Monday, November 26, 2012

Citicoline: Supplement for the Brain?


      Citicoline is a novel nutrient with the potential to treat a variety of neurological dysfunctions.  It is already being prescribed by physicians in some countries to help treat such conditions.   Citicoline is well absorbed via oral and IV administration. It can also be obtained through a variety of fresh food sources.  Either way it crosses the blood brain barrier and is broken down into cytidine and choline.   Cytidine is necessary for the formation of nucleotides and both are required by the structural components of neuronal cellular membranes. 

     In the event of neuronal cellular damage, as would be the case in ischemic stroke or other type of brain injury, the release of certain chemicals such as free fatty acids, glycerol, and arachidonic acid occurs.   Additionally, toxic metabolites and free radicals are accumulated causing further damage to the brain.   Supplementation with citicoline can help sequester this process. The methods which are known to be implemented for this effect include promoting the synthesis of acetylcholine, phosphoplipids, and halting the free fatty acid accumulation that can lead to more extensive damage.  The phospholipids that are generated with the assistances of citicoline are required to maintain the structural integrity of the neuronal cell membranes.

     Studies have been conducted with mixed results regarding the benefits of citicoline on problems related to neurological dysfunctions.  Some small animal and human studies have found beneficial effects of the afore mentioned supplement on conditions like Alzheimer’s disease, learning and memory,eye and mental health as well as appetite control.   More studies need to be conducted to validate these results.  Recently, the largest clinical trial conducted on the effects of citicoline on stroke was completed.  Unfortunately the results were not promising as they proved that citicoline was not protective against the damage incurred following a stroke.  Overall it is known to be a safe supplement to take for a period of 90 days.   Safety of long term use has not been established.

 

Endres, Irfan, ND, and John R. Endres, ND. "Citicoline: A Novel Therapeutic Agent with Neuroprotective, Neuromodulatory, and Neuroregenerative Properties." Natural Medicine Journal 2.6 (2010): 11-24. Web.

Kamel, Hooman, MD. "Citicoline Disappoints as a Neuroprotectant After Ischemic Stroke." Online posting. Journal Watch. N.p., 17 July 2012. Web. 26 Nov. 2012. <http://neurology.jwatch.org/cgi/content/full/2012/717/5>.

Laidlaw, Sarah H., MS. "Citicoline: A Promising Dietary Supplement for Preventing Cognitive Decline." Integrative RD 13 (2011): 32-34. Print

Tuesday, November 13, 2012

Part Two: My FNCE 2012 Experience


  Following the DIFM Pre-FNCE workshop, I attended the opening ceremony which included an address by keynote speak Mr. Dean Karnazes, an ultra marathon runner and successful businessman.  One of his claims to fame was a three day non stop run that he was able to accomplish because of a unique ability to metabolize lactic acid in such a way that he does not get fatigued.  Well, his story of perseverance and endurance was meant to inspire the nutrition professionals in attendance to take charge as they forge ahead in their careers.   I also attended two networking events while I was there.  The events were hosted by the Nutrition Entrepreneurs  DPG and Renal Dietitians DPG.   It was interesting to see what other dietitians around the country were up to and how they were going about enhancing their careers while having some fun.    

   Finally there were all the wonderful lectures I had the pleasure to attend.   Below I have outlined some of the major points that I felt were notable to mention of the things I managed to pick up while I was there:     

 

“Calling All Food Bloggers: Stay in the Game”

Toby Amidor

Dana Angelo White

 

--- 70% of households cook their meals at home.  
--- RD's should be food blogging
---- Tweet at least once a day
---- Put up your blogs/tweets early in the morning as most people
like to check their facebook/blogs early in the day. This will help
drive traffic to your site.
-- have a separate fan page on facebook for your blogs and
advertise your posts on that page versus your own page

“Forewarned if Forearmed: Legal Use of Social Media”

Debra King

Stephen Stromberg


--- Do not give personal diet advice on social media forums. Take
it off facebook and discuss in private. Even if they are friends!!
-- Do not plagiarize and make sure you give credit to your sources.

“The Dollars and Sense of Telehealth: Designing Programs to Maximize Effectiveness”

Mary Ann Hodorowicz, MBA, RD, LDN, CDE

Joanne Shearer, MS, RD, LN


--Telemedicine and telenutrition are gaining ground.
-- You can actually obtain reimbursement for online nutrition
counseling but you have must contact the individual insurance
companies. Some may only reimburse with the use of video
conferencing.
-- Make sure you contact whatever states you choose to take clients
from for their rules and regulations regarding telenutrition services.

