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My diet is super healthy. Why isn’t my Nutrition GPA higher?

I received the following email from a frustrated user of the Nutrition GPA app.  I’m posting it here, along with my response, in case other app users might find it useful as well.

“I have been somewhat frustrated with the scores I’ve been getting on the Nutrition GPA app.  I know I definitely do not eat enough fresh fruits and vegetables some days. But I think my diet is very good otherwise–just not in ways the app measures!

“For instance, I don’t eat any meat, I eat no dairy on an average day, I rarely eat eggs, I obsess over sodium, I rarely eat baked goods–and when I do, they’re homemade, low sugar, low sodium, dairy-free, etc., and the only white flour I eat is in baguettes, Portuguese rolls, or occasional pasta. Nevertheless, I’m getting Cs and  even a D!”

How does the Nutrition GPA assess your diet?

The questions in the Nutrition GPA quiz represent the foods most strongly associated with overall diet quality, risk factors, and health outcomes.  If your grade is not as high as you think it should be, perhaps aspects of your diet that you think are “not so bad” or “occasional” are having more of an impact than you realize.
Conversely, aspects of your diet that you think of as  “very good” may not have as much impact (or be as consistent) as you think.
Let’s take a closer look at some of the details you mentioned:
  • If you don’t eat any meat, then you are always getting points on Q9.  So that’s certainly not responsible for your low grade!
  • Avoiding diary and eggs is not associated with improved diet quality or reduced health risks.  So they don’t impact your grade one way or the other.
  • If you have high blood pressure and are sensitive to the effects of sodium, then that might be an important thing for you to watch. But for the majority of the population, avoiding sodium does not improve their health or their risks. So it’s not monitored in the Nutrition GPA.
  • Baked goods that contain white flour will impact your grade–even when they are homemade, low sugar, low sodium, and dairy-free! If you’re only eating them occasionally, it shouldn’t affect your GPA too much.  But research shows that replacing white flour with whole grain flour (or avoiding it altogether) improves health and nutrition.  And that’s why you get a higher grade on days when you don’t eat things made with white flour.

There are also a few things that you DIDN’T mention. But if you are frequently having more than one alcoholic drink, more than 25 grams of added sugar, eating fried foods and/or you rarely eat fish, legumes, and nuts, this will drag down your Nutrition GPA.

All of which is to say that the whole point of the Nutrition GPA is to shine a light on those areas of our diet that could stand improving. And sometimes it reveals things that we may have over or under-estimated.  In which case, it’s working exactly as designed–and presents a great opportunity to improve your nutrition!

 

Are wild blueberries pesticide free?

Q. I buy wild blueberries because I assume they are not treated with pesticides. Am I correct about this?

A. Not necessarily. It’s possible that growers may cultivate “wild” blueberries for the commercial market and they may apply pesticides to reduce weeds or insects. (Here, for example, is some information from the Maine Extension for farmers who want to improve the yield of their wild blueberry crops.

For that matter, wild blueberries growing next to a farm could potentially be exposed to pesticides used on other crops.

Wild blueberries that are certified organic should be free of all but organic-approved pesticides. But either way, I don’t think that pesticides on blueberries poses a concern for your health.
According to the pesticide residue calculator at Safe Fruits and Veggies, you could consume over 13,000 servings of blueberries in a day without being exposed to a harmful amount of pesticide reside, even if the blueberries had the highest level of pesticides residue ever measured by the USDA.

How sleep affects weight gain with Dr. Jade Wu

Many people have more difficulty sleeping when they reach midlife, which is also when they start to see their weight creeping up. In this episode of the Nutrition Diva podcast, sleep medicine specialist Dr. Jade Wu talks about the relationship between sleep, appetite, weight gain, and midlife changes.

Highlights from our conversation

Monica Reinagel: I’ve written a lot about the connection between sleep and hunger, appetite, and weight management. But I’m looking at this problem as a nutritionist. How do you see the relationship between sleep, appetite, and weight management as a sleep expert?Jade Wu:  When we are sleep deprived, the body compensates for lack of energy by craving more calories and tends to reach out for more saturated fats, carbs, and sweets. We also have less leptin and more ghrelin levels in our blood after a night of not enough sleep, which is how these hormones behave when we’re very hungry.

What’s less talked about is the role that our circadian clocks play in all of this. We all have biological clocks that follow a roughly 24-hour rhythm, and these clocks love to run on time. Having a disrupted circadian rhythm (jet lag, shift work) can slow down our metabolism, make us crave more high-fat foods, and generally increase the stress on our bodies.

