Top 10 Flat Belly Foods

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Your abs are made in the gym and revealed in the kitchen. A good training program develops the muscles in your midsection and the right diet helps banish bloating so you can see your abs. Here are the 10 flat belly foods you should add to your diet for a better looking (and better feeling) mid-section):Greek yogurt for belly fat

Greek Yogurt with Live and Active Cultures

Look for Greek yogurt with “live cultures (aka good bacteria)” or the “Live & Active Cultures” seal. The cultures are good bacteria that take up valuable real estate in your gut, helping your body digest food and decreasing gas and bloating. The amount of healthy, versus harmful, bacteria influences body weight and how much weight you can lose while following a lower calorie diet. Plus, a study published in the International Journal of Obesity found people who get their calcium from yogurt, as opposed to other foods, may lose more weight in their belly. Even more evidence to support yogurt consumption comes from a study showing dieters who ate five servings of dairy, such as Greek yogurt, daily lost more weight and abdominal fat than those who ate just three servings every day. A more recent review of the research found higher dairy intake was associated with lower risk of obesity in the midsection and yogurt seems to help keep weight in check.

2 Nuts

Though nuts are relatively high in calories for a small amount of food,  people don’t gain weight when they add nuts to their previously nut-free diet. A study in over 13,000 adults revealed nut eaters, those who ate at least ¼ ounce of nuts or peanuts (technically a legume) per day had smaller waists than adults who didn’t eat nuts. Additionally, tree nuts and peanuts contain a considerable amount of monounsaturated fat. Dieters who eat more foods containing monounsaturated fats may lose more belly fat than those who eat the same number of calories per day with less monounsaturated fat.

3 Asparagus

When examining dietary patterns, weight and waist circumference in close to eighty thousand people over a 10-year period, researchers found those who ate more vegetables every day had both a lower BMI and smaller waistline compared to adults who ate few vegetables. Asparagus contains prebiotic fiber, a type of fiber that is food for the good bacteria in your gut. Plus, asparagus is a natural mild diuretic making it the perfect food before hitting the beach or wearing a more formfitting outfit.

4 Avocados

Avocados contain a good amount of monounsaturated fat, not to mention nineteen vitamins and minerals. But, their monounsaturated fat is the ticket to a smaller waistline. In one study scientists gave obese adults with type 2 diabetes diets rich in saturated fat, monounsaturated fat or  carbohydrates. Those on the high carbohydrate diet ended up with fat redistributed to their stomachs while the monounsaturated fat rich diet prevented fat redistribution to the belly area. Plus, a look at dietary intake data from close to 18,000 adults found body weight, BMI and waist size were all significantly lower in avocado consumers versus those who didn’t include avocados in their diet.

5 Popcorn

Popcorn is a whole grain and when you pop it yourself on the stovetop (or in a brown paper bag in the microwave, just add good old fashioned popcorn kernels in a brown paper bag and fold the top) and top it with a little spray butter or spices for flavor, you’ll end up with a snack that takes a long time to eat and fills you up on relatively few calories. In addition, several studies show people who eat about three servings of whole grains per day weight less and have a smaller waistline compared to those who don’t.

6 Cold Pea Salad

Peas are naturally rich in resistant starch, a type of fiber that isn’t completely broken down or absorbed during digestion. Cooking and cooling peas to make a pea salad will significantly increase the amount of resistant starch they content. Rodent studies show resistant starch helps reduce stomach fat and increase hormones that tell the brain it’s time to stop eating.

7 Eggs

Choose eggs over cereal in the morning and you’ll tame hunger pangs for hours after breakfast, decreasing the likelihood of overeating later in the day. Make a meal containing at least 25 – 30 total grams of protein (the protein is in the white of the egg so this equates to 4 – 5 egg whites though you can choose any combination of whole eggs and egg whites as long as you consume at least 4 -5 of the whites) so you can cash in on the satiety-enhancing benefits of eggs. Added bonus: following a high protein diet for a short period of time can lead to significant reductions in belly fat.

8 Green Tea

The combination of caffeine and antioxidants in green tea may lead to small to moderate reductions in body fat and waist size. However, you need to consume quite a bit of it so get creative and cook with green tea by brewing it and using it to cook rice (it’s particularly good with jasmine rice), make stews, soups or stocks. You can also poach fruit green tea or use dried green tea leaves as part of a rub for meats, tofu or fish.

9 Barley

Barley is a cereal grain with a nutty taste and consistency that is a cross between pasta and rice. In a double-blinded trial (both the men and the researchers didn’t know which food they were getting), Japanese men were given rice or a mixture of rice with pearl barley. The group receiving the pearl barley and rice mixture lost a significant amount of visceral fat, the kind that covers your organs like a thick winter blanket and increases risk of heart disease, stroke and type-2 diabetes. Compared to the rice only group, the group who ate pearl barley decreased their waist size.

10 Blueberries

Blueberries are an excellent source of dietary fiber, which will not only help keep you full but also help keep your waistline in check. Plus they are a natural source of prebiotic fiber – the kind that the good bacteria in your gut munch on.

A flat belly is one of the most recognized signs of a fit body. Blast away abdominal fat with high-intensity cardio and build the underlying muscle by regularly switching up your training program. Also, incorporate a 30-minute abs classes to your routine. At least one study found you can spot reduce if you exercise the same muscle group for at least 30 minutes at a time. Keep in mind abs are made in the gym but revealed in the kitchen. Add the top 10 flat belly foods to your diet while cutting down on sugar alcohols (sorbitol, maltitol, and mannitol are the worst for causing gas and bloating), fizzy drinks and chewing gum (all of these can increase bloating at least temporarily) and you may fall in love with skinny jeans.

 

References
Clifton PM, Bastiaans K, Keogh JB. High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol. Nutr Metab Cardiovasc Dis 2009;19(8):548-54.

O’Neil CE1, Keast DR, Nicklas TA, Fulgoni VL 3rd. Nut consumption is associated with decreased health risk factors for cardiovascular disease and metabolic syndrome in U.S. adults: NHANES 1999-2004. J Am Coll Nutr 2011;30(6):502-10.

Kahn HS, Tatham LM, Rodriguez C, et al. Stable behaviors associated with adults’ 10-year change in the body mass index and likelihood of gain at waist. Am J Public Health 1997;87:747-54.

Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 2013;341:6150.

Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 2006;444:1027-1031.

Vidrine K, Ye J, Martin RJ, McCutcheon KL et al. Resistant starch from high amylose maize (HAM-RS2) and dietary butyrate reduce abdominal fat by a different apparent mechanism. Obesity (Silver Spring) 2014;22(2):344-8.

Bisanz JE, Reid G. Unraveling how probiotic yogurt works. Sci Transl Med 2011;3:106.

Dhurandhar NV, Geurts L, Atkinson RL et al. Harnessing the beneficial properties of adipogenic microbes for improving human health. Obesity Reviews 2013;19:721-735.

Delzenne NM, Neyrinck AM, Bäckhed F, Cani PD. Targeting gut microbiota in obesity: effects of prebiotics and probiotics. Nat Rev Endocrinol 2011;7(11):639-46.

Furet JP, Kong LC, Tap J et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes 2010;59:3049-3057.

Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444: 1022–1023.

Santacruz A, Marcos A, Warnberg J et al. Interplay Between Weight Loss and Gut Microbiota Composition in Overweight Adolescents. Obesity 2009;17:1906–1915.

Harland JI, Garton LE. Whole-grain intake as a marker of healthy body weight and adiposity. Public Health Nutr 2008;11(6):554-63.

Yadav BS, Sharma A, Yadav RB. Studies on effect of multiple heating/cooling cycles on the resistant starch formation in cereals, legumes and tubers. Int J Food Sci Nutr 2009;60 Suppl 4:258-72.

