Posts filed under 'Diet and Nutrition'
by: Shelley Green
Fruit and vegetables are brimming with fibre, plus a whole range of vitamins and minerals, and because they’re low in calories, they make an important and healthy addition to any diet. Here is some information for you about vegetable nutrition. “Eat your fruits and vegetables” is one of the tried and true recommendations for a healthy diet, and for good reason. Eating plenty of fruits and vegetables can help you ward off heart disease and stroke, control blood pressure and cholesterol, prevent some types of cancer, avoid a painful intestinal ailment called diverticulitis, and guard against cataract and macular degeneration, two common causes of vision loss.”5 A Day” is a national health programme in the USA and also in the UK to explain why you need vegetable nutrition as well as fruit and to encourage you to eat more servings of fruit and vegetables every day. People all over the world are becoming more and more aware of how important fruit nutrition and vegetable nutrition is to stay healthy.
In general, yellow and dark green vegetables are excellent sources of vitamin A. Green leafy vegetables are rich in calcium, iron, magnesium, vitamin C and many of the B vitamins. The greener the leaf, the richer the nutrients will be. Here are some suggestions to think about color to pack nutritional power in your diet: · White: Eat cauliflower more often than potatoes, onions and mushrooms.· Green: Add more dark lettuces, such as romaine and red leaf lettuce, spinach, broccoli and Brussels sprouts to replace iceberg lettuce and green beans. · Yellow-orange: Substitute more carrots, winter squashes, sweet potatoes, cantaloupe, oranges and grapefruit for corn or bananas. · Red: Select tomatoes, red peppers and strawberries in favor of apples. If you are trying to watch your weight, an idea is to make sure you are not eating too many calories if you are adding these foods to your diet. increasing the amounts of fruits and vegetables you eat can promote weight control, but only if they replace higher fat foods like ice cream, meat and chips to help you consume fewer calories. But if fruits and vegetables are simply added to what you already eat, total calories won’t significantly drop and weight loss should not be expected. The most important thing to do is to vary the fruit and vegetables that you eat from day to day. This is to give your body a variety but to also keep you interested in your food. There are always great new recipes, ideas and ways to make your food look and taste great!
About The Author
Shelley Green is the owner of http://www.vegetable-delivery.com, a site that specializes in vegetable delivery including organic vegetables, organic fruit, fruit and vegetable boxes, and also other recommended sites.
January 18th, 2007
Gluten intolerance also goes by the name of coeliac disease. There are various definitions of what gluten intolerance is, but the average definition describes it as a malabsorption syndrome precipitated by the ingestion of the gluten protein found in wheat products, known as “gliadin”.
There are two peak incidences of the disease - one in infants between six months and two years of age, and the other in adults between the ages of 30-50 years. Also, women tend to be more prone.
It is characterised by the flattening of the villi (thread-like projections responsible for absorption of fluids and nutrients) in the small intestine, which severely reduces the area available for nutrient absorption, resulting in potential or actual malabsorption of virtually all nutrients. The cells of the villi become deficient in digestive enzymes which leads to maldigestion. The mechanism by which gliadin damages the small bowel is not known, but it has been found to have genetic, immune and environmental components. The amount of small intestine that is affected can vary from person to person, but usually the upper bowel is most affected.
There are many symptoms of gluten intolerance and therefore no one symptom can be regarded as characteristic of the disease. Lack of energy, malaise or weakness are the most common symptoms, while others include diarrhoea, fat malabsorption (steatorrhoea), growth failure in children, bloated abdomen and vomiting.
Dietary Management
Since it has been shown that the gliadin fraction of gluten causes the problems, its complete withdrawal from the diet is needed, which normally results in prompt improvement. In fact, 50-60% of sufferers have few or no symptoms following a strict dietary regimen. Initially, the afflicted person may have malabsorption, therefore vitamin and mineral supplements and possibly even extra protein may be required.
Lactose intolerance sometimes appears secondary to gluten intolerance, however, once the bowel begins to heal after gliadin is omitted, lactase (enzyme that breaks down lactose) usually returns to normal levels and the lactose intolerance disappears.
The gluten-free diet excludes wheat, rye, barley, and oats, with wheat having the highest gluten content and oats the lowest. Thus oats may be tolerated in moderate amounts by some people, since it contains very little gliadin. Suitable substitutes for these foods include rice, potato, corn, tapioca, chickpea, soya, arrowroot and gluten-free flour. If these are not available at local supermarkets, then inquire at your local health shop.
Menu Adaptations
* A guarantee of a gliadin-free diet requires careful inspection of the labels of all bakery products and packaged foods. Gliadin-containing grains are used not only as a basic ingredient, but may also be added during processing or preparation. It is important to read food labels carefully since often gluten-containing products are used but are labelled with alternative names, such as:
o “Hydrolysed vegetable protein” can be made from wheat, soy, corn or a mixture of all three.
o “Flour” or “cereal products” and “vegetable products” may be made from wheat, rye, oats or barley.
o “Malt” or “malt flavouring” can be made from barley.
o “Modified food starch” may be made from wheat.
o “Vegetable gum” is made from oat gum.
o “Soy sauce” may contain wheat.
Other words to look out for are: emulsifiers, stabilisers, thickeners and hydrolysed starch.
* Additional hidden sources include beer; cereal beverages (e.g. Ovaltine, Milo); commercially prepared cakes and biscuits; ice-cream; processed soups; frozen foods with sauces; some cereals; crackers; most crisps; processed cheese; canned and processed meats and candy bars (unless pure chocolate)
* If you are wondering about good thickening flours for gravies and sauces, then arrowroot, tapioca and corn starch are suitable options. Furthermore, the best agents for combination with eggs and milk in a baked product are corn, potato, rice or soya flour.
* Some gluten-free foods and beverages include tea; coffee; rum; wine; jelly babies; chocolate; fresh fruit and vegetables; fresh fish, meat or poultry; eggs; rice; potatoes; rice cakes; peanut butter; popcorn; jam; honey and sugar.
* If gliadin is reintroduced into the diet, symptoms may occur within a few hours or even up to eight weeks later. People who go off and on the diet may become tolerant to it, with the result that it no longer has any effect. Note that gliadin must be avoided for life!