“Cancer Survivorship and Energy Balance:  Going Beyond Obesity”

Suzanne Dixon

Lee Jones

 

---  The percentage rate of cancer survivors has increased in recent years.

---  Improved fitness levels can improve survivorship further

---   Your fitness levels decrease by 10%  every decade normally

--- Fitness levels decrease by 10% following 12 weeks of chemo in patient

--- Mice studies have shown that when combining exercise with chemo treatments you have a marked decrease in the rate of tumor progression.  

 

“Myths and Mysteries: Dietary Intake and Diabetes”

Amy Campbell

Osama Hamdy

 

--- There is no standard Diabetes Diet!!

--- RD’s should individualize diabetic diet therapy

---  High protein and low carb diets for the first two years  is recommended (unless patient also has renal disease)

--- Higher protein diets lower blood glucose lab values, improve cardiovascular health and any change in GFR is not significant.  

--- Change in GFR with diabetic patients is more related to sodium intake than protein. 

Sunday, October 28, 2012

Part One: My FNCE 2012 Experience


      FNCE (Food and Nutrition Conference and Expo) 2012 was held earlier this month at the Pennsylvania Convention Center located in the hub of Philadelphia.  Thousands of Nutrition and Dietetics professionals from around the country traveled for the incredible educational and networking opportunities this annual event provides.    The expo provided an opportunity for food companies, authors and organizations to showcase their products and services.   Additionally, the expo lightened up the mood of the conference by giving out food product samples, gifts and prizes.   My favorite was the stability ball that was gifted by Pepsico after you visited several of their booths and answered several questions relating to their products.   They put a clever spin on the word PLAY which they used as an acronym for Protein Liquid Activity and You to promote physical activity and show how their products (i.e Gatorade chewables) can help in achieving optimum nutrition for physically active people. 

     I jump started my FNCE experience by attending the pre-FNCE workshop entitled, “Integrative RD: Nutrition as Medicine Confronting Cardiometabolic Syndrome,”   hosted by the dietitian practice group called Dietitians in Integrative and Functional Medicine (DIFM).  Several speakers discussed a holistic approach to combatting cardiometabolic syndrome which is associated with central obesity, hypertension, high triglycerides, low HDL and elevated blood glucose levels.   Dr. Mark Hyman, the first speaker of the event, discussed functional medicine as it relates to cardiometabolic syndrome.    Functional medicine, according to Dr. Mark Hyman,  views illness in the body as a systemic disorder and not as a disease.   In relation to heart disease, he states that 90% of such cases can be prevented through lifestyle changes.  Less than 1% of Americans are said to ,”…. fill the criteria for factors that are good for cardiovascular health.”   And he noted that more people die from physical inactivity than from smoking.  He also briefly spoke about how toxins and food can effect our DNA and thereby lead to illness or improved health.  For example, high levels of lead in the environment can increase the incidence of stroke by 151%.   The body  as a complex system requires a non- linear understanding of its’ functioning which is vastly different from the linear thought processes that can be used to understand mathematical  concepts.   Dr. Mark Hyman also discussed how simple lifestyle changes can be more effective than medical treatments like Avandia or insulin which are said to increase the risk of death.   He also discussed how fecal transplants have been shown to be successful for insulin resistance.  Statins supposedly increased the risk of diabetes in patients per Dr. Hyman.   Lifestyle changes are said to decrease the incidence of diabetes.  Effective techniques to bring about these changes for overall improved health are food journaling and group therapy.  Another technique called Emotional Brain Training (EBT) was described by Ms. Laurel Mellin, MA, RD, cPhD.  

     According to Ms. Laurel Mellin, it takes one year to rewire your brain.   Stressors in a child’s parents life can lead to faulty conditioning thereby causing unhealthy relationships to things like food.   The first three years of life is crucial in this regard as that is when 70% of a child’s brain wiring takes place.  This wiring leads to a persistent brain state that provides an emotional set point.   The goal of EBT is to shut off the emotional drive and rewire the brain from stress to joy so that psychologically healthier choices can be made in relation to food or anything else.  Registered Dietitians can obtain certification via an  18 month distance learning program.  Information on this can be obtained at www.ebt.org.  Ms. Kathie Madonna Swift, MS, RD, LDN discussed how sometimes normal isn’t optimal and that investigative work and clinical wisdom should be implemented by the RD in assessing the patient.  Things are not necessarily clear cut because as mentioned before the biological system of the body is complex.   And then finally, the last speaker Ms. Coco Newton, MPH, RD, CCN gave a brief overview of the nutrition focused physical exam and encouraged participants to examine the patient and to take mental notes of any physical observations and research any unique findings.   She reported that waist to hip/waist to height ratios are better predictors of the risk of cardiometabolic disease than BMI.   Here are a few of the many things she pointed out during her lecture:

