Thursday, February 9, 2012

Jennifer Sygo: Food addiction and other trends from the year in nutrition | Appetizer | National Post

Jennifer Sygo Dec 21, 2010 – 8:00 AM ET | Last Updated: Dec 20, 2010 5:31 PM ET

Finbarr O’Reilly/Reuters

While restaurants make small strides toward reducing sodium on their menus, researchers are trying to figure out what makes some of us more susceptible to tempting fatty foods.

Not surprisingly, nutrition found its way into plenty of headlines again this year, as populations continue to age and the health problems from not eating well become more apparent in medical stats. Several significant trends emerged in 2010. Here’s a summary of the most important:

1. Cardiovascular carbs and protein power: We’ve all suspected it for years, but 2010 was the year we got some data to confirm the potential impact the so-called “bad” carbohydrates (white or refined) have on our hearts. Emerging evidence suggests a diet rich in high glycemic carbs (the ones that cause our blood sugar to rise rapidly) can impact our so-called “bad” (or LDL) cholesterol in a subtle, but significant way by causing our body to produce LDL cholesterol that is particularly dense and “sticky.” The result is more cholesterol stuck to arteries, which can trigger a cascade of plaque-building and inflammation that is the hallmark of atherosclerosis.

2. Calcium conundrum: The other big news of the year came from the bombshell British Medical Journal study that highlighted the potential harm of taking high doses of supplemental calcium. A compilation of data from several studies indicated those taking high-dose calcium supplements, in particular post-menopausal women, could be putting themselves at risk of a cardiovascular event (i.e. a heart attack), especially if they exceed the Dietary Reference Intake (1,200 mg per day for men and women over 50, or 1,000 mg per day for those 50 and under).

The take-home message was not that calcium supplements should be avoided, but that supplementation should only be used within the recommended range. In other words, it’s best to first figure out how much calcium you are getting from your diet (online calculators can help with this), then add only a supplement to reach an intake of 1,000-1,200 mg
per day, but not more.

3. Vitamin D: Finally, some new guidelines With much ballyhoo, this year finally brought the long-awaited new recommendations for vitamin D intake from the U.S. Institute of Medicine, but not without controversy. While the IOM recommends adults triple their intake of the so-called “sunshine vitamin” from 200 to 600 IU per day to optimize bone health, that number still falls short of the 1,000-2,000 IU per day that many researchers believe is needed to help prevent various forms of cancer, not to mention heart disease, type 2 diabetes, and other conditions ranging from chronic pain to multiple sclerosis. The reason for the conservative increase largely relates to a dearth of randomized, controlled trials — the perceived gold-standard for assessment of benefit of a vitamin, drug or supplement — comparing vitamin D against placebo.
On the other hand, the report, which is expected to trigger revisions to the daily recommended intakes established by Health Canada, also doubled the upper level, or safe limit, for vitamin D from 2,000 IU to 4,000 IU per day, providing clinicians with significantly more flexibility to recommend supplementation as the individual may require.

4. Sodium reduction: As a result of the recently released Sodium Working Group’s report, the pressure is on the food and restaurant industries to cut salt levels in prepared foods. While the voluntary reductions have so far been modest — most companies are looking to cut salt in their products or meals by 10% to 25% over the next one to three years — the reality is that this might be the most realistic way to wean us all off our collective addiction to salt. Much like spicy foods, salt is something we adapt to over time, so the more salt we consume, the more we feel we need. By that logic, cutting sodium gradually might be the only way most people will be able to reduce their intake without feeling deprived.

5. On the horizon … Food addiction? The concept of food addiction is one that’s been batted around for years, but in 2010 the media started to take more notice. While food addiction will likely never make its way into the Diagnostic and Statistical Manual of Mental Disorders — because food is a necessity in our lives, unlike cigarettes, alcohol or drugs — there is a growing appreciation that, for some people, food can trigger a response in parts of the brain consistent with addictive drugs. Most commonly, foods that we usually think of as less healthy, such as salty, fatty or very sweet foods, elicit a stronger addictive-type response than, say, vegetables or fruit.

While some individuals seem to be partly immune to these addictive pathways, be it for genetic or environmental reasons, others are much more susceptible. The challenge for researchers will be to determine which individuals are at risk for food addiction, and then to develop tools and strategies to help break the cycle of addictive behaviours in a world where temptation from food is all but omnipresent.

