How to Ensure Your Breakfast is the Most Important Meal of the Day!

Yes, you read that right! Merely just having breakfast does not ensure a healthy day. You have to have the RIGHT KIND of breakfast. The right foods, right amounts, and right flavors. When I have a satisfying breakfast that is high in protein, I have more energy throughout the day, less cravings, and am an overall happier person! However, if I have a quick bowl of oats without any fat or protein, a piece of fruit, or just some gluten free toast, I am hungry a few short hours later and am usually fighting off cravings and low energy all day long! I did some research on this breakfast phenomenon and found a great article on the subject! The article is entitled: "A randomized crossover, pilot studying examining the effects of a normal protein vs. high protein breakfast on food cravings and reward signals in overweight/obese "breakfast skipping" late-adolescen girls."

Phew! Long title! Here is the citation if anyone is interested in looking it up!

Hoertel, Heather A., Matthew J. Will, and Heather J. Leidy. "A randomized crossover, pilot study examining the effects of a normal protein vs. high protein breakfast on food cravings and reward signals in overweight/obese." Nutrition Journal 13.1 (2014): 80.

This study was not complicated to understand, but had profound implications on the types of breakfasts we should be consuming, as well as the breakfast foods I should be promoting to my clients and people I educate about nutrition! The study was done on 19-20 year old girls who normally skip breakfast. They were put into three groups: no breakfast, normal protein (NP) breakfast, and high protein (HP) breakfast. The NP breakfast consisted of 13 grams of protein, while the HP breakfast had 35 grams of protein. The subjects were told to continue these breakfasts for 6 consecutive days, then were tested on day 7. They were questioned on their food cravings 4 hours after breakfast. Researchers also collected blood samples from the subjects to test HVA blood concentrations, which is a strong indicator of dopamine's activity in our body.

Wait, what's dopamine? Dopamine is a neurotransmitter in our brain that regulates our pleasure and reward system. Our appetite and food cravings are strongly reward-driven, and it has been found that people with low dopamine levels often suffer from sugar cravings and tendencies to overeat. Dopamine's activity has been seen to be blunted in those who are overweight or obese. Therefore, high dopamine levels indicate less cravings and a greater ability to have a normal appetite and eating pattern.

SO back to the study! After testing these girls in the different groups, the researchers found that those who consumed the NP and HP breakfasts experienced a decline in sweet cravings compared to those who skipped breakfast. However, what was more interesting is that only HP breakfast significantly increased levels of HVA in the blood, indicating an increase in dopamine! This means that these subjects, who were 19-20 year old overweight and obese women, actually were able to increase their dopamine levels and thus, have a greater ability to control their food cravings and appetite.

This is what makes breakfast the most important meal of the day! Not just having it, but also the quality of your breakfast. The fact that these subjects were able to increase their dopamine levels just by having a high protein breakfast has many implications as to what type of breakfast we should be consuming. Most people consume breakfast foods that are obviously not healthy, such as donuts, high sugar coffee drinks, pastries, and drive-through processed meals. However, there are some meals that seem healthy, but don't elicit the same fullness cues and protection against cravings as a high protein breakfast would. These seemingly healthy breakfasts include cereal, bagels, crackers, granola, fruit bowls, or even whole grain toast and bread products. These foods may not be bad or unhealthy, but they still turn into sugar in your body (even if they are labeled "low sugar," carbohydrates turn into sugar in our body, independent of how much sugar is added to these products). So that bowl of cereal will not produce the same fullness as a couple of scrambled eggs and vegetables would. A typical cup of breakfast cereal contains 25-30 g carbs and 2-4 g protein. 30g carbs is the equivalent of about 7 tsp of sugar entering your system, and the 2g of protein is nothing compared to the 35g that was tested in this study!

If this all seems technical to you, let me boil it down to what I believe is a healthy way to approach breakfast. I don't think this study is saying to not have cereal or oats or even bagels. We need carbohydrates, protein, and fat. I think what this research shows is that organizing meals and making sure you have protein, fat, and carbohydrates at each meal is crucial to appetite regulation. There are several ways to go about this while still enjoying your favorite foods:

- 1/2 bagel, hard boiled eggs or egg whites, spinach, and sliced avocado for an open-faced bagel breakfast sandwich! By cutting out half of the bagel, you have room for protein and fat that will help keep you full and send those lovely signals to your brain to not crave sugar later in the day!

-2 scrambled eggs with veggies cooked in olive or coconut oil, 1/2 cup roasted sweet potato. This meal has the right balance of protein, carbs, and fats from all whole food sources, so you can't go wrong!

-1/2 cup cooked oats with nuts sprinkled on top, side of breakfast sausage or eggs

-Big baked egg frittata with bowl of fruit topped with a few nuts

-Protein pancakes or waffles made with whey protein, topped with nut butter

- Leftover protein of any kind with vegetables and avocado (who says breakfast food has to be only "breakfast food?")

The possibilities are endless when you view breakfast, and essentially each meal, as a balance of protein, carbohydrate, and fat. The amount of protein you would need at each meal will vary based on gender, size, activity level, weight, and goals. Experiment and find what works for you! If you have one or two eggs and find yourself hungry an hour or two after, you probably need to add another egg or some sausage to the meal! Try to include vegetables in your meals and snacks whenever possible. These fill us up while still allowing us to eat large volumes of food (and who doesn't like that?)

In conclusion, I think this article shows that having breakfast is an important part of a healthy life. But we need to realize that it isn't just merely having "a" breakfast that makes us healthy. It's having the right breakfast with the right amount of protein that will help keep us full, avoid sugar cravings, and will increase our dopamine production in our brain!

