Nutrition Science

3 Nutrition Truths for the New Yea

thewanderingrd1 Comment

Happy New Year! I know it’s late, but I decided to sit out the first Internet wave of new year nutrition advice. This was intentional, but then the SEVEN snow days with my three kids at home kicked me completely out of commission. (Although extending vaca wasn’t half bad…if I’m honest!)

So, although I am somewhat late, at this point I hope you are like me and still mulling over what/if anything to do differently now that it’s January. If so, these are my deep thoughts and words of encouragement to help you keep it real for 2018—with real food and real talk, as always! Because January is the peak of nutrition-related misinformation, in case you haven’t noticed.

But stick with me (if you want, subscribe to follow this blog via email, or follow @dvnorwood on Instagram or The Wandering RD on Facebook) and we’ll get through it together. Let’s start with three “nutrition truths” to help you wade through the media buzz and start your year off with steady, science-based steps in the right direction.

  1. Goals Are Still Resolutions (Do Set Goals)

So, new year. New you? Wrong. If you read the many wellness articles this year, most tell you not to set resolutions. Have you noticed lately the health and wellness conversation has shifted from always trying to improve yourself to accepting yourself?

I get the focus on self-love. I mean, I love you (ya know, as a neighbor) enough to want to help you figure this stuff out. So, surely, I want you to love yourself. But as with all things, a healthy balance is important. And to be our best, I believe we all can make small changes to our lives that would improve our health, wellness, relationships, productivity, etc. The important things in life are worth the effort—are they not?

Nothing explains what happens when we don’t put forth the effort as well as the scientific concept of “entropy,” which is the universe’s tendency for disorder (a.k.a. why our kids’ rooms get messier by the day.)

So, there’s absolutely nothing wrong with setting goals. And you can even call it a resolution, if you want. Because isn’t a goal still a resolution? “Resolutions” just have a bad rap because it’s human nature to want to change ourselves in grandiose ways and then drop the ball when it’s unachievable. So, if “resolutions” are a New Year thing, then maybe “goals” are better.

But the point is this: it’s never a bad idea to set realistic, small resolutions (a.k.a. goals) to improve yourself or your circumstances. Don’t let anyone make you feel bad about that. It doesn’t mean there’s anything wrong with the current you. It doesn’t necessarily mean your self-worth is in jeopardy. If anything, it means you are investing in yourself, and isn’t that something we do when we can see our own potential?

And further, there’s no reason anything has to start on January 1st. I don’t know about you, but I’m still mulling my goals over and yes, it’s almost February. It’s great if you want to ride the wave of motivated people in January, but it’s equally great if you decide you’re ready to start something in September. Goals have to be realistic and practical. It helps to have a plan in place to be able to achieve them. And most importantly, before you even try, you have to decide which goals will be meaningful or you will fail and not even care about it—don’t ask me how I know this…

So, wait till you are fully ready, but go ahead and start to wrap your brain around what it is that would help you become the you that you’ve always wanted to be!

I was reminded recently in this NYT article that sometimes, for many of us, the hardest part of doing anything is starting…(unless it’s finishing, then read the book, Finish: Give Yourself the Gift of Done. Ha! It’s a great quick read and I am not paid in any way to say this.)

  1. Diet is a Four-Letter Word (Do NOT Restrict Drastically)

About half of the population makes resolutions that involve losing weight and getting in shape. But have you heard? “Diet” is a “four-letter” word—literally, and figuratively. Yes, diet can be just a word that means “habitual nourishment,” but it has come to conjure up images of a very restrictive way of eating to lose weight. Research shows that’s bad because most people lose weight only to gain it back when they go “off” the diet, and often even more weight than they lost. So, bottom line: diets don’t improve your health if you gain back the weight (or more) and even decrease your metabolism in the process. And then there are the feelings of failure you’ll have to deal with, too.

