Tuned in to nutrition with Radio Nutrition

  Walk Talk Nutrition RDs discuss labeling Added Sugars The FDA has proposed changes to the Nutrition Facts panel on food products.  One major change is including “Added Sugars” on the label.  Why?  The new US Dietary Guidelines expressly tell people to cut back on added sugars.  The proposed limits are no more than 100 calories/day (6 tsp) of added sugars for women and no more than 150 calories/day (9 tsp) for men.  But without labeling, there’s no way to know which sugars are added right now.  Food consumption surveys show that average intake of added sugars is 16% of daily calories, almost 1/2 cup (22 tsp). Most of our added sugar intake comes from soft drinks, including soda pop, fruit drinks, sports drinks.  Candy, cookies, cakes, pies, dairy desserts and table sugar are also major contributors.  Added sugars have no nutritional value but plenty of calories.  Loading up on added sugar foods crowds out healthier whole foods. The usual suspects (sugar and dessert manufacturers) think this is a bad idea and will be expensive to implement.  Health organizations, health professionals and plenty of consumers think it’s a great idea.  What do we think?  We think it’s an idea whose time has come.  Unfortunately, we have no idea where this labeling proposal stands at the moment.  It could be a very long while before food labels actually provide this information.  Meanwhile if you want to cut back on added sugars, the easiest way is to avoid sugary beverages, and limit candy and desserts. A list of words that mean Added Sugar: * anhydrous dextrose * brown sugar * confectioner’s powdered sugar * corn syrup * corn syrup solids * dextrose * fructose * high-fructose corn syrup (HFCS) * honey * invert sugar * lactose * malt syrup * maltose * maple syrup * molasses * nectars (e.g., peach nectar, pear nectar) * pancake syrup * raw sugar * sucrose * sugar * white granulated sugar * cane juice * evaporated corn sweetener * fruit juice concentrate * crystal dextrose * glucose * liquid fructose * sugar cane juice * agave syrup * fruit nectar You can find more information about added sugars from the USDA MyPlate website or Harvard University’s Nutrition Source. Here’s the American Heart Association statement on added sugars from 2009.  As Kathy points out, that’s 6 years ago, and we still don’t have labeling to help consumers identify foods high in added sugars.

Here’s one thing I love about the field of nutrition: nothing is sacred.  We have one idea set in concrete, and then some new research comes along and the concrete starts to crack.  What we thought was bad turns out to be good.  What we thought was healthy — mmm, not so much. The ongoing controversy about saturated fats is the perfect example.  They were considered the root cause of all health problems.  Food companies scrambled to cleanse foods of saturated fats, even foods that are inherently full of saturated fats.  We ended up with fake cheese, low fat milk and hydrogenated vegetable oils with trans fats.  Oops!  Now  a growing pro-saturated fat faction claims that saturated fats are healthy. Which brings me to cheese.  Real cheese is naturally high in saturated fat.  It makes cheese melt nicely and gives it a lovely texture and flavor.  And, according to a new study, those fats may in fact provide health benefits. The researchers were inspired by the so-called French Paradox: why are French people healthy, despite eating a diet with plenty of saturated fat.  The original theory was that wine was key.  Makes sense to wine lovers.  Studies were designed to investigate special health properties of wine.  But now, with increasing focus on saturated fats, the focus turned to the cheese itself.  In particular, this study looks at the by-products of saturated fat digestion.  The saturated fat in cheese is metabolized by gut microbes to short chain fatty acids, such as butyrate.  Subjects eating a diet high in cheese excreted significantly more butyrate compared to a diet high in milk. Butyrate is linked to lower cholesterol.  It acts as an energy source for cells lining the colon, and can have an anti-inflammatory effect in the gut.  So theoretically, eating cheese can help maintain gut health.  Meanwhile in the US, we’ve been told to avoid cheese, or eat fake, low-fat cheese for better health. But what about the calories?  Being high fat, cheese is high calorie.  To control calories, control portions.  The best approach is modest amounts of cheese: a small piece for a snack, or a bit of cheese grated onto a salad or a burrito. Hard cheeses are nutritionally very similar, even though they taste different.  Higher fat cheeses, like Brie, are softer due to higher fat content.  Some nutrition facts for 1 oz of cheese: * 110 calories * 7 grams protein * 9-10 grams fat * 5-6 grams saturated fat * 200 mg calcium * some vitamin A, zinc, B12 and vitamin K Cheese-making involves the addition of salt, so cheese is a source of sodium, 160 – 190 mg per oz. I’m adding more cheese to my diet, in small amounts, using a variety of interesting cheeses.  Right now I’ve got a cheddar from Oregon, a cheddar from England, Manchego (one of my faves) and Jarlesberg.  I’ll eat a few thin slices for a high protein snack, or grated on salad. If you really want to participate in the French Paradox lifestyle, serve a cheese plate for dessert.  Pick 3-4 different cheeses, arrange on a platter or cutting board, add some fresh fruit, such as grapes of apple slices.  A couple of small bites of cheese and fruit might be a satisfying 100-150 calories.  A big piece of cake or bowl of ice cream could be 300-400 calories, and your gut microbes won’t metabolize cake into butyrate.