Keenan MJ, Zhou J, McCutcheon KL et al. Effects of resistant starch, a non-digestible fermentable fiber, on reducing body fat. Obesity (Silver Spring) 2006;14(9):1523-34.

Nagao T, Komine Y, Soga S et al. Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr 2005;81(1):122-9.

Paniagua JA, Gallego de la Sacristana A, Romero I et al. Monounsaturated fat-rich diet prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects. Diabetes Care 2007;30(7):1717-23.

Fulgoni VL 3rd, Dreher M, Davenport AJ. Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Nutr J 2013;12:1.

Shimizu C, Kihara M, Aoe S et al. Effect of high beta-glucan barley on serum cholesterol concentrations and visceral fat area in Japanese men–a randomized, double-blinded, placebo-controlled trial. Plant Foods Hum Nutr 2008;63(1):21-5.

Du H, van der A DL, Boshuizen HC et al. Dietary fiber and subsequent changes in body weight and waist circumference in European men and women. Am J Clin Nutr 2010;91(2):329-36.

Peters EM, Anderson R, Nieman DC, et al. Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running. Int J Sports Med 2001;22(7):537-43.

 

Focusing on Fewer Ingredients in Food is Pointless

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Zoning in on the number of ingredients in packaged foods is one of the stupidest consumer driven trends to date. Fueled by the unsubstantiated fear of anything not immediately recognizable or easy to pronounce, companies are turning to “fewer ingredients” to make their food stand out on over-crowded store shelves. Short, recognizable ingredient lists are leading packaged food trends in 2016 yet the number of ingredients or your ability to pronounce an ingredient has absolutely nothing to do with the nutrition value of the food and therefore shouldn’t guide your buying decisions.

The # of Ingredients Has Nothing to do with Nutrition Value

Shorter ingredient lists do not mean a food or beverage is better for you. Companies that make chips, ice cream and other dessert items are among the fiercest competitors for simplifying ingredient lists. According to an article in the Huffington Post, Hershey Co. improved their classic chocolate syrup by cutting the list to 5 simple ingredients. The new version took food scientists a year and a half to make with recognizable ingredients. The challenge? Making a syrup that also tastes good. The new version with cane sugar and organic invert cane syrup instead of high fructose corn syrup will cost you 1 more gram of sugar than the original version. How does this make it nutritionally superior to the old version?

Here’s another example. Let’s say you are in the grocery store debating between protein choices for dinner. Do you pick up the omega-3 and protein-packed (23 grams for 190 calories) salmon or beef franks (15 grams protein for 190 calories and 3x the saturated fat). I hope you choose the salmon if you are choosing based on nutrition value.

Simple Ingredients

I found many similar examples in the grocery store including potato chips with just a few ingredients compared to whole grain, higher fiber crackers with three times the ingredients and Häagen-Dazs ice cream with five ingredients, 250 calories and almost 5 grams of sugar per ½ cup compared to Giant brand ice cream with more than twice the number of ingredients, 160 calories and less than 3 grams of sugar per ½ cup. If you are choosing your dessert not based on taste but instead based on the nutritionally superior option (because that’s why people are focusing on the total number of ingredients right?), you’ll pick up the Giant brand with more ingredients.

Just Because You Don’t Recognize it and Can’t Pronounce it Doesn’t Mean it is Bad

Head over to Cooking Light or any other well-recognized cooking magazine and I’m willing to bet you’ll find ingredients that you don’t recognize and can’t pronounce. I live in the world of food, nutrition and supplements and restaurant menus often stump me while the sheer number of unfamiliar spices in Penzeys Spices satisfies my creative desire for something new and unique. Just because an ingredient is unfamiliar to you does not automatically make it bad. After all you’re probably not a food scientist entrenched in the world of food development and food safety.

Some misunderstood ingredients are emulsifiers – they help ingredients stay together in a mixture vs. separating (for example, salad dressings often contain emulsifiers including lecithin), others add nutrition value, help products retain their color, prolong shelf life or keep the product safe. Pyridoxine hydrochloride sounds scary right? It’s a vitamin B6. Cyanocobalamin? That’s vitamin B12. Beta-glucan? Oat and barley beta-glucan are soluble fibers sometimes added to food to increase the fiber content. They also help you feel more full (satiated) and are fantastic for your immune system. Lupin kernel fiber – lupin is a legume. In other words, it’s good for you. All substances allowed in food in the U.S. are GRAS – Generally Recognized as Safe by the Food and Drug Administration.

Even though manufacturers are scurrying to chop down their ingredient lists to meet this silly consumer demand, focusing on the number of ingredients in a food isn’t worth your time or attention span. If you don’t order food in a restaurant based on the number of ingredients used in the recipe why would you choose foods in the grocery store based on the total number of ingredients? In addition, don’t be scared of any ingredient with a sprinkling of scientific reasoning behind its use.

 

 

 

 

 

 

 

3 Major Myths About Organic & Conventional Food

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organic blueberries, raspberries and blackberries

 

There is very little that distinguishes organic food from conventional food. In an attempt to follow the pervasive “good food vs. bad food” storyline, many people have grossly exaggerated the differences between organic and conventional foods leaving readers with few facts grounded in scientific evidence. Don’t let the top three misperceptions about organic and conventional food influence your food choices.

This post covers:

  • Pesticide residues on food and human safety
  • Organic foods, conventional foods and the environment
  • Nutrition differences between organic and conventional foods

This post does not cover worker safety or in-depth environmental issues.

#1 Myth: Organic Foods are Grown Without Pesticides

Both organic and conventional crops are sprayed with pesticides, compounds that control a variety of pests (1, 2). In fact there is a long list of substances, including pesticides, allowed for use on organic farms. The differentiating factor between organic and conventional farming is the source of pesticides. Organic farmers primarily use naturally occurring pesticides in addition to a small number of man-made pesticides while conventional farmers primarily use man-made pesticides.

In some instances there is a man-made form of a compound identical to the one found in nature. For instance, methyl bromide, a fumigant gas used to kill fungi, nematodes and weeds, is found in nature and also made in a lab. Both conventional and organic farmers can use methyl bromide on strawberry plants. Bacillus thuringienis, the most commonly used organic pesticide, is both naturally occurring and man-made; incorporated into some genetically engineered foods. One is natural, one is man-made yet there is no detectable difference between the two (3).

#2 Myth: Organic Foods are Safer for Human Consumption and Better for the Environment

Compounds found in nature are not automatically safe and non-toxic, or safer than man-made compounds (4, 5). Both naturally occurring compounds and man-made chemicals are completely harmless, extremely toxic at a certain dose, or fall somewhere in between these two extremes. You’ve probably heard the saying “the dose makes the poison.” Many compounds we consume every day, from vitamin A to water, can be lethal if consumed in extremely high doses. The same is true for pesticides. Dose and length of exposure determine toxicity. Our government has several safeguards in place for the use of pesticides. First, the EPA evaluates all pesticides. Prior to use in the United States pesticides must be free from unreasonable risk to human health or the environment. Regardless of the type of pesticide used, whether organic or man-made, the Environmental Protection Agency limits the amount of pesticide residues allowed in food and water. The USDA Pesticide Data Program routinely monitors pesticide residues in foods and has found pesticide residues, whether organic or conventional, “pose no safety concern” (8, 9).

Organic pesticides are also not necessarily better for the environment, though they are considered safe in the amounts used (just like man-made pesticides). As an example, rotenone, a naturally occurring compound used in fisheries and can be fatal if inhaled (staff spraying this pesticide must be protected from risk of inhalation) and kills fish within an hour of spraying. Waters treated with rotenone are closed for public swimming for several months after treatment allowing dead fish time to decompose. When used according to instructions, rotenone poses “no overall risk to human health” or the environment (6). In addition, a study in soybeans found organic pesticides did not control aphids (plant lice) as effectively as man-made pesticides and they were more detrimental to the environment (partly due to the amount that needed to be used) (7).