-          The skin and liver have the same detox processes

-          Low Essential Fatty Acids can lead to impaired wound healing, dermatitis, and photodamage.

-          Some signs of vitamin B12 deficiency are vitilgo and hyperpigmentation.

-          Low Vitamin D can lead to Calcium and Phosphorous malabsorption causing rickets and osteomalacia.

-          Hypercalcemia can lead to calcification of kidneys

-          She also promoted the site nutritionfocusedexam.com as one resource to gain additional knowledge. 

 

Stay tuned for the second part of my FNCE experiences………

Thursday, October 11, 2012

The Wonders of Cranberry



     Cranberry is a fruit that can be useful in preventing bacterial infections, managing cholesterol, wound healing and with cancer.   The Native American peoples were well aware of the health promoting and healing properties of the cranberry fruit which is indigenous to the North American region.    Dr. Amy B. Howell, an associate research scientist at the Marucci Center for Blueberry and Cranberry Research at Rutgers University in New Brunswick, NJ  wrote an article in the recent issue of the Dietitians in Integrative and Functional Medicine (DIFM) newsletter entitled, “Health Benefits of Cranberries-It’s not just UTI’s anymore!” where she discussed this subject.   She also lectured on this same topic at the 2011 Food and Nutrition Conference Expo (FNCE) DIFM breakfast meeting.    And of course, as she further explains, the potent phytochemicals found in the fruit are responsible for it’s health promoting properties. 

     According to Dr. Amy Howell, the phytochemical known as polyphenolic proanthocyanidin (PACs) is responsible for preventing bacterial adhesions that lead to UTI’s, stomach ulcers and oral health issues.   The PACs found in cranberry are unique to those found in foods like grapes and chocolate because of its’  distinct type of chemical linkage that disrupts the bacterial adhesion process which is the first step towards infection.   As such, these PACs work differently from antibiotics as they do not kill bacteria and therefore bacteria is not apt to form resistance against these chemicals.   Regarding dental health, even advanced cases of periodontal disease benefitted from cranberry extract per Canadian researchers as reported by Dr. Howell.   Apparently cranberry has a powerful effect on bone formation in periodontal disease.   The combination of phytochemicals found in cranberries may prevent cardiovascular disease (CDV).  In one study noted in Dr. Howell’s works, participants consuming a little over 8oz. of a low-calorie cranberry drink containing 27% of pure cranberry juice over a 12 week period showed a significant increase of high density lipoprotein levels (HDL) in overweight men.   Higher HDL levels are typically associated with reduced risk of CVD.   Cranberry is also suspected to exhibit anti-carcinogenic properties as some research has suggested a reduction of tumor growth and protection against cancer.

     To benefit from the healing nature of cranberries, Dr. Howell makes the following recommendations regarding cranberry products:

1.)    When seeking cranberry supplements, look for those made with whole cranberries and carry the United States Pharmacopeia (USP) or Good Manufacturing Process(GMP) stamp of approval on the packaging. 

2.)    Cranberry drinks should containing at least 25% of 100% cranberry juice.

3.)    Approximately 1 cup/day  of sugar sweetened or a low calorie cranberry cocktail drink is beneficial.

4.)    2oz. of 100% pure cranberry juice added to other juices to improve taste can be used as an alternative to cranberry juice drinks.

 

Howell, Amy B. "Health Benefits of Cranberries-It's Not Just about UTI's Anymore!" Food and Nutrition Conference Expo Dietitians in Integrative and Functional Medicine Breakfast. San Diego Convention Center, San Diego. 26 Sept. 2011. Lecture.

Howell, Amy B. "Health Benefits of Cranberries-It's Not Just UTI's Anymore." Dietitians in Integrative and Functional Medicine 14 (Sept. 2012): 49-51. Print.
 