July 21st, 2005
If you are breast-feeding, you should be applauded since breast milk is the best form of nutrition for your baby, being superior to any alternative. It is always fresh and contains a variety of anti-infectious factors and immune cells. Also, it is the least allergenic of any infant food and automatically encourages close mother-child contact. But what must you eat and what kind of diet should you be following while trying to provide optimal nutrition for your child?
What should you eat? The process of lactation is nutritionally demanding and therefore a nutritious diet is very important. The recommended calorie increase is for an extra 500kcal per day above the levels for non-pregnant women. Maternal fat stores accumulated during pregnancy provide about 100 to 150 kcal per day during the early months of lactation — that is good news — you probably also want to shed those extra kilos.
The more often you breast-feed, the more milk your body will produce and the more energy you will expend — and the quicker you will lose the weight. But, be careful; this is not the time for strict weight-loss diets or crash diets during lactation — this can lead to decreased production of milk each day. Once lactation is well established, a moderate reduction in calorie intake (to increase the rate of fat utilisation) can usually be initiated without any detrimental effects.
A healthy, sensible eating and exercise programme should be your primary focus. The trick is to eat everything in moderation. Try to eat three or six meals a day. In other words, either three larger, fully satisfying meals, or six smaller meals throughout the day. Skipping a meal can result in low blood sugar level, which can cause you to overeat later or at the following meal. If this happens, often you get desperate and eat whatever you can lay your hands on — fatty foods like pastries, biscuits and chocolate which is not going to do much for the waistline.
Breads, cereals and grain products It is best to follow a high-carbohydrate, low-fat diet — as recommended by the Food Guide Pyramid. Breads, cereals and grain products like pasta and rice contain mostly carbohydrate and provide the body with energy and are easily burned up by the body. Luckily, carbohydrate foods also make wonderful comfort foods and lead to a calming effect on the brain, as the sleep-inducing hormone serotonin is released after eating carbohydrates that transmits calmness and mood stability to your brain cells.
Unfortunately, carbohydrates — especially bread — have been labelled fattening. Remember, it is not the carbohydrates that are fattening, but what you choose to put on it such as the butter, avocado, full fat cheeses, peanut butter, cold meats, cream sauce etc. In addition, the high fibre content of unrefined carbohydrates means that they help promote satiety, regulate our digestive process and help control our blood sugar levels — all useful in weight control.
Fruits and VegetablesEat lots of fruit and vegetables — the goal is to eat at least five servings of fruit and vegetables a day. They are a rich source of vitamins and minerals and are therefore termed our “protective” foods as they help the body fight off sickness and disease.
An added benefit is that they are relatively low in calories and also contribute to our daily fibre intake. Fruits are quick and easy to eat as snacks during the day, as are vegetables at meal times or as snacks. Just be cautious of “windy” foods such as dried fruit, green leafy vegetables like lettuce and spinach, onions, peas, cabbage, cauliflower and Brussels sprouts, which could upset your baby’s tummy and cause colic-like symptoms.
Milk and Dairy Products It’s recommended that pregnant and lactating women have a calcium intake of 1 200mg per day. Do this by including at least four to five portions of the following foods in you daily diet:
* 1 glass skim or 2% milk
* 1 fat-free or low-fat yoghurt (175ml)
* 30g reduced fat cheese
* ½ cup ricotta cheese
* 80g sardines
* ½ cup low-fat custard
As you can see, “low-fat” or %E
July 21st, 2005
Question:
Could you please send me some information about iron deficiency in pregnancy and how it can be treated and prevented?
Answer:
Possible causes of iron deficiency anaemia are:
# Inadequate iron intake due to a poor diet.
# Inadequate absorption of iron due to diarrhoea, intestinal disease, or interference by drugs such as antacids, cholestryramine, Tagamet, Zantac and tetracycline.
# Inadequate iron utilisation due to chronic gastro-intestinal disturbances.
# Increased iron requirements, which occur during infancy, adolescence, pregnancy and lactation.
# Increased excretion of iron because of excessive menstrual blood in females, haemorrhage from injury, chronic blood loss from a bleeding ulcer, bleeding haemorrhoids, oesophageal varices, ulcerative colitis, parasites and malignancy.
A marked increase in the maternal blood supply during pregnancy greatly increases the demand for iron. In total, the pregnant woman must have between 700 and 800mg of extra iron, most of which is needed during the last half of pregnancy, when the heaviest maternal and foetal demands occur.
Averaged over the entire pregnancy, this amounts to a daily increment of 15mg of iron. Adding this amount to the 15mg per day recommendation for non-pregnant women, brings the 1989 RDA for iron during pregnancy to a total of 30mg per day. Liver, kidney, beef, egg yolk, dried fruits, dried peas and beans, nuts, peanut butter, green leafy vegetables, molasses, wholegrain breads and fortified cereals are the best sources of iron. In most cases, women need to be supplemented, since it is difficult to meet the RDA through diet alone.
In fact, it has been recommended that all pregnant women with a well-balanced diet should take 30mg of ferrous iron supplement daily during the second and third trimesters. Further, for optimal absorption, the iron supplement should ideally be taken between meals and not with milk, tea or coffee.
Treatment Medication — the main treatment for iron-deficiency anaemia consists of oral administration of inorganic iron. Iron is best absorbed when the stomach is empty, however under these conditions it tends to cause gastric irritation.
Gastro-intestinal side effects of nausea, epigastric discomfort and distension, heartburn, diarrhoea and constipation can be minimised by increasing the dose slowly over a few days until the required amount is reached. In addition, iron should be given in at least three doses per day. Since side effects are dose-related, smaller dosages with a longer therapeutic programme have been suggested.
Diet Therapy — In addition to medication, attention should be given to the amount of absorbable iron in food. Liver, kidney, beef, egg yolk, dried fruits, dried peas and beans, nuts, peanut butter, green leafy vegetables, molasses, wholegrain breads and fortified cereals are the best sources of iron.
The bioavailability of iron in the diet is more important than the total dietary iron in correcting or preventing iron deficiency.