So, if your goal is to restrict yourself so drastically that you can’t maintain it, then please, please, please change your goal to a more attainable, sustainable one. It’s okay to want to make changes to your diet, even to lose weight and/or improve other aspects of health, but consider smaller changes that you can incorporate to become lifelong habits.  That said—even a lower sugar, and/or lower carbohydrate diet can be maintained if you slowly make changes that become your new normal, which is especially helpful for preventing and managing obesity, prediabetes and diabetes.

  1. Mindfulness Isn’t Always Intuitive (Do Practice Mindfulness)

So, 1) set goals, 2) don’t drastically restrict—this begs the question: what’s a person to do?

Have you heard about Intuitive Eating? It’s often used in the same sentence as “mindfulness.” The principles promote a non-diet approach to eating, which involves ditching the scale, listening to hunger and fullness cues to determine food intake, and perhaps most importantly, finding other ways besides food to deal with emotions.

Let’s be clear, I am not at all against any of these things. But I do have a serious problem with the word “intuitive.”  If eating is supposed to be so intuitive, how are so many people doing it “wrong”? It appears to me that eating is not intuitive for a large part of the population, or there wouldn’t be a growing obesity and diabetes epidemic.

The problem may be this: it’s intuitive to eat what is available. Studies show people weigh more when presented with more variety and diversity of food options (think: buffets). And in America, we have a disproportionate amount of unhealthy foods available at our every turn.

Or the problem may be this: what if certain people with a genetic predisposition for overweight or obesity are biologically driven to overeat certain foods (such as refined carbohydrates and sugar)? It is far from conclusive, (and I talk about it in this comprehensive post about sugar) but there is a school of thought that refined carbohydrates and sugar could be addictive in some individuals. If it proves true, aren’t we judging and–even worse—alienating many people we are trying to help by telling them, or even trying to teach them, to simply “eat intuitively”?

I believe it’s not fair, accurate, or helpful to call eating “intuitive” in our food culture and that it does more harm than good.

Rant over!

That said, can one learn to eat mindfully? Absolutely.

 

 

 

 

 

 

 

However, it appears mindfulness may be harder for some people to learn and practice, perhaps due to one or more of the following:

  • our fast-paced culture,
  • our food supply,
  • differing genes,
  • and/or emotional issues (including eating disorders).

Some people can eat “everything in moderation” while others prefer to avoid certain foods because they can’t stop at a “reasonable” portion. It’s highly individual and we all know ourselves best, although sometimes need help and guidance teasing out all the factors that affect building healthy eating habits.

It should be noted it is impossible to talk about mindful eating without fully addressing the emotional aspects of eating, especially eating disorders, preferably with qualified therapists, psychologists and psychiatrists, in addition to RDs.

Nonetheless, mindfulness for most everyone involves learning to incorporate more real foods, and far fewer processed foods, especially those with refined carbohydrates. I like to say it is a practice, because it is important enough to do the hard work and there is no room for perfection or guilt–just keep at it the best you can.

And you can always count on me to try to make practicing mindfulness as simple as possible with an ever-growing list of easy, real food recipes.  Stay tuned for a post with specific tips on how to practice eating mindfully!

Sugar: What You Should Know

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Sugar is always making it into the news—and into products on grocery store shelves.  It, apparently like sex, sells. As a result, we are bombarded with conflicting and even controversial information about sugar every day. We love it, and at the same time, we hate it. One minute dietitians (RDs) are telling us “everything in moderation.”  How can we not love that–permission to eat what tastes good? The next minute, we hear how Americans should banish sugar from our lives forever.  And oh, how we hate that! Sugar is the ultimate love-hate relationship! What gives? Sugar tastes so good. How could it be so bad?