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Sunday, August 19, 2012

Dietary Management of some Cancer and Cancer Treatment Related Issues



Anemia

-Increase the intake of foods high in B-complex vitamins, vitamin C, protein and iron.  Long term supplemention of Iron is discouraged.   Small meals every few hours is advised.

Aversion to foods/Anorexia/Cachexia/Colder Food Preference

-Appetite stimulants and small feedings throughout the day are recommended.  If patient finds food to have a metallic taste, using plastic utensils, ginger ale and/or mint may help to mask that.  Try different seasonings.   If patient is found to have an aversion towards meat, encourage consumption of poultry, fish, legumes and dairy products.   Cleansing the palate with baking soda and water or salty water before meals may help.  Nutritional supplements to help increase nutrient intake can also be used.   Some patients may better tolerate colder food items. 

Dental cavities

-Being extra diligent about  good oral hygiene, avoidance of sweets, and the use of sodium fluoride three times a day is recommended to help prevent  cavities in cancer patients.

Constipation

-Increasing fluid and fiber intake as well as getting extra fiber into the diet can help.   Hot drinks and milk (if tolerated) are said to be helpful as well.

Diarrhea

-Patient should be encouraged to limit consumption of the following items:  sorbitol, sugar substitutes,  caffeine,  carbonated drinks,  and foods which are fatty, acidic, gas forming or spicy.  The patient should be monitored for development of  lactose intolerance due to the illness or associated therapies.  If patient is lactose intolerant, dairy products should be avoided.  Foods which may be helpful  for those suffering from diarrhea include  potato’s, skinless chicken, rice, and eggs.

Nausea/Vomiting

-Bland foods are recommended for patients  experiencing nausea.  Also small meals throughout the day and drinking fluids between meals can be helpful.  Extra hydration is also advised prior to and following chemotherapy treatments.  If patient is vomiting, following the episode patient should sip liquids every 10 to 15 minutes.  Additionally, “flat” carbonated drinks can provide some relief. 



Escott-Stump, S. Nutrition and Diagnoses-Related Care.  7th ed.  Philadelphia, PA: Lippincott, Williams and Wilkins:2012.

Sunday, August 12, 2012

MNT of Head and Neck Cancers


      The grouping, “Head and Neck Cancers,” is descriptive of the cancers found in the following areas: esophagus, lips, mouth, salivary glands, pharynx, nasal sinuses and lymph nodes.   Diets low in fruits, vegetables,  zinc, folate and selenium, as well as, obesity and tobacco use predisposes individuals to these cancers.   General symptoms of this type of diagnoses include voice changes, dysphagia, or persistent lump or sore throat that will not heal on it’s own.   Chemoradiotherapy ( a combination of chemotherapy and radiation) treatments are usually employed in the treatment of head and neck cancers.  The chemotherapeutic drugs Cisplatin, Carboplatin, and/or Taxol along with radiation is usually given over several weeks.  This type of therapy can lead to conditions like mucositis, odynophagia, and dysphagia which make it difficult to eat and therefore obtain the required nutrition to deal with these illnesses.   As such, the expertise of dietitians and speech pathologists in providing supportive care is invaluable in improving patients quality of life. 

     Prior to treatment, an RD should evaluate the patients nutritional status.   The main goal of nutrition therapy is to limit weight loss and help to prevent malnutrition.   It is highly recommended that these patients have a PEG feeding tube inserted prophylactically to help meet patients nutrient needs without disruption to the treatment plan.   Before the onset of treatment, patients are encouraged to gain weight via a high calorie and high protein diet.  As treatment progresses and symptoms resulting in poorer oral food intake take into effect, PEG feedings should be implemented to assist in meeting nutritional needs.   Tube feedings high in omega 3 fatty acids and arginine are recommended.   When and if food is being consumed orally, it is advised that patients follow a soft bland diet plan.  To help encourage oral food intake, fluids should be consumed between meals.  High calorie and high protein nutrition supplements  are recommended to improve nutritional intake.   As the treatment progresses, diet consistency will need to be downgraded to liquid or pureed consistency as required.   Eventually patients diet will be advanced as tolerated to soft and then to regular. 

     Patients should visit the speech pathologist before and after treatment is completed.   In so doing, patients will be educated on, “compensatory swallowing strategies,”  as well as electrical stimulation to improve swallowing as needed post treatment.    