Nutritional factors enhancing iron absorption:
# The lower the iron stores in our bodies, the greater will be the rate of iron absorption.
# Heam-iron present in meat, fish and poultry (MFP) is much better absorbed than is non-heam iron, which is mainly present in eggs, grains, vegetables and fruits.
# MFP factors which are products of digestion of meat, fish and poultry increase the absorption of iron.
# Vitamin C and acidic foods (namely fruit) increase iron absorption.
Nutritional factors that decrease iron absorption:
# Carbonates, oxalates, phosphates and phytates (found in unleavened bread, unrefined cereals and soya beans) bind iron rendering it inabsorbable.
# Vegetable fibre inhibits non-heam iron absorption.
# Taken with meals, tea can reduce iron absorption by 50% through the formation of insoluble compounds with tannins found in the tea.
# EDTA (ethylenediaminetetra-acetic acid), a food preservative, causes a 50% reduction in non-heam iron absorption.
# Iron in egg yolk is poorly absorbed because of the presence of phosvitin. Also milk proteins and albumin reduce iron absorption.
Summary:
# Improve food choices to increase total dietary iron.
# Include meat, fish or poultry at every meal if possible.
# Include a source of Vitamin C at every meal. Examples include tomatoes, broccoli, Brussels sprouts, guavas, paw paw, pineapple and citrus fruits.
# Avoid drinking large amounts of tea with meals.
# Avoid high quantities of the preservative EDTA by checking food labels.
July 21st, 2005
Whether you are currently healthy and want to remain so, or are not-so-healthy and want to be, here are some guidelines to help get you there.
Ensure Adequate Energy (or Calorie) Intake
Energy requirements depend on sex, age and energy expenditure. Enough energy should be provided from a variety of foods to ensure the maintenance of a desirable body weight. In children and adolescents enough energy should be provided for growth and development.
Limit Fat and Cholesterol Intake
Whether from plants or animals, fat is a very concentrated source of calories. It is common for South Africans to consume 40-50% of their total energy intake in the form of fat, with usually more than 50% of these fats being saturated (animal fats).
To be healthy, this need to be less than 30% of total daily energy intake. You should also divide this 30% equally between the three different types of fats i.e. around 10% for saturated, monounsaturated and polyunsaturated fats each.
Saturated fats are generally animal fats and are found in meat, full cream dairy products, shortening, coconut and palm kernel oil.
Mono-unsaturated fats are found in olive oil, canola oil, avocado pears and nuts such as almonds, pecans, hazelnuts and peanuts and soft-type tub margarines, e.g. olive oil- or canola oil-based margarines.
Polyunsaturated fats are found in some vegetable oils like sunflower and corn oil, soft margarines, oily fish and flaxseed oil.
There is a fourth type of fat known as trans fatty acids. These are regarded as saturated fats and should be restricted. Foods typically high in trans fatty acids are hydrogenated vegetable fats, e.g. some brick margarines, and foods prepared with these hydrogenated vegetable oils.
Reduce your daily intake of dietary cholesterol to less than 300 mg. All animal foods contain dietary cholesterol and contribute to the cholesterol intake. Eggs, organ meats and shellfish are the richest sources.
Increase Intake of Complex Carbohydrates and Fibre
You should take in 55-60% of total energy per day as carbohydrates from a variety of sources, e.g. grains, cereals, fruit and vegetables. Sugar forms part of total carbohydrate intake and should be restricted to 10% of total energy - use in moderation!
Dietary fibre passes almost intact through your digestive system. It may help you to avoid constipation, stay healthy and prevent certain lifestyle diseases.
There are two types of fibre: water soluble and water insoluble fibre. Water soluble fibre is found in oats, barley, seeds, legumes and some fruit. Water insoluble fibre is found in roughage foods, such as wholewheat products, brown rice, and in the outer parts of seeds and fruit skins, husks and peels.
Most Western people eat only 10 to 15 grams of fibre per day, but a healthy diet should contain a daily intake of between 25 and 35g fibre per day. When fibre is added to the diet its intake should be increased gradually and accompanied by adequate fluid intake.
Moderate Protein Intake
A protein intake of approximately 15% - 20% of energy is recommended. This should come from animal as well as vegetable sources. The daily requirement for protein is relatively low and easily met by a varied and mixed diet.
Beef, mutton and pork contain a fair amount of saturated fat and cholesterol and should therefore be eaten in moderation. Chicken without the skin contain less fat and can be eaten more frequently - the same goes for fish.
Dry legumes, for example dried beans, peas, lentils and soya are also good protein sources. Furthermore legumes are high in fibre and low in fat. Nuts, although a good protein source should be used in moderation because of their high fat content.
Limit Sodium
In the body, sodium regulates fluid balance and affects blood pressure. High salt intake is associated with higher blood pressure in some people. A sodium intake of 3g sodium (5g salt) per day is recommended. Foods high in salt and those containing flavouring salts should be limited in the diet. Remember - most processed foods contain sodium.
Eat a Variety of Foods
No single food can provide all the nutrients you need. A varied diet increases the likelihood you’ll get all of the required nutrients. Variety also allows you to balance a few higher-fat, higher-calorie items with more lower-fat, lower-calorie ones. As a result, you are more likely to eat less fat and fewer calories.
Grains, vegetables and fruits should form the foundation for your diet because they provide excellent sources of vitamins, minerals, antioxidant, dietary fibre and other substances that are important for lowering the risks of many chronic diseases.
Use Alcohol in Moderation
You don’t have to drink! These guidelines are for those who do - not to encourage you to start!
One to two alcoholic drinks per day are allowed - don’t accumulate this for the weekend. This constitutes binge drinking which is harmful in itself.
Pregnant and lactating women should not drink alcohol at all. It is also not a good idea for people with a family history of alcoholism, high triglycerides, pancreatitis, liver disease, heart failure or uncontrolled hypertension, and for those on medication that interacts with alcohol. Also, since alcohol is high in calories, people with a weight problem should restrict alcohol intake.