Well, let’s discuss all things sugar. In this post, I will do the following:

We Are Simply Eating Too Much Sugar
American women eat an average of 15 teaspoons of sugar each day, while men eat 21 teaspoons (it likely differs because men eat more, in general).1 Children eat an even higher percentage of added sugar than adults each day, and surprisingly, the majority of sugar is coming from store-bought foods eaten at home.2

These numbers are likely significantly lower than actual intakes, because they are estimates from 24 hr recalls, which are notoriously unreliable. Yet, even these numbers far surpass any current recommended limits (see chart), which I believe could even be falsely high due to sugar industry lobbyists influencing them. After all, a 20-ounce soda alone provides a day’s worth of sugar (about 15 teaspoons of sugar) according to all these current guidelines. I’d say soda companies have a vested interest in the science and policies of sugar, wouldn’t you?

Most concerning is the fact that people haven’t always eaten sugar in these proportions. In fact, for the great majority of human history, before sugar and flour became easily refined and cheap during the industrial revolution, we ate far less sugar and carbohydrate.  Americans have increased our sugar intake more than 40-fold since the American Revolution!6

Not everyone agrees on the cause, but all researchers agree that people grow fatter and sicker after adopting the “Western” diet and/or lifestyle. This has occurred in many populations around the globe, and it seems to happen within only two generations. Many argue that we grow fatter and sicker because of increased total calories, which have no doubt increased over time.

But even if refined sugar and flour aren’t specifically to blame  (although many experts, including me, would argue that they might be), it’s hard to argue that these excess calories are coming from anything other than refined sugar and flour. Yes, some increased calories are coming from the fat in our ice cream and other processed foods, but we probably wouldn’t be eating these foods if they didn’t have the added sugar.

Since the beginning of the low-fat diet craze that started in the early 1980’s, added sugar, and carbohydrate intake in general, has dramatically increased (food companies had to replace the fat with something) and so have many diseases.32  It appears that many chronic diseases such as obesity, diabetes, metabolic syndrome, heart disease, Alzheimer’s, and cancer are negatively associated with sugar intake.6-31

Soda often takes the brunt of the blame for added sugar intake because 1) Americans drink a lot of it, and 2) there are very few foods that are pure sugar like soda is, which makes it easier to identify and study than the various types of sugar in other mixed-nutrient foods. 6-31   I’m not a soda fan, but soda does not appear to be any worse than any other source of added sugar. The problem is it all adds up.

Sometimes certain sugars are described as “better” than others. Particularly, there has been a lot of misguided focus on high fructose corn syrup (HFCS) as the “worst” added sugar, and honey, agave or maple syrup are often described as “better.” The bottom line is this: existing research shows (and in my opinion future research will continue to show) excess sugar of any kind appears to be harmful to your health—which is the first compelling reason we should limit all types of sugar–and FYI, sugar has 50+ names.

  1.  Sugar is Linked to Many Diseases

This is my first point deliberately—it’s actually many related points. Just look at this long list of diseases associated with sugar. It’s shocking, and I promise I don’t mean to scare you as much as educate you. But frankly, I find it a little scary. The good news: eating less sugar may improve your health.

  • Sugar typically provides excess calories and increases levels of the hormone insulin, which promotes fat storage and leads to obesity.
  • Chronically elevated levels of insulin are linked to insulin resistance, type 2 diabetes, and metabolic syndrome, all of which increase your risk for heart disease.
  • Sugar contributes to increases in blood levels of circulating fatty acids (dyslipidemia), which increases your risk for fatty liver disease and heart disease.
  • Sugar (perhaps more so than salt) also contributes to hypertension, which may increase your risk of heart disease, stroke, and renal failure.
  • Chronically elevated levels of blood glucose and insulin levels are linked to cancer, including endometrial, esophageal, pancreatic, kidney, gallbladder, breast and colon cancer.
  • Chronically elevated levels of blood glucose and insulin levels are also linked to Alzheimer’s disease.

Further, there is research linking nearly all of these “Western” diseases with each other. Obese people are more likely to develop diabetes. People with diabetes are at higher risk for heart disease. Cancer occurs more frequently in people who have diabetes and obesity.  Alzheimer’s has been dubbed “type 3 diabetes” by many researchers.30

Is sugar part of the connection? It is not completely clear. It is very complicated and difficult to study to be sure what is causing the associations. And your genetics most certainly play a part. But let’s discuss what happens in your body when you eat sugar.

