Archive for June, 2005
Warnings about children’s unhealthy lifestyles are common, but experts are now showing how junk food fans could look in middle age.
Computer wizardry allowed one family to see how their children will look at 40, if they do not change their habits.
Child health experts are overseeing the experiment for the BBC3 show Honey We’re Killing the Kids!
Julie Buc, whose children loved eating fried food and sweets, said she was shocked by the images she saw.
‘Got to change’
Her children, Jason, aged 10, and Joanna, eight, also enjoyed up to two litres of fizzy drinks each day.
They ate their food while watching TV, and did not have a set bedroom routine.
A team of experts, led by child psychologist Kris Murrin, used data from Institute of Child Health-approved medical and scientific tests to collate information on the Stockport family’s lifestyle.
They then used high-tech computer graphics to show how the children would look as adults.
Julie said: “All those years that we’ve been giving the children what they want has got to change and I’m actually quite scared.”
The psychologists and nutritionists gave the family a four-week plan on how to change their dietary and living habits.
Julie and her husband Jimmy were told to set bedtimes for 8.30, to eat at the dining table, and to introduce a healthier diet.
Sugary drinks, sweets, fried foods and crisps were banned, and salads, fruits and vegetables were introduced.
‘We’ve changed’
Jason said: “It’s been really good eating at the table, but I think it’s good for the family to tell each other what they’ve been doing during the day.”
The children also took up new hobbies, including ballet, to encourage them to exercise more.
The family were even encouraged to go orienteering together.
At the end of the project, Jimmy Buc said: “The most important things to me are my wife and my children, and I want my children to be successful.
“I hope my children will be now, because we have changed, and there’s no way we will be going back.”
June 30th, 2005
If your cheese or bread has grown mold, don’t merely cut off the moldy part and eat the section that still looks okay.
According to the U.S. Department of Agriculture, mold can grow where you can’t see it, especially in high-moisture or porous foods. So if you see mold on foods such as bread, soft cheeses, grain, meats, dairy foods, or fruits and vegetables, it’s best to throw out the entire package.
Mold on hard cheese can be cut off one inch around all sides of the mold, but take care to keep the knife out of the mold to avoid contamination. And throw out the old wrap in which it was stored.
June 30th, 2005
Dietary Fiber - Dietary fiber is found only in plant foods. Fiber should be consumed daily to improve movement in the gastrointestinal tract, to keep blood sugar levels moderate after eating, and to maintain healthy cholesterol levels.
Vitamins - Vitamins enable many chemical reactions to occur in the body and are necessary for metabolism. Vitamins are classified as water soluble (C, B) or fat soluble (A, D, E, and K). Vitamins do not provide energy because they do not contain calories, but they do help the body convert food into energy.
Minerals - Minerals play an important role in metabolism and are involved in the make up of the body’s structure. Minerals do not provide energy directly, but they are important for the body to function properly.
Water - Water is a vital nutrient. It dissolves substances, lubricates our joints, and provides a way to transport nutrients and waste. Every cell in your body needs water. Most people in the U.S. do not consume enough water. The rule is 1 liter (4 cups) per 1,000 calories.
Nutrients
Macronutrients -Carbohydrates, Protein, and Fat
Macronutrients are required daily. They supply the energy (calories) and building blocks needed for growth, maintenance and activity. They are broken down into their basic units: sugars from carbohydrates, fatty acids and glycerol from fats, and amino acids from proteins.
It is very important to recognize that calorie content varies among the macronutrients:
Carbohydrate: 4 calories per gram
Protein: 4 calories per gram
Fat: 9 calories per gram
**Although alcohol is not a macronutrient it contributes 7 calories per gram and should be taken into consideration for calorie balance.
Micronutrients - Vitamins and Minerals
Micronutrients include vitamins and minerals. Micronutrients are necessary for using the food you digest, but they do not directly provide energy.
Calories Do Count
The nutrition facts panel on foods lists the number of calories per serving. The number of calories is determined by the amount of carbohydrate, protein, and fat. Cutting down on fat may help you lower caloric intake as well as keeping a close eye on portion sizes. Low fat is not always the best strategy. If you choose a lower-fat food but double the portion, the result will be a higher caloric intake.
Simple Math Made Easy
Example of calorie calculation : Most foods are a combination of carbohydrate, protein, and fat. The number of calories in a food is the sum of the calories provided by each nutrient. Reading the nutrition labels is important.
Nutrition Facts
Nutrition Label of a Blueberry Muffin
Serving Size 1 muffin
Serving per Container 1
Calories 199
Total Fat 7g
Protein 4g
Total Carbohydrate 30g
7 grams of fat x 9 calories per gram = 63 fat calories
4 grams of protein x 4 calories per gram = 16 protein calories
30 grams of carbohydrate x 4 calories per gram = 120 carbohydrate calories
Total = 199 calories
This Blueberry Muffin contains 7 grams of fat, 4 grams of protein and 30 grams of carbohydrate for a total of 199 calories A closer look at Fat Calories will help you achieve a diet with less than 30 % fat.
63 fat calories divided into 199 (total calories) x 100 = 32% Fat
This quick calculation of % of total calories from fat demonstrates how this food may or may not fit into an overall nutrition program to achieve 30% fat.
Nutrition Examples:
It will take approximately 20-30 minutes of jogging to burn off the calories in the blueberry muffin used in the example above*.
*Based on a 150lb. Person
Portion Control
Keep an eye on servings. For example, many people eat 2 slices of bread in a meal, which really equal 2 servings.
Portion Control = Calorie Knowledge = Weight Control
Choose sensible portion sizes.
Use this as a guide:
Fist = about 1 cup, or 1 medium fruit
Palm = about 3 oz. Cooked poultry, meat, or fish
Cupped hand = 1 - 2 oz. Pretzels
Thumb = about 1 oz. Cheese or meat
Thumb tip = 1 Tbsp
Fingertip = 1 tsp.
Body Mass Index (BMI)
Body Mass Index (BMI) is the ratio between your height and weight. The BMI calculation is derived from weight in kilograms divided by height in meters squared. According to the National Institutes of Health, anyone with a body mass index of 25 or above is considered overweight. BMI does not provide any information on body composition. It is possible for a person to have a normal BMI and have a high body fat percentage. BMI may not be appropriate for individuals with a high amount of lean muscle mass because it may overestimate their BMI.
Another way to assess your health risk is to figure out your body weight in comparison to your ideal body weight.
110% Ideal Body Weight = Overweight
120% Ideal Body Weight = Obese
130% Ideal Body Weight = Morbidly Obese
Dietary Guidelines for Americans, 2000
• Aim for a healthy weight. A healthy weight is key to a long, healthy life
• Be physically active each day. Aim to accumulate at least 30 minutes of physical activity daily. Physical activity and nutrition work together for better health. Physical activity increases the amount of calories you use as well as improves bone health.
• Let the Pyramid guide your food choices.
• Choose a variety of grains daily, especially whole grains.
• Choose a variety of fruits and vegetables daily.
• Choose a diet that is low in saturated fat and cholesterol and moderate in total fat.
• Choose beverages and foods that limit your intake of sugars.
• Choose and prepare foods with less salt.
• If you drink alcoholic beverages, do so in moderation.
Culture, family background, religion, moral beliefs, cost, availability of food, life experiences, food intolerances and allergies affect food choices. Use the Pyramid as a guide.
June 29th, 2005
Calories are simply a way to measure energy- the energy that the food will supply to the body. This energy will be stored or burned. The word calorie is synonymous with kilocalorie or kcal. 1 calorie = the amount of energy (heat) needed to raise 1 gram of water 1 degree Celsius.
Carbohydrate - Carbohydrates are the body’s main source of energy. Sources of carbohydrates include starches, sugars and fiber.
Sugars -The most basic type of carbohydrates, such as table sugar, are called simple sugars. Complex carbohydrates, such as starch in potatoes, are made up of simple sugars linked together.
Fat - Fats supply energy and essential fatty acids help absorb the fat-soluble vitamins A, D, E, and K.
Types of Fats:
Saturated Fat - Foods high in saturated fats tend to raise blood cholesterol. These foods include high-fat dairy products (whole milk, cheese, butter); higher fat meats, the skin and fat of poultry, lard, palm oil and coconut oil. Reducing saturated fat to less that 10 percent of calories is recommended. A helpful hint for identifying saturated fats: saturated fat is solid or semi-solid at room temperature.
Trans Fatty Acids - Foods high in trans fatty acids tend to raise blood cholesterol. The best way to identify foods with trans fatty acids is to look for “partially hydrogenated vegetable oils” (hard margarines, and shortenings) in the ingredient list on the food label.
Unsaturated Fats - Replacing foods high in saturated fats with foods that contain unsaturated fat, can help to reduce blood cholesterol level.
Unsaturated are divided into 2 types:
Monounsaturated - Monounsaturated fats are found mostly in canola oil, olive oil, peanuts and avocados.