 Cheek, B. Scott, MD, Eric Nadler, MD, MPP, Caroline Nickel, MS, CCC-SLP, and Andrea Nguyen, MS, RD, CSO, CNSC. "Head and Neck Cancer: A Multidisciplinary Approach to Treatment." New Frontiers in Oncology Symposium. Texas, Dallas. 27 Apr. 2012. Lecture.

Escott-Stump, S. Nutrition and Diagnoses-Related Care.  7th ed.  Philadelphia, PA: Lippincott, Williams and Wilkins:2012.

Tuesday, July 10, 2012

Nutritional Intervention in Cancer Cachexia



     Cancer Cachexia is a wasting syndrome that over half of cancer patients will experience.   Some of the symptoms of cancer cachexia include weight loss, loss of appetite, early satiety, changes in taste, ascites, and dry mouth.  There are two forms of this syndrome, primary anorexia cachexia and secondary anorexia cachexia.   Primary anorexia cachexia is directly related to the disease process while the latter version is a consequence  of other factors not directly associated with the disease such as chronic infection, inadequate food intake, and impaired absorption of nutrients among other things.  Treatment measures are mainly to improve quality of life and reverse the condition through early detection, nutrition counseling, exercise, medications and treating the secondary causes as well as taking care of their emotional well being. 

     Patients have been shown to benefit from dietary counseling in treating cancer cachexia.  When assessing the patient it is important to review the patient’s medical history, medications/supplements taken, weight changes, dietary intake, labs, bioimpedance analysis, skin fold thickness, mid arm circumference, and DEXA scan.  Pertinent labs in the nutritional assessment of the patient include transferrin, retinol binding protein, albumin and prealbumin.  Patients should be encouraged to consume nutrient and energy dense foods.   High calorie nutrition supplements are also beneficial in treating this condition.   Exercise can help build lean body mass in these patients.  For patients with very poor appetites, appetite stimulants like megace, medroxyprogesterone, and prednisolone can be effective in improving oral intake of food.   Nutrition support may be warranted in situations where oral intake is not adequately meeting the patient’s nutritional needs. Enteral tube feedings, as always is the preferred method of administering nutrition support if the patient is agreeable to such methods of nutrition support and if the patient’s condition exhibits no contraindications for enteral tube feeds.  In cases where enteral tube feeds are contraindicated (ex. bowel obstruction, malabsorption, etc.) parenteral nutrition is preferred.    

     There is some evidence that omega-3 fatty acid supplements may improve appetite and hinder growth of tumors.  Additionally, growth hormones, testosterone, melatonin, cannabinoids and thalidomides have shown that they may be beneficial in combatting symptoms such as weight loss and lack of appetite but these benefits have also not been established. 
Reference:

Granda-Cameron, Clara. "Cancer Cachexia." A Guide to Oncology Symptom Management. Ed. Mary P. Lynch. Pittsburgh: Oncology Nursing Society, 2010. 65-89. Print.

Sunday, July 8, 2012

Summary of the, "American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention"


     According to nutrition research scientists and the American Cancer Society, a substantial percentage of newly diagnosed cancer cases could have been prevented with proper attention to food choices and living a more physically active lifestyle.  Guidelines set forth by the American Cancer Society for cancer prevention encourage maintaining a healthy weight, consuming 2.5 cups of fruits and vegetables a day, limiting intake of alcohol, tobacco products, red meat, processed meats, and refined grains should considerably reduce an individual’s risk of becoming a cancer victim.  The information presented in this blog will discuss some of the American Cancer Society’s recommendations. 

     The predisposition of overweight and obese individuals to cancer is due to alterations in metabolism that effect hormones, immune functioning and inflammation.   Levels of obesity have stabilized in women and youth but are on the rise for adult men.  Increasing physical activity and limiting caloric intake are encouraged to help with weight loss efforts and chronic disease prevention, including cancer.  For adults, it is recommended that they partake in 150 minutes of moderate activity (examples given are: mowing the lawn, walking, dancing)  or 75 minutes of intense activity (examples include jogging, martial arts, soccer)  a week.  Children are encouraged to partake in at least 1 hour of activity each day.  Three days out of the week should be allocated for more intense physical activity for these youth.  Exceeding these recommendations for all groups could be even more beneficial to health and well being.  A 50 to 100 calorie a day reduction of intake from foods should prevent weight gain according the American Cancer Society.  