I hope this article was as interesting to you as it was to me! Have a great Thursday everyone!

References:

http://www.psychologytoday.com/basics/dopamine

http://caloriecount.about.com/calories-special-k-red-berries-cereal-i8383

Protein Confusion Made Simple

I've noticed that protein has been such a popular topic in the nutrition world today. Protein is so important to our health and often either gets overlooked, or becomes TOO much a part of our daily dish. I thought I would write this post to share my thoughts on protein as a dietitian, as well as shed some light on the research for, and against, a high protein consumption. Recently, I came across an article entitled "High-Protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health." Here is the link if anyone is interested:

Russell, Wendy R., et al. "High-protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health." The American journal of clinical nutrition 93.5 (2011): 1062-1072.

These types of articles rub me the wrong way because they automatically take one side without considering other possibilities. I won't go into too much of the scientific detail, but the researchers compared a "weight-maintenance" diet of 85g protein with a "high protein, moderate carbohydrate" diet with 139g protein, and a "high protein low carbohydrate" diet with 137g protein and only 22g carbohydrate daily. They found that the diet with the highest protein and lowest carbohydrate level showed a decrease of colonic protein metabolites (also known as the short chain fatty acid butyrate)...leading to the conclusion that a high intake of protein may cause colon cancer. However, they found that if the diet still contains adequate amounts of fiber, the benefits of the fiber could counteract the possible negative side-effects of the high protein diet. With only 22g carbs a day, I highly doubt that diet contained enough fiber! Lastly, the researchers concluded that even though this relationship exists, there could be other factors leading to an increased risk of colon cancer, such as the fact that all of these experiments were done on obese people, as well as the fact that these findings depend on age, gender, and other lifestyle factors.

To me, these findings don't necessarily mean that we should all cut out protein and eat carbs all day long. I think protein is essential to health, well-being, energy, clear skin, good hair, and muscle strength. I believe that it all comes down to the quality of the foods we eat, including our protein quality. The quality of the foods we eat helps us maintain a healthy weight, which IN TURN decreases our chances of colon cancer, as well as many other chronic lifestyle diseases such as diabetes and heart disease. Stabilizing your weight to a healthy place while eating quality, real foods, and decreasing processed carbohydrates and sugars, leads to optimal health. Protein is definitely a part of that equation in my opinion. I would also like to note that a diet of 22 g of carbohydrates is just too low for a healthy body function. I don't believe we need as many carbohydrates as we are told to eat, but I also think that 22g of carbohydrates is a bit extreme. Going too low prevents you from even eating a good amount of vegetables, which provide vitamins, minerals, and fiber, as well as contribute to overall health. However, an adequate and moderate consumption of carbohydrates (100-200g depending on goals and activity level) can be reached by vegetables, fruits, and starchy vegetables (think sweet potatoes, squash, pumpkin, etc) without having to turn to breads, cereals, and other processed carbohydrate choices. Real food always wins! :)

Anyways, back to protein! At about the same time I came across the colon cancer article, I came across this article as well from Today's Dietitian Magazine:

http://www.todaysdietitian.com/newarchives/060114p22.shtml

This article is about athletes and protein intake. The article suggests that the amount of protein we have been recommending throughout the years (0.8 g protein/kg body weight for the average person) may actually not be enough for some people, including athletes. The author, a PhD RD, suggests that protein needs should be increased to 1.2-1.7g protein/kg body weight based on the activity level and age of the person in question. I fully agree with this! This article even goes on to address concerns of the high-protein diet, and that no data fully establishes a connection between a high protein intake and impaired kidney function in HEALTHY individuals that consume protein. Again, we must remember who we are comparing. In the first article, the experiment was done on obese people with multiple other health problems other than a colon cancer risk. In Today's Dietitian magazine, the author is reviewing studies that have been done on healthy, athletic people. Context is crucial.

Where does that leave us? As cliche, and perhaps disappointing as it sounds, I think it all boils down to balance. We can't completely cut out protein, but we always can't make it 80% of our diet. In fact, our bodies and brains won't let us. Protein has built in mechanisms to keep us full. Think about it; have you ever binged on chicken, or felt an uncontrollable need for 4, 5, or even 6 chicken breasts? I didn't think so. But, how easy it is to have 4, 5 or 6 dinner rolls before even touching your actual meal? Yes, been there, done that! That's why I love having protein with every meal. It's like a built in regulator for how much food I will consume and ensures that I will really stop eating when I am full. Protein is satisfying and filling, and should be a part of a healthy diet! However, please don't eat 4 chicken breasts in one sitting unless you are 300 lbs of pure muscle. You probably wouldn't want to anyway.

Lastly, what kind of protein do I recommend? Well, first of all, animal protein is the most bioavailable protein there is. So I recommend sources such as chicken, eggs, turkey, fish, grass-fed beef*, lamb, pork, etc. But I am also a realist and know that, at times, animal sources of meat may seem overwhelming, especially when consumed multiple days in a row. This is why other sources such as beans and lentils can be used as well. However, I recommend that animal proteins be given priority because they are more nutrient rich and satiating! And, as always, let's not forget what the majority of our plate should consist of...VEGETABLES! As long as your plate is full of those leafy greens, bright oranges, or deep reds, your protein options can vary.

I hope this review was helpful to those out there who are protein confused and will help you gage if you need to increase the quality and quantity of the protein you consume! I always recommend people trying things for themselves. Nutrition research is important, but it is also flawed as it has to do with so many factors other than solely what food is consumed during a certain period of time. And on that note, I am off to prepare my lunch for tomorrow! Green bean stew with leftover Armenian sausage patties...YUM! (Both recipes can be found on the blog with some searching!) Have a great night folks!

