Category Archives: Recommendations

Nutrition Fact: Proper Hydration is Important to Overall Health

The Importance of Good Hydration

We all lose water throughout the day just from breathing, perspiration, urine and bowel movements. Did you know that as little as a 2% reduction in hydration begins to impair every physiological function in our bodies? So in order for the body to function optimally, this water needs to be replaced by drinking fluids and eating foods that contain water.

Source: Body,health,fitness Blog

 

Why is water important? 

Water plays a crucial role in every physiological function in the body. It helps flush toxins out of vital organs and carries nutrients from food to cells for energy. Water also regulates hormones, body temperature, and the digestive process (preventing constipation). Joints, skin, and internal organs also all depend on water to function properly.  Also, proper hydration is important to maintain proper weight. A study from researchers from Virginia Tech found that drinking 16 oz. of water before meals three times a day over 12 weeks led to an increased average weight loss by about 5 lbs., compared to those who did not increase water intake before meals.  So having enough water could help you control your appetite and your intake helping to maintain proper weight or lose weight.

How do I know if I’m properly hydrated?  

One way to tell if you’re properly hydrated is your urine should be clear and relatively odor-free. Dark yellow or cloudy urine is often a sign of dehydration. Another sign of dehydration is thirst. If you’re only drinking water when you’re thirsty, you’re probably not drinking enough water. And if you’re really dehydrated, you could experience other signs such as: dry mouth, headaches, muscle cramps, fatigue, inability to concentrate, dizziness and nausea.  Also, many times, dehydration often can feel like hunger, so next time you feel hungry and you’ve already eaten, try drinking water to get yourself properly hydrated again.

How Much Water Should I Drink?   

How much water you need to drink per day depends on several factors, including exercise, the environment, injury or illness, and pregnancy or breast feeding. In addition, food contributes roughly 20 percent to overall hydration needs. Although specific recommendations vary among organizations, it is generally accepted that if an adult consumes two liters — or a little more than eight cups — of water daily in addition to a normal diet, this satisfies hydration needs.

Instances where more water may need to be consumed include before, during, and after exercise, exercising in hot weather, if you are ill or injured, or during pregnancy or breast feeding. Sports drinks that contain sodium and potassium (electrolytes) are generally only necessary when exercising vigorously for an hour or longer, otherwise water is always the best source for hydrations.  Beware of the high caloric count in sports drinks. Even drinks that claim to have 10 calories per serving often have two to three servings per bottle so the calories can add up if you were drinking enough.

While caffeinated beverages such as coffee, tea and soda do count towards hydration, water is still the best choice because it is stimulant and calorie free.

Tips to Increase Daily Water Intake

  • Carry a large water bottle and drink from it throughout the day.
  • Drink a full glass of water with each meal or snack.
  • Drink a full glass of water whenever taking medication.
  • Drink water before, during and after exercise.
  • Add a slice of lemon, lime or a handful of raspberries to water to add a little flavor.
  • Instead of soda, try sparkling water with some berries or a hint of fruit juice for flavor.
  • When drinking alcohol, alternate every alcoholic beverage with a glass of sparkling water.
  • When drinking juice, fill half of the glass with juice and top it off with water.
  • While water is the best source of hydration, your body does get some water intake through other beverages and foods.  Here’s a great diagram that shows one potential recommendation of how to balance beverage intake to optimize health benefits of certain beverages and mitigate the excess calories of others.

    Source: The Drinking Water Research Foundation

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Nutrition Fact: Not All Sources of Omega-3 Fatty Acids are Equal

You’ve all heard that omega-3 fatty acids are good for you but you may not know why and the best ways to get it so let me try to clarify a few things first.

  • Omega-3 fatty acids are a class of polyunsaturated fatty acids and α-linolenic acid is one form that is essential for metabolism but not synthesized by the body so needs to be received from diet.
  • α-linolenic acid (ALA) is converted to long-chain forms of omega-3’s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the body.
    • The conversion from ALA to EPA is only 5-10%
    • The conversion from ALA to DHA is only 0.1-1.0%.
    • EPA and DHA omega-3 fatty acids can be directly consumed in the diet from fish and small amounts from chicken.