Of course, as you know, there are different types of sugar. But when they are metabolized, many break down into varying amounts of glucose and fructose in the body. The body handles both of of these differently.

Glucose enters the blood stream, increases your blood sugar, and your pancreas pumps out the hormone insulin to escort the glucose into the cells, where it can be used for energy. To be clear, insulin itself is not the problem. In fact, you can’t live without insulin; it is just the catalyst for increased fat storage in response to excess sugar intake.  Some glucose is used directly for energy, some is stored as glycogen in the muscles and liver, and some is converted and stored as fat. So, a high sugar diet may contribute to obesity, which then puts you at increased risk for metabolic syndrome, diabetes, heart disease and some cancers.

Many types of added sugar, including HFCS, white table sugar (sucrose), honey, maple syrup and agave also break down into about half fructose and half glucose. Fructose is the natural sugar found in fruits, and it should be noted it would be difficult to get too much by eating fruit alone.  But when you eat unnatural amounts of fructose from various sources of added sugar, fructose can be converted into fat directly in the liver, and this process also produces uric acid, which can contribute to gout and possibly hypertension. So, a high sugar diet may also increase your risk of gout, hypertension, and dyslipidemia, which further contributes to metabolic syndrome, obesity, diabetes, and fatty liver disease.

The metabolic pathways that occur when we eat various types of sugar are also thought to cause inflammation, especially when you have abdominal fat, which may be part of the process by which sugar is linked to certain diseases, especially cardiovascular disease.31 More research is needed, but the arrow is pointing in the right direction: cutting out many forms of added sugar and refined grains (which break down and are metabolized much like sugar) and eating mostly easy, real food can only help.

  1. Sugar Provides No Essential Nutrients

I know it tastes great—but you do not need sugar, and it takes the place of more nutritious real foods. This is the second reason I urge you to look at your sugar intake. It provides energy (that is, calories, usually in excess of what you need), but no other nutrients. (That’s what we RDs mean by “empty calories.”) There’s never been a research study or a dietary guideline that has suggested we need to eat any amount of refined sugar regularly. (And it’s usually crazy to say “never” and “research” in the same sentence!)

If you want to get even more technical, carbohydrates from foods are not exactly “necessary” to eat either, meaning we can make them. There are “essential amino acids” (protein) and “essential fatty acids” (fats) that our bodies cannot make, so we need to eat them from foods. But your body is technically able to make the carbohydrate it needs, specifically glucose from protein or even from glycerol, which is released in fatty acid metabolism.33

And contrary to popular opinion, your brain is able to function quite well on mostly ketones, which are produced when you burn fat for energy (hence, the popular “keto” diet, which was first discovered as a way for people with epilepsy to control seizures. Of course, that’s another topic altogether…but I’m not recommending a keto diet if you don’t have epilepsy or any other “diet” that eliminates whole food groups.)

For most people, this discussion is moot because our food supply provides more than enough carbohydrates for our bodies…even if you’re eating mostly real foods, which is the best way to get your carbohydrates because then you also get beneficial nutrients and fiber and phytochemicals that only whole foods provide.

Are you with me so far? We are eating too much sugar, it negatively affects your health, and it provides nothing your body needs. Still need another reason to lower your sugar intake?

  1. Sugar May Be Addictive

It is not my intent to minimize how hard it is to cut out sugar—it does take some getting used to. It even requires some determination.  But that might be putting it mildly, for some people. Although it’s controversial, some scientists suggest sugar may be addictive.34-36 Addiction or not, the jury is out, but sugar tends to lead to continued cravings for some people. If you’re one of them and you’ve ever tried cutting it out, you know the feeling. Sugar hovers in your forethought, almost haunting you, even after you’ve eaten a meal and should feel satiated.