One alcoholic drink is defined as the equivalent of one beer (340 ml); 120ml wine; 25 ml of brandy, whisky, other spirits and liqueur. The current guidelines define moderate consumption as no more than one drink per day for non-pregnant women and no more than two drinks per day for men.
So how can we interpret this into actual eating?
Easy, following the Food Guide Pyramid and Nutrition Facts Labels on food packages, show you how to turn the guidelines of 50% carbohydrate, 20% protein and 30% fat into healthy food choices. So go ahead and start eating healthily, the benefits are enormous. And don’t forget to exercise as well!
July 21st, 2005
The fact that more than 20% of the United States adult population is obese presents a major public health concern. However, the failure to follow through and maintain weight loss on their own, after termination of counselling, makes the long-term success of weight loss programs difficult to achieve.
Health professionals often assume that patients will dutifully comply with recommendations simply because they are urged to do so. The magnitude of noncompliance has been well documented. Adherence to dietary programs is thought to be poorer than to medication regimens. [Glanz, K.: Dietitians’ effectiveness and patient compliance with dietary regimens. JADA 84:444, 1984.] Dietary regimens are often restrictive, require changes in life-style and behaviours, interfere with family habits and customs, and are of long duration.
Weight control methods are considered a success if weight loss is maintained without expense to overall health. A goal of any successful weight reduction program is to promote permanent life-style changes. The physical and psychological consequences of repeated weight fluctuations may be more harmful than maintaining some degree of overweight. [Rock, C.L., & Coulston, A.M.: Weight control approaches: A review by the California Dietetic Association. JADA 86:44, 1988] The ultimate goal of all weight loss programs is to reduce nutritional risk factors associated with chronic diseases by increasing consumer awareness of healthy food choices.
In 1992 over 49 million people were dieting. The National Council Against Fraud estimates that quackery costs consumers between $25 billion and $50 billion a year - and nutrition fraud is the most common type. [Legislative Highlights, Journal of the American Dietetic Association. Page 648 - 650. May 1990]
Therefore to identify a quality weight loss program, and not to be misled by a “fad diet”, the following indicators must be considered:
* A variety of foods. Weight control programs should be individualized to fit people’s life-styles and food preferences. Individualization diminishes feelings of deprivation, which lead to discouragement, bingeing, and rebound weight gain - all hallmarks of the yo-yo diet syndrome.
*Enough calories to maintain good health. Consuming less than 1200 kcal a day may result in loss of muscle instead of fat and may compromise nutritional status as a result of deficient nutrient intakes.
*Realistic weight loss goals. To lose body fat and not just water, a maximum weight loss of 2 pounds per week is advised.
*Regular exercise. Especially as we age, exercise can be the key to weight loss and maintenance of a desirable weight.
*Behaviour modification. Registered dietitians counsel people to keep lost weight off by helping them alter their eating behavior and responses to foods for the rest of their lives.
Unfortunately, a current trend toward the view that a single food is either a panacea or a poison is being gradually adopted by major health associations. This “good food/bad food” dichotomy ignores the consensus among nutritionists that all foods can be compatible with health when used in moderation as part of a balanced, varied diet.
Over the past decade people have become obsessed with the nutritional value of the food they eat. Time and again, nutrition ranks high among consumer concerns, along with food safety, convenience, quality, and value. In the United States sales in the “healthy foods” category accounted for $65 billion in 1985, but are expected to reach $98 billion by 1995.
Consumers are asking for specific information about which foods and, in particular, which brands of packaged foods to choose from when they eat or purchase foods. For example the broad guideline to avoid to much fat, saturated fat and cholesterol require specific behaviour implementations that include:
* Eat more fresh fruits and vegetables, whole grain breads and cereals, potatoes, rice noodles, dried beans, peas, and lentils.
* Choose low fat dairy products, including skim, 1%, and 2% milk, low-fat cheeses, and low-fat yogurt.
* Choose lean meats, fish, chicken and turkey.
Very Low Calorie Weight Loss Diets (VLCD)
It is the position of the American Dietetic Association that while VLCD’s promote rapid weight loss and may be beneficial for certain individuals, such diets have health risks and should be undertaken only with the supervision of a multidisciplinary health team with monitoring by a physician and nutrition counselling by a registered dietitian.
Side effects that have been associated with VLCD’s are cold intolerance, fatigue, light-headedness, nervousness, euphoria, constipation or diarrhoea, dry skin, thinning of hair, anaemia, and menstrual irregularities.
Low body weight and Weight Loss
Excessive concern about weight may cause or lead to such unhealthy behaviors as excessive exercise, self-induced vomiting, and the abuse of laxatives or other medications. These practices may only worsen the concern about weight. Excessive exercise may also affect hormone production, increase the loss of calcium from the bones, and increase the risk of fractures.
Low body weight and rapid unintentional weight loss are highly predictive of mortality, especially in the elderly population. Weight loss is frequently reported in elderly patients.
Acute and chronic diseases are leading causes of involuntary weight loss. Whereas physical disease probably accounts for a majority of cases of involuntary weight loss, psychiatric disorders such as dementia and depression also may result in severe nutritional deficiencies.
Energy requirements decrease because of the lower basal metabolic rate and reduced physical activity. These low energy requirements make it more difficult for the elderly to obtain adequate amounts of required nutrients. Health care professionals must monitor body weight in elderly persons and carefully evaluate any cases of rapid, unintentional weight loss to prevent further deterioration of health status. [Low body weight and weight loss in the aged. JADA 90:1697-1706, 1990]
Weight loss generally consists of both lean body mass and body fat. Contributions of lean body mass and fat to total weight loss is a function of body fat content. Excessive loss of lean body mass will result in skeletal and cardiac muscle wasting and loss of visceral protein. Because lean body mass declines with age, elderly individuals who are at average or slightly above average weight may be better able to tolerate weight loss that occurs with aging or disease than underweight individuals.
It has been well documented that physical disease can lead to weight loss. Disease may limit dietary intake or may alter physiological processes, resulting in decreased nutrient digestion or absorption, increased nutrient excretion, or increased nutrient requirements.
