Tuned in to nutrition with Radio Nutrition

The Walk Talk Nutrition RD team visits the salad dressing aisle. After our visit to the cereal aisle, we felt it was only right that we reviewed another popular food product with multiple variations on choice.  Our first question, was where did bottled salad dressing come from?  And where did all the creamy varieties come from?  Kathy found a History of Salad Dressings, which informs us that Babylonians and Egyptians used oil and vinegar thousands of years ago.  Did they put it on lettuce?  Years later, European monarchs were known to be fond of salad, although they used ingredients like eggs, potatoes and sardines.  Commercially prepared dressings made their appearance at the beginning of the 20th century.  And the rest is history. Now we have dozens of choices, although most are variations on a theme: * oil and vinegar or other vinaigrette styles * Ranch variations * other creamy/cheese flavors Two key nutritional concerns: * calories, which depend on the ingredients  and portion size * sodium, which is not related to cost, style or brand Kathy is a bottled dressing user, and is in favor of label reading to identify lower sodium options, with up to 230 mg sodium per 2 TB serving.  She also advocates for measuring or weighing how much dressing you use a couple of times to get a handle on portion sizes.  Donna is in favor is just using olive oil, vinegar, salt and pepper to toss salads.  After taping this episode, Kathy reports she is now a convert to the from-scratch olive oil and vinegar option. All this talk of salad dressings brings up an even more basic question: why is there salad?  We’ll talk about that another time.

When it comes to food and nutrition, there always seems to be something new to learn.  ‘World Salt Awareness Week’ just made my list of things I never knew about.  Given all the hysteria about salt and health, including admonitions to eat as little salt as possible, you might think Salt Awareness Week was another excuse to spread scary stories about salt.  But, no!  According to The Salt Institute, we’re supposed to celebrate salt this week.  Well, in fact there are plenty of other organizations using this opportunity to nag us about salt. Salt is sodium chloride: NaCl.  It’s a very simple molecule, but so important to life.  Sodium is a critical part of the fluid balance system in cells and blood, and a key component of numerous metabolic functions.  Plus salt makes food taste good.  As described in the very interesting book “Salt: A World History“, salt production and trade guided many important events in human history, from the location of settlements to trade routes and the growth of major trading centers.  Salt was critical for food preservation, and so was a valuable commodity. But in recent decades salt has become a four letter word, so to speak.  Early research on links between diet and hypertension found that risk for high blood pressure increased with increasing salt intake.  A low salt diet became standard treatment for hypertension.  Health organizations like the American Heart Association weren’t satisfied with the original restrictions and kept paring them down to the current measly 1500 mg/day.  Push back was inevitable.  Recently other experts on hypertension and diet found that populations with more generous salt intakes were not at increased risk for high blood pressure.  In fact, people with very low salt intakes were also at increased risk for problems.  Intakes of 2600 – 4900 mg sodium/day were associated with the lowest heart disease risk. Who to believe? There are a lot of potential problems with all of the research.  Simply asking people what they eat is never going to give an accurate picture of intake of anything.  People forget, they misunderstand portions sizes, they tell the researchers a good story to make themselves sound like socially acceptable health-conscious people.  All kinds of problem are inherent in that kind of research.  Another problem is failure to account for other aspects of diet: potassium intake, calories, total food intake.  Another confounding factor that’s extremely relevant to blood pressure: weight.  Obesity is linked to hypertension regardless of salt intake.  An obese person eating only 2000 mg of sodium a day might skew the results of heart disease risk due to the obesity, not due to the sodium.  But if the researchers are measuring sodium only, then they blame that.  Result: lower and lower sodium recommendations. Another problem with this type of research is the type of diet being eaten.  Higher salt intakes usually result from diets high in processed food.  Which means diets that have few whole foods, or fruits, vegetables and whole grains.  If the researchers are just looking at salt, they blame the salt, when in fact it’s the whole diet that’s the problem. Sodium limits and salt intake are not interchangeable.  1 teaspoon of salt weighs 6 grams, but the sodium portion of that is about 2300 mg, in line with some of the current limitations.  Research suggesting higher limits would put your daily intake between 1 and 2 tsp of salt.  That doesn’t sound like much, and if most of your salt intake comes from your own salt shaker,

