Apple Cider Vinegar for your Health?

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Vinegar was first described as a weight-loss aid over two hundred years ago.¹ Nowadays, many claim that vinegar, and specifically apple cider vinegar, can help you shed pounds, reduce cholesterol, manage blood sugar, and more.  Vinegar is made when the sugar in fruit juice, fruits, or grains is fermented into acetic acid; in apple cider vinegar, the sugar comes from apple cider.² Vinegar’s supposed health benefits come from the fact that it is fermented into acetic acid.  Studies suggest, however, that vinegar’s impact on health is not as significant as some sources would like you to believe.

Few scientific studies have been done in humans to see if apple cider vinegar truly leads to weight loss.  One widely cited experiment found that obese people who took apple cider vinegar every day did lose weight; however, this study is not reliable because it didn’t include many subjects and was carried out by a company that actually produces vinegar.^3,4 More unbiased studies with human subjects will be needed to say for sure whether apple cider vinegar has any influence on weight loss.

Sources also claim that apple cider vinegar can help lower cholesterol levels.  As with weight loss, more research in humans is needed to say whether this is actually true.  Right now, scientific studies on this topic have mixed results, and a lot of the research showing that apple cider vinegar does impact cholesterol levels has been done in mice and rats, not humans.⁵ One study that included humans asked people to take 30 milliliters (about 2 tablespoons) of apple cider vinegar every day.  After four months, there were no significant changes in their cholesterol or triglyceride levels.⁶

One area where apple cider vinegar has shown some promise is in the reduction of blood glucose levels.  A review of eleven scientific studies found that the average blood glucose and insulin levels after eating were lower when the subjects had taken vinegar before eating.  Subjects who used apple cider vinegar consumed about 4 teaspoons of vinegar before meals, and subjects who used white vinegar consumed between 2 and 6 teaspoons.⁷ Researchers aren’t exactly sure why this might happen.  One possible explanation is that vinegar causes your stomach to empty more slowly, so you won’t digest and absorb sugar as quickly.^6,7 This makes sense because vinegar is very acidic, and when your stomach contents are more acidic the sphincter between your stomach and intestines opens less often.  It’s important to note that vinegar’s impact on blood glucose is unpredictable, and therefore it would not be a good idea to try to use vinegar as a way to manage your blood sugar if you have diabetes or to combine vinegar with glucose-lowering medications.

Large doses of apple cider vinegar can make you lose potassium in your urine, so taking it with diuretics can cause your blood potassium levels to become dangerously low.  Taking undiluted apple cider vinegar can also irritate your throat because of its acidity.¹ Instead, use apple cider vinegar in a salad dressing or marinade to add flavor to your foods without adding a lot of calories.  If your goal is to lose weight, reduce cholesterol, or manage diabetes, talk to a Registered Dietitian who can give you an appropriate meal plan.  In all cases, eating within your calorie needs, reducing your intake of foods high in fat and added sugar, and choosing a variety of fruits, vegetables, whole grains, and lean protein is a great way to start!

References:

1.         Kohn JB. Is Vinegar an Effective Treatment for Glycemic Control or Weight Loss? J Acad Nutr Diet. 2015;115(7):1188. doi:10.1016/j.jand.2015.05.010.

2.         Ho CW, Lazim AM, Fazry S, Zaki UKHH, Lim SJ. Varieties, production, composition and health benefits of vinegars: A review. Food Chem. 2017;221:1621-1630. doi:10.1016/j.foodchem.2016.10.128.

3.         KONDO T, KISHI M, FUSHIMI T, UGAJIN S, KAGA T. Vinegar Intake Reduces Body Weight, Body Fat Mass, and Serum Triglyceride Levels in Obese Japanese Subjects. Biosci Biotechnol Biochem. 2009;73(8):1837-1843. doi:10.1271/bbb.90231.

4.         Younkin L. Is Apple Cider Vinegar Good for Weight Loss? EatingWell. http://www.eatingwell.com/weight-loss/foods/faq/apple-cider-vinegar/is_apple_cider_vinegar_good_for_weight_loss. Published March 2016. Accessed April 25, 2017.

5.         Samad A, Azlan A, Ismail A. Therapeutic effects of vinegar: a review. Curr Opin Food Sci. 2016;8:56-61. doi:10.1016/j.cofs.2016.03.001.