There are environmental effects, both good and bad, from conventional and organic farming. Organic farming has advanced nonchemical methods of pest control and in some instances improved soil quality while decreasing soil erosion. However, organic farming also produces a lower yield, which means more environmental resources are used to produce the same total amount of food.

Can’t we farm without any pesticides?

Sure. Some conventional and organic farms do not use pesticides. A conventional farm may choose not to get organic certification, even if they don’t use any pesticides, because of the cost of certification. Keep in mind pesticides help get rid of pests and, can therefore help make food safer by the decreasing the likelihood of pathogens such as E. coli through use of anti-microbial compounds (10, 11).

What about the “Dirty Dozen”, Should I Steer Clear of the Foods that have the Most Pesticide Residues?

Some groups rank foods based on total pesticide residues – foods that are the “most contaminated.” Though some foods may have more pesticide residues on them than others, a study from the University of California Davis found all 12 commodities identified in the Dirty Dozen contained pesticide residues well below the established safe level (called the chronic reference doses or RfDs for short). In fact, only one pesticide residue, found on bell peppers, exceeded 1% of the RfD, coming in at 2%. So the largest total “dose” of a pesticide residue found was still 50 times lower than the established safe dose. Three quarters of the pesticides detected were at levels 1,000 times below the RfD. Therefore, the 12 foods listed on the Dirty Dozen “most contaminated” foods pose “negligible risks” for consumers. Choosing organic over conventional to avoid the fruits and vegetables on the Dirty Dozen will not completely negate your exposure to pesticides (because some organic produce has pesticide residues as well) or lower your risk from exposure to pesticides because your risk is negligible to begin with (12). Given the low amount of pesticide residues found on conventional and organic produce, there’s little appreciable difference in total pesticide exposure, whether you eat conventional or organic.

Though some studies, as well as pesticide monitoring programs have found conventional produce contains significantly more total pesticide residues then organic produce, significantly more than a miniscule amount is still a miniscule amount. Here’s an analogy: if I give you one penny and give your friend 2 pennies, your friend has 100% more money than you do – that’s a statistically significant difference. However, the financial impact of two pennies vs. one penny is meaningless.

If you want to add up your total exposure, check out the Alliance for Food and Farming developed a pesticide calculator and research behind the calculator:

http://safefruitsandveggies.com/pesticide-calculator

#3 Myth: Organic Food is More Nutritious

Several studies have examined nutrient differences between organic and conventionally produced foods. Most of this research shows no appreciable difference in vitamin or mineral content or health effects. What about plant compounds including antioxidants? In some cases organic farming may improve antioxidant content while in others man-made pesticides actually increase concentrations of certain beneficial plant-based compounds (13, 14).

In a world where we have many food choices and an overabundance of incorrect nutrition information, it’s easy to grasp onto a concept that isn’t evidence-based. Don’t get caught up in the hype and instead look for the scientific details. When it comes to organic and conventional foods, you’re not stuck choosing sides but instead can enjoy both – there is no appreciable difference in pesticide residues or nutrition content between the two.

Disclosure: I am an advisor for USFRA. All opinions expressed are my own after taking my typical nosedive into the scientific literature and government regulations on this subject.

References

1 Types of pesticide ingredients. US Environmental Protection Agency.
https://www.epa.gov/ingredients-used-pesticide-products/types-pesticide-ingredients

2 Food and Pesticides. US Environmental Protection Agency
https://www.epa.gov/safepestcontrol/food-and-pesticides

3 Koch MS, Ward JM, Levine SL, Baum JA, Vicini JL, Hammond BG. The food and environmental safety of Bt crops. Front Plant Sci 2015; 6: 283.

4 Pesticides – What’s my risk? National Pesticide Information Center.

5 Contaminants Found in Groundwater. The USGS Water Science School. http://water.usgs.gov/edu/groundwater-contaminants.html

6 Lake and stream rehabilitation: rotenone use and health risks. Washington department of fish and wildlife. http://wdfw.wa.gov/licensing/sepa/2016/16041_2002_fseis.pdf

7 Bahlai CA, Xue Y, McCreary CM, Schaafsma AW, Hallett RH. Choosing Organic Pesticides over Synthetic Pesticides May Not Effectively Mitigate Environmental Risk in Soybeans. PLoS One 2010; 5(6): e11250.

8 What Consumers Should Know. 2014 Pesticide Data Program Annual Summary. United States Department of Agriculture. https://www.ams.usda.gov/sites/default/files/media/PDP%202014%20Annual%20Summary%20Consumers.pdf

9 Pesticide Program Residue Monitoring. US. Food and Drug Administration. http://www.fda.gov/Food/FoodborneIllnessContaminants/Pesticides/ucm2006797.htm

10 Mukheriee A, Speh D, Dyck E, Diez-Gonzalez F. Preharvest evaluation of coliforms, Escherichia coli, Salmonella, and Escherichia coli O157:H7 in organic and conventional produce grown by Minnesota farmers. J Food Prot 2004;67(5):894-900.

11 Johannessen GS, Bengtsson GB, Heier BT, Bredholt S, Wasteson Y, Rørvik LM. Potential uptake of Escherichia coli O157:H7 from organic manure into crisphead lettuce. Appl Environ Microbiol 2005;71(5):2221-5.

12 Winter CK, Katz JM. Dietary Exposure to Pesticide Residues from Commodities Alleged to Contain the Highest Contamination Levels. J Toxicol 2011; 589674.

13 Dangour AD, Lock K, Hayter A, Aikenhead A, Allen E, Uauy R. Nutrition-related health effects of organic foods: a systematic review. Am J Clin Nutr 2010; 92(1):203-210.

14 Rosen J. A Review of the Nutrition Claims Made by Proponents of Organic Food, Comprehensive Reviews in Food Science and Food Safety 2010;9(3): 270-277.

Ketogenic Diets: Fat-Filled Lies Won’t Make You Slim (or a Better Athlete)

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How do you turn your body into a fat burning machine, run faster than Usain Bolt, recover from exercise immediately and wake up each day bursting with energy? According to some people, the ketogenic diet is your answer (learn the basics of this diet here). This high-fat, moderate protein diet that is practically void of carbohydrates forces your body to use fat for energy. LeBron James supposedly tried it and offensive lineman decided to give it a shot after an ex-NFL center and O-line coach LeCharles Bentley recommended it. However, the offensive lineman and LeBron weren’t actually following a ketogenic diet. Though these athletes didn’t really know what they were following (no worries LeCharles, I’m sure your nutrition advice is on par with me coaching the O-line), people who actually follow it swear by it. Could this be an unconventional path to weight loss and better health? Unfortunately, the ketogenic diet craze has been fattened with misinformation.

Here is what I am covering in this post:

  • Eat Fat, Lose Fat? Does the ketogenic diet make you lose weight?
  • How does this diet impact muscle?
  • The ketogenic diet and athletic performance.
  • The issue with ketogenic research studies.

I am not covering “training low” or low carbohydrate  / non-ketogenic diets in this article.

Eat Fat, Lose Fat?

During the first several days on a ketogenic diet your weight will take a nosedive. Carbohydrate is stored in the form of glycogen in liver and muscle. Each gram of carbohydrate is stored with 3 – 4 grams of water. Decrease your carbohydrate intake, use glycogen and you’ll lose water weight very quickly. Weight loss, even if from water, can motivate people driven by the number on the scale. Given that adherence is the number one predictor of weight loss when on a diet, we can’t discount psychological effect of the number on the scale going down.