Polyunsaturated - Polyunsaturated fats are found mostly in all other vegetable oils, nuts and high fat fish.
Cholesterol* - Our bodies are capable of making all of the cholesterol we need. Cholesterol is also obtained from food. Dietary cholesterol comes from animal sources such as egg yolks, meat, poultry, fish, and higher fat dairy products. Foods that are high in cholesterol tend to raise blood cholesterol. However, saturated fats may play a more significant role in raising blood cholesterol.
*Cholesterol is important to monitor because it can be associated with chronic diseases specifically heart disease.
Protein - Proteins are made of amino acids. Good sources of protein include meats, legumes and dairy products. Proteins are necessary for growth, maintenance, and tissue repair.
June 29th, 2005
Nutrition Overview
Nutrition is the science of food, the nutrients and other substances, their action, interaction, and balance in relation to health and disease. It is the process of consuming, absorbing, and using nutrients needed by the body for growth, development, and maintenance of life.
Why nutrition is important.
In simple terms food is energy. It is the fuel our body uses to enable us to carry on our daily activities. Some nutrients have energy (calories) and others do not, but both are critical to our bodies. There are over 45 different nutrients that our bodies need every day. Proteins, fats and carbohydrates are the three nutrients that have energy.
The objective of a proper diet is to meet the body’s energy and nutrient requirements, while achieving and maintaining a desirable body composition. The daily requirements for essential nutrients depend on a person’s age, sex, height, weight, metabolic rate and physical activity.
Obesity and related medical conditions are the second leading cause of death in America . Health risks related to obesity include coronary heart disease, hypertension, diabetes, gallstones, osteoarthritis and certain cancers. A basic understanding of nutrition can also help you achieve your personal health, weight and lifestyle goals.
Basic Nutrition Terms
Nutrient - Nutrients are the substances in foods that nourish and provide energy for the body. Many nutrients are made in the body. Nutrients that are not made in the body are called essential nutrients and must be consumed in the foods we eat.
June 29th, 2005
Nutrition Education
In simple terms food is energy. It is the fuel our body uses to enable us to carry on our daily activities. Some nutrients have energy (calories) and others do not, but both are critical to our bodies. There are over 45 different nutrients that our bodies need every day. Proteins, fats and carbohydrates are the three nutrients that provide energy.
The objective of a proper diet is to meet the body’s energy and nutrient requirements, while achieving and maintaining a desirable body composition. The daily requirements for essential nutrients depend on a person’s age, sex, height, weight, Metabolic Fingerprint™ and physical activity.
Obesity and related medical conditions are the second leading cause of death in America. Health risks related to obesity include coronary heart disease, hypertension, diabetes, gallstones, osteoarthritis and certain cancers. A basic understanding of nutrition can also help you achieve your personal health, weight and lifestyle goals.
BalanceLog has multiple applications for monitoring your health:
Pregnancy Monitoring: Calorie, protein, and iron monitoring
Cardiovascular Disease: Cholesterol/Saturated fat monitoring
Hypertension Management: Sodium intake monitoring
Cancer Prevention & Treatment: Fiber & calorie monitoring
Osteoporosis Prevention: Calcium monitoring
Kidney Disease: Protein and sodium monitoring
Diabetes Management: Weight management, carbohydrate & calorie monitoring
June 29th, 2005
Weight Education
A successful weight and nutrition management program is just a matter of having the right information and balancing calories “in” and “out”. Most of us know this reality, but it’s not always easy to put into practice.
Burn more calories than you consume and you will lose weight.
Consume the same amount of calories that you burn and you will maintain your weight.
Consume more calories than you burn and you will gain weight.
Achieving and maintaining a healthy weight is key to a long, healthy life. For most individuals, being overweight or obese results from consuming too many calories and/or inadequate physical activity. Being overweight or obese may lead to premature death, type 2 diabetes, heart disease, stroke, hypertension, gallbladder disease, osteoarthritis, sleep apnea, asthma, certain cancers, and high blood cholesterol. Balancing food intake with physical activity is important to preventing unhealthy weight gain. Burning more calories than you consume is important to losing weight.
Most experts use the Body Mass Index (BMI) to determine a healthy weight. BMI is calculated from your height and weight [weight in kilograms/(height in meters) 2 ]. A BMI of 18.5 to 24.9 is considered healthy depending on your frame size. To calculate your BMI, visit the body calculators page.
Reference: NIH, NHLBI. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. HHS, PHS; 1998.
June 29th, 2005
BalanceLog®
Log your daily calories with a database of more than 4,000 foods and 300 exercises.
Professional Resources
As a professional, HealtheTech tools enhance your ability to help your clients and patients accomplish their goals. This professional resources portion of HealtheTech.com has been designed to place important resources, tools, and information at your fingertips.
Whether you’re providing weight management programs, nutritional coaching, patient counseling, or personal training, the information in this section will positively impact your results. To learn more, select the category that most closely fits your facility from the list on the left side of this page.
Until now, there has been no cost-effective, easy-to-use and practical device for obtaining a Metabolic Fingerprint™. Predictive equations are still widely used in estimating metabolism and caloric needs, which can be inaccurate, and lead to frustrating failure. The HealtheTech tools are portable, accurate, affordable, and easy to use, making them effective tools in a variety of healthcare, wellness and fitness environments.
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Other Related Nutrition and diet Software
June 29th, 2005
We offer our exclusive Smooth brand of treadmills, home gyms and elliptical trainers. We are the only manufacturer of quality fitness equipment to primarily sell over the Internet. By selling factory direct and online, we eliminate the overhead costs of retail sales. That is why we are able to sell comparable equipment well below the price of our competitors. You get the convenience of shopping online combined with factory direct prices.
All of our Smooth Fitness® equipment is made to the highest standards. The Smooth brand is not your budget fitness equipment you will find in mass merchants. For example, our Smooth 9.25X is built with a powerful 3.0 continuous duty hp motor and an extra long 62″ treadbelt. And we back it with an industry leading lifetime warranty.
We designed our products to exceed normal requirements. We want our customers to focus on getting in shape and losing weight, rather then maintaining their fitness equipment. Our equipment is built to last, which is reflected in the warranties we provide.
Smooth Fitness® was established in 1984, beginning with brick and mortar fitness specialty retail stores that served the greater Philadelphia area. Recognizing the ever-growing popularity of the internet, Smooth was the first fitness retailer to begin selling online back in 1996 (the stone ages in internet e-commerce!) Since that time, Smooth Fitness® has made the internet our primary sales channel, experiencing tremendous growth year after year. The Smooth brand is the most recognized brand of fitness equipment on the internet. We have sold thousands of Smooth treadmills, elliptical trainers, and home gyms throughout the United States, and we are proud of the thousands of positive reviews we have received from our customers.
You may find when shopping for brand fitness equipment like True and Precor you are restricted to online purchases of only dealers in your regional area (Beware of warranty limitations). And consequently you are required to pay state taxes. The Smooth brand of fitness equipment is available throughout the U.S. and Canada (No warranty limitations). We not only ship through our two manufacturing facilities, but also our warehouses in NJ and NV.
Smooth Fitness® is not a retail company that also sells fitness equipment online as a side business. The Internet is our primary sales medium (over 90% of sales). We are geared towards the sale, service and fulfillment of cyber customers. Customers are assured of satisfaction through a 30 money-back guarantee. All treadmills and elliptical trainers are backed with 1-year in-house repair warranty (Lifetime parts warranty on home gyms). Should your equipment require service, there is an extensive nationwide network of certified technicians. In addition, customers can call or email inquiries to our professional service group.
Over the last several of years the purge of the Internet has resulted in the survival of the fittest. Those companies that were able to translate successful business practices to a virtual environment have reaped the rewards. Smooth Fitness® not only offers the convenience of shopping online, but also backs it with a business model designed to satisfy our customers. And don’t forget the factory direct prices!
We look forward to assisting you in achieving your fitness goals.
Sincerely,
Joe Alter
President
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June 29th, 2005
“One of the most effective, powerful, and dynamic body-mind techniques ever developed!”
Learn the principles first, then follow along with me.
It takes just 4 minutes a day.
You will learn to:
- gently move almost every muscle and joint
- strengthen your back
- reduce pain
- become more present and focused
- reduce stress levels almost instantly
- worry less and live in gratitude
- breathe more deeply and fully all the time
- improve flexibility, strength, circulation and balance
- change your thought patterns from negative to positive
- change the neurochemicals in your brain to help heal your body.
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4 Minute Fitness SEMINAR INFORMATION? CLICK HERE
4 Minute Fitness™ is one of the easiest, most all encompassing and effective mind body techniques ever developed, thanks to a wellness breakthrough known as “Layered Practice™”.
Quite simply, in Layered Practice™ we take dynamic principles from t’ai chi, yoga, meditation and ancient qi gong (chi kung)…
…as well as vital modern medical theories, relaxation methods and key motivational techniques used by today’s athletes.