6.         Panetta CJ, Menk JS, Jonk YC, Brown AJ, Powers MA, Shapiro AC. Prospective Randomized Clinical Trial Evaluating the Impact of Vinegar on High Density Lipoprotein. J Am Diet Assoc. 2010;110(9):A87. doi:10.1016/j.jada.2010.06.321.

7.         Shishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017;127:1-9. doi:10.1016/j.diabres.2017.01.021.

Image source: http://www.prevention.com/eatclean/apple-cider-vinegar-facts

Sweet Without Sugar?

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Have you ever had a craving for something sweet but didn’t want the calories from a sugary snack?  Some people manage this by eating foods made with artificial sweeteners.  Artificial sweeteners are ingredients that provide sweetness without adding calories.  Right now, there are five FDA-approved artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose.¹ They’re usually found in diet soda and sugar-free versions of candy, ice cream, sports drinks, fruit spreads, and juice.²

You might choose a food made with artificial sweeteners to keep your overall calorie intake lower as part of a goal to lose or maintain weight.  Unfortunately, studies have shown that using artificial sweeteners might not really help with weight loss, and could also raise your risk for Type 2 Diabetes and heart disease.^2–4 Eating artificial sweeteners makes it more difficult to regulate the amount of sugar-sweetened foods you eat later because your brain no longer realizes that sugar-sweetened foods actually contain calories.³ It also looks like artificial sweeteners don’t satisfy the “reward center” of your brain the same way regular sugar does, so you’ll still crave sweets after eating an artificial sweetener and may be more likely to overeat and gain weight as a result.² Other studies also suggest that artificial sweeteners change your microbiome, or the bacteria that live inside your intestines.  This change might contribute to Type 2 Diabetes and weight gain.³

Some people react to the controversy around artificial sweeteners by looking to a more natural, calorie-free alternative sweetener: stevia.  Although it seems like stevia first showed up only a few years ago, people have been using it as a sweetener for hundreds of years.⁵ The stevia found in food products is actually the compound Rebaudioside A (Reb A), a highly purified extract from the plant Stevia rebaudiana.  Reb A is the only part of the stevia plant that has been generally recognized as safe by the Food and Drug Administration (FDA).  Stevia leaves, crude stevia extracts, and whole leaf stevia have not been given FDA approval, and can therefore only be sold as supplements.^6,7

Although in the past stevia was thought to be connected with fertility problems and birth defects, in 2008 the FDA determined that Reb A is safe after reviewing studies submitted by the companies that produce stevia. While the FDA reviewed these studies and decided that they show Reb A’s safety, it’s difficult to solely rely upon studies that were conducted by the company that makes a product; research without bias holds more credibility.  When a company who can profit from a product funds a study about the safety of that product, the study may be influenced by research or funding bias in which the results are either consciously or unconsciously influenced to show the product in a more favorable light.^8,9

For this reason, when Reb A received FDA approval in 2008 it was important for companies without ties to stevia production to conduct more studies to truly prove stevia’s safety.⁶ Since then, not many studies have been performed in humans and few of them are long-term.  However, some independent studies suggest that eating Reb A does not result in any significant toxicity.  A systematic review by Massachusetts General Hospital found that stevia should be evaluated farther for potential positive impacts on blood cholesterol levels and insulin sensitivity.¹⁰ Other studies suggest that stevia doesn’t lead to the same sugar cravings that other artificial sweeteners are known to cause.^11–13 Since stevia has only been FDA-approved for 9 years, more research is needed to learn about stevia’s long-term health impacts.

The amount of artificial sweeteners and stevia that the FDA considers safe to eat in one day varies depending on your body weight and the type of sweetener.¹⁴ For example, the FDA recommends eating no more than 4 milligrams of stevia per kilogram of your body weight per day, but states that it’s acceptable to eat up to 50 milligrams of aspartame per kilogram of your body weight per day.¹⁵ Since more research is needed to learn about their long-term health impacts, it is best to use them all in moderation.  Limit the amount of artificial sweeteners and stevia you use by choosing unprocessed foods, drinking water or milk instead of diet soda or juice, and satisfying your cravings for sweet foods with fruit instead of candy, desserts, or baked goods.

References:

1.         Strawbridge H. Artificial sweeteners: sugar-free, but at what cost? Harvard Health Blog. http://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030. Published July 16, 2012. Accessed March 15, 2017.

2.         Harvard T.H Chan School of Public Health. Artificial Sweeteners. The Nutrition Source. https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/artificial-sweeteners/. Published September 4, 2013. Accessed March 15, 2017.

