Many people crave carbohydrates when they feel low.
By Kathleen Doheny
Does a bad day at the office or a tiff with your spouse send you marching to the cookie jar or the corner bakery?
Or do you find yourself at the vending machine every day precisely at 4 p.m. for some crackers or candy?
If either scenario fits, you're not alone. Many people crave carbohydrates -- especially cookies, candy, or ice cream -- when they feel upset, depressed, or tired.
"Carb craving is part of daily life," says Judith Wurtman, PhD, a former scientist at the Massachusetts Institute of Technology and co-author of The Serotonin Power Diet. She and her husband, MIT professor Richard J. Wurtman, have long researched carbohydrates and their link to mood and depression.
The Wurtmans published a landmark article about carbs and depression in Scientific American in 1989. They are convinced that the carbohydrate craving is related to decreases in the feel-good hormone serotonin, which is marked by a decline in mood and concentration.
Other experts aren’t so sure. Some wonder if depressed mood and reaching for carbs are both related to an external event -- such as the stock market decline -- or to simply habit.
Carbohydrate Cravings: What's Known? What's Debated?
Carb cravings seem to be related to decreases in serotonin activity, says Wurtman.
"We discovered years and years ago that many people experience the 'universal carbohydrate craving time' between 3:30 p.m. and 5 p.m. every day," she says. "I suspect the tradition of English tea with its carb offering is a ritual developed to fill this need."
"It's a real neurochemical phenomenon," she says.
The Wurtmans’ work, however, has its skeptics.
Edward Abramson, PhD, a psychologist and professor emeritus at California State University, Chico, wrote the book Emotional Eating. He does not think the link is strong and clear-cut.
"You could be down because of loss of money in the stock market," he says. "The depression is triggered by an external event, not by [only] a dip in serotonin. It may be the external event causing the dip in serotonin, not the dip occurring, then the craving, he says.
Another possibility, says Abramson, is that carb craving may be just a habit, learned early. For instance, a woman brought up to believe that anger is not an acceptable emotion may turn to eating treats such as cookies instead -- because that's what she did as a kid and perhaps was encouraged to do by a parent.
Carb cravings can also result from diets, says Evelyn Tribole, RD, a dietitian in Newport Beach, Calif., and author of Healthy Homestyle Cooking.
She sees quite a few dieters who crave carbohydrates, especially if they’re on one of the high-protein, low-carb diets.
"You don't want to kill for a piece of broccoli, but you'd kill for a piece of bread. It's a clear signal,” she says, “that your body needs more carbs. It’s not an abnormal craving.”
Carbohydrate Cravings: The Research
Several research studies have uncovered interesting facts about carb cravers.
Wurtman found that carb cravers can eat 800 or more calories a day than other people. While many carb cravers do become overweight or obese, others control their weight by exercising more, eating less at meals, or turning to low-fat carbs such as popcorn.
Researchers at Rush University Medical Center in Chicago found that carb cravers who have a mildly depressed mood seem to be self-medicating. They studied women who were overweight and had a history of carb cravings. They gave them a choice between a protein-rich beverage or a carb-rich one. They found that when the women reported being in the worst moods, they picked the carb beverage more often than the protein one. In addition, the carb drink improved their mood better.
Eating carbohydrates seems to help carb cravers feel better in about 20 minutes, according to Wurtman’s research. When you eat carbs, your body makes more serotonin, the feel-good hormone that is boosted when you are on an antidepressant. Eating the carbs, she says, is an attempt to undo the depressed mood.
Carbohydrate Cravings: Normal or Not?
Step back and analyze your cravings a bit, Wurtman suggests.
Do you crave carbs only when you see someone eating something you like? Then, says Wurtman, you may simply be succumbing to the power of suggestion.
Or do you crave carbs when you face an unpleasant task, like balancing the checkbook, and feel better after you’ve had some? Then you may be “self-medicating.” Your serotonin is up, and you are doing what you are supposed to, says Wurtman.
Late-afternoon carb cravings are also quite normal, Wurtman says, and don’t necessarily signal depression. "The reason we want to self-medicate with carbs late in the afternoon is not just that life is difficult and filled with frustration, but that it is a normal day-night cycle."
When is a carb craving over the top? If you go to great lengths for a carb-rich food continually, you may want to seek professional help, Wurtman says.
She recalls a woman who was driven to have a brownie from her favorite bakery many times a week. When a ride wasn’t available, she would go to great lengths to get it, even walking several blocks in the dark or bad weather.
That kind of persistent craving may be a sign of depression, not just a funky off mood, and perhaps a clue you should seek mental health care, Wurtman and others say. If your mood stays low and the carbs don't seem to be helping, you should also consider checking in with a health care provider.
Carbohydrate Cravings: Living With Them, Taming Them
If you're a carb craver, you can learn to cope with them -- at minimal or no expense to your health or waistline, experts say.
Time your eating to accommodate your cravings. The carb cravings typically grow stronger as the day goes on, experts agree. So eat healthfully at breakfast and lunch and focus on protein-rich foods. "In the afternoon, by the time the sun and your mood start sinking, have a carb snack -- popcorn or breakfast cereal -- around 4 p.m.," Wurtman says. Then for dinner, pick pasta, rice or waffles, she suggests.
Choose sensible carbohydrate-rich foods. Carbs don't have to be gooey and chocolatey every time, Wurtman says. She suggests low-fat crackers, for instance, or pretzels. It keeps the fat low but gives you the carbs you want.
Don't buy into the guilt. "The current low-carb phase is making people feel guilty," Wurtman says. "There is nothing wrong with having a carb for dinner, or for a snack. You have to have it in a very low-fat form."
Focus on carbs that are "slow foods." Think sip, not gobble, when eating these. One of Tribole's favorites: hot chocolate. "You get carbs in the milk and the sweetened chocolate," she says. "It's hard to guzzle hot chocolate, so you are going to savor it."
SOURCES:
Judith Wurtman, PhD, former research scientist, Massachusetts Institute of Technology, Cambridge, Mass.; co-author, The Serotonin Power Diet.
Evelyn Tribole, RD, dietitian, Newport Beach, Calif.; author, Healthy Homestyle Coking and Ultimate Omega-3 Diet.
Edward Abramson, PhD, professor emeritus of psychology, California State University, Chico; author, Emotional Eating.
Wurtman, R. Scientific American, January 1989; vol 260: pp 68-75.
Corsica, J. Eating Behaviors, December 2008; vol. 9: pp 447-454.
Thursday, December 30, 2010
Diet 911: After You Overindulge
What to do after you've blown your calorie budget.
By Daphne Sashin
Holiday parties, gourmet meals, and celebratory dinners can easily get a little (or a lot) more decadent than you expected. Let’s face it: Everyone blows his or her calorie budget every now and then.
Do you need to worry? Is that old dieter’s saying, “a moment on the lips, forever on the hips” really true? And what should you do next?
WebMD asked medical experts, registered dieticians, and weight management specialists about the damage done by one-time splurges and their tips for getting back on track. Here’s what they recommend, whether you’re looking to maintain your weight or lose some extra pounds:
Relax (For a Moment)
The good news is, one meal is not going to ruin you if you eat sensibly and exercise regularly the rest of the time and get back to your routine, experts say. You need to eat 3,500 calories to gain one pound of body fat, so it’s unlikely that a single overindulgence will show up on the scale, experts say.
“We call these ‘taking time-outs,’ and we all take them,” says Rebecca S. Reeves, DrPH, RD, assistant professor at Baylor College of Medicine in Houston. “No one is perfect in their eating habits. What we have to learn is that we are giving ourselves permission to do this, and as soon as it’s over, we should go back to the eating plan we normally follow. This does not give us permission to continue to overeat and binge.”
The problem is, overeating is not a one-time affair for most Americans, says cardiologist Allen Dollar, MD, chief of cardiology at Grady Memorial Hospital and assistant professor of medicine at Emory University School of Medicine in Atlanta.
“Most people overeat somewhere between 500 and 1,500 calories every single day,” Dollar says. “If they don’t consciously think about their dietary intake every day, they will be overweight.”
Don’t Beat Yourself Up
Too many dieters throw in the towel after a splurge, says Kathleen M. Laquale, PhD, a licensed nutritionist, athletic trainer, and associate professor at Bridgewater State University in Massachusetts.
“You may feel defeated and say, ‘Oh I blew my diet, and I’ll just eat the whole Christmas season and the heck with it,” Laquale says. “When you do overindulge, don’t be self-deprecating. You overeat for one day; let’s get back on track again. Let’s be more conscious of our portion sizes the next day.”
Think of Your Diet Over the Course of Several Days
It’s typical to eat more sensibly during the week and take in more calories on the weekend, says Joan Salge Blake, MS, RD, clinical associate professor at Boston University.