I don’t envy parents of teens today.  Raising teenagers can be difficult enough without adding all the issues unique to our times.  There’s one problem that’s not new: eating disorders.  They’ve been around for a very long time.  Long ago, anorexia was associated with religious fervor.  Now we associate it with fashion magazines.  While the classic image is of an anorexic middle class teenaged girl who wants to look like a fashion model, kids (and adults) from all backgrounds can develop this type of problem for a wide variety of reasons.  Risk factors include genetics, psychological predisposition, peer pressure and family environment. The impact of family was the focus of a recently published research article with the imposing title: Intergenerational Transmission of Parent Encouragement to Diet From Adolescence Into Adulthood Here’s what it means: when parents “encourage” (nag, badger, criticize) their kids to diet, that pressure can push the child into destructive food behaviors like binge eating, bulimia and anorexia.  Worse, when those eating-disordered kids grow up, they are likely to pass that attitude and behavior on to their children.  the study followed over 550 adolescents for many years.  Result: kids who were pushed into dieting by a parent were more likely to be obese or engage in destructive dieting behaviors like bingeing or anorexia, and to then encourage their own children to diet.  It’s a vicious circle of inherited eating disorders. Parents might thing: “Oh I don’t do that.  I don’t pressure my child to diet.”  Well maybe not in so many words, but there are plenty of subtle indirect ways to encourage dieting.  One of the least appreciated is the parent’s own obsession about his or her own weight, out loud and frequently.  Young children watch Mom weighing herself and sighing or exclaiming over the number on the scale.  They hear Mom or Dad say things like “I need to lose 15 lbs” or “I’m on a diet, I can’t eat that (delicious dessert)”.  Or “Do I look fat?”  You may not be directing that fat talk at your child, but your child hears it loud and clear.  Conclusion: this is what is important. Criticizing other people about their weight is another way to transmit those negative messages.  But of course the most negative messages would come from direct criticism of your child.  Comments about clothing size or lack of fitness or how much is eaten at a meal or what food is chosen at a restaurant are all examples of indirect encouragement.  Direct statements like “You need to go on a diet” or “You can’t eat that, you’re on a diet” or “You’re too fat” are equally bad. Some kids in diet-focused families never develop problems.  They may remain obese, which isn’t a great outcome either.  Kids with a predisposition to an eating disorder are easily pushed into that behavior by this kind of parental pressure.  Initially if they lose weight, they get additional encouragement from the parents: “good for you,” “you look so much better”, “how much do you weigh now?”  Parents frequently stop paying attention once the excess weight goes away. One potential warning sign that the diet is going wrong, which I discuss in my book “Feed Your Vegetarian Teen,” is a progression to restrictive eating.  It all starts innocently enough.  The teen becomes vegetarian, which sounds so healthy and admirable.

Well that’s 1:41 I can’t get back. PETA produced a Super Bowl ad to promote veganism, except the ad didn’t run during the Super Bowl.  Perhaps PETA couldn’t afford the ad time.  Or perhaps someone realized it would be counter productive.  The basic story line is some guy who allegedly created marketing campaigns for meat goes to confession at a church and asks the priest for forgiveness for his meat-promoting activities.  Because apparently meat is sinful.  Sustainability and humane livestock management are fake.  The priest decides Mr. Meat Marketer is beyond redemption and slams the little confessional window shut.  It’s all done in dark gloomy colors and dolorous tones.  A guaranteed method for converting carnivores to start eating highly processed soy burgers. Not. Sanctimonious badgering about food choices is a turn off.  You especially aren’t going to persuade any dedicated meat eaters to make the drastic switch to a vegan diet with this kind of ad.  So what’s the purpose?  Self-congratulation on a national stage?  Sanctimonious badgering about religious or political beliefs is similarly unsuccessful.  Why did anyone think this was a good idea? Meanwhile meat was the focus of a recent puff piece by food writer Mark Bittman in GQ, in which he outlines how to be a “smarter happier meat eater.”  Quite the opposite of PETA’s message.  The article was full of PR for those purveyors of ethical meat products condemned by PETA.  I won’t bore anyone with those details.  The Big Picture message was one I can agree with: if you eat meat, buy quality meat.  That means raised and slaughtered according to ethical and sustainable practices.  And yes PETA, that is possible. It’s also expensive.  But in a way that’s a good thing if it means you eat meat less often and probably in smaller portions.  If you’re eating less meat, you are by default eating more plant-sourced foods.  It’s sort of a back door way of adopting a more Mediterranean style diet.  Here’s an example: for some people, a 1 lb rib eye steak is just right for 1 person, maybe two.  Yes it is a ridiculously large serving size, but it’s not unusual.  What if you split that steak among 4 people?  Everyone gets a small portion and the rest of the meal is made up of plant foods such as potatoes, salad, a legume dish, a cooked grain or sautéed vegetables.  Here’s another option: let’s say that 1 lb steak is for 2 people, because you like to really indulge when you eat steak.  But you only serve meat like that once a month, or once every 6 months.  It’s enjoyable but only rarely, no pun intended.  So that’s another way to have your meat and eat it too, so to speak.  Less often.  The rest of your meals are more plant-centric.   It’s a more positive way to address the meat eating dilemma.  Instead of sneering at meat eaters, present a solution so people can enjoy quality meat in a more sensible way. In retrospect, PETA was wise not to run that kind of ad during the Super Bowl, which after all is watched by people who are mostly dedicated meat eaters.  Vegans make up 1% or less of the population.  They are typically quite committed to their dietary cause, and don’t need additional validation from an ad, especially one that makes them look gloomy, judgmental and smug.  You aren’t going to win any friends that way.  Maybe if they try again next year, they can figure out a more positive and humorous message.

