Around this time of year, people start making their new year resolutions. Many of us will decide that this year we will finally go on that diet and keep the pounds off.
Here they are, in no particular order.
1. Sardines. Much cheaper than salmon. Additionally, due to their small size and diet consisting of plankton, sardines do not accumulate heavy metals in their bodies like the big fish do. There is also no fear of stock depletion any time soon. Sardines are a nutrition powerhouse: rich in omega-3 fatty acids, high in vitamin D and B12, and a great source of protein. Bonus: lots of calcium from their edible bones. The one caveat – high sodium content. So watch out.
2. Nuts (instead of salted nut mixes). Buy them in the bulk section. unsalted. mix them up. Place in a ziplock bag and keep in your backpack, purse, office drawer, glove compartment, and anywhere you may get the munchies.
3. Granola. It takes no more than 5 minutes preparation and 60 minutes in the oven to make your own batch. You’ll never go back to store brought. Promise.
4. Legumes. If you’re looking for a more plant based diet, legumes are an important source of protein. Whether beans, lentils, or peas, there are endless recipes and serving variations.
5. Hummus Dip (instead of mayo). It’s a healthy dip because it is full of heart healthy fats, high in protein and very satisfying. The beans also contain nice amounts of fiber. But it can also be a healthy spread to use instead of mayonaise. By the way, hummus is a type of legume.
6. Berries. Fresh or frozen, berries are rich in antioxidants, sweet and tasty.
7. Plain yogurt (instead of flavored). Yogurt has become all the rage in diet circles, and Greek Yogurt even more so recently. If you’ve moved up to yogurt, take the next step and buy it plain. You’ll save yourself half the amount of sugar. Additionally, you’ll avoid all sorts of unnecessary ingredients used to suspend and preserve the fruit inside the yogurt. Most importantly is to try to increase yogurt with live cultures. Your body needs to have a healthy amount of ''good'' bacteria in the digestive tract, and many yogurts are made using active, good bacteria. One of the words you’ll be hearing more of in relation to yogurt is ''probiotics.'' Probiotic, which literally means ''for life,'' refers to living organisms that can result in a health benefit when eaten in adequate amounts. the benefits associated with probiotics are specific to certain strains of these "good" bacteria. Many provide their benefits by adjusting the microflora (the natural balance of organisms) in the intestines, or by acting directly on body functions, such as digestion or immune function. (Keep in mind that the only yogurts that contain probiotics are those that say "live and active cultures" on the label.)
8. Unsweetened tea. Americans are drinking too much sweet. Even if you’re off the soda bandwagon, iced tea can contain just as much sugar.
9. Flavored Water: For some people, water gets too boring. You can add a slice of lemon, or cucumber, or lemongrass, or other herbs, and instantly you’ve upgraded your drink. Too lazy to do this on your own? Companies offer a wide variety of flavored waters with 0 added sugar.
10. Fruit: Pass the fruit juice in the grocery aisle and go directly to the fruit, preferrably the fruit in the produce section. Americans drink far too much juice. The cons are that it is calorie dense, no fiber content, and states in your mouth for a such short time. Actually eating the fruit, the chewing and allowing the flavors to actually absorb into the taste buds of mouth is far more satisfying that quickly swishing fruit juice around in your mouth and swallowing it. The actual fruit is fiber rich. Fiber has been shown to be beneficial to your health in so many ways.
11. Olive Oil: Full of monounsaturated fats, olive oil lowers bad LDL cholesterol and reduces your risk of developing heart disease.
12. Flaxseed Full of fiber and omega-3 and omega-6 fatty acids: a little sprinkling of flaxseed can go a long way for your heart. Top a bowl of oatmeal or whole-grain cereal with a smidgen of ground flaxseed for the ultimate heart-healthy breakfast.
13. Soy: Soy may lower cholesterol, and since it is low in saturated fat, it's still a great source of lean protein in a heart-healthy diet. Look for natural sources of soy, like edamame, tempeh, or organic silken tofu. And soy milk is a great addition to a bowl of oatmeal or whole-grain cereal. But watch the amount of salt in your soy: Some processed varieties like soy dogs can contain added sodium, which boosts blood pressure.
ref: www.fooducate.com
http://well.blogs.nytimes.com/2008/06/30/the-11-best-foods-you-arent-eating/
http://articles.cnn.com/2009-03-23/health/best.foods.for.your.heart_1_monounsaturated-fats-heart-health-olive-oil?_s=PM:HEALTH
Saturday, December 31, 2011
Monday, January 3, 2011
What is a Registered Dietitian?