3.         Swithers SE. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends Endocrinol Metab. 2013;24(9):431-441. doi:10.1016/j.tem.2013.05.005.

4.         Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016;164, Part B:488-493. doi:10.1016/j.physbeh.2016.04.029.

5.         Stevia: It’s Not Just About Calories. ResearchGate. https://www.researchgate.net/publication/228831065_Stevia_It’s_Not_Just_About_Calories. Accessed March 21, 2017.

6.         Is Stevia Safe? - EatingWell. http://www.eatingwell.com/nutrition_health/nutrition_news_information/is_stevia_safe. Accessed March 22, 2017.

7.         Nutrition C for FS and A. FDA Basics - What refined Stevia preparations have been evaluated by FDA to be used as a sweetener? https://www.fda.gov/AboutFDA/Transparency/Basics/ucm214865.htm. Accessed March 22, 2017.

8.         Six industry-funded studies. The score for the year: 156/12. Food Polit Marion Nestle. March 2016. http://www.foodpolitics.com/2016/03/six-industry-funded-studies-the-score-for-the-year-15612/. Accessed April 22, 2017.

9.         Who pays for science? http://undsci.berkeley.edu/article/who_pays. Accessed April 22, 2017.

10.       Ulbricht C, Isaac R, Milkin T, et al. An evidence-based systematic review of stevia by the Natural Standard Research Collaboration. Cardiovasc Hematol Agents Med Chem. 2010;8(2):113-127.

11.       Anton SD, Martin CK, Han H, et al. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite. 2010;55(1):37-43. doi:10.1016/j.appet.2010.03.009.

12.       Abo Elnaga NIE, Massoud MI, Yousef MI, Mohamed HHA. Effect of stevia sweetener consumption as non-caloric sweetening on body weight gain and biochemical’s parameters in overweight female rats. Ann Agric Sci. 2016;61(1):155-163. doi:10.1016/j.aoas.2015.11.008.

13.       Shivanna N, Naika M, Khanum F, Kaul VK. Antioxidant, anti-diabetic and renal protective properties of Stevia rebaudiana. J Diabetes Complications. 2013;27(2):103-113. doi:10.1016/j.jdiacomp.2012.10.001.

14.       Artificial Sweetener Labeling Initiative. The Sugar Association. https://www.sugar.org/nutritional-advocacy/artificial-sweetener-labeling-initiative/. Accessed March 15, 2017.

15.       Nutrition C for FS and A. Food Additives & Ingredients - Additional Information about High-Intensity Sweeteners Permitted for use in Food in the United States. https://www.fda.gov/food/ingredientspackaginglabeling/foodadditivesingredients/ucm397725.htm#Steviol_glycosides. Accessed April 22, 2017.

Cacao and Cocoa: Is there a Difference?

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

The two words are so similar that if you read them quickly you might not even notice they’re spelled differently.  Some websites use them interchangeably, and a Google search for “cacao” will turn up results that include the term “cocoa.”  On the other hand, some health blogs assert that there is a difference between the two, leaving a lot of room for confusion.  Are they two separate things?  Is one better than the other?  It turns out, while “cacao” is usually used to refer to a product that comes out of an earlier stage in the chocolate-making process, there is not technically any difference between the two words, and it’s possible that the only reason there are two terms at all was a simple spelling mistake.¹

All chocolate originates from the tropical cacao tree Theobroma cacao.  These trees produce football-sized pods, which have a hard outer shell and are full of cacao beans surrounded by a sweet pulp.  To begin the chocolate-making process, the pods are harvested and cracked open.  The beans and pulp are then removed and fermented for up to six days, after which the outer shell of the beans is removed and they are roasted.  The fermentation and roasting process causes the chocolate flavor to become richer.²

At this point the product may be sold as a cacao nib, cocoa nib, or cracked cocoa.  The Food and Drug Administration (FDA) defines these terms and states that they all refer to the same thing.³ The cacao nib can be sold unroasted, or it might be heated again after the fermentation stage to improve its flavor.³ Cacao nibs have about 180 calories, 4 grams protein, 14 grams fat, 8 grams carbohydrate, and 6 grams fiber per 1-ounce serving.⁴ They are also high in several different antioxidants, which explains why they are known to improve blood pressure and promote heart health.  Antioxidants break down when exposed to heat, so some people recommend looking for “raw” cacao nibs to get the most health benefits from a chocolate product.^5,6