Psychologically, this stress from a disrupted body clock (together with the stress of insufficient sleep) makes us less motivated to stick to healthful behaviors… it makes us more cranky so we’re more likely to eat as a way of regulating our emotions… it makes us less energetic and less likely to be active.

So there are both biological and psychological ways that insufficient sleep and a disrupted circadian rhythm can affect weight loss and nutrition.

MR: Most of us the basics of good sleep hygiene (avoiding screens, caffeine, alcohol, keeping a consistent schedule, cool, dark rooms, etc.). But a lot of people still struggle to sleep through the night, despite taking all of those steps. You’ve suggested that sleep hygiene may not be all that. So what is the solution?

JW: Sleep hygiene is a good place to start. It’s like dental hygiene… good as a general baseline, but not enough if you already have a cavity.

If you do have a sleep disorder, like insomnia or sleep apnea, it’s important to get those addressed using evidence-based treatments. Like you mentioned, sleep hygiene is the placebo condition in our clinical trials… not enough to cure insomnia. What is recommended by the American Academy of Sleep Medicine as a first-line treatment is cognitive behavioral therapy for insomnia (CBT-I).

MR: A lot of people develop sleep issues for the first time as they get into midlife–which is also when many of them start to see their weight creeping up. First, Is there something physiological that occurs in midlife that affects sleep rhythms? Or have we just had longer to develop bad habits? Or more to worry about?

JW: There are physical and psychological changes. In terms of physical changes:

  • We need less sleep as we age
  • Our sleep tends to be more often punctuated by wakefulness, and we tend to have less deep sleep
  • Hormonal changes like menopause can certainly disrupt sleep… but this should not permanently make you a bad sleeper
  • More aches and pains, less physically and socially active

As for psychological changes, our expectations need to move along with the physical changes.

  • We may get more anxious about sleep and health
  • We may become increasingly psychologically dependent on sleep aids
  • We’ve had longer to learn unhelpful things… like our brains learning that the bed is an awake place

MR: In your opinion, then, how much of an impact does midlife sleep difficulty have on midlife weight gain?

JW: This is hard to tease out because there are so many things that are changing mid-life… perhaps our activity levels, our social lives, our stress levels, our eating habits. I see this time as an opportunity to tune up health in all domains, such as learning to cook more nutritious meals now that the kids have left the house and you have more time. Or doing more self-care, taking up meditation… all good things for sleep and overall health. There’s no reason why sleep has to be bad in midlife or after.  It will change, but if you listen to your body and change with it, you can still have great sleep health.

Recommended Sleep Resources

Behavioralsleep.org

Penn CBT-I Provider Directory

American Academy of Sleep Medicine

www.jadewuphd.com

This article originally published at QuickandDirtyTips.com

How to make Socca

Socca is a flatbread made from chickpea flour and is one of our favorite weekday suppers.  Grain and gluten free and rich in protein and fiber. You can top it however you like or just eat it plain.  Here’s a quick video tutorial.  (Instructions below.)

 

Instructions

Combine 1 cup chickpea flour, 1 cup water, 2 cloves crushed garlic, 1 tablespoon olive oil, and 1 teaspoon each salt and fresh ground pepper.  Whisk until blended and let sit for 1 hour.

Meanwhile, slice 1-2 onions, toss with olive oil and and place in a cast iron or ovenproof skillet. Roast in a 400 degree oven for 15 minutes.

Pour the batter over the onions, turn up the oven to 500 degrees and return the pan to the oven. Bake for around 15 minutes, or until it’s starting to brown at the edges.

Slide the socca onto a cutting board and gently flip it over. At that point, you can cut into pieces and serve as an appetizer or with soup or salad. Or, slide it back onto the pan, top with veggies and cheese and run it under the broiler to melt the cheese.

Lose More Fat and Less Muscle with Slow Weight Loss

A new paper in the British Journal of Nutrition asks whether the pace at which you lose weight affects how much of that lost weight is fat (as opposed to muscle) and the impact on your metabolism after weight loss. To answer this question, the authors pooled the results of seven studies that compared rapid to gradual weight loss, where both groups lost about the same amount of weight but at different speeds.

This is a question that I am very interested in, so I was excited to find a breakdown of this new study in a recent issue of the Nutrition Examination Research Digest, a terrific publication affectionately known to subscribers as NERD.

This article also available as a podcast. Click to listen.

Advantages of slower weight loss

For years, I’ve been advocating slow weight loss as a better way to achieve sustainable weight loss, which is the only kind that really counts and the hardest to achieve.

Make smaller but more permanent changes to your habits and behavior. The weight comes off more slowly, but you aren’t just losing weight; you’re learning how to be someone who weighs less.