Registered Dietitians are your most credible source of nutrition information. A registered dietitian (RD) is a food and nutrition expert who has met academic and professional requirements including:
What can a Registered Dietitian do for you?
A Registered Dietitian is a food and nutrition expert who has met the minimum academic and professional requirements to qualify for the credential “RD.”
A Registered Dietitian:
A Dietetic Technician, Registered is a food and nutrition practitioner, often working in conjunction with a Registered Dietitian, who has met the minimum academic and professional requirements to qualify for the credential “DTR.” In addition to DTR credentialing, some states have regulatory laws for Dietetic Technicians, Registered.
Dietetic Technicians, Registered must meet the following criteria to earn the “DTR” credential:
A registered dietitian is a healthcare professional who has completed a nutrition-related degree (minimum of a bachelor's degree) which includes a rigorous course of study in the scientific areas of biochemistry, human anatomy and physiology classes. A Registered Dietitian (R.D.) requires a minimum of a 4-year degree in a nutritional dietetic program, which is heavily concentrated in the sciences of metabolism, physiology, biology, chemistry, and clinical implications. They also must complete an internship (just like a medical doctor), or go through an approved coordinated undergraduate program that combines supervised practice and the last two years of college. Then all dietitians must pass a national board examination before they can receive the credentials R.D. (registered dietitian).
By the time an individual receives their RD credential, they have specialized knowledge in the area of nutrition. Registered dietitians also must complete continuing education courses regularly in order to keep their registration current.
A registered dietitian is a healthcare professional who applies principles of food and nutrition to health. A registered dietitian can practice in a variety of settings.
Many people refer to themselves as a nutritionist. The term nutritionist can be misleading. A nutritionist does not have to meet all of the rigorous requirements a registered dietitian needs to. A nutritionist is not required to complete a degree, a supervised experience, a national board examination, or continuing education courses. Nutritionists have much less fewer training requirements and responsibilities than an R.D., as stated previously; anyone can use the title Nutritionist. Because unqualified individuals can use this title, many states require all those offering clinical nutrition advice, be licensed within their state of practice.
Let's review:
sources:
http://www.eatright.org
http://www.eatrightma.org/content4085
http://www.utsouthwestern.edu/utsw/cda/dept27717/files/354575.html
- Bachelor Degree with course work approved by the American Dietetic Association’s Commission on Accreditation for Dietetics Education. Coursework typically includes food and nutrition sciences, food service systems management, business, economics, computer science, sociology, biochemistry, physiology, microbiology and chemistry.
- Complete an accredited, supervised, experiential practice program at a health-care facility, community agency or food service corporation.
- Pass a national examination administered by the Commission on Dietetic Registration.
- Complete continuing professional educational requirements to maintain registration.
What can a Registered Dietitian do for you?
A Registered Dietitian is a food and nutrition expert who has met the minimum academic and professional requirements to qualify for the credential “RD.”
A Registered Dietitian:
- Provides reliable, objective information
- Separates facts from fads
- Translates the latest scientific findings into information that is easy to understand and use
A Dietetic Technician, Registered is a food and nutrition practitioner, often working in conjunction with a Registered Dietitian, who has met the minimum academic and professional requirements to qualify for the credential “DTR.” In addition to DTR credentialing, some states have regulatory laws for Dietetic Technicians, Registered.
Dietetic Technicians, Registered must meet the following criteria to earn the “DTR” credential:
- Complete at least a two-year associate’s degree at a U.S. regionally accredited university or college and course work approved by the Commission on Accreditation for Dietetics Education of the American Dietetic Association, which must include 450 hours of supervised practice experience in various community programs, health care and food service facilities
- Pass a national examination administered by the Commission on Dietetic Registration
- Complete continuing professional educational requirements to maintain registration
What is the difference between a registered dietitian and a nutritionist?
A registered dietitian is a healthcare professional who has completed a nutrition-related degree (minimum of a bachelor's degree) which includes a rigorous course of study in the scientific areas of biochemistry, human anatomy and physiology classes. A Registered Dietitian (R.D.) requires a minimum of a 4-year degree in a nutritional dietetic program, which is heavily concentrated in the sciences of metabolism, physiology, biology, chemistry, and clinical implications. They also must complete an internship (just like a medical doctor), or go through an approved coordinated undergraduate program that combines supervised practice and the last two years of college. Then all dietitians must pass a national board examination before they can receive the credentials R.D. (registered dietitian).