Maybe you need that piece of chocolate after your meal? You’re used to that feeling of satisfaction that serotonin triggers in your brain after you eat sugar.  We are learning more and more that our gut hormones are also intricately involved in appetite, satiety and sugar metabolism. Some people can have a little sugar and be fine. Some people find it easier to try to avoid sugar because even having a little leaves them wanting more and more. I suspect there’s something in that beyond just will power.

However, as hard as it is to avoid sugar—both due to its prevalence in our food supply and the possibility it may be addictive—the cravings can be overcome with time, the right mindset—and by sticking with real foods. The body is able to adjust to lower sugar intake in a few weeks, natural foods like fruit will taste sweeter and it gets easier, so don’t give up and give it enough time!

Sugar: Putting the Science into Real-Life Perspective

To summarize this evidence-based perspective and put it into practical terms, I will ask you the very questions I consider when deciding what to eat and feed my family:

  1. What if you have genes that are prone to obesity? Or diabetes? Or heart disease? Or cancer? Or Alzheimer’s? In other words, you may not know you have these genes, but what if these health problems run in your family, and therefore, you might also be more susceptible to them?

and

  1. What if our food supply is providing too much refined carbohydrate and sugar, often in hidden places, so that it’s nearly impossible to eat within the recommended guidelines (if you’re not purposely trying to avoid sugar and refined carbohydrates)? (Or worse still, what if the guidelines aren’t low enough for optimal health, even if you are eating within the recommendations?)

and

  1. What if sugar and/or refined carbohydrates may be addictive?

Add together these very real (evidence-based, although not all conclusive as of yet) possibilities and ask yourself this final question:

Do you want to be a slave to the high-sugar, highly-refined processed foods you eat, so that eating them makes you crave more and sabotages your health?

I, for one, don’t. So, I choose easy, real food. Every. Single. Day. And I personally find that once you limit sugar, it’s easier to eat for your health and most surprisingly, it’s equally satisfying. Do I deviate sometimes? Yes. I just got back from a week at Walt Disney World. I still tried to limit my carbohydrates to mostly real foods, but I had some dessert foods. You know how the term moderation makes me cringe, but that’s my kind of moderation–a very small portion of one or two of my favorites when I’m on vacation once or twice a year!

Real Food: a Work Around?

You know how I love simplicity. And real food. And most importantly–life itself (hence the extreme value I place on health.) So, while we are continually waiting for more conclusive research, I do not believe you need to count grams of sugar or carbohydrates. The simplest way to limit sugar is to choose real, unprocessed, whole foods.

Added sugars are not going away from our food supply. And public health policies or guidelines are not going to dramatically change anytime soon either. (Well, the Nutrition Facts Label is, but you can read what I think about that here.)  Rather, I see it as a “work around” to these fundamental problems if you choose to be mindful of your body and intentional with real-food fuel.  The quantity and the quality of the carbohydrates you eat will be vastly improved when you choose real, whole foods and you will drastically cut added sugars.

You might worry it will take lot of time looking for sugar in products, researching healthier options, and cooking from scratch. But I would argue lowering my sugar intake has even simplified my life. I share here How Slashing Sugar Can Simplify Life.

Final Thoughts

Slashing sugar (and refined carbohydrates) in your diet can be a big adjustment, I realize. We are surrounded by convenient, overly processed foods not ideal for healthy lifestyles. But choosing better food doesn’t have to be complicated or a negative experience of deprivation. You are changing your health for the better, going back to the basics and simplifying your life, and enjoying foods as nature intended them. With the right mindset about food (which science shows you have control over, so think positively…more on that later), I believe it can be a very rewarding experience. Don’t aim for perfection, but aim for improvement with consistent healthy habits. You can retrain your brain and your body. You have nothing to lose–except possibly some excess weight and/or some health risk–giving it a try.

Start with these Tips for Slashing Sugar. I’d love to hear how it goes for you…please share your comments and tips if you’ve been trying to cut out sugar!