In the next step in the chocolate-making process, the cacao nib is ground into something known as chocolate liquor.^2,3 This paste may be further separated into cocoa butter (the fat in the cocoa bean) and cocoa powder (the powder you are likely familiar with used in baking and hot chocolate), and each product may go on to be used as an ingredient in another item.  The paste could also be sold as unsweetened chocolate or baking chocolate, or it may be ground up, heated, and mixed with sugar, milk, and vanilla to form a chocolate bar.²

Many health websites recommend eating cacao instead of cocoa on the assumption that cacao is less processed.  This recommendation only adds to confusion, however, because the terms “cacao” and “cocoa” are legally allowed to refer to the same product.  Instead of getting caught up on the difference between cocoa and cacao, look for a less-processed form of chocolate, such as raw cocoa or cacao nibs, which will contain more antioxidants because they have been exposed to less heat.⁶ This is also a great way to enjoy some chocolate without getting all of the added sugar from a chocolate bar!

References:

1.         Coles T. Cacao Nibs: Even Better For You Than Dark Chocolate. Huffington Post. http://www.huffingtonpost.ca/2013/08/02/cacao-nibs_n_3695571.html. Published August 2, 2013. Accessed March 19, 2017.

2.         From Bean to Bar | Equal Exchange. http://equalexchange.coop/products/chocolate/steps. Accessed March 20, 2017.

3.         CFR - Code of Federal Regulations Title 21. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=163&showFR=1&subpartNode=21:2.0.1.1.39.2. Accessed March 20, 2017.

4.         USDA. 45010024, SUNFOODS, RAW ORGANIC CACAO NIBS, UPC: 803813030208. USDA Branded Food Products Database. https://ndb.nal.usda.gov/ndb/foods/show/18331?fgcd=&manu=&lfacet=&format=&count=&max=50&offset=&sort=default&order=asc&qlookup=cacao+nibs&ds=&qt=&qp=&qa=&qn=&q=&ing=. Accessed March 20, 2017.

5.         Health Benefits of Raw Cacao Nibs. http://healthyeating.sfgate.com/health-benefits-raw-cacao-nibs-7364.html. Accessed March 20, 2017.

6.         Hu S, Kim B-Y, Baik M-Y. Physicochemical properties and antioxidant capacity of raw, roasted and puffed cacao beans. Food Chem. 2016;194:1089-1094. doi:10.1016/j.foodchem.2015.08.126.

Prevent Hypertension Before it Starts

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Hypertension, or high blood pressure, is considered an “insidious disease” because it doesn’t come with any obvious symptoms.  For most adults, there’s no one definite cause of hypertension, but things like stress, physical inactivity, eating a lot of salt, using tobacco, and drinking a lot of alcohol can all increase your risk.¹ Many people don’t know they have it until it starts to cause complications,² such as damage to the blood vessels, stroke, heart attack, vision loss, memory problems or kidney failure.^1–3 Adults over the age of 50 have a 90% risk of developing hypertension⁴ but until you start getting complications, the only way to know whether you have it is to get your blood pressure checked.  When you do, your doctor will tell you your blood pressure as one number “over” another number.  The first number is your systolic pressure, or the pressure your blood puts on your arteries when your heart is contracting.  The second number is your diastolic pressure, or the pressure your blood puts on your arteries when your heart is relaxed.³

A healthy blood pressure is considered to be 120/80 millimeters of mercury (mmHg), but some researchers believe the risk of complications increases beginning at a blood pressure of 115/75 mmHg, well before 140/90 mmHg when hypertension would be diagnosed.⁴ This means it’s crucial to get your blood pressure checked regularly and take a few precautions in your diet and lifestyle to prevent hypertension in the first place.

Achieve or Maintain a Healthy Weight

Many studies show that weight loss lowers blood pressure.  Ideally your body mass index should be at or below 25, but weight loss will improve your blood pressure even before you reach your goal weight.  Losing about 11 pounds can lead to a reduction of about 4.4/3.6 mmHg.⁴ If you’d like to lose weight, talk to a registered dietitian to learn some strategies to reduce your calorie intake that you’ll be able to maintain for the long term.

Stay Active

The American Heart Association recommends that people do some type of aerobic exercise for at least 30 minutes every day to keep their blood pressure low.  Aerobic exercises include power walking, jogging or running, dancing, cycling, swimming, and anything else that gets your heart rate up.  In general, the more intensely you exercise, the better.  Some studies also suggest that resistance exercise, such as weight lifting, can also improve your blood pressure.⁵ Since both aerobic and resistance exercises are also known to help you maintain weight loss, reduce your risk for diabetes, and maintain your muscle mass and balance as you get older, lowering your blood pressure is just one more reason to get active every day!