Walk Talk Nutrition RD team visits the cereal aisle. We’re horrified. Kathy and Donna visited the cereal aisle where we estimate 98% of the products are junk. Our main points: * Breakfast cereal should provide a decent amount of protein.  Kathy thinks at least 10 grams/serving.  Most of the junk cereals have only about 1 or 2 grams. * Most have excessive amounts of added sugars, 1 tablespoon per serving in many products.  And we don’t care if it’s free of high fructose corn syrup, or it’s organic.  It’s still SUGAR. * Adding cow’s milk or soy milk at least adds some protein.  Using a plant “milk” like almond or coconut does nothing to improve protein content.  A sugary cereal with one of those milks is not a great breakfast for a kid heading out to school. * Cereals are made from grains and should provide a significant amount of fiber.  Most do not. * Many are enriched with vitamins/minerals.  That’s nice but doesn’t justify high sugar or low protein content.

According to the book “Clean Meat“, our food future is all about lab grown meat.  What are the implications for that?  And what will vegetarians and vegans do about non-animal meat?

Exporting the American norm of excess food Anyone who has traveled the world knows that U.S.-based franchise restaurants know no borders.  You can find McDonald’s in India and Starbucks in Paris.  Kentucky Fried Chicken is extremely popular in Japan.  In fact, it’s the  official Christmas food of Japan, despite the fact that almost no one celebrates Christmas there.  Not to be outdone, Cheesecake Factory is expanding, and recently opened the first restaurant in Hong Kong.  It was an eye-opener for Hong Kong locals. Let’s think about this.  Cheese.  China.  No connection whatsoever.  There is no dairy industry in China.  Milk and cheese are not traditional parts of their diet.  Ever see Cheese Lo Mein on a menu?  Moo Shu Pork in cheese sauce?  I think not.  So here we have a restaurant dedicated to cheese, particularly the iconic cheesecake desserts, opening in a place that doesn’t do cheese.  The Wall Street Journal (subscription required) article referenced above is alternately hilarious and cringe-worthy.  Chinese customers flocked to the new restaurant for the experience, standing in line for 2-hours to get in.  Some said they’d heard about American food excess, but had never actually seen it in action.  Portions in China are normally small, and of course every course isn’t loaded with cheese.  The article notes the common reaction: How are we supposed to eat all this food? That thought probably never occurs to Cheesecake Factory patrons in the U.S.  The ginormous portions are what we take for normal.  Which is why obesity is rampant.  Not because we fail to stick to Paleo Diets or vegan diets or fail to avoid gluten or to obsess about the glycemic index.  We just eat too much of everything.  Period.  And sadly, while other chains adapt and adjust menus to accommodate local tastes, Cheesecake Factory is belligerently adamantly refusing to change a thing in China.  Not menu options.  Not portion sizes.  A spokeswoman is quoted as saying “The Cheesecake Factory has always been about choices.”  Yes, you can choose too much, or too much, or too much.  And have some cheese with that.  To their credit, the customers in Hong Kong are taken aback by the portion sizes, not to mention the cheese on everything. Meanwhile I still can’t find any nutrition information whatsoever on the Cheesecake Factory website.  What am I missing?  Every other chain restaurant on the planet at least has nutrition information somewhere on the website.  What are they hiding??  If you search on “Cheesecake Factory Nutrition” you get hits on random websites like Self or SparkPeople that claim to have information, but if the corporation doesn’t provide it on the website, then where are these websites getting it?  I wrote about cheesecake calories over 4 years ago, and actually went to a Cheesecake Factory, bought a piece of cheesecake, took it home, weighed it and did the math, based on standard values for cheesecake.  By my estimates a piece of plain vanilla cheesecake was 650 calories.  It only goes up from there.  Apparently there’s a cheesecake that’s layered with chocolate cake, brownies and coconut pecan frosting. It’s as if the Hong Kong Cheesecake Factory is selling a nightmarish Disneyland-like experience of the worst aspect of American food culture — excess.  I was happy to read that plenty of the Chinese patro...