By the time an individual receives their RD credential, they have specialized knowledge in the area of nutrition. Registered dietitians also must complete continuing education courses regularly in order to keep their registration current.
A registered dietitian is a healthcare professional who applies principles of food and nutrition to health. A registered dietitian can practice in a variety of settings.
- Management dietitians work in healthcare institutions, schools, cafeterias and restaurants.
- Clinical dietitians are a vital part of the medical team in hospitals, nursing homes, health maintenance organizations, and other healthcare facilities.
- Community dietitians work in public and home health agencies, daycare centers, health and recreations clubs, and in government-funded programs.
- Educator dietitians work in colleges, universities and medical centers.
- Research dietitians work in government agencies, food and pharmaceutical companies, and in major universities and medical centers.
- Consultant dietitians work under contract with a healthcare facility or in their own private practice.
- Business dietitians work in product development, sales, marketing, advertising, public relations and purchasing in food and nutrition related industries.
Many people refer to themselves as a nutritionist. The term nutritionist can be misleading. A nutritionist does not have to meet all of the rigorous requirements a registered dietitian needs to. A nutritionist is not required to complete a degree, a supervised experience, a national board examination, or continuing education courses. Nutritionists have much less fewer training requirements and responsibilities than an R.D., as stated previously; anyone can use the title Nutritionist. Because unqualified individuals can use this title, many states require all those offering clinical nutrition advice, be licensed within their state of practice.
Let's review:
Registered Dietitians and Nutrition Supplements
Registered Dietitians have only recently started recomending nutrition supplements. The American Dietetic Association has established professional guidelines for Registered Dietitians regarding nutrition supplements. These guidelines can be found here: Guidelines Regarding the Recommendation and Sale of Dietary Supplements with the full text here: Full Text: Guidelines Regarding the Recommendation and Sale of Dietary Supplements. Typically, the Registered Dietitian does NOT sell nutrition supplements. With The American Dietetic Association having strict practice guidelines in place regarding nutrition supplements, the Registered Dietitian must adhere to these guidelines for professional credibility.
sources:
http://www.eatright.org
http://www.eatrightma.org/content4085
http://www.utsouthwestern.edu/utsw/cda/dept27717/files/354575.html
Tuesday, December 28, 2010
Olive Oil - Liquid Gold
Olive oil is technically a fruit juice rather than an oil. The olives are pressed to release their juices just like an orange or a lemon be pressed. Spain is the world's largest overall producer of olive oil. Italy is second. Greece is the world's largest producer of extra-virgin olive oil. Italy and Spain come in second and third in the extra-virgin race. Greece consumes the most olive oil per capita. Spain, Italy, Tunisia, and Portugal also top the per-capita consumption list. Italy exports more olive oil to the United States than to anywhere else.
It is also more expensive to manufacture compared to canola and soy oils. Like wine, complex flavors abound, depending on the growing region, olive type, and extraction methods. Indeed in some parts of the world, olive oil has a cult like following.
Despite its characteristic greenish tinge and taste, many people are conned into buying adulterated products – olive oil mixed with canola or soy. And even when buying 100% olive oil, the price variations and various claims on the bottles are very confusing to the average consumer.
Marketers want you to buy their olive oil and therefore you’ll see – pure, extra filtered, cold pressed, natural, extra virgin, and the likes. To make things easier for us, starting in October, the USDA now requires importers to abide by strict labeling guidelines[PDF]
The virgin designation means that the olives were cold pressed, and no chemicals were used to extract the oil.
Cold pressing means that no heating was involved in the oil extraction, and more of the original flavor and nutrients are available.
Despite this, from a nutrition perspective, as long as they are 100% olive oil, there is not much difference among the different brands and markings.
sources:
25 facts about Olive Oil
Olive Oil Source
Fooducate
Sunday, November 21, 2010
Metabolic Syndrome – Medical Nutritional Therapy Goals
I recently got this article published "Connections" Volume 35, Issue 2, Fall 2010, Dietetics in Health Care Communities- A dietetic practice group of the American Dietetic Association. I thought I would share it here.