So if you eat more calories than you should at a party on a weeknight, consider that one of your “weekend” days and compensate for it accordingly.
“In other words, you had a party on a Tuesday, and that party was quite fun and it almost became like a Saturday,” Salge Blake says. “Just make sure that the days that come after that festive occasion reflect more of the structured Monday-through-Thursday eating pattern, rather than the weekend.”
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
Resume Sensible Eating
You may be tempted to compensate for the extra calories by skipping meals the next day. But skipping breakfast or lunch will only leave you hungry and at risk for pigging out later.
Salge Blake recommends cutting back throughout the day with a series of small meals packed with fiber-rich fruits and vegetables:
Wait until you’re hungry. Then have a light breakfast such as a bowl of low-fat yogurt and berries.
Mid-morning snack: A piece of fruit and an ounce of low-fat cheese
Lunch: A big salad with lean protein such as fish or chicken, or a whole-wheat pita pocket with lettuce and tuna or turkey
Afternoon snack: A cup of vegetable soup and an orange
Dinner: A piece of fish and plenty of vegetables
Skip the Scale
After a feast, your weight is bound to be inflated. That’s not because of an increase in body fat, but because of water retention brought on by the excess salt you likely ate.
Weighing yourself will only make you feel defeated. Salge Blake tells clients to weigh themselves on Fridays, when they’re likely to weigh their lowest.
Stick to Your Normal Exercise Routine
Compensating for the extra calories by over-exercising will leave you burned out or worse, Laquale says.
“If you overload and do more than your regular routine, you could strain a muscle, you could hurt a joint. So muscle soreness may set in. Then you can’t exercise,” she says. “So now we’re into your third day, and you’re tight all over and you’re still feeling down because you overate, so it creates a vicious cycle.”
Track What You Eat
Setting a caloric goal for the day and recording what you eat keeps you conscious of what you’re eating, Dollar says. There are many calorie-counting web sites and mobile applications to choose from, including WebMD’s Food & Fitness Planner.
The only way to win the game “is to be meticulous about your total calories for the week,” Dollar says. “If you don’t stay on top of things, you’ll slowly and subtly lose the battle. You have to be conscious every time your hand goes from a plate to your mouth.”
SOURCES:
Rebecca S. Reeves, DrPH, RD, assistant professor, Baylor College of Medicine.
Allen Dollar MD, chief of cardiology, Grady Memorial Hospital; assistant professor of medicine, Emory University School of Medicine.
Kathleen M. Laquale, PhD, licensed nutritionist; athletic trainer; associate professor, Bridgewater State University.
Joan Salge Blake, MS, RD, clinical associate professor, Boston University
By Daphne Sashin
Holiday parties, gourmet meals, and celebratory dinners can easily get a little (or a lot) more decadent than you expected. Let’s face it: Everyone blows his or her calorie budget every now and then.
Do you need to worry? Is that old dieter’s saying, “a moment on the lips, forever on the hips” really true? And what should you do next?
WebMD asked medical experts, registered dieticians, and weight management specialists about the damage done by one-time splurges and their tips for getting back on track. Here’s what they recommend, whether you’re looking to maintain your weight or lose some extra pounds:
Relax (For a Moment)
The good news is, one meal is not going to ruin you if you eat sensibly and exercise regularly the rest of the time and get back to your routine, experts say. You need to eat 3,500 calories to gain one pound of body fat, so it’s unlikely that a single overindulgence will show up on the scale, experts say.
“We call these ‘taking time-outs,’ and we all take them,” says Rebecca S. Reeves, DrPH, RD, assistant professor at Baylor College of Medicine in Houston. “No one is perfect in their eating habits. What we have to learn is that we are giving ourselves permission to do this, and as soon as it’s over, we should go back to the eating plan we normally follow. This does not give us permission to continue to overeat and binge.”
The problem is, overeating is not a one-time affair for most Americans, says cardiologist Allen Dollar, MD, chief of cardiology at Grady Memorial Hospital and assistant professor of medicine at Emory University School of Medicine in Atlanta.
“Most people overeat somewhere between 500 and 1,500 calories every single day,” Dollar says. “If they don’t consciously think about their dietary intake every day, they will be overweight.”
Don’t Beat Yourself Up
Too many dieters throw in the towel after a splurge, says Kathleen M. Laquale, PhD, a licensed nutritionist, athletic trainer, and associate professor at Bridgewater State University in Massachusetts.
“You may feel defeated and say, ‘Oh I blew my diet, and I’ll just eat the whole Christmas season and the heck with it,” Laquale says. “When you do overindulge, don’t be self-deprecating. You overeat for one day; let’s get back on track again. Let’s be more conscious of our portion sizes the next day.”
Think of Your Diet Over the Course of Several Days
It’s typical to eat more sensibly during the week and take in more calories on the weekend, says Joan Salge Blake, MS, RD, clinical associate professor at Boston University.
So if you eat more calories than you should at a party on a weeknight, consider that one of your “weekend” days and compensate for it accordingly.
“In other words, you had a party on a Tuesday, and that party was quite fun and it almost became like a Saturday,” Salge Blake says. “Just make sure that the days that come after that festive occasion reflect more of the structured Monday-through-Thursday eating pattern, rather than the weekend.”
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
Resume Sensible Eating
You may be tempted to compensate for the extra calories by skipping meals the next day. But skipping breakfast or lunch will only leave you hungry and at risk for pigging out later.
Salge Blake recommends cutting back throughout the day with a series of small meals packed with fiber-rich fruits and vegetables:
Wait until you’re hungry. Then have a light breakfast such as a bowl of low-fat yogurt and berries.
Mid-morning snack: A piece of fruit and an ounce of low-fat cheese
Lunch: A big salad with lean protein such as fish or chicken, or a whole-wheat pita pocket with lettuce and tuna or turkey
Afternoon snack: A cup of vegetable soup and an orange
Dinner: A piece of fish and plenty of vegetables
Skip the Scale
After a feast, your weight is bound to be inflated. That’s not because of an increase in body fat, but because of water retention brought on by the excess salt you likely ate.
Weighing yourself will only make you feel defeated. Salge Blake tells clients to weigh themselves on Fridays, when they’re likely to weigh their lowest.
Stick to Your Normal Exercise Routine
Compensating for the extra calories by over-exercising will leave you burned out or worse, Laquale says.
“If you overload and do more than your regular routine, you could strain a muscle, you could hurt a joint. So muscle soreness may set in. Then you can’t exercise,” she says. “So now we’re into your third day, and you’re tight all over and you’re still feeling down because you overate, so it creates a vicious cycle.”
Track What You Eat
Setting a caloric goal for the day and recording what you eat keeps you conscious of what you’re eating, Dollar says. There are many calorie-counting web sites and mobile applications to choose from, including WebMD’s Food & Fitness Planner.
The only way to win the game “is to be meticulous about your total calories for the week,” Dollar says. “If you don’t stay on top of things, you’ll slowly and subtly lose the battle. You have to be conscious every time your hand goes from a plate to your mouth.”
SOURCES:
Rebecca S. Reeves, DrPH, RD, assistant professor, Baylor College of Medicine.
Allen Dollar MD, chief of cardiology, Grady Memorial Hospital; assistant professor of medicine, Emory University School of Medicine.
Kathleen M. Laquale, PhD, licensed nutritionist; athletic trainer; associate professor, Bridgewater State University.
Joan Salge Blake, MS, RD, clinical associate professor, Boston University
Tuesday, December 28, 2010
Beyond Dieting: Alternative Approaches to Weight Loss
How acupuncture, hypnosis, meditation, prayer, and other mind-body practices may help you lose weight.
By Shahreen Abedin
To lose weight, some people look beyond diet and exercise. Would methods like hypnosis, acupuncture, meditation, prayer, and traditional Eastern methods help budge the pounds?
Perhaps. But if you want to ditch diet and exercise altogether, think again.
“The bottom line is to be more active and consume less calories,” says Elisabetta Politi, MPH, RD, LDN, CDE, nutrition director at the Duke Diet and Fitness Center in Durham, N.C. “There is no magic bullet for solving your weight loss problem."
So the basics will always be eating right and exercising.
But there is a "third part, the mind-body aspect, you need to make sure you're not missing out on," says Wendy Kohatsu, MD, an integrative medicine specialist and assistant clinical professor of family and clinical medicine at the University of California, San Francisco.
Most complementary approaches don't have much research showing how well they work for weight loss. Some are tricky to test by Western standards, and not enough studies have been done to determine effectiveness.
Here's what you need to know before you consider trying these methods.
Acupuncture
One of the best-known branches of traditional Chinese medicine, acupuncture aims to remove blockages in the flow of your qi, or life force.