*I encourage grass-fed beef because it has more nutrition and is much better for us. Grass-fed meat is rich in vitamins and micronutrients, omega-3 fatty acids, and even antioxidants. So, my opinion is that grass fed is best. But I certainly can't control the source each and every time I have red meat, especially when eating out. The point is to do your best, don't stress yourself out, and enjoy your food and good health!

Daley, Cynthia A., et al. "A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef." Nutrition journal 9.1 (2010): 10.

The Magic of Avocados!

Wow, it has been such a crazy and busy week! I feel like I have barely had time to breathe with my work schedule and evening activities. Since I don't work until 11am today, I figured it would be the perfect time to post about a topic I have been wanting to post about for a while! This will be an review on two articles all about the greatness of avocados! Avocados have become so popular lately, so I thought I'd do some research on the specific health benefits researchers have associated with the consumption of this fruit! Yes, even though avocados are high in healthy fats (which we will get into later), they are actually botanically a fruit. Their widespread health benefits, and their effect on overall health, will be the focus of this review.

The two articles I read are entitled: "A randomized 3x3 crossover study to evaluate the effect of Hass avocado intake on post-ingestive satiety, glucose and insulin levels, and subsequent energy intake in overweight adults."

and...

"Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008."

Here are the citations!

Wien, M., Haddad, E., Oda, K., & Sabaté, J. (2013). A randomized 3x3 crossover study to evaluate the effect of Hass avocado intake on post-ingestive satiety, glucose and insulin levels, and subsequent energy intake in overweight adults. Nutrition journal, 12(1), 155.

III, V. L. F., Dreher, M., & Davenport, A. J. (2013). Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008.

Review:

I was actually really excited when I found these articles because the first one was written by many of my former graduate school professors at Loma Linda University! This article focused on the satiety effects of avocados. Satiety is the feeling of fullness we experience after a meal. Some foods promote satiety, while others do not, and actually promote the opposite: overeating! Obviously, if we want to eat healthy amounts of foods, we want to pick foods that promote satiety and keep us full until our next meal. This study also measured the glucose and insulin effects of avocado, as well as its impact on over energy intake. All of these factors were measured in overweight individuals. What the researchers found is that, by adding half of an avocado to your lunch meal, meal satisfaction significantly increased by 23%, while the desire to eat or snack again over the course of 5 hours post lunch decreased significantly by 28%. When avocado was included in the meal (replacing the avocado for another food item), satiety increased significantly by 26%, while the desire to eat over the course of 5 hours post lunch decreased significantly by 40%. Eating the avocado portion at lunch also produced a more favorable blood glucose and insulin response compared to those who did not include or add avocado to their lunch meals. This study shows that eating even half of an avocado with your lunch, or replacing part of your lunch with this food, increases your satisfaction with your meal, and will keep you full for a LONG while afterwards! This is good news for you afternoon snackers out there, who are ready for some crackers or chips just a couple hours after lunch! Even though the avocado adds calories (about 115 calories in half of an avocado), the quality of and satisfaction with your lunch increases, leaving you full and energetic long after your lunch meal.

Which brings me to my second article, which measured the diet quality and nutrient intake of avocado consumers, as well as participants' overall risk of metabolic syndrome. Compared to non-avocado consumers, this study found that diet quality was significantly higher in those who consumed avocados. These people had an increased intake of micronutrients from fruits and vegetables, and a decreased intake of foods with added sugars. Those who ate avocados had a higher total fat, fiber, vitamin E, magnesium, potassium, and vitamin K intake. They also tended to consume less carbohydrates, and have a  lower body weight, BMI, and waist circumference than those who did not consume avocados. Yet another reason to include these delicious fruits in your diet! Even though those who ate avocados had a higher fat intake, they actually weighed less. These people also had a lower risk of developing metabolic syndrome, which includes a myriad of health problems including poor blood glucose control, high triglycerides, low protective HDL cholesterol, high blood pressure, and a large waist circumference. In addition to all of these health benefits, avocados are also high in monounsaturated fatty acids (or MUFAs), which have cardiovascular benefits and prevent the oxidation of small LDL particles. Oxidized LDL is a huge contributor to heart disease, which is the main reason why avocados promote heart health as well.

My opinion:

Wow, how much more of a reason do we need to eat avocados? Not only do they taste creamy and delicious, they also provide a large host of health benefits. They are good for our bodies and our brains. Promoting satiety helps us focus on other things because, as we all know, when we are hungry, food is all we can think about! The satiety promoting factors in avocados are a great reason to include them in your breakfasts, lunches, or dinners. They are also good for our health and protective against heart disease. I recommend having 1/2-1 avocado per day, depending on your activity level and overall size. I also suggest replacing your usual nutrient poor foods, such as bread, rice, or pasta, with avocados, which are much more nutrient dense and have higher satiety signals and fullness cues than our other refined carbohydrate choices! Some ways to include avocados are with your eggs in the morning, with salads at lunch, or by making some guacamole to dip veggies in at dinner! So enjoy some avocado today and I hope you all have a great Wednesday!

Redefining the Snack!

I love snacking and have always been a snacker! When I was younger, I would look forward to my afternoon snacks, which would usually consist of goldfish crackers while watching "Little House on the Prarie." (Loved that show!) Throughout the recent years, I have found that my nostalgic love of snacking still rings strong and true. I would much rather snack throughout the day than have 3 square meals a day. But, since most snack foods tend to be processed, high in salt and sugar, and not the healthiest of options, snacking has gotten a bad reputation. The action of snacking also stimulates us to eat more by triggering that mindless "put food in mouth, repeat, repeat, repeat" action, which makes it easy to ignore our satiety signals (aka your brain screaming "I am full so stop feeding me!!!") Makes you almost feel like a crazy cooke monster, huh??