What are health benefits of omega-3 fatty acids?

  • The omega-3 ALA has not been shown to show the same beneficial health benefits as EPA and DHA.
  • EPA and DHA have been found to be beneficial for infant growth, neural and retinal development, heart disease protection, and some evidence of reducing risk of coronary heart disease.
  • Omega-3 fatty acids, EPA and DHA have been shown to decrease triglyceride levels, decrease growth rate of atherosclerotic plaque, and slightly lower high blood pressure.

What are sources of omega-3 fatty acids?

  • ALA is commonly found in chloroplast of green leafy veggies, flaxseeds, chia, and walnuts.  But remember, the conversion to EPA and DHA is fairly inefficient from these sources.
  • EPA and DHA is best consumed from cold water oily fish like salmon, sardines, mackerel, anchovies, and herring but is found in small amounts in most other seafoods too.

Source: Cornerstone Wellness and Rebuild Blog

Official Recommendations

Organizations Official Recommendations
Academy of Nutrition and Dietetics 2 servings of fish per week, preferable from fatty fish  (500 mg/day EPA and DHA)
National Cholesterol Education Program Fish is recommended as a food item for people to choose more often as protein
World Health Organization Regular fish consumption (1-2 servings/week; each serving should provide 200-500 mg EPA and DHA)

* 8 ounces of cooked fatty fish per week is equivalent to 500 mg/day of EPA and DHA

 Other Useful Tips to Know

  • Farmed salmon actually has more EPA and DHA than wild salmon but both are excellent sources of omega-3’s.
  • White albacore tuna has twice as much EPA and DHA as light tuna.
  • Omega-3 from foods is always better than from supplements.  One of the reasons is that often times supplements actually just contain ALA which does not have the true health benefits you want which come from EPA and DHA.  Additionally, if you get fish oil supplements, it’s difficult to determine what fish they use and also the level of mercury in the fish, especially if they extract it from the fish skin.  So unless your doctor recommended increased intake of omega-3, you can get plenty from a healthy diet.
    • If you do take supplements, the FDA recommends that consumers not exceed more than a total of 3 grams per day of EPA and DHA, with no more than 2 grams per day from dietary supplements.  (unless otherwise recommended by your doctor)
  • While Flaxseeds don’t convert to EPA and DHA as efficiently as from fish, it’s a great food that can be added easily in your diet.  Make sure you use ground flaxseed and not whole.  Ground flaxseed is also preferable to flaxseed oil because in addition to omega-3 fatty acids, the seeds contain fiber, protein, vitamins, and minerals.  Try to add about 2 tablespoons of ground flaxseed to cold and hot cereals, oatmeal, batters, yogurts, salads, milkshakes, or smoothies.  I personally add it to cereals and milkshakes to to make them more nutritious.
  • Walnuts are also good sources so try adding it to your yogurt in the mornings or blend in your milkshakes or smoothies.  Because walnuts are a soft nut, they blend really well into milkshakes and not only do they add omega-3’s, but also adds a little bit more protein.
  • Canola and soybean oil both are good sources of omega-3 so try cooking with those oils from time to time and use flaxseed or walnut oil in salad dressings.
  • If you want to find out the EPA content of various types of seafood check out the USDA website and search their database. When looking at the full nutrient profile, you can find the amount of EPA by looking at the amount listed under 20:5 (the scientific abbreviation for EPA).

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Is ALL red meat bad for you?

Earlier this week, the LA Times published an article called “All Red meat is risky” based on a new study released by the Harvard School of Public Health that found increased risk of premature death with increased red meat consumption.  Some notable conclusions included that one 3 oz. serving of red meat per day was associated with 13% increased chance of premature death and change that to processed meat it jumps up to 20% increased chance of premature death. 

Source: LA Times

The article had stated that eating any kind of red meat in any amount was bad for you.  Now before you go and give up red meat completely, I wanted to share a few key points/thoughts I had after reading the published study.  I hope they help put things into perspective and help you make more realistic decisions.