Has anyone noticed that chips take up a whole aisle in the grocery store?  We have. Chips are increasingly being marketed as health food.  You can buy “veggie” chips in addition to corn and potato, although technically potatoes and corn are also vegetables.  You can find chips made with sea salt, or baked in olive oil (still high fat) or non-GMO or gluten-free (aren’t they all??) or organic or natural or sustainable.  All health halo buzzwords designed to obscure the fact that you’re buying chips after all. Why we like chips: * salt * fat * crunch Why we think chips are a problem: * salt * fat * calories Nothing wrong with crunch. Kathy also raises concerns about acrylamide, a chemical described as a neurotoxin and probable carcinogen.  It’s found in certain starchy foods , such as potatoes, that have been cooked with high heat.  Acrylamide is formed when the amino acid asparagine reacts with certain sugars.  Potato chips and french fries are some of our most concentrated sources.  Research done on rodents using very large doses of acrylamide — up to 10,000 times as much as a human would consume — have shown cancer-causing potential.  However, studies on actual people who eat potato products do not show clear evidence of risk.  The FDA has evaluated some foods for acrylamide content, listed as parts per billion.  That’s not very helpful when the suggested limit is in micrograms — 140 mcg per day, or 0.2 mcg per kilogram body weight.  According to food intake data, an average adult in the US consumes about 35 mcg per day, with chips and french fries representing the largest portion.  So if you don’t eat those foods everyday, your intake will be lower. And there are plenty of other reasons not to eat high calorie chips every single day.  Empty calories and sodium are two good reasons.  Health halo ingredients like sea salt or olive oil or coconut oil or alternative vegetable ingredients do not justify daily doses of chips. Our bottom line: occasional chips aren’t a problem.  If chips are a staple food in your diet, you need to rethink that.

