Tag Archives: nutrition

Know your nutrients: Protein

For the last two weeks, I have written about carbohydrates and fats. This week in my Health & Fitness column in the Aiken Standard I am covering protein, another essential macronutrient in your diet.

Protein-rich_Foods


Protein is part of all cells and is the main component of muscles. Proteins are made up of building blocks called amino acids. The human body requires 20 amino acids for the synthesis of its proteins. Your body can produce some of these amino acids, so they are called non-essential because you do not need to get them from your diet. There are nine essential amino acids that cannot be made by the body and are obtained only from food. If the protein in a food supplies enough of the essential amino acids, it is called a complete protein. An incomplete protein is one that does not supply all the essential amino acids.

All meat and other animal products are sources of complete proteins. These include beef, lamb, pork, poultry, fish, shellfish, eggs, milk, and milk products. Protein in plant foods (such as grains, legumes, nuts, fruits, and vegetables) are either low in or lack one or more of the essential amino acids. These food sources are considered incomplete proteins. One exception is soy protein, which contains all of the essential amino acids.

Plant proteins can be combined to form a complete protein. This is called complementing. Examples of complementing plant proteins are food combinations such as rice with beans or black-eyed peas, beans with corn or wheat tortillas, and hummus, which combines chick peas with sesame paste. Since plant sources of protein are lower in fat and higher in fiber than meat, there are health benefits from getting more protein from plants.

A diet low in protein could lead to poor growth in children or result in muscle loss. For this reason, many people, especially athletes, are concerned about their protein intake. The typical diet for most people contains more than enough protein, so this concern is often unwarranted. People who follow vegetarian or vegan diets do need to pay extra attention to their protein intake. This is especially true for vegetarian athletes.

The amount of recommended daily protein depends on age, medical conditions, and activity level. The recommended intake for protein is 0.8 g protein per kg of body weight (or about 0.4 g protein per pound), so a 200 lb. person would require about 80 g protein per day. In general, two to three servings of protein-rich food will meet the daily needs of most adults. For example, four ounces of meat contains about 40 g protein, one cup of cooked beans contains about 15 g protein, and two slices of whole wheat bread have about 6 g protein.

Protein needs are higher for children, pregnant women, and athletes. That said, the average American’s protein intake is sufficient for most of these special situations. While athletes who are training to add muscle require much more protein than the typical adult, the average intake of most athletes is sufficient to meet these needs. In cases when it is not, the recommendation is to get extra protein from food, not supplements.

Since you probably get enough protein in your diet already, you should focus on healthier sources of protein. Select lean meat, poultry without skin, fish, lentils, and legumes often. Also try adding soy protein to your diet by eating tofu, soy milk, and soy beans (edamame) since soy protein contains beneficial compounds called phytochemicals. As always, you should get your protein by eating naturally protein-rich foods rather than through supplements or processed foods with added protein.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr
Aside

We have known for a long time that kids who spent more time watching TV were more likely to be obese. This was thought to be due to the fact that sedentary time in front of the television replaced physical … Continue reading

Know your nutrients: Carbohydrates

Nutrition and healthy eating are common themes in my writing, so it seems appropriate to provide more information about the major nutrients in our diets: carbohydrates, fats, and protein. These nutrients provide nearly all of the calories we eat and have a large impact on our health. Given the importance of these nutrients, there tends to be much confusion about the different forms they come in and how much of each we should eat.

In my Health & Fitness column in the Aiken Standard this week I  begin with carbohydrates. If this looks familiar, there is good reason: I have written about this topic in the past. Considering that I am asked basic questions about carbohydrates (and fat and protein) frequently, it is worth revisiting. Plus, it’s summer vacation so I am giving myself a bit of a break!


 

Starchy-foods

Carbohydrates are an important energy source in your diet. All carbohydrates contain four calories per gram. Grains, fruits, and vegetables are good sources of carbohydrates. Carbohydrates include starches, naturally occurring and added sugars, and fiber.

Carbohydrates are produced as a result of photosynthesis in plants and are stored as complex carbohydrates or starches in grains and many vegetables and as simple sugars in other vegetables and fruits. When you eat carbohydrates, your body breaks down the starches and converts the sugars to glucose, or blood sugar, which is used for energy.