The RDs visit IHOP. IHOP isn’t exactly the place you’d expect to find a lot of ‘healthy’ or low calorie menu choices.  We found a few, but the emphasis is clearly on pancakes, waffles and Criss-Croissants, which are a sort of croissant/pancake hybrid with the obligatory fruit toppings and fillings.  We understand the most popular pancake is the New York Cheesecake.  1100 calories, and that’s without syrup. Like most chain restaurants, IHOP does provide nutrition information on the website.  Many of the pancake breakfasts are over 1000 calories, again without syrup or butter.  Add sausage or bacon and the total goes up more.  Even the omelets can be calorific.  The Chorizo Fiesta is 1300 calories.  The healthy-sounding Garden Omelette is 930.  Think those are high?  Try the Chicken/Country Fried Steak Skillet with Sausage Gravy: almost 2400 calories. We liked the idea of the Simple and Fit menu choices, which are under 600 calories/meal (without syrup!).  Kathy ordered the Blueberry Harvest Grain and Nut pancake combo.  We liked the distinctive whole grain flavor.  The 55+ menu features more conventional menu items, but in smaller portions, an option we always favor. Our Bottom Line: watch the syrup!   And if you go to IHOP on a regular basis, familiarize yourself with the calorie counts so you know what you’re in for.  Like all large restaurant chains, IHOP will have to post calories on the menu by December 2015.

It the time of year for foodies to predict the food and nutrition trends for 2013.  These lists tend to be rather repetitive, as foodie experts read existing trend lists and then write up their own lists using some of the same ideas.  The one trend that's common this year is vegetables.  We'll apparently be eating a lot more vegetables in 2013, sometimes as dessert.  One list claimed everyone will be making their own locally sourced, artisanal snack foods from scratch.  As soon as the from-scratch dinner is done. Rather than rehash other people's predictions, here's the Radio Nutrition fantasy list of Food and Nutrition Trends 2013 that I'd like to see, but probably won't: Consumers stop buying "energy" drinks and start drinking water when they're thirsty.  Or just have an espresso.  It's more honest, plus you get the coffee polyphenols. Not one new fad diet surfaces all year long. Restaurants realize they can offer smaller portions and still appeal to customers with quality food. Everyone eats less meat. "Added Sugars" is added to the nutrition facts label. Megadose supplements fade away. Everyone gets more physically active all day, including walking for transportation. Consumers realize that "protein" does not automatically make a food or diet "healthy".  Protein bars and high protein diets are shunned. We lose our cultural aversion to being hungry.  No more overloading the digestive system with all-day snacking and drinking. The demise of Nutritionism.  The nutrition department in a store isn't where the pills are.  It's the food. The world would be a healthier place if these all came true.  Hey, I can dream, can't I?  Even if these don't turn out to be population-wide trends, you can implement many of them on your own, making you a healthier individual.

