Tuesday, December 23, 2008

What's the Deal with Acai?

Question: I know Acai Juice is a new flavor trend, but I'm now seeing it marketed as a health food and for weight loss. So, I'm wondering.... is it just a trend or does it have real benefits?

Answer: Both. Yes, acai, often used in various juice blends, smoothies, sodas and other beverages, is definitely trendy. However, it has also been dubbed a "superfood" because of it's antioxidant and flavonoid properties. Antioxidants may help prevent diseases caused by oxidative stress such as heart disease and cancer. However, while it has been proven that acai contains antioxidant properties and has been named as a superfood (a food that confers a health benefit), it's important to note that LOTS of foods (such as concord grapes and grape juice, pomegranates, cranberries, raspberries, blueberries, blackberries and others) also contain antioxidants, so this does not make acai unique. Furthermore, according to an article published earlier this year (Feb. 2008 J Agric Food Chem), it was found that that acai juice may in fact have less antioxidants than concord grapes or pomegranates. Admittedly, it can be challenging making the comparison since acai comes in many different forms (juice mixes, freeze-dried powder, etc.) Furthermore, while it has been dubbed a "superfood," there isn't a legal definition of the word "superfood" so it may be abused as a marketing tool.

Bottom line: Acai DOES have health benefits, but so far it has not been shown that these health benefits are any different or greater than that of similar berries (blueberries, strawberries, raspberries, blackberries, cranberries).

Thursday, December 18, 2008

MSG

Question: What is MSG? Should I be avoiding it?

Answer: MSG, or monosodium glutamate, is a flavor enhancer that is commonly added to food items such as canned vegetables, soups, Chinese food and processed meats. It has been used for decades in the United States and is "generally recognized as safe" by the FDA. Some people may have short-term reactions to MSG such as a headache, sweating, chest pain, shortness of breath or nausea, but symptoms are typically mild and don't require treatment. Other reports that have suggested that MSG may be linked to Alzheimers or more serious ailments have never been shown scientifically despite much research in this area. My personal opinion is this: if MSG bothers you (resulting in some of the above symptoms), avoid it. If not, don't worry about it -- there are enough other things on the food label to worry about!

Tuesday, December 16, 2008

Tilapia: Getting a bad rap?

Question: I've heard that tilapia is also known as the "garbage" fish. Why is that? Is it at all healthy to eat?

Answer: In July of this year, a study was published in the Journal of the American Dietetic Association indicating that tilapia may actually harm your heart due to the low levels of omega-3 fatty acids and high levels of unhealthy omega-6 fatty acids.

First of all, it's important to note that this study was isolated to farmed tilapia and it does matter how the fish were farmed. In order to keep fish prices down, farmed fish may be fed inexpensive food which affects the quality of their meat. Also, it's important to know that omega-6 fatty acid is an essential fatty acid. We need it in our diet because our body doesn't produce it. However, research does suggest that consuming too much of it may lead to heart disease among other health problems such as cancer or asthma. However, to be fair, tilapia is considered a "whitefish" and this category as a whole is a very low fat fish. In fact, tilapia only contains (on average) 36 calories and 1 gram of fat/ounce with only 16mg of cholesterol, 16mg of sodium and a whopping 7 grams of fiber! But according to Monterey Bay Aquarium's Seafood Watch and the Environmental Defense Fund, they rate China, the world's leading producer of farmed tilapia as the worse quality of tilapia and they recommend avoiding eating any tilapia from Asia. However, most of the tilapia served in the United States is from the United States or Central/South America which are better sources.

Bottom line: If you have heart disease, limit the amount of tilapia as well as other high omega-6 fatty acid foods in your diet. If you do not have any heart-related problems, I think tilapia can be part of a healthy, low-fat diet as long as it comes from North, Central or South America!

Sunday, December 14, 2008

Nuts for Nuts!