The extent to which a food affects blood glucose is called the glycemic index, or GI. Refined carbohydrates, like white rice, pasta, and flour, and sugars typically have a high glycemic index, meaning they cause spikes in blood glucose. Whole grains, like whole wheat, whole oats, and brown rice, have more of a “low and slow” effect on blood glucose. This can help with blood glucose control and may affect appetite. For these reasons, low GI foods like complex carbohydrates from whole grains are called “good carbs,” in contrast to high GI refined grains and sugars, known as “bad carbs.” In reality, the glycemic index can provide a guide for selecting carbohydrates in the diet, but is no guarantee you are making healthy choices.

Carbohydrates also include fiber, the nondigestible portion of plants. Whole grains, fruits, and vegetables are rich sources of fiber while refined grains and sugars contain little, if any, fiber. Fiber comes in two forms, soluble and non-soluble. Non-soluble fiber, also called roughage, promotes good digestive health. Soluble fiber, like that found in oats, may help lower blood cholesterol. Studies show that diets higher in fiber tend to promote weight loss over time.

You should make an effort to reduce your intake of sugars, especially added sugars, in your diet. Even though all sugars have the same number of calories, foods and beverages containing added sugars should be avoided. Look for “corn syrup” and “high fructose corn syrup” on the label to identify added sugars. You may be surprised how much added sugar you consume! Fruits or 100% fruit juices are a healthy choice since they are rich in vitamins and minerals, even though they contain sugar.

Carbohydrates should be the major part of your diet. Current recommendations call for 45–65% of your daily calories to come from carbohydrates, so a person who eats 2000 calories per day should consume about 300 grams of carbohydrate. Sugars should be limited to less than 10% of calories, so the majority should be complex carbohydrates.

You can meet this goal by reducing your intake of sugars, especially added sugars, and refined grains while increasing your consumption of whole grains, fruits, and vegetables that are high in fiber. When comparing food labels, look for foods that contain whole grains (the first ingredient should be something like “whole wheat flour”) and higher levels of fiber. But be aware that some foods, like many breakfast cereals, contain whole grains but are also high in added sugar.

The best advice is to get the majority of your carbohydrates from real food, including vegetables, fruits, whole grains, and legumes, rather than from processed foods.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

 

 

 

Affordable care acts

The Affordable Care Act is in the news again, this time because the U.S. Supreme Court recently ruled on the legality of subsidies offered to help people afford health insurance. Health care has long been an important and contentious topic in both political and social circles. Given the importance that accessing quality health care has for everyone, it is unfortunate that promoting good health has turned into a political debate.

In addition to expanding access to health care, the Affordable Care Act should also make it easier for people to get preventive care. This is important since preventable chronic diseases including diabetes and heart disease, are among the leading causes of disability and death as well as contributing to high health care costs. It turns out that adopting some simple lifestyle modifications can go a long way toward making you and your family healthier, as well as saving money.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

2013-10-24 15.59.46


Here are a few affordable care acts you can implement today:

1. Move more

Significant health benefits, including weight loss and improved fitness, can be achieved with as little as 30 minutes of activity per day, but more is better. The activity doesn’t have to be “exercise.” It can include walking the dog, yard work, or house work. Research shows that sitting too much is just as unhealthy as not exercising. Spending less time sitting at work, home, or in the car is another easy way to improve health. And getting up and moving for even a few minutes is better than staying seated for long periods of time. Every little bit of activity really does count.

2. Eat smart

Making dietary changes can be difficult, but a few simple changes can lead to big benefits. Eating more real food including fruits, vegetables, whole grains, and lean meats and less added sugar is a good place to start. Fresh fruits, vegetables, and whole grain bread, pasta, and cereals are rich in vitamins, minerals, and fiber and most are low in calories. Eating less added sugar in sweets and processed foods can help you cut down on calories and lead you toward healthier food choices. Controlling portion sizes plays as big of a role in weight gain and loss as the types of food you eat, so pay attention to how much you eat, especially when you eat out. Chances are, it is more than you think!