If you're taking a multiple vitamin, why are you doing it?  To prevent heart disease?  If so, the long-running Physicians' Health Study has some mixed news: multiple vitamins may slightly reduce cancer risk, but they don't prevent heart disease. Vitamins were originally discovered when medical researchers realized that animals fed purified diets grew poorly and were very unhealthy compared to animals that ate whole food.  One hundred years ago, the word "vitamine" was coined by Casimir Funk, who researched beriberi.  He realized that brown rice prevented the disease, while milled white rice did not.  He theorized that brown rice contained some unidentified substance - a "vitamine" - that was essential to health.  Nutrition was born. The misconception that vitamins cure diseases other than deficiency diseases is rather new, and so far not supported by any evidence.  So it's not surprising that multiple vitamins don't prevent heart disease, which is linked to genetics and numerous lifestyle factors like exercise, fat intake, obesity and smoking. There's another complication with judging health benefits of multiple vitamin use: the general health habits of the user.  People who take vitamins tend to have better habits in general: lower weight, healthier diet, more exercise and less smoking.  Vitamins are just one piece of the puzzle.  Did the vitamins cause the healthy habits?  Not likely.  Could vitamins cancel out bad habits?  Very unlikely. This study has received some criticism from vitamin advocates.  Focusing on white male physicians, who already tend to have healthier lifestyles, may have skewed potential results from the get go.  A multiple vitamin wasn't likely to add dramatically to their health.  Steve Mister, President of the Council for Responsible Nutrition added "we shouldn't expect vitamins to perform miracles." If you're going to take a multiple vitamin, to add to your already healthy lifestyle (right?), keep these tips in mind: Vitamins are not drugs.  They do not cure diseases. Vitamin supplements are not regulated like prescription drugs are.  There is no government testing to make sure supplements contain what the label says.  Buy reputable products. There is no standard formula for "multiple vitamin".  The formulas can vary wildly from one to another.  The best choices contain about 100% of the RDA for a large number of vitamins and minerals for the target population. Beware formulas that try to impress you with big numbers, such as 2000% of the RDA for one or two vitamins.  Would your car run better if you dumped 1000 gallons of oil over the engine? Remember: they're supplements, not replacements.  A healthy diet will provide nutrients.  Remember, Casimir Funk discovered that brown rice fixed B1 deficiency. Finally, In my professional opinion, the formulas for many of the multiples aimed at children are either incomplete or contain weirdly low and/or excessive amounts of some nutrients.  Other experts agree with me.  A study on multiple intake in a large group of children showed nutrient intakes ranging from inadequate to excessive.  What's true for adults is true for children: vitamins do not replace a healthy diet.

Is there a nutrition solution for ADHD?  Desperate parents are looking for alternatives to prescription drugs, and diet is high on the list of preferred natural interventions.  But does diet work?  Is there evidence for a benefit? Suspected causes of ADHD have ranged from childhood vaccinations (debunked numerous times) to food additives to toxic levels of metals like lead or mercury to genetics to prenatal environment.  A pregnant woman's tobacco exposure has been linked to her child's risk for ADHD.  One study of newborns found a link between the mother's age and education level and family history of ADHD to the infant's chance of being diagnosed with ADHD later in life.  But are those causes, or just indicators for some other risk pattern? A nutrition fix for ADHD sounds easy, natural and healthy.  But so far, nothing is proven.  Back in the 1970's, food additives, colorings and salicylates were blamed for "hyperactivity" in children.  Salicylates are a family of chemically similar compounds, like aspirin and some food colorings.  Sodium salicylate is naturally present in most fruits and many vegetables, and kids were put on rigid diets, which sadly excluded these healthy foods.  Despite the fruit-and-vegetable-free diets, hyperactivity didn't go away.  In fact, ADHD diagnoses are increasing. So far, diet/ADHD research focuses mostly on single nutrients. This isn't a very useful way to think about a nutrition connection, since all nutrients interact with each other in the human body.  For example, zinc, iron and magnesium are individually linked to fetal brain development, and research on ADHD children shows lower levels of all of these.  In some studies, giving supplements led to some improvements, but not for all children or all symptoms.  No study looked at all three of these minerals together, not to mention all the other nutrients that impact brain function.  Low levels of any of these minerals likely indicate poor intake.  Is poor intake part of a generally poor diet?  And is a generally poor diet part of the problem? Omega-3 fats look promising.  Omega-3 fats are an essential part of brain structure and metabolism, and play a critical role in fetal and newborn brain development.  ADHD children seem to have lower levels of omega-3 compared to un-afflicted children.  But are low omega-3 levels a cause or an effect of some other problem?  Could omega-3 supplements fix ADHD?   Studies give mixed results, so it's hard to compare results.  Different doses or sources of omega-3 and different sets of symptoms in different age groups of children complicate conclusions.   In some cases, some symptoms improve.  But that's not sufficient evidence to make blanket recommendations for omega-3 supplements for ADHD. If in fact the conditions for developing ADHD are created by genetics and prenatal exposures, diet and nutrients are not likely to fix the problem after the fact.  Nutrition certainly impacts fetal development, so the pregnant woman's diet could affect risk by affecting the infant's brain development.  Pregnant women should follow healthy balanced diets, gain the proper amount of weight and avoid toxic exposures like tobacco.  There's no guarantee this will eliminate all ADHD risk for a child, but a healthy balanced diet certainly can't hurt.  Meanwhile, we'll have to wait on future research to clarify any links between nutrition and ADHD. For more news on omega-3 studies and cognitive ability, check out the podcast.