Despite all the hype about local foods, for better or worse, we’re now dependent on a global food supply chain.  We have fresh vegetables and herbs all winter.  Olive oil, chocolate, cheese and coffee come from far-flung countries across the oceans.  Barring the occasional outbreak of an infectious disease from contaminated produce, the food import system usually works fine.  We have a vast variety of foods to choose from in the average grocery store, year round.  It’s easy to get complacent about this abundance; why poke around behind the scenes looking for problems.  But someone did just that recently, and found that a very popular food is being processed by slave labor.  Not just slave labor, but labor that financially benefits North Korea. The Associated Press sent investigators to China recently to look into reports of North Korean slave labor used to process salmon and other fish products that are exported to markets in the US and other developed countries.  They found North Korean laborers living in highly controlled conditions, working in fish processing factories.  It’s estimated that 50,000-100,00 North Koreans are sent to work in other countries.  Most of their “pay” is sent back to NK and used to fund government programs, such as nuclear weapons. Salmon and other fish products sent to the US from these processing centers have gone to Walmart and the parent company of Trader Joe’s.  When presented with the evidence, seafood distributors took steps to investigate their supply chains.  In the US, it’s illegal for anyone to import any products, including food, made by North Koreans anywhere in the world.  But of course, it’s not always possible to know who is processing your salmon.  Until the AP uncovered this situation, Walmart and others were selling salmon to Americans, funding North Korea. I’ve written about slave labor in the fish industry before.  South East Asia is notorious for using slave labor in shrimp processing.  I’ve stopped eating any shrimp unless it’s specifically labeled as coming from the US Gulf Coast or some other known local source.  Grocery chains and distributors try to verify that shrimp is not from slave labor sources, but how do you really know unless you travel to the source and follow your packages of shrimp all the way to your plate?  Now do I have to stop eating salmon that isn’t wild caught from Alaska?  Possibly not.  There are reputable salmon sources.  Salmon fish farming can be a reliable source; I’ve had very nice farmed salmon from Scotland, for example.  But many people object to the whole idea of fish farming, for environmental reasons. This issue is complicated by the fact that salmon has a huge health halo.  We’re all told to eat fish twice a week, and people are aware that salmon is especially healthy because it’s high in omega-3 fats.  If you’re a price-conscious twice-a-week salmon eater, it’s possible you’ve unknowingly helped fund NK’s nuclear weapons program.  Talk about environmental impact of a food! What to do? If you don’t eat much fish or don’t particularly like salmon anyway, you might not need to do much. The NK slave laborers are also used to process other fish products, such as crab and squid, so it’s possible that any imported fish, particularly from Asia, is a potential risk.  Given that it’s a federal crime to import products made by North Koreans,

The Walk Talk Nutrition RD team is back, and we’re discussing some of the more common changes we’ve noticed on food labels lately.  We compared current labels to those from a few years back for the same products to see what kind of changes were made and how those changes impacted the nutrient profile of the food. When food companies change ingredients, they don’t have to announce it on the food label.  Food manufacturers change recipes all the time.  They may do this for cost savings, to remove ingredients that are no longer useful, or to improve the nutrition profile of the food.  Cutting back on added sugars, sodium and fat are usually seen as more healthful changes.  But the companies are not obligated to make any type of announcement about ingredient changes.  They just have to change the ingredients list, note any potential allergens and adjust the Nutrition Facts information as necessary. In recent years, soup companies have been quietly reducing the salt content in soups, but not announcing it, because consumers widely believe that soup with less sodium doesn’t taste as good.  An industry rule of thumb says that reducing salt by 10% is fairly easy to accomplish, but beyond that people start to notice a taste difference.   For example, Kathy found an old label for Sargento cheese sticks and compared it to the current label.  The ingredients have changed, and the current version has more protein, slightly more calories and less sodium. We were both surprised by changes to the signature Kashi Go Lean cereal.  The serving size increased, and ingredients changed considerably.  Soy grits used to be the first ingredient, but not anymore.  As a result, the protein is slightly less, even with the bigger suggested serving size. Our conclusion: many ingredient changes result in products with less sodium, sugar or fat.  If you buy a product because it contains a certain ingredient or has a certain nutrient content, check the ingredients list occasionally to be sure it wasn’t changed!  