… and DO THEM SIMULTANEOUSLY, rather than one at a time.
The result? The most powerful 4 minutes ever developed! And it’s easy.
“We don’t just tell you what to do, we show you how to do it.
Results in just 4 minutes a day”
Q. Why does it take an hour long video to teach 4 minutes of movement?
A. In order to make these the most powerful 4 minutes of your day, we need time to teach and create value for each of powerful mind and body skill used in the Layered Practice™ technique.
It’s a bit like learning 4 minutes of a Mozart piano sonata. First learn the right hand, then the left, then add heart for maximum value. It’s easy, step by step.
Packages 1 - 3 Our very popular video-only packages
Packages 4 - 5 Include the videos PLUS personalized coaching with Keith. Includes weekly classes in the comfort of your home - and a lifetime membership.These packages include extra lessons, bonus exercises, more readings and philosophy and personalized instruction.
Testimonials
American Fitness Magazine (excerpt from May/June, 2003 issue):
“4 Minute Fitness is a refreshing break from over produced, hyper-energized videos. His step-by-step guidance leads the viewer through basic t’ai chi moves to improve focus, balance, flexibility and decrease stress.
By the look on his face, his program obviously works for him - he’s the first t’ai chi teacher I’ve seen who wears a huge smile from start to finish.”
Meg Jordan, Ph.D, R.N., Editor
How beneficial your workout is for the mind & soul. Thank you.”
C. Santella, FL
checkmrk.wmf (1228 bytes) “I love the 4 Minute Video. I have several yoga and t’ai chi videos, but there is nothing out there that makes you feel so good so fast. I can hardly wait to show my family your wonderful video. I am so impressed!”
L. Govett, Texas
checkmrk.wmf (1228 bytes) “I love how my spine feels after the workout, as well as feeling more peaceful, positive and energized.”
B. Evoy, BC
checkmrk.wmf (1228 bytes) “You have turned a skeptic into a believer. I am sleeping the entire night through - which I haven’t done in years. Thank you!
S. Wingfield, GA
checkmrk.wmf (1228 bytes) “I love the down to earth, accessible and sincere attitudes I find (in your DVD). Getting my husband to try this movement series is a great achievement, believe me! He would not stick with it if he detected a shred of pretension or ulterior motives. So thank you.”
T. Crockett, CA
checkmrk.wmf (1228 bytes) “It is absolutely wonderful. In fact, I find it very, very difficult to do the 4 minute video only once a day! Therefore I do it for a half hour.”
F. Kelly, NC
checkmrk.wmf (1228 bytes) “Wow! I borrowed the 4 Minute Fitness DVD from a friend. I am most impressed by how you have synthesized Western and Eastern ideas into the movement sequence. Well done! I have taught Qi Gong for 20 years and never considered condensing it into 4 minutes, yet it works.”
N. Taylor, BC
checkmrk.wmf (1228 bytes) “It is a wonderful way to begin each day and fills me with joy and gratitude each morning.”
T. Monty, BC
checkmrk.wmf (1228 bytes) “Please send me another video. We love it and want to share one with our family.”
M. Fenzl, FL
checkmrk.wmf (1228 bytes) “I originally ordered your video because I hoped it might help me recover from my recent stroke. What I have accomplished is beyond anything I expected - in just 5 months I have gained strength, increased my overall fitness and improved my balance. I am now able to stand on one leg - which is amazing. This is the only therapy I am undergoing … so thank you Dr. Jeffery for everything.”
G. Campbell, NC
checkmrk.wmf (1228 bytes) “… so much better than my previous tapes.”
James E, TX
checkmrk.wmf (1228 bytes) “Every word is simply said JUST RIGHT! Dr. Keith - you are amazing. You are sending good vibrations and good mood with your sense of humor through the screen. I feel great!”.
I. Mandzuka, Boznia
checkmrk.wmf (1228 bytes) “I would highly recommend this to my family and friends. I find it highly beneficial both physically and mentally.”
L. Ruff, BC
checkmrk.wmf (1228 bytes) “I knew I would be into this but I had no idea the results could be seen so soon. I am more focused and get more done in the same period of time. I find a smoothness in motion and greater awareness of objects around me so I drop and bungle into things less often. Strength in my legs has improved… I am no longer impatient…
Dr. J. Kerr, SD
checkmrk.wmf (1228 bytes) “I feel GREAT both physically and mentally after a session, with increased energy!”
R. Wolfskill, PA
checkmrk.wmf (1228 bytes) “I love what it’s been doing in my own life and for me.
H. Busse, MN
checkmrk.wmf (1228 bytes) “What is readily apparent and impressive in the KJ 4 minute program is that YOU really want the ME to understand. That is quite a feat.”
R. Adamo, NY
checkmrk.wmf (1228 bytes) “Beautifully choreographed! I think we all need to heal from something. There is no such thing as a perfect body/mind in my view so the tapes are universally useful.”
J. Foster, BC
checkmrk.wmf (1228 bytes) “I’ve totally fallen in love with it! I am waking up with an optimistic attitude instead of “oh no not another day” and I am sleeping better. After 30 days, I must say that things have steadily improved and I am very impressed.”
J. Whitemarsh, Alberta
checkmrk.wmf (1228 bytes) “The exercises were so easy and at the time I wasn’t relating to how many different muscle groups I was actually working. The next day I could feel different muscles and then knew how beneficial those simple exercises had been.”
P. Miller, BC
checkmrk.wmf (1228 bytes) “Just to let you know I received my package yesterday and I am very impressed.”
C. Sloneker, OH
checkmrk.wmf (1228 bytes) “I love this video and am a faithful participant!”
K. Hartman, OH
checkmrk.wmf (1228 bytes) “I began your 4 Minute Fitness program approximately two weeks ago - it’s AWESOME. I am feeling like I’m 18 again! Since I’m having such great results, I am definitely interested in pursuing your instructor’s course.”
S. Wingfield, GA
checkmrk.wmf (1228 bytes) “It is so easy, so portable and has such a positive impact. I use it as a windup to my daily fitness routine, whether swimming, weights & cardio or walking/biking”
J. Blayone, AB
checkmrk.wmf (1228 bytes) “After practicing your tai chi and 4minute fitness DVD’s for 3 weeks I am seeing and feeling results. I am a single mother of a 3 year old daughter and I am finding I have more patience with her. I am now turning negatives in my life into positives and my concentration is starting to be clearer.”
P. Price, IN
checkmrk.wmf (1228 bytes) “I’ve been meaning to write to you for awhile now. It’s been about 15 months now since I ordered 4 minute fitness. You may remember I wrote after my first listening about how pleased I was with the tape.
Well now a little over a year later, I think the 4 Minute Fitness is one of the most powerful things I have ever discovered!
M. Noreen, VA
checkmrk.wmf (1228 bytes) “Your instruction on deep breathing was a revelation, although I have been practicing this technique for over 20 years since I first took singing lessons. Your demonstration on the DVD of the expansion in the back is amazing, and not a concept that I had grasped before.
Dr. P.B.
checkmrk.wmf (1228 bytes) “Got your 4 minutes….and easy tai chi last night. Loved soooooooo much I just order weight loss….got anything else? Love the theory….the exact slow instruction….your nature and face…..and the not-too-preachy part.”
Bonnie L., NY
checkmrk.wmf (1228 bytes) “Thank you, Thank you, Thank you! I am a massage therapy student. We have been using your easy Tai Chi and 4 Minute Fitness as part of our personal development class this quarter. I LOVE THEM! Once I complete school, I will seriously consider becoming certified in your programs!”
P.C, SD
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June 29th, 2005
That’s right! Mankind’s oldest cosmetic problem; thinning hair - has been solved! The answer is PRO-GENESIS. Until now, the only methods of preventing hair loss or covering it up have been embarrasing hair pieces, painful and costly transplants and pharmaceutical treatments. However, Studies Show That these methods are painful, costly and have alarming side effects!
How it works
At first, PRO-GENESIS changes the structure of your hair follicle. Thin, fine hair becomes thicker, coarser and stronger. It will resemble hair you had as a teenager. Soon after - PRESTO! No more hair loss! You will never be self-conscious again!
The PRO-GENESIS Hair Enhancement System is an all-natural solution to thinning hair and baldness. A unique combination of herbs, PRO-GENESIS stops abnormal hair loss and enhances the growth of thick, healthy hair
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Ingredients and other information
PRO-GENESIS is an odorless, topical cream prepared using the highest quality ingredients and herbal extracts specifically formulated to promote growth of thick, healthy hair for men and women.
Product characteristics:
Low aroma profile
Insensitive to temperature changes
No coloring agents
Site specific
Non-perfumed formula
Deionized Water, Emu Oil, Aloe Vera Gel, Glycerin, Emulsifying Wax, Vitamin E (d-alpha tocopherol), Vitamin B (Panthenol), Germal Plus, Hydrolyzed Protein, Herbal Extracts Of Colsfoot, Horsetail, Nettle, and Burdock, Vitamin A palmitate (Retinyl A), Sage Essential Oil, Rosemary Essential Oil, Citric Acid.