Paleo diet got you down?  All that heavy meat and bacon can leave your taste buds and digestive system screaming for something refreshing, like an orange.  There's good news: according to a recent essay in Scientific American, our Paleo ancestors ate lots of other stuff besides meat.  In fact, they probably ate little meat, and definitely no bacon. The essay by science writer and biologist Rob Dunn, examines evidence for what our human and primate ancestors ate, as well as what primates eat now.  The vast bulk of food stuff is from plants: fruit, leaves and nuts.  "Meat" may be more from insects than mammals or fish.  Analysis of dental remnants from Neaderthals shows significant consumption of plant food.  The manly image of our primitive ancestors running down large animals every day and gorging on meat doesn't jive with reality.  Our ancestors ate whatever they could find, and most of that was plant food.  Conclusion: they were primarily vegetarians, just as most primates today are. Things could be worse.  In fact, there's plenty of evidence that plant-based diets are especially healthy.  Preliminary results from an ongoing study of 96,000 subjects shows that the vegetarians live years longer than people who eat meat-heavy diets.  On average, men live 9.5 years longer and women 6.1.  Vegans in this study are 30 lbs lighter and have much less insulin resistance, a risk for Type 2 diabetes. Dunn mentions another interesting issue in his essay: the effect of diet on our gut microbe population.  By coincidence, I came across an article on bacteria, in particular the bacteria that make humans their home.  Or not.  Our gut bacteria has been fundamentally changed by modern life, notably frequent use of antibiotics.  It turns out there's a link between significant changes in our gut bacteria and obesity.  For example, wiping out certain bacteria with antibiotics causes mice to gain weight, even though they aren't eating more calories.  Livestock like cattle and chickens are routinely given antibiotics, because those drugs make the animals gain weight quickly.  This indiscriminate use of antibiotics is a major complaint of organic food advocates. The effect of gut bacteria on weight gain in humans is likely to turn out to be a very complicated system.  Simply taking capsules of a bacteria isn't likely to help.  Our gut microbe populations reflect what we eat.  If your diet is heavy on meat and processed food, your gut bacteria will be fundamentally different from a person who eats a plant-based diet and few processed foods.   Vegan diets are known to help people lose weight.  But is it the vegan diet?  Or is it the effect of that diet on gut microbes?  We don't yet have the answer to that question.  Meanwhile, you can hedge your bets by moving to a more vegetarian type diet.  