What happens if you stay on the diet? A group of NIH researchers admitted seventeen overweight or obese men to a metabolic ward and placed them on a high carbohydrate baseline diet for four weeks followed by four weeks on an isocaloric ketogenic diet (this diet contained the same amount of calories as the high carbohydrate baseline diet). The men lost weight and body fat on both diets. The ketogenic diet did not lead to greater fat loss as compared to the high carbohydrate diet and in fact body fat loss slowed during the ketogenic diet and subjects lost muscle (1). Time to chuck the “carbohydrates make you fat” books in the recycling bin.

What about other studies showing ketogenic diets help athletes lose body fat and maintain performance? These studies were not actually using a ketogenic diet protocol but instead were high fat, high protein, low carbohydrate diets. Also, none of the studies measured if the study subjects were actually in nutritional ketosis (2, 3, 4).  See the section on The Issue with Ketogenic Research Studies for more information on this topic.

Ketogenic diet and weight

Regardless of the studies indicating the ketogenic diet will not lead to greater weight loss and could result in a decrease in muscle mass, I know I would lose weight on it only because I’d get sick of eating. If faced with eating a fatty steak with melted butter on top for dinner followed by spoonfuls of oil for dessert, I’d rather not eat.

Muscle Up with the Ketogenic Diet?

The ketogenic diet isn’t high enough in protein for maximal muscle gains. Using the lower end of fat intake on a classic ketogenic diet (80% of calories), one could consume 15% of calories from protein (112 grams) on a 3,000-calorie diet. Protein requirements are at least 1.2 – 1.8 grams of protein per kilogram bodyweight (or 0.55 – 0.82 grams per lb. bodyweight) per day if training and eating a diet with enough calories to maintain weight. Protein needs go up if you are cutting calories to spare the breakdown of muscle tissue when dieting. On this diet, 112 grams of protein equals just under 1.3 grams of protein per kg bodyweight for a 200 lb. person and even less for anyone who weighs more.

In addition to inadequate protein intake, “the ketogenic diet reduces many of the signaling molecules involved in muscle hypertrophy (growth),” states Dr. Antonio Paoli, M.D., B.Sc., Associate Professor and Vice Dean of the School of Human Movement Sciences, University of Padova. Without getting too technical, even with sufficient calorie intake, the ketogenic diet suppresses the IGF-1 / AKT / mTOR pathway (5). Using ketones for energy slows muscle breakdown. However it doesn’t stop this process (5).

The Ketogenic Diet and Athletic Performance

Once fully adapted to a ketogenic diet, athletes can supposedly rely on a seemingly endless supply of body fat for energy. No need for carbohydrate gels, beans, gummies and sports drinks every 15-30 minutes during long runs, rides or triathlons to sustain energy levels. Fewer calories consumed may make it easier for some people to stay within their total daily calorie needs (though if you are training that much staying within your calorie requirements shouldn’t be difficult).

Trading carbs for fat seems like a huge benefit for athletes, particularly endurance athletes who train and compete for several hours at a time (6). In addition to utilizing body fat, fat actually produces more energy (ATP) (5). However, fat is a slow source of fuel (see graphic below), the human body cannot access it quickly enough to sustain high-intensity exercise and therefore, this diet is really only (potentially) applicable to ultra-runners and triathletes competing at a relatively moderate to slow pace.

In a ketogenic diet study examining athletic endurance, researchers had subjects cycle at a snails pace (equivalent to a heart rate of about 120 beats per minute for anyone 20-30 years old or 115 for a 40 year old) until they became exhausted before and after 4-weeks on a ketogenic diet. There were no differences in the amount of time they were able to cycle before getting tired prior to or after the four-week ketogenic diet (7). In studies examining high fat diets (not ketogenic and ketones weren’t measured) and endurance performance, study subjects relied on more fat as opposed to carbohydrate during low intensity exercise, yet there was no clear performance advantage on the higher fat diet (8). A recently published study examined 20 elite ultra-marathoners and Ironman distance triathletes. Some were habitually consuming a traditional high carbohydrate diet while the other group was following a ketogenic diet (slightly adjusted macronutrient ratios yet they were in ketosis as measured by blood ketone levels). As expected, those following a higher fat diet used a greater percentage of fat for energy while the higher carbohydrate diet group used more carbohydrate for energy during a 180 minute submaximal running test (I’d call that leisure running intensity). There was no difference in calories burned over the course of the run. Both groups had the same level of perceived exertion and there was no test to determine performance differences between groups (9).

If there’s no performance benefit and we know carbohydrates work, why follow this diet? If your primary goal is weight loss, it doesn’t matter if you use more fat than carbohydrate while exercising (SN: can we please stop talking about the fat burning zone) as long as you’re burning more total calories over the course of the day. Plus, in the interest of (if you are not an ultra endurance athlete) jack up the intensity and burn as many calories in a short period of time as possible. Unfortunately, a ketogenic diet won’t help you do that – when relying on fat for fuel, the intensity of your exercise will drop – the body simply can’t access fat (a slow source of energy) quickly enough to sustain high-intensity exercise. Instead, carbohydrates are necessary for high intensity activity.
ketogenic diet and sports

The Issue with Ketogenic Research Studies

Here’s the issue with many ketogenic research studies and media reports based on them: in most cases, the study subjects were not actually following a ketogenic diet – they were following a higher fat, high-protein low carbohydrate diet (10, 11, 12). Each person’s carbohydrate and protein limits needed to stay in ketosis vary and therefore, measuring ketones through blood or urine is the only definitive way to determine if you are in ketosis. Complicating matters more, low carbohydrate diets (including ketogenic diets) lead to a substantial drop in carbohydrate content, and associated water stored with it, in muscle. This change overestimates the drop in lean body mass as measured by DEXA.

ketogenic and low carbohydrate diets

There are no modifications, higher protein intakes or “on again, off again” (where you go on it one day and off it the next) to this diet. You must be in a state of nutritional ketosis or you will need to decrease carbohydrate and protein intake even further to get into nutritional ketosis and rely on ketones for energy.

Is There Any Benefit?

Ketogenic diets help decrease incidence and severity of seizures in epileptic patients (this is what the diet is intended for). Also, ketogenic diets may be beneficial when implemented soon after a traumatic brain injury (including concussion) (13). In addition, scientists are examining if this diet is beneficial for diseases that affect the brain such as Alzheimer’s.

If you want to lose weight, the ketogenic diet is not superior to a reduced calorie diet. Also, unless you are an ultra endurance athlete who just loves dietary fat, hates eating at social occasions and can put up with the potential side effects from this diet it isn’t for you.
Now where is the O-line? I’ve got some coaching to do…

References

1 Hall KD, Chen KY, Guo J, Lam YY, Leibel RL, Mayer LE, Reitman ML, Rosenbaum M, Smith SR, Walsh BT, Ravussin E. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr. 2016 Jul 6. [Epub ahead of print]

2 Zajac A, Poprzecki S, Maszczyk A, Czuba M, Michalczyk M, Zydek G. The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists. Nutrients 2014;6(7):2493-508.

3 Rhyu HS, Cho SY. The effect of weight loss by ketogenic diet on the body composition, performance-related physical fitness factors and cytokines of Taekwondo athletes. J Exerc Rehabil 2014;10(5):326-31.

4 Paoli A, Grimaldi K, D’Agostino D et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. JISSN 2012;9:34.

5 Paoli A, Bianco A, Grimaldi KA. The ketogenic diet and sport: a possible marriage? Ex Sports Sci Reviews 2015.

6 Volek J, Noakes T, Phinney SD. Rethinking fat as a fuel for endurance exercise. Eur J Sport Sci 2014;2:1-8.

7 Phinney SD, Bistrian BR, Evans WJ, Gervino E, Blackburn GL. The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism 1983;32(8):769-76.

8 Burke LM, Kiens B. “Fat adaptation” for athletic performance: the nail in the coffin? J Appl Physiol 2006;100(1):7-8.

9 Volek J, Freidenreich DJ, Saenz C, Kunces LJ, Creighton BC, Bartley JM, Davitt pm, Munoz CX, Anderson JM, Maresh CM, Lee EC, Schuenke MD, Aerni G, Kraemer WJ, Phinney SD. Metabolic characteristics of keto-adapted ultra-endurance runners. Metab Clin Exp 2016;65(3):100-110.

