Author: kellidunagan

What is the food of the future? In a recent seminar at the 2016 Food and Nutrition Conference and Expo in Boston, this food was identified as pulses. No. Not like the cardiovascular pulses that assure us that our hearts are still pumping. Instead these pulses enhance how well our hearts work and include dried beans, dried peas, chickpeas, and lentils. Dr. John Sievenpiper presented a Canadian study that showed pulses having a significant effect not only on cardiovascular events, but also on diabetes outcomes.

In his research, Sievenpiper has found that incorporating 120 g of pulses a day into the diet has a positive effect on glycemia, lipid levels, blood pressure and body weight. How does this happen? His collaborative studies over the past decade have shown that pulses reduce starch absorption and reduce postprandial glycemia,. By including five servings of pulses a week and following a low glycemic diet (and watching blood sugar levels), hemoglobin A1c can be significantly (p<0.05) improved. Pulse servings eaten consistently through the week were also shown to significantly reduce more weight than isocaloric diets and reduce coronary heart disease risks.

In a case study example, Dr. Sievenpiper brought up a 74-year-old overweight patient with dyslipidemia and metabolic syndrome. He prescribed a Portfolio Diet to replace the high red meat and refined carbohydrate, low fiber, fruit and vegetable diet he had been consuming. The Portfolio Diet includes a variety of cholesterol-reducing food such as, 20 g of fiber from vegetables, whole grains, and pulses and 45 grams of plant proteins including soy products and pulses. After following this patient for less than two years, his triglyceride levels had decreased by 47% and his LDL levels had improved by 78%! While this may not be the standard for every patient, it is quite a show of success.

This information could be life-saving for some patients in desperate need to improve their health. Type 2 diabetes, hypertension, and obesity go hand in hand, and with a few changes to the diet all three could be improved. Clinical practice guidelines are beginning to shift from nutrient-based recommendations, such as low carb or high protein, to more food and dietary pattern-based recommendations. Increasing pulse servings in the diet fits right in with this strategy and can be much more easily understood to the standard layperson. Additionally, the inclusion of pulses can be incorporated into widely recognized and evidence-based diets like the Mediterranean Diet or the DASH diet very simply. More randomized control trials are needed in this area, but the data looks incredibly promising.

Kim SJ, de Souza RJ, Choo VL, Ha V, Cozma AI, Chiavaroli L, Mirrahimi A, Blanco Mejia S, Di Buono M, Bernstein AM, et al. Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition 2016;103(5):1213-23. doi: 10.3945/ajcn.115.124677.

Ha V, Sievenpiper JL, de Souza RJ, Jayalath VH, Mirrahimi A, Agarwal A, Chiavaroli L, Blanco Mejia S, Sacks FM, Di Buono M, et al. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. Canadian Medical Association Journal 2014. doi: 10.1503/cmaj.131727.

Farmer’s Markets are a breeding group for food borne illnesses. Think of how many people touch those peaches or how long that hand milled cream has been sitting in the sun! You should never, ever, frequent these places!

Or so someone would think if they glanced at Dr. Marc. F Bellemare’s initial research and New York Times article published on this research. In a recent presentation at the University of Georgia, Dr. Bellemare went through his results in depth to explain what he actually found.

Over the past 20 years, farmers markets in the United States have been on the rise, with a five-fold increase. The food sold at these markets typically isn’t regulated like the food bought in grocery stores and convenience markets and fresh produce has been a growing cause of food-borne illnesses like Campylobacter.

Dr. Bellemare and his research team set out to research the relationship between farmer’s market and food borne illness rates across the nation. They began by looking at a survey study by Lusk et. al, in which 45% of participants reported that they did not know if the food at farmer’s market was safer or not than grocery store products, 27% thought it was more dangerous, and 27% thought it was safer. In other words, no one really knows. From there, the team set out to give everyone a definite answer.

Using CDC and USDA data on food borne illness cases and outbreaks and the density of farmer’s markets in each state, Bellemare collected the data needed to find a correlation. The research team did control for spillover in other states and regions and utilized state-specific, year-specific, and region-specific linear trends to make sure nothing out of the usual had occurred to skew data. They also recognized that food borne illness rates are typically under-reported to the CDC, as not everyone who gets sick got to a doctor for treatment.

Norovirus

So after evaluating data for year, what did the Bellemare team find? A positive linear relationship exists between the number of outbreaks and individual cases of food borne illnesses, especially Norovirus, and the number of farmer’s market in any given state. They confirmed this as a causation by using weather data and noting that lower average temperatures usually meant lower numbers of markets and in turn outbreaks. But this isn’t inherently the fault of the farmer’s and suppliers of the markets, instead it is most likely due to what happens after the transaction has taken place. Food borne illnesses are typically the result of errors in food preparation, such as cooking at incorrect temperatures or leaving food exposed for too long.

This information can be used to inform consumers on how to properly handle food. Practitioners can make sure that their patrons are not only selecting the best foods from these local suppliers, but also serving them in the safest way possible. Eat local, but be mindful of temperatures!