Should you count calories?  Believe it or not, there is controversy among nutrition professionals about this simple advice.  Chronic dieters think nutrition is all calories, and nothing but calories.  Diets and meal plans usually come with daily calorie limits attached.  Food packages all list calories.  Food marketers tout lower calories, when artificial sweeteners or fake fats are used.  The restaurant industry will soon be subjected to a burdensome new law mandating calorie counts on menus, as if these numbers will magically cure obesity. But plenty of people -- nutrition experts and consumers alike -- are questioning whether calorie counting is necessary or even useful.    I had this discussion with a colleague recently.  We generally agree it's a good idea.  Calorie counting helps you focus on how much you're eating.  As my colleague pointed out, calorie counting gives her clients an eye-opening reality check about how much they're eating.  The typical reaction: "I had no idea I was eating so much".  Followed by:  "No wonder I gained so much weight." One of the frequent criticisms of calorie counting is that it can't possibly be accurate.  And that's true, it can't, unless you're locked up and being fed pre-measured food.  But so what?  Being 100% accurate isn't so important as being consistent in how you measure and record your food portions.  Whether you're trying to lose weight or maintain weight loss, calorie counting can help you stay at a target intake range, so you're successful.  If you're trying to stick to 1200-1500 calories, and your system keeps you in that range, it doesn't matter if your estimate of 1375 one day is off by 50 or 100 calories. Another criticism is that calorie counting is cumbersome and time consuming.  Yes it can certainly be that.  Years ago, before apps, it was way more trouble: you had to write everything down on paper, and then look the foods up in calorie books and do a lot of math.  The calorie books contained very few foods, so you'd have to look up ingredients to make something like lasagna work.  Now we have apps with values for thousands of foods at your fingertips.  But even with apps, it's still a lot of trouble for some people.  Our suggestion for weight control: count calories for a 1-2 days/week, just to keep on track. Or try monitoring your servings of food groups, or go by how your clothes fit, as other nutrition professionals recommend.  One problem with the food group method is that you still have to be monitoring food intake.  Another problem: our food supply doesn't always fit that model.  We eat a lot of combination dishes, like burritos, pizza, casseroles, even smoothies.  How do you mentally break those down into little piles of vegetables, dairy, grains and fruit?  Frankly, I'll go with calories. Check out the podcast for tips on using up Halloween candy and pumpkin nutrition.

The child obesity epidemic is causing widespread anxiety in the public health community.  While everyone agrees something needs to be done, few people have effective answers.  Surprisingly, we can’t even agree on why the problem keeps getting worse.  The idea of treating children with prescription drugs, or worse, bariatric surgery, is alarming, given the potential for adverse long term effects that we can’t predict. For children, the best solution is going to be the same as for adults: a combination of healthy balanced lower calorie diet and increased daily physical activity.  There are plenty of diet books geared to helping adults do that, but books for teens are few and far between.  Or maybe non-existent.  Registered dietitian Lisa Stollman, MA RD set out to remedy that situation, and her book The Teen Eating Manifesto is a step in the right direction.  She’s spent years working with weight control clients of all ages, including teens, and she’s compiled her common sense advice in a handy book. The book is divided into 3 major sections: A discussion of 10 key steps to help teens lose weight.  The list includes obvious things like exercise, and not-so-obvious recommendations like getting enough sleep and what's called Mindful Eating. Tips on dealing with unusual eating situations, like holidays, vacations, restaurant meals and the transition to college dining Tools to help teens make it happen, from shopping lists to recipes to sample menu plans. Stollman has many years of experience counseling clients of all ages on weight loss strategies, so her advice is based on experience as well as on professional expertise.  And while her book is written for teens, parents can certainly benefit from the information, especially as they can better understand their role in the solution.  And yes, parents of teens do have a role to play, although it should not be the role of Food Police.  Most parents find the role of Food Policeman to be thankless and ineffective.  While teens need guidance, they also need to develop the ability to monitor their own eating habits and make their own appropriate choices.  Lisa Stollman’s book is a great resource for teens who want good information, but want to learn to work things out on their own.  If you are a teen or a parent looking for help on weight management, the Teen Eating Manifesto might be just the ticket. You can buy The Teen Eating Manifesto on Amazon.

Type 2 diabetes is exploding into a major public health problem, thanks to the obesity epidemic. While many diabetes patients are content to rely on drugs and medical treatments to control disease, they can take control of their condition by losing weight.  Most diets are general purpose, but registered dietitian Jill Weisenberger has written a book on weight loss that’s specific to diabetics: Diabetes Weight loss week by week. Her book presents a 16 week action plan to help diabetics lose weight, gain control of their diabetes and transition into a permanently healthier lifestyle. Rather than vague and generalized goals common to many weight loss programs, this program focuses on SMART goals: Specific Measurable Action-oriented Realistic Timely Weisenberger gives examples of how these type of goals are better for achieving success, but clearly action is a big part of her plan.  Each of the 16 chapters for each week end with an Action Plan, based on behavior changes recommended for that week.  Rather than waiting to see if blood glucose or weight changes, readers are told to establish food and lifestyle changes that can easily be measured and quantified. The book includes recipes, meal plans and plenty of information and tips to help diabetics learn how to help themselves with diet.  Diabetes Weight Loss Week by Week is available from Amazon.

