CNN recently claimed gym go-er’s can exercise off the negative health risks associated with alcohol—but it has left scientists rolling their eyes at the weight rack. The article took its presumptuous turn when the conclusion from an observational study was “exercising the recommended amount “cancels out” the higher risk of cancer death brought about by drinking”. By the sheer nature of an observational study, it is scientifically impossible to make a statement of this magnitude. Though physical activity attenuates the risk of cancer, a closer analysis of the study design raises some points of concern that could be influencing the results.

It is extremely important to analyze how participants were characterized for analysis; the following table demonstrates researchers organization scheme. Physical activity was collected from self-report data which was validated against accelerometers (the “gold standard”). However, it was only validated in the English cohort, not the Scottish cohort. Considering the conclusions were based on survey data, readers need to be mindful of how inaccurate self-reporting can be. The different categories of alcohol consumption were also collected from self-report data, which may not be wholly accurate, especially at the two extremes of rare or excessive alcohol intake. An important limitation of the article is the lack of analysis regarding the patterns of alcohol consumption. Researchers noted a health difference between binge drinking and other drinking patterns—this was not mentioned on CNN.

A statement omitted in the CNN piece is very important for critical analysis of the results, “our results confirmed that the inclusion of former drinkers in the reference group…has the potential to overestimate the protective effects of drinking at the recommended level.” Taking a closer look at this reference group reveals the potential limitations. “Never drinkers” reported the lowest amount of PA and were older than the “hazardous” drinkers. The chronic disease and CVD rates were higher in this group as compared to “hazardous” drinkers, as well. Though researchers controlled for these variables, the statistical limitations of the more severe characteristics of this reference group is notable. reported 1.6 hr/wk of PA, they were, on average, 60 years old with a BMI of 26.7. Many (57.3%) reported a long standing illness and 12.1% reported a diagnosis of CVD. On the other hand, “hazardous” drinkers interestingly had the highest levels of PA of any group (6.3 hours per week). They were much younger (53), with a similar BMI (26.5). Their rates of chronic illness and CVD were also lower (46% and 6.9%, respectively). These variables were controlled for in the statistical analysis, however, the baseline participants from which others were compared had a very different health profile.

Finally, these data were collected at baseline and may not be representative of long-term behaviors of the participants. Furthermore, researchers did not analyze dietary habits at all, which largely contribute to the environmental risk associated with cancer. The limitations discussed here are fairly common in this type of research; observational data is plagued by limitations due to study design. However, when research scientists analyze the data, they understand this. Identifying such concrete conclusions from observational data is reckless on the part of CNN, and likely the article was approved because of the traffic it would bring to the site.

Ultimately, for the average consumer, the message media sources need to be sending is that exercise is healthy, no matter which health outcome you statistically manipulate to tell your story. Articles such as this try to tease out the mechanisms of the benefits, when really, the focus should be articles that teach people how to implement the behaviors. Taking alcohol as the example, an article teaching ways to choose exercise over alcohol drinking a couple nights a week would be great! That type of article would be directed at the root cause a population is not exercising (lack of time) and creating a solution for their barrier–inspiring more change than this “click bait” article ever could.

Coffee is the choice elixir of night owls, professionals, new moms and the sleep deprived alike. For some, it’s the sound of the bubbling water, for others it’s the aromatic, earthy smell that creeps through their morning-lit kitchens. Many will agree, though, that the appeal is the jolt of energy that quickly follows their morning cup of joe—thank you, caffeine.

Caffeine, found in coffee, energy drinks, soda and even chocolate, stimulates neurotransmission in the central nervous system (the noggin) to prevent the onset of drowsiness. This increase in communication between areas in the brain results in the caffeine “buzz” associated with coffee. However, an additional effect of caffeine is a narrowing of the blood vessels in the brain, causing a reduction in blood flow. This decrease in blood flow is an undesirable effect because adequate blood flow is associated with better brain function. Researchers hypothesize that coupling the stimulatory effects of caffeine with a strategy to increase blood flow will result in greater cognitive function. Dr. O’Connor at the University of Georgia aimed to test the effects of the brain stimulatory effect of caffeine coupled with the vessel dilating effects of polyphenols in apple juice¹.

The experiment included placebo drinks, a caffeine control and apple juice “caffeine cocktails” with varying levels of caffeine. Researchers investigated their effects on motivation, sustained attention and reaction time. In the lab, participant’s tasks were quite tedious number identification exercises, but in a real life scenario, these measurements can translate to:

• Desire/motivation to buckle down and get to work
• How long focus can be maintained and accuracy of the work completed
• How quickly work is performed

His experiments revealed that apple juice with about 40 mg of caffeine (the amount in about ½ cup of green tea²) yielded comparable or better results than the apple juice with 75 mg caffeine (the amount in about ½ cup of coffee). The apple juice with ~40 mg caffeine increased motivation, sustained attention and resulted in a faster reaction time compared to the other beverages and the placebo.

Should you guzzle the coffee for the caffeine, or “spiked” apple juice for the additional polyphenolic effects? More research is needed to say with certainty but this new evidence is quite exciting. Practitioners can add this “cognitive” piece of the caffeine puzzle to the extensive research on coffee and caffeinated beverages. Most importantly, and not covered in Dr. O’Connor’s talk, is the safety of caffeine. According to the Dietary Guidelines for Americans, up to 400 mg of caffeine can be incorporated into healthy eating patterns(3) This may be the sweet spot for those desiring the cognitive benefits of coffee while still balancing a healthy lifestyle. Dr. O’Connor made one point clear, that “caffeine effects how you feel as much as it affects how you perform”. Coffee drinkers, unite, and celebrate over your favorite (cold) brew.