Practitioners do this by sticking very thin metal needles into strategic points on the skin. Qi is thought to circulate throughout the body and balance out spiritual, emotional, mental, and physical health.
In 2007, about 3 million U.S. adults reported using acupuncture in the previous year, especially for back pain, nausea, depression, and arthritis.
Weight loss isn't a traditional acupuncture goal, says Victor Sierpina, MD, an acupuncturist, holistic medicine expert, and family doctor at the University of Texas Medical Branch in Galveston, Texas.
But some aspects of acupuncture seem particularly useful in losing weight, Sierpina says.
Acupuncture may help you relax. That's useful if you eat because you're stressed or depressed
Acupuncture is generally safe when done by a competent practitioner. The cost -- typically $50-$85 per session -- can be pricey, Sierpina says.
Acupressure
Like acupuncture, acupressure targets certain points on the body. But it's done with pressure from the fingers or other devices, not needle sticks.
In 2007, a small study lasting six months showed that people using one form of acupressure lost about 2.5 pounds more than those who went to a support group. But more research is needed for experts to support acupressure as an effective weight loss method.
You can learn to do acupressure yourself, and it can even be learned from a book or video, Sierpina says.
Ayurveda
A form of traditional Indian medicine, Ayurveda strives for harmony and balance between body, mind, and spirit. In modern India, Ayurveda is still widely used, though not exclusively.
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
A key to Ayurveda is developing your “dosha,” or “life force” profile. The three doshas are called kapha, pitta, and vata. Your dosha balance is based on your eating habits, behaviors, lifestyle, and medical history.
For weight loss, an ayurvedic practitioner will probably try to rebalance your doshas through your diet. For example, kaphas may be told to switch to leaner proteins and trim calories for better harmony.
Ayurveda is a highly personalized method that requires careful guidance by an experienced practitioner. So be sure to ask about background and training, Sierpina says.
Also, be careful about any herbal supplements prescribed. Choose only high-quality products to avoid dangerous contaminants and heavy metals. And tell your mainstream doctor about any supplements you take.
Mindfulness and Meditation
Meditation and mindfulness have a lot in common. And they can both help with your eating.
Mindfulness is a nonjudgmental way of paying attention to the present moment.
For weight loss, mindfulness includes noticing when you're hungry and full, so you don’t eat out of automatic patterns, Hecht says.
Try it. Study a piece of food intensely before putting it in your mouth. Then eat it very slowly, paying close attention to the taste, texture, and how your body responds as you eat.
That's very different from eating food on the run, disconnected from your feelings.
When you're mindful, you might even notice that you're not all that hungry, or that you're satisfied sooner than you think. That may help you not overindulge.
“There is strong weight loss evidence that eating slowly and mindfully helps you eat less, even without meditation,” Politi says.
Meditation is about focusing your attention -- often on your breath, thoughts and feelings, or mantra.
People use meditation to deal with anxiety, pain, depression, stress, sleep problems, and just to feel better. A 2007 study showed that more than 9% of American adults had meditated in the previous year.
Frederick Hecht, MD, researches meditation and mindful eating. “Based on our preliminary research, we do think both mindfulness and meditation may assist people in losing weight, especially in maintaining weight loss, but it would have to be in combination with diet and exercise,” says Hecht, the research director at the Osher Center for Integrative Medicine at the University of California, San Francisco.
Meditation and mindfulness are easy to learn. It may help to take some classes, but once you know how, they cost nothing to practice and can be done anywhere.
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
Qi Gong
Qi gong, a Chinese form of meditation, has shown some early success in weight loss and is being studied further.
The practice includes gentle movements to help stimulate digestion and mental exercises to learn how your body works best, in terms of energy, sleep, and activity.
“As you become more in tuned with what your body needs, you get more from what you eat, so you eat less,” says Alex Holland, MAc, LAc, president and co-founder of the Asian Institute of Medical Studies in Tucson.
Holland stresses finding a reputable instructor and using qi gong to complement a regular weight loss program.
Hypnosis
The research is still scarce, but there is some evidence that hypnosis might help you lose extra weight when used with diet and exercise.
Studies have shown an average of about 6 pounds of weight loss through hypnosis, according to the Mayo Clinic.
“You learn to focus your concentration and enter a state of inner absorption, like a trance,” says mind-body psychologist and clinical hypnotherapist Steven Gurgevich, PhD, author of The Self-Hypnosis Diet.
Combining hypnotic suggestions with other mind-body methods -- such as affirmations, visualizations, and mentally rehearsing how you will approach food and exercise -- can train you to make those changes, Gurgevich says.
“Effective self-hypnosis relies on being highly motivated, and on believing it’s going to help you,” says Gurgevich, , a clinical associate professor of medicine at the Arizona Center for Integrative Medicine at the University of Arizona College of Medicine.
It takes consistent effort. People practice at least twice a day for about 20 minutes for a few months before seeing results, Gurgevich says.
Some people might require extensive work with a licensed hypnotherapist to get past certain barriers, like past psychological traumas. But after learning the techniques, most people practice self-hypnosis on their own or with a CD for guidance.
Gurgevich recommends finding a medical professional trained to treat your specific condition who also practices clinical hypnotherapy.
Prayer
Popular faith-based weight loss books include The Weigh Down Diet, The Hallelujah Diet, The Prayer Diet, and The Maker’s Diet.
Some of them suggest that spiritual hunger is often mistaken for physical hunger, and encourage people to turn to God, rather than food, to ease their emotional pain.
Many of these programs focus on your mental and emotional relationship to food, hunger, and feeling full -- and on how you relate to a higher power.
Some faith-based weight programs take a relaxed attitude toward eating, instead emphasizing your spiritual side. Others tout stricter regimens, like vegan diets or 40-day diet plans.
“Prayer can be a contemplative, peaceful event to help you control your life emotionally. Like meditation, it’s a great way to tune out mental noise and use your inner resources for positive reinforcement,” says Roberta Lee, MD, vice chairwoman of the integrative medicine department at New York City’s Beth Israel Medical Center.
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
Many faith-based weight loss programs include support groups. Those can help, Lee says.
“As long as a program uses a reasonable plan that’s not extreme, I can imagine a prayer-based weight loss program can work,” says Lee, author of The Superstress Solution.
But such programs, Lee says, still need diet and exercise as their backbone.
Her advice: If this type of program appeals to you, look for one that encourages you and makes you feel more centered, and be wary of those that judge or shun people who fall off the wagon.
SOURCES:
Barnes P. National Health Statistics Reports; December 2008; pp 1-24.
Elder, C. The Journal of Alternative and Complementary Medicine, January/February 2007; vol 13: pp 67-78.
Sharpe, P. The Journal of Alternative and Complementary Medicine, March 2007; vol 13: pp 217-222.
CDC: 2007 National Health Interview Survey.
Steven Gurgevich, PhD, clinical associate professor of medicine, Arizona Center for Integrative Medicine, University of Arizona College of Medicine; mind-body psychologist; clinical hypnotherapist, Sabino Canyon Integrative Medicine, LLC; co-author, The Self-Hypnosis Diet.
Frederick Hecht, MD, research director, professor of medicine, Osher Center for Integrative Medicine, University of California, San Francisco.
Alex Holland, MAc, LAc, president, co-founder, Asian Institute of Medical Studies, Tucson, Arizona.
Wendy Kohatsu, MD, assistant clinical professor of family and clinical medicine at University of California, San Francisco; director, Integrative Medicine Fellowship, Santa Rosa Family Medicine Residency program; chef, Santa Rosa, California.
Roberta Lee, MD, vice chairwoman, Department of Integrative Medicine, Beth Israel Medical Center, New York, NY; integrative medicine specialist at the Continuum Center for Health and Healing at New York City’s Beth Israel Medical Center; author, The Superstress Solution.
Elisabetta Politi, MPH, RD, LDN, CDE, nutrition director, Duke Diet and Fitness Center, Durham, North Carolina.
Victor Sierpina, MD, acupuncturist, holistic medicine expert, WD and Laura Nell Nicholson Family Professor of Integrative Medicine, University of Texas Medical Branch (UTMB) in Galveston, Texas; founding diplomat, American Board of Integrative and Holistic Medicine; author, The Healthy Gut Workbook.
FDA.
Mayo Clinic: "Is Hypnosis Effective for Weight Loss?"
National Center for Complementary and Alternative Medicine: “Ayurvedic Medicine: An Introduction.”
National Center for Complementary and Alternative Medicine: “Meditation: An Introduction.”
National Center for Complementary and Alternative Medicine: “Traditional Chinese Medicine: An Introduction.”
By Shahreen Abedin
To lose weight, some people look beyond diet and exercise. Would methods like hypnosis, acupuncture, meditation, prayer, and traditional Eastern methods help budge the pounds?
