Well, I’m happy to say I do think there is hope, especially for the children. In fact, after attending the IFIC Scientific Communications Summit yesterday where obesity specialist Dr. William Dietz of the Centers for Disease Control spoke, I have new optimism. Dr. Dietz began his talk explaining the latest obesity tracking data published in JAMA shows the obesity epidemic appears to be leveling off, especially among Non-Hispanic White and Mexican American men and women. The stats aren’t as promising, however, for Non-Hispanic Black women. The better news is that among children age 2-19, obesity prevalence appears to be stable for both sexes. This gives us an opportunity to make progress in reversing these trends. 

At yesterday’s summit, Dr. Dietz, who is often quoted in the HBO series, made several suggestions about ways communities can prevent and treat childhood obesity, including:

• Promoting safe routes to schools where children can walk
• Promoting active living where children have access to parks and playgrounds
• Supporting policies and programs that increase physical activity and physical education
• Including physical activity in all sectors of life, including where people work, during child care, in schools, throughout communities and throughout states

Successful community programs to address childhood obesity meet local needs by taking advantage of local opportunities. Examples include the Santa Ana California community that purchased a foreclosed property and turned it into a park, or the Let’s Move Salad Bars to Schools program that introduced salad bars into 100 Texas schools for children to become familiar with local fresh fruits and vegetables and even hard boiled eggs, which they can prepare inexpensively at home as well.

Dr. Dietz went on to discuss the difference between a social movement and today’s obesity prevention movement, which he feels still lacks the community grassroots commitment to make it a full-blown social movement. Examples of successful social movements are Mother’s Against Drunk Driving or the fight against secondhand smoking that resulted in laws outlawing smoking in public places. Social movements share some common threads, including:

• A shared personal perception of a threat
• An emotional engagement usually based on a personal incident or story
• A feeling of collective identity and solidarity with the cause
• A collective action against a common target
• Wide and rapidly responsive communication channels
• Sustained action that shows that this issue is not going to go away and demands attention

If the HBO series “Weight of the Nation” can kick off this social movement, then there is hope our obesity problem can be fixed.

This week marks National Women’s Health Week and the theme is appropriately titled “It’s Your Time”. Health Professionals spend endless hours helping others, but we may forget to take “our” time.  Be mindful of what you are doing for yourself and your patients/clients.  This theme resembles the March “Get Your Plate in Shape” but is specifically for women.  Men encourage and support the women in your life to take care of themselves too!  Here are some tips from an article with a few of our own tips added in:  

1. YOUR regular checkups:  There are a variety of articles circulating this week on multiple health issues related to women: preventive care and success rates with early diagnoses of medical conditions.  We often put these visits off, yet we may do them every day for clients.
2. YOUR nourishment: Eat to live healthy and well. Sometimes it can be hard to know what is really healthy.  A Registered Dietitian can help you and your clients get on the road to good health.  Forget the fads and enjoy healthy choices. Start your day out well with a protein rich breakfast such as an open=faced egg sandwich with veggies on a whole wheat English muffin and a glass of fat-free milk.
3. YOUR movement:  Exercise should be a part of your day just like breakfast!  If you need fitness ideas consider enlisting a fitness professional (one on one or in a group setting).   Also, if you have a sitting/desk job make sure to get up and move so you don’t sit for hours at a time!
4. YOUR wellbeing: Sleep, mental health, and more fall into this category.  This area can affect every other area of your health!
5. YOUR habits:  If eating well and exercise are not current habits, that is a great place to start and as you know health professionals can help you achieve this. You can overcome less healthy habits with other habits, such as smoking cessation, with the help of health professionals
6. YOUR behaviors-this can include simple safety issues such as using your seatbelt, bike helmets, and more.  We take these for granted but they cannot be forgotten.

I love how our health professional groups can play a part in every area for Women’s Health Week.  I think too often we feel “we are the health professional”, so we can’t turn to other health professionals for guidance in other areas (for our own well-being).  However, we of all people should know that using other health professionals improves our health forecast.  After all, we are not Docstrainersnursedietitianphysicianassts are we? That would be quite the long title

As the baby boomer generation enters their senior years there seems to be a growing concern about keeping healthy through diet and exercise. Baby boomers are seeing that the high carbohydrate/low fat meals they were advised to prepare left them perpetually hungry and often at risk of cardiovascular disease related to the unattractive spare tire around their abdomen.  It’s time to ask why have the last 20 years seen an epic growth of obesity, metabolic syndrome and little change in the cardiovascular disease rates despite this supposedly healthy dietary advice?