I read an interesting article this week entitled "Half of eating occasions are snacks." Here is the link below!

http://www.foodnavigator-usa.com/Markets/The-end-of-the-meal-as-we-know-it-Half-of-eating-occasions-now-snacks-says-Hartman

A new report by the Hartman group states that more and more people are eating on the go, snacking, and replacing traditional meals with more snack foods. The authors stated that people are eating "on a whim" and "according to cravings," making them more likely to go through the drive thru, stop at a grocery store, or pick up a yummy baked good from the local bakery on their way home from work, school, or any function. The report also stated that half the time, people eat alone, which means that smaller portions are even more necessary. The report states that these snacks have become replaced meals, and some people are even starting to snack at home when they are too tired to make a full course, nutritionally balanced meal.

My opinion:

I am a healthy eater, but also love to snack. I completely understand the need to eat something on your way home, or the feeling of being too exhausted to cook a full meal after a long day at work. But, there are some healthy ways to prevent a snack attack that leads to an all day eating fest! Planning and prepping your meals and snacks are the key to establishing healthy meal and snacking patterns, leading to a happier and healthier life! Check a few posts back if you need some meal planning ideas, and keep reading for some snacking tips!

Since I get off work at 5:45pm, have a 45-50 minute commute home, I know that I will get hungry on my drive. I always make sure to either pack a quest bar or some nuts for my drive home.

The combination of nuts with either veggies or fruit is also very satisfying and filling!

In my experience, the key to being a healthy snacker is to PLAN your snacks. Most people plan meals, but simply leave the snacks up the chance. This usually leads to overeating snack foods such as chips, popcorn, candy, etc. The reason why these foods are SO easy to overeat is that they are full of sugar and very devoid of nutrition, which leads to these foods having addictive qualities. Think about it, have you ever eaten 4 plates of steak or grilled chicken? Your body just screams NO and physically doesn't let you because of all the nutrition and protein in these foods. But, have you ever polished off 4 baskets of chips and salsa without even thinking about it?? Be honest, because even I can answer that question with a  resounding YES! As delicious as some of these snack foods are, they have no internal mechanisms that make us say STOP EATING. Most snack foods do not contain adequate protein to keep us full and do what snacks are intended to do: keep us full enough till our next meal. Which is why, I recommend, redefining the snack!

1.) MINI-MEALS: A snack should really be more of a mini-meal. Think of your snack as a protein, veggies, and some healthy fats. If you have a hard-boiled egg, carrots, and a 1/4 cup of hummus, nuts, or guacamole, I guarantee that you will feel satisfied and full, without feeling the need to have a second, third, or fourth portion of this "snack" or mini-meal. Another idea is 2 oz grilled chicken, some snap peas or mini bell peppers, and a string cheese. This meal would fill you up without stuffing you up, and will keep your energy levels steady for a few hours instead of leaving you hungry and wanting more.

2.) QUICK STOP PROTEIN: When it comes to stopping on the way home for a snack, most people turn to Starbucks, fast food joints, or ice cream parlors. However, in the same amount of time it takes for you to pull into one of these food establishments, it would take the same amount of time to stop at a nearby grocery store with a prepared foods section and pick up a rotisserie chicken. Chicken has good protein, is a fast snack option that you can leave in your fridge at work, and can even be taken home to your family for a quick dinner. Just whip up a salad or some steamed veggies (keep a few bags of frozen veggies on hand for emergencies such as these!) and you've got yourself a nice protein+veggies meal! You can even boil cook up some sweet potatoes or some brown rice as a carbohydrate side as well.

The more our world changes and gets busier, the more our daily habits change as well. As this article has shown, the "traditional" meal is taking a back seat to snacking and eating on the go. Even though we all have busy schedules, don't let health and nutrition take a back seat as well! Use some of these tips, or create your own protein, veggie, and healthy fat meals that will help you stay full and resist the need for salty or sugary snacks. By packing each meal with as many nutrient-dense foods as possible, you will leave your body and brain satisfied and going strong throughout the day, preventing the overeating and mindless snacking that so often occurs when you let yourself go hungry! So go ahead, redefine your snacks, and see how much better your moods, energy, and overall health will be!

Article Review: Picking Your Battles with Meat

The article I am writing about today discusses the dangers of processed meats.  Processed meats are usually a staple in most people's diets, whether the person is careless about his or her health, or an extremely health conscious individual. Every now and then, we all need a little convenience in our lives! However, this article does a great job of clearly outlining the different dangers associated with a high consumption of processed meats, while making the public aware of some healthier alternatives. This article is entitled "Processing of meats and cardiovascular risk: time to focus on preservatives." Here is the citation before I forget!

Micha, Renata, et al. "Processing of meats and cardiovascular risk: time to focus on preservatives." BMC medicine 11.1 (2013): 136.

The purpose of this article was to explain why deli meats have been associated with adverse health effects, as well as to provide ways to enjoy meats in healthy and less harmful ways. The article begins by expressing how the consumption of red meat has been considered to be a major risk factor for cardiovascular disease because of saturated fat and cholesterol. However, recent findings suggest that the saturated fat and cholesterol of red meat do not provide sufficient evidence to prove a causative effect between red meat and cardiovascular disease. The authors state that a more rounded view must be taken on this topic.