  1. Dietary intake over the 20 years of the study was assessed using a Food Frequency Questionnaire (FFQ).  While FFQ’s are the best dietary assessment tool we have aside from controlled feeding studies, they still are inherently flawed. They ask participants to retroactively remember what they eat, make estimates and guesses, and in many cases over simplify ones diet so it’s important to keep this in mind when making drastic changes and conclusions based on studies using FFQs.
  2. While the study did separate out unprocessed red meat from processed red meat, it does not separate out organic from non-organic or grass-fed red meat, and also the various types of leaner cuts of red meat from fattier forms.
  3. The study also found that replacing 1 serving of total red meat with 1 serving of fish, poultry, nuts, legumes, low-fat dairy products, or whole grains daily was associated with a lower risk of total mortality: 7% for fish, 14% for poultry, 19% for nuts, 10% for legumes, 10% for low-fat dairy products, and 14% for whole grains.  This shows that by including other things in your diet and substituting some of your servings of red meat for healthier alternatives can help reduce the risk associated with red meat consumption.

In addition, about a month ago, a study from Japan with more than 51,000 men and women over 16 years found no connection between moderate meat consumption up to 3 ounces a day and premature death and another study from the Havard School of Public Health on red meat also found no connection between red meat consumption and heart disease and diabetes, though it did find an association with processed red meat consumption and heart disease and diabetes.

I also found the absolute risks of red meat consumption from the latest study on Harvard’s blog and it puts things into better perspective:


Deaths per 1,000 people per year

1 serving unprocessed meat a week

2 servings unprocessed meat a day

Women

7.0

8.5

3 servings unprocessed meat a week

2 servings unprocessed meat a day

Men

12.3

13.0

Source: http://www.health.harvard.edu/blog/study-urges-moderation-in-red-meat-intake-201203144490

The bottom line is that if you do eat red meat, processed red meat should be avoided or greatly limited in our diet (things like hot dogs, bacon, fast food hamburgers, pepperoni, etc.) and that unprocessed red meat should be eaten in moderation (1-3 times a week).

In addition, I find it interesting that the study in Japan found no connection between red meat consumption and premature death.  From my experience visiting Japan, I think there are three reasons that may be the case.

1. Japanese don’t eat very much red meat in general and have a diet high in fish compared to Americans.

2. Their red meat is much more likely to be organic and grass-fed than most meat Americans eat.

3. When they do eat red meat, the serving is generally less than 3 ounces and is prepared as thin slices either boiled or lightly seared.

I think more research is needed to make firm conclusions about whether or not grass-fed red meat is in fact much healthier and what amounts and cooking methods minimize risk, but based off ecological studies and comparisons, it may be true that what we feed our cows in America has an effect on how red meat affects our health, in addition to how much processed meats Americans tend to eat.

So when you do eat red meat, try to choose more unprocessed red meats and try to consume leaner cuts.  Below is a few of the extra lean cuts for you to choose from.

Extra Lean Cuts of Beef:

  • Eye of round roast or steak
  • Sirloin tip side steak
  • Top round roast and steak
  • Bottom round roast and steak
  • Top sirloin steak

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Nutrition Fact: More than 25% of Americans are Vitamin D Insufficient

Are YOU Getting Enough Vitamin D?

It seems like Vitamin D has been the “fashionable” vitamin over the past few years mainly because there has been a trend in research suggesting vitamin D deficiency/insufficiency may play a role in various diseases other than just bone health.  Additionally, while the the Institute of Medicine (IOM) increased their recommendations and upper limits for vitamin D for optimum bone health in 2010,  other experts don’t agree with those recommendations and more and more research is showing increased intake may protect against several chronic diseases.  So, with all the controversy and inconclusive evidence out there how do you tease out what you really need to know about Vitamin D?  Let’s start by understanding what vitamin D is and where you get it from.     

What is Vitamin D? 