Enter the shocking success of the Atkins/South Beach diets that found followers experienced more sustained relief from hunger and improved cardiovascular risk factors resulting from a reduction in carbohydrates and an increase in both fat and protein intake. People who previously sacrificed their favorite full fat meat, cheese and chicken dishes found that they could eat these foods again if they gave up white rice, bagels and pasta and surprisingly, were rewarded with increased high density lipoprotein levels along with reduced triglycerides and body weight garnering praise from their physician.

Now the scientific community appears to be catching up with the success of the higher protein intake. Two published studies^1,2 looked at the effect of high protein intake on diabetes control.  In the Why WAIT (Weight Achievement and Intensive Treatment) Program, developed at the Joslin Diabetes Center for diabetes weight management in clinical practice, a high protein-low carbohydrate (30% protein [1.5–2 g/kg] and 40% carbohydrates) energy–restricted diet was tried within a multidisciplinary diabetes weight management program for 12 weeks. The authors conclude that an intake of 1.0-1.5 gm/kg of protein is appropriate for diabetics, helping to improve many health risk factors including a lower HbA1c in addition to a reducing total serum cholesterol, LDL cholesterol, triglycerides, blood pressure and markers of inflammation. The researchers reported diabetic patients were less hungry after meals, which contributes to their lower calorie intake and subsequent reduced body weight while maintaining muscle mass. The authors do however make the point that a higher protein intake may be contra- indicated in patients with diabetes accompanied by chronic kidney disease.

More recently, a study published in Advances in Nutrition ³ suggests the brain’s control of appetite is greatly affected by protein intake. From both animal and human research the authors conclude that after protein consumption, peptide hormones are released from the gastrointestinal tract that communicates information about the peripheral energy status to the brain. These hormones control food intake by acting on brain regions involved in energy homeostasis such as the brainstem and the hypothalamus.  High-protein diets lead to greater activation than a normal-protein diet in the regions of the brain responsible for satiety. These areas are triggered particularly by leucine, a branched chain amino acid that influences the reward and motivation aspects of eating behavior and plays an important role in the reduced hedonic response associated with a high-protein intake.

Dietary Guidelines Protein Tips

1         Hamdy, O. Issues in Nutritional Treatment of Type 2 Diabetes Mellitus and Obesity, Current Diabetes Reports, April 2011, 11(2):75-6.

2         Hamdy, O. and Norton E.S. Protein Content in Diabetes Nutrition Plan, Current Diabetes Reports, April 2011, 11(2):111-9.

3         Journel, M. et. al. Brain Responses to High Protein Diets, Advances in Nutrition, 2012, 3:322-9.

So why are eggs so great?
Appealing Taste
Convenience
Economy
Natural Nutrition
Versatility

Also it is quite convenient that it is also National Salad Month, so why not merge the two holidays together and have a hardboiled egg on your salad!

Enjoy!

By now you have most certainly heard that breakfast is the most important meal of the day. There are many benefits to eating breakfast – positive impacts on learning and memory, increased likelihood of meeting daily nutrient intake recommendations, lower BMI, and avoiding weight gain. Another study area is relationship between breakfast consumption and decreased risk of Type 2 Diabetes (TD2).

A recent study published in the American Journal of Clinical Nutrition examined the relationship between eating patterns and T2D risk in men. Almost 30,000 health professionals were followed twenty years and provided information regarding their medical histories, lifestyles and health related behaviors. Their diets were assessed according to reported foods eaten and dietary patterns based on when and how often they ate daily. Diet quality was reflected as a prudent diet (increased fruit, vegetable, fish, poultry, and whole grain consumption) or a Western diet (increased red and processed meats, French fries, high-fat dairy, refined grains, sweets, and dessert consumption). This information was then synthesized to evaluate health habits and diabetes risks.

Out of all the men in the study, 83% consumed breakfast. These men generally had healthier lifestyle factors – slightly lower BMIs, smoked less, exercised more, better diet quality, consumed less alcohol and more cereal fiber, and drank less coffee. After adjusting for age, there was a 50% greater risk for T2D in men who did not eat breakfast versus the men who did. This was significant even after adjusting for other dietary and T2D risk factors. Even after adjusting for BMI (well known to correlate with T2D risk), skipping breakfast resulted in a 21% greater risk. The most significant increased risk came from skipping breakfast and having a Western dietary pattern, than for each factor separately.