3. Chill out.

Reducing and managing stress is essential for good health. Uncontrolled stress can lead to high blood pressure, poor immune function, and weight gain. Daily exercise will help, as will using stress management techniques like progressive relaxation. When you can, avoiding stressful situations is wise. Taking time to do something you enjoy each day is a good idea, too. Getting enough sleep (most adults require 7–9 hours) is also important for good physical and mental health.

4. Don’t smoke

Cigarette smoking more than doubles your risk of heart disease and stroke, and is by far the leading cause of lung cancer and other lung diseases. If you smoke, quitting now is one of the most important things you can do to improve your health—and the health of those around you. Nicotine replacement therapy and prescription medications can help, but quitting really does require serious dedication. It’s well worth the effort and the benefits of quitting can be realized almost immediately.

Regular activity, quitting smoking, managing stress, and the types of dietary changes described here can have a profound effect on preventing and treating many health problems. Best of all, these affordable care acts are basically free to implement and can lead to both health and financial savings now and in the future.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

School gets out, weight goes up. Why now is the time to focus on preventing childhood obesity.

Obesity is a major concern for adults, linked to several leading causes of death and numerous other health problems. What you may not know is that obesity is also a serious health issue for children. It is troubling to note that nearly one-third of school-aged children and teenagers are over a healthy body weight and nearly 20% are considered obese. Remarkably, 10% of infants, toddlers, and preschoolers, are also considered obese.

This is important because the common combination of poor nutrition, physical inactivity, and obesity has physical, psychological, and social consequences for children that frequently persist into adulthood. There are many reasons why childhood obesity occurs and much that can be done to prevent it. Now that school is almost out for the summer, this is a critical time of year to focus on good nutrition and activity to help prevent unhealthy weight gain in kids. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Childhood obesity cartoon


Overweight and obese children are at increased risk for type 2 diabetes, high blood pressure, heart disease and even stroke – conditions usually associated with adulthood. Even if an overweight child does not have these conditions now, he or she is likely on that path. Many experts predict that children born today will be the first generation in history to have a shorter lifespan than their parents due to obesity-related diseases that begin in childhood.

Children who are overweight are also more likely to suffer other consequences including lower self-esteem, social functioning, and academic performance. Overweight children are also less likely to play sports or participate in other forms of physical activity. Considering that the consequences of obesity are made worse by low levels of activity, this creates a cycle leading to poorer and poorer health.

There are numerous potential causes of obesity in children, but the most likely suspects are too little activity and excessive calorie intake, largely because of added sugars. Fewer than half of all kids meet the minimum recommendation of 60 minutes of activity each day and many children spend as much time watching television or playing video games as they do in school. We shouldn’t be surprised that we have a childhood obesity problem!

While poor nutrition and a lack of activity in schools is thought to contribute to the problem, many children get more activity and eat better at school than they do at home. A recent report suggests that children gain more weight over the summer than during the rest of the year. Furthermore, for many kids, fitness gains made during the school year are frequently lost over the summer. Since summer vacation is rapidly approaching, this is a critical time to help our children stay fit and healthy.

The good new is there is much we can do. Ensuring that children get plenty of healthy foods such as fruits and vegetables, reducing the consumption of added sugars, and eating appropriate portion sizes will go a long way to addressing the diet aspect of obesity. Making sure that kids of all ages have opportunities to be active while limiting time spent sitting, especially in front of a screen, are equally important.

Since children don’t make most of the decisions about their activity and diet, it is important to recognize the role that parents, grandparents, and other caregivers play. More often than not, obesity is a family issue. This means that  solving the problem is a family issue, too. Adults should model healthy behaviors by making diet and activity changes themselves. A good place to start is by turning off the TV and going outside to play or for a walk. It’s something all of us—adults and children—will benefit from.

Exercise, like all prescriptions, only works if you use it as directed.

Earlier this week  I wrote about the Exercise is Medicine initiative and why physicians should prescribe exercise to all of their patients.

Despite the widely-known benefits of exercise, many physicians—and people in general—believe that chronic health conditions should be managed using medications, not  proper nutrition and physical activity. This is a misguided approach considering that weight gain and health conditions related to weight gain  accumulate over a period of years, resulting from eating too much combined with low levels of activity.