The authors proceed to summarize various studies that have proven that unprocessed red meat does not have a significant association with cardiovascular risk. The consumption of unprocessed poultry (chicken, turkey) was slightly associated with a lower risk of cardiovascular disease. Another study reviewed in this article, conducted in 2010, found that unprocessed red meat and coronary heart disease had no significant association; however, there was a significant association between processed meat intake and coronary heart disease. The most notable differences between processed and unprocessed meats are sodium and nitrates. These preservatives are added to most deli meats and are thought to be the cause of these adverse associations between processed meats and cardiovascular disease. The authors conclude that these "low-fat" deli meats should not be advertised as "healthy" and that dietary recommendations should not just be "fat-based" but overall "nutrient" based, promoting fruits, vegetables, nuts, whole grains, and fish, while recommending the avoidance of processed meats and other high-sodium and refined foods.

My opinion:

Okay, so basically, preservatives are bad, fresh meats are good, class dismissed. But, I feel that there is a very important concept to note and always remember when dealing with these scientific discoveries. Associations do not necessarily mean causation. What I mean by this is that one factor can be associated with another. For example, an association is that people who have a lighter in their pockets have a high association with smoking. But, the fact that these people have lighters in their pockets is not the only reason why they are smoking; it is not the cause of them smoking. The cause is most likely because of addiction, habits, etc, and not just because they happen to have a lighter in their pocket. The authors in this study note that some of the studies they reviewed did not adjust for certain "outside forces" that may have impacted their participants. Many people who eat a high amount of processed meats have higher rates of smoking, drinking, having inactive lifestyles, and have poor eating habits in general. These outside forces, or "confounding factors" can impact the findings of these studies and make the outcomes somewhat fuzzy and unclear. We don't know if the adverse effects are just from the processed meat consumption, lack of exercise, lack of whole foods, or because these people happen to smoke and drink. That is why it is always important to read scientific studies with a watchful eye.

Now, while I firmly believe that these preservatives and additives are harmful and should be avoided, I understand that real life happens. Sometimes, in our healthy eating journeys, we have to make allowances for certain convenience items. In a perfect world, we would all have time to cook our meats from fresh, grass fed, antibiotic free sources, bake our own breads from the wheat we have grown ourselves, and eat fresh (not frozen) fruits and vegetables all day long. Unfortunately, our world is not perfect, and sometimes even the most health-conscious individuals must take the easy route to get nutritious foods in our diets without having to start from square one. For me, this is where deli meats come in. When I need a quick protein source but know I won't have time to cook some meat, I usually grab a case of deli turkey from Trader Joe's. Thankfully, they have a nitrate free option, which makes me feel a little less guilty about my once in a while protein choices!! But, I also understand that these choices are not always available, and that is okay. If you can avoid these types of foods most of the time, the rare instances where you may have high sodium, nitrate-filled meats won't cause as many problems as having them consistently every day for weeks or months at a time. My recommendation would be to always try to cook fresh meat, poultry, and fish, but not fear the occasional need for some convenience "healthy" food options. If you are going to eat processed meat, I recommend getting a nitrate-free and low-sodium version whenever possible. 

I hope this article was educational and interesting for you all! Have a wonderful Thursday evening!

Article Review: Paleo, Heart Disease, and Diabetes

Today was my first day of my new (and first) job! As I mentioned a few posts back, I am now a Nutritionist-RD at WIC, a supplemental nutrition program for parents and children to receive food and good nutrition counseling! I am beyond excited and was pretty much acting like it was Christmas morning all day long! So, in honor of my first day, I have decided to dissect a rather scientific article I read on our cruise! :) I've talked about the Paleo diet before, but will do a brief overview again before getting into the article I read. This diet may be surprising to some who have not heard about it, but be patient, do some extra research if you are interested, and learn something new! :) The Paleo diet is one that focuses on foods that our ancestors ate before modern agriculture. This includes animal proteins (meat, chicken, fish, lamb, eggs, etc), vegetables, fruits, and healthy fat sources such as coconut, nuts, avocado, and olive oil. NO dairy, legumes, grains, soy, seed oils, or artificial sweeteners allowed. Foods like corn, oats, rice, peas, and quinoa are all considered grains, so those are omitted as well (and if you look at the nutrition composition of these foods, they are mostly carbohydrate and act as starches in your body, so they are omitted with good reason).

I am a fan of the Paleo diet (while I still do love my cheeses...just can't seem to give them up)! I did my first Whole 30 (a very strict Paleo diet for 30 days) last March-April, and it was a good experience for me and my health. However, I did suffer from the usual restriction-overconsumption syndrome that usually follows a strict diet, and proceeded to crave and include gluten in every single thing I ate for a few months. But this experience also reminded me that my reactions to gluten are not too desirable, as I was sick and experiencing symptoms I didn't feel when abstaining from gluten. After a few break ups and reunions with the G-word, we finally broke up on the cruise about a month ago. While I am still having dairy, I am otherwise following a gluten-free and mostly grain-free diet. I feel so much healthier in every aspect of the word. I now have rare, if any tummy issues, am finally sleeping through the night (something I haven't been able to do well since I was an infant), feeling more mentally alert and energetic, and enjoying clearer skin! I am also eating more plants and fruits than I ever have before in my entire life...including when I was vegetarian! I am loading my plate with dark green leafy vegetables, broccoli, carrots, kale, sweet potatoes, ANY vegetables I can find. I firmly believe that this is the key to a successful and healthy Paleo lifestyle; focusing on the whole, real, and nutritious vegetables, fruits, and healthy proteins and fats you can eat!