Choose Nutrient-Dense Foods

The DASH (Dietary Approaches to Stop Hypertension) Diet was developed specifically to help people keep a healthy blood pressure.  Other healthy-eating plans, such as the Mediterranean diet, the OmniHeart diet, and the vegetarian diet, are also known to improve blood pressure.  In general, you should aim for 8-10 servings of fruits and vegetables and 2-3 servings of low-fat dairy each day.  These food groups are high in potassium; people who consume about 4.7 grams of potassium each day tend to have lower blood pressures.⁴

Fruits, vegetables, and whole grains are also good sources of fiber, which is associated with reduced blood pressure.  Although your recommended daily intake of fiber is 25-30 grams, most Americans do not meet this recommendation.  Studies have shown that increasing your fiber intake by 14 grams per day can lead to modest improvements in blood pressure.⁴

 Drink Alcohol in Moderation

Studies have shown that the more alcohol you drink, the higher your blood pressure will get, especially if you have more than two drinks per day.  This will happen regardless of your weight, age, and other dietary factors; however, reducing your alcohol intake will lead to improved blood pressure.  At the most, men should have no more than two alcoholic drinks per day and women should have no more than one.⁴ One drink is considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.  All of these provide about 14 grams of pure alcohol.⁶

Limit Added Salt and Sugar

It’s pretty well known that eating a lot of sodium can increase your blood pressure.  Studies have shown that blood pressure rises as sodium intake does.  To combat this, people should limit themselves to no more than 2300 milligrams of sodium each day, and people who are over the age of 50 or African American should have no more than 1500 milligrams every day.  Using herbs and spices to flavor your foods and limiting the amount of processed foods you eat will help you keep your sodium intake within these recommendations.⁴

At the same time, studies suggest that eating added sugar will increase your blood pressure four times as much as sodium.  Researchers believe that eating a lot of sugar causes hypertension by promoting inflammation, insulin resistance, and obesity.  The blood sugar spike after eating sugar causes water to move out of the cells and into the blood vessels, raising blood pressure.  It doesn’t take long for a high-sugar diet to impact blood pressure.  After just a few months, people who ate a high-sugar diet had blood pressures that were an average of 7.6/6.1 mmHg higher than those who ate a low-sugar diet.⁷ To combat this, satisfy your sweet tooth with fruits rather than candy or desserts high in added sugar.  Also check the ingredients list on foods such as bread, canned sauces, yogurt, and cereal to make sure that some type of sugar hasn’t been added.

While these recommendations are important for a healthy blood pressure, following them will also help you maintain your weight, reduce your risk for Type 2 Diabetes, and stay healthy while you age. Stay active, choose a variety of fruits, vegetables, lean protein, and whole grains, limit alcohol, sodium, and sugar intake, and speak with a registered dietitian if you’d like more personalized recommendations!

References:

1.         High blood pressure (hypertension) Causes. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/causes/con-20019580. Accessed March 1, 2017.

2.         Hypertension. Tutorials - Pathology Subjects. http://library.med.utah.edu/WebPath/TUTORIAL/HYPERTEN/HYPERTEN.html. Accessed February 15, 2017.

3.         5 things you should know about high blood pressure - Nutrition Action. http://www.nutritionaction.com/daily/heart-and-disease-cat/5-things-you-should-know-about-high-blood-pressure/?mqsc=E3871758&utm_source=WhatCountsEmail&utm_medium=Nutrition_Action_Daily_TipsNutrition%20Action%20Daily&utm_campaign=2017.02.13%20Heart%20and%20Disease. Accessed February 14, 2017.

4.         Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary Approaches to Prevent and Treat Hypertension. Hypertension. 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6.

5.         Brook RD, Appel LJ, Rubenfire M, et al. Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure. Hypertension. 2013;61(6):1360-1383. doi:10.1161/HYP.0b013e318293645f.

6.         What Is A Standard Drink? | National Institute on Alcohol Abuse and Alcoholism (NIAAA). https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink. Accessed March 1, 2017.

7.         DiNicolantonio JJ, O’Keefe JH. Hypertension Due to Toxic White Crystals in the Diet: Should We Blame Salt or Sugar? Prog Cardiovasc Dis. 2016;59(3):219-225. doi:10.1016/j.pcad.2016.07.004.