Perhaps. But if you want to ditch diet and exercise altogether, think again.
“The bottom line is to be more active and consume less calories,” says Elisabetta Politi, MPH, RD, LDN, CDE, nutrition director at the Duke Diet and Fitness Center in Durham, N.C. “There is no magic bullet for solving your weight loss problem."
So the basics will always be eating right and exercising.
But there is a "third part, the mind-body aspect, you need to make sure you're not missing out on," says Wendy Kohatsu, MD, an integrative medicine specialist and assistant clinical professor of family and clinical medicine at the University of California, San Francisco.
Most complementary approaches don't have much research showing how well they work for weight loss. Some are tricky to test by Western standards, and not enough studies have been done to determine effectiveness.
Here's what you need to know before you consider trying these methods.
Acupuncture
One of the best-known branches of traditional Chinese medicine, acupuncture aims to remove blockages in the flow of your qi, or life force.
Practitioners do this by sticking very thin metal needles into strategic points on the skin. Qi is thought to circulate throughout the body and balance out spiritual, emotional, mental, and physical health.
In 2007, about 3 million U.S. adults reported using acupuncture in the previous year, especially for back pain, nausea, depression, and arthritis.
Weight loss isn't a traditional acupuncture goal, says Victor Sierpina, MD, an acupuncturist, holistic medicine expert, and family doctor at the University of Texas Medical Branch in Galveston, Texas.
But some aspects of acupuncture seem particularly useful in losing weight, Sierpina says.
Acupuncture may help you relax. That's useful if you eat because you're stressed or depressed
Acupuncture is generally safe when done by a competent practitioner. The cost -- typically $50-$85 per session -- can be pricey, Sierpina says.
Acupressure
Like acupuncture, acupressure targets certain points on the body. But it's done with pressure from the fingers or other devices, not needle sticks.
In 2007, a small study lasting six months showed that people using one form of acupressure lost about 2.5 pounds more than those who went to a support group. But more research is needed for experts to support acupressure as an effective weight loss method.
You can learn to do acupressure yourself, and it can even be learned from a book or video, Sierpina says.
Ayurveda
A form of traditional Indian medicine, Ayurveda strives for harmony and balance between body, mind, and spirit. In modern India, Ayurveda is still widely used, though not exclusively.
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
A key to Ayurveda is developing your “dosha,” or “life force” profile. The three doshas are called kapha, pitta, and vata. Your dosha balance is based on your eating habits, behaviors, lifestyle, and medical history.
For weight loss, an ayurvedic practitioner will probably try to rebalance your doshas through your diet. For example, kaphas may be told to switch to leaner proteins and trim calories for better harmony.
Ayurveda is a highly personalized method that requires careful guidance by an experienced practitioner. So be sure to ask about background and training, Sierpina says.
Also, be careful about any herbal supplements prescribed. Choose only high-quality products to avoid dangerous contaminants and heavy metals. And tell your mainstream doctor about any supplements you take.
Mindfulness and Meditation
Meditation and mindfulness have a lot in common. And they can both help with your eating.
Mindfulness is a nonjudgmental way of paying attention to the present moment.
For weight loss, mindfulness includes noticing when you're hungry and full, so you don’t eat out of automatic patterns, Hecht says.
Try it. Study a piece of food intensely before putting it in your mouth. Then eat it very slowly, paying close attention to the taste, texture, and how your body responds as you eat.
That's very different from eating food on the run, disconnected from your feelings.
When you're mindful, you might even notice that you're not all that hungry, or that you're satisfied sooner than you think. That may help you not overindulge.
“There is strong weight loss evidence that eating slowly and mindfully helps you eat less, even without meditation,” Politi says.
Meditation is about focusing your attention -- often on your breath, thoughts and feelings, or mantra.
People use meditation to deal with anxiety, pain, depression, stress, sleep problems, and just to feel better. A 2007 study showed that more than 9% of American adults had meditated in the previous year.
Frederick Hecht, MD, researches meditation and mindful eating. “Based on our preliminary research, we do think both mindfulness and meditation may assist people in losing weight, especially in maintaining weight loss, but it would have to be in combination with diet and exercise,” says Hecht, the research director at the Osher Center for Integrative Medicine at the University of California, San Francisco.
Meditation and mindfulness are easy to learn. It may help to take some classes, but once you know how, they cost nothing to practice and can be done anywhere.
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
Qi Gong
Qi gong, a Chinese form of meditation, has shown some early success in weight loss and is being studied further.
The practice includes gentle movements to help stimulate digestion and mental exercises to learn how your body works best, in terms of energy, sleep, and activity.
“As you become more in tuned with what your body needs, you get more from what you eat, so you eat less,” says Alex Holland, MAc, LAc, president and co-founder of the Asian Institute of Medical Studies in Tucson.
Holland stresses finding a reputable instructor and using qi gong to complement a regular weight loss program.
Hypnosis
The research is still scarce, but there is some evidence that hypnosis might help you lose extra weight when used with diet and exercise.
Studies have shown an average of about 6 pounds of weight loss through hypnosis, according to the Mayo Clinic.
“You learn to focus your concentration and enter a state of inner absorption, like a trance,” says mind-body psychologist and clinical hypnotherapist Steven Gurgevich, PhD, author of The Self-Hypnosis Diet.
Combining hypnotic suggestions with other mind-body methods -- such as affirmations, visualizations, and mentally rehearsing how you will approach food and exercise -- can train you to make those changes, Gurgevich says.
“Effective self-hypnosis relies on being highly motivated, and on believing it’s going to help you,” says Gurgevich, , a clinical associate professor of medicine at the Arizona Center for Integrative Medicine at the University of Arizona College of Medicine.
It takes consistent effort. People practice at least twice a day for about 20 minutes for a few months before seeing results, Gurgevich says.
Some people might require extensive work with a licensed hypnotherapist to get past certain barriers, like past psychological traumas. But after learning the techniques, most people practice self-hypnosis on their own or with a CD for guidance.
Gurgevich recommends finding a medical professional trained to treat your specific condition who also practices clinical hypnotherapy.
Prayer
Popular faith-based weight loss books include The Weigh Down Diet, The Hallelujah Diet, The Prayer Diet, and The Maker’s Diet.
Some of them suggest that spiritual hunger is often mistaken for physical hunger, and encourage people to turn to God, rather than food, to ease their emotional pain.
Many of these programs focus on your mental and emotional relationship to food, hunger, and feeling full -- and on how you relate to a higher power.
Some faith-based weight programs take a relaxed attitude toward eating, instead emphasizing your spiritual side. Others tout stricter regimens, like vegan diets or 40-day diet plans.
“Prayer can be a contemplative, peaceful event to help you control your life emotionally. Like meditation, it’s a great way to tune out mental noise and use your inner resources for positive reinforcement,” says Roberta Lee, MD, vice chairwoman of the integrative medicine department at New York City’s Beth Israel Medical Center.
Top PicksProbiotic Foods: Should You Be Eating Them? RA: Eat to Beat Inflammation High-Fiber Super Foods What's Stopping You From Eating Right?
Many faith-based weight loss programs include support groups. Those can help, Lee says.
“As long as a program uses a reasonable plan that’s not extreme, I can imagine a prayer-based weight loss program can work,” says Lee, author of The Superstress Solution.
But such programs, Lee says, still need diet and exercise as their backbone.
Her advice: If this type of program appeals to you, look for one that encourages you and makes you feel more centered, and be wary of those that judge or shun people who fall off the wagon.
SOURCES:
Barnes P. National Health Statistics Reports; December 2008; pp 1-24.
Elder, C. The Journal of Alternative and Complementary Medicine, January/February 2007; vol 13: pp 67-78.
Sharpe, P. The Journal of Alternative and Complementary Medicine, March 2007; vol 13: pp 217-222.
CDC: 2007 National Health Interview Survey.
Steven Gurgevich, PhD, clinical associate professor of medicine, Arizona Center for Integrative Medicine, University of Arizona College of Medicine; mind-body psychologist; clinical hypnotherapist, Sabino Canyon Integrative Medicine, LLC; co-author, The Self-Hypnosis Diet.
Frederick Hecht, MD, research director, professor of medicine, Osher Center for Integrative Medicine, University of California, San Francisco.
Alex Holland, MAc, LAc, president, co-founder, Asian Institute of Medical Studies, Tucson, Arizona.
Wendy Kohatsu, MD, assistant clinical professor of family and clinical medicine at University of California, San Francisco; director, Integrative Medicine Fellowship, Santa Rosa Family Medicine Residency program; chef, Santa Rosa, California.