Food marketers must think we’re really dumb. Recently, a colleague was asked to make a vegan chocolate pie for a friend’s dinner party.  She found a recipe that called for silken tofu, almond flour crust, vegan unsweetened chocolate (is there any other kind?) and maple syrup for sweetener.  Oh wait, no maple syrup.  According to her friend, maple syrup is not an acceptable sweetener for some reason.  Only agave syrup will do.  So my colleague was forced to jump through all kinds of hoops to find the acceptable ingredients to make this chocolate pie, including a bottle of agave syrup she will never use again.  We both had to laugh though — no maple syrup?!  One of the most pristine sweeteners around — nothing added, comes from trees, not GMO.  Gluten free!  But no, it won’t do for this particular vegan.  Agave was just sooooooo much better. Let’s do the math. 1 tablespoon    calories sugars  fructose  sucrose   agave             64       14 g   11.5 g      0            maple syrup       50       13 g     <<1       12 g Agave is mostly fructose, while maple syrup is mostly sucrose; fructose is negligible.  If this friend is on some anti-fructose kick, this makes no sense.  So what is the point of agave?  Her friend objects to trees?  Trees aren’t vegan?  The vegan friend is pro-fructose?  Or perhaps he equates “maple-flavored” pancake syrups with pure maple syrup, making him a very poorly informed consumer. All this got me thinking yet again about the massive amount of misinformation about sweeteners and sugar floating around in the mainstream media.  And then, right on schedule, another laughable example of this stupidity showed up on a box of cereal: No High Fructose Corn Syrup!!! Made with REAL BROWN SUGAR! Seriously!?  Brown sugar is now a health food?  I looked at the ingredients on a box of Raisin Bran.  And predictably, no HFCS.  Instead, we have sugar, brown sugar syrup and malted barley syrup.  So much healthier.  Not.All of this nonsense makes me want to start guzzling high fructose corn syrup just to be contrary.  Sweeteners are all sugar.  It doesn’t matter if it comes from corn or a tree or a bee or a cactus or a beet.  It’s all sugar.  It’s all digested and metabolized in the same basic way.  Over-eating any of it is not a good idea.  None of them are more pure or saintly or vegan than any other (although some vegans object to honey because it’s made by bees*).  Brown sugar is not a healthful ingredient; neither is agave. But high fructose corn syrup is now a villain, and all other sweeteners that are not HFCS can be positioned as healthy and used to push market sell food products.  I have no doubt if agave syrup were cheaper it would be added to ready-to-eat cereals or ice cream or Snickers bars for the health halo marketing effect.  People would conclude “Yay! Snickers bars have agave syrup, they’re healthy, I can eat more of them.”  It’s my Golden Rule of Health Halos: If you can give people permission to keep eating what they already want to eat by slapping a health halo on it, sales will go up. It never fails. One reason to prefer one sweetener over another is flavor.  There are definitely flavor differences.  Honey, maple syrup and brown sugar have distinctive flavors; granulated sugar and light corn syrup do not.  Some sweeteners work better is certain types of recipes than others.  Substituting a liquid-type sweetener (corn or agave syrup) into a recipe that calls for granulated sugar will change how the food comes out.  Making that substitution because you think one is “healthier” than another?  Not a valid reason at all.  Agave syrup will never show up in my kitchen. Maple syrup is always welcome, though. It’s great on yogurt, and apparently it’s great in vegan chocolate pie.

I’ve written about the necessity, or lack thereof, of cooking before, 7 years ago and 5 years ago.  Since then we’ve been bombarded by cooking shows, cooking competitions, an entire network dedicated to cooking and a non-stop onslaught of recipes and cooking videos on the internet and in print.  Pinterest is overflowing with recipes.  Print magazines still pump out recipes.  Even the Wall Street Journal has recipes!  Who is cooking all this stuff when the signs of the death of cooking are unmistakeable: * Grab ‘n Go snacking all day is the new normal.  According to the NPD Group, the number of people who snack 2-4 times a day has grown in just the past 2 years. * People are eating fewer actual meals, particularly millennials and the elderly. * Meal kit businesses are growing. * The average number of items served at a home meal is down 27% in the past 3 decades, to 2.2 items * Meals at home are increasingly one items affairs, with everything mixed together (think pizza). * Shoppers increasingly buy take-out food rather than pantry items. * Grocery stores are under pressure to reduce the number of stores and the size of any new stores. Why is this happening? * Millennials don’t know how to cook; no one taught them, probably because their parents didn’t know much about cooking and didn’t have time. * Single-person households are another new norm, and a person living alone isn’t likely to spend time shopping, cooking and cleaning up for one. * Older adults, free of family responsibilities, aren’t interested in cooking and cleaning up anymore. * No one has time.  Long commutes and busy lives mean cooking and family meals fall by the wayside. But perhaps the main reason is this: there’s plenty of ready-to-eat food, so cooking isn’t necessary.  I don’t think there are 10’s of millions of people out there, snacking their way through the day, bemoaning the fact they they aren’t in the kitchen chopping and cooking and cleaning up.  Cooking used to be essential for eating; now it isn’t and it turns out few people were actually that interested in food preparation. What’s the impact on healthy eating?  Is from-scratch food preparation essential for that?  If you don’t cook are you doomed to unhealthy eating?  No and No. First let’s get over the idea that cooking equals healthy eating.  There are plenty of home-cooked meals that leave a lot to be desired: hot dogs and potato chips, packaged mac ‘n cheese, Re-heated fried chicken nuggets and french fries.  The list can go on.  Plenty of people think this is home cooking, but I wouldn’t call it healthful.  Healthy cooking requires some skills and some effort.  You need to have ingredients available; you need to pay attention to expiration dates and freshness and shop for groceries as necessary; you need to have decent equipment; you need to have time and you’ll have to clean up.  There are certainly people who meet all those criteria.  Some of them may prepare fresh food every day.  Some of them may see food preparation as a weekend hobby. If you don’t cook, you’ve got plenty of options for healthy eating, but of course you have to make those choices.  You can rely on fast food take out or frozen pizza, or you can choose healthier foods with lots of vegetables.  Or you can use one of the growing number of meal kit companies and pretend to cook.