Question: I know nuts are high in fat, but they help me feel full longer. Are nuts a healthy snack? Are some nuts better for you than others? I heard macadamias weren't good for you.

Answer: Yes, you are right in that nuts are high in fat, so watching your portion size is important, but nuts can be, and arguably should be, an important part of a healthy diet. The FDA states that "Scientific evidence suggests.... that eating 1.5 ounces per day of most nuts, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease." Furthermore, nuts have been found to help aid in weight control. The International Journal of Obesity published an article in October 2001 with research supporting that three times as many people trying to lose weight were able to stick to diet that included nuts versus the traditionally recommended low-fat diet. The Journal of the American Medical Association published an article in Nov. 2002 supporting nuts as a means of reducing your risk of developing Type 2 diabetes.

As a general rule, nuts are a fabulous source of protein, zinc, phosphorus, fiber, manganese and magnesium and are cholesterol and sodium-free (unless salt is added, of course).

So, to answer the first part of your question, yes, nuts absolutely can be used as a healthy snack choice. As for the second part of your question, really all nuts do add health benefit. All nuts have approximately the same calories per ounce (between 160-200), but macadamias do have more fat per ounce (22) than nearly any other nut and less protein (2 grams) than most other nuts, which average ~15 grams of fat/ounce and 4-6 grams of protein per ounce. As for the FDA claim, I previously mentioned, they restrict this claim to almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachio nuts and walnuts because do not exceed 4 grams of saturated fat per 50 grams of nuts. So, snack away, my friend, but keep it to an ounce or so!

Tuesday, December 9, 2008

Truth about Truvia

Question: I heard there is a new zero calorie sweetener on the market called Truvia. What do you think of Truvia and can you use it when baking?

Answer: Truvia comes from the Stevia plant. More specifically, Truvia is the brand name for the product currently being marketed which comes from Rebiana, arguably the best tasting part of the Stevia leaf. Truvia contains two other ingredients as well - erythritol, a natural sweetener found in certain fruits, and natural flavors, being the other ingredient.

Can you use it in cooking and baking? Technically, yes you can, although it's important to remember that sugar serves as a browning agent and adds structure to foods in addition to contributing to sweetness. Truvia, as the company suggests, is best used when making such items as pudding, pie filling, hot cocoa mix, etc. As for cookies and cakes, I would stick with Splenda. One other important thing to note is the conversion: 1 Tablespoon of sugar is equal to 1 1/4 teaspoons of Truvia (which is the same as 1 1/2 packets).

So, go ahead and make a pie for Christmas dinner with Truvia, then write back to My Personal Dietitian and let us know how it turned out!

Monday, December 8, 2008

Vitamin D Supplementation

Question: I recently bought a Vitamin D supplement when my friend told me that it wasn't worth taking unless it was Vitamin D3. Is that true and what is the difference?


Answer: There are two forms of vitamin D that are important to humans --ergocalciferol (D2) and cholecalciferol (D3). D3 is the type that is synthesized by humans in the skin when exposed to ultraviolet rays from the sun. However, when foods are supplemented with vitamin D, it may be in the form of D2 or D3. When purchasing a vitamin D supplement, it is largely assumed that it is in the form of D2 and or D3, so it is not necessary, in my opinion, to specifically look for a D3 supplement.

Also keep in mind that Vitamin D is found in many food sources such as (fortified) milk, eggs and fish. As little as 10 minutes of sun exposure a day is thought to be enough to prevent deficiencies (leading to rickets and/or osteomalacia).

As for supplementation, I recommend getting a Calcium supplement (women over the age of 50 need 1200 mg Calcium/day and many do not get this consistently from their diet) that contains vitamin D as vitamin D is necessary for calcium absorption. This way, you are likely to get enough Calcium and vitamin D and can do it all in one pill!

Thursday, December 4, 2008

Confusion over Cholesterol

Question:

I always hear about Good Cholesterol vs. Bad Cholesterol. What is the difference between the two and how do I lower my cholesterol without medication?