Cancer is the most frequently cited cause of involuntary weight loss, and weight loss may occur during early stages of tumour growth before other symptoms emerge. The anorexia of malignancy has been related to taste alterations; changes in gastrointestinal tract contraction and secretion; metabolic disturbances resulting in changes of circulating glucose, amino acid, fatty acid, or lactic acid levels; changes in hypothalamic function; and weakness leading to decreased motor activity.
In addition to cancer, gastrointestinal disease, uncontrolled diabetes, and cardiovascular disorders such as congestive heart failure, alcohol abuse, pulmonary disease, and infection are major causes of involuntary weight loss. Less common, but still a cause of notable weight loss, is hyperthyroidism.
Specific nutrient deficiencies and low nutrient intakes, which may contribute to weight loss, have been documented in patients with dementia. Deficiencies of folate, thiamin, niacin, riboflavin, and vitamin B12 and electrolyte imbalance may impair cognitive function and mimic dementia.
Some nutrient deficiencies that alter mental status may be present in the elderly population. Altered mental states attributable to nutrient deficiencies and weight loss can be corrected. Several studies have shown that folate deficiency leads to confusion and signs of dementia in elderly individuals, but can be reversed with appropriate supplementation. If confusion and dementia caused by nutrient deficiencies are not diagnosed and corrected, they may lead to even lower nutrient intakes and more severe alterations in mental status.
July 21st, 2005
Abstract
It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred, and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians, including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits, including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fiber, magnesium, potassium, folate, and antioxidants such as vitamins C and E and phytochemicals. Vegetarians have been reported to have lower body mass indices than nonvegetarians, as well as lower rates of death from ischemic heart disease; vegetarians also show lower blood cholesterol levels; lower blood pressure; and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. Although a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes. J Am Diet Assoc. 2003;103:748-765.
Vegetarianism in perspective
A vegetarian is a person who does not eat meat, fish, or fowl or products containing these foods. The eating patterns of vegetarians may vary considerably. The lacto-ovo-vegetarian eating pattern is based on grains, vegetables, fruits, legumes, seeds, nuts, dairy products, and eggs but excludes meat, fish, and fowl. The lacto-vegetarian excludes eggs as well as meat, fish, and fowl. The vegan, or total vegetarian, eating pattern is similar to the lacto-vegetarian pattern, with the additional exclusion of dairy and other animal products. Even within these patterns, considerable variation may exist in the extent to which animal products are avoided.
People choosing macrobiotic diets are frequently identified as following a vegetarian diet. The macrobiotic diet is based largely on grains, legumes, and vegetables. Fruits, nuts, and seeds are used to a lesser extent. Some people following a macrobiotic diet are not truly vegetarian because they use limited amounts of fish. Some “self-described” vegetarians, who are not vegetarians at all, will eat fish, chicken, or even meat. Some research studies have identified these “self-described” vegetarians as semivegetarians and have defined semivegetarian as occasional meat eaters who predominately practice a vegetarian diet or those who eat fish and poultry but less than 1 time per week. Individual assessment is required to accurately evaluate the nutritional quality of the diet of a vegetarian or someone who says that they are vegetarian.
Common reasons for choosing a vegetarian diet include health considerations, concern for the environment, and animal welfare factors (5,6). Vegetarians also cite economic reasons, ethical considerations, world hunger issues, and religious beliefs as their reasons for following their chosen eating pattern.
Consumer trends
In 2000, approximately 2.5% of the US adult population (4.8 million people) consistently followed a vegetarian diet and affirmed that they never ate meat, fish, or poultry. Slightly less than 1% of those polled were vegans. According to this poll, vegetarians are most likely to live on the east or west coast, in large cities, and to be female. Approximately 2% of 6- to 17-year-old children and adolescents in the United States are vegetarians, and around 0.5% of this age group are vegan. According to a 2002 survey, about 4% of Canadian adults are vegetarian; this represents an estimated 900,000 people.
Factors that may affect the number of vegetarians in the United States and Canada in the future include an increased interest in vegetarianism and the arrival of immigrants from countries where vegetarianism is commonly practiced. Twenty to 25% of adults in the United States report that they eat 4 or more meatless meals weekly or “usually or sometimes maintain a vegetarian diet,” suggesting an interest in vegetarianism. Additional evidence for the increased interest in vegetarianism includes the emergence of animal rights/ethics courses on college and university campuses; the proliferation of Web sites, magazines and newsletters, and cookbooks with a vegetarian theme; and the public’s attitude toward ordering a vegetarian meal when eating away from home. More than 5% of those surveyed in 1999 said they always order a vegetarian meal when they eat out; close to 60% “sometimes, often, or always” order a vegetarian item at a restaurant.
Restaurants have responded to this interest in vegetarianism. The National Restaurant Association reports that 8 out of 10 restaurants in the United States with table service offer vegetarian entrees. Fast-food restaurants are beginning to offer salads, veggie burgers, and other vegetarian options. Many college students consider themselves vegetarians. In response to this, most university foodservices offer vegetarian options.
There has also been a growth in professional interest in vegetarian nutrition; the number of articles in the scientific literature related to vegetarianism has increased from less than 10 articles per year in the late 1960s to 76 articles per year in the 1990s. In addition, the main focus of the articles is changing. Twenty-five or more years ago, articles primarily had themes questioning the nutritional adequacy of vegetarian diets. More recently, the theme has been the use of vegetarian diets in the prevention and treatment of disease. More articles feature epidemiological studies, and fewer reports are case studies and letters to the editor.
There is a growing appreciation for the benefits of plant-based diets, defined as diets that include generous amounts of plant foods and limited amounts of animal foods. The American Institute for Cancer Research and the World Cancer Research Fund call for choosing predominantly plant-based diets rich in a variety of vegetables and fruits, legumes, and minimally processed starchy staple foods and limiting red meat consumption, if red meat is eaten at all. The American Cancer Society recommends choosing most food from plant sources. The American Heart Association recommends choosing a balanced diet with an emphasis on vegetables, grains, and fruits, and the Heart and Stroke Foundation of Canada recommends using grains and vegetables instead of meat as the centerpiece of meals. The Unified Dietary Guidelines developed by the American Cancer Society, the American Heart Association, the National Institutes of Health, and the American Academy of Pediatrics call for a diet based on a variety of plant foods, including grain products, vegetables, and fruits to reduce risk of major chronic diseases.