PRO-GENESIS is to be applied sparingly to the scalp and massaged in. Use once before bedtime and again upon rising.
Caution: For external use only. Wash hands after application. Avoid contact with eyes. In case of such contact, flush eyes immediately with water or milk. Discontinue use if rash or irritation occurs.
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June 29th, 2005
If a safe and effective diet pill is what you’re waiting for, I’ve got some bad news for you. It doesn’t exist, and probably never will. If you’re overweight, you have just two options – either learn to accept the way you are or learn how to lose weight.
Yes, losing weight can be a lot of work. But the more you know about weight loss, the easier your task becomes. If you’re willing to accept the challenge, please read on for ND’s most helpful dieting and weight loss tips:
The 2 Most Important Facts about Successful Weight Loss
Before beginning any diet, it’s important that you understand these two important facts:
1. Weight loss depends on energy balance.
To lose weight, your energy intake must be less than your energy expenditure. This will always be true. There are no foods, pills, or potions that will magically melt the pounds off. The only approach that works is eating less and/or exercising more.
2. Permanent weight loss requires permanent change.
Don’t assume that you can spend six weeks on a diet and then return to your old eating habits. Short term diets only produce short term results. The only successful way to keep the weight off is to make small but permanent changes in your lifestyle. Coincidentally, this is also the best way to improve your health.
The 6 Most Important Principles for Enabling Weight Loss
Although many different weight loss techniques exist, nearly all are variations of just six basic principles. Study these principles, and make them part of your action plan:
1. Maintain or improve your health.
If you don’t take care of your body, it won’t take care of you. So, as a first step, make sure that your diet supplies adequate amounts of vitamins and minerals, that you’re drinking plenty of water and getting enough sleep and fresh air, and aren’t under too much unhealthy stress. Everything that you do to improve your overall health will help make weight loss more likely to occur.
2. Reduce your total Caloric intake.
To lose weight, you have to change your energy balance. (See Fact #1 above.) There are just two ways to do this – either consume less energy (Calories) or expend more energy (via exercise). The easiest way to reduce your consumption is simply to cut back on the size of your meals and/or the amount of high-Calorie foods that you consume. This doesn’t mean that you have to give up any particular food. In fact, completely avoiding a food can lead to strong cravings that derail your diet. A smarter approach is to just eat less of those high-Calorie foods.
To get a good perspective of how many Calories that you consume, it’s important that you keep a food diary. You don’t have to keep your diary going forever, but do track your daily intake for at least one week. The Running Total function of ND’s Pantry make this Calorie counting exercise especially easy to do, and also provides you with totals of all other nutrients as well.
Also beware of foods containing “hidden” Calories. For example:
Watch what you drink. What you drink during the day can have a major impact on the number of Calories that you consume. There is very little difference between the satiating effects of different drinks, so this is one of the easiest places to improve your diet. Water is almost always your best choice, but coffee, tea, and diet drinks can also help cut Calories.
Be smart about condiments and toppings. Butter, mayonnaise, and a lot of the “special sauces” used by restaurants are very concentrated sources of Calories. If you want to add flavor to your food, try using lemon juice, soy sauce, salsa or different spices instead.
3. Maintain or increase your metabolism.
One of the most common mistakes that dieters make is to get excited or impatient with their diet, and reduce their Caloric intake too far. If you do that, your body will respond by lowering your metabolism and slowing your weight loss. To prevent this downward adjustment of your metabolism, make smaller changes to your eating habits. Your patience will pay off in terms of more consistent weight loss, more energy, and fewer cravings.
For the best results, add exercise to your plan. Regular exercise not only expends energy as you’re doing it, but can also lead to increases in your basal metabolic rate, so you’ll burn more Calories even at rest. High-intensity exercises burn the most Calories, but don’t select exercises solely on their fat-burning potential. Instead, pick exercises (i.e. sports activities) that you enjoy, and want to incorporate into your daily routine.
4. Avoid hunger.
Hunger is one of your body’s strongest stimuli, and can be an evil challenger to your will power. Hunger is also relatively slow to subside, and can cause you to eat more than you intended. To break this unproductive hunger-overeating habit, always try to eat before you get hungry. This may seem counter intuitive to someone who’s trying to limit their Calories, but it’s a very effective concept. Two different techniques can help make this easier to accomplish:
Eat smaller, more frequent meals. Instead of three meals per day, try eating five or six smaller meals. By eating more frequently, there will be less time between your meals, and less chance of you experiencing such intense hunger. As an extra benefit, there is some evidence that suggests that eating more frequently can also help raise your metabolism.
Include more slow-to-digest foods in your meals. When it’s not possible to eat more frequently, make sure that your meals contain a mix of nutrients. In particular, fats and protein are much slower to digest than carbohydrates. While most carbohydrates leave your stomach within about two hours, protein takes approximately four hours to digest, and fat takes as long as six hours.
5. Correct bad eating habits.
We eat not only for nourishment, but also as part of our social interactions. However, many people develop unhealthy habits that encourage overeating. Here are a few examples of bad eating habits that you should try to avoid:
Mixing food and entertainment. It’s easy to mindlessly eat a tub of popcorn, a whole bag of chips, or a carton of ice cream while you’re watching TV. Make eating a separate activity, and you’ll consume less.
Eating to relieve stress. There’s nothing wrong with taking pleasure from eating, but try not to use food as your primary stress reliever. Find other ways to dissipate stress (such as exercising, listening to music, or meditating) before eating.
Eating on the run. With the abundant availability of convenience foods, it’s easy to grab something from a vending machine and eat your meals in your car. But try not to make this a regular daily habit. Plan your schedule to include enough time to prepare and eat your meals in a quiet place, without the rush.
No one eats perfectly. However, if you continuously have trouble controlling what you eat, realize that correction of your eating problems may be beyond your own abilities. Please consult a psychologist or weight loss professional for additional help.
6. Make a record of everything you eat
When making changes to your diet, it’s very easy to lapse back into your old eating habits. Keeping a food diary is a great way to help prevent that from happening. Buy an inexpensive spiral notebook, and simply write down everything that you eat during the day. If possible, keep your food diary with you, and make your entries soon after you’ve eaten. For maximum benefit, keep making entries for at least three weeks.
Keeping a food diary forces you to give conscious thought to everything that you eat. It may be a tedious task at first, but it will help you more quickly develop better eating habits. Your food diary will also be a tremendous asset if you later consult a dietician or health care provider for assistance with your diet.
When keeping a food diary, it’s also a good idea to take the time to add up the total Calories and nutrients that you consume each day. For your diet to be successful, your total Calories will need to decrease from their original level, but your nutrient intake must at least meet your minimum needs. One of the easiest ways to determine this is with the Running Total feature of ND’s Pantry.
June 28th, 2005
By Lori Beth Dixon, Frances J. Cronin and Susan M. Krebs-Smith
STRATEGIES FOR IMPROVEMENT
Improving food guidance
Although the food guidance system succeeded in its goals of nutrient adequacy, moderation of potential excesses and usability that were set at the time, the research that led to its development is now 20 years old, and much has changed since then in our understanding of nutrition and in the demographics and eating patterns of the American public. However, the food guidance system was designed to accommodate anticipated changes in dietary recommendations over time without the need for substantial revision of the associated food guide (e.g., the Pyramid). For example, recent changes in nutrient recommendations and increasing numbers of fortified foods can be accommodated. Although the Dietary Guidelines state that supplements should not replace foods to meet usual nutrient needs, increases in the requirements of some nutrients (e.g., calcium) may require that the recommended number of servings from certain food groups be modified for certain subgroups (e.g., increase in recommended number of servings of milk products for children). Increased recommendations for other nutrients (e.g., folate) may require messages about the use of supplements by some Americans (e.g., women of child-bearing age) for whom it would be difficult to obtain the recommended amounts by diet alone.
Various food group designations, however, may deserve reconsideration. In particular, specific types of fat might receive greater or lesser emphasis, and a new typology for fruits and vegetables may be required. For example, a recent report notes convincing evidence that diets high in vegetables, particularly dark green leafy, cruciferous and alium vegetables, and/or high in fruits, particularly citrus fruits, are protective for some types of cancer. This report recommends five or more servings a day of a variety of vegetables and fruits, excluding starchy vegetables and fruits (e.g., cassava, sweet potato, potato, yam, plantain, banana). This report also recommends more than seven servings a day of a variety of other plant foods including cereals (grains), pulses (legumes), roots, tubers and plantains.