Roberta Lee, MD, vice chairwoman, Department of Integrative Medicine, Beth Israel Medical Center, New York, NY; integrative medicine specialist at the Continuum Center for Health and Healing at New York City’s Beth Israel Medical Center; author, The Superstress Solution.
Elisabetta Politi, MPH, RD, LDN, CDE, nutrition director, Duke Diet and Fitness Center, Durham, North Carolina.
Victor Sierpina, MD, acupuncturist, holistic medicine expert, WD and Laura Nell Nicholson Family Professor of Integrative Medicine, University of Texas Medical Branch (UTMB) in Galveston, Texas; founding diplomat, American Board of Integrative and Holistic Medicine; author, The Healthy Gut Workbook.
FDA.
Mayo Clinic: "Is Hypnosis Effective for Weight Loss?"
National Center for Complementary and Alternative Medicine: “Ayurvedic Medicine: An Introduction.”
National Center for Complementary and Alternative Medicine: “Meditation: An Introduction.”
National Center for Complementary and Alternative Medicine: “Traditional Chinese Medicine: An Introduction.”
Monday, December 27, 2010
The Deadliest Diets: Study ID's 2 Eating Patterns That Make Older Adults Die Sooner
By Daniel J. DeNoon
Dec. 22, 2010 -- Two specific eating patterns increase the risk of death for older adults, a 10-year study finds.
Compared to people who ate healthy foods, men and women in their 70s had a 40% higher risk of death if they got most of their calories from high-fat dairy foods or from sweets and desserts.
University of Maryland researcher Amy L. Anderson, PhD, and colleagues monitored the eating patterns of 2,582 adults aged 70 to 79. They found that these diets fell into six patterns or clusters.
After adjusting for risk factors such as sex, age, race, education, physical activity, smoking, and total calories, "the High-Fat Dairy Products cluster and the Sweets and Desserts cluster still showed significantly higher risk of mortality than the Healthy Foods cluster," Anderson and colleagues found.
The six dietary patterns were:
Healthy Foods: Higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables. Lower intake of meat, fried foods, sweets, high-energy drinks, and added fat.
High-Fat Dairy Products: Higher intake of ice cream, cheese, and 2% and whole milk and yogurt. Lower intake of poultry, low-fat dairy products, rice, and pasta.
Sweets and Desserts: Higher intake of doughnuts, cake, cookies, pudding, chocolate, and candy. Lower intake of fruit, fish and other seafood, and dark green vegetables.
Meat, Fried Foods, and Alcohol: Higher intake of beer, liquor, fried chicken, mayonnaise/salad dressings, high-energy density drinks, nuts, snacks, rice/pasta dishes, and added fat. Lower intake of low-fat dairy products, fiber/bran breakfast cereal, and other breakfast cereal.
Breakfast Cereal: Higher intake of fiber/bran and other breakfast cereals (especially the latter). Low intake of nuts, refined grains, dark yellow vegetables, and dark green vegetables.
Refined Grains: Higher intake of refined grains (such as pancakes, waffles, breads, muffins, and cooked cereals such as oatmeal) and processed meat (such as bacon, sausage, ham, and other lunchmeats). Lower intake of liquor, breakfast cereals, and whole grains.
Several of the groups got an unusually large amount of their total calories from just one food group:
The sweets and desserts cluster got 25.8% of its total energy from sweets.
The refined grains cluster got 24.6% of its total energy from refined grains.
The breakfast cereal group got 19.3% of its total energy from cold cereals other than those full of fiber and bran.
The high-fat dairy products group got 17.1% of its total energy from higher-fat dairy foods.
Healthy Eaters Live Longest
Overall, people in the healthy foods cluster had more years of healthy life and a lower death rate than all other groups. Moreover, their blood tests came back with significantly more indicators of health than the other groups.
But not all of the study findings were so predictable.
"Unexpectedly, in this and in several other studies, a [dietary] pattern higher in red meat was not significantly associated with increased risk of mortality," Anderson and colleagues note.
It's also not entirely clear why the Meat, Fried Food, and Alcohol cluster didn't have a significantly higher death risk, as most diets warn people to limit or avoid such foods.
"In our study, the Meat, Fried Food, and Alcohol cluster did have a slightly higher percentage of total energy from vegetables, fruit, and whole grains than both the High-Fat Dairy Products and Sweets and Desserts clusters, which showed higher risk of mortality," Anderson and colleagues suggest.
This was by far the most common eating pattern seen in the study: 27% of participants were in the meat, fried food, and alcohol cluster. But Anderson and colleagues do not recommend such a diet.
Instead, they point to the fact that 14.5% of study participants were in the healthy foods cluster.
"Adherence to such a diet appears a feasible and realistic recommendation for potentially improved survival and quality of life in the growing older adult population," Anderson and colleagues conclude.
The study appears in the January 2011 issue of the Journal of the American Dietetic Association.
SOURCE:
Anderson, A.L. Journal of the American Dietetic Association, January 2011; vol 111: pp 84-91.
Dec. 22, 2010 -- Two specific eating patterns increase the risk of death for older adults, a 10-year study finds.
Compared to people who ate healthy foods, men and women in their 70s had a 40% higher risk of death if they got most of their calories from high-fat dairy foods or from sweets and desserts.
University of Maryland researcher Amy L. Anderson, PhD, and colleagues monitored the eating patterns of 2,582 adults aged 70 to 79. They found that these diets fell into six patterns or clusters.
After adjusting for risk factors such as sex, age, race, education, physical activity, smoking, and total calories, "the High-Fat Dairy Products cluster and the Sweets and Desserts cluster still showed significantly higher risk of mortality than the Healthy Foods cluster," Anderson and colleagues found.
The six dietary patterns were:
Healthy Foods: Higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables. Lower intake of meat, fried foods, sweets, high-energy drinks, and added fat.
High-Fat Dairy Products: Higher intake of ice cream, cheese, and 2% and whole milk and yogurt. Lower intake of poultry, low-fat dairy products, rice, and pasta.
Sweets and Desserts: Higher intake of doughnuts, cake, cookies, pudding, chocolate, and candy. Lower intake of fruit, fish and other seafood, and dark green vegetables.
Meat, Fried Foods, and Alcohol: Higher intake of beer, liquor, fried chicken, mayonnaise/salad dressings, high-energy density drinks, nuts, snacks, rice/pasta dishes, and added fat. Lower intake of low-fat dairy products, fiber/bran breakfast cereal, and other breakfast cereal.
Breakfast Cereal: Higher intake of fiber/bran and other breakfast cereals (especially the latter). Low intake of nuts, refined grains, dark yellow vegetables, and dark green vegetables.
Refined Grains: Higher intake of refined grains (such as pancakes, waffles, breads, muffins, and cooked cereals such as oatmeal) and processed meat (such as bacon, sausage, ham, and other lunchmeats). Lower intake of liquor, breakfast cereals, and whole grains.
Several of the groups got an unusually large amount of their total calories from just one food group:
The sweets and desserts cluster got 25.8% of its total energy from sweets.
The refined grains cluster got 24.6% of its total energy from refined grains.
The breakfast cereal group got 19.3% of its total energy from cold cereals other than those full of fiber and bran.
The high-fat dairy products group got 17.1% of its total energy from higher-fat dairy foods.
Healthy Eaters Live Longest
Overall, people in the healthy foods cluster had more years of healthy life and a lower death rate than all other groups. Moreover, their blood tests came back with significantly more indicators of health than the other groups.
But not all of the study findings were so predictable.
"Unexpectedly, in this and in several other studies, a [dietary] pattern higher in red meat was not significantly associated with increased risk of mortality," Anderson and colleagues note.
It's also not entirely clear why the Meat, Fried Food, and Alcohol cluster didn't have a significantly higher death risk, as most diets warn people to limit or avoid such foods.
"In our study, the Meat, Fried Food, and Alcohol cluster did have a slightly higher percentage of total energy from vegetables, fruit, and whole grains than both the High-Fat Dairy Products and Sweets and Desserts clusters, which showed higher risk of mortality," Anderson and colleagues suggest.
This was by far the most common eating pattern seen in the study: 27% of participants were in the meat, fried food, and alcohol cluster. But Anderson and colleagues do not recommend such a diet.
Instead, they point to the fact that 14.5% of study participants were in the healthy foods cluster.
"Adherence to such a diet appears a feasible and realistic recommendation for potentially improved survival and quality of life in the growing older adult population," Anderson and colleagues conclude.
The study appears in the January 2011 issue of the Journal of the American Dietetic Association.
SOURCE:
Anderson, A.L. Journal of the American Dietetic Association, January 2011; vol 111: pp 84-91.
