“Lowering Calories” vs Lowering Serving Size

January 30th, 2014

Are you fooled (or irritated) by food manufacturers/processors claims of lowering calories?

When a food is packaged in 100-calorie portion sizes, you may eat less (IF you eat only one portion).

BUT have the calories been lowered, OR has the portion size been lowered?

Thinking about it, we know the answer, but are you influenced by the ads and packages?  It costs more for the packaging and convenience. . . you are paying more for their help in lowering your calorie intake.

Calories are lowered in foods if the content is altered: less fat is used (not just a switch to another form of fat,  less flour is used (not just switching to flour from another grain) and less sugar is used (substituting a sweetener alternative).

Three common substances used to lower calories in food:  air, water and some indigestible fibers.


White Foods

January 30th, 2014

Catchy, blanket diet recommendations may be easy to remember, but miss  the mark on nutrition wisdom. “Don’t eat white foods” would mean you exclude foods such as cauliflower, onions, turnips, garlic, bananas, popcorn, chicken . . .

It also brings up the question: does that mean white inside or white outside?  Dinner rolls, cereal flakes?

If you are prone to using generalizations to run your life, make sure you take mental note of all the exceptions.

(This topic excerpted from a practice group list serve of the Academy of Nutrition and Dietetics)

Nutrition Screening and Mental Health

December 27th, 2013

Nutrition Screening and Mental Health

An internet search for material on nutrition screening reveals many defined groups are discussed, surveyed, and screened: the elderly, cancer patients, renal/kidney patients, hospitalized and patients admitted for long term care, those with autism and individuals with developmental disability.  But information on patients admitted for mental health care seems unavailable.

A notable exception was the 2011 survey by the British Association for Parenteral and Enteral Nutrition (BAPEN) in England, Scotland and Ireland included a category of Mental Health Units. Up to1 in 5 (19%) adults on admission to Mental Health Units in the UK were at risk for malnutrition. Most of those affected were in the high risk category.

Malnutrition is most often defined by BMI, Calorie and/or Protein intake and loss of fat or muscle tissue. See:

White JV, Guenter P, Jensen G, Malone A, Schofield M. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36:275-283.
Tappenden, Kelly A., Beth Quatrara, Melissa L. Parkhurst, Ainsley M. Malone, Gary Fanjiang and Thomas R. Ziegler. Critical Role of Nutrition in Improving Quality of Care: An Interdisciplinary Call to Action to Address Adult Hospital Malnutrition. JPEN J Parenter Enteral Nutr 2013 37: 482 originally published online 4 June 2013

Scientific research is indicating that vitamins and minerals are involved in mental status, mood, and function of the brain and central nervous system. Individuals with diagnoses of mental concerns are frequently found to have different biochemistries, genetics, and needs when it comes to nutrition.

Malnutrition relevant to mental health and mental illness likely needs to be defined as much by vitamin and mineral status as by calories, weight and protein intake.

The Alliance for Natural Health reported in September 2010 Medicare reduced support for nutritional screening to one lab test per year to screen for all nutrient deficiencies or imbalances.  http://www.anh-usa.org/medicare-cuts-back-on-nutritional-screening/. A Medicare web site lists 18 preventive services covered by Medicare: depression and alcohol use are the two included in Mental/Behavioral health area. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/PreventiveServices.html

As much as we now know, is it ethical to NOT screen for nutritional status when people are admitted for mental  health care?

Thriving vs Surviving

October 23rd, 2013

Have you ever wondered how people stay alive when their diet is so very poor?  The answer is the “tropic value” of different foods, described in 1973 by Roger Williams, PhD, a biochemist at the University of Texas who researched areas of nutrition. 

            The tropic value of a food is a descriptor of the quality of a food beyond calorie (energy) content. Substances “beyond calories” include vitamins, minerals, essential fatty acids, essential amino acids, or other as yet unrecognized substances.  Tropic value is determined by feeding a minimal protein intake to sustain life and making the rest of the diet one single food. After a given time period on this combination (12 weeks in rats), results are measured by 1) occurrence of death (rare, considering the protein), 2) amount of weight gain (tissue added, or growth), and 3) whether the stages of sexual maturity were achieved. For normal growth and development foods taken must be totally complete for the specific animal. Obviously, this type of study can’t be ethically conducted on humans, which made the original science not 100% transferable to human nutrition.

            A food or a combination of foods which supply total needs (a high tropic score) will allow an individual to thrive.  A food intake that is not totally complete (a lower tropic score) will allow an individual to survive, but not grow to achieve their genetic potential. A food intake that is even less complete (a very low tropic score) will not allow an individual to mature sexually.

            It has been found that a diet of only rice or potatoes had higher tropic values than predicted – as illustrated by populations who have survived famine on these foods. Individuals survived, but didn’t thrive and children did not reach their growth potential. An early puzzle was that whole milk had a tropic value five times higher than the tropic value of fortified skim milk.  Work on essential fatty acids came later, but even today parents are advised to feed children under two years old whole milk.[i] Other scientists later found that young boys who did not mature sexually were found to be consuming a diet quite low in zinc

[i] Williams, Roger J. , James D. Heffley,  Man-Li Yew, Charles W. Bode. The “Tropic” Value of Foods. Proc Nat Acad Sci USA   1972; 70(3):710-713.

Nutrition and Mental Health – The Research

August 15th, 2013

Nutrition and Variation in Research Results 

Ruth Leyse-Wallace PhD

            Assumptions are everywhere, even in scientific research.Often nutritional status of the participants is not reported in research studies. If nutritional status of participants within or between groups is not the same, this may account for some of the unexplained variation in results.  

            One assumption is often that individuals accepted into a scientific study and randomly assigned to either group, are equal. Equal means alike in significant ways – ways that may make a difference.  For instance two groups may be equal in males and females, in age groups of participants, in health, race or culture, etc.  If a group of mostly males was compared to a group of mostly females, the investigators could not be sure the results were related to the treatment.  Results may have been affected by the fact males were affected differently than females.

            In other words, results may vary depending on the equality of the participants in each group. The variation in outcomes observed in research is often not understood or accounted for. This variation “muddies the waters” when drawing conclusions.

            Hypothetically, if a nutrient which affects mood (or other aspect of mental status) is at different levels in individuals who are receiving the research treatment (whether the treatment is a drug, cognitive therapy, or ECT, etc,), how do researchers know if any variation in results was due to the treatment or to the difference in nutritional status?  

            Even though determination of nutritional status is an incomplete science determination, consideration, and report of nutritional status in reports of clinical research has potential for explaining some of the observed and unexplained variation in results.  Nutrients that affect mental status include omega-3 fatty acids, folic acid, vitamin B-12 (cobalamin), vitamin C (ascorbic acid) , vitamin B-1 (thiamin), zinc, and others.Variation in results of scientific experiments may be explained if nutritional status was determined instead of assumed to be equal.