• Jennifer Sygo is a dietitian in private practice at Cleveland Clinic Canada (clevelandclinic.ca), which offers executive physicals, prevention and wellness counselling and personal health care managemen

Are Canadians eating too much sugar? | Life | National Post

Life

Are Canadians eating too much sugar?

Jennifer Sygo Oct 4, 2011 – 1:30 PM ET | Last Updated: Oct 4, 2011 1:51 PM ET

Justin Sullivan/Getty Images

Just a few sweets can seem innocuous enough, but what about when you find yourself reaching for that tenth handful?

Canadians like their sugar. According to last week’s Statistics Canada report, Canadians consume an average of about 110 grams of sugar per day, the equivalent of about 26 teaspoons. But since the report did not differentiate between different types of sugar, it is left to tease out the implications of this new data. Let’s give it a shot:

TYPES OF SUGAR

Sugar finds its way into our diet naturally through fruits, some vegetables and unsweetened dairy products. It also creeps in as added or refined sugar via candy, pop and baked goods, as well as some types of cereal, flavoured yogourt, chocolate milk or soy milk, canned fruit and fruit drinks. While the research differentiating between the effects of naturally occurring vs. added sugar is still lacking, it is generally accepted that so-called natural sugars are a better, healthier choice than refined or added sugars. Part of the reason could be metabolic — many of the foods that contain natural sugars have a lesser impact on blood sugar compared with many sweetened foods — and part of it could be nutritional, since foods with naturally containing sugars are often rich in vitamins, minerals and other nutrients such as protein or fibre.

HOW MUCH ARE WE EATING?

According to the new Statscan report, which used data from the 2004 Canadian Community Health Survey, one in every five calories that Canadians consume comes from sugar. About a third of that intake is derived from vegetables and fruit, but some 35% comes from what is described as the “other” food category, namely the category that includes sweets and soft drinks. This means the average Canadian consumes about 38.5 grams, or 10 teaspoons, from that “other” category per day.

HOW MUCH IS TOO MUCH?

So is this a lot or a little? Unfortunately, the lack of consistent guidelines makes it hard to give a clear answer. The World Health Organization recommends that no more than 10% of our total calories come from added or refined sugar, which translates to no more than about 50 grams per day for a person consuming 2,000 calories per day (there are four calories in a gram of sugar; note that a typical can of pop contains between 36-42 grams of sugar). Since the Statscan survey found that we consume 38.5 grams of added sugar from candy and pop, you could argue there is little need for alarm.

But not everyone would agree. In 2009, the American Heart Association came out with new guidelines around sugar intake that are much less liberal than the WHO. The AHA recommendations are based on what they deem discretionary calories, or calories from foods that aren’t vital to meeting our nutrient needs. According to their data, a person consuming 2,000 calories per day needs to eat about 1,750 calories per day from such healthful foods as fruits, vegetables, fish, eggs, beans, yogourt and nuts to meet all of their nutrient needs. That leaves only a fraction of calories for what you might call “the sins”: unhealthy fats, added sugars and booze. Give each of the three a piece of this limited pie, and you’re left with enough room for a mere 32 grams, or eight teaspoons of added sugar per day for an average person.

So, by the AHA standards, which in my opinion are much more reflective of the current state of research than the older WHO and IOM guidelines, Canadians are consuming too much sugar from the “other” category alone. But here’s the rub: the Statscan report does not differentiate between added and naturally occurring sugars that fall within the traditional four food groups (grains, vegetables and fruit, meat and alternatives, and milk products). That means that added sugars found in cereals, flavoured oatmeal, sweetened yogourt, fruit cocktails and chocolate milk are not included in the 38.5 grams that we already consume every day from “other” foods. Once you factor all of those extra sugars in, then our total intake will undoubtedly jump, probably beyond the more liberal WHO guidelines.

WHY WORRY?

As mentioned, sweets and added sugars crowd out more nutritious food, but they also add unwanted extra calories to otherwise nutritious food, such as yogourt or oatmeal. Beyond that, added sugars can harm our hearts by driving up triglycerides (a type of fat circulating in our blood stream), and possibly contribute to elevated blood pressure. Perhaps even more concerning is emerging evidence that also suggests excess sugar contributes to inflammation in our body, which over time may play a role in the development of chronic disease. And, finally, sugar has an addictive quality that tends to leave the eater craving more.