Friday, December 24, 2010
U.S. Spending Millions to See if Herbs Truly Work: Research aims to remove the mystery around popular dietary supplements
By Dennis Thompson
HealthDay Reporter
THURSDAY, Dec. 16 (HealthDay News) -- People have been using herbal supplements for centuries to cure all manner of ills and improve their health. But for all the folk wisdom promoting the use of such plants as St. John's wort and black cohosh, much about their effect on human health remains unknown.
"A lot of these products are widely used by the consumer, and we don't have evidence one way or the other whether they are safe and effective," said Marguerite Klein, director of the Botanical Research Centers Program at the U.S. National Institutes of Health. "We have a long way to go. It's a big job."
In August, the U.S. National Center for Complementary and Alternative Medicine and the Office of Dietary Supplements awarded about $37 million in grants to five interdisciplinary and collaborative dietary supplement centers across the nation. The grants were part of a decade-long initiative that so far has awarded more than $250 million toward research to look into the safety and efficacy of health products made from the stems, seeds, leaves, bark and flowers of plants.
The increase has prompted some concern from doctors and health researchers. There are worries regarding the purity and consistency of supplements, which are not regulated as strictly as pharmaceutical drugs.
Some products contain less than the promoted amount of the supplement in question -- such as a 400-milligram capsule of echinacea containing just 250 milligrams of the herb. Other products are tainted by pesticides or heavy metals.
But even when someone takes a valid herbal supplement, it may not be as effective when taken as a pill or capsule rather than used in the manner of a folk remedy.
Researchers also are concerned that there just isn't a lot of evidence to support the health benefits said to be gained from herbal supplements. People may be misusing them, which can lead to poor health and potential interactions with prescription drugs.
Botanical research efforts that received recent federal funding include:
•Pennington Biomedical Research Center in Baton Rouge, La., to investigate how supplements such as artemisia and St. John's wort can reduce a person's chances of developing metabolic syndrome.
•University of Illinois at Chicago, to examine how the body processes herbal supplements.
•University of Illinois at Urbana-Champaign, to investigate the safety and efficacy of such botanical estrogens as wild yam, soy and dong quai, and particularly their potential to contribute to cancer in women.
•University of Missouri, Columbia, to look at the molecular pathways used by supplements such as garlic and elderberry to affect human health.
•Wake Forest University Baptist Medical Center, Winston-Salem, N.C., to study the potential of botanical oils to boost the immune system and reduce inflammation.
Despite the concerns of the medical community, researchers believe there are a lot of valid health benefits that can be derived from botanical supplements. These benefits just need to be proven in the lab.
To read the entire story, go to:
http://consumer.healthday.com/Article.asp?AID=644082
HealthDay Reporter
THURSDAY, Dec. 16 (HealthDay News) -- People have been using herbal supplements for centuries to cure all manner of ills and improve their health. But for all the folk wisdom promoting the use of such plants as St. John's wort and black cohosh, much about their effect on human health remains unknown.
"A lot of these products are widely used by the consumer, and we don't have evidence one way or the other whether they are safe and effective," said Marguerite Klein, director of the Botanical Research Centers Program at the U.S. National Institutes of Health. "We have a long way to go. It's a big job."
In August, the U.S. National Center for Complementary and Alternative Medicine and the Office of Dietary Supplements awarded about $37 million in grants to five interdisciplinary and collaborative dietary supplement centers across the nation. The grants were part of a decade-long initiative that so far has awarded more than $250 million toward research to look into the safety and efficacy of health products made from the stems, seeds, leaves, bark and flowers of plants.
The increase has prompted some concern from doctors and health researchers. There are worries regarding the purity and consistency of supplements, which are not regulated as strictly as pharmaceutical drugs.
Some products contain less than the promoted amount of the supplement in question -- such as a 400-milligram capsule of echinacea containing just 250 milligrams of the herb. Other products are tainted by pesticides or heavy metals.
But even when someone takes a valid herbal supplement, it may not be as effective when taken as a pill or capsule rather than used in the manner of a folk remedy.
Researchers also are concerned that there just isn't a lot of evidence to support the health benefits said to be gained from herbal supplements. People may be misusing them, which can lead to poor health and potential interactions with prescription drugs.
Botanical research efforts that received recent federal funding include:
•Pennington Biomedical Research Center in Baton Rouge, La., to investigate how supplements such as artemisia and St. John's wort can reduce a person's chances of developing metabolic syndrome.
•University of Illinois at Chicago, to examine how the body processes herbal supplements.
•University of Illinois at Urbana-Champaign, to investigate the safety and efficacy of such botanical estrogens as wild yam, soy and dong quai, and particularly their potential to contribute to cancer in women.
•University of Missouri, Columbia, to look at the molecular pathways used by supplements such as garlic and elderberry to affect human health.
•Wake Forest University Baptist Medical Center, Winston-Salem, N.C., to study the potential of botanical oils to boost the immune system and reduce inflammation.
Despite the concerns of the medical community, researchers believe there are a lot of valid health benefits that can be derived from botanical supplements. These benefits just need to be proven in the lab.
To read the entire story, go to:
http://consumer.healthday.com/Article.asp?AID=644082
Monday, December 20, 2010
Kids' Diets Rarely Mimic Their Parents' By Brenda Goodman
Dec. 10, 2010 -- A new study suggests that parents have minimal sway over their children's diets.
The review, which flouts conventional wisdom and previous research, takes a new look at studies of family eating habits published since 1980 and finds little similarity between the diets of children and their parents.
"This result contradicts other studies," says Marion Nestle, PhD, MPH, a professor of nutrition and sociology at New York University, who was not involved in the current research.
Nestle says previous work has found that parents have a good deal of influence over what their kids eat, but that the degree of influence lessens as kids move into their tweens and teens.
"If it's little kids, parents have plenty of influence. High school? Forget it. Peer pressure is overwhelming," Nestle says.
Still, she thinks the study, which is published in the Journal of Epidemiology and Community Health, may have captured an important shift in how children make choices about what to eat.
"It's certainly true that advertisers have penetrated the consciousness of even very young children, as any parent of a 2-year-old can attest," Nestle says. "The very purpose of marketing to children is to convince kids that they are supposed to eat 'kids' food,' not what their parents eat, and that they know more about what they are supposed to eat than their parents do. So if this study is correct, they are succeeding."
Kids, Parents, and Eating Habits
The authors of the new review, who were from Johns Hopkins University and the National Institutes of Health, combed the scientific literature for studies that assessed the diets of parents and their children from January 1980 through September 2009. Only 24 were deemed to be strong enough to be included.
The reviewers point out that many of the studies were small, which may weaken the statistical power of the results, and that the conclusions of the individual studies varied considerably.
When taken together, though, researchers say it appears that kids eat the same percent of recommended daily calories and fat as their parents only about 20% of the time.
"It was a weak to moderate association," says May A. Beydoun, PhD, staff scientist at the National Institute on Aging in Baltimore, who co-authored the study.
Beydoun thinks several factors probably contributed to the results.
"It's possible that there are only one or two shared meals with parents each day, especially if kids are eating at school, and that has an effect, or that parents who are trying to save money are giving their kids different foods than they eat," Beydoun says, "or because of the increasing influence of marketing that kids are making more of their own food choices."
The study's authors also found that children eat more like their parents in other countries, particularly non-European ones. A study in Brazil, for example, found that kids eat like their mothers do about 40% of the time.
Expert Opinions
But other nutrition experts said they were perplexed by the conclusions of the review.
"I'm a little surprised, actually," says Susan H. Babey, PhD, a research scientist for the Center for Health Policy Research at the University of California at Los Angeles. She published a policy brief in 2009 that found that teenagers were more likely to copy either the good or bad nutrition habits of their parents.
"It does make me wonder what's causing the difference in these findings," Babey says.
Her paper found, for instance, that adolescents whose parents drink soda daily were 40% more likely to drink it themselves compared to kids whose parents did not drink soda. And children whose parents ate at least five daily servings of fruits and vegetables were at least 16% more likely get their recommended amounts, compared to children whose parents didn't eat at least five servings of those foods.
"Our data suggests, and it's my own personal belief as a parent that I have some control over what my kids eat. I'm not really sure how to reconcile the two," she says.
And other experts cautioned that it is very difficult to make any assessments about how kids eat compared to their parents, largely because of the difficulty of getting kids to accurately remember the details of meals and snacks.
But even with questions about the reliability of the data, they say the study's conclusions rang true.
"I'm doing a large childhood obesity study, and we were just talking about this the other day, how kids don't eat like their parents," says Kerri N. Boutelle, PhD, associate professor of pediatrics at the University of California at San Diego, who was not involved with the study.
"My 9-year-old daughter is eating a peanut butter sandwich for lunch, and I'm having a salad," Boutelle says. "And kids eat the same things over and over again, while adults won't. So I'd say no, kids don't really eat like their parents, especially as they get older."