1. O’Connor P. Effects of Low Doses of Caffeine Added to Apple Juice and Cocoa on Mental Energy. Department of Foods and Nutrition Seminar. Athens, GA. August 31, 2016.
2. Cabrera C, Reyes A, and Giménez R. Beneficial effects of green tea—a review. Journal of the American College of Nutrition. 2006;25:2:79-99.
3. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8^th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.

Locally grown foods can be found easily at most grocery stores and even some restaurants, but have you ever thought about schools serving local foods? Now, the idea of buying locally is emerging into schools as well. In this webinar on Farm to School menu planning, Chef Kent Getzin of Wenatchee’s Farm to School Movement in Washington discussed the success of his program and encouraged other schools to give it a try. He found that local food and ingredients could impact children’s health and introduce them to delicious, healthy meals, and also benefit the local farmers. Surprisingly, local farmers are also eager to get their food into schools to introduce their products and provide fresh and healthy lunches to the children in their community. By establishing relationships with the farmers and accessing supports, he was able to have a successful program.

Many schools are anxious to try this kind of program, but it is not as difficult as one may think. A concern to this type of program is with untrained staff and not being able to manage the preparation of unprocessed local foods. However, by taking small steps in the right direction, programs can be successful anywhere. It is important for a school to do what best works for them. For example, starting with one recipe at a time rather than an entire menu. Setting small goals allows the process to be less overwhelming and still lead to changes in the schools.

Many positive outcomes can result from introducing new foods to children. A fun event that was done with the Wenatchee program was providing taste testings in the cafeteria for the students. Local farmers would come in to highlight new foods and see how the children react to them. It is like a farmer’s market for the kids and shows them that the food on their plate comes from a farm right down the road from their school. Chef Kent Getzin emphasized how much positive feedback is received on these farm-to-school programs, and how easy it can be for other schools to implement local foods into their menus. I believe schools all over the United States could benefit from farm-to-school programs, especially states in the Southeast with high rates of childhood obesity. If children are able to eat more about healthy foods and learn about what is grown in their community, this could potentially lead to them adapting healthy eating habits that will continue throughout their lives. In addition to physical health, healthy lunches can also influence classroom learning and learning abilities. By eating healthy, local foods, children are more energized throughout the day and can perform better in the classroom. With benefits such as these, more schools should consider looking into farm-to-school programs for their school lunch programs.  There are many resources available for schools and communities to provide guidance in implementing these programs.  The USDA Food and Nutrition services have many resources on their website including information on establishing a vision and goals, buying local foods, and menu planning strategies.  Some of the menu planning resources even include food buying guides, worksheets, and a food buying guide calculator for building shopping lists and determining how much of an item to purchase. These resources are great toolkits for getting one of these programs started as well as making it successful.

In August 2015, The New York Times published an article titled “Eating Spicy Food Linked to a Longer Life.” According to the article, in a study that was published in The BMJ titled “Consumption of spicy foods and total and cause specific mortality: population based cohort study,” researchers concluded that having chili peppers either once a week or once or twice a week reduced mortality risk by 10 percent and consuming spicy food six to seven times a week reduced mortality risk by 14 percent (Bakalar, 2015). Does this mean that spicy food lovers have a much higher chance to live longer than spicy food haters? Not necessarily the case.

Taking a more in-depth look at the study, there seems to be more to the story. When looking at the absolute mortality rates, the difference between the group that ate the spicy foods less than once a week (6.1) and the group that ate spicy foods six or seven days (5.8) a week is quite small compared to the groups that ate spicy foods once or twice a week (4.4) and three to five times a week (4.3) (Jun et al., 2015).  The article merely mentions that the mortality rates for cancer, ischemic heart disease, and respiratory diseases were lower among the group that ate spicy foods six to seven days a week.  Looking at the actual range in which the risk for mortality can lie shows that this is not as black and white. The group who ate spicy food six or seven days a week actually had a zero to 15 percent chance of having a reduced mortality risk due to cancer but did have a 11 to 36 percent  chance of having a reduced mortality risk due to ischemic heart disease and a 19 to 50 percent chance of having a reduced mortality risk of respiratory disease (Jun et al., 2015). These ranges have a 95% confidence interval which means that there is a 95% chance that the actual mortality risk falls within these values.

The article says that the researchers did not draw any conclusions about cause and effect and said there needs to be more evidence.  So while the title says one thing, in the end, the authors do not want us to jump to conclusions. In the actual study, they even mentioned that eating spicy foods might be correlated to other dietary and lifestyle behaviors (Jun, et al., 2015) Those who ate more amounts of spicy foods lived in rural areas and ate more fruit and vegetables. While there needs to be more research regarding the relationship between spicy food consumption and mortality risk, it certainly doesn’t hurt to add a little bit of spice to your life. Practitioners can find this information to be useful when working with patients who are suffering from the diseases mentioned in the study. In making suggestions for changing one diet, practitioners could mention the possible benefit of chili peppers in terms of reducing mortality risk. Patients can have difficulty knowing where to start with making major dietary changes and this information could  be helpful to them.

SOURCES
Bakalar, N. (2015). Eating Spicy Food Linked to a Longer Life. New York Times. Retrieved from

Jun, L., Qi, L., Yu, C., Yang, L., Guo, Y., Chen, Y., Bian, Z.,…Li, L.(2015). Consumption of spicy foods and total and cause specific mortality: population based cohort study. BMJ 351, 1-10.

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.

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