When it comes to bone health, the true measure is fracture risk.  You may be loading up on calcium, but if you still get fractures, something might be missing.  Bones are not just inert slabs of calcium.  They’re living tissue, and bone strength depends on many nutrients, including protein, vitamin D, phosphorus, potassium, calcium and magnesium.  The connection between magnesium and bone health is in the news again, thanks to a new study on fracture occurrence in older people. In the study, more than 3700 people aged 60+ years were followed for 8 years.  At the beginning of the study, everyone was assessed for magnesium intake, based on diet and supplement intake records.  During the 8 year period, fractures were documented.  Then at the end of 8 years, the relationship between magnesium intake and fracture occurrence was analyzed.  People in the top 20% for intake had significantly less risk for fractures.  The effect was especially strong for women. Interestingly, the people in the top 20% intake group were not consuming wild amounts of magnesium.  The highest intakes were just above the RDA, which is 320 mg/day for women and 420 mg/day for men.  It’s relatively easy to consume that much from food, assuming your diet is plant-based, with less processed whole foods.  The women in the study who at least met the RDA had significantly lower fracture risks compared to women who consumed less.  Unfortunately it’s easy to have a poor magnesium intake if you eat mostly processed foods.  The subjects with the highest fracture risk were only consuming about half the RDA. What foods are high in magnesium? * nuts and seeds (and nut butters) * legumes * tofu/soy * whole grains, such as whole wheat, oats, quinoa, buckwheat, barley, brown rice * vegetables like spinach, tomatoes, squash, peas Poor sources include foods made with white flour, meats, dairy, sugars, fats and meats.  So the highest magnesium diet is going to be plant-based, as long as plenty of legumes, nuts and whole grain foods are included. Supplements can boost intake.  While multiple vitamin/mineral formulas may contain some magnesium, it’s usually a trivial amount.  Most magnesium supplements provide around 250 mg, and one a day is plenty.  There are several forms of magnesium found in supplements.  Magnesium oxide is common, and less expensive,, although slightly less well absorbed.  Magnesium citrate is better absorbed.  You can also find liquid supplements.  Some so-called bone health supplement include both magnesium and calcium.  However, they compete for absorption in the digestive system, so better to take magnesium separately from calcium, and also better to take it with food, not on an empty stomach. I’ve written about bone health nutrients before, and this new study adds to the evidence that calcium alone is not the answer to fracture prevention for older people.