Metabolic Syndrome, a constellation of metabolic risk factors for type 2 diabetes and cardiovascular disease, is one of the fastest growing disease entities in the world. With this being evident, it may be surprising to some that even as early as the late 1930s research and experiments produced the first evidence of this disease (1). It wasn’t until the late 1970s the actual term of Metabolic Syndrome became commonly used in medical terminology. Metabolic Syndrome is also known as Metabolic Syndrome X, Syndrome X, Insulin Resistance Syndrome, Reaven's Syndrome (named for Gerald Reaven), and CHAOS (in Australia) (2). Due to the epidemic of obesity, Metabolic Syndrome has become more prevalent and closely associated with obesity related co-morbidities within the last decade.
Metabolic Syndrome has concurrent grouping of low levels of high-density lipoprotein cholesterol, hyperglycemia, high waist circumference, hypertension, and elevated triglycerides, which is associated with cardiovascular disease often leading to Type 2 diabetes mellitus (3,4). Although it is synonymous with the “insulin resistance syndrome,” not all patients with the Metabolic Syndrome will have insulin resistance (5).
In 2001, the National Cholesterol Education Program (NCEP) developed operational criteria to make a diagnosis of the Metabolic Syndrome based on clinical grounds and commonly used laboratory tests that are frequently carried out in an office practice (6). The importance of the Metabolic Syndrome was further highlighted in 2001 with the approval of an ICD-9 code (277.7) for the Metabolic Syndrome by the National Center for Health Statistics (7). Individuals with at least three of the five criteria listed in Table 1 are identified as having Metabolic Syndrome and are at greater risk for cardiovascular disease (4,8). The five criteria listed in Table 1 appear to have been selected due to their tendency to cluster together and have been long associated with cardiovascular disease (CVD) risk. The fallacy in choosing the numeric upper limits for each criterion is less clear and not derived from outcome data (3). For this reason individual upper limits of each criteria is not the aim of the diagnostic evaluation, but rather the aim is to evaluate the relationship of each criteria and the relationship with insulin resistance and the role of increasing the CVD risk.
Impaired Fasting Glucose (IFG) Concentration (also known as FPG or Fasting Plasma Glucose), defined by The American Diabetes Association as 110 to 126 mg/dL (9) and that these individuals are considered prediabetic. Evidence does suggest that the higher the IFG concentration the more likely an individual is to develop Type 2 Diabetes Mellitus. It should be noted that the 2003 American Diabetic Association Expert Committee report reduced the lower IFG/FPG cut off point from 110 mg/dl to 100 mg/dl, in part to make the prevalence of IFG more similar to that of the Impaired Glucose Tolerance (IGT). However, the World Health Organization (WHO) and many other diabetes organizations did not adopt this change. Further clarification is needed to determine if the individual with an elevated IFG provides a particularly effective method to identify the presence of insulin resistance or predictor of CVD risk (1).
The correlation between insulin resistance and essential hypertension and CVD risk is complicated. The relationship between insulin resistance/hyperinsulinemia and blood pressure does seem to indicate that essential hypertensive individuals are insulin resistant and hyperinsulinemic. Further the normtensive first-degree patients with essential hypertension are relatively insulin resistant and hyperinsulinemic in comparison with a matched control group without family history of hypertension. Finally the hyperinsulinemic individual, as a surrogate estimate of insulin resistance, has been shown in studies to predict the future development of essential hypertension. Additionally, other factors of the relationship between blood pressure and the CVD risk individual include electocardiographic evidence of ischemic changes due to these individuals demonstrating glucose intolerance and hyperinsulinemia when compared to individuals whose electrocardiograms are normal (1).
Components of dyslipidemia in the Metabolic Syndrome are the aspects associated most closely with insulin resistance and CVD risk. Low High-Density Lipoprotein (HDL)-C concentration as a predictor of CVD risk has been known for many years. The role of an increase in Triglyceride (TG) concentrations as an individual CVD risk factor certainly exists in the presumption as a component of Metabolic Syndrome. Hypertriglyceridemia is a central aspect of dyslipidemia in of itself associated with insulin resistance/hyperinsulinemia. This presents as another example of the importance in the diagnostic criteria for Metabolic Syndrome (1).