-Jennifer Sygo is a dietitian in private practice at Cleveland Clinic Canada, which offers executive physicals, prevention and wellness counselling and personal health care management in Toronto.

How to Have a Healthy Heart For Life - MSN Health & Fitness - Cholesterol

Find more

Ready for some exciting health news? "Ninety-nine percent of heart disease is preventable by changing your diet and lifestyle," says Dean Ornish, MD, a clinical professor of medicine at the University of California at San Francisco and author of Dr. Dean Ornish's Program for Reversing Heart Disease. What's more, scientists are discovering that we don't have to ban all fat and salt to stay healthy. Instead, you just need to cut back on saturated fat (which comes from meat and whole-fat dairy) and trans fats (found in partially hydrogenated oils in fried and many processed foods). These types of fat seem to increase levels of "bad" LDL cholesterol, which lines arteries with plaque and can cause a heart attack or stroke.

Good fats, on the other hand— — such as monounsaturated (think olive oil and avocados) and polyunsaturated fats, like omega-3 fatty acids (found in sunflower oil, soybeans, and some fish) — —lower LDL levels and raise levels of "good" HDL cholesterol. Meanwhile, a 2011 study in the Journal of the American Medical Association challenges the notion that we all need to slash our salt intake, suggesting that going low-sodium is more important if you're at high risk of heart disease—say, you have a family history of the condition, you have diabetes, or you smoke.

Whether or not you have these risk factors, though, prevention is key. And it starts on your plate. See how three women staged their own heart-healthy dietary interventions, and follow in their footsteps to keep your heart pumping strong now and in the decades to come.

Build a better diet

Lily Lin, 31, recently got a serious health wake-up call: She was diagnosed with prehypertension at 30, then prediabetes the next year — —both conditions that up your chances of developing heart disease. She was placed on blood pressure medication as a result. Then her maternal grandmother died from a stroke. Lin knew that her dad had high blood pressure and her mother had high cholesterol — —heart disease risk factors that she had a chance of inheriting. "I'd thought I had years before I needed to worry about those things," she says.

Lin, a business analyst in New York City, decided to take charge of her health and went to the Pritikin Longevity Center in Miami, which focuses on reversing heart disease and other conditions through lifestyle changes. Pritikin doctors advised Lin to lower her intake of animal protein, due to its saturated fat content, so she traded her deli meat lunches for tofu, beans, and grilled fish.

Lin also learned to limit refined carbohydrates, including muffins and her 100-calorie cookie snack-pack breakfasts. Moderate to heavy consumption of simple carbs like these can double your risk of heart disease, a 2010 Archives of Internal Medicine study suggests. Instead, she now fills up on fiber-full complex carbohydrates such as oatmeal. "I learned that fiber carries cholesterol out of my body instead of into my bloodstream," Lin says. Adding in more fruit made a difference, too; in fact, scientists have just discovered that the effects of the gene most closely linked with heart disease can actually be modified by eating plenty of fruits and raw vegetables.

Lin's efforts have paid off: She was recently told she could stop taking her blood pressure meds. "I've never felt so good," she says. "My friends and family see the changes in me. I used to live to eat, but now I eat to live."

Moves to make in your 30s: Talk to your MD about your family history of heart disease, and ask about any other personal risk factors to watch for. For example, if you had gestational diabetes or preeclampsia when you were pregnant, your risk of heart disease is at least doubled. If you're at low or no risk, get your blood pressure checked every year and get a cholesterol baseline, too. "If results are normal, you can wait till your 40s to repeat the test," says Jacob DeLaRosa, MD, author of the Heart Surgery Game Plan.

Go for the best new tests

At 45, Stephanie Corn looked and felt healthy. Her cholesterol tests were normal. But because her mother had suffered three arterial blockages and undergone open-heart surgery in 2008, her doctor decided last year to go beyond the standard screenings and give her a new type called an LDL particle test which, while not routine, can give a fuller picture of heart-disease risk. In fact, major organizations like the American College of Cardiology and the American Diabetes Association now believe that your concentration of LDL particles— — which adhere to the arterial wall and deposit cholesterol there — —is a better predictor of heart disease risk than high LDL cholesterol levels in and of themselves.