(NOTE: podcast by Donna P Feldman MS RDN) This has been a bad year for the sugar industry. Last September, the New York Times released an article blaming the the Sugar Association for paying off researchers in the 1960’s to direct attention away from the damaging effects of sugar and establish a link between fat and cardiovascular disease. Dr. Cristen Kearns, the dentist who uncovered this alleged deception, has received national attention, publishing three journal articles that have been picked up by hundreds of news outlets. Dr. Kearns’ story goes something like this: she claims the sugar industry produced some shoddy science, using their money and power to sway Harvard researchers to publish journal articles that favored sugar. Dr. Kearns suggested the researchers knew all along that sugar, not fat, was to blame for America’s epidemic heart disease but chose to cover it up for a $50,000 bribe. When Dr. Kearns combed through The Sugar Association’s documents, she found links between researchers and Sugar Association stakeholders, pay-offs, deception and lots of bad science. In a published research article, Kearns and her co-authors clam the following: In the ‘70s, the National Institute of Dental Research focused on pushing fluoride instead of reducing sugar intake to prevent dental carries. This, Kearns claims, “failed to significantly reduce the burden of dental carries” and remains a widespread, yet misguided, solution to cavities With endorsement from President Nixon, the National Carries Program (NCP) promoted “solutions” to dental carries, such as vaccines, directing blame for this major public health issue away from sugar The Sugar Association acted much like the tobacco industry, minimizing what research clearly showed to be a dangerous substance, and passing the blame for public health problems in order to sell their product    For Kearns, the journey to damn sugar is personal. She quit her high-level job as a dental care program manager when she saw the government-published information her peers were distributing to their patients. The handouts recommended reducing salt, fat and calories to prevent cavities but never once mentioned reducing sugar as a way to improve dental health. Dr. Kearns thought the sugar industry was using dental care providers to influence the public’s perception that sugar is not to blame for our nation’s poor oral health. She may be right. The American Dental Association fact sheet about diabetes, diet and dental care says nothing about sugar. It recommends frequent dental checkups and ADA approved toothpaste, but does not mention the connection between sugar and cavities, or sugar and diabetes, or sugar and mouth bacteria—connections that are well-known and backed up with credible science7. An Oral Health Factsheet published by the Washington School of Dentistry recommends ‘monitoring’ diabetic patients’ diets but does not recommend restricting carbohydrates, sugar being a major player and one that irrefutably affects diabetic patients. “Educate on proper oral hygiene and nutrition,” it declares, without mentioning what proper nutrition means, what to recommend, or which nutrients to talk about. The Academy of General Dentistry

I’m done worrying about what this person or that person says about salt these days.  The health and nutrition minders have split into two groups: * Salt is poison and we should eat almost none (although, oopsie!, the sodium in salt is actually an essential nutrient) * Salt is not a big deal When it comes to nutrients, such as sodium, there is always the possibility that while some is good, a lot is bad.  This goes for water.  It’s hard to drink excess water, but sometimes a person does that and ends up in serious trouble (brain swelling, coma).  Fat soluble vitamins are another classic example: too much vitamin A or vitamin D can cause serious problems.  Extremely high doses of vitamin C can cause kidney stones.  Iron overload causes a host of medical problems and is sometimes hard to distinguish from other problems, making diagnosis difficult.  The list goes on.  Suffice it to say you can get too much of a good thing. Now we have the latest salt rant from Dr. James DiNicolantonio, an associate editor for the a British Medical Journal’s Open Heart and a cardiovascular researcher, who not only says salt is fine, but eating too little will “.. make you fat and ruin your sex life.”   Surprise!  He’s written a book about this very topic — The Salt Fix — wherein he explains how: * too little salt leads to insulin resistance and increased fat storage * a low salt diet reduces sex drive, contributes to erectile dysfunction, and decreases fertility. * low salt intake adversely impacts trauma recovery He observes, correctly, that like other mammals, humans have been seeking out salt since time began.  He also notes that Koreans, for example, have a relatively high sodium intake — 4 grams/day — but have low rates of hypertension and coronary diseases.  At which point he makes the classic mistake of assuming that association equals causation, or in this case non-causation.  Koreans may eat a lot of sodium, but they also have a very unique diet, with lots of fermented foods and lots of vegetables.  Don’t tell me sodium is the only significant nutritional factor.  He makes the same mistake the anti-salt crowd makes: looking only at salt intake, rather than to the whole diet as a factor in heart disease. His article does have an interesting discussion about the history of anti-salt research, much of which was done with rats bred to be sodium-sensitive (normally rats are not sodium-sensitive).  Surprise again!  If you feed sodium-sensitive rats a lot of salt, they develop health problems.  Translating those results to humans is problematic, but apparently that’s the intellectual leap researchers made.  He talks about the assumption behind the belief that excess salt in the body causes high blood pressure: the simplistic idea that sodium accumulates in blood, causing more water to pour into blood vessels to dilute the sodium, leading to higher blood pressure.  If that’s truly how some scientists think, it’s almost laughable (in any case, it’s recently been refuted).   Then there’s a rather exaggerated explanation for how low salt diets lead to insulin resistance which leads to obesity.  Not sure that train of thought holds up.  There is an unstated assumption that people actually are following the punitive 1.5 gram/day sodium limit imposed suggested by the American Heart Association, which I doubt.  And certainly eating a drastically low sodium diet could lead to adverse effects, but such a diet is likely to have other nutritional issues that can cause problems. Dr.