However, keep in mind that you don't have to stay away from these foods 100% of the time. Many Paleo enthusiasts follow an 80/20 lifestyle, keeping to the Paleo diet 80% of the time and allowing the occasional non-Paleo foods 20% of the time. Just figure out what works for you, makes you happy and healthy, and go with that!

The article I read is entitled "Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study." Citation is below! :)

Jönsson, T., Granfeldt, Y., Ahrén, B., Branell, U. C., Pålsson, G., Hansson, A., ... & Lindeberg, S. (2009). Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovasc Diabetol, 8(35), 1-14.

The goal of this research group was to determine the effects of a paleolithic diet and a typical diabetic diet as "generally recommended" on risk factors for cardiovascular (or heart) disease. The study was done on patients with type 2 diabetes who were not on insulin. The different biomarkers that were measured were HA1C (hemoglobin A1C), which is basically an average of your blood sugars for the past 3 months, blood pressure, HDL cholesterol, and triglycerides. Body measurements were kept track of as well, such as weight, BMI, and waist circumference.

Participants were placed in two, random groups and were told that they were both going to receive a "healthy diet." Each group received guidelines for either the typical diabetic diet (whole grain carbohydrates, legumes, fruits, vegetables, and high fiber foods, with a decrease in fat), or the Paleo diet (defined as I did above).  The majority of the diabetic diet came from carbohydrates, while the majority of the Paleo diet came from proteins and fats, as well as carbohydrates from fruit and vegetable sources. After following their originally assigned diet for 3 months, the group switched diets and followed the alternate diet for the next 3 months.

The findings of this study may surprise some people! Results showed that the Paleo diet significantly resulted in lower HA1C, blood pressure, triglycerides, and waist circumference, and higher HDL (good cholesterol), compared to the typical, recommended diabetic diet. The Paleo diet was also naturally lower in calories, even though no guidance was given to the participants on the amount of food they should be eating. They were just told what kinds of foods they should be eating (quality) and were allowed to regulate themselves. The Paleo diet also increased insulin sensitivity, which means that the insulin was able to work more efficiently in the body, clear the blood sugars effectively, and prevent high blood sugar levels.

What got me the most excited about this study is that the HDL (protective) cholesterol and triglyceride values both improved! HDL increased while triglycerides decreased, which is a markedly improved cardiac outcome. This is huge because many opponents to the Paleo diet claim that the diet is too high in proteins and fats (both from animal sources and nuts/oils). However, this demonstrates that eating these foods does not necessarily cause us to build up cholesterol and triglycerides in our bodies. From my own personal experience, since adopting a mostly Paleo lifestyle, my cholesterol has dropped from 185-113! And I was eating at least 2 whole eggs a day, as well as meats.

Additionally, the study found that the Paleo diet led to decreases in waist circumference, proving that the Paleo diet is not going to pose a health risk on those choosing to follow this eating plan. Cardiovascular markers significantly improved, decreasing people's risk of developing heart disease. Participant's waists actually got smaller, and who doesn't want that? The fact that the diet was also self-regulated and those on Paleo naturally ate less also shows that the Paleo diet, with its combination of protein, vegetables, fruits, and healthy fats, is more filling than the typical recommended diabetic diet. I think all of these findings provide ample evidence that adopting a Paleo diet may be a beneficial decision for many people. It isn't just about the quantity of foods we are eating, which I will get into more in one of my upcoming book review posts. The quality of our food matters, and when we are eating high quality, whole, unprocessed foods, our bodies will thank us and start functioning the way they were intended to function!

I hope this post provided some information on the Paleo diet and the possible benefits of following this lifestyle. There is a plethora of information on this internet of ours to help guide you. Again, the best way to find out what lifestyle works for you is to try it and see! It is important to follow a plan that is beneficial, but is also doable and realistic for you. I am also planning on writing a few book review posts in the next few weeks highlighting some books that also support the idea of eating wholesome unprocessed foods for better health!

Have a great night everyone! This girl's gotta pack her lunch for work tomorrow! :)

Article Review: Nuts about nuts!

It’s time for my second article review post! I have realized this past week just how big of a nerd I am. Since we are going on our 2-week cruise to Hawaii in just 3 short days, I have been downloading a ton of reading material onto my iPad. This reading material consists of journal articles, clinical trials, and meta-analysis studies all pertaining to nutrition. In addition to this, I also had the idea of writing mini-essays on the cruise about the articles I read, what I am learning, and what new things I obtain from reading these articles. I am giving myself homework while on VACATION!!! Either a.) I am a complete nerd, or b.) I definitely have gone into the right field since I am genuinely excited about learning new things every day! I think it is a little bit of both a and b! Today’s article will focus on nuts and their health benefits! The article I chose is entitled: “Prospective study of nut consumption, long-term weight change, and obesity risk in women.” Here is the citation, because I am a good little student!

Bes-Rastrollo, M., Wedick, N. M., Martinez-Gonzalez, M. A., Li, T. Y., Sampson, L., & Hu, F. B. (2009). Prospective study of nut consumption, long-term weight change, and obesity risk in women. The American journal of clinical nutrition, 89(6), 1913-1919.

Nuts have been included in both dietary recommendations and dietary restrictions throughout the years. Because of their high fat content, nuts have been banished from many a weight-loss program. However, the benefits of nuts have been coming to light, which is making many people turn to nuts as snacks, toppings for salads, and even to bake with (almond flour, cashew flour, etc.). The authors of this article focused on measuring the association between long-term nut consumption and changes in weight in women. The women chosen for this study were ages 20-45 years, and had no cardiovascular disease, diabetes, or cancer. Nut consumption was measured over a period of 8 years, since authors were looking at long-term nut consumption.