One reason that physicians are hesitant to prescribe exercise (and, similarly, good nutrition) is that in their experience, it doesn’t work. What they mean is that the results they see after recommending lifestyle modifications are typically not sufficient. So the assumption made by doctors and patients is that lifestyle modifications don’t work. But this is not necessarily the case

This debate comparing lifestyle modification with medical management of chronic diseases is familiar. Consider statins, the popular lipid-lowering medications that are currently among the most-prescribed drugs (examples include Lipitor, Zocor, Crestor and Vytorin). The effect of statin drugs on lowering blood lipids is significant in most patients. This, together with clever marketing to both patients and physicians, explains why they are so widely used.

It is possible to lower blood lipids as much as statins by carefully controlling diet and regular exercise, but it is difficult. How difficult depends on the individual, but everyone would agree that successful lifestyle modification takes more effort and dedication than taking a pill. In order for any treatment to work, it has to be followed. A patient who doesn’t follow their diet or exercise program is no different from a patient who doesn’t take their medication as directed. In both cases, the response to the treatment will fall short of expectations.

If someone didn’t take their statin medication and their blood cholesterol didn’t go down, no one would label the drug a failure. The medication may well have worked if the patient took it. But people routinely claim that diet and exercise don’t work, when the real problem is that these treatments aren’t followed. This could be because the patients weren’t provided with appropriate and actionable information or because they didn’t faithfully follow the instructions they were given.

The problem isn’t that lifestyle modification isn’t effective, it’s that people don’t implement healthy changes for the long-term. Whereas a statin drug results in rapid changes, the benefits of behavior change are realized more slowly. This can lead to the incorrect conclusion that diet and exercise aren’t working, even though they are.

In reality, medication can be part of a treatment plan, but should not be the only prescription.  Long-term health benefits come from changing eating and activity patterns. Medications should be used as a  “jump start” to treating a condition, with a goal of developing a new way of eating and regular activity as the long-term treatment.

For example, medications like statins can lower cholesterol quickly. Then, lifestyle changes can keep the cholesterol down, reducing the need for the drug. Since side effects depend on the dose and duration of treatment, this approach would reduce the risk of potentially dangerous side effects.

For many patients, lifestyle changes are effective on their own, meaning the medication isn’t necessary. And consider this: maintaining a healthy body weight, proper nutrition, and regular exercise has been proven to be the best—and at this point, only—way to prevent most of the health problems most of us will face. Good nutrition and physical activity really are the best medicine!

Skip the smoothie, have a burger? Fast food for exercise recovery.

Many athletes use specialized supplements before, during, and after exercise to improve performance and enhance strength and endurance gains from training. Many non-athletes also use similar supplements, even though they may not need them. And a recent study suggests that fast food, literally meals from McDonald’s, can work as well as more expensive sports supplements for promoting muscle recovery following intense exercise. I try to make sense of all of this in my Health & Fitness column in the Aiken Standard this week.



SONY DSC

After exercise, many athletes consume specialized beverages and foods that supply nutrients to help their muscles recover. These recovery drinks generally contain some combination of carbohydrates (sugar) and protein and come in liquid, shake, or smoothie form. There are also energy bars specifically formulated for use after exercise. Research shows that these carbohydrate-protein recovery drinks and foods enhance muscle recovery and adaptations to training in some athletes. Even if you aren’t an athlete, you may consume these products after you work out. Let’s explore when and for whom these recovery products might be useful.

Intense endurance exercise—think of a distance runner, cyclist, or triathlete—uses muscle glycogen as a fuel. Muscle glycogen is a storage form of glucose, sugar that the muscle converts into energy. During prolonged exercise sessions that last at least 60–90 minutes, muscle glycogen levels can be severely depleted. Resynthesizing that muscle glycogen is a priority following exercise.

Athletes who are engaging in intense resistance training to build muscle and strength may also benefit from a recovery drink. Weight training stimulates protein synthesis in the muscle, so it makes sense that consuming additional protein would be beneficial. As new muscle protein is formed, both strength and muscle size are increased.

