nutrition advice that all experts agree: a starting point ... · guideline: sugars intake for...

Nutrition Advice That All Experts Agree: A Starting Point For a Vibrantly Healthy Diet

TODAY’S AGENDA:• Introduction & Housekeeping• Speaker Introduction• Presentation• Q&A• Closing

WEBINAR HOST:Keith Hine MS, RDSr. Director of Healthcare & SportsOrgain, Inc.

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WEBINAR PRESENTER:Dr. Jim Painter, PhD, RDN Adjunct Professor University of Texas, School of Public jimpainterphd@gmail.com

Nutrition: Where the Experts Agree!The Starting Place for a Healthy Diet

Jim Painter, PhD, RDN Adjunct Professor, University of Texas -Houston

Speaker Disclosure •Board Member/Advisory Panel/Consultant● Present–University of Texas, Sun-Maid Raisins, National Dairy Council, United Sorghum Checkoff Board, Dole Food Company, Atkins, Sugarwise.•Past–Eastern Illinois University, University of Illinois –Champaign, Chic-fil-A, American Heart Association Eat Well Task Force, California Raisin Marketing Board, Wonderful Pistachios, White Wave Foods, Davidson’s Safest Choice Eggs, Tree Top Apples, Bush’s Beans,•Honoraria–Honorarium underwritten by Sun-Maid Growers of California–Dietitians of Canada, Exxon Mobil, Frito Lay, Midwest Dairy Council, Pennsylvania Nutrition Network, California Raisin Marketing Board, Alaska Tanker Company, Dairy Max, Texas AND, California AND, Florida AND, MINK, NY AND, South Carolina AND, Iowa AND, Nebraska AND, Manitoba Dairy Farmers, Dairy Farmers of Canada, Davidsons Safest Choice Eggs, National Dairy Council, New Products Conference, the Flavor Experience, BNP Media, and Cooper Vision.

Speaker Credentials

Introduction Are you tired of conflicting nutrition data regarding popular diets?

Each diet has peer reviewed studies that show that their diet is effective.

But what are they comparing each diet to?

How should you advise your clients?

Paleo, keto, low fat or vegan, which one is most efficacious for overall health?

Comparing the Diets

6

Low Fat /High Carb High Fat/Low Carb

Animal Based

Plant Based

Paleo

Vegan

Introduction Ornish diet: “Animal products are the problem. Eat plants”

Atkins: “Animal products are the answer, Carbs are the problem”

Both claim they are healthy and reduce disease.

Did you know that there is a large area of agreement. What if it is the areas of agreement that are causing the benefit??

Where All Nutritionists Agree Don’t eat the Standard American Diet (SAD)

1. Eat less added sugar

2. Eat more green leafy vegetables

3. Eat more cruciferous and allium vegetables

4.Herbs and spices

5. Eat the right portion

Based on data from the United States Department of Agriculture, Courtesy Dr. Joel Fuhrman, author: Eat to Life; Anti-Aging and Wellness Medical( AluvaLife company)

Almost 50% of fruits and vegetables consists of French fries and Ketchup

55%

30%

11%

4%

Standard American Diet (SAD)

Processed foods

Animal Products

Vegetables, fruit, nutsand beansWhole Grains

“Ultra-processed foods comprised 57.9% of energy intake, and contributed 89.7% of the energy intake from added sugars.”

Definition of Ultra-Processed Foods

•Flavors, colors, sweeteners, emulsifiers and other additives

•used to imitate sensorial qualities of unprocessed foods, or

•used to disguise undesirable qualities of the final product.

What To Do?

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/can-processed-foods-be-healthy-infographic

What To Do?

https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/can-processed-foods-be-healthy-infographic

What is The Problem With Added Sugar?What Does Science Say on Added Sugar?

2014

Hazard Ratios of CVD Mortality According to Usual % of Calories

from Added Sugar

1 1.09 1.231.49

2.43

0

0.5

1

1.5

2

2.5

3

Adjusted Hazard Ratios of CVD Mortality

7.40%11.40%14.80%18.70%25.20%

Reduction in Nutrientsas Added Sugar Increases

17Marriott, B. P., Olsho, L., Hadden, L., & Connor, P. (2010). Intake of added sugars and selected nutrients in the united states, national health and nutrition examination survey (nhanes) 2003-2006. Critical Reviews in Food Science and Nutrition,50, 228-258.

Reduction in Nutrientsas Added Sugar Increases

18Marriott, B. P., Olsho, L., Hadden, L., & Connor, P. (2010). Intake of added sugars and selected nutrients in the united states, national health and nutrition examination survey (nhanes) 2003-2006. Critical Reviews in Food Science and Nutrition,50, 228-258.

116 115

118

121123

110

115

120

125

>5 5 to >10 10 to >17.5 17.5 to >25 >25

Av. LDL levels for women by % total energy from added sugar

intake

*There were no significant trends in LDL-C levels among men.