The researchers measured these women’s nut consumption by using a food-frequency questionnaire (or FFQ), which measures how often you eat certain foods over a period of time. Nut butters, as well as tree nuts, and peanuts (which are botanically legumes, but share nutritional properties with nuts) were included in this questionnaire. Data on changes in body weight in these women were also collected over the years.

Results showed that over the course of the 8-year study, average weight gain was about 5 +/- 7 kg among the participants of the study (or 11 +/- 15 lbs). The women who consumed more nuts were older, had a higher average caloric intake, and were more physically active than those who did not consume nuts at all. However, interestingly enough, these women who consumed more nuts were actually leaner and gained weight at a slower rate compared to those who rarely consumed nuts. The researchers found no association between high nut consumption and increased rate of weight gain throughout the years, which means eating more nuts does not equal gaining more weight. The average daily consumption of the women who experienced the benefits of eating nuts was about 1-2 oz/day, which is the equivalent of about 1/4-1/2 cup of nuts. However, a key point the authors emphasized is that the women that consumed more nuts had a healthier and more active lifestyle overall. They also stated that the replacement of other foods is key. If we are to increase our nut consumption, the calories from the nuts must take the place of other foods that we are eating. The authors concluded that regular nut consumption could be a vital component in an overall healthy lifestyle.

Personal reflections:

I really enjoyed reading this article because I found that it greatly supported my experience with snacking and nuts. In my high school and early college years, I was a very big “100-calorie pack” snacker. I loved crackers, Oreos, gold fish, and other kinds of highly refined and processed carbohydrate snacks. However, the fact that they were in 100-calorie packs made me feel better about my choices because these snacks controlled my portions. What I did not like about these snacks was that they made me feel hungry about an hour later! After starting more of my nutrition classes and learning more about the feeling of fullness fats provide and the health benefits of nuts, I started consuming more nuts on a regular basis. I felt fuller for a longer period of time, had more energy, and even experienced other benefits such as stronger hair and nails. About a year ago, I started eating less grains and more healthy fats, incorporating nuts into my diet every day, as well as other healthy fats such as olive oil and avocados. However, I also replaced these foods with my usual crackers, popcorn, breads, and pastas. I have found that even though my caloric intake is slightly higher now while eating a higher fat diet (1g of fat provides 9 calories vs. 1g of protein and carbohydrates, which only provides 4 calories), I have found myself to be more satisfied with my meals, feel fuller for a longer period of time, and lose weight in a much easier, less deprived manner.

Now don’t get me wrong, I do not eat low carb, I just have a lower grain consumption than I used to have. I still have bananas, sweet potatoes, and rice because we need carbohydrates for fuel, and they taste amazing! I am just not as scared of higher-fat food choices anymore. I realize that my body needs these foods as much as it needs carbohydrates and protein. I am also a “happier” person when I include these fats into my diet! I have more energy and am in a better mood than when I am feeling weak, lightheaded, and hungry! Overall, I have realized that incorporating high fat foods into my diet, and replacing my usual refined carbohydrate food choices with these healthy fats has had a tremendously positive impact on my health! I have lost weight, have more energy, and don’t have a fear of getting hungry an hour after eating!

However, I do believe that portion size is an important factor to consider here. 1-2 oz of nuts a day (or 1/4-1/2 cup of nuts) is the proper portion for this food, providing 200-400 calories. This is a hefty number to just add on to your typical diet already, which is why the replacement factor is key to having success with this type of lifestyle! Instead of having a sandwich with two slices of bread, how about ditching the bread, making the meal into a salad or a lettuce-wrapped sandwich, and then adding ½ an avocado or a small handful of nuts to your meal? These small choices will help us incorporate more healthy fats into our diet, while losing weight and having more energy. In conclusion, I firmly agree with the findings of this article and believe we need to include more nuts, as well as other healthy fats (olive oils, avocados, etc.) into our daily diets!

Article Review: To yolk, or not to yolk?

I’ve decided to start something new on my little blog here. I’m going to start an article review section and summarize some scholarly articles or scientific journal articles I read. I have always been interested in keeping up with my nutrition knowledge long into my career. I officially passed my boards and became a registered dietitian (RD) a week ago (yay)! I know that keeping up with the newest findings and having scientific knowledge and data to back up recommendations is one of the most important aspects of this field! So, this is my first article review for my blog. It won’t be anything fancy, but it will help me: a.)   Stay up to date with current nutrition findings and studies

b.)  Keep my writing skills up to par, and…

c.)   Summarize articles that may seem daunting and complicated at first in order to make them easy to understand for all my readers!

I will include some personal background, opinions, and information into my reviews. I hope you all enjoy this new section!

The first article I have chosen is entitled “Dietary Cholesterol and egg yolks: Not for patients at risk of vascular disease ” by Spender, Jenkins, and Davignon. Here is my citation before I forget!

"Spence, J. D., Jenkins, D. J., & Davignon, J. (2010). Dietary cholesterol and egg yolks: not for patients at risk of vascular disease. Canadian Journal of Cardiology, 26(9), e336-e339."

To yolk, or not to yolk? That is a question I get almost every time I speak to someone about nutrition and food choices. It is a topic that is always up for debate. It seems that for every article I find that supports the consumption of egg yolks, I find one that discourages the consumption of egg yolks. What is one to do? Nutrition is such a complicated field because there are always studies contradicting each other. Every body is different and reacts to food choices differently. Therefore, you have to find what works for you! I’ll try to summarize this article as clearly as possible, while hoping to equip you all with the knowledge you need to make the choices and changes that work well for you!