Answer:

Cholesterol, a fat-like, waxy substance found in the blood is necessary for the body to function, but excess cholesterol can build up inside your arteries and cause them to narrow. When blood does not flow properly to the heart or brain, a stroke or heart attack may result.

LDL, otherwise known as "bad cholesterol" can increase your risk of a heart attack or stroke if it is too high because it may lead to the formation of plaque in the arteries that feed the heart and brain.

HDL, or "healthy cholesterol" carries cholesterol away from the arteries and may remove excess cholesterol from plaque.

If you have high cholesterol and want to avoid medication, there are lifestyle changes that can be implemented to assist you. However, due to genetics or other factors, medication may be necessary even in those individuals who follow all of the following guidelines:

  • Maintain a healthy weight
  • Exercise for at least 30 minutes most days of the week
  • Limit your saturated fat and trans fat intake
  • Limit your cholesterol intake to <200mg/day>
  • As your main fat source, use mono- and polyunsaturated fats (olive oil, canola oil, nuts, etc)
  • Add soluble fiber into your diet
  • Include Omega 3 fatty acids, found in salmon, tuna, walnuts, spinach, and other foods

Know your numbers! Always get a copy of your lab work for your own personal records.

Thursday, November 20, 2008

Weight Loss with alli

Our next question comes from San Francisco. MM wants to know if she is looking to lose a few pounds and is wondering if alli is the right choice for her.

First of all, alli has a wonderful website (www.myalli.com) and I would encourage anyone considering the product to check out their website. They even have a quiz you can take to see if you are a good candidate for the product.

How does it work? alli, the only FDA approved over-the-counter (OTC) weight loss product currently on the market, works by preventing the body from absorbing some (approximately 25%) of the fat that you eat. Because of this, an individual can lose about 50% more weight than dieting without the use of the product. alli promotes gradual, modest weight loss of about 1-2 pounds per week.

Is it right for you? alli asks you the following questions so that you can see for yourself:

Are you willing to do the hard work to lose weight gradually?
Are you committed to following a reduced-calorie, low-fat diet (an average of 15grams of fat/meal)?
Do you understand that if you take alli with a meal containing too much fat that you may get bowel changes that may include gas with oily spotting, loose stools and more frequent stools that may be hard to control?
Are you committed to eating smaller portions?
Are you committed to making time to be more physically active?

There is also a wt/ht chart and the product is not recommended unless you weight at least the amount shown in the chart. For a 5'3" person, the product is not recommended unless you are at least 152 pounds.

Full of Fiber

Okay, for this next question, we're going to get a little "graphic." When you think about fiber, you often think about your bowels all in the same thought. Our next question comes from Huntington Beach and it is this:

I notice my bowel movements are smooth and soft and "normal" when I eat fiber from natural sources, but different when I eat foods that are supplemented with fiber or have fiber added to them. Why is that and is it better to eat the natural fiber foods?

Answer: First of all, let's define fiber. It is the part of plant foods that your body can't digest. Fiber is found in fruits, vegetables, whole grains, beans, nuts and seeds. High fiber foods are typically low in calories and fat and loaded with vitamins and minerals. As far as the fiber itself is concerned, it is virtually the same whether it is in a supplement form or in the food itself, so I'm not sure why it is affecting your bowel movements differently. However, hydration status and activity level also play a huge role in "normal" bowel movements, so if either of these altered at all, it may be due to that instead of the fiber.

Side note:
What is the difference between Soluble and Insoluble Fiber? Soluble fibers absorb many times their own weight in water. Soluble fibers, therefore, tend to give you an increased sense of satiety. Insoluble fiber passes through the intestine almost unchanged. Both kinds help to make your bowel movements softer and easier to pass. However, when increasing the fiber in your diet, do it SLOWLY until you reach the recommended goal of 21-25 grams/day for women and 30-38 grams/day for men.