New product availability
The US market for vegetarian foods (foods like meat analogs, nondairy milks, and vegetarian entrees that directly replace meat or other animal products) was estimated to be $1.5 billion in 2002, up from $310 million in 1996. This market is expected to nearly double by 2006 to $2.8 billion. Canadian sales of meat analogs more than tripled between 1997 and 2001.
The ready availability of new products, including fortified foods and convenience foods would be expected to have a marked impact on nutrient intake of vegetarians. Fortified foods such as soymilks, meat analogs, juices, and breakfast cereals can add substantially to vegetarians’ intakes of calcium, iron, zinc, vitamin B-12, vitamin D, and riboflavin. Vegetarian convenience foods including veggie burgers and veggie dogs, frozen entrees, meals in a cup, and soymilk can make it much simpler to be a vegetarian today than in the past.
Vegetarian foods are readily available, both in supermarkets and in natural foods stores. About half of vegetarian foods volume is sold through supermarkets and about half through natural foods stores. Three-fourths of soymilk sales take place in supermarkets.
Public policy statements and vegetarian diets
The United States Dietary Guidelines state, “Vegetarian diets can be consistent with the Dietary Guidelines for Americans, and meet Recommended Dietary Allowances for nutrients.” They give recommendations on meeting nutrient requirements for those who choose to avoid all or most animal products. Some have said that implementation of the Dietary Guidelines can best be achieved by use of vegetarian and plant-rich diets. National food guides include some vegetarian options. Foods commonly eaten by vegetarians such as legumes, tofu, soyburgers, and soymilk with added calcium are included in a table accompanying the USDA’s Food Guide Pyramid. Canada’s Food Guide to Healthy Eating can be used by lacto and lacto-ovo-vegetarians. Health Canada has stated that well-planned vegetarian diets are supportive of good nutritional status and health.
July 5th, 2005
From Cathy Wong, N.D.,
Your Guide to Alternative Medicine
Why do people follow this diet?
Some people with migraine may be sensitive to certain chemicals that occur naturally in foods. The chemicals that most commonly trigger migraines are tyramine and other amines, including phenylethylamine and histamine. Amines can trigger migraines because they are vasoactive substances that act directly on small blood vessels to expand their capacity.
Foods that contain tannins, compounds that occur naturally in plants, can also trigger migraines. Researchers are not certain what the exact relationship is, but many agree that the neurotransmitter serotonin is involved.
Do I stay on this diet permanently?
No. The migraine elimination diet is a testing diet. It is unrealistic to permanently eliminate these foods from the diet. After learning what the offending food groups are, additional testing can be done with different quantities to learn how much of each food will cause symptoms. This way, a person will know what their limits are and still be able to enjoy eating these foods.
What are the guidelines of the migraine elimination diet?
Foods that are known to trigger migraines are systematically eliminated to identify offending food groups. Each food group is avoided for six weeks, or long enough to see if it causes an improvement in migraine symptoms.
Step 1: Eliminate amine foods
Tyramine is a chemical called a monoamine that is found in higher concentrations in foods that have been fermented, such as aged cheddar, red wines, and blue cheese. American and cottage cheese can be substituted. Foods containing tyramine include:
*Aged Cheeses
*Yogurt, buttermilk, sour cream, dried milk
*Tofu, soy sauce, miso, tempeh
*Smoked, cured, or pickled fish or meat
*Beer, wine
*Lima beans, Italian beans, lentils, navy beans, pinto beans, fava beans, broad beans
*Snow peas
*Peanuts
*Eggplant
*Sauerkraut
*Oranges, citrus fruit
*Cola drinks
*Banana
*Grapes, Raisins
*Plums, Prunes, or Figs
*Pineapple
*Avocado
*Chocolate
In addition to tyramine, foods containing the chemical phenylethylamine should also be eliminated. These foods include:
*Cheesecake
*Yellow cheeses
*Chocolate
*Citrus fruit
*Alcohol/Red Wine
*Chocolate
*Cocoa
*Berry pie filling or canned berries
*Red wine
Foods that containe histamine or cause the release of histamine should be eliminated. These include:
*Banana
*Beef, pork (can eat lamb or chicken instead, these are safe foods for most people)
*Beer
*Cheese, especially yellow ripened
*Chicken liver
*Egg Plant
*Fish, shellfish
*Processed meat, such as salami
*Sauerkraut
*Soy, tempeh, tofu, miso, tamari
*Spinach
*Strawberry
*Tomato, tomato sauce, tomato paste
*Wine
*Yeast and foods containing yeast
*Pineapple
*Citrus fruit
*Chocolate
Step 2: Eliminate food additives
Some people react to the food additives such as artificial sweeteners, flavor enhances, and food coloring found in processed and packaged fast foods. These foods include:
*Monosodium glutamate (MSG) is sometimes added as a flavor enhancer in Chinese dishes. It is also found in commercial soups, soy sauce, salad dressings, frozen dinners, soup mix, croutons, stuffing, and some chips. It is also disguised in the label as sodium caseinate, hydrolyzed proteins, or autolyzed yeast.
*Aspartame and other artificial sweeteners can trigger migraines in some people.
*Food coloring, especially FD&C yellow dye #5 and red dye #40, are known to trigger migraines in some people. Check labels, as both are found in common foods such as beverages, ice cream, candy, and some cereals.
*Nitrites and nitrates are found in bacon, luncheon meats, smoked ham, and hot dogs.
Step 3: Eliminate foods that contain tannin
*Bruised fruits
*Red skinned apples and pears
*Berries, cherries
*Tea and coffee
*Alfalfa
*Barley
*Chocolate
*Nuts
*Apple Juice, Apple Cider
*Beer
*Grape Juice
*Wine
*Black and Red Beans
*Apricots, ripe bananas, unripe peaches
*Kiwi
*Persimmons, pomegranates, dates, currants, nectarines
*Eggplant
*Smoked meats
*Most herbs
Step 4: Eliminate or reduce caffeine
Although some people find that coffee helps migraines by constricting blood vessels, the blood vessels can swell beyond their original size causing an even worse rebound headache. If using a decaffeinated coffee substitute, be sure to use one that has been Swiss water processed — the chemicals that are used in the decaffeination process can trigger headaches.