High cholesterol levels have long been thought to be associated with actual dietary cholesterol intake from our food. However, there have been studies in the past few years supporting the belief that actual cholesterol in the diet does not contribute to blood cholesterol levels, and therefore does not add any risk of cardiovascular disease.

The authors of the article for this review focused on whether or not egg yolks are suitable food choices for people already at risk of vascular disease. Vascular disease is a form of cardiovascular (heart and blood vessels) disease that affects the actual blood vessels in the arteries. The authors claim that the previous studies done proving that the dietary cholesterol found in egg yolks, red meat, and cheese does not harm individuals was done on subjects that were already healthy, young, and on a weight loss and diet plan. The story seems to be a little different for those who are already at risk of cardiovascular disease, are sedentary, and are not losing weight, which unfortunately includes the majority of the population.

The guidelines originally promoted by the National Cholesterol Education Program recommended a low fat diet, which has now been proven to not be very effective in overall weight loss or the improvement of blood cholesterol levels. While nutrition experts are now recommending healthier, low cholesterol fats to be part of the everyday diet (nuts, olive oil, avocado, etc), the authors believe that those at risk of cardiovascular disease should still avoid foods high in cholesterol. “At risk” can be defined as those who already have high cholesterol levels or have familial hypercholesterolemia (those genetically predisposed to having high cholesterol levels).

The authors refer to studies showing that as much as 12% of dietary cholesterol is in the oxidized form. Oxidized cholesterol, and especially LDL oxidation, puts people at risk for plaque formation in the arteries, leading to the thickening of arteries, which can be very dangerous for cardiovascular health. Another interesting point the authors make is that, in the previous studies proving that the cholesterol in egg yolks was harmless to healthy individuals, those who consumed egg yolks regularly actually became diabetic during the study. And this was only from the consumption of one egg yolk per day! This blew me away. You may wonder what cholesterol has to do with diabetes, but it actually has a lot to do with diabetes! High cholesterol, high triglycerides, high blood glucose, an increased weight circumference, and high blood pressure all are components of what is called “metabolic syndrome.” Having three of any of the above symptoms puts people at an increased risk of cardiovascular disease, diabetes, and obesity. At the end of the article, the authors conclude that egg yolk consumption should not be encouraged for those who are inactive and are already at an increased risk of cardiovascular disease.

Personal reflections:

My history with egg consumption has been an "up and down” kind of experience. I was very much against the consumption of egg yolks a few years ago and only ate egg whites. I saw egg yolks as little cholesterol bombs that would basically cause me to have a heart attack. After reading more about how dietary cholesterol levels are actually more related to refined carbohydrate intake rather than cholesterol intake, I started incorporating more egg yolks into my diet. My blood cholesterol levels went from 183 mg/dL of total cholesterol (as a vegetarian) to 115mg/dL (as a definite meat and egg eater). I was amazed! However, I realized that at the time I raised my egg yolk consumption, I also dramatically decreased my refined carbohydrate and grain intake. I was only receiving carbohydrates from fruits and vegetables, and had cut out all grains and legumes (which are basically a carbohydrate considering their high starch content). I think this is an important factor to consider. Most people cannot simply just add egg yolks to their already poor, refined carbohydrate-rich diet and expect to see their cholesterol levels drop. Considering my experience with egg yolks, I started to eat them regularly, almost 2-3 whole eggs a day. I usually mixed in some liquid egg whites to my omelets as well for added fluffiness and protein. So you can imagine my surprise when I read this article last week! I was left so confused about what to do with these pesky little yolks and how to make recommendations to my clients.

I realized that, while the articles promoting egg yolks focused on healthy individuals, this article focused on those who are already sick or at risk of cardiovascular disease. I think this is a very crucial point to address. The target population that these scientific research studies are focusing on is the key to knowing how to apply their various, and often contradictory findings. Keeping all of this in mind, I concluded the following:

In my experience, I have found that eating egg yolks has provided me with more energy, better hair and skin, has kept me feeling full for longer than a typical high carbohydrate breakfast, and has actually lowered my cholesterol levels. However, I also have a family history of cholesterol (even though I have been blessed with low numbers thus far, and very high HDL levels!) and do not want to put myself at any more risk for heart disease or cholesterol problems later on in life. I have decided to take a "middle of the road" approach to egg yolk consumption. No, I will not cut out egg yolks from my diet. But I probably won’t be consuming 2-3 whole eggs a day. I will aim to consume one whole egg, with a max of two a day, with an increased amount of egg whites whisked in. I will also be watching my carbohydrate intake, as I have reintroduced some grains into my diet, and know full well that these can contribute to high cholesterol levels as well. I think it is very important to experiment and find out what works for YOU. I recommend starting out with a blood test with your doctor to determine what your cholesterol levels are and if you are at risk for cardiovascular disease. Above all, I believe that a HIGH fruit and vegetable intake can clear up so much of our food confusion!! Filling our plates with fruits and vegetables regularly leaves us full and limits other unhealthy choices from filling up our plates, such as refined carbohydrates, junk foods, and, for some, high cholesterol meats and eggs! Half of our plates, or even more in my opinion, should be filled with these colorful fruits and vegetables!

Overall, the takeaway from this article is that those at risk for cardiovascular diseases should watch their egg yolk consumption, since it has been linked to various cardiovascular issues, as well as diabetes. If you are a healthy, active individual who is at a normal weight, I don’t see why egg yolks should be eliminated from your diet. I recommend consulting with your doctor, getting your blood cholesterol levels checked, and always staying in tune with your body and aware of your food intake. AND EAT THE RAINBOW! :)

That is all for now and I hope you all enjoyed this article review!