Vitamin D is a family of fat-soluble vitamins which functions to regulate calcium and phosphorus homeostasis.  Additional functions include:

  1.  Helps maintain bone health
  2. Aids in cell differentiation of hemotapoietic and epithelial cells
  3. Enhances immunity
  4. Helps reduce inflammation
  5. Aids in regulation of blood pressure and insulin

Aside from these known functions Vitamin D plays, new research suggests that vitamin D status may also be linked to chronic diseases including cardiovascular disease, certain cancers, cognitive decline, depression, diabetes, pregnancy complications, and some autoimmune diseases.  Although the link between Vitamin D and these chronic diseases is still inconclusive, it’s not surprising that there has been a dramatic increase in sales in Vitamin D supplements and manufactures of the vitamin dues to evidence of protection against certain chronic diseases.

Where do I get Vitamin D from? 

Vitamin D is mostly obtained through skin exposure to UV B light where it is converted to the active form for Vitamin D (D3) in our skin.   Some Vitamin D is also obtained from the diet in fortified foods such as milk, cereals, and juices as well as some natural foods such as some fish (i.e. salmon and sardines) and liver.  But more recently many have been receiving vitamin D from supplements which either come in the form of D2 or D3.

Because most of our Vitamin D supply comes from sunlight, there are certain populations that are at risk of deficiency because they convert less sunlight to Vitamin D from their skin.  This includes:

  • Those with darker skin tones.  The increased melanin reduces conversion of sunlight to Vitamin D.
  • Those that don’t expose skin in the sunlight or wear high levels of sunblock all the time.  Clothing and sunblock inhibit the conversion of Vitamin D from sunlight.
  • Those that live in geographies that have less sun exposure.
What are the recommendations for Vitamin D intake?  

The Institute of Medicine (IOM) who puts out the Recommended Daily Allowances (RDAs) for nutrients makes the following recommendations for Vitamin D:

Recommended Dietary Allowance (RDA) for Vitamin D
Set by the Institute of Medicine
Life Stage  Age  Males
mcg/day (IU/day)
Females
mcg/day (IU/day)
Infants 0-6 months 400 IU (AI) 400 IU (AI)
Infants 6-12 months 400 IU (AI) 400 IU (AI)
Children 1-3 years 600 IU 600 IU
Children 4-8 years 600 IU 600 IU
Children 9-13 years 600 IU 600 IU
Adolescents 14-18 years 600 IU 600 IU
Adults 19-50 years 600 IU 600 IU
Adults 51-70 years 600 IU 600 IU
Adults 71 years and older 800 IU 800 IU
Pregnancy all ages 600 IU
Breast-feeding all ages 600 IU

Credit: Linus Pauling Institute on Micronutrients 

The IOM also set the tolerable Upper Limits for Children 9 years and older at 4,000 IU/ day to prevent any toxicity from over consumption of Vitamin D.  It’s important to keep in mind that these are conservative recommendations based only on the IOM’s review of the research related to optimum bone health.  Many other experts are now recommending increased intake of vitamin D in light of new research linking increased Vitamin D status to lower risk of certain chronic diseases and based on data from a NHANES study showing that about 30% of Americans are Vitamin D deficient or at risk of being deficient according to IOM serum Vitamin D levels for optimum bone health.  I personally was tested two years ago and was severely deficient as well.  In order also project against some chronic diseases, some experts such as the Vitamin D Council are now recommending as much as 5,000 IU/day for adults.

SO WHAT DO I RECOMMEND?

I think it’s still too early to be recommending everyone to start taking high dose Vitamin D supplements to protect against various chronic diseases, however, there is promising research for additional benefits with increased Vitamin D coupled with the fact that many Americans are in fact not getting enough Vitamin D from sunlight or the diet so I would recommend the following to increase your intake of Vitamin D:

  1. Get tested.  Testing your Vitamin D level is a simple blood test and especially if your insurance covers it, I would recommend it.  That will give you a basis on how much Vitamin D supplements, if any you really need.  There are also tests you can do at home with a simple blood pinch that are fairly inexpensive with decent accuracy to give you some idea of your Vitamin D levels.
  2. Try consuming more Vitamin D rich foods from your diet.  Natural is ALWAYS better so make sure you’re including enough milk, salmon, and other fortified foods in your diet to help increase your Vitamin D intake.
  3. Try to expose enough skin (arms and/or legs) to at least 5-15 minutes of sunlight twice a day.  That amount of time without sunblock should provide you with more than enough Vitamin D while still minimizing risk to harmful side effects of sun exposure.  Additional plus is that you can’t get Vitamin D toxicity from Vitamin D synthesized from sunlight, only from too much supplement or intake from the diet.
  4. If you do wish to take supplements, or if your doctor recommends it, make sure you take Vitamin  D3 over D2 which research indicates may be up to three times more potent.