While there is still work to be done to better understand the link between breakfast and diabetes, here is just one more reason to encourage getting the day off to a healthful start. Be sure to fill your plate with healthy foods, including a quality protein, fruits or vegetables, low or no fat dairy and complex carbohydrates. Fuel yourself for a healthy day and a healthy future!

Enjoy!

Updates on Choline and Pregnancy

Pregnancy is a nutritionally significant period of life and a healthful and balanced diet is required to support proper growth and development of the baby and mother. Choline is an essential, but not a widely known nutrient for which mothers have increased needs during pregnancy. An interview with Cornell researcher, Dr Marie Caudill, highlights the significance of choline and further research endeavors.

Choline is required for proper cell functioning, cognitive functioning, and stress modulation. Adequate maternal intake can have significant long term impact on the child such as improved memory and learning. It is also believed that reductions in stress hormones mediated by choline can improve the temperament of babies and reduce future anxiety and stress related diseases. While choline can be taken later in life, choline exposure in utero has a stronger effect over time.

For more information make sure to check out The Scientist: Prof. Caudill Researches the Effects of Choline on Fetal Development in the Cornell Daily Sun and be on the lookout for her published findings in the Journal of the Federation of American Societies for Experimental Biology.

We highlighted the new Protein Trainer Toolkit with a continuing education credit opportunity at the booth and the workout sessions. ENC hosted an education session “Stronger, Healthier Boomers: The Role of Resistance Training and High Quality Protein” presented by Dr. Wayne Campbell, PhD and Nicole Nichols, Personal Trainer. This session was well received and participants were engaged. This was a great event to get to know this target audience better.

The American Society for Nutrition and the International Life Sciences Institute formed a taskforce in May of 2011 charged with the goal of clarifying what is known about energy balance and their findings should be enlightening:

• Energy balance is a complex system involving many individualized factors including components of intake, output and storage which interact with each other. Those who “gain weight at the sight of food” will be comforted at the recognition that resting energy expenditure (REE) varies between and within individuals and cannot be explained by body composition. The study also remarks that there is a hierarchy of macronutrient effects on the magnitude of the thermal effect of food (TEF), which means isocaloric amounts of protein has a greater effect on TEF than carbohydrate or fat. So a calorie is not always a calorie, regardless of the source.

• Another interesting conclusion is that short term weight loss is really a reflection of a temporary energy imbalance. What the panel felt was a key point was that energy balance as a concept depends on the time over which it is considered. We generally compensate for energy imbalances over the short term but over the long term our intake and our expenditure don’t vary greatly. Since dietary carbohydrate intake has an impact on renal sodium excretion, which results in changes in extracellular fluid, short term changes in macronutrient composition despite calories being held constant, are not reflective of changes in body weight. As an example, every 10 calorie reduction in energy/day will lead to an eventual loss of 1 pound when the body weight reaches a new steady state. It will take nearly a year to achieve 50% and about 3 years to achieve 95% of this weight loss.

• A caution that this paper suggests is that people tend to compensate for increased exercise with elevating food intake and reductions in physical activity at other times of the day. When people who are attempting to lose weight reach a plateau, the authors state that it is not due to metabolic slowing but to failure to comply with their diet. Often this is due to biological and psychological drives to eat which are hard to control.

These experts conclude that since it is expected to take a relatively long time for human body weight and composition changes to occur, it is important not to have unreasonable expectations about the impact of dietary or exercise changes on body weight. More research needs to be done especially to identify the mechanism(s) responsible for how and why we compensate for differences in energy intake.

Remember to keep your eggs safe during these festive times and year round!
We don’t usually focus on egg safety, but with the holidays I thought it might be a nice to review
General Egg Safety.

It is easy to keep eggs safe if you remember to Cook, Clean, Chill and Separate
• Cook
• Eggs should be cooked until the whites and yolks are firm or, for dishes containing eggs, until an internal temperature of 160 degrees Fahrenheit is reached because Salmonella is destroyed by the heat of cooking.
• Do not eat raw eggs.
• Clean
• Clean your hands, as well as the surfaces and utensils that come into contact with raw eggs – an important step for avoiding cross-contamination.
• Cool
• Keep eggs in the main section of the refrigerator at a temperature between 33 and 40 degrees Fahrenheit – eggs accidentally left at room temperature should be discarded after two hours, or one hour in warm weather.
• Separate
• Separate eggs from other foods in your grocery cart, grocery bags and in the refrigerator to prevent cross-contamination.

For Coloring Eggs
See the incredibleegg.org for great coloring and safety tips.

With all the festivities and fun, don’t forget to make Egg salad for Egg Salad Week starting April 9th!