Did you know that drinking water is the real key to losing weight? Well, not exactly. CNN says they have dug up some “serious evidence” that says drinking water or eating water-loaded fruits and vegetables when your stomach starts growling could help with weight management. The evidence, though, comes from a cross-sectional study in which the authors state “these data… cannot be used to infer causation.”

Chang and colleagues recognized that the relationship between weight status and hydration status is still relatively unknown. So, using data pulled from 2 recent National health and Nutrition Examination Surveys (NHANES), the researchers set out to see if there was an association between obesity and urine osmolality as a cursor of hydration status. No research had been conducted on this area of interest prior to this study, as urine osmolality was only added to the national survey in 2009. Additionally, the researchers only categorized study participants into two categories of weight: Body Mass Index (BMI) > 30 kg/m² or BMI < 30 kg/m² .  So after combining the results from the 2009-2010 and 2011-2012 NHANES surveys, what did they find?

The University of Michigan researchers found that hydration status could be quantified as adequate over 800 mOsm/ kg or inadequate below 800 mOsm/ kg. The overall average urine osmolality was 631.4 mOsm/ kg, well below the adequate hydration marker. Hydration status was associated with age, race, sex, poverty level, and BMI in this study. They reported that adults who were inadequately hydrated had a mean BMI of 1.32 30 kg/m² more than hydrated individuals. Additionally they stated that the odds of being obese were 1.59 times higher for inadequately hydrated individuals compared with hydrated individuals. Interestingly, about 68% of those who were classified as adequately hydrated were obese. The exact percentage of the 9,528 participants who fell about the BMI of 30 kg/m² is never reported.

As this is not a causation study, the researchers inferred reasons for the lower hydration status of obese individuals but made only suggestions and educated guesses. Even in CNN citations, Chang states that it could just be because “a bigger person needs more water than a smaller person to stay hydrated.” This would make sense, as urine osmolality is measured in mOSM/ kg. In the study discussion, higher sodium intakes from “unhealthy” foods and increased metabolism of individuals with higher BMIs were cited as a possible causes for decreased hydration. Overall, the reasoning has not been researched, though Chang encouraged new studies in this area. Clinicians can also take this into consideration for counseling weight loss clients, although water intake as a weight loss tool is not an evidence based recommendation. As for individuals trying to lose weight, eating more fruits and vegetables with higher in general is a great idea and replacing soda and other sugar-sweetened beverages can definitely help with weight loss. Unfortunately, for now, there is no single key to weight loss as it involves changing a multitude of daily behaviors and habits.

What if I were to tell you that some American children are eating salmon and bison in their cafeterias? Some trays are filled with poi or blue corn. No, these aren’t the private schools of the extremely wealthy. These are schools that have a primarily Native American population. Jenny Montague from the USDA Food and Nutrition Services and Jo Dawson, State Director of the Alaska Child Nutrition Program had insight into the menus of school districts across the country that have recently introduced the use of “traditional foods.”

First and foremost, what are “traditional foods”? Foods that traditionally have been prepared and consumed by an Indian tribe fall into this category. This consists of venison, amaranth, barley, bison, various types of seafood, and even seal and whale oils. Montague set out to discuss and test the acceptability of traditional foods in schools in Montana, Alaska, Hawaii, and North Carolina. She feels that it is crucial to incorporate traditional foods into the menus of certain school districts in order to “learn about [cultures] through food.” Some techniques that she reported schools practicing were using traditional ingredients and recipes, growing traditional foods and using traditional languages, and substituting meal components with traditional equivalents. In Cherokee County School District in North Carolina, students were taste testing traditional foods, such as trout cake, growing traditional foods in their school garden, and using traditional names on their menus. For example, the August word of the month was shvng-ta, or apple. They found that the acceptability of these foods and of learning about this culture was improved through these practices.

Alaska’s push for “traditionalizing” the school menu was by far the most interesting to me. Alaskan schools are able to accept donated foods that fit the ‘traditional” parameter. In one district, a “Sockeye Salmon Donation Day” resulted in the procurement of 12,000 pounds of salmon that were then flash-frozen to be served once a week in the schools and has since become a community tradition. The largest discovery of these programs were an analysis of the barriers to introducing the “traditional foods” elsewhere. Researchers found that their largest barrier was supply, which stemmed from a lack of knowledge of the donation allowances. In other words, people just didn’t know that they could donate meat and other foods to the schools. Once that issue is remedied, supply is expected to increase.

Traditional native foods are now being celebrated and found culturally significant by overarching organizations. Those who work for county and state schools systems may want to take another look at their menus before bidding to see if cultural foods could be added. The incorporation of these traditional foods into the menus of schools could spur more interest in these cultures and how to properly preserve their customs and way of life. This could potentially reduce cost and increase the efficiency of  the food service system. By using locally grown and harvested foods, we are supplying our children with wholesome and educational habits to use in their futures.