The verdict: Corn's particle number was about 1,700. The ideal number is under 1,000— — meaning she was at high risk of heart disease. "I just about cried," says Corn, a finance officer for the city of Claremont, North Carolina. To get her out of the danger zone quickly, Corn's doctor put her on statins — —drugs that lower cholesterol— — but for long-term results, he encouraged her to change her diet, which, for this Southerner, meant saying good-bye to her beloved fried fish and its trans fats. He also warned her to stay away from soda: A 2011 study from the University of Oklahoma shows that women who drink two or more sweetened beverages a day are more likely to gain weight, increase waist size, and develop other risk factors for heart disease. In just one year, Corn brought her particle number down to 900 and is no longer at high risk. "I wouldn't have known I was in any danger without the test," Corn says. "It saved my life."

Moves to make in your 40s: If your chances of getting heart disease are above average, ask for a blood test to measure your LDL particles in addition to a standard cholesterol test. Women without risk factors should still get a standard cholesterol test at least every five years beginning at age 40, since plaque on your arterial walls can become more problematic with age. Being overweight or obese ups your odds of getting heart disease, too, so now's a good time to get your diet in check to help halt the middle-age spread.

Eat your superfoods

Maryann Chiaro, 54, of Valatie, New York, had gotten a clean bill of health at every checkup for decades. So when she saw a new doc last year, she was surprised to learn that her total cholesterol was high. "He told me that if I didn't get my levels down, I'd be going on Lipitor," says the upstate New York mom. Chiaro does have a family history of hypertension; her mother suffered a heart attack at age 62. She'd thought being a vegetarian was keeping her healthy, but, she admits, she was only getting in two veggies a day — —"barely." Instead, she built meals around her favorite food: cheese.

To avoid following in her mother's footsteps, Chiaro worked with her doctor and a dietitian. They identified super-foods that Chiaro makes sure to eat every day, including oatmeal, dark green veggies, nuts, and olive oil. "I'm eating kale, turnips— — things I'd never had before," she says. She also lowered her saturated fat intake by giving up cheese entirely, getting her protein instead from hummus, beans, and salmon.

In only five months, Chiaro has lowered her cholesterol from 181 to 138— — without medication. Those are results anyone can achieve: "The more you change," Dr. Ornish says, "the more your heart health improves."

Moves to make in your 50s: Have your cholesterol and blood pressure checked every year, and ask your doctor about getting a blood-sugar test to rule out diabetes. On a daily basis, simply eating well and staying slim will go a long way toward keeping the cardiologist away.

California lawmaker plans hearings on soda-obesity link

LOS ANGELES (Reuters) - The California lawmaker who spearheaded a high-profile anti-obesity effort across the country's most populous state is now training his sights on sugar-sweetened drinks.

Sen. Alex Padilla, who led a campaign requiring big restaurant chains to disclose calories in meals, said on Thursday he planned to hold hearings in November on the link between soda consumption and obesity.

The announcement from Padilla -- who chairs the California Senate's Select Committee on Obesity and Diabetes -- coincides with the release of a study that shows nearly two-thirds of children aged 12 to 17 gulp down at least one sugar-sweetened beverage daily.

According to the UCLA Center for Health Policy Research and the California Center for Public Health Advocacy, 62 percent of children aged 12 to 17, and 41 percent of children aged 2 to 11, drink at least one sugar-sweetened beverage a day.

"I don't think that most parents truly appreciate the role soda pop has in causing weight gain," Padilla said. "It is unfortunate that soda is actually cheaper than milk and even bottled water in many instances."

California was the first state to pass menu labeling rules and has been among the pioneers of public health initiatives such as bans on artery-clogging trans-fats in restaurant cuisine and on soda sales in public schools.

Experts say the U.S. obesity epidemic has turned into a public health crisis and overweight adolescents are starting to suffer problems that used to plague mainly middle-aged adults -- early heart disease and type 2 diabetes.

SHARP CUTBACK RECOMMENDED

The American Heart Association in August took on the $115 billion soft drink industry, recommending that Americans cut back dramatically on sugar and singling out soft drinks as the top source of "discretionary" sugar calories.