Keep Your Heart Healthy

Submitted by Amy Sercel MS RD CD

Edited By Marcia Bristow MS RDN CSSD CD

February is National Heart Health Month!  During this month every year, we are reminded to take care of our hearts and take steps to prevent heart disease.  Heart disease is the leading cause of death for Americans, but it is considered a “silent killer” because people often aren’t aware they have it until it starts to cause serious problems.¹ For this reason, it’s really important to have regular visits with your doctor where you get your blood pressure, triglycerides, and cholesterol levels checked.  At the same time, maintaining a healthy weight, staying active, and following a heart-healthy diet are valuable ways to slow or prevent heart disease from developing in the first place.

A heart-healthy diet is full of fruits, vegetables, whole grains, low-fat dairy, fish, legumes, vegetable oil, and nuts, and lower in sweets, sugar-sweetened beverages, processed red meats, and sodium.  If you’d like a more specific meal plan, both the DASH diet and the Mediterranean diet have been shown to reduce the risk for heart disease.² You can also modify your current diet to incorporate some heart-healthy elements; the first step could be to eat more fruits and vegetables.  Studies have shown that eating more than five servings of fruits and vegetables every day improves blood pressure and the health of your small blood vessels, and eating more than seven servings of fruits and vegetables each day can reduce your risk of death from cardiovascular disease by 31%.³ One possible explanation for this is the high fiber content in fruits and vegetables.  Fiber can keep you full for longer so you won’t be tempted to snack later in the day, make you absorb sugar more slowly so your blood sugar stays even, and reduce the amount of cholesterol you absorb from food.  Vegetables seem to have a stronger impact on heart disease risk than fruits,³ so consider adding an extra serving of vegetables to your lunches and dinners.

It is also important to limit the amount of saturate fat you eat, and choose unsaturated fats instead of saturated fats whenever possible.  Unsaturated fats are liquid at room temperature and are found in vegetable oil, nuts, seeds, fatty fish, and avocados.  Saturated fats are solid at room temperature and are found in full-fat dairy, red meat, animal fat, and coconut oil.⁴ Reduce the amount of saturated fat you eat by choosing lean meat, vegetable oil, and low-fat dairy instead.  Low-fat dairy in particular has been shown to help reduce blood pressure, possibly because it contains a lot of potassium and calcium.³

In addition to modifying your diet, the American Heart Association recommends at least 2½ hours per week of moderate-intensity physical activity, or 1¼ hours per week of vigorous activity to reduce your risk for heart disease.² Studies have shown that active people are about 30-35% less likely to develop heart disease than inactive people.  Among active people, spending less time sitting every day further lowers your risk for heart disease. Among inactive people, even small amounts of activity can help you reduce your risk for heart disease – there is no “minimum threshold” where activity becomes helpful.  In general, though, the more active you are, the lower your risk of heart disease gets.⁵ 

The American Heart Association says the entire population would benefit from eating a heart-healthy diet and engaging in regular physical activity.² In addition to protecting you against heart disease, following these recommendations can help you maintain a healthy weight, lower your risk for Type 2 Diabetes, and keep you healthy as you age.  It is never too soon to start working to prevent heart disease.  This National Heart Health Month, make one change that will benefit you for a lifetime!

References:

1.         The Heart Foundation. http://www.theheartfoundation.org/heart-disease-facts/heart-awareness-month/. Accessed February 21, 2017.

2.         Millen BE, Wolongevicz DM, Jesus JM de, Nonas CA, Lichtenstein AH. 2013 American Heart Association/American College of Cardiology Guideline on Lifestyle Management to Reduce Cardiovascular Risk: Practice Opportunities for Registered Dietitian Nutritionists. J Acad Nutr Diet. 2014;114(11):1723-1729. doi:10.1016/j.jand.2014.07.037.

3.         Berciano S, Ordovás JM, Berciano S, Ordovás JM. Nutrition and Cardiovascular Health. Rev Esp Cardiol. 2014;67(9):738-747. doi:10.1016/j.rec.2014.05.003.

4.         Saturated fat, regardless of type, linked with increased heart disease risk. The Nutrition Source. https://www.hsph.harvard.edu/nutritionsource/2016/12/19/saturated-fat-regardless-of-type-found-linked-with-increased-heart-disease-risk/. Published December 19, 2016. Accessed February 21, 2017.