     Decreasing caloric intake and making an emphasis to eat more plant based foods can help reduce risk of cancer.   High fat and sugary foods/beverages  should be minimized.   Consumers should be aware that just because a food product is labeled as, “nonfat” or “low in fat,” does not assure that the item is low in calories.  Increasing fiber through consumption of whole grain bread, pasta and cereal products is encouraged.  Additionally, red meat and processed meat products should be limited because of their association with mutagens and carcinogens.  In preparing meat, poultry, and fish meals cooking methods such as frying and charbroiling should be avoided.  Instead, it is advised that you bake, broil or poach these food products to limit exposure to mutagens and carcinogens like nitrosamines and heterocyclic amines.  Processed meats have a stronger correlation to disease risk.  These meats are preserved in using nitrates which can lead to disease causing mutations.  There is an established link between alcohol and certain cancers and therefore it is advised that men drink no more than 2 drinks a day and women drink no more than 1 drink a day to minimize the risk.   If you do not already drink, it is advised that continue to abstain.  One alcoholic beverage serving is equivalent to 12oz. of beer, 5oz. of wine or 1.5 oz. of 80 proof distilled spirits. 

     Food contaminants can unintentionally affect our food supply that can indirectly or directly make metabolic alterations that may result in cancer.   Some of these include antibiotics or hormones injected into animals, bisphenol A or phthalates that are found in packaging, heavy metals and a fungal toxin called aflatoxin produced by Aspergillus flavus.  It is also unclear whether or not organic foods are effective in decreasing cancer risk.   For now, the American Cancer Society feels that the evidence is inconclusive and that food recommendations are effective if followed using either organic or conventional food products. 

Thursday, June 28, 2012

Nutrition and Pregnancy Lecture Highlights!


    Recently, Bridget Swinney MS, RD, LD, an expert on prenatal and child nutrition, gave a talk entitled, “ You Are What Your Mom Ate: The Prenatal Nutrition Environment and It’s Effect on Long Term Health.”  I will relay much of the information presented during this talk via this blog post. She discussed some of the impacts that improper diet and environmental insults can have on the fetus.  Women of child bearing age, especially those planning on eventually having children, should eat properly to ensure the health and well-being of any future offspring should they become pregnant. High risk pregnancies can result from improper nutrition and lifestyle choices (i.e. alcohol and or drug use, sedentary lifestyle) prior to the woman becoming pregnant during the first trimester.   Visual and cognitive deficits can result from improper distribution of omega 3 and omega 6 fatty acids in the diet as well as low levels of DHA.  Additionally, preeclampsia may come about due to improper intake of Mg, Ca, Vit D, Zn, folate, and vitamins B6, B12, D.  Inflammation and bone density are also the result of inadequate nutrient intake.  Whether the woman is undernourished or excessively nourished, the unborn child has an increased risk of diabetes, hypertension, metabolic syndrome and future weight problems.  She defined excessive nutrition as having the following four criteria:  generally overweight prior to pregnancy, exhibiting excessive weight gain, high blood glucose and imbalance of a macronutrient.  Overweight expectant mothers are more likely to have gestational diabetes, a 60% increased chance of having a child with autism, children with high body fat, among other health issues.  Those woman who suffer type 1, type2 or gestational diabetes have an increased likelihood of giving birth to a child with macrosomia which also predisposes the child to health problems later on in life.  The criteria used to define undernourished expectant mothers are as follows: being underweight, not able to gain adequate weight, nutritional deficits, and issues with delivering nutrients to the fetus.  The undernourished expectant mother will have a smaller placenta which makes it more difficult to pass on nutrients to the fetus.  Endocrine Disrupting Chemicals or EDC’s (i.e industrial chemicals, BPA, phthalates) can be harmful to the fetus.  These chemicals can lead to low birth weight, obesity, reproductive issues, diabetes as well as cancer.  High fat meats and skins of poultry and fish should be avoided as they store many of these industrial chemicals.   Heavy metals in the environment can also lead to spontaneous abortions, birth defects and learning problems in children.  The fathers diet and lifestyle choices also affect the health of the offspring.  Environmental toxins, alcohol, drugs and inadequate antioxidant intake can all affect the quality of the sperm. 

     Having a diet high in fiber improves glucose tolerance and decreases the risk of gestational diabetes according to Ms. Bridget Swinney.   She also encouraged lean beef, more specifically the “BOLD” diet or Beef in Optimal Lean Diet which encourages lean beef intake and plenty of fruits and vegetables, whole grains, nuts and beans.  She also notes that adequate dairy intake can increase placental weight and reduces the incidence of preeclampsia. 