After I finished my prescription dose of Vitamin D to get me back to a healthy blood level,  my doctor recommends to get between 1,000- 2,000 IU/ day so I eat fortified foods and take a 1,000 IU supplement daily.  That recommendation is based on the fact that I don’t get much sun exposure living in Seattle, have darker skin, and that my levels were low.  So before you start popping 1,000 IU or 2,000 IU Vitamin D supplements per day, I would recommend you get your levels tested and try moderate sun exposure and diet before you choose supplements.  That will prevent any potential toxicity from too much Vitamin D intake and will save you money…and who doesn’t need to save money right?

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Nutrition Fact: Not All Calories are Equal, Especially Liquid Calories.

Why liquid calories are different… 

Ever heard that a calorie is a calorie and that weight loss/gain is simply a matter of calories in versus calories out?  Well, while that theoretically is true, the reality is that our bodies process calories from different sources differently, and liquid calories are no exception.  The mechanisms for controlling thirst and hunger differ in our bodies.  So while liquid calories may quench our thirst, they do very little when it comes to curbing our hunger.

One of the reasons liquid calories act differently is because they travel faster through our intestinal tract which affects the nutrient absorption rate leading to altered effects on satiety hormones.  What does this mean?  Basically that 100 calories from a soda will not curb your hunger as well as 100 calories from something like an apple or other solid foods in general.

Ok but why is this important?

  1. Liquid calories add up fast and don’t keep you full! A 12 oz of cola contains 140 calories; A 12 oz. latte made with whole milk contains 180 calories; 16 oz. ice cream milkshake has 625 calories. But because they don’t provide the same satiety as solid calories, you usually just end up consuming more calories than you need. (Remember that every 3,500 calories eaten above your needs = 1 pound of fat gained)
  2. Liquid calories can lead to increased weight gain.  A recent Harvard Nurse’s Health study of more than 50,000 women over eight years found that those who increased their intake of sugar-sweetened beverages, such as sodas or fruit punch, from one per week to one or more per day consumed an average of 358 extra calories per day and gained a significant amount of weight. And vice versa, the women who reduced their intake cut their calories by an average of 319 and gained less weight.
  3. Most liquid calories are high in sugar!  

    Drinks

    Estimated Sugar Content

    Soda (8 oz) 22 g
    Fruit Smoothie (10 oz) 34-50 g
    Sports Drinks (8 oz) 7g
    Fruit Juice (8 oz) 24 g
    Energy Drinks (12 oz) 42 g

I know when you’re working all day or on the go, you need something sweet and caffeinated right?  Grabbing a latte or soda is just the easy thing to do.  But if you want to avoid liquid calories creeping up on you, here’s a few ideas for healthy alternatives or substitutions to try in situations like that:

  • Instead of soda, try sparkling water and squeeze a slice of lemon, lime, an orange, or even add a hint of fruit juice for a lower calorie, less sugar sweet alternative.  Added bonus, sparkling water does not contain phosphoric acid like most sodas which is bad for your bones.  
  • Instead of a normal latte, use soy or non-fat milk instead for a lower calorie drink or just coffee or tea and go easy on the sugar or sweetener.  
  • If you like drinking alcoholic cocktails, try ordering a glass of wine or lite beer instead for a lower calorie alcoholic beverage
  • When it comes to smoothies, just order the smallest portion to keep calories under control.  Usually smoothies come in 16oz servings or more so go for the half portions.  
  • And remember, water is always your best option to quench your thirst.  Your body needs 8-10 glasses a day!  

So next time you’re debating whether that drink is worth it, think twice before you drink those liquid calories =)

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