September 29th is Coffee Day.  I'll be sure to celebrate in my usual way as soon as I wake up: strong brewed coffee with half and half. Coffee is something a lot of people enjoy, so it's not surprising the Food Police try to spoil the fun with claims that coffee is somehow bad for health.  The myth that coffee causes dehydration persists, despite actual evidence that it doesn't.  In fact, coffee without all the add-ins adds to fluid intake. Good things about coffee: Coffee contains several antioxidants. There's evidence that coffee consumption is linked to lower risk for Parkinson's Disease and Type 2 diabetes.  However, Association Does Not Equal Causation.  It could be something else about coffee drinkers that lowers risk for these. It's enjoyable. It's also vegetarian and vegan. Bad things about coffee: We're in the habit of loading it up with excess calories from sugar, sweetened flavored syrups and cream. Not only do we load it up with excess calories, we order super-sized portions of this stuff. Drinking a lot of coffee could give you a buzz from too much caffeine, leading to sleep disturbances.  Especially bad idea for kids. Does espresso have less caffeine?  It depends on whether you're comparing servings or volume.  While espresso has more caffeine compared to coffee when compared by volume, the typical serving of espresso is much smaller, so can you end up consuming less caffeine.  Another factor: type of bean.  More expensive arabica beans are much lower in caffeine, while robusta beans are higher.  So coffee that contains more robusta beans will have more caffeine.  Unfortunately it's not always possible to get that information. Caffeine is metabolized by a specific enzyme system that varies from one person to the next.  Normally the system can ramp up activity when people habitually drink more caffeine.  People who drink no coffee may have little initial ability to quickly metabolize caffeine, so when they do drink coffee, they feel it.  The best solution for caffeine is to know your limits.  If 2 cups of coffee makes you unpleasantly jittery, cut back.  If you know coffee from a certain coffee bar makes you jittery, find an alternative. By the way, not only is it Coffee Day, but Wednesday was Better Breakfast Day.  Better than what, you might ask?  My answer: better than: nothing sugary coffee or tea only sugary coffee plus sugary pastry or donut giant stack of syrup-drenched pancakes "energy" drink toaster pastry "breakfast" bar (candy bar in Health Halo disguise) sugar-sweetened cereal I could go on.  I wrote about breakfasts earlier this week, and noted a surprising finding from market research firm The NPD Group: breakfast is the least skipped meal (lunch is most) and take-out breakfast is the fastest growing restaurant segment.  So we're trying to eat breakfast, we're just not sitting at a table at home eating eggs and toast.  Most likely, you're sitting in a car or at a desk.  This doesn't mean you can't eat a decent breakfast though.  There are plenty of good take-out options, like oatmeal, bagel sandwiches, burritos, whole grain muffins yogurt, fresh fruit and wraps.  No excuses.  Better Breakfasts aren't anymore difficult or expensive that that other stuff.

Cholesterol continues to be a national obsession.  I’ve heard that some doctors think statin drugs should be added to the water supply.  That would certainly be controversial.  And, in my humble opinion, terribly insulting to all those people who are successfully controlling blood lipids with diet and exercise.  Yes, despite what the drug ads may imply, diet and and exercise do work, when you make the right changes and stick to them Registered dietitian Janet Bond Brill can tell you how to do that.  Her book, Cholesterol Down, has been helping people control blood lipids with diet changes for years.  Her book is set up like a diet prescription, with 10 clearly defined diet changes to make, what foods to use and how much to eat.  The promise is that you will lower your cholesterol in 4 weeks without drugs, if you follow through on all 10 steps. Brill intends the book for people who are already on cholesterol-lowering medications as well as people who would rather avoid medications and control their health with diet and exercise.   The 10 simple steps for lowering cholesterol are set up like a prescription, rather than like the more general diet changes recommended in typical diet books.  The recommendations are based on nutrition research that links each of these foods to a cholesterol-lowering effect.  Some are familiar, like oatmeal and apples.  Others may sound unusual or difficult to incorporate into a daily food plan, such as flax and plant sterols.  Brill gives advice for achieving all of the changes, and the book has lots of recipes that help readers use these foods. Will it work?  Brill says she's gotten lots of feedback from readers who have successfully lowered cholesterol using her plan.  While the plan will necessitate changes that some people may find unusual, they will be effective if done correctly.  The promise is lower cholesterol in 4 weeks, but as Brill notes in our interview, you have to maintain all or most of the changes indefinitely to keep blood lipids at healthy levels.  An added benefit for some people: weight loss, which can also help with cholesterol levels and many other health risks.  So if you're serious about taking control of your heart health, check out the 10 simple steps in Cholesterol Down.