5.         Shiroma EJ, Lee I-M. Physical Activity and Cardiovascular Health. Circulation. 2010;122(7):743-752. doi:10.1161/CIRCULATIONAHA.109.914721.

Nutrition for Peak Performance

 

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Between the Australian Open, the Super Bowl, and the World Alpine Ski Championships, there are a lot of major winter sports competitions.  While the physical demands of these sports vary quite a bit, the athletes that play them all have something in common: their careers depend on their athletic performance, making it even more important for them to properly fuel up to achieve their maximum potential.

It’s crucial for an athlete to be well nourished going into an event.  The nutritionist for the Atlanta Falcons stresses that an athlete can’t correct a “low-energy and/or poorly hydrated state” right before a game, so instead the athlete needs to focus on meeting his or her calorie, protein, and carbohydrate needs every day.¹

Within these guidelines, there are many ways to create a nutritious diet.  For example, Patriots quarterback Tom Brady says he largely avoids any white flour or sugar, instead focusing on whole grains and consuming a plant-based diet where vegetables make up around 80% of his meals.  On the other hand, his rival Matt Ryan of the Falcons eats a variety of fruits and vegetables, striving to make his plate as colorful as possible, while still enjoying the occasional slice of cake.  Like Brady, the fat in Ryan’s diet primarily comes from vegetable sources.² Each quarterback has a unique eating plan that meets his energy, carbohydrate, and protein needs and provides some healthy fat.

No matter what the sport, athletes depend on carbohydrates stored as muscle glycogen for energy while they’re in a competition.  If an athlete doesn’t eat enough carbohydrates throughout each day, he or she will fatigue more quickly and not perform as well during a competition.^3,4 Before an event, a meal should be high in carbohydrates such as pasta, rice, bread, and fruit, contain a good source of lean protein, and be lower in fiber and fat to promote easy digestion.^1,4

During an event, it’s important to keep muscle glycogen stores high and maintain blood sugar levels in the normal range.  The nutritionist for the Falcons suggests that his athletes eat every 3 hours so they never get hungry.² Blood sugar can drop within 30 minutes of vigorous activity, leading to difficulty concentrating and decreased neurological function.  To combat this during events, athletes eat fast-digesting sources of carbs, such as sports drinks that also help with hydration.¹ Athletes usually avoid high-fat and high-fiber foods during prolonged exercise, as these are digested more slowly and may sit in the stomach and slow the athlete down.

After exercise, an athlete should strive to replenish muscle glycogen as soon as possible so his or her stores will be full for the next competition.  Within 90 minutes, the athlete should eat about 1 gram of carbohydrate per kilogram of body weight.  Consuming protein right away will also help keep muscle glycogen stores high and aid in muscle repair.⁴ The New England Patriots and the Atlanta Falcons will usually be seen eating a recovery snack on the field immediately after a game.¹ These recovery foods ensure that the athlete will be properly fueled and will achieve peak performance at every competition and practice!

References:

1.         Atlanta Falcons’ Team Nutritionist Dr Dan Benardot On Super Bowl Nutrition. http://www.cleanplates.com/know/people-places-know/atlanta-falcons-head-nutritionist-reveals-game-day-secrets/?utm_source=My+Sports+Dietitian+Connect&utm_campaign=4be72f173d-EMAIL_CAMPAIGN_2017_02_05&utm_medium=email&utm_term=0_c3aed6e419-4be72f173d-128820021. Accessed February 10, 2017.

2.         Doheny K. Dueling Quarterback Diets: Matt Ryan vs. Tom Brady. WebMD. http://www.webmd.com/diet/news/20170201/dueling-quarterback-diets-matt-ryan-vs-tom-brady. Accessed February 10, 2017.

3.         Baranauskas M, Stukas R, Tubelis L, et al. Nutritional habits among high-performance endurance athletes. Medicina (Mex). 2015;51(6):351-362. doi:10.1016/j.medici.2015.11.004.

4.         Klossner D. Nutrition and Performance Resources. NCAA.org - The Official Site of the NCAA. http://www.ncaa.org/health-and-safety/nutrition-and-performance/nutrition-and-performance-resources. Published November 22, 2013. Accessed February 10, 2017.

