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!

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!

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!

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!

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.