Here it is, the #1 Dumb Diet Mistake: #1: Bad breakfasts. Breakfast probably doesn't sound that important, but it's possibly the most critical step you can take get a handle on hunger and overeating.   And Bad Breakfasts come in two varieties: No breakfast at all.  You're just too busy rushing out the door, and you're not all that hungry anyway.  Probably because the giant evening meal you ate last night is still sitting in your stomach.  So you don't eat anything until maybe lunch or afternoon.  You go through the busiest part of your day with no food.  Eventually your metabolism catches up with you.  You get hungry fast, and you spend the late afternoon and evening eating, just as your metabolism is slowing down for the day.  You go to bed stuffed, and start the process all over again the next day.  Not a great way to control calorie intake. Breakfast that's too small and/or heavy on the simple carbs.  Examples: a giant mocha latte, just juice with no food, sugary cereal, pastries and sweetened coffee.  The effect ends up being the same.  By mid afternoon, the effect of a lightweight breakfast full of sugar hits you in the form of hunger.  And you eat your way through the rest of the afternoon and evening. The solution isn't necessarily a complicated sit-down meal of eggs and toast.  Nor is it necessarily a substantial meal eaten the minute you wake up.  Breakfast timing and food choices are very flexible.  Separate breakfast and lunch by about 3 hours, maybe more.  Avoid added sugar foods and beverages.  Eat high fiber whole grains, fruit or vegetables.  And include some protein.  It doesn't have to be a massive portion.  One egg, a glass of milk, a cup of yogurt, cheese or peanut butter on toast will all suffice. Whether you eat breakfast at home, on the road or at the office, you can find something healthy that will moderate hunger and help you avoid the starving munchies later in the day: egg, toast, juice toast or bagel with peanut butter (or other nut butter) yogurt fruit smoothie whole grain cereal with milk and fresh fruit burrito with egg, potato, beans and cheese slice of cheese pizza loaded with vegetables yogurt and fresh fruit turkey sandwich on pita