More recent data on typical portion sizes of commonly consumed foods may be helpful in quantifying the desirable number and size of servings from each group. For example, the Pyramid graphic recommends 6–11 servings of grain but does not specify how much counts as a serving. Examination of the Pyramid brochure reveals that each serving is the equivalent of only 1 slice of bread or 1/2 cup of rice or pasta, amounts that are about half the size of typical portions, if not smaller. This was the case even when the food guidance system was developed, but the developers chose to keep the suggested serving sizes consistent with previous food guides and with food labels of that time period. This decision allowed the recommended number of servings to be greater, thereby giving grains more attention in order to increase consumption. Consequently, the grains group formed the base of the Pyramid. This message requires clarification, given that grain consumption has increased without noticeable improvement in whole-grain intake.
It has been argued that the Pyramid recommendations are not the only way to achieve a nutritionally adequate diet, and that alternative schemes must be developed for vegetarians and persons who abstain from milk and milk products. In fact, the food guidance system was never meant to be limiting. The developers recognized that different guidance would be necessary for infants and very young children, vegetarians, particular ethnic groups and others with distinctly different food preferences or dietary needs. Given the increasing diversity of the U.S. population and the accompanying changes in the marketplace, the system must be adapted to different cultures and incorporate more types of foods commonly consumed by members of the rapidly growing ethnic groups in the U.S. Many alternative “pyramids” have been put forth. However, with the exception of the Puerto Rican Pyramid, none has been tested rigorously for validity and reliability against a set of stated goals and objectives based on current nutrition science. Superficial changes in the graphics with examples of ethnic or vegetarian foods will not suffice, particularly because nutrient adequacy is not verified. At the present time, national dietary data are lacking for many cultural groups and should be collected for alternative pyramids to be formally developed, tested and disseminated at the national level.
Indispensable pieces of healthful dietary patterns must be identified, and commonalities drawn across different schemes to produce universal nutrition messages. However, it is important to recognize that food guidance development is an evolutionary process. Accommodation must be made for nutrient attainment of the population, nutrient availability, diet/health recommendations and what is acceptable to people. The total diet concept, which has barely been realized, given the Pyramid graphic’s emphasis on only the major food groups, continues to have merit and should be retained and strengthened. Many of the inadequacies and imbalances in the current American diet relate to issues that were integral in the development of the food guidance system but lost in the translation to the Pyramid graphic, i.e., insufficient intakes of whole grains and dark green/deep yellow vegetables and an overabundance of added sugars and, to a lesser degree, total fat. Graphic representations of any subsequent guidance systems should prominently display these ideas.
In addition, changes in the food supply are necessary for all Americans to meet Pyramid recommendations. McNamara estimated the gaps between recommended intakes and food intakes in 1994 in order to determine changes in agriculture policy that might be needed for all consumers to meet recommended intakes. These gaps were substantial for fruits, certain subgroups of vegetables, and added sugars, and to a lesser degree, discretionary fats. For all Americans to immediately meet the corresponding Pyramid recommendations, the following changes in the food supply were estimated. The supply of fruit would have to increase by approximately two thirds. The supplies of dark green vegetables, deep yellow vegetables, and dry beans, peas and lentils would each have to triple. The supply of white potatoes and other starchy vegetables would have to decrease by about one half. The supply of added sugars would have to decline by at least one half (amounting to 21 billion pounds). The supply of added fats would have to decline by 16% (amounting to 3 billion pounds). Projecting to the year 2020, based on Census estimates for population shifts and growth, larger gaps would occur in dark green and deep yellow vegetables and in legumes. Such changes in the food supply, in combination with improved food guidance, could certainly increase the likelihood that more consumers would “Let the Pyramid guide their food choices.” The challenge is how to make these changes in the food supply.
Improving assessment
The PSDB has proved to be an extremely worthwhile tool for evaluating the diet relative to current recommendations and could aid future assessments of dietary variety, food patterns and scores. Though developed originally for use with the CSFII, it can also be used to examine data from the NHANES III with a food code linking system designed for this purpose (available at http://www-dccps.ims.nci.nih.gov/ARP/). The incorporation of tools such as the PSDB into dietary assessment software programs would broaden their capabilities tremendously. However, even the PSDB could be expanded to examine intricacies of the diet beyond those incorporated into the food guidance system. For example, it would be useful to have information on more levels of disaggregation (such as individual food commodities as well as food groups) and on more attributes of foods (such as botanical classifications for fruits and vegetables). A multilevel system with numerous attributes would increase the flexibility of the food grouping system and facilitate future analyses of the total diet accordingly.
The variety, food patterning and scoring methods provide worthwhile starting points with which to assess the total diet of Americans. Each method utilizes a different approach for condensing numerous continuous variables into a single assessment. Variety scores assess the presence/absence of food intakes, then assign a score for the number of different foods/groups; food patterns measure food group intake continuously, then truncates intake into categories; total dietary scores measure intakes of food and other dietary components continuously, then add them together. To improve upon these methods, further consideration is warranted regarding the underlying goal of the assessment.
If the goal is descriptive, such as an overall assessment of diets in relation to current guidance, scoring multiple components associated with specific dietary recommendations makes sense. However, glyphs may provide more useful information than a total diet score. A glyph is a way of visually depicting the dimensions of several variables simultaneously by constructing a common object, such as a face, and graphing each parameter to a particular feature, such as nose length or mouth shape. For example, The Interactive Healthy Eating Index, an on-line version of the HEI, allows someone to enter the foods he/she has eaten in a day. In addition to receiving a “score” for the overall quality of their diet and a “score” for each of the components in relation to the dietary recommendations, this tool also depicts a person’s diet according to building blocks of the pyramid. This pyramid glyph shows how each component of that pyramid measures up visually to the recommended amounts.
If the goal is to determine which areas of the diet are most critical, an assessment technique that discriminates, through an iterative process, which dietary factors (such as food groups) will best distinguish between “healthful” and “nonhealthful” diets would be preferred. Grain intake may contribute to the diet’s healthfulness, but grains are so ubiquitous in American diets that their measurement does not sort diets into qualitatively different groups. On the other hand, if fruit intake is the food group most likely to be absent, then fruits would discriminate among diets better than other food groups. Subgroup intakes (e.g., whole grains, dark green/deep yellow vegetables) are likely to be more discerning than the main food groups. Use of dietary supplements may further discriminate among individuals. Discussion regarding what are appropriate outcomes (e.g., nutrient adequacy, mortality, body fatness) and ways to validate these methods are necessary (e.g., use of biomarkers).
In addition to food and nutrient intakes, the concepts of variety, moderation and proportionality are important to consider. Although measures of variety and moderation have been developed and used in methods that assess the total diet, further empirical evaluation of these measures is required. Ways to assess proportionality also must be explored and tested empirically. Consistency in these measures would aid in the comparison of results across studies.
Other analytical methods, not discussed in this paper, have been used to assess the total diet. Methods such as cluster analysis, principal component/factor analysis and structural equation modeling take advantage of the correlations between dietary components to characterize diets and identify patterns. For example, cluster analysis identifies clusters of individuals with characteristic dietary patterns. Factor analysis identifies groups of dietary variables (e.g., foods listed on food records or food-frequency questionnaires), related to each other but relatively independent of other dietary variables, and calculates factor scores for each pattern for each individual. The application of other methodologies including discriminant analysis, categorization and regression tree analysis, hierarchical regression and signal detection methodology to dietary patterns is intriguing because of their potential to discriminate among interrelated variables. It is important to keep in mind that many elements of these methods are subjective. In addition, dietary patterns that result from such methods can be difficult to interpret and translate into usable dietary guidance.
Unfortunately, all methods that assess the total diet are plagued by measurement error and bias that affect dietary assessment in general. National food consumption surveys are limited by the number of days of dietary data collected; thus, they cannot provide estimates of usual intakes by individuals. Analyses based on single 24-h recalls further increase the likelihood that food and nutrient intakes of individuals, especially those in the extremes of the distributions, are misclassified, resulting in overestimation of those above or below a particular cut-off value (e.g., servings of food groups). Underreporting of energy is particularly prevalent in 24-h recalls, which may further affect whether individuals are classified as meeting or not meeting recommendations.
Efforts to counter these limitations are ongoing. For example, methods have been developed to adjust dietary data to produce nutrient estimates that more closely represent “usual intake,” provided that at least 2 d of dietary data have been collected on a subset of individuals. Use of these methods is strongly recommended when assessing the percentage of individuals whose nutrient intakes meet the dietary recommendations (e.g., percentage of individuals with saturated fat <10% of energy). Methods to adjust dietary data to produce food estimates that more closely represent “usual intake” are being explored. To increase awareness and use of these methods, software programs that incorporate these methods (e.g., C-SIDE developed by researchers at Iowa State University) must be disseminated throughout the research community with the release of national survey data. Use of doubly labeled water to validate energy intake and analytical techniques that compute energy intake in relation to basal metabolic rate using age- and gender-based equations are strategies to assess the degree of underreporting.