Flex Your Self Control

Submitted by Amy Sercel MS RD CD

Edited By Marcia Bristow MS RDN CSSD CD

Whether you realize it or not, you exercise self control throughout the most of the day, every day.  You use willpower to get up in the morning when you’d rather sleep in, to act cheery at times when you might not feel very friendly, or to motivate yourself to work out.  You also use willpower to make over 200 food choices every day, especially when you’re deciding between a less-healthy but quick snack and something that will take longer to prepare but might be lower in calories.² It just happens that you might not have an unlimited supply of willpower.  When you use it repeatedly, you might not have any left over to make a healthy choice later on.

Researchers believe that willpower is like a muscle – early on, you can use it easily, but after repeated use you’ll experience something called “willpower depletion” where your willpower runs out and it’s harder to resist temptations.^2–4 When this happens, your desires feel more intense than usual and it can be more difficult to stop or hide your natural response to a stimulus.⁴ For example, if you spend all day using willpower to keep yourself on track at work, by the time you go to the grocery store you may crave a chocolate bar more strongly than usual, and you will find it more difficult to stop yourself from buying it.  Willpower depletion isn’t related to physical fatigue, but you do tend to have more willpower earlier in the day, and willpower depletion will occur more slowly if you're in a good mood.³ In several studies, people who were put into a good mood through receiving a gift or through watching a pleasant film showed more willpower when faced with a complicated task than the people whose moods were neutral or unhappy.  It’s apparent that being in a good mood will help you maintain willpower over a longer period of time, but it’s not clear whether the good mood actually replenishes willpower, or whether it just gives you the extra energy you need to exert willpower even when your willpower reserves are low.⁵

Lots of studies have looked at the impact of willpower depletion on food choices.  In one study, people were brought into a room with a bowl of radishes and a plate of cookies on a table and asked to solve a puzzle.  Some people were offered the radishes, and others were offered the cookies.  When people were offered the cookies, they worked on the puzzle for about 19 minutes.  On the other hand, the people who were offered radishes and therefore had to use willpower to stop themselves from eating the cookies gave up on the puzzle after about 8 minutes.  In another study, people who were told to hide their emotions while watching a sad movie ate about twice as much ice cream as the people who were not trying to restrict their emotional response.³

Does this mean that we’re all doomed to make poor decisions after we’ve been using self-control to get through our day-to-day responsibilities?  Not necessarily.  For starters, people who are strongly motivated by an internal goal or an external reward are able to resist willpower depletion.^2,3 This suggests that setting a meaningful health-related goal that you are driven to achieve will make it easier to stick to your original plan when you’re faced with a tempting, less healthy, alternative.

Lastly, your environment plays a huge role in your choices, even when your self-control is running low.  In one study, people who had their willpower depleted still made nutritious food choices when they believed the nutritious option was more popular than the calorie-dense option.⁶ For this reason, going grocery shopping with someone who is strongly motivated to choose nutritious foods may influence you to make similar choices.  Making your health-related choices earlier in the day when you have the most willpower, instead of in the evening after you’ve been using a lot of willpower, may also help you keep on track with your goals.⁴ Finally, keep a bowl of fruit out in your kitchen or office, and rearrange your cabinets so the less healthy items are at the back, so you will need less willpower to make a healthy choice.

References:

1.         Image Source: Brain Science Secrets to Increasing Leadership Willpower. Empower Bus. May 2014. http://www.empoweredbusiness.com/brain-science-secrets-to-increasing-leadership-willpower/. Accessed February 1, 2017.

2.         Salmon SJ, Adriaanse MA, Fennis BM, De Vet E, De Ridder DTD. Depletion sensitivity predicts unhealthy snack purchases. Appetite. 2016;96:25-31. doi:10.1016/j.appet.2015.08.027.

3.         Weir K. What You Need to Know about Willpower: The Psychological Science of Self-Control. The American Psychological Association; 2012. http://www.apa.org/helpcenter/willpower.aspx. Accessed January 26, 2017.

4.         Baumeister RF. Self-regulation, ego depletion, and inhibition. Neuropsychologia. 2014;65:313-319. doi:10.1016/j.neuropsychologia.2014.08.012.

5.         Tice DM, Baumeister RF, Shmueli D, Muraven M. Restoring the self: Positive affect helps improve self-regulation following ego depletion. J Exp Soc Psychol. 2007;43(3):379-384. doi:10.1016/j.jesp.2006.05.007.

6.         Salmon SJ, Fennis BM, D T, Adriaanse MA, de Vet E. Health on impulse: When low self-control promotes healthy food choices. Health Psychol. 2014;33(2):103-109. doi:10.1037/a0031785.