IFG and IGT should not be viewed as clinical entities as diagnostic indicators, rather risk factors for Diabetes Mellitus as well as CVD. IFG and GT are associated with obesity (especially abdominal and visceral obesity), dyslipidemia with high triglycerides and/low HDL cholesterol, and hypertension. Goals must be tailored to each individual while not losing sight of the overall outcome to increase mortality and decrease the co-morbidities associated with Metabolic Syndrome. These goals must encompass a lifestyle change, as well medical nutritional therapy interventions and pharmacological strategies of medications. Structure lifestyle interventions, aimed at increasing physical activity and producing 5-10% loss of body weight, and certain pharmacological agents have been demonstrated to prevent or delay the development of diabetes in people with IGT. Interventions addressed in Table 2 should be the reference guide for dietetic professionals in the medical nutritional therapy management of the Metabolic Syndrome individual. It is imperative that dietetic professionals, working as a key member of the healthcare team, be aware of the intervention objectives in working with the Metabolic Syndrome individual.
Source: extrapolated from Escott-Stump, S. Nutrition and Diagnosis – Related Car. 6th ed. Baltimore, MD: Lippincott Williams & Walters; 2008 (3)
References:
1) Shils, M.E., Shike, M., Ross A.C., Caballero B., and Cousins R.J. Modern Nutrition in Health and Disease, 10th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2006:1004-1012.
2) Saradis PA, Nisson PM. The metabolic syndrome: a glance at its history. .J Hypertens. 2006 Apr; 24(4):621-6 http://www.ncbi.nlm.nih.gov/pubmed/16531786.
3) Escott-Stump, S. Nutrition and Diagnosis – Related Car. 6th ed. Baltimore, MD: Lippincott Williams & Wolters; 2008:496-499.
4) Niedert, KC, Dorner B. Nutrition Care of the Older Adult, 2nd ed. Chicago, IL: American Dietetic Association 2004:35-40.
5) Cheal KL, Abbasi F, Lamendola C, McLaughlin T, Reaven GM, Ford ES: Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome. Diabetes 53: 1195–1200, 2004.
6) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285: 2486–2497, 2001.
7) Reynolds K, Muntner P, Fonseca V: Metabolic Syndrome Underrated or under diagnosed? Diabetes Care: 10.2337/diacare.28.7.1831.
8) National Instituted of Health. Third Report for the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda MD: National Institutes of Health; 2001. NIH Publication 01-03670.
9) Expert Committee on the Diagnosis and classification of Diabetes Mellitus. Diabetes Care 2002:25 [Suppl 1]: 58-2-8.
Metabolic Syndrome – Medical Nutritional Therapy Goals
By Carol S. Casey, RD, CDN, LDN
Metabolic Syndrome, a constellation of metabolic risk factors for type 2 diabetes and cardiovascular disease, is one of the fastest growing disease entities in the world. With this being evident, it may be surprising to some that even as early as the late 1930s research and experiments produced the first evidence of this disease (1). It wasn’t until the late 1970s the actual term of Metabolic Syndrome became commonly used in medical terminology. Metabolic Syndrome is also known as Metabolic Syndrome X, Syndrome X, Insulin Resistance Syndrome, Reaven's Syndrome (named for Gerald Reaven), and CHAOS (in Australia) (2). Due to the epidemic of obesity, Metabolic Syndrome has become more prevalent and closely associated with obesity related co-morbidities within the last decade.
Metabolic Syndrome has concurrent grouping of low levels of high-density lipoprotein cholesterol, hyperglycemia, high waist circumference, hypertension, and elevated triglycerides, which is associated with cardiovascular disease often leading to Type 2 diabetes mellitus (3,4). Although it is synonymous with the “insulin resistance syndrome,” not all patients with the Metabolic Syndrome will have insulin resistance (5).
In 2001, the National Cholesterol Education Program (NCEP) developed operational criteria to make a diagnosis of the Metabolic Syndrome based on clinical grounds and commonly used laboratory tests that are frequently carried out in an office practice (6). The importance of the Metabolic Syndrome was further highlighted in 2001 with the approval of an ICD-9 code (277.7) for the Metabolic Syndrome by the National Center for Health Statistics (7). Individuals with at least three of the five criteria listed in Table 1 are identified as having Metabolic Syndrome and are at greater risk for cardiovascular disease (4,8). The five criteria listed in Table 1 appear to have been selected due to their tendency to cluster together and have been long associated with cardiovascular disease (CVD) risk. The fallacy in choosing the numeric upper limits for each criterion is less clear and not derived from outcome data (3). For this reason individual upper limits of each criteria is not the aim of the diagnostic evaluation, but rather the aim is to evaluate the relationship of each criteria and the relationship with insulin resistance and the role of increasing the CVD risk.