In conclusion, the diets of most Americans are in need of improvement. The issues surrounding dietary guidance are complex. To best assist consumers, messages must be simple and direct. This is the intent of the newly worded guideline, “Let the Pyramid guide your food choices.” However, clarification and promotion of key themes of the total diet, i.e., variety, moderation and proportionality, inherent in the food guidance system that underlies the Pyramid, are required for the guideline to have the desired effect. Improvements in methods that capture the total diet concept are warranted to best assess the diets of Americans.
June 28th, 2005
By Lori Beth Dixon, Frances J. Cronin and Susan M. Krebs-Smith
ASSESSING THE TOTAL DIET: MEASURES AND RESULTS
Methods have been developed to measure variety, moderation, and proportionality in the total diet in order to assess the diets of the U.S. population. Like food guidance, the development of such methods is evolutionary, with more recent methods attempting to incorporate the strengths and address the limitations of the previous methods.
Variety measures
Initial attempts at capturing the total diet were related to the original guideline, “Eat a variety of foods,” and involved measuring dietary variety in different ways. Dietary variety, or dietary diversity as it is sometimes called, refers to the inclusion of different items in the diet. Krebs-Smith measured variety among and within food groups from 24-h recall data in the 1977–1978 Nationwide Food Consumption Survey (NFCS). They assessed whether these variety measures were related to variety’s purported benefits of dietary quality, specifically nutrient adequacy and the intakes of energy, fat, sugar, cholesterol and sodium. The authors controlled for the number of foods to measure the effects of variety per se, apart from the additional food that a varied diet often entails. Variety among the major Pyramid food groups (counted as the number of groups present in the diet) explained as much variation in nutrient adequacy as variety within those groups (counted as the number of subgroups or as the number of individual foods within the groups). Neither type of variety was related to intakes of energy, fat, sugar, sodium or cholesterol. This study suggested that variety might best be interpreted as choosing the recommended number of servings from each group. Telling consumers this directly might be an improvement over the ambiguities of “Eat a variety of foods.” The finding that there is little nutritional advantage to increasing variety within the food groups is consistent with the fact that certain foods within each group are more nutrient dense than others. This suggests that choosing foods simply because they are different from one another may not be as important as selectively including more of some foods and less of others.
Other studies have examined dietary variety or diversity among food groups. Kant created two different scores from 24-h recall data in the Second National Health and Nutrition Examination Survey (NHANES II) to measure dietary diversity. A food group score gave a maximum score of 5 to adults who reported at least one food, above a minimum gram weight amount, from each of five food groups (dairy, meat, grain, fruits, vegetables). A serving score gave a maximum score of 20 to adults who reported at least two servings each from dairy, meat, fruit, and vegetable groups and four servings from the grain group. Serving sizes were based on the median gram weights of each food reported. Using the food group score of dietary diversity, only one third of the adult population consumed foods from all five food groups on a given day. Using the serving score of dietary diversity, <3% consumed the designated minimum number of servings from all food groups on a given day.
Researchers have also examined whether variety among food groups is linked to health outcomes. Using the 5-point food group score from 24-h recall data in the NHANES I Epidemiologic Follow-Up Study, Kant reported an association, among adults, between the consumption of two or fewer food groups and increased mortality. Lower scores, from similar scoring systems using food-frequency data, have also been associated with increased risk of mortality or chronic disease.
A recent study measured within food group variation using food frequency data from 71 healthy adult men and women. The authors examined whether this type of dietary variety was related to energy intake and body fatness. In this study, variety was defined as “the percentage of different food types within each of 10 food groups, regardless of the frequency with which they were consumed.” Results showed increased variation within all food groups to be positively associated with energy intake. Increased variation within certain food groups (e.g., sweets, snacks, condiments, entrees and carbohydrates) was positively associated with body fatness, but increased variation within the vegetable group was negatively associated. Variety ratios of the vegetable group to other food groups were negatively associated with body fatness, even after adjustment for dietary fat.
Dietary variety among or within food groups is related to the total number of foods in the diet (i.e., increases in variety will necessitate increases in food intake), and the quantity of foods is related to nutrient adequacy (i.e., more foods will increase nutrient intakes). Accordingly, many studies of variety have controlled for the number of foods and/or energy intake. However, variety scores do not take into account portion size, beyond a minimum amount, or otherwise quantify the intake of each group. Although variety captures the presence or absence of different food groups, it does not capture them as true “dimensions” of the diet because their quantities are not assessed. Furthermore, the variety score tallies only the number of food groups but does not indicate which groups are included. For example, a score of 3 merely indicates the presence of three food groups, not which groups they are or how much of any group is present. Last, these scores are based on the assumption that eating foods from all food groups is preferable and are biased against diets that do not include certain classes of foods such as meat or milk, which could also be nutritionally adequate.
Quantifying the individual dimensions of the diet
Quantification of the different dimensions of the diet became possible with the development of the Pyramid Servings Database (PSDB) for use with the USDA’s Continuing Survey of Food Intakes by Individuals (CSFII) . This database provides the number of servings of each of the Pyramid’s major food groups and subgroups, and the amounts of discretionary fat and added sugars contained in 100 g of every food mentioned in the survey. It required the development of a recipe file to disaggregate food mixtures into their component ingredients or foods before assigning the components to food groups. Because 75% of the foods reported in the 1989–1991 CSFII were mixtures, this task was especially challenging and required many difficult decisions as to the level of disaggregation and the choice of appropriate food groups. In addition, food intakes were reported in grams and converted to serving sizes, and new variables were developed to quantify discretionary fat and added sugars. In effect, the PSDB’s exacting system of operationalizing the recommendations of the Pyramid brings to light many of the ideas that were emphasized in the original food guidance system and the brochure, but lost in the widespread use of the graphic icon.
Intakes of all major food groups and subgroups, along with the percentage of energy from total fat, discretionary fat and added sugars were assessed by combining dietary data from both the 1994–1996 CSFII and 1989–1991 CSFII with the PSDB. Intakes were compared to individual-specific recommendations determined from the sample patterns in the Pyramid. The dairy recommendation was based on age and physiologic status; recommendations for other food groups were based on energy needs. In both the 1994–1996 and 1989–1991 surveys, mean intakes of males were more in accordance with Pyramid recommendations than mean intakes of females. For example, mean intakes of males >=12 y old met the minimum grain, vegetable and meat recommendations, and mean intakes of males ages 6–19 y met the minimum dairy recommendations. However, with the exception of 2- to 5-y-old males in 1994–1996, mean intakes of all age groups of males failed to meet the minimum fruit recommendation. In both surveys, mean intakes of very few age groups of females met the minimum recommendations for any food group. In 1994–1996, mean intakes of females ages 2–19 y met the minimum grain recommendation, mean intakes of females >=20 y old met the minimum vegetable recommendation, and mean intakes of females ages 2–5 y met the minimum fruit recommendation. Mean intakes of all other age groups of females were below the minimum recommendations for all food groups. In 1989–1991, with the exception of 6–11 y-old females with mean intakes above the minimum dairy recommendation, mean intakes of all ages of females were below the minimum recommendations for all food groups.
For all individuals, whole grains comprised between 15 and 17% of the grain intake, and dark green and deep yellow vegetables comprised between 10 and 12% of the vegetable intake, noticeably less than amounts intended by the food guidance system. Mean intakes of total fat, discretionary fat and added sugars exceeded Pyramid recommendations. Among all age groups, the percentage of energy from total fat decreased from 1989–1991 to 1994–1996. However, the percentage of energy from discretionary fat remained essentially the same, whereas the percentage of energy from added sugars increased.
Differences emerge when food group intakes are compared among groups of individuals defined by socioeconomic status (e.g., years of education of the head of household or income according to the federal poverty threshold adjusted for household size). According to 1994–1996 CSFII data for adults >=20 y old, mean numbers of servings from the grain, fruit, vegetable and milk intakes were highest among the high education (>high school) and high income (>350% of poverty) groups. Mean numbers of servings from meat intake were generally lower in the higher socioeconomic groups. Intakes of discretionary fat did not differ by education or income. Added sugars were highest among the middle income group (131–350% of poverty) and tended to decline with education.
Patterning techniques
Measures of patterns of Pyramid food group intakes have built upon earlier measures of variety. For example, Kant evaluated 24-h recall data in the NHANES II for the presence or absence, according to a minimum gram weight amount, of five food groups (dairy, meat, grain, fruit, vegetable). Each adult’s pattern was then determined on the basis of whether the individual did/did not report consuming at least a minimum amount of food from each of these groups. Two categories for each of five food groups generated 32 possible patterns. The most prevalent patterns among the population were as follows: all food groups present (34%), no fruit (24%), no dairy or fruit (9%), no dairy (8%), and no fruit or vegetable (6%). The pattern with all food groups was associated with mean nutrient intakes above the RDA. This pattern also had the lowest proportion of the population with mean nutrient intakes below the respective RDA. Patterns with fruit and vegetable intakes were also associated with higher concentrations of serum vitamin C.