10 Tinsley GM, Willoughby DS. Fat-Free mass changes during ketogenic diets and the potential role of resistance training. Int J Sport Nutr Exerc Metab. 2015 Aug 12. [Epub ahead of print]2 Rouillier MA, Riel D, Brazeau AS, St. Pierre DH, Karelis AD. Effect of an Acute High Carbohydrate Diet on Body Composition Using DXA in Young Men. Ann Nutr Metab 2015;66:233-236

11  Paoli A. The ketogenic diet and sport: a possible marriage? Ex Sci Sports Sciences Rev 2015;43(3):153-62.

12  Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am Society Clin Nutr 2008;87(1):44-55.

13 Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel (2011). The National Academies Press, Institute of Medicine. Washington DC. 2011 http://www.nap.edu/read/13121/chapter/15

 

The Ketogenic Diet Craze: Fat-Filled Lies, Part 1

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ketogenic diPicture this: a thick, juicy, tender eventeak grilled to perfection with melted butter glazed on top, gently dripping down the sides. Lying next to the steak there’s a side of dark green asparagus sautéed in coconut oil and dusted with a sprinkle of sea salt. Could a diet loaded with fat help you lose diet-resistant body fat that’s been taunting the seams of your dress pants and poking through buttons on your shirt? Will eating fat turn you into an all-star athlete? This is part 1 of a 2 part series on the ketogenic diet.

Here is what I will cover in this blog post:

  • What is the ketogenic diet?
  • Adverse health effects.

Here is what I will cover in tomorrow’s blog on this topic:

  • The issue with ketogenic research studies.
  • Is the ketogenic diet superior for losing fat?
  • How will the ketogenic diet affect muscle?
  • How will the ketogenic diet impact athletic performance?

What is the Ketogenic Diet?

For nearly a century, epileptic patients have used ketogenic diets to control seizures when common medications provide no relief. Scientists aren’t sure why following a ketogenic diet decreases the incidence and severity of seizures but it works.

The ketogenic diet contains – 80-90% of calories from fat, 15% from protein and 5% from carbohydrate (1, 2). Food choices may include heavy cream, bacon, eggs, non-starchy vegetables, mayonnaise and sausage while fruits, starchy vegetables, breads, pasta, cereal and other carbohydrate-rich foods are not allowed.

During the first several days on a ketogenic diet, your body’s limited supply of carbohydrate stored in liver and muscle tissue decreases dramatically. As a result, you will feel like you have mono – exhausted, with headaches and easy exercise will feel like you’re climbing Mount Everest (3). Once your stored carbohydrate has dwindled, ketones, formed from the breakdown of dietary fat, become the primary source of energy for brain and body. Ketogenic means “ketone forming.” It takes at least seven days to reach nutritional ketosis and several weeks to fully adapt to the diet (12). If you aren’t in nutritional ketosis (as measured by blood, urine or breath ketones; ketone levels > 0.5 mmol/L), then you aren’t following a ketogenic diet, you are on a low carbohydrate diet.

Adverse Health Effects from the Ketogenic Diet

Much of the research on adverse effects comes from studies in epileptic children since they have been on the diet for long periods of time. These studies show soon after starting a ketogenic diet, blood cholesterol levels and artery stiffness increase (4, 5). High total and LDL cholesterol are risk factors for cardiovascular disease (diseases of the heart and blood vessels). When arteries are stiff, they cannot expand as well in response to changes in blood pressure. Think of this like a garden hose when you turn up the water pressure, your hose either expands or the water bursts out of the space between the faucet and the hose. When arteries cannot open widely to accommodate increases in blood flow, blood pressure increases leading to microscopic tears on artery walls, development of scar tissue and the perfect surface for plaque buildup (6). Blood cholesterol levels returned to normal in patients who went off the diet and in those who stayed on it, they returned to normal after 6 to 12 months. Artery stiffness returned to normal after 24 months on a ketogenic diet.5 Studies in obese patients suggest ketogenic diets improve blood sugar and blood cholesterol levels over time, either due to the diet, weight loss from the diet, a combination of the two or carbohydrate restriction (7, 8). Lose weight, regardless of what you eat and blood cholesterol, blood pressure, inflammation, blood sugar and many other disease risk factors will improve.

Ketogenic diets are typically low in calcium, vitamin D, potassium, magnesium, folic acid and fiber. There are several potential consequences associated with consistently low intake of each of these micronutrients including softening of the bones, decreased bone density, muscle damage, muscle weakness or spasms, and abnormal heart rhythm. However, with careful planning, a fiber supplement, multivitamin and under the guidance of a physician who may prescribe potassium and sodium supplements (blood sodium could drop to dangerously low levels while on this diet), nutrient needs can be met. Also, to prevent constipation when on a ketogenic diet, a fiber supplement may be necessary along with more water / fluid intake then you are used to.

Here are some other potentially bad side effects from following a high fat diet:

  • Harm to your Brain. Studies in mice show a high fat diet, even when followed for as little as two months leads to chronic inflammation, sedentary immune cells in the brain – these cells typically act like janitors picking up trash and infectious compounds but when they become sedentary they stop doing their job, leading to cognitive impairment (9).
  • Mad Bacteria in Your Gut. A diet with no probiotics (healthy bacteria) and low in prebiotics (certain types of fiber that the healthy bacteria much on for food keeping them happy) will likely change the composition of bacteria in your gut so you have more harmful and less beneficial bacteria.
  • Leaky Gut. High saturated fat meals increase bacterial toxins (endotoxins) in the intestines and intestinal permeability. In other words: leaky gut (10, 11).
  • Free radicals in overdrive? If you can’t eat a number of colorful foods including blueberries, beets, corn, oranges, and more, chances are you won’t get a wide array of antioxidant compounds to quench free radicals (compounds that are important for good health but can wreck your body when they aren’t tamed by antioxidants) as well as other plant-based compounds that keep your arteries, muscles and other parts of your body healthy.

Are the side effects and potential negative side effects worth it if you can lose weight on this diet? Stay tuned for tomorrow’s post on how the ketogenic diet impacts body fat and athletic performance.

References

1 Freeman JM, Freeman JB, Kelly MT. The ketogenic diet: a treatment for epilepsy. 3rd ed. New York, NY: Demos Health; 2000.

2 Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases. BioMed Research International 2014, Article ID 474296, 10 pages, 2014.

3 White AM, Johnston CS, Swan PD et al. Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study. J Am Diet Assoc 2007;107(10):1792-6.

4 Tanakis M, Liuba P, Odermarsky M, Lundgren J, Hallböök T. Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 2014;18(4):489-94.

5 Coppola G, Natale F, Torino A et al. The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study. Seizure 2014;23(4):260-5.

6 Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease 2012;1(4):1-10.

7 Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol 2004; 9(3): 200–205.

8 Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond) 2005;2:31.

9 Hao S, Dey A, Yu X, Stranahan AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun 2016 Jan;51:230-9.

10 Mani V, Hollis JH, Gabler NK. Dietary oil composition differentially modulates intestinal endotoxin transport and postprandial endotoxemia. Nutr Metab (Lond) 2013; 10: 6.

11 Lam YY, Ha CW, Campbell CR, Mitchell AJ, Dinudom A, Oscarsson J, Cook DI, Hunt NH, Caterson ID, Holmes AJ, Storlien LH. Increased gut permeability and microbiota change associate with mesenteric fat inflammation and metabolic dysfunction in diet-induced obese mice. PLoS One 2012;7(3):e34233.

12 Paoli, A, Grimaldi K, D’Agostino D, Cenci L, Moro T, Bianco A, Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J Int Soc Sports Nutr 2012;9:34.