Lets hear it for the beans! Beans are a FABULOUS way of adding fiber to your diet! They are a great source of protein, low in fat and contain no saturated fat or cholesterol. In addition, research has shown that diets including beans may reduce the risk of certain cancers as well as heart disease, currently the number one killer of Americans. The 2005 Dietary Guidelines for Americans developed by the USDA recommends that Americans eat 3 cups of beans/week. The current average is only one cup per week.

Monday, November 17, 2008

Hoodia -- Is it Safe?

My latest inquiry is from M.E. out in Southern California. Her question is in regards to appetite stimulants... are they effective? Are they safe? Specifically, are there any side effects or reasons not to use Hoodia, which she has used in the past and worked well for her. I should put here that M.E. only wants to lose 5-6 pounds; she is not obese. She already exercises regularly and eats an overall healthy diet; she is just struggling to lose that last little bit of weight.

First of all, what is Hoodia? Hoodia is a genus that contains many species, one of which is Hoodia gordonii, which is the species currently being investigated for use as an appetite suppressant. It grows naturally in South Africa and Namibia, but the supply is scarce due to the plant being difficult to grow and due to the fact that it takes 4-5 years to mature. As a result, there are many counterfeit products out there claiming to contain 100% pure hoodia, when in fact they do not. Some experts claim that as many as 80% of the Hoodia products on the market are counterfeit. This brings us to our next question.....

How do I know if I am getting a pure product? One way is to look under the "Other Ingredients" on the label. It should say "None" in this spot. Secondly, you can go to Alkemists Pharmaceuticals at http://www.alkemist.com/ to check for yourself. They do testing on many products, including many hoodia products. Desert Burn, Hoodoba and Hoodia Hoodia are three products that have been consistently verified.

Does it work? This is debatable. The only way to truly know is to try it for yourself and see. There is currently no published scientific evidence that supports that Hoodia gordonii works as an appetite suppressant. That may mean that it doesn't work or it may just mean that research hasn't yet proven it. Research has not disproven it either.

What makes it act as an appetite suppressant? If in fact Hoodia gordonii is an appetite suppressant, it is due to the active ingredient known as P57.

Are there any side effects or reasons not to use the product? There are not any known side effects to using the product. However, it is not recommended that diabetics, pregnant or nursing women, children or people with liver or kidney disease use the product. The warning for diabetics is due to the fact that there is a theory that the product may work due to the P57 tricking the brain into thinking it has enough blood sugar, when in fact it does not. This may cause diabetics to become hypoglycemic. The warning for the other groups of individuals is a general precaution due to lack of research showing the products safety. One final note on the safety is to make sure you drink enough liquids while taking Hoodia gordonii. If it suppresses your appetite, it may also suppress your thirst and dehydration could result.

So, to answer your question, M.E. from Southern California.... since you do not fit into any of the categories of people stated above and you have found Hoodia gordonii to work in the past, then there is no reason not to try it again! Just make sure you are using a pure product and check back to let us know the results!

Wednesday, November 12, 2008

Welcome to My Personal Dietitian!

As a Registered Dietitian for over 9 years, I have had the opportunity to work in many different places, with many different people and in various areas of expertise. Currently, I work at an outpatient facility affiliated with a large community hospital. While I spend most of my time working with diabetics and people who are getting and/or have had bariatric surgery, we see anybody and everybody who has been referred by their physician to see a dietitian. However, there are many people out there who, for whatever reason, don't get referred to a dietitian, don't live near an outpatient facility offering dietitian consults or have transportation issues. Many people who would benefit from seeing a RD can't or don't see one. For this reason, I am setting up this blog to come to you! Feel free to ask me any and all nutrition-related questions. We will discuss various topics from heart-healthy recipes, to the latest weight-loss trends to how to treat, from the nutrition stand-point, various dieseases or health-related conditions.