Krebs-Smith characterized patterns of adults in a similar way, but was able to quantify the number of servings of Pyramid food groups by combining dietary data from the 1989–1991 CSFII with the PSDB. Each person’s servings were compared with the recommended number of servings of each food group that corresponded to their reported energy intakes. Each person’s pattern was then determined on the basis of whether they met/did not meet the recommendation for each of the five major food groups. Of the 32 possible patterns, six represented 44% of the population. The most prevalent pattern (11%) was meeting the recommendations only for vegetables and meat. Only 1% of the adults met the recommendations for all five food groups. Such patterning techniques involve simultaneously assessing multiple food groups and allowing relationships among the various dietary dimensions to emerge. For example, the pattern of meeting all five food groups was associated with intakes of dietary fat, added sugars and micronutrient intakes all in accordance with recommendations. All other patterns were associated with micronutrient and/or fiber intakes below the recommended amounts, intakes of fat and/or sugars above the recommended amounts or some combination. All five patterns that averaged >=20 g of fiber met the grain recommendation and one or both of the fruit and vegetable recommendations. Similarly, only five patterns had < =30% energy from fat, and all of them met the fruit recommendation.
Similar pattern analyses were conducted on the diets of children and adolescents, ages 2 to 19 y, who participated in the 1989–1991 CSFII. The most prevalent food pattern was meeting dairy only (12%). The next most prevalent food pattern was not meeting any of the food group recommendations (11%). Almost 40% of children and adolescents had patterns of meeting none or only one of the recommendations. Only 2% met all recommendations; only 10% met four or five of the recommendations. Those who met all food group recommendations had micronutrient intakes above the recommended amounts but also had intakes of fat and added sugars above the recommended amounts. Thus, in contrast to findings among adults, meeting the major food groups recommendations was not necessarily sufficient to ensure a healthful total diet.
Scoring methods
Scoring methods that incorporate aspects of the Pyramid have been developed to assess the total diet. One scoring method is the Healthy Eating Index (HEI). The HEI is a 10-component index, i.e., five components measure how diets conform to the Pyramid food group servings of grains, vegetables, fruits, milk and meat, and the other five components include intakes of total fat, saturated fat, cholesterol, sodium and a measure of dietary variety. The scoring system totals 100 points with each of the components having a score that ranges from 0 to 10. Scores of 0 are assigned if no foods are consumed or if nutrient intakes are above the recommended amounts; scores of 10 are assigned if the recommended amounts of foods or nutrients were consumed; intermediate scores are assigned proportionately to the amounts of food or nutrient intakes.
Another scoring method is the Diet Quality Index (DQI). The original DQI was based on eight Diet and Health recommendations, and included intakes of six nutrients (total fat, saturated fat, cholesterol, protein, sodium, calcium), and servings from two food groups (fruits and vegetables, grains). The DQI was modified recently to separate servings of fruits and servings of vegetables according to the Pyramid recommendations, include iron intake and scores of dietary diversity and dietary moderation, and no longer include protein intake. This revised index (DQI-R) has 10 components, each with a score of 0–10 points. Like the HEI, higher scores reflect diets more in accordance with the current dietary guidance.
Both scoring methods have been used to assess the diets of Americans and have produced similar results. In 1994–1996, the mean HEI score was 63.6. In 1994, the mean DQI-R score was 63.4 . In both analyses, 18% of the population had scores <51, indicative of a poor diet, and 12% had scores >80, indicative of a healthy diet. For both indices, less than half of the population met the recommendations for any of the food groups, or for total fat, saturated fat and sodium. More than half of the population met the recommendations for dietary cholesterol. Both scoring methods correlated positively with nutrient intakes, with higher HEI and DQI-R scores associated with higher nutrient intakes in relation to the RDA. Higher HEI and DQI-R scores were also associated with being female, and having higher education or income levels.
Both scoring methods have also been used to evaluate dietary change in the population. In 1994–1996, higher percentages of individuals met several of the recommendations related to components of the HEI compared with 1989–1991 data (in particular, total and saturated fat). Similar findings were observed for components of the DQI. However, change in mean scores across the surveys was very small, suggesting that although Americans improved some aspects of their diets, other aspects of their diets remained unchanged or worsened. For example, the percentage of individuals with adequate intakes of calcium or recommended servings of milk declined. When examined over a longer time period (1965–1991), change in mean DQI scores among both Caucasians and African-Americans, and among low, middle and high income Americans indicated a small improvement in dietary quality. Among the individual components of the DQI, average intakes of dietary fats and sodium remained above the recommended amounts, whereas average intakes of calcium and servings of fruits, vegetables and grains remained below the recommended amounts in all subgroups of the population.
Notable differences emerge between the two scoring methods on the measure of dietary variety. More than half of the population met the variety measure in the HEI in 1994–1996, but <15% met the variety measure in the DQI-R in 1994. This discrepancy is due to differences in how variety is measured. The HEI counts the number of different foods and assigns a maximum score (on a 10-point scale) to individuals who report consuming at least half of a serving of 8 or more different foods over 1 d, or 16 or more over 3 d. The DQI counts the number of different food groups and assigns a maximum score (on a 10-point scale) to individuals who report at least half of a serving of foods in those food groups, weighted according to their representation in four primary food subgroups (grains, vegetables, meat/dairy, fruits), over a 2-d period. In addition, the methodology used to place foods in Pyramid food groups differs. The DQI-R uses the USDA PSDB to place foods in food groups. In the DQI-R, legumes are counted as vegetables with the exception of soy, which is considered a meat substitute. The HEI originally used a commodity equivalent methodology, unique to the developers of this index, to classify foods but has since switched to using the PSDB. In the HEI, legumes are first assigned to the meat group. When meat serving recommendations are met, legumes are then counted as vegetables.
Measures of moderation and proportionality
Aspects of the total diet, other than variety, include moderation and proportionality. Moderation refers to the avoidance of excesses, especially of those food components (e.g., fats, added sugars, alcohol, sodium) believed to be related to suboptimal health outcomes. A unique component of the DQI-R is the assignment of a maximum dietary moderation score to individuals with intakes of discretionary fat, added sugars, alcohol intakes and sodium intakes below cut-off points determined from Pyramid recommendations. The dietary moderation score contributed significantly to the variation in the overall DQI-R score, providing evidence that dietary moderation is positively associated with diet quality.
Proportionality refers to the amounts of foods consumed in relation to each other. The shape of the Pyramid suggests that more servings of foods should be consumed from the grain group and fewer servings of foods should be consumed from the dairy and meat groups. Although not obvious from the Pyramid graphic, proportionality also refers to recommendations for subgroups within major food groups (e.g., dark green vegetables should be consumed several times per week). Proportionality implies that, to maintain energy intake, increased intake from one food group or subgroup necessarily results in decreased intake from another. The food groups interact, as demonstrated by results of Krebs-Smith who showed that food group patterns meeting the Pyramid recommendation for total fat also met the Pyramid recommendation for fruit.
Issues associated with patterning and scoring methods.
The development of the PSDB has made a major contribution to analyses of the U.S. diet, considering the disaggregation of food mixtures, the assignment of foods to their respective groups (including fats and sweets) and the quantification of all food groups (including the tip of the Pyramid) in terms that are consistent with current guidance (e.g., servings). Each of the various dimensions of the diet can be quantified and examined, singly or simultaneously, providing a foundation for assessments of total diet and the direct comparison of diets to recommendations.
However, quantifying the multiple dimensions of diet simultaneously has proven problematic. The seemingly infinite variations in intake along these multiple dimensions necessitate some sort of summary function with which to simplify the interpretation of results. The patterning approach retains the multiple dimensions on which it is based but, on each dimension, dichotomizes the continuous data into categories of “met”/”not met.” Thus, for individuals whose energy-based recommendation for fruit is 2 servings, those who report as few as 2 servings or as many as 10 servings of fruit would be in the “met” group, whereas those who report no servings or as many as 1.9 servings of fruits would be in the “not met” group. Krebs-Smith stated that this approach “obscures the large variability in the amounts of each food group consumed” in an effort to “separate people according to the most rudimentary categories of interest.” In addition, patterns are defined on the basis of the five major food groups and do not include recommendations related to fats and sugars. Had fats and sugars been evaluated as separate food groups, and a category of “exceeding the energy-based recommendations” for each of the food groups been created in addition to “met”/”not met,” the number of patterns would have increased exponentially. Such a large number of patterns would certainly reduce the precision of estimates associated with those patterns and limit their interpretation. Consequently, fats and sugars were not included in defining the pattern, but only as an outcome.