It has also been shown that combining the carbohydrates with protein results in more rapid muscle glycogen replenishment and increases muscle protein synthesis. This is why many specialized recovery drinks and foods include a combination of carbohydrates and protein. The best time to consume carbohydrates to restore muscle glycogen levels is immediately following exercise. Similarly, the muscle is most responsive to extra protein immediately after a resistance training session.

Perhaps these recovery drinks, bars, and shakes aren’t even necessary. Sports nutritionists have long recommended conventional foods and beverages for athletes after exercise. Research shows that chocolate milk is just as effective as more expensive supplements for replenishing muscle glycogen and promoting muscle protein synthesis. Remarkably, according to a study published last week, fast food may work just as well!

In this study cyclists were fed either commercial recovery aids or food from McDonald’s including pancakes, sausage, juice, a burger, fries, and soda after they completed an intense exercise session. Importantly, the meals contained equal amount of calories and nutrients. It turns out that there was no significant difference in how quickly muscle glycogen was replenished or in performance in a subsequent exercise bout between the two conditions. While the authors don’t recommend eating more fast food, this study suggests that foods not typically thought of as sports nutrition products can be effective for muscle recovery following vigorous exercise.

But what about people who engage in regular exercise to improve fitness or lose weight? The benefits of recovery drinks in athletes exist because the intense training causes changes in the muscle that allow the extra carbohydrates and protein to have a positive effect. Training at a lower intensity is unlikely to create this stimulus in the muscle, so these nutrients would not have a significant benefit. Simply put, most people don’t train hard enough to need a recovery drink.

The bottom line is that these recovery aids are not always necessary and you can get the same benefits from regular food. Something else to keep in mind is that these supplements, especially in shake or smoothie form, can be high in calories. It is entirely possible to consume more calories in a recovery beverage than you burn during exercise. This could diminish the effect of exercise on weight loss and may actually lead to weight gain. For most of us, a sensible diet with regular exercise is the key to meeting fitness and weight loss goals.

Driving yourself to the doctor.

Have you ever thought about how much time you spend in your car? On average, Americans face a 50-minute round-trip drive each day just for their jobs, and nearly thee-quarters of commuters drive alone. In suburban and metropolitan areas the commute can be much longer. Even in Aiken the average commute time is about 23 minutes. When you include driving to work, taking the kids to school, and doing errands, sitting in a car can easily account for an hour or more each day.

You can find the average commute time in your area using this really cool interactive map from WNYC.

You are probably very aware of the time you spend in the car. What you may not know is that sitting in your car can also have negative effects on your health and happiness. This is the conclusion of several studies that examined the relationship between commuting time and indicators of health. One of these studies suggests that vehicle miles traveled is a strong predictor of obesity. In another study, commuting a greater distance was associated with lower levels of physical activity and fitness as well as a higher waist circumference and blood pressure.

This makes sense because spending more time sitting in your car means you have less time to dedicate to being physically active, something we know is good for your health. Add to that the fact that driving is sedentary. There is accumulating evidence that spending more time sitting in the car, at work, or at home is a predictor of poor health, regardless of how active you are the rest of the day.

It gets worse. Many people eat in their cars during long commutes. Much of the time these “meals” consist of fast food and other prepackaged foods—not many people eat salads while they drive! Since these foods are typically of questionable nutritional quality and high in calories, this alone can contribute to obesity and poor health. The combination of inactivity and eating behind the wheel can easily shift the balance toward weight gain. Plus, eating while you drive is dangerous!

Beyond the direct impact on health through eating and activity behaviors, commuting alone in a car is a form of social isolation. Research suggests that this can lead to depression, itself an important factor leading to poor health.

The problems with long commute times are well established and easy to appreciate. Unfortunately, the solutions are not. Most people can’t move in order to have a shorter commute and relying on public transportation isn’t practical or even possible for many people, especially in our area. Replacing driving a car with active modes of transportation simply isn’t practical.

Aside from the time requirement—imagine how long a 25 minute drive would take on a bike or on foot!—our environment doesn’t adequately support active travel. Being able to walk or bike requires access to safe bike lanes and sidewalks that connect people’s homes to work, school, and other destinations. Even public transportation increases activity over driving and enhances social connections. Sadly, this infrastructure doesn’t exist in most communities, which were built to support cars, not people.