References

“Not All Those Who Wander Are Lost.”

thewanderingrd7 Comments

I love this quote (by J.R.R. Tolkien). It is so reassuring. Because during the past few years I have been wandering more than I’d like to admit.

I mean, literally, I can’t stop wandering every 3 to 4 years because we are a military family. And I wouldn’t trade the wonderful opportunities we’ve had to explore 30 countries during 7 of the past 10 years. Especially because it gave me an excuse to not feel guilty about staying home full time with my three children.  But in this time, I have been pondering nutrition from the sidelines, which I feel has required more effort in keeping up with continually changing nutrition science and trends. I am easily distracted by my other jobs and interests and not surrounded daily by my knowledgeable nutrition peers to “talk shop” and stay current. Even though I’ve been inspired by other food cultures, if I’m honest, I have been floundering in my own “expertise”–and therefore, at times I have even questioned what to feed my own family. Gasp. I tell you this because mommy self-doubt even affects nutrition experts!

It didn’t happen overnight, but I began to feel unnerved a few years ago when my husband, B, a pediatrician, began an in-depth self-study of nutrition in his free time in an effort to help his patients achieve a healthy weight. He often discussed his readings with me, but I myself felt a bit out of touch with nutrition science. Wait, who’s supposed to be the nutrition expert here? (But you could ask me anything about travel planning in Europe or being a mother to 3 girls–not that I always do either well, necessarily!)

Well, ultimately, my husband’s dedication to help people with their nutrition inspires me to stay in touch with the latest nutrition. The bottom line is, the more I have delved in, the more uncomfortable I have become with many conventional nutrition guidelines. At first, I resisted my doubts, as all good dietitians would. How could I disagree with expert nutrition committees forming the guidelines?  But once I got past feeling overwhelmed, I realized questioning the evidence is never a bad thing to do, especially in the evolving field of nutrition. And in questioning, I reminded myself I am, indeed, a nutrition expert and it’s my responsibility to question the science. And now I’m on a roll with topics I want to share with you!

The number one thing I have wrestled with is whether our diets should really be so high in carbohydrate and grain-based, as the USDA dietary guidelines suggest. And in full disclosure–I, like Oprah, love bread.

But the list of things I have been grappling with goes on… Is saturated fat bad? Is “moderation” really the right approach to eating? Does exercise help you lose weight? Why is everyone you know eating a gluten-free diet? Why are there still so many overweight and obese people in America???

Well, I can’t claim to know the answer to every nutrition-related question. But I will certainly explore many of these topics, slowly but surely, in an attempt to find out the latest information–for you and me. Nutrition research is complicated, and economics, politics, and the media have such influence–you really have to tease out the actual evidence. And sometimes, more often than not it seems, the evidence is lacking. When it is, I will say so. When it is fairly conclusive, I will say so. But when nutrition guidelines suggest evidence is conclusive and it is not, I will also say so. No one is paying me to say otherwise. Oh, the freedom that provides!

In a nutshell, I describe my approach to nutrition as “unconventional in a conventional way.” I don’t believe you need special foods or products to be healthy. I believe in the natural simplicity of eating real foods as much as possible, as opposed to processed foods or proprietary supplements. You might agree this makes me pretty conventional. Boring maybe? (I hope to show you that’s not true, at least with regards to the way we eat!) But I am unconventional as a dietitian in that I no longer believe the nutrition guidelines always provide the most evidence-based advice. Nor have they ever provided hands-on practical suggestions for what exactly to feed your family.

So, this blog is my mission to share with you my every-day journey grappling with the science of nutrition, savoring delicious real foods, and balancing my humanity (read: vulnerability) along the way. Most importantly, I hope you will find something meaningful in my musings. It will feel like we are wandering, sometimes literally and sometimes figuratively, but I hope you will stick with me and relate with your food and nutrition experience. And even if we get a little lost, I’ve come to realize there’s growth in that.