The scoring methods retain the quantification of each dimension but sum these together, in effect reducing the number of dimensions to one. Although this approach is intuitively appealing and offers a simple way to evaluate diets, it implies that certain components of the diet are independent, equally important and additively related to health. This is probably not the case. For example, two components of these indices, total and saturated fat, are highly correlated; consequently, the score is more heavily weighted toward dietary fat than any other dietary component. The assignment of a range of points to each component does take variability in food and nutrient intakes into account, but like the variety scores and food patterning techniques, intakes of food groups above energy-based recommendations are not distinguished further. Total scores at the extremes of the distribution are straightforward in their interpretation, but those in the middle of the distribution (where the majority of individuals fall) are difficult to interpret because distinctly different dietary patterns could result in the same score. For example, one person could score a 70 by completely meeting 7 of 10 recommendations but completely failing to meet 3 recommendations. Another person could score a 70 by partially meeting each of the 10 recommendations. To clarify total scores, individual components of the index are often evaluated. This raises questions concerning whether total scores add information beyond traditional analyses of individual food and nutrient intakes.
Summary of how U.S. diets fare
Evidence from studies of dietary variety shows that one third of the population eats at least some food from all food groups. Evidence from studies of food group patterns shows that many fewer (1–3%) eat the recommended number of servings from all food groups on a given day. Fruits are the most commonly omitted food group, whereas vegetables and meat are the most commonly met by adults and dairy the most commonly met by youth. Among adults, mean number of servings of fruits and dairy fall noticeably below that recommended, whereas among youth, mean number of servings from all food groups but dairy fall below the recommendations. Specific choices within vegetables (i.e., dark green, deep yellow) and within grains (i.e., whole grains) are noticeably below amounts recommended by current food guidance. Intakes of total fat, discretionary fat and added sugars continue to exceed current recommendations. Analyses of diets in relation to socioeconomic status have consistently shown that diets improve with increases in education and income. These results demonstrate shortcomings in variety, proportionality and moderation in the diets of most Americans.
June 28th, 2005
By Lori Beth Dixon, Frances J. Cronin and Susan M. Krebs-Smith
“Eat a variety of foods” was the first guideline in the Nutrition and Your Health: Dietary Guidelines for Americans, from their inception in 1980 through the fourth edition in 1995. Targeting nutrient adequacy, it was meant to convey that no single food supplies all of the nutrients and other food components required for optimum health. In all four editions, to ensure variety, Americans were encouraged to consume foods from among each of several major food groups—breads, cereals, rice and pasta; vegetables; fruits; milk, cheese and yogurt; meat, poultry, fish, dry beans, eggs and nuts. In the 1985 and 1995 editions, Americans were also encouraged to consume different foods within those groups. Variety was quantified in the text of the guideline in 1990 by including recommended ranges for the number of servings from five food groups (grains, vegetables, fruits, milk, and meat or meat alternates). These recommendations were from a food guidance system developed by the USDA, which, in 1992, was published as the Food Guide Pyramid (referred to in this paper as the Pyramid) . The Pyramid was included in the text of the 1995 Dietary Guidelines. From 1980 through 1995, the guideline statement remained, “Eat a variety of foods.”
After extensive discussion, the 2000 Dietary Guidelines Advisory Committee (DGAC) elected to change the statement to “Let the Pyramid guide your food choices” in the 5th edition of the Dietary Guidelines . Their reasons for changing the statement were threefold as follows:
that variety among (as opposed to within) the food groups was most likely to promote nutrient adequacy
that variety within some food groups might lead to excessive intakes of energy
that the original statement simply was not clear to consumers
Members of the DGAC proposed using the Pyramid in the guideline statement because of its familiarity to consumers and success as a nutrition education tool. Naming the Pyramid in the guideline statement clarified its intent and suggested action by encouraging consumers to follow its recommendations. The text accompanying the guideline suggests using plant foods as the foundation of meals, and encourages consumers to emphasize foods from the grain, fruit and vegetable groups, along with moderate amounts of low fat foods from the milk and meat groups. To alleviate concern that the Pyramid could be perceived as prescriptive rather than flexible, the text also emphasizes that there are many healthful eating patterns, and suggests ways to obtain nutrients that may be limited if the milk and/or the meat group are not included in the diet. Variety among grains and among fruits and vegetables is now emphasized by two other guidelines, “Choose a variety of grains daily, especially whole grains” and “Choose a variety of fruits and vegetables daily.”
Although the Pyramid has been featured in the Dietary Guidelines as a way to attain nutrient adequacy, the underlying food guidance system was designed to do much more. The system was based on a series of guiding principles that aimed to achieve the following:
provide a framework for a diet to meet the needs of most healthy Americans >=2 y old, based on current
nutrition research and dietary recommendations feature foods commonly eaten by Americans, classified
into easily recognizable food groups, and allowing maximum flexibility in food choices cover the range of
energy needs among the population by including a range of recommended intakes provide nutrient
adequacy without dependence on dietary supplements or highly fortified foods moderate food
components for which overconsumption was a concern (energy, total fat, saturated fat, cholesterol,
added sugars, sodium and alcohol) account for all foods and beverages consumed as part of meals and
snacks. Inherent in this idea is that any food can be part of nutritious diet, although each choice has
implications. be evolutionary. The food guidance system was built on previous food guides but considered
current research directions.
The most distinguishing feature of the food guidance system was that, in addition to promoting nutrient adequacy, it provided proportionality and moderation by accounting for all foods consumed—the “total diet”concept.4 This was a departure from the “foundation diet” concept used by a previous food guide, “Food for Fitness-A Daily Food Guide ” , popularly referred to as the Basic Four or the Four Food Groups . The Basic Four was designed to provide ~1200 kcal and >=80% of eight nutrients for which Recommended Dietary Allowances (RDA) existed in 1953. The four food groups, fruit and vegetables, milk, meat, breads and cereals, targeted specific nutrients often low in the diets of Americans. The fruit and vegetable group targeted vitamins A and C, the milk group targeted calcium, and the meat and meat alternates group targeted micronutrients that were difficult to obtain from other food groups. It was assumed that individuals would consume more food than the guide recommended to satisfy energy needs. These less nutrient-dense foods would supply additional nutrients required to bring diets close to the levels of the RDA.
By the 1970s, many scientists recognized that dietary guidance should not only target nutrient adequacy but also provide guidance related to moderation of those dietary components that were being consumed excessively. In 1979, the USDA released the “Hassle-Free Guide,” a minor revision of the Basic Four that included a fifth group called “Fats, Sweets, and Alcohol,” but did not quantify recommendations for that group . Like the Basic Four, the Hassle-Free Guide suggested amounts of foods to provide a foundation diet.
In contrast, the food guidance system developed in the 1980s and used today suggests amounts of foods for a total diet. To cover the range of energy needs of the population, a range of servings from each major food group is recommended. To achieve nutrient adequacy, certain subgroups within the food groups are emphasized. Although not illustrated in the Pyramid graphic, the text in the Pyramid brochure recommends that dark green leafy vegetables and legumes be included in the diet several times a week, and at least three or more servings from the breads and cereals group be whole grain.
Moderation of fat and lower energy intakes become possible by adjusting the amounts of discretionary fat and added sugars. Discretionary fat includes amounts of fat above that consumed if the lowest fat choices were made in all the food groups (e.g., amount of fat in 2% milk above the amount of fat in skim milk). Added sugars represent all caloric sweeteners, such as table sugar, high fructose corn syrup, and honey, added to foods during processing or preparation, or eaten separately. The system allows for the inclusion of modest amounts of fat and added sugars within an individual’s energy needs. As was the case with the subgroup recommendations, detailed suggestions of amounts of fat and added sugars are included in the Pyramid brochure, but not in the Pyramid graphic.
The food guidance system was designed to provide the recommended amounts of essential nutrients without depending on the use of supplements or highly fortified foods. This was consistent with the recommendations that nutrient needs should be met by the consumption of a variety of foods rather than from supplements. Recently, there has been the recognition of the need for supplementation to meet the nutrient recommendations for some segments of the U.S. population. The first edition of the Dietary Guidelines stated that “you rarely need a vitamin or mineral supplement if you eat a variety of foods”. The most recent edition states “some people need a vitamin-mineral supplement to meet specific needs”. It places special emphasis on foods rich in folate or folic acid supplements to reduce the risk of certain birth defects. However, because foods contain beneficial substances in addition to nutrients, it cautions against depending on dietary supplements to meet usual needs.
To promote the Pyramid only as a means to achieve nutrient adequacy is to ignore some of its most promising aspects. Unfortunately, the Pyramid, although first released as a brochure with detailed information, is most often depicted as a graphic showing quantified recommendations from only the major food groups. As such, it has become something of an icon. It is not obvious, even to a serious observer, that this simple scheme represents an entire guidance system that incorporates suggestions on the consumption of specific types of foods within the major food groups, intakes of fat and added sugars, serving sizes and energy levels. Nonetheless, “Let the Pyramid guide your food choices” is unique among the Dietary Guidelines in that it considers multiple aspects of the diet simultaneously. The themes of variety, moderation and proportionality—in sum, the total diet—have been inherent in this guideline, although to varying degrees over time.
June 28th, 2005
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