SOURCES: Marion Nestle, PhD, MPH, professor of nutrition and sociology, New York University.Babey, Susan, PhD, research scientist, University of California, Los Angeles.May Beydoun, PhD, staff scientist, National Institute on Aging.Kerri Boutelle, PhD, associate professor of pediatrics, University of California, San Diego.Susan H. Babey, PhD, research scientist, Center for Health Policy Research, University of California, Los Angeles.Da Veiga, G. Nutrition Research, October 2006; vol 26: pp 517-523.Wang, Y. Journal of Epidemiology and Community Health, published online Nov. 4, 2010.
The review, which flouts conventional wisdom and previous research, takes a new look at studies of family eating habits published since 1980 and finds little similarity between the diets of children and their parents.
"This result contradicts other studies," says Marion Nestle, PhD, MPH, a professor of nutrition and sociology at New York University, who was not involved in the current research.
Nestle says previous work has found that parents have a good deal of influence over what their kids eat, but that the degree of influence lessens as kids move into their tweens and teens.
"If it's little kids, parents have plenty of influence. High school? Forget it. Peer pressure is overwhelming," Nestle says.
Still, she thinks the study, which is published in the Journal of Epidemiology and Community Health, may have captured an important shift in how children make choices about what to eat.
"It's certainly true that advertisers have penetrated the consciousness of even very young children, as any parent of a 2-year-old can attest," Nestle says. "The very purpose of marketing to children is to convince kids that they are supposed to eat 'kids' food,' not what their parents eat, and that they know more about what they are supposed to eat than their parents do. So if this study is correct, they are succeeding."
Kids, Parents, and Eating Habits
The authors of the new review, who were from Johns Hopkins University and the National Institutes of Health, combed the scientific literature for studies that assessed the diets of parents and their children from January 1980 through September 2009. Only 24 were deemed to be strong enough to be included.
The reviewers point out that many of the studies were small, which may weaken the statistical power of the results, and that the conclusions of the individual studies varied considerably.
When taken together, though, researchers say it appears that kids eat the same percent of recommended daily calories and fat as their parents only about 20% of the time.
"It was a weak to moderate association," says May A. Beydoun, PhD, staff scientist at the National Institute on Aging in Baltimore, who co-authored the study.
Beydoun thinks several factors probably contributed to the results.
"It's possible that there are only one or two shared meals with parents each day, especially if kids are eating at school, and that has an effect, or that parents who are trying to save money are giving their kids different foods than they eat," Beydoun says, "or because of the increasing influence of marketing that kids are making more of their own food choices."
The study's authors also found that children eat more like their parents in other countries, particularly non-European ones. A study in Brazil, for example, found that kids eat like their mothers do about 40% of the time.
Expert Opinions
But other nutrition experts said they were perplexed by the conclusions of the review.
"I'm a little surprised, actually," says Susan H. Babey, PhD, a research scientist for the Center for Health Policy Research at the University of California at Los Angeles. She published a policy brief in 2009 that found that teenagers were more likely to copy either the good or bad nutrition habits of their parents.
"It does make me wonder what's causing the difference in these findings," Babey says.
Her paper found, for instance, that adolescents whose parents drink soda daily were 40% more likely to drink it themselves compared to kids whose parents did not drink soda. And children whose parents ate at least five daily servings of fruits and vegetables were at least 16% more likely get their recommended amounts, compared to children whose parents didn't eat at least five servings of those foods.
"Our data suggests, and it's my own personal belief as a parent that I have some control over what my kids eat. I'm not really sure how to reconcile the two," she says.
And other experts cautioned that it is very difficult to make any assessments about how kids eat compared to their parents, largely because of the difficulty of getting kids to accurately remember the details of meals and snacks.
But even with questions about the reliability of the data, they say the study's conclusions rang true.
"I'm doing a large childhood obesity study, and we were just talking about this the other day, how kids don't eat like their parents," says Kerri N. Boutelle, PhD, associate professor of pediatrics at the University of California at San Diego, who was not involved with the study.
"My 9-year-old daughter is eating a peanut butter sandwich for lunch, and I'm having a salad," Boutelle says. "And kids eat the same things over and over again, while adults won't. So I'd say no, kids don't really eat like their parents, especially as they get older."
SOURCES: Marion Nestle, PhD, MPH, professor of nutrition and sociology, New York University.Babey, Susan, PhD, research scientist, University of California, Los Angeles.May Beydoun, PhD, staff scientist, National Institute on Aging.Kerri Boutelle, PhD, associate professor of pediatrics, University of California, San Diego.Susan H. Babey, PhD, research scientist, Center for Health Policy Research, University of California, Los Angeles.Da Veiga, G. Nutrition Research, October 2006; vol 26: pp 517-523.Wang, Y. Journal of Epidemiology and Community Health, published online Nov. 4, 2010.
Friday, December 17, 2010
Diabetes and Weight Loss: Finding the Right Path By Jeanie Lerche Davis
There's no question about it: If you're overweight and have type 2 diabetes, dropping pounds lowers your blood sugar, improves your health, and helps you feel better.
But before you start a diabetes weight loss plan, it's important to work closely with your doctor or diabetes educator - because while you're dieting, your blood sugar, insulin, and medications need special attention.
Make no mistake -- you're on the right path. "No matter how heavy you are, you will significantly lower your blood sugar if you lose some weight," says Cathy Nonas, MS, RD, a spokeswoman for the American Dietetic Association and a professor at Mount Sinai School of Medicine in New York City.
A National Institutes of Health study found that a combination of diet and exercise cuts the risk of developing diabetes by 58%. The study involved people who were overweight (average body mass index of 34) and who had high -- but not yet diabetic -- blood sugar levels.
"We know it's true -- that if someone with diabetes loses 5% to 10% of their weight, they will significantly reduce their blood sugar," Nonas tells WebMD.
"We see it all the time: people can get off their insulin and their medication," she says. "It's wonderful. It shows you how interwoven obesity and diabetes are."
Even losing 10 or 15 pounds has health benefits, says the American Diabetes Association. It can:
Lower blood sugar
Reduce blood pressure
Improve cholesterol levels
Lighten the stress on hips, knees, ankles, and feet
Plus, you'll probably have more energy, get around easier, and breathe easier.
On a Diabetes Weight Loss Plan, Watch for Changes in Blood Sugar
Cutting back on just one meal can affect the delicate balance of blood sugar, insulin, and medication in your body. So it's important to work with an expert when you diet.
Check with your doctor before starting a diabetes weight loss plan, then consult with a diabetes educator or nutritionist, advises Larry C. Deeb, MD, a diabetes specialist in Tallahassee, Fla. and president-elect of the American Diabetes Association.
"Don't try to lose weight on your own," says Deeb. "With a doctor and a good nutritionist, it's very safe to do. This is very important if you're taking insulin or medications."
Go for the Right Balance in a Diabetes Weight Loss Plan
Christine Gerbstadt, MD, a spokeswoman for the American Dietetic Association, warns: "You don't want to run the risk of high or low blood sugar while you're dieting," she tells WebMD. "You want tight glucose control while you lose weight."
Gerbstadt suggests cutting 500 calories a day, "which is safe for someone with diabetes," she says. "Cut calories across the board -- from protein, carbohydrates, and fat -- that's the best way." She recommends that people with diabetes maintain a healthy ratio of carbs, fat, and protein. The ideal:
50% to 55% carbs
30% fat
10% to 15% protein
Top PicksType 2 Diabetes Health Check: Assess Your Symptoms Can Dietary Supplements Help Control Diabetes? Diabetes and Your Sex Life: Assess Yourself 18 Tips for Controlling Blood Sugar and Insulin 9 Painful Signs of Depression
For people with diabetes, a refresher course on carbs may also be in order, Gerbstadt says.
That's because carbs have the biggest effect on blood sugar, since they are broken down into sugar early in digestion. Eating complex carbs (whole-grain bread and vegetables, for example) is good because they are absorbed more slowly into the bloodstream, cutting the risk of blood sugar spikes, Gerbstadt explains.
"Worst case scenario is sliced white bread," she says. "Whole-wheat bread is an improvement. Adding a little peanut butter is even better."
Simply cutting lots of carbs -- a common dieting strategy -- can be dangerous, Gerbstadt says. When your body doesn't have carbs to burn for fuel, your metabolism changes into what's known as ketosis -- and fat is burned instead. You'll feel less hungry, and eat less than you usually do -- but long-term ketosis can cause health problems.
"Ketosis decreases oxygen delivery to the tissues, which puts stress on eyes, kidneys, heart, liver," Gerbstadt says. "That's why the low-carb, high-protein Atkins diet is not really safe for people with diabetes. Diabetics need to try to stick with a more balanced diet so your body can handle nutrients without going into ketosis."