58.7 57.5 53.7 51 47.7

010203040506070

>5 5 to >10 10 to >17.5 17.5 to >25 >25

Av. HDL levels by % total energy from added sugar intake

Added Sugars and Glycemic Index

22

John Yudkin suggested that sugar was the main causative factor in ischemic heart disease, more so than fat:

“National levels of consumption of fat and of sugar are closely similar. Statistics relating fat intake to … CHD in different populations may therefore express only as an indirect relationship, and the causal relationship may be with sugar”

(Yudkin, 1964).

...the industry sponsored a research program in the 1960s and 1970s that successfully cast doubt about the hazards of sucrose while promoting fat as the dietary culprit in CHD.

“We urge dietary guidelines to shift focus away from recommendations to reduce saturated fat and toward recommendations to avoid added sugars.”

2016

Guideline: Sugars intake for adults and children (2015) ‒Reduce intake of free sugars throughout the

lifecourse‒Reduce intake of free sugars to less than 10% of

total energy intake‒A further reduction of the intake of free sugars to

below 5% of total energy intake is beneficialRecommendations do not apply to “intrinsic” sugars

FDA, What Counts As Added Sugars?

•Definition Includes: –Sugars that are either added during the processing or are packaged as such –Includes sugars (free, mono and disaccharides) and sugars from syrups and honey–Sugars that are added to an ingredient used in a finished food 27

So what are we to do?- We like sweet- Are there alternatives?- Replace added sugar with intrinsic

sugar

Adaption In Action: Small Changes, Big Results

INGREDIENTS:• 1 c. almond meal/flour• ½ c. unsweetened coconut• ½ c. cocoa powder• 1 tsp baking soda• ¼ tsp salt• 1 cup raisins• ½ cup pitted dates• ¾ c. water• 3 Eggs• 2 T coconut oil• 2 tsp vanilla

DIRECTIONS:Preheat oven to 325 F. Grease an 8” round cake pan.Mix together almond meal, cocoa powder, baking soda, and salt in a bowl and set aside.In a blender, food processor, or an immersion blender, blend the raisins, dates, and water until smooth.Add the eggs, coconut oil, and vanilla to the blended mixture and mix until smooth.Add the wet ingredients to the dry ingredients and mix just until incorporated. Pour batter into greased cake pan and spread evenly.Bake for 25-30 minutes or until toothpick comes out clean. Let cool 10-15 minutes.

2. Green Leafy Vegetables This is not a new idea!Genesis 1:29And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in the which is the fruit of a tree yielding seed; to you it shall be food for you.

Photosynthesis: Powering the Planet!

Greens are Great Sources of Nutrients

Spinach 1 cup approximately 1 ounce, 7 calories = .4% of calories for the day

● Vitamin K 181%● Beta carotene = Vitamin A 56%● Folate 15%● Vitamin K Vitamin C = 14%● Lutein - prevents Macular degeneration● Magnesium, Iron

● A diet rich in fruits and vegetables is estimated to reduce:

○ Heart disease (15%), Stroke (27%)

○ Delay cataracts, Prevent asthma, bronchitis, COPD

○ Prevent & treat high blood pressure

Cancer Associated With Intakes of Selected Nutrients

McCann, S. E. et al. 2005.

0

0.2

0.4

0.6

0.8

1

1.2

Beta Carotene Alpha Carotene Lutein Lycopene

Low Medium High

Getting Children to Eat Greens • Start the meal with a salad

• Start with the mild flavored greens: leaf lettuce or• spinach over kale• Cooked as greens

• Again use spinach over collard greens• On sandwiches• Blended up in smoothies• Added to soup and stews• Let children make something with it

3. Cruciferous Vegetables, Broccoli, Cauliflower, Brussel

Sprouts, Cabbage• Cruciferous, Brassica• Allyl isothiocyanate• Phase II enzymes▫ Quinone reductase▫ Glutathione S-transferase

Munday R, Munday CM. Nutr Cancer. 2002;44:52-59.

Cruciferous Vegetables • Arugula • Bok choi• Broccoli • Brussels sprout • Cabbage• Cauliflower • Chinese broccoli • Chinese cabbage • Collard greens • Horseradish

• Kale • Kohlrabi • Pak choi• Radish• Rutabaga • Wasabi • Watercress

https://www.gardeningknowhow.com/edible/vegetables/vgen/cruciferous-vegetables.htm

Cruciferous Vegetables

• Consumption has protective effect on development of colorectal cancer• Indole-3-carbinol & sulforaphane• Consumption inversely related to incidence of prostate cancer• 300 g Brussels sprouts per day

Frydoonfar HR, McGrath DR, Spigelman AD. Anx J. Surg. 2003;73:154-156.

Effect of Sulforaphane on Prostate Cell proliferation

Frydoonfar, H. R., McGrath, D. R., Spigelman, A. D. 2002.

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0 2 4 6 8 10 12

Concentration of Sulforaphane

UV

inte

nsity

Effect of Indole-3-Carbinol on Prostate Cell Proliferation

Frydoonfar, H. R., McGrath, D. R., Spigelman, A. D. 2002.

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0 0.2 0.4 0.6 0.8 1

Groups

UV

inte

nsity

Effect of Sulforaphane on Colon Cell Proliferation

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0 0.01 0.02 0.03 0.04 0.05 0.06 0.07

Groups

UV

inte

nsity

Frydoonfar, H. R., McGrath, D. R., Spigelman, A. D. 2002.