Count Macros, Eat Doughnuts & Get Ripped

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If you’re counting macros (grams of protein, carbohydrate and fat), are you stuck with a boring diet full of egg whites, chicken, brown rice and broccoli or, can you indulge in doughnuts and other foods typically considered “off limits” and still get ripped? A recent study from the University of South Florida examined both approaches. I think you’ll be happy with their results.
Doughnuts and macros

Macros Study: Flexible vs. Rigid Dieting

In this study,  27 resistance trained men and women (this is huge because many studies use untrained subjects – the kind that have never seen the inside of a gym so almost any intervention is guaranteed to produce results) about 25 years of age were placed on either a Rigid or Flexible 10-week diet phase based on macros and a 25% decrease in calories:

  • Rigid Macro Counting (termed “exclusive” in the study) included a pretty basic diet (given they were 25-year-olds on a limited budget) including foods such as eggs, egg whites, protein shakes (they were given preparation instructions), oats, berries, 99% lean turkey breast, chicken breast, fish (they were given specific options), brown rice, potatoes, choices of different vegetables, oils (added if need be to increase fat intake).
  • Flexible Macro Counting (termed “inclusive” in the study) –  the study subjects could eat whatever they wanted as long as it fit their macros. They were given no food restrictions and could therefore incorporate more variety into their diet.

All continued on their regular training program.

Results

Both groups lost weight and body fat  with no differences between groups in weight loss, body fat mass loss and body fat % decrease. However, in the 10 week post diet, the flexible diet group gained a significant amount of fat-free mass compared to the rigid group (+1.53kg vs. -0.59kg respectively) though there was no difference, between groups, in resistance and aerobic exercise (I suspect the rigid group when crazy shoveling in junk food but the study didn’t collect food records +  most people lie on food records anyway when they feel ashamed about what they ate). No other changes were noticed in the 10 week post diet phase.

Take Home Message

Does this mean you can go gangbusters on gummy bears and doughnuts? Not exactly.  After all, if you’re cutting calories it’s pretty difficult to incorporate high calorie foods that aren’t very filling unless you don’t mind the distraction of hunger pangs later the day. However, it does mean you might need to loosen up a little on rigid dieting. As stated by study author, Bill Campbell, PhD, CSCS, FISSN, Associate Professor – Exercise Science, University of South Florida. “If you are the type of person that has cravings for certain foods, you may be able to consume them in limited quantities during a diet phase within the flexible dieting strategy – this is very appealing for some dieters. Others prefer to have a meal plan created for them with specific foods that they are to consume during their diets – in this case a rigid/exclusive diet is more appealing,” states study author,

If you’re interested in more information about macros, physique and fitness nutrition, follow the study authors on social media:

Bill Campbell on instagram: billcampbellPhD and Facebook

Lorin Conlin, IFBB Bikini Pro, MS Research Assistant – Physique Enhancement Laboratory, University of South Florida on instagram: @laurinconlin and Facebook: FB page Laurin Conlin IFBB Pro

Yikes! Are there Antibiotics or Hormones in Your Milk & Dairy Foods?

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milk

Are antibiotics and hormones used in dairy cows contributing to the obesity epidemic, early puberty and antibiotic resistance? Before going down that road, we have to first we have to first ask if there are any antibiotics or hormones in milk and dairy products.

In this blog post I will cover:

  • Why are antibiotics given to cows?
  • Antibiotics are not in milk, here’s why.
  • Why are growth hormones given to cows? Are there any hormones in my milk and dairy food?
  • What are the cows Eating?

Why are Antibiotics given to Cows?

Antibiotics are used on farms to treat animals who are sick just like you would give an antibiotic to your child if he or she gets sick or take one yourself. There is no reason for dairy farmers to give antibiotics to cows who are not sick. Doing so costs additional money,  serves no clear purpose and arbitrarily giving animals antibiotics could contribute to antibiotic resistance. Now imagine you are a farmer and your life depends on the health of your cows – would you want to run the risk of antibiotic resistance and your cows getting sick with fewer treatment options?

Some antibiotics are also used for animal growth. The FDA is phasing out this practice so medically important antimicrobial drugs (antibiotics) will no longer be allowed to enhance growth or feed efficiency. In the future antibiotics will only be allowed to treat, control or prevent disease and of course require a prescription from a licensed veterinarian. Regardless of whether or not the antibiotic is used for growth or treatment of disease, no traces of antibiotic residues are allowed in milk or dairy products.

Antibiotics are Not in Milk, Here’s Why.

Any cow that gets an antibiotic is milked separately from the rest of the herd and the milk is thrown out. That milk will never be sold or consumed. All antibiotics have a different period of time before all traces of the medication leaves the body (whether we are talking about a cow or a human). Once this period is up and the cow is completely healthy again, the farmer tests her milk. Milk cannot be sold until it is completely clear of all drug residues. Whether organic or conventional, all milk is tested several times before making it to market. It is tested on the farm and at the milk processing plant. Any milk that tests positive for any medication residue, including antibiotics, is thrown out (1).

According to national Milk Drug Residue Data Base compiled for the years 2013 to 2014, 0% of milk tested positive for drug residues. In 2015, the FDA’s Center of Veterinary Medicine surveyed 1,918 raw milk samples (before pasteurization) from across the country. Samples were tested for residues of 31 drugs including the antibiotics, NSAIDs (ibuprofen etc.) and an antihistamine. They found 99% of sampled milk was free of any drug residues. Keep in mind the 1% of milk with residues must be thrown out – it cannot be sold (1, 2).

Cheese and yogurt are made from milk and therefore, there are no antibiotics in your cheese or yogurt either.

If you want to learn more about what farmers are doing about antibiotic resistance, Minnesota Farmer Wanda Patsche wrote an excellent blog on this topic.

Growth Hormones in Dairy Cows

Growth hormones are approved for use in dairy cows to improve milk production. Greater milk production means fewer environmental resources used to raise cows for milk. Bovine somatotropin (bST; also called bovine growth hormone or rBGH) is perhaps the most well recognized growth hormone used on dairy farms. bST is “a protein hormone produced in the pituitary gland of animals, including humans, and is essential for normal growth, development, and health maintenance.” Very little bST is used in dairy cows and there is no test that can distinguish between cows treated with bST and naturally occurring bST (3). Humans do not have receptors for bST and therefore it is passed through your body intact without being absorbed (4). As a result, there are no known side effects or health issues associated with consuming dairy from cows treated with bST. IGF-1 (insulin like growth factor 1) concentrations are slightly higher in cows treated with bST. However, the human body synthesizes IGF-I and drinking 1.5 L of milk is equivalent to an estimated 0.09% of the IGF-I produced by adults each day (5, 6, 7, 8).

USDA organic dairy products are “produced without antibiotics fed or administered to the animal at any point in its life” (9). There are no meaningful nutrition differences between organic and conventional dairy products. I covered that topic in this post.

What are the Cows Eating?

Cows’ diets also vary depending on many of the same factors that influence your food choices. However, unlike humans, all cows have the benefit of seeing a nutrition expert (like dietitians, animal nutrition experts are specialists). Many consumers also have questions about how cows are fed. Cows are fed nutritious diet to ensure health of cow and nutrition of milk. Typical feed mixtures may include haylage (grass with a higher water content), corn silage, sugar beet pulp and a protein mineral mix.

Rest assured, your dairy products are safe. In fact, the dairy product that says it is made with cows not treated with antibiotics is the exact same as the one from a cow that may have been treated with antibiotics. Both contain no antibiotic residues. Growth hormones used in dairy also pose no known threat to human health. The human body does not even recognize the main hormone used in cows. So, regardless of what milk, yogurt, or cheese you choose, all have been produced and extensively tested to ensure they are safe for human consumption.