Part of my rationale for this approach is psychological and behavioral. To lose weight quickly, diets usually involve a dramatic but temporary change in your behavior. Once you’ve lost the weight, however, you tend to revert to old habits and behaviors that lead you to regain the weight you’ve lost.

Instead, I’d rather see you make smaller but more permanent changes to your habits and behavior. The weight comes off more slowly, but you aren’t just losing weight; you’re learning how to be someone who weighs less.

But another big part of my rationale is physiological. Many popular diets are designed to produce weight loss at a rate of 5-10% of your body weight per month. But that’s significantly faster than most people can shed body fat. If you’re losing weight faster than you can lose fat, that means you’re losing lean muscle, and that’s not what you want to be losing.

RELATED: How Fast Can You Lose Fat?

I’m convinced that slower weight loss (2% or less of your body weight per month) results in losing more body fat (and less muscle). It’s also less likely to cause a slowdown in your metabolism, which is going to make it easier to maintain the weight loss. And I’m always on the lookout for research to either support or refute this belief.

To date, there have only been a handful of studies on the advantages of slower weight loss, some of them pretty small. The latest attempts to get a better grasp on the subject by pooling the results of several studies and doing a meta-analysis of the results.

What research says about slower weight loss

Joining me to talk about the results is Gregory Lopez. He’s editor in chief of the Nutrition Examination Research Digest and Examine.com. He obtained his master’s degree in molecular biophysics from Johns Hopkins University, and his doctor of pharmacy degree from the University of Maryland, Baltimore. Greg and his team took a closer at this study in a recent issue of the Nutrition Examination Research Digest

Greg, first give us the topline: How did slow weight loss compare with fast weight loss in this meta-analysis?

Overall, their conclusion is that slow weight loss is better for body composition than fast weight loss. There are a couple of caveats based on their selection criteria. They looked at studies that had similar total amounts of weight that were lost. And so these results would not apply to people who lose more weight on one program versus another. Also, the studies were relatively short term—all less than a year.

They also looked at the resting metabolic rate. We know that when we restrict calories, eventually the body may adjust its metabolic rate downward in order to conserve energy. And that’s, of course, the bane of dieters everywhere. If we’re restricting calories more dramatically in order to lose weight more quickly,  is that having an even more deleterious effect on resting metabolic rate? What did they see in terms of resting metabolism?

The metabolic rate didn’t sink as much on a slow diet as opposed to a fast diet. Essentially, slower dieting came out on top.

Whenever we have studies comparing fast versus slow weight loss, my question is always: How fast is fast and how slow is slow? And when you and I went through the individual seven studies that they looked at, we found a really big range. The slow paces ranged from less than half a pound a week, which is pretty slow, to over two pounds a week. The fast paces ranged anywhere from one to four pounds a week.

There were a couple of studies where the slow pace was actually faster than the fast pace of one of the other studies! How does that impact what we can take away from these results?

It does muddle things. You really can’t answer the question of how much going slower or faster changes things given the analysis they did here and the data that’s available. It would have been really interesting to see an individual-level meta-analysis.

A meta-analysis takes a bunch of studies and lumps them together, and it takes the average results of these studies. So you’re taking an average of an average. If you can get the data for each individual person in the studies, you can pull them all into one single big study. And since you’d know how much exactly each person lost, rather than how much they lost on average within a study, you can do a dose-response analysis. So, if you’re interested in figuring out how slow is slow enough and how fast is too fast, that kind of analysis could be useful.

So, what we know from this particular meta-analysis is that  it looks like whether you’re losing weight faster or slower does make a difference in terms of how much fat you lose. What we can’t answer from this study is: What is the sweet spot? What is the perfect pace where most of the weight you’re losing is fat and the least is lean muscle. That is still an open question. 

I would agree with that. And I would also say that it provides a direction for future research.

I also want to talk a little bit more about the Nutrition Examination Research Digest. Tell us a little bit about what you do at Examine.com.

We try to distill the research around nutrition and supplementation—what the evidence says works and what doesn’t work. And we pride ourselves on being independent. Our goal is to kind of help people who are nutrition enthusiasts, or even professionals, get some of the latest evidence that they need.

I think you guys do such a great job—not only at going through the research but putting it into context, explaining some of the trickier concepts and pointing out potential weaknesses. I also think it’s extraordinary that you do not sell any products and don’t accept advertising. This work is completely supported by your subscription fees. That puts it pretty much in a class by itself. So, thank you for what you do, Greg, and for joining me today to add your insights. 

Digging into the Data

After my conversation with Greg, I did delve into the details of a couple of the larger studies included in the meta-analysis, where the slow pace of weight loss matched what I would recommend, to see how those folks fared.