Source: Expert Panel on Detection, Evaluation and Treatment of High Blood cholesterol in Adults. Executive summary of the third report of the NCEP on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III); JAMA. 2001; 2486-2497. Complete report available at: http://www.nhilbi.nih.gov
.Waist Circumference is one method and often the easiest of obtain to determine excess adiposity. This criteria is not a consequence of insulin resistance, rather it is lifestyle variable. The combination of physical inactivity and elevated waist circumference has a direct negative effect on insulin-mediated glucose disposal. These two factors alone increase the possibilities of abnormalities and clinical syndromes associated with insulin resistance/compensatory hyperinsulinemia (1). Caveat is not all insulin-resistant individuals are overweight or obese as well as not all overweight or obese individuals are insulin resistant
Impaired Fasting Glucose (IFG) Concentration (also known as FPG or Fasting Plasma Glucose), defined by The American Diabetes Association as 110 to 126 mg/dL (9) and that these individuals are considered prediabetic. Evidence does suggest that the higher the IFG concentration the more likely an individual is to develop Type 2 Diabetes Mellitus. It should be noted that the 2003 American Diabetic Association Expert Committee report reduced the lower IFG/FPG cut off point from 110 mg/dl to 100 mg/dl, in part to make the prevalence of IFG more similar to that of the Impaired Glucose Tolerance (IGT). However, the World Health Organization (WHO) and many other diabetes organizations did not adopt this change. Further clarification is needed to determine if the individual with an elevated IFG provides a particularly effective method to identify the presence of insulin resistance or predictor of CVD risk (1).
The correlation between insulin resistance and essential hypertension and CVD risk is complicated. The relationship between insulin resistance/hyperinsulinemia and blood pressure does seem to indicate that essential hypertensive individuals are insulin resistant and hyperinsulinemic. Further the normtensive first-degree patients with essential hypertension are relatively insulin resistant and hyperinsulinemic in comparison with a matched control group without family history of hypertension. Finally the hyperinsulinemic individual, as a surrogate estimate of insulin resistance, has been shown in studies to predict the future development of essential hypertension. Additionally, other factors of the relationship between blood pressure and the CVD risk individual include electocardiographic evidence of ischemic changes due to these individuals demonstrating glucose intolerance and hyperinsulinemia when compared to individuals whose electrocardiograms are normal (1).
Components of dyslipidemia in the Metabolic Syndrome are the aspects associated most closely with insulin resistance and CVD risk. Low High-Density Lipoprotein (HDL)-C concentration as a predictor of CVD risk has been known for many years. The role of an increase in Triglyceride (TG) concentrations as an individual CVD risk factor certainly exists in the presumption as a component of Metabolic Syndrome. Hypertriglyceridemia is a central aspect of dyslipidemia in of itself associated with insulin resistance/hyperinsulinemia. This presents as another example of the importance in the diagnostic criteria for Metabolic Syndrome (1).
IFG and IGT should not be viewed as clinical entities as diagnostic indicators, rather risk factors for Diabetes Mellitus as well as CVD. IFG and GT are associated with obesity (especially abdominal and visceral obesity), dyslipidemia with high triglycerides and/low HDL cholesterol, and hypertension. Goals must be tailored to each individual while not losing sight of the overall outcome to increase mortality and decrease the co-morbidities associated with Metabolic Syndrome. These goals must encompass a lifestyle change, as well medical nutritional therapy interventions and pharmacological strategies of medications. Structure lifestyle interventions, aimed at increasing physical activity and producing 5-10% loss of body weight, and certain pharmacological agents have been demonstrated to prevent or delay the development of diabetes in people with IGT. Interventions addressed in Table 2 should be the reference guide for dietetic professionals in the medical nutritional therapy management of the Metabolic Syndrome individual. It is imperative that dietetic professionals, working as a key member of the healthcare team, be aware of the intervention objectives in working with the Metabolic Syndrome individual.
1) Shils, M.E., Shike, M., Ross A.C., Caballero B., and Cousins R.J. Modern Nutrition in Health and Disease, 10th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2006:1004-1012.
2) Saradis PA, Nisson PM. The metabolic syndrome: a glance at its history. .J Hypertens. 2006 Apr; 24(4):621-6 http://www.ncbi.nlm.nih.gov/pubmed/16531786.