This post was written as part of my ongoing sponsored partnership with U.S. Farmers & Ranchers Alliance. All opinions expressed are my own and per the usual, took me hours to research and double check my facts.References (if not cited via a hyperlink in the text of this post)

References

1 Questions and Answers: 2012 Milk Drug Residue Sampling Survey. FDA.

2 NATIONAL MILK DRUG RESIDUE DATA BASE FISCAL YEAR 2014 ANNUAL REPORT October 1, 2013 – September 30, 2014 http://www.fda.gov/downloads/food/guidanceregulation/guidancedocumentsregulatoryinformation/milk/ucm434757.pdf

3 Bovine Somatotropin (BST) http://www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm055435.htm

4 Bovine Somatotropin. National Institutes of Health, Technology Assessment Conference Statement. December 5-7, 1990. https://consensus.nih.gov/1990/1990BovineSomatotropinta007html.htm

5 Joint FAO/WHO Expert Committee on Food Additives (JECFA). 1998. Toxicological evaluation of certain veterinary drug residues in food; Summary and conclusions. 50th report of the Joint FAO/WHO Expert Committee on Food Additives. World Health Organization, Geneva, Switzerland.

6 Collier RJ, Bauman DE. Update on human health concerns of recombinant bovine somatotropin use in dairy cows. J Animal Sci 2013; 92(4): 1800 – 1807. https://www.animalsciencepublications.org/publications/jas/articles/92/4/1800

7 Recombinant Bovine Growth Hormone. http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/recombinant-bovine-growth-hormone                  

8 Report on the Food and Drug Administration’s Review of the Safety of Recombinant Bovine Somatotropin. Food and Drug Administration. http://www.fda.gov/animalveterinary/safetyhealth/productsafetyinformation/ucm130321.htm

9 Stacy Sneeringer, James MacDonald, Nigel Key, William McBride, and Ken Mathews. Economics of Antibiotic Use in U.S. Livestock Production, ERR-200, U.S. Department of Agriculture, Economic Research Service, November 2015. http://www.ers.usda.gov/media/1950577/err200.pdf

 

 

Full Fat or Low Fat Dairy?

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If you are totally against low-fat dairy, it’s time to take a closer look at the research. After listening to this dairy debate and watching the finger pointing, I started searching through the literature for an answer to this question “does dairy fat increase LDL cholesterol and risk for cardiovascular disease?” Then I came to my senses. No one eats dairy fat. Unless you’re a food scientist, you aren’t separating the fat from milk or full-fat yogurt and eating it or adding it as an ingredient to your recipes. However, we do eat cheese and yogurt and drink milk. The array of compounds in each of these foods influences how they affect your cholesterol and risk for heart disease. So, I revised the question to: “how does full fat cheese, yogurt and milk impact cholesterol and risk for heart disease?”

Here’s what I’ll cover in this article:

  • Why people are up in arms about saturated fat – saying it is either good or bad;
  • How does full fat cheese, yogurt and milk impact cholesterol;
  • What should you do with this information?

Dairy Fat isn’t the Only Factor

The research on dairy generally follows the research on saturated fat: the replacement strategy matters. For instance, it isn’t a good idea to take cheese out of your diet and replace it with a highly refined carbohydrate (not a good move for blood fats). Butter isn’t better than liquid oil. Butter raises LDL cholesterol. Some research suggests dairy fat might raise the large, less artery clogging LDL cholesterol compared to small dense LDL. However, “less artery clogging” does not mean “not artery clogging” and this area of the science needs more work before we can draw firm conclusions. Also, there are a few differences based on the type of food (milk, cheese, yogurt, butter); cheese reigns.

dairy and cheddar cheese

-> Cheese does not raise LDL as much as butter (accounting for total fat in each). In fact, several studies show cheese appears to have a “relatively minor” impact on LDL cholesterol or no impact at all. This could be due to the calcium content, which leads to the excretion of some fat or, fermentation may have an effect. Cheese stands out in the research.

-> Yogurt appears to have less of a cholesterol raising effect than expected. However this research is inconsistent possibly due to differences in the type of bacteria in the yogurt (aka probiotics). I recommend choosing one with “live and active cultures.”

– > Milk – when consuming the same amount of fat from whole milk or butter, both raise LDL to the same extent. Milk contributes substantially less total fat per amount consumed compared to full fat yogurt and butter. Cross-sectional studies suggest milk consumption doesn’t raise coronary artery disease risk, however, this may reflect lower total fat intake from milk compared to butter.

-> Cottage cheese –  this incredible food is oftentimes forgotten yet an excellent addition to your diet. I couldn’t find any studies on cottage cheese, however, the highest fat cottage cheese I could find  (4% milk fat) contained 5 g total fat per serving so we can expect the impact cottage cheese may have a lower impact compared to whole milk.

What Should You Do with this Information?

If your LDL is high, choose skim, 1% or low fat milk. Opt for a good quality yogurt with naturally occurring probiotics. As far as cheese goes – I’d take out all of the other offending foods and work on other aspects of heart health before ditching the cheese (unless your LDL is very high) and cottage cheese. However, always follow the dietary advice of your registered dietitian since there are many variables that should be taken into consideration.

What about the trans fats in dairy? They are good for you right? No. In large amounts, the trans fats in dairy have the same impact as those found in partially hydrogenated oil (not good for cholesterol, cardiovascular disease risk etc.). However, we don’t eat dairy trans fats in significant quantities (they make up very tiny amounts of dairy fat and beef fat).

Take Home Points

In general, dairy foods help lower blood pressure plus there is emerging evidence about the positive role dairy foods may play in metabolic syndrome. What about dairy fat? Consider the whole food and your diet overall so you can make the right choices based on your personal risk factors for cardiovascular disease. Also, keep in mind there are many factors that influence cardiovascular disease pathology, some of which are unrelated to cholesterol.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Hjerpsted J, Leedo E, Tholstrup T. Cheese intake in large amounts lowers LDL-cholesterol concentrations compared with butter intake of equal fat content. Am J Clin Nutr 2011;94:1479–84.

Biong AS, Muller H, Seljeflot I, Veierod MB, Pedersen JI. A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine. Br J Nutr 2004;92:791–7.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Thorning TK et al. Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial. Am J Clin Nutr 2015.

Labonté MÈ et al. Dairy product consumption has no impact on biomarkers of inflammation among men and women with low-grade systemic inflammation. J Nutr 2014;144(11):1760-7.

Sjogren P et al. Milk-derived fatty acids are associated with a more favorable LDL particle size distribution in healthy men. J Nutr 2004;134(7):1729-35.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

Grebe A, Latz E. Cholesterol crystals and inflammation. Curr Rheumatol Rep 2013;15(3):313.

 

 

Is Saturated Fat Good for You?

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Though largely driven by misinterpretation of the science and cherry-picked population studies, the “Butter is Back” movement comes with very persuasive sound bites followed by arrogant punctuation marks. No wonder so many people hopped on board the bandwagon while looking back, pointing fingers and shouting “health professionals have been misleading us for decades!” Yet the flawed reasoning behind the pro-saturated fat movement comes with a hefty price tag – you could be making food choices that, over time, will increase your risk for cardiovascular disease and type 2 diabetes.

Here’s what I’ll cover in this article:

  • Why is there so much confusion about saturated fat?;
  • The science behind saturated fats, cardiovascular disease (diseases of the heart & blood vessels) and type 2 diabetes;
  • Best food choices for heart health.

Why is there so Much Confusion about Saturated Fat?