Cruciferous Vegetables

•Consumption has protective effect on development of colorectal cancer

•Sulforaphane

•Consumption inversely related to incidence of Colon cancer

Frydoonfar HR, McGrath DR, Spigelman AD. Colorectal Dis. 2004;6:28-31.

The Challenge!!! Getting Children to Eat Cruciferous Vegetables

● Use the milder ones, not horseradish ● Serve as finger food

Serve a dip, ranch, Italian, French● Add to other cooked veggies● Covered with a cheese sauce● Grate cauliflower use as a pizza crust● Mash cooked cauliflower like potatoes● Cabbage in coleslaw● Don’t try juicing!!!!

Allium Vegetables: Onions, Garlic, Leeks

Garlic• Garlic has been used in traditional and folk medicine for

over 4,000 years• Garlic contains sulfur compounds• Eating one clove of garlic per day may help decrease blood

cholesterol levels

Most Notable Health Benefits of Garlic

• Antimicrobial

• Anticarcinogenic

• Cancer prevention

Component Responsible • Allicin, a sulfur compound

• Diallyl Diasulfide = breakdown product

• Volatile sulfur compounds are not present in intact cells

• Release by:

–chopping

–steaming

–crushing

Effect of Diallyl Disulfide on Growth Suppression of Prostate Cancer Cells

Arunkumar et al 2005.

• In vitro test • Of aged garlic at various levels• Prostate cancer cells• Growth suppression• As measured by Thymidine uptake

Effect of Diallyl Disulfide on Growth Suppression of Prostate Cancer Cells

Arunkumar et al 2005.

0

20

40

60

80

100

120

Control 10 25 50 100

Upt

ake

UM concentration

24 hr 48 hr

How Much Garlic?• Experts still researching optimal dose• Conservative estimate = 1-3 cloves per day

Getting Children to Eat Allium Vegetables

• In spaghetti sauce• Background flavor in general

cooking• Added to soups and sauces • Minced onion on salads• Topping for hot dogs, hot dogs

pizza• Onions on sandwiches• Grilled sweet onions on fajitas• Grilled sweet onions as a base for

any sauce

4. Herbs and Spices.

Rosemary (Rosmarinus officinalis)

•Leaves are used as a spice •Contains antioxidants• Used commercially as a antioxidant•Prevents oxidation in vegetable oil•Potency comparable to BHT & BHA

Percent of Mice With Tumors

0%

100%

Weeks 5 10 15

control

1.2 mg rosemary

3.6 mg rosemary

Turmeric:• Used as a yellow food coloring and spice.• A principal ingredient in curry

powder(28%).• Contains three major curcuminoids, which

are responsible for the yellow color of the herb.

• Curcumin (diferuloylmethane) is the most significant curcuminoid.

Effect of Turmeric on Lung Cancer in Mice. Percentage that Developed Cancer

0 10 20 30 40 50 60 70 80 90 100

Placebo

Taxol

Curcumin

Curcumin & Taxol

Percentage Mice that Developed Cancer

Turmeric Meta-analysis

Conclusions:Average dose 500mg/d.Mixed results for turmeric’s anti-inflammatory activity. More studies need to be done.

Di Lorenzo, C, et al, 2013

5. Eat the right portion

- Portion size me- Visual cues, Soup study- Proximity of food, candy study

Portion Size Me Documentaries

CBS Morning Show –Portion Size Me

Soup Study

0

50

100

150

200

250

300

Normal Soup Bowl Refilling Soup Bowl

Estimated Calories Consumed Actual Calories Consumed

Wansink, B., Painter, JE., North, J. 2005. Bottomless Bowls: Why Visual Cues of Portion Size May Influence Intake. Obesity Research, 13,1, 93-100.

Refillable Soup Bowls Increase Consumption, But Not Perception of Consumption

Visibility Intervention Closed candy container containing 30 Hershey kisses replenished daily

Three conditions:•on top of the desk (visible & convenient)• in a desk drawer (not visible & convenient)•away from desk (inconvenient)

02468

10

On Desk In Desk 2 Meters fromDesk

# of Candies Consumed

Amount of Candy Consumption According to Condition

Painter, J., Wansink, B., Hieggelki, J. (2002). How Visibility and Convenience Influence Candy Consumption. Appetite 38, 237-238.

Conclusion

- Don’t eat the Standard American Diet (SAD)

- Eat less added sugar

- Eat more green leafy vegetables

- Eat more cruciferous and allium vegetables

- Eat more herbs and spices

- Eat the right portion

Thank You!

@DrJimPainter jimpainterphd@gmail.com

WEBINAR HOST:Keith Hine MS, RDSr. Director of Healthcare & SportsOrgainkeith.hine@orgain.com

GENERAL INQUIRIES OR TO REQUEST SAMPLES:medinfo@orgain.com

WEBINAR PRESENTER:Dr. Jim Painter, PhD, RDN Adjunct Professor University of Texas, School of Public jimpainterphd@gmail.com