3) Escott-Stump, S. Nutrition and Diagnosis – Related Car. 6th ed. Baltimore, MD: Lippincott Williams & Wolters; 2008:496-499.
4) Niedert, KC, Dorner B. Nutrition Care of the Older Adult, 2nd ed. Chicago, IL: American Dietetic Association 2004:35-40.
5) Cheal KL, Abbasi F, Lamendola C, McLaughlin T, Reaven GM, Ford ES: Relationship to insulin resistance of the adult treatment panel III diagnostic criteria for identification of the metabolic syndrome. Diabetes 53: 1195–1200, 2004.
6) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285: 2486–2497, 2001.
7) Reynolds K, Muntner P, Fonseca V: Metabolic Syndrome Underrated or under diagnosed? Diabetes Care: 10.2337/diacare.28.7.1831.
8) National Instituted of Health. Third Report for the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda MD: National Institutes of Health; 2001. NIH Publication 01-03670.
9) Expert Committee on the Diagnosis and classification of Diabetes Mellitus. Diabetes Care 2002:25 [Suppl 1]: 58-2-8.
Monday, September 13, 2010
Just WHAT is Stevia?
I am sure you have seen the television commercials for it, you know the one with the green leafs and proclaiming it is "all natural." So,m why don't you see stevia on supermarket shelves next to the Sweet’N Low or Equal? The is a GRAS List that is the jusdiction of the Food and Drug Adminstration. The GRAS List is a list of food additives that are 'GENERALLY RECOGNIZED AS SAFE' (GRAS). This means the food is considered safe by experts, and so is exempted from the usual Federal Food, Drug, and Cosmetic Act (FFDCA) food additive tolerance requirements, The substance must be shown to be "generally recognized" as safe under the conditions of its intended use.
The hasn’t approved stevia because they do not have enough data to conclude that the use of stevia would be safe in food. The U.S. isn’t alone. Canada doesn’t allow food companies to add stevia to their products. Nor does the European Union. In 1999 the scientific panel that reviews the safety of food ingredients for the EU concluded that stevioside is “not acceptable” as a sweetener because of unresolved concerns about its toxicity. In 1998, a United Nations expert panel came to essentially the same conclusion. Further verdicts about the use of stevia remain out or are inconclusive.
The herb of which stevia is dervived has been consumed without apparent harm in different parts of the world for many years, they argue. No reports of any adverse reactions have surfaced after 30 years of use in Japan, for instance. But the Japanese don’t consume large amounts of stevia.
In the U.S., we like to go to extremes. So a significant number of people here might consume much greater amounts. Stevioside seems to affect the male reproductive organ system,” European scientists concluded last year. When male rats were fed high doses of stevioside for 22 months, sperm production was reduced, the weight of seminal vesicles (which produce seminal fluid) declined, and there was an increase in cell proliferation in their testicles, which could cause infertility or other problems.1 And when female hamsters were fed large amounts of a derivative of stevioside called steviol, they had fewer and smaller offspring.2 Would small amounts of stevia also cause reproductive problems? No one knows. Do you want to risk it? Well I am not.
In the laboratory, steviol can be converted into a mutagenic compound, which may promote cancer by causing mutations in the cells’ genetic material (DNA). Hey, the same thing was said about Sweet-N-Low and Equal and Nutra-Sweet.
All of this means is that some issues still persists with stevia that must be clarified for the FDA before any approval can be considered.
sources:
J. Food Hyg. Soc. Japan 26: 169, 1985.
Drug Chem. Toxicol. 21: 207, 1998.
Wednesday, September 1, 2010
A Feather in My Cap
Received this message via email today. If you look on the last page of this PDF file (click on the link just below) and look in the box under "Reviewers" you will see my acknowledgement for my effort as a reviewer. ADA position Integration of MNT and Pharmacotherapy
"Hello Carol,
On behalf of the Association Positions Committee (APC), I would like to thank you and the MNPG DPG for all of the time and effort you put in assisting in the review of the ADA position Integration of MNT and Pharmacotherapy published in the June 2010 Journal of the American Dietetic Association. As experts in your area of practice, we realize that the practice group is frequently requested to share knowledge and expertise. We are especially grateful that you were willing to accept this additional responsibility for the Association and the dietetics practice group.
A thorough and careful review is critical to the position development process which results in an accurate, credible, and up-to-date position. For your information, if the comments you provided were not addressed in the published paper, the authors have provided a collective response (attached) to comments provided from all reviewers involved in the review process.