But we can take steps to undo some of the damage that so much driving can cause. Making activity at other times of the day a priority is a good start. This could include exercise at the gym, going for a walk, or even yard work or housework. When possible, replace car trips with walking or biking. Planning these activities with others can strengthen social connections as well as improve health and fitness. Finally, act as an advocate for changes in the community that will make active transportation more realistic.

More confusing food labeling, from people who should know better!

Since I am thinking about the topic of confusing food labeling this week, I wanted to share another example that I read about recently.

The Academy of Nutrition and Dietetics, formerly the American Dietetic Association, announced the first food to bear their “Kids Eat Right” label. This is a big deal, because the label is a sort of endorsement from the professional organization that represents nutritionists and dietitians. It follows that these foods would be among the healthiest choices for kids.

Unless they aren’t.

It turns out that the first food to bear this label is Kraft American Singles cheese “product.” It’s not even real cheese. Or even real food for that matter. Obviously, there is more going on here than helping consumers identify healthy foods for their kids. Hint: it involves money!

Nutritionist, professor, and author Marion Nestle provides some excellent commentary about this on her blog, Food Politics. Check it out…she is an excellent resource for all things nutrition.

When it comes to making good food choices, knowledge is power.

My Health & Fitness column in the Aiken Standard this week is about making smart food choices and how the nutrition information we are provided with can complicate that process.


Making smart decisions about what you eat is an important step in losing weight, feeling better, and preventing and treating a host of health conditions. But doing so requires that you have the knowledge to make those healthy decisions. Unfortunately, most people don’t have a good education in nutrition, forcing them to rely on information provided to them.

Some of this information comes from reputable sources and is based on research and experience. More often, though, nutrition information is provided by food manufacturers whose interests may not be consistent with providing smart recommendations. The end result is that consumers (that’s us) may not understand the information they get or know how to use it to make healthy choices.

A good example is the health claims about whole grains found on many food packages, including breakfast cereals. “A good source of whole grains,” is a common claim. Most people would reasonably interpret as a sign that the food inside is healthy, or at least is healthier than similar foods that don’t contain whole grains.

These types of claims are allowed by the FDA, but they refer only to what is in the food, not whether it is healthy or not. Many of the foods bearing this claim probably are healthy choices, but this isn’t always the case.

For example, Lucky Charms cereal contains whole grains. In fact, whole grains are the first ingredient, as the claim on the box indicates. Sounds good, right? But, when you read the Nutrition Facts panel on the side of the box you will find that the second ingredient is marshmallows! Does that sound like a healthy breakfast? (Hint: It’s not!)

Lucky_Charms package

 

This is the problem. If you are like most people, you won’t take the time to read the ingredients or the nutrition information on the back of the package. And even if you do, you may find that information to be confusing. Even if you wanted to make healthy choices, you might not have the knowledge to interpret and apply the available nutrition information.

This general lack of knowledge we have about nutrition has led to situations in which some foods are restricted or banned. Recently, the city of Berkeley, California voted to impose a tax on soda and other sugary drinks in an effort to keep people from consuming too much sugar and too many calories.

This effort, and others like it, have contributed to a vigorous debate about personal choice and freedom for people to make their own decisions about what to eat and drink. One argument against these types of restrictions is that if people have the nutrition information about soda (or any other food) they can make informed choices.

This is a nice idea, but it simply isn’t fair to expect people to make good decisions if the information isn’t available or is not easy to understand. Worse, misleading information can lead to making bad decisions.

Help may be on the way. The FDA is working on a redesigned Nutrition Facts panel that should help us make better food choices. In particular, the amount of sugar added to foods will be listed. This change alone will help identify foods that may appear to be healthy, like Lucky Charms which contain whole grains, but are actually high in added sugar. Additional changes include more realistic serving sizes and better information about fat content.

It is unclear when the updated nutrition facts panel will be implemented. In the meantime, do your best to read labels and use common sense as your guide: The addition of marshmallows does not make any food any healthier, no matter how much whole grain it contains!