Although both groups lost the same amount of weight, the slow group lost 10% more body fat than the faster group and 50% less lean muscle.

One of them involved 200 subjects, both men and women. Over the course of the study, the subjects lost 15% of their starting body weight on average. The slower group lost at a pace of about 1.5% of their total body weight per month. The faster group lost at a more typical rate of 4.5% of their total body weight per month. Although both groups lost the same amount of weight, the slow group lost 10% more body fat than the faster group and 50% less lean muscle.

The other study I looked at involved 68 subjects, all men. This was a shorter study and so the total amount of weight lost was less: about 6% of their starting body weight. But the pacing was virtually identical. The slower group lost 1.5% of their total body weight per month and the faster group 4.5% per month. But the difference in body composition was a lot more dramatic. The slower group lost 50% more fat and 75% less lean muscle than the faster group.

In short, slowing down the pace of weight loss does appear to offer some real advantages. For more on my approach to creating sustainable weight loss, please check out the resources at Weighless.Life.

Originally published at Quickanddirtytips.com

Are Superfoods For Real?

Kale, goji berries, salmon, quinoa, broccoli sprouts...all have been heralded as superfoods. But what makes these foods so special? Guest contributor Dena Gershkovich weighs in.

The term superfood likely first appeared as part of a food marketing strategy, according to an article by the Harvard School of Public Health’s Nutrition Source. Around the time of World War I, there was a major import of bananas, and the United Fruit Company wanted to encourage people to eat the fruit. This marketing led to a buzz around the term superfood.

The superfood buzz was further perpetuated after physicians used the term in medical journals, when discussing how a banana diet can be used to treat conditions such as celiac disease (this was before a gluten-free diet was found to be the best way to treat celiac disease). Soon, tons of moms were preparing banana-based foods for their kids, even if they did not have celiac, due to all of the hype. (As an aside – I really can’t imagine only eating bananas! Those poor kids!).

Just so we’re clear here, the term superfood was not coined by a nutrition professional or food scientist. It was popularized by smart marketing strategy.

WHAT ARE SUPERFOODS?

Continue Reading

Protein Content of Common Foods

This table shows the amount of protein per serving of several common foods.

Note that the standard serving size for meat is 3 ounces, which is considerably smaller than the portions you may be used to seeing.   A 3-ounce serving of meat is about the size of a deck of cards.

Click here to see a table of protein density (how much protein various foods provide per calorie).

FoodServing SizeProtein (g)
Chicken breast3 ounces25
Pork tenderloin3 ounces22
Hamburger, lean (broiled)3 ounces22
Ground turkey (broiled)3 ounces22
Salmon3 ounces19
Shrimp3 ounces19
TunaSmall can17
Cottage cheese, lowfat1/2 cup14
Plain yogurt1 cup12
Greek yogurt1/2 cup11
Tofu, firm1/2 cup10
Lentils, cooked1/2 cup9
Peanut butter2 tablespoons8
Black beans1/2 cup8
Chickpeas1/2 cup8
Spaghetti, cooked1 cup8
Edamame (soybeans)1 cup8
Oat bran, uncooked1/3 cup7
Egg1 large6
Hummus1/2 cup6
Egg white1 large4
Quinoa, cooked1/2 cup4
Brown rice, cooked1/2 cup3
Whole wheat bread1 slice3

See also:
Quick Guide to Complementary Protein Sources

New Ways to Use Whey Protein Powder

 

How to make homemade corn tortillas

Photo by Amber Engle

Making your own corn tortillas is fun and easy. With just three basic ingredients, a tortilla press, and a hot skillet, you’ll be on your way to having gluten-free, delicious, soft corn tortillas in less than an hour. You can use them for enchiladas, tostadas, tacos, nachos, and more.

How to make tortillas

Here comes the fun part. Although it is easy to do, you will need to be patient if this is your first time making homemade tortillas. There are times where the dough will feel dry or soggy. All you have to do is add more water or add more masa. As you make more homemade corn tortillas, you will quickly learn and enjoy the tortilla-making process.

Ingredients

2 cups of Masa Harina (not regular cornmeal or corn flour)

½ teaspoon of salt

1 ½ to 2 cups of warm water

Important: Masa harina is different from regular corn flour or cornmeal. In order to create masa harina, the corn goes through a process called nixtamalization, which involves soaking it in an alkaline solution (usually lime). This changes the structure of the grain which enables it to form a dough. It also adds calcium and makes the nutrients in the grain easier to absorb. Continue reading “How to make homemade corn tortillas” >