APC is proud of the final position and extend our congratulations and appreciation for your contribution to this position and the Association.
Sincerely
Donna L. Wickstrom, MS, RD
Manager, Governance"
I am elated...this is a real feather in my cap. I have been published elsewhere, but not in my own professional journal. Even through I was a reviewer to this position paper, I contributed and got mentioned.
"Hello Carol,
On behalf of the Association Positions Committee (APC), I would like to thank you and the MNPG DPG for all of the time and effort you put in assisting in the review of the ADA position Integration of MNT and Pharmacotherapy published in the June 2010 Journal of the American Dietetic Association. As experts in your area of practice, we realize that the practice group is frequently requested to share knowledge and expertise. We are especially grateful that you were willing to accept this additional responsibility for the Association and the dietetics practice group.
A thorough and careful review is critical to the position development process which results in an accurate, credible, and up-to-date position. For your information, if the comments you provided were not addressed in the published paper, the authors have provided a collective response (attached) to comments provided from all reviewers involved in the review process.
APC is proud of the final position and extend our congratulations and appreciation for your contribution to this position and the Association.
Sincerely
Donna L. Wickstrom, MS, RD
Manager, Governance"
I am elated...this is a real feather in my cap. I have been published elsewhere, but not in my own professional journal. Even through I was a reviewer to this position paper, I contributed and got mentioned.
Monday, August 30, 2010
The Soda (Soft) Drink Controversy
The Good Cop/Bad Cop Scenairo
The Good Cop: There are some 16 million less Americans are drinking sugary soft drinks now compared to 6 years ago (68% of adults vs 76%). This, from a report published by Mintel, a marketing research firm.
The Bad Cop: What are we drinking instead
1. 7.8 million switched to diet soft drinks.
2. 24 million added bottled water to their shopping carts. (the healthiest choice, but oh so many plastic bottles…)
3. 17 million more gulped down energy drinks. (the caffeine, the calories…)
4. 11 million additional future Olympians opted for sports drinks. (the broken dream of enhancement…)
The study also found that 16% of Americans are concerned about high-fructose corn syrup, while 15% are worried about artificial sweeteners in diet drinks.
At the same time, an academic research report affirms what dietitians have been telling us for quite some time: cutting calories from sugary drinks may be more effective for weight loss than reducing the same amount in solid foods.
What you need to know:
Soft drinks are a very lucrative market for the food industry. The raw materials are dirt cheap (water, sugar, food coloring), and the returns are very high.
The top 2 players in the US, The Coca Cola Company and PepsiCo, are well aware of shifting trends in consumer preferences and have plenty to continue to offer us from their quiver of brands picked up over years of consolidation.
What to do at the supermarket: Here’s a radical idea. Why not skip the beverage aisle next time you go shopping? Tap water in the US is clean, refreshing, and of negligible cost. In fact, a family of 4 will save over $500 in grocery bills by just quitting soft drinks.
source
Fdoducate
The Good Cop: There are some 16 million less Americans are drinking sugary soft drinks now compared to 6 years ago (68% of adults vs 76%). This, from a report published by Mintel, a marketing research firm.
The Bad Cop: What are we drinking instead
1. 7.8 million switched to diet soft drinks.
2. 24 million added bottled water to their shopping carts. (the healthiest choice, but oh so many plastic bottles…)
3. 17 million more gulped down energy drinks. (the caffeine, the calories…)
4. 11 million additional future Olympians opted for sports drinks. (the broken dream of enhancement…)
The study also found that 16% of Americans are concerned about high-fructose corn syrup, while 15% are worried about artificial sweeteners in diet drinks.
At the same time, an academic research report affirms what dietitians have been telling us for quite some time: cutting calories from sugary drinks may be more effective for weight loss than reducing the same amount in solid foods.
What you need to know:
Soft drinks are a very lucrative market for the food industry. The raw materials are dirt cheap (water, sugar, food coloring), and the returns are very high.
The top 2 players in the US, The Coca Cola Company and PepsiCo, are well aware of shifting trends in consumer preferences and have plenty to continue to offer us from their quiver of brands picked up over years of consolidation.
What to do at the supermarket: Here’s a radical idea. Why not skip the beverage aisle next time you go shopping? Tap water in the US is clean, refreshing, and of negligible cost. In fact, a family of 4 will save over $500 in grocery bills by just quitting soft drinks.
source
Fdoducate
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