There are a few reasons for the confusion about saturated fat (fat that is solid at room temperature such as butter, shortening, coconut oil and the fat on meat) and misinterpretation of the science. First off, some people group all saturated fatty acids (saturated fatty acids make up saturated fat) together as a team. However, there are several types of saturated fatty acids. Some raise LDL cholesterol (the kind that contributes to clogged arteries and is a risk factor for cardiovascular disease) as well as HDL cholesterol (“good” cholesterol, the kind that removes bad cholesterol; SN: drugs that increase HDL do not lower risk of heart disease so there is some considerable debate regarding the role of HDL), others don’t raise LDL cholesterol and some we aren’t quite sure about. Secondly, using population-based studies alone to draw conclusions about saturated fat intake and heart disease is misguided.  These studies are not designed to determine cause and effect (that’s the job of well-designed clinical trials) plus, there are inherent issues with the methods used in many of these studies.  Nutrition research is not easy, especially in humans living their life (those not in a metabolic ward where all factors are controlled and measured including diet and physical activity).

Lastly, some research studies (and the media) take the results way out of context. So, here’s the lowdown based on sound science:

The Science Behind Saturated Fat, Cardiovascular Disease and Type 2 Diabetes

  • There is no dietary requirement for saturated fat. Your body can make all of the saturated fatty acids it needs.
  • Foods high in saturated fat typically increase total, HDL and LDL cholesterol. However, the impact dietary saturated fat has on increasing LDL-cholesterol (the kind that contributes to clogged arteries and an inflammatory cascade in arteries) may depend on the amount of polyunsaturated fat (PUFAs) in your diet (as well as the type of saturated fatty acids consumed).
  • In general, replacing saturated fat with polyunsaturated fat (and monounsaturated fat though there is less evidence for monounsaturated fat) reduces LDL and total cholesterol, both risk factors for cardiovascular disease.
  • saturated fat and cholesterolOverweight, obesity and insulin resistance may reduce the beneficial effects (lowered LDL cholesterol) generally noticed from a reduction in saturated fat intake. *If obese or overweight, losing excess body fat (regardless of the type of diet used to lose the weight) has powerful effects on lowering risk for cardiovascular disease, some cancers, and type II diabetes.
  • Food contains a complex mixture of compounds that may affect cholesterol and cardiovascular disease risk (it is not just the fat). The food “matrix” matters.
  • Many factors impact how a food affects cholesterol and blood lipids (fats) including fats eaten at the same time, overall diet, and carbohydrate intake (and type of carbohydrates consumed – high fiber vs. foods high in added sugar with few other nutrients).
  • There are individual, genetic differences in response to saturated fat intake – your cholesterol might shoot up after eating a diet containing a diet high in the type of saturated fatty acids that raise LDL cholesterol and I might be able to get away with this diet without a problem (blame your genetics or consider it an opportunity to open your taste buds to foods containing less saturated fat; particularly the kind that is artery clogging).
  • Certain saturated fatty acids, or a diet high in saturated fat, may increase risk for type 2 diabetes.

Best Choices for Heart Health

If you are overweight, focus on losing excess body fat. Even small amounts of fat loss will improve health and risk factors for cardiovascular disease. If you have high total and LDL cholesterol, swap foods high in saturated fat for foods high in polyunsaturated fat (liquid oils, nuts, seeds, olives, avocados). Minimize your intake of foods high in added sugars and refined, white flour, carbohydrates. Instead, choose higher fiber carbohydrates as often as possible.

Don’t get sucked into the media headlines written by journalists who could sell ice to an eskimo. Butter isn’t back (for good health anyway). The bulk of your fat intake should still come from foods that are higher in polyunsaturated and monounsaturated fats. However, food is a complex matrix of compounds and therefore, some foods higher in saturated fat may have little to no impact on cholesterol and therefore fit into your diet while contributing to your vitamin and mineral needs and providing plant-based compounds important for good health.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

 

Sourdough – Safe for Gluten Sensitivity?

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There’s something special about sourdough bread. Made through a slow process that begins with simple ingredients, warm water and flour, yeast and bacteria feast on the flour’s carbohydrate, producing carbon dioxide gas and bubbles that expand the dough. Each batch may tastes a little different depending on the flour and water used as well as the environment the starter is made in. My favorite sourdough bread, the kind that is made over the course of several days, has an alluring pungent, slightly sour taste. This long fermentation process leads to more complex flavors while also creating bread that is easier for those with gluten sensitivity to digest. I shared the science behind sourdough in this segment on Fox TV:

What is Gluten?

Gluten’s stretchy fibers give dough it’s rubberband-like elasticity allowing it to stretch when pizza dough is tossed in the air like a frisbee. Gluten-rich dough traps air and water during the baking process so bread rises with delicate ease, producing light and fluffy baked goods. Without wheat (and therefore gluten, which is produced when wheat flour is mixed with water), gluten free items require a blend of flours, starches and additives yet they still can’t replicate the texture of gluten-containing baked goods.

In people with celiac disease, an autoimmune digestive disease, repeated exposure to gluten damages villi, fingerlike projections in the small intestine that help us absorb nutrients from food. Over time, a decrease in nutrient absorption can lead to anemia, osteoporosis, miscarriages and other complications. The University of Chicago Celiac Disease Center website lists over 300 symptoms associated with celiac disease though anemia is the most common symptom in adults. The only available treatment is a strict gluten free diet – which helps reverse intestinal damage over time. Gluten sensitivity is not an autoimmune disease but instead a vague medical condition without a uniform definition or diagnostic test at this time. People with gluten sensitivity report various symptoms triggered by the ingestion of gluten-containing foods including abdominal pain, bloating, and constipation or diarrhea. Though gluten sensitivity is real, someone who thinks they have sensitivity may actually be reacting to something other than gluten (another protein or the starches – see below under Is it the Gluten?)

Sourdough bread

The Science behind Sourdough

Standard yeast leads to a fast fermentation process. This ramps up production speed and it is also foolproof so companies can produce batches of bread at warp speed. Sourdough bread is made slowly, over time, letting the yeast work it’s magic to deliver an array of flavors as well as bread that is easier to digest. In one study, sourdough bread made with selected sourdough lactobacilli and long-time fermentation resulted in bread with gluten levels of 12 parts per million (ppm), which qualifies for gluten-free (anything below to 20 ppm is gluten free). A long fermentation process allows bacteria and yeast adequate time to feed on proteins and starches breaking them down into more digestible parts. Yet sourdough also boasts a lower glycemic index than many other types of bread (including white bread) and therefore it doesn’t lead to a quick spike in blood sugar levels.

In 2011, a small study conducted in Italy tried giving volunteers with celiac disease a small amount of specially prepared sourdough bread. The bread was fermented until the gluten was broken down to more easily digestible parts. The subjects in the study reacted well to the sourdough, with no changes in intestinal villi and no detectable antibodies typically found when a celiac disease patient eats a gluten containing food. According to the study authors, the bread “was not toxic to patients with celiac disease.”

In another study, conducted over 60 days, baked goods made from hydrolyzed wheat flour, manufactured with sourdough lactobacilli and fungal proteases, was not toxic to patients with celiac disease. Though these studies are groundbreaking, it is far too soon for celiac disease patients to try this at home. For sourdough bread to be an option for those with celiac disease, a uniform production process would need to be established to ensure the end product is gluten-free.

For those with Gluten Sensitivity, Is it Really the Gluten?

Some people may experience bloating and flatulence in response to FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). FODMAPs are a type of carbohydrates that are not well absorbed in the small intestine and are present in bread along with a number of other foods (other grains, some vegetables and fruits). In some people the problem may be FODMAPs, not gluten. The long fermentation process reduces FODMAPs.

How to Make Sourdough at Home

Sourdough starter begins with flour and water that sits for several days while being fed intermittently with both flour and water allowing bacteria (lactobacilli) and yeast to grow and multiply creating live cultures. These microorganisms are what makes the dough ferment similar to the way milk ferments to become yogurt. Check out these recipes to make your own sourdough bread: Healthy Aperture, the Perfect Loaf.

If you run into problems making sourdough check out this page for troubleshooting.