In addition to coffee, tea and sodas containing caffeine should also be avoided.
Additional Testing
A person may have other food sensitivities that may be involved in migraine symptoms. A nutritionist or holistic practitioner can conduct complete testing and create a customized treatment plan.
July 4th, 2005
From Cathy Wong, N.D.,
Your Guide to Alternative Medicine.
The food combining diet is based on the theory that different food groups are digested optimally when eaten in the following combinations:
Proteins (beans, nuts, seeds, meat, fish, poultry) and starches (grains, pasta, breads, cereal, rice, carrots, etc.) should be eaten at separate meals. Proteins can be eaten with vegetables and starches can be combined with vegetables.
Fruits should be eaten alone.
Starches are absorbed best when the pH of the digestive tract is alkaline. This occurs when starches are eaten alone or with vegetables.
The digestion of proteins, however, requires stomach acid. When proteins and starches are combined, the digestive environment is neither acid or alkaline enough for either group to be absorbed well. Many proponents of the food combining diet believe that this can lead to digestive problems and weight gain.
However, the following points should be considered before trying this diet:
1. Most people can handle a variety of foods at the same time without causing health problems. Simply changing to a diet higher in fruits, cooked vegetables, and whole grains often has a greater impact on digestion.
2. This diet can be difficult and time-consuming to follow. Favorite pairings such as chicken with potatoes, tofu with rice, soy milk fruit shakes, beans and rice, and tuna sandwiches are not allowed.
3. Nutritional deficiencies can occur. Protein and starches cannot be eaten together, so people have to choose one or the other. As a result, people often consume more starch than protein, as starches tend to be more filling and satisfying. Special care should be taken to ensure adequate intake of protein, calcium, zinc, vitamin D, and vitamin B12.
4. Many health practitioners believe that combining protein and starch can be beneficial. When protein and fats are combined with starch, the absorption of starches is slowed. This helps to maintain stable blood sugar and insulin levels and prevent cravings. A full evaluation by a health practitioner is the best way to determine what the most suitable diet is for you.
July 4th, 2005
From Jennifer Moll,
Your Guide to Cholesterol.
A low cholesterol diet is not hard to follow, given the variety of foods available. Many food manufacturers also have low fat, low cholesterol foods available for people who do not have the time to fix elaborate meals. When you are shopping for such foods, be sure to look at the labels and keep the following in mind:
•Eat plenty of fruits and vegetables–they are low in calories and fat.
•Try to lower your intake of saturated fats–they are associated with heart disease.
•Partially hydrogenated vegetable oils, such as those used in many margarines and shortenings, contain a particular form of unsaturated fat known as trans-fatty. They
raise blood cholesterol levels (including LDL, the bad cholesterol), just like saturated fat.
•Grain products, such as cereals, pastas, and breads, are low in cholesterol.
•Use low fat or skim milk instead of regular milk as an alternative.
•Cook with lean meats (turkey, chicken) instead of red meat, which is associated with increasing cholesterol levels. For instance, using ground turkey meat instead of ground beef is a delicious alternative for hamburgers.
•Limit cheeses in your recipes.
•When cooking with oils, use olive and canola oils, which are particularly high in monounsaturated fats or vegetable oil, which is high in polyunsaturated fats.
Unsaturated fats help lower cholesterol levels.
July 4th, 2005
Mediterranean diet
The Mediterranean diet is associated with longer life expectancy among elderly Europeans.
The Mediterranean diet is characterised by a high intake of vegetables, legumes, fruits, and cereals; a moderate to high intake of fish; a low intake of saturated fats, but high intake of unsaturated fats, particularly olive oil; a low intake of dairy products and meat; and a modest intake of alcohol, mostly as wine.
Current evidence suggests that such a diet may be beneficial to health.
The study involved over 74,000 healthy men and women, aged 60 or more, living in nine European countries. Information on diet, lifestyle, medical history, smoking, physical activity levels, and other relevant factors was recorded. Adherence to a modified Mediterranean diet was measured using a recognised scoring scale.
A higher dietary score was associated with a lower overall death rate.
A two point increase corresponded to an 8% reduction in mortality, while a three or four point increase was associated with a reduction of total mortality by 11% or 14% respectively.
So, for example, a healthy man aged 60 who adheres well to the diet (dietary score of 6-9) can expect to live about one year longer than a man of the same age who does not adhere to the diet.
The association was strongest in Greece and Spain, probably because people in these countries follow a genuinely Mediterranean diet, say the authors.
Adherence to a Mediterranean type diet, which relies on plant foods and unsaturated fats, is associated with a significantly longer life expectancy, and may be particularly appropriate for elderly people, who represent a rapidly increasing group in Europe, they conclude.
Source: Mediterranean diet and survival: EPIC-elderly prospective cohort study
July 2nd, 2005
Could what you eat affect your risk for breast cancer?
We know that diet can have a big impact on health. Now there have been two recent studies suggesting that a high-fat diet - especially a diet high in animal fat - may increase a woman’s risk for breast cancer.
Researchers in Britain and the United States found in separate studies that women who ate more fat had a higher cancer risk than women who ate a lower-fat diet. The British study found that women who ate less than 40 grams of fat a day had half the risk for breast cancer than women who ate 90 grams of fat. The American study found that women who ate the most fat had a 33 percent higher cancer risk than the women who ate the least fat. Saturated fat, which is found in animal products like milk, cheese and meat, seemed to have the most effect on breast cancer risk.
Researchers at UT Southwestern Medical Center at Dallas say most previous research has shown that it’s a high-fat diet during childhood and early adolescence that has the greatest impact on adult breast cancer risks. Other research hasn’t found a strong link between adult fat intake and breast cancer risk.
At any rate, there are still numerous health benefits to eating a diet low in saturated fat. That’s a good way to lower your risk for heart disease and some other kinds of cancer.