Special Challenges when Following a Diabetes Weight Loss Plan
"For anyone, losing weight is challenging enough," Luigi Meneghini, MD, tells WebMD. Meneghini is director of the Kosnow Diabetes Treatment Center at the University of Miami School of Medicine. "For people who inject insulin, it's even more difficult because they have to eat when they have low blood sugar. When you have to reduce calorie intake, prevent overmedication, and eat to correct your low blood sugar, it's very challenging."
Indeed, both low and high blood sugar levels are the two big concerns for people with diabetes.
Low Blood Sugar (hypoglycemia) occurs when the amount of insulin in the body is higher than your body needs. In its earliest stages, low blood sugar causes confusion, dizziness, and shakiness. In its later stages, it can be very dangerous -- possibly causing fainting, even coma.
Low blood sugar is common when people lose weight because cutting calories and weight loss itself affect blood sugar levels. If you don't reduce your insulin dosage or pills to match new blood sugar levels, you'll be risking high blood sugar.
High Blood Sugar (hyperglycemia) can develop when your body's insulin level is too low to control blood sugar. This happens when people on insulin or sugar-lowering medications don't take the correct dose or follow their diet.
The Effects of Exercise on Diabetes
One of the benefits of exercise is that it helps keep your blood sugar in balance, so you won't have to cut as many calories.
"Walk an extra 20 minutes a day, and you can eat a little bit more," Gerbstadt explains, and instead of cutting 500 calories, "you can cut back just 200 or 300 calories, and still get excellent results in weight loss. You'll also control your blood sugar. And the weight will be more likely to stay off if you lose it slowly, safely."
Top PicksType 2 Diabetes Health Check: Assess Your Symptoms Can Dietary Supplements Help Control Diabetes? Diabetes and Your Sex Life: Assess Yourself 18 Tips for Controlling Blood Sugar and Insulin 9 Painful Signs of Depression
Keep in mind: Each type of exercise affects blood sugar differently.
Aerobic exercise -- running or a treadmill workout -- can lower your blood sugar immediately.
Weight lifting or prolonged strenuous exercise may affect your blood sugar level many hours later. This can be a problem, especially when you're driving a car. It is one of the many reasons that you should check your blood sugar before driving. It's also a good idea to carry snacks such as fruit, crackers, juice, and soda in the car.
"With physical activity, you burn blood sugar as well as sugar stored in muscle and in the liver," explains Meneghini. "People using insulin or medications to simulate release of insulin should closely monitor blood sugar levels when they begin exercising more. Over time, as you exercise regularly, you can reduce doses of medications and insulin."
Getting Started on Your Diabetes Weight Loss Plan
Losing weight is never easy. That's where a diabetes educator or a nutritionist can help, advises Deeb A diabetes educator or nutritionist can develop a program that fits you and your lifestyle -- a program with realistic goals, he says.
"You will need a meal plan, one that you can follow every day. You'll need to know how to alter your insulin and medication based on what you're eating and whether you're exercising more," Deeb tells WebMD. "That's the safest way to lose weight."
A consultation with a diabetes educator or dietitian/nutritionist can cost from $60-$70. Typically, insurance covers the first two visits, but may not cover additional visits, says Meneghini.
Reasonably priced diabetes support groups and classes are available, frequently through hospitals. Ask your doctor or physician assistant for recommendations.
There are also diabetes web sites with in-depth exercise and weight loss information, including:
American Diabetes Association at http://www.diabetes.org
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) http://diabetes.niddk.nih.gov/
"Information is power, and the better informed you are, the better decisions you can make," says Meneghini.
SOURCES: Cathy Nonas, MS, RD, spokeswoman, American Dietetic Association. Christine Gerbstadt, MD, MPH, RD, LDN, spokeswoman, American Dietetic Association. Luigi Meneghini, MD, director, Kosnow Diabetes Treatment Center at the University of Miami School of Medicine. National Institute of Diabetes and Digestive and Kidney Diseases: "Taking Care of Your Diabetes at Special Times." Larry C. Deeb, MD, president-elect, American Diabetes Association. WebMD Medical News: "How to Avoid Diabetes -- Landmark Results Unveiled." American Diabetes Association: "Healthy Weight Loss." WebMD Medical Reference provided in collaboration with the Cleveland Clinic: "Diabetes." WebMD Medical Reference provided in collaboration with the Cleveland Clinic: "Weight Loss."
But before you start a diabetes weight loss plan, it's important to work closely with your doctor or diabetes educator - because while you're dieting, your blood sugar, insulin, and medications need special attention.
Make no mistake -- you're on the right path. "No matter how heavy you are, you will significantly lower your blood sugar if you lose some weight," says Cathy Nonas, MS, RD, a spokeswoman for the American Dietetic Association and a professor at Mount Sinai School of Medicine in New York City.
A National Institutes of Health study found that a combination of diet and exercise cuts the risk of developing diabetes by 58%. The study involved people who were overweight (average body mass index of 34) and who had high -- but not yet diabetic -- blood sugar levels.
"We know it's true -- that if someone with diabetes loses 5% to 10% of their weight, they will significantly reduce their blood sugar," Nonas tells WebMD.
"We see it all the time: people can get off their insulin and their medication," she says. "It's wonderful. It shows you how interwoven obesity and diabetes are."
Even losing 10 or 15 pounds has health benefits, says the American Diabetes Association. It can:
Lower blood sugar
Reduce blood pressure
Improve cholesterol levels
Lighten the stress on hips, knees, ankles, and feet
Plus, you'll probably have more energy, get around easier, and breathe easier.
On a Diabetes Weight Loss Plan, Watch for Changes in Blood Sugar
Cutting back on just one meal can affect the delicate balance of blood sugar, insulin, and medication in your body. So it's important to work with an expert when you diet.
Check with your doctor before starting a diabetes weight loss plan, then consult with a diabetes educator or nutritionist, advises Larry C. Deeb, MD, a diabetes specialist in Tallahassee, Fla. and president-elect of the American Diabetes Association.
"Don't try to lose weight on your own," says Deeb. "With a doctor and a good nutritionist, it's very safe to do. This is very important if you're taking insulin or medications."
Go for the Right Balance in a Diabetes Weight Loss Plan
Christine Gerbstadt, MD, a spokeswoman for the American Dietetic Association, warns: "You don't want to run the risk of high or low blood sugar while you're dieting," she tells WebMD. "You want tight glucose control while you lose weight."
Gerbstadt suggests cutting 500 calories a day, "which is safe for someone with diabetes," she says. "Cut calories across the board -- from protein, carbohydrates, and fat -- that's the best way." She recommends that people with diabetes maintain a healthy ratio of carbs, fat, and protein. The ideal:
50% to 55% carbs
30% fat
10% to 15% protein
Top PicksType 2 Diabetes Health Check: Assess Your Symptoms Can Dietary Supplements Help Control Diabetes? Diabetes and Your Sex Life: Assess Yourself 18 Tips for Controlling Blood Sugar and Insulin 9 Painful Signs of Depression
For people with diabetes, a refresher course on carbs may also be in order, Gerbstadt says.
That's because carbs have the biggest effect on blood sugar, since they are broken down into sugar early in digestion. Eating complex carbs (whole-grain bread and vegetables, for example) is good because they are absorbed more slowly into the bloodstream, cutting the risk of blood sugar spikes, Gerbstadt explains.
"Worst case scenario is sliced white bread," she says. "Whole-wheat bread is an improvement. Adding a little peanut butter is even better."
Simply cutting lots of carbs -- a common dieting strategy -- can be dangerous, Gerbstadt says. When your body doesn't have carbs to burn for fuel, your metabolism changes into what's known as ketosis -- and fat is burned instead. You'll feel less hungry, and eat less than you usually do -- but long-term ketosis can cause health problems.
"Ketosis decreases oxygen delivery to the tissues, which puts stress on eyes, kidneys, heart, liver," Gerbstadt says. "That's why the low-carb, high-protein Atkins diet is not really safe for people with diabetes. Diabetics need to try to stick with a more balanced diet so your body can handle nutrients without going into ketosis."
Special Challenges when Following a Diabetes Weight Loss Plan
"For anyone, losing weight is challenging enough," Luigi Meneghini, MD, tells WebMD. Meneghini is director of the Kosnow Diabetes Treatment Center at the University of Miami School of Medicine. "For people who inject insulin, it's even more difficult because they have to eat when they have low blood sugar. When you have to reduce calorie intake, prevent overmedication, and eat to correct your low blood sugar, it's very challenging."
Indeed, both low and high blood sugar levels are the two big concerns for people with diabetes.
Low Blood Sugar (hypoglycemia) occurs when the amount of insulin in the body is higher than your body needs. In its earliest stages, low blood sugar causