile, and that can increase the risk of gallstone formation. It is also believed gallstones are formed when the gallbladder does not empty completely or often enough, which is the case when eating a very low fat diet.

Bile travels through ducts, or tubes, to get from the liver to the gallbladder to the intestines. If there are stones in a bile duct that block the flow of bile it can cause inflammation. That can lead to the fever, jaundice and the pain commonly associated with a gallstone attack.

Who Gets Gallstones?

In addition to being overweight and losing weight too quickly, simply having gallstones is a risk factor for developing more. Other contributing factors identified by the National Digestive Disease Information Clearing House include:

Female – Women are twice as like as men to develop gallstones

Family History – There is a possible genetic link to gallstone problems

Diet – The more cholesterol and fat in your diet, the greater your chances of making gallstones

Ethnicity – American Indians have a genetic predisposition for gallstones and Mexican-Americans men and women also have higher rates

Cholesterol-lowering drugs – Drugs that lower blood cholesterol levels may increase the amount of cholesterol in the bile

Gallstone attacks typically occur after eating a meal and can mimic signs of a heart attack, so getting a proper evaluation is critical.

If your pain is in your lower back, see my post about kidney stones to see if they are a problem for you.

Heart disease research shows eggs unfairly blamed for clogged arteries in cardiovascular disorders

Clogged Arteries Are Not Due to Eggs

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can view it here.

HEART DISEASE RESEARCH SHOWS EGGS UNFAIRLY BLAMED FOR CLOGGED ARTERIES IN CARDIOVASCULAR DISORDERS

One of the first things I remember learning about cardiovascular disorders as a student dietitian was that clogged arteries was the common cause. I vividly recall the illustration in my textbook of a heart attack triggered by a blockage in the flow of blood. The heart disease research available at the time hinted that it was the cholesterol in eggs that was responsible for that blockage.

I’d like to revisit the subject of eggs, cholesterol and heart disease as we celebrate American Heart Month.

Eggs were first linked to the rising rates of cardiovascular disorders in this country back in the 1970s. As a result, dietary guidelines started recommending that we limit our consumption of egg yolks to no more than 3 per week.

That triggered a lot of diners to add egg white omelets to their menus, but it didn’t slow down the rates of heart disease. It is the number one cause of death for men and women alike, and has held that distinction for over 60 years. More Americans will die of heart disease this year than all forms of cancer combined.

600,000 deaths a year can’t possibly be due to eggs.

What’s Do You Like With Your Eggs?

Some of the earliest evidence used to blame eggs for heart disease was based on research that showed the people who ate the most eggs had a greater incidence of heart attacks than those who ate few eggs. But as we should all know by now, that kind of data does not prove causation.

A closer look on the plates of the egg eaters revealed they liked their eggs with bacon or sausage, fried potatoes, buttered toast and cream in their coffee, followed by a cigarette. When more diligent researchers took a look at what else the big breakfast crowd was eating, they found plenty of other incriminating evidence. Their diets were filled with meats high in saturated fats and low in fruits, vegetables and whole grains, yet eggs took all the blame for their chest pain.

Then there was the research that showed heart disease was caused by clogged arteries, and the plaque clogging our arteries was formed by cholesterol, and eggs were high in cholesterol. The advice that followed was to eat fewer eggs to stop plaque formation. But the dots hadn’t been connected yet that could prove the cholesterol in eggs was the same cholesterol that found in heart-stopping plaque.

As it turned out, those dots didn’t connect. The dietary cholesterol we get from egg yolks, liver and lobster is not the same cholesterol that ends up causing clogged arteries. Instead, we make our own custom cholesterol, mostly from saturated fat, and eggs are low in saturated fat.

Vindication of the Egg

A large scale study published this month in the British Medical Journal provides a much-needed defense of the egg. Scientists did a meta-analysis of 17 previously published reports on egg consumption and the incidence of heart disease or stroke. The analysis included over 12,000 cases of either heart disease or stroke and follow up that covered more than 7 million “person years.” The conclusion was that consuming up to an egg a day was not associated with increased risk of coronary heart disease or stroke among non-diabetic people.

Getting to The Heart Truth About Heart Disease

Just like eating eggs does not cause heart disease, wearing red doesn’t stop it. The Heart Truth campaign uses the red dress to promote awareness of the risk factors for heart disease in women so we will take action to lower our risk. The first step is to know these numbers:

  • Blood pressure
  • Blood cholesterol
  • Blood glucose
  • Body Mass Index (based on height and weight)
  • Waist circumference

If your numbers are too high, work with your health care team to lower them. At least you won’t have to worry about giving up eggs to do it!

Controversy over eating too many eggs continues with recent study

Is Eating Too Many Eggs Bad For You?

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

CONTROVERSY OVER EATING TOO MANY EGGS CONTINUES WITH RECENT STUDY

If your neck got sore last week after hearing the report that eating too many eggs might be bad for your arteries, blame it on whiplash. The reemergence of bad news about good foods always leaves me feeling like I’ve been hit from behind, too.

Fortunately, there’s relief in the facts.

The Hard Boiled Truth

First, I want to disclose that I’m a big fan of eggs. Chicken eggs in the shell are a 100% natural, nutrient-dense, low cost food that are widely available and highly versatile in the culinary world. I cannot think of another food that delivers so much value for just $0.20 apiece.

I will come to the defense of eggs whenever they are under attack because I know we have a lot to lose if we let this fragile but mighty food get knocked out of our diets without good cause.

Headlines Scramble the Details

The latest study linking eggs to clogged arteries was done at Western University in Ontario, Canada and published online Monday in the journal Atherosclerosis. The headlines covering the research said eating too many egg yolks was as bad for your heart as smoking cigarettes. That really got me riled because I really don’t like tobacco products.

So I looked into the details of the study, not just the news coverage about it. Here are the facts that once again back up my defense of eggs.

  • The study was observational, not designed to prove cause and effect.
  • The subjects were people at risk for heart disease and smokers, not a random, healthy population.
  • Subjects answered questions about how many eggs they ate, smoking history, and some other lifestyle factors, but none about the rest of their diet, exercise habits, or alcohol use.
  • Plaque build-up was similar between those who ate the most egg yolks and those who smoked the most, but the egg eaters did not have higher total cholesterol and bad (LDL) cholesterol or lower good (HDL) cholesterol levels compared to those who ate fewer eggs.

Sunny Side of the Story

What this means is that the researchers did not ask enough questions to be able to explain why the people who enjoyed eggs the most had more plaque in their carotid arteries. It could be they ate their eggs with other foods high in saturated fat, like bacon and sausage, which do clog arteries. Maybe they did not eat many fruits and vegetables rich in protective antioxidants. Or it’s possible they did a poor job of estimating the number of eggs they actually ate in their lifetime. Do you know how many eggs you’ve ever eaten?

What the research did show is that eating eggs improves the overall blood cholesterol profile, but that was nowhere to be found in the headline.

My take-away is this retrospective study of 1262 people based on survey data does not outweigh the results of a prospective study done at Harvard with more than 100,000 subjects. It found no significant difference in cardiovascular risk between those consuming one egg per week and those eating an egg a day.

That means eggs will remain a regular part of my diet, how about yours?

Soy is good for everyone, not just vegetarians

Soy is Good for Everyone, Not Just Vegetarians

This post was written as a guest blog for Family Goes Strong. You can read the original post here.

YOU DON’T HAVE TO BE A VEGETARIAN TO BENEFIT FROM INCLUDING MORE SOY IN YOUR DIET

Being a vegetarian isn’t the only reason to eat soy-based products. There are benefits for all of us – young or old, vegan or omnivore – to incorporating more soyfoods into our meals. The one I promote the most is that it increases the variety in our diets. That is also the tagline for National Soyfoods Month, which is celebrated in April each year.

I like to focus on variety because it’s the best way to make room on “your plate” for everything you enjoy while keeping any food from taking up more space than it should. And that helps you deal with the hard-to-grasp concept of moderation. Simply put, it means you must control the amount and frequency of everything you eat to have a balanced diet.

Yet with all the news you hear about “super foods,” it’s easy to believe you can eat all you want of some foods (you can’t), or you’d be better off limiting your diet to some top ten list (you won’t). Eating a greater variety of foods is the best bet for optimal nutrition.

So in honor of National Soyfoods Month, here are some reasons why you might want to expand the variety of your family’s diet with the addition of more soyfoods:

12 Reasons to Add Soy to Your Diet

  • Lower dietary cholesterol
  • Enjoy more meatless meals
  • Decrease risk of breast cancer in later life
  • Use instead of peanuts for those with peanut allergy
  • Replace cow’s milk for those with lactose intolerance
  • Provide choice for those with milk protein allergy
  • Reduce saturated fat in diet
  • Increase fiber in the diet
  • Ease constipation
  • Incorporate another vegetable (yes, soybeans are vegetables!)
  • Provide an alternate protein source to a vegetarian or finicky eater
  • Get another source of calcium using fortified soy milk

You can find soy-based products in every section of the grocery store, so why not add a few of these to your shopping list?

Where to Find Soyfoods in the Supermarket

Produce – fresh soybeans, tofu, tempeh, miso

Freezer – edamame, soy burgers, soy nuggets, soy crumbles

Dairy – soymilk, soy yogurt, soy cheese

Snack – soy nuts, soy chips, soy bars

Staples – canned soybeans, soy pasta, soy flour

How many different soy foods do you eat each week?