The group said women should eat no more than 100 calories of added processed sugar per day, or six teaspoons (25 grams), while most men should keep it to just 150 calories or nine teaspoons (37.5 grams).

To put that in perspective, one 12-ounce (355-millilitre) can of soda can contain as much as 13 teaspoons (54.6 grams) of sugar, often in the form of high fructose corn syrup.

That's more than half the total 22 teaspoons (90 grams) or 355 calories of added sugar consumed by the average American each day, according to a 2004 government survey.

Being overweight costs, experts say.

Obesity-related diseases account for nearly 10 percent of all medical spending in the United States, or an estimated $147 billion annually. Health experts increasingly are calling for taxes on soft drinks and other sweetened beverages to offset medical costs and fund public health efforts.

"If we are serious about curbing the obesity epidemic, we have to start with the biggest culprit," said Harold Goldstein, executive director of the California Center for Public Health Advocacy.

The American Beverage Association has opposed efforts to tax soda and other beverages. An industry group called Americans Against Food Taxes -- whose backers include soft drink maker PepsiCo Inc, the American Beverage Association, the Corn Refiners Association and McDonald's Corp -- has taken to the airwaves with anti-tax advertisements.

Sugar should be controlled like alcohol: report | News | National Post

Sugar should be controlled like alcohol: report | News | National Post

Margaret Munro

Sugar is so toxic it should be controlled like alcohol, according to new report that goes so far as to suggest setting an age limit of 17 years to buy soda pop.

It points to sugar as a culprit behind many of the world’s major killers — heart disease, cancer and diabetes — that are now a greater health burden than infectious disease.

A little sugar “is not a problem, but a lot kills — slowly,” says the report to be published Thursday in Nature, a top research journal.

Over the eons sugar was available to our ancestors as fruit for only a few months a year at harvest time, or as honey “which was guarded by bees,” says the report by Dr. Robert Lustig, a noted childhood obesity expert at the University of California, and two U.S. colleagues specializing in health policy.

Now it is added to “nearly all processed foods.” In developing countries, sugary soft drinks are often cheaper than potable water or milk, they say, noting that over the past 50 years, consumption of sugar has tripled worldwide.

The sweetener is made from sucrose, found in sugarcane and sugar beets or from high-fructose corn syrup (HFCS), and contains a roughly equal mixture of glucose and fructose.

A growing body of scientific evidence shows that the fructose “can trigger processes that lead to liver toxicity and a host of other chronic diseases,” Lustig and his colleagues say.

“If international bodies are truly concerned about public health, they must consider limiting fructose — and its main delivery vehicles, the added sugars HFCS and sucrose — which pose dangers to individuals and to society as a whole,” they say.

“We recognize that societal intervention to reduce the supply and demand for sugar faces an uphill political battle against a powerful sugar lobby,” the researchers say, “and will require active engagement from all stakeholders.”

But such “tectonic shifts” in policy are possible, they say, pointing to bans on public smoking, limits on alcohol sales and condom dispensers in public washrooms. “It’s time to turn our attention to sugar.”

Many schools have removed pop and candy from vending machines, but “often replaced them with juice and sports drinks, which also contain added sugar,” the report says.

Canada and some other countries have also imposed small taxes on some sweetened food, but the researchers say it would take a big price hike to impact consumption.

“Statistical modelling suggests that the price would have to double to significantly reduce soda consumption — so a $1 can should cost $2,” they say.

The report suggests governments introduce zoning rules to control the number of fast-food outlets and convenience stores in low-income communities and around schools.

“Another option would be to limit sales during school operation, or to designate an age limit (such as 17) for the purchase of drinks with added sugar, particularly soda.”

Parents in South Philadelphia, Pennsylvania recently lined up outside convenience stores and blocked children from entering them after school. “Why couldn’t a public-health directive do the same?” says the report.

Ultimately, it says, food producers and distributors must reduce the amount of sugar added to foods. “But sugar is cheap, sugar tastes good and sugar sells, so companies have little incentive to change.”

Lustig and his colleagues say the U.S. Food and Drug Administration could “set the table” for change by limiting the amount of sugar that can be added to food.

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