    To summarize her recommendations, having a nutrient rich diet, obtaining protein from a variety of sources, having a proper balance of macronutrients in the diet, including dairy with probiotics in the diet, consuming healthy fats like DHA, and monitoring  weight before and during pregnancy and exercising for at least 30minutes daily should benefit expectant mothers in their goal of having a happy and healthy pregnancy.   Check out the link posted below detailing the Institute of Medicines guidelines for weight gain during pregnancy! http://www.iom.edu/~/media/Files/Report%20Files/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines/Resource%20Page%20-%20Weight%20Gain%20During%20Pregnancy.pdf
You can also check out Bridget Swinney's websites at www.eatingexpectantly.com and http://www.healthyfoodzone.com/

Sunday, May 20, 2012

Dr. Felicia Stoler's talk on Sports Nutrition


    A few months back I went to an interesting lecture on sports nutrition given by Dr. Felicia Stoler, DCN, MS, RD, FASCM.  She is a fellow RD and Exercise Physiologist who has been featured in various media outlets and has a book out called, “Living Skinny in Fat Genes.”  She is a strong proponent of meeting your exercise/sports nutrition needs via foods rather than supplements.  For one, there is limited regulation on supplements and secondly, with regards to protein supplements for athletes, most can (and probably do) consume adequate amounts from the foods they eat.  To optimize athletic performance, nutrition helps but training and getting adequate rest for an event is key.

     An athlete requires fluids and electrolytes for hydration, carbohydrates for fuel (which can also come from candy),  protein for repair, and vitamins and minerals for health.  To properly hydrate yourself in preparation for an athletic event requires that you do not rely on the feeling of thirst to determine when you drink water, as it is not a reliable indicator of when you should drink.   Sports drinks can be useful when exercising for greater than one hour.   They not only rehydrate you but also provide necessary fuel.   These sports drinks should consist of 5 to 8% carbohydrates, contain sodium, and consumed when exercising greater than one hour.   

     The following is a breakdown of some of the nutritional tips Dr. Felicia Stoler gave to encourage top athletic performance:

1.)    Have the athlete create a food log to determine what diet regimen works best for that athlete.

2.)    The athlete should weigh him or herself before and after exercising to determine fluid losses (or if too much fluid has been consumed).

3.)    2 hours before an event/training

-          Drink approximately 17 oz. of water

-          Consume a well chewed solid food meal

4.)    1 hour prior to event/training semi liquid or liquid meals are allowed.

5.)    10-15 minutes prior to and during exercise drink 8 to 10 oz. of water.

6.)    After 90 minutes of exercise, 8-10 oz. of a sports drink should be consumed every 15 to 30 minutes.

7.)    Following exercise, consume 20-24 oz. of water for every pound lost.

8.)    During the important 2 hour recovery period, make sure you have a snack consisting of a 4:1 carbohydrate to protein ratio.  (examples she gave were chocolate milk, turkey and cheese with apple slices and pretzels, and tuna on whole wheat).

Friday, May 18, 2012

Dietary Guidelines for Americans 2010

(Originaly posted May 14th, 2012 on www.tigrisnutrition.com)

The expanding girth of Americans has prompted governmental agencies such as the USDA to step up it's efforts in combating obesity. On January 31st of 2011, the USDA and HHS released the updated Dietary Guidelines for Americans 2010. A few months back, I attended a lecture on efforts in communicating and promoting these guidelines by Dr. Richard Post, Deputy Director of the USDA's Center for Nutrition Policy and Promotion. He noted that the focus of these guidelines is to tackle the obesity epidemic

Americans are knowledgeable on how to eat well, they just need guidance in navigating portion control and caloric intake according to Dr. Richard Post. To help out, tools such as those found under choosemyplate.gov were developed. The site helps out with everything from food journaling (which is an effective weight loss tool) to meal planning. And, of course, MyPyramid was replaced with the now famous MyPlate for it's simplicity in assisting with consumers food choices on a meal by meal basis. Games, aprons and other visual tools are being implemented to reinforce healthier dietary habits on the American population.

Caloric balance (calories taken in vs. those expended via physical activity) and choosing foods that are nutrient dense are focal points of these guidelines. Eating more seafood, choosing lower fat dairy products, increasing whole grain consumption and limiting sodium intake are encouraged. I would like to point out that eating healthy should not only be about weight loss. No matter what your size you need to eat well to maintain your well being at it's optimal level.