July 2nd, 2005
Adding whole grains to your diet may help protect you from diabetes.
Type 2 diabetes has been on the rise in the United States in recent years. This condition occurs when insulin no longer effectively regulates blood sugar. Before people develop diabetes, however, they usually first develop symptoms that may lead to diabetes. These symptoms are grouped as the metabolic syndrome, and they include excess weight in the abdomen, high blood sugar, high blood pressure and low levels of good cholesterol. Preventing the metabolic syndrome from developing is a good way to prevent diabetes.
Researchers have found that people who eat about three servings of whole grains a day are less likely to develop insulin resistance or the metabolic syndrome. Unfortunately, most Americans barely get one serving of whole grains a day. Many patients at risk for insulin resistance and diabetes are encouraged to eat low-carbohydrate diets, but this study demonstrates that not all carbohydrates are alike. Carbohydrates that come in the form of whole grains may be beneficial.
Researchers at UT Southwestern Medical Center at Dallas have found that a high-fiber diet helps diabetics better manage their blood sugar levels. The American Diabetes Association recommends a diet incorporating fiber-rich foods, including fruits, vegetables and whole grains .
To add grains to your diet, switch from white bread to whole grain bread and from white rice to brown rice.
July 2nd, 2005
Cheeses
The CDC says listeriosis, a food-borne illness with mild flu-like symptoms that can be overlooked, can result in premature delivery, miscarriage, severe illness, or death of the baby. Heidi Murkoff, author of What to Expect When You’re Expecting, concurs with the U.S. Department of Agriculture, which cautions that you not eat unpasteurized soft cheeses (and other unpasteurized dairy products), hotdogs, or lunch meat unless cooked.
Cheeses made in the U.S. must be made from pasteurized milk (this process kills the listeria organism), so they are fairly safe. Imported soft cheeses are potentially problematic. These may include Brie, Camembert, feta, goat, Montrachet, Neufchatel, and queso fresco. Listeria may also be found in unpasteurized semi-soft cheeses (slightly more solid cheeses that do not grate easily and are often coated with wax to preserve moisture and extend shelf life). Semi-soft cheeses include Asiago, blue, brick, Gorgonzola, Havarti, Muenster, and Roquefort.
Cheddar, mozzarella, cream cheese, and cottage cheese are fine. “Stay away from those yummy roadside ciders, too,” Murkoff advises. “They’re not pasteurized.”
Diet soda
Minimal harmful effects have been shown from the use of the artificial sweetener aspartame in pregnancy, according to Siobhan M. Dolan, MD, assistant professor of obstetrics and gynecology at the Albert Einstein College of Medicine in the Bronx, N.Y. “Like everything else, moderation is best.” A daily diet pop or aspartame-sweetened yogurt is probably harmless.
Coffee
Most studies show no adverse effects from three or four cups of coffee. Still, some doctors and midwives are cautious and point to studies linking java to attention deficit hyperactivity disorder and migraines. There are some data that suggest that large amounts of caffeine lead to low-birth-weight babies.
However, if you choose to drink coffee, moderation is key. “Sometimes it’s harder on you to quit entirely,” Dolan admits. “Pregnancy is hard enough on you.”
July 1st, 2005
A high intake of monounsaturated and polyunsaturated fatty acids could lower the risk of developing Parkinson’s disease, according to researchers in the Netherlands.
Both types of unsaturated fatty acids are contained within neuronal cell membranes and are known to have neuroprotective, antioxidant, and anti-inflammatory properties.
The researchers involved in the new study, published in Neurology (2005;64:2040-2045), wanted to build on this knowledge by determining whether a high intake of unsaturated fatty acids might be associated with a lower risk of Parkinson’s disease.
Monounsaturated (MUFAs) fatty acids have been shown to help lower LDL (bad) cholesterol when substituted for saturated fat. Sources of MUFAs include olive, canola oils, avocados, peanuts, nuts and seeds.
One of the main forms of polyunsaturated fatty acids (PUFAs) is omega-3, commonly derived from fish, which have been shown to deliver considerable benefits for cardiovascular health and cognitive function. Omega-6 is also essential for human health, found in grains, most plant-based oils, poultry, and eggs.
However the modern diet is more heavily weighted towards omega-6 consumption than omega-3, an imbalance that has led to the growing popularity of the latter in fortified and functional foods and in supplement form.
The new study may give further weight to arguments in favor of the Mediterranean diet, which typically consists of foods rich in both MUFAs and PUFAs since it is based as it is on olive oil, nuts, fresh fish, fruits and vegetables. Three separate studies published this year have highlighted the heart health benefits of this diet, in lowering cholesterol levels, lowering the risk factors for heart disease and boosting longevity.
The new prospective population-based cohort study involved 5,289 people aged 55 or over, all of whom were free of dementia and Parkinson’s disease at baseline.
At the start of the trial the participants underwent complete dietary assessment, and the incidence of Parkinson’s disease was assessed through repeated in-person examination and continuous monitoring by computer linkage to medical records.
The mean duration of the study was six years, during which time 51 patients were diagnosed with Parkinson’s. Higher intakes of total fat, MUFAs, and PUFAs were “significantly associated” with a lower risk of developing the disease, but no associations were found for dietary saturated fat, cholesterol, or trans-fat.
“These findings suggest that high intake of unsaturated fatty acids might protect against Parkinson’s disease,” concluded the researchers.
Parkinson’s disease is a progressive neurological disorder that affects around 6.3 million people worldwide. One in ten cases are diagnosed before the age of 50.
The cause is not understood but it is thought to result from the combined effects of factors including aging, genetic predisposition, and environmental exposures. Symptoms include tremors, stiffness, slow movement and poor coordination and balance.
A study published in the Archives of Neurology (59, pp 1541-1550) in 2002 linking coenzyme-Q10 to a slowing of the progressive disability caused by Parkinson’s is thought to have been at least partly responsible for a surge in consumer demand for CoQ10, usually sourced from Japan, in the past three years. Prices are high, however, and supply is short, so the new research may present a viable alternative method of prevention.
July 1st, 2005
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