Flax is everywhere.  And because it's touted on hundreds of food labels in a positive way, consumers start to believe it's important and healthy.  It's another fascinating example of how nutrition beliefs develop, not from evidence but from marketing.  Push some ingredient enough, brag about it on food labels, and people will believe.  So what is the evidence for flax?  Is it all that healthy? Flax in food is from flax seeds, from the plant that gives us linen and linseed oil.  Linen fibers from the plant have been used to make cloth for thousands of years.  The seeds are high in oil, and linseed oil has been used for a long time in paint and varnish.  The whole seed makes an excellent high protein animal food.  Widespread use in human food is quite recent, and one key reason is the high content of omega-3 fats in the flax seed oil.  Since flax is a plant, the omega-3 is the far less biologically active alpha-linolenic acid, which makes up almost half the fats in flax seed.  For this reason, if you buy flax oil, you might notice is smells a bit fishy.  That's from the high omega-3 fat content.  Alpha-linolenic acid is highly reactive to heat and oxygen, so it's not an oil you would use for frying.  You should keep any flax oil or flax seeds you buy in the refrigerator, away from light and heat. The omega-3 content is the primary reason flax is being touted as a health food, despite the fact that plant-sourced omega-3 is much less biologically active.  The 18-carbon alpha-linolenic acid fatty acid chain has to be elongated to the 20 or 22-carbon chain omega-3 fats, and that metabolic process is not very efficient.  But it's a lot easier and a whole lot cheaper to put flax into a food product in order to brag about omega-3 content than it is to put salmon or sardines or purified EPA or DHA in the same product.  Imagine a snack bar that touted "contains salmon!" on the package. Another nutritional plus for flax is the high fiber content.  A mere tablespoon of ground flax seed has almost 2 grams of fiber.  So sprinkling it on cereal or adding it to bread or energy bars boosts the fiber content, creating another nutrition marketing opportunity. Back to the question: is flax all that healthy?  It's certainly got some benefits, with high fiber and signifiant plant omega-3.  If you're a vegan, this might be a key source of omega-3 fatty acids.  But is it some miracle food?  No.  You can get more biologically active omega-3 from animal sources, like salmon or sardines.  You can get fiber from vegetables, fruits and other whole grains.  If you think the omega-3 and fiber from flax justifies a diet of granola bars, you'd be wrong.  If you think flax is a good selling point for pricey cereals, well that's your choice. The only drawback for flax is the taste.  In high amounts, it can be distinctly fishy (it's the omega-3).  People can get used to the taste, and have figured what the right amount is to add to their oatmeal or yogurt smoothie, to avoid strong flavors.  If you buy flax seed or flax seed meal for home use, be sure to refrigerate it.  Speaking of which, here's another issue: whole flax seed is not well digested.  Much as fresh corn is not well digested, because people don't chew it up completely, tiny flax seeds may just pass right through your system.  You won't get any benefits from the omega-3 or fiber if you don't chew them up properly.  If you think large soft corn kernels are a problem, tiny hard flax seeds are going to be even more of a problem.  The solution is to purchase ground flax seed meal and use that.  But because it's been ground up, it's more exposed to oxygen, making it even more important to keep it in the refrigerator. Find some flax recipe ideas here. The podcast concludes with a discussion of a recent article on "sedentarism", a newly recognized public health threat of sitting too much.

Some recent headlines: "Fatigue? Weakness? Headache? It could be iron deficiency" "Study: Iron supplements fight fatigue." "Iron supplements fight fatigue in women." -- Well, at least the New York Times qualified it a little. All of which emphasizes the point that you should never get your nutrition advice from headlines. A study released last month, and published recently in the Canadian Medical Association Journal, did indeed come to the conclusion that iron supplements can fight fatigue.  In women of child-bearing age who complained of fatigue and had low end ferritin (a form of stored iron) levels, but were not officially anemic.  Not in men.  Not in children.  Not in post-menopausal women.  And extra iron isn't likely to boost energy for anyone, including women of child bearing age who have higher ferritin and who aren't complaining of fatigue.  While fatigue improved in those women given iron, anxiety and depression scores did not improve. Iron is a mineral nutrient, and most people understand that it's an important part of red blood cells, where iron is a key component of hemoglobin, which carries oxygen to cells, where it is used in energy metabolism.  About 2/3 of the iron in our body is in hemoglobin.  We lose 1-2 mg/day through normal processes of digestion and metabolism, and need to absorb that much from food.  The recommended daily intake varies by age and gender.  Women of childbearing age, who lose considerably more iron through menstruation, should get 18 mg/day, but men only need about 8 mg.  Not all is absorbed, which is why the RDI is higher than the amount we actually need to absorb.  Iron from meat is absorbed more efficiently than from plant foods, but it's not hard to get enough iron from a vegetarian or vegan diet, with some planning.  And recent research indicates that the form of iron in many plant foods may be better absorbed than previously thought. Who might need an iron supplement?  People with iron deficiency anemia, as diagnosed by a physician.  Note, there are other types of anemia caused by other metabolic problems that have nothing to do with iron intake, so taking iron for those would not help.  That's why anemia needs to be evaluated by a physician.  Simply taking iron supplements because you feel fatigued and read a headline is a bad idea, considering that excess iron causes it's own set of problems.  Iron storage disease, once considered unusual, may be more common than thought.  Ironically one of the symptoms of iron storage disease is... you guessed it .... fatigue.  So if you're a guy who feels fatigue, and you read a headline about iron supplements and started taking them to fight fatigue, you could be doing more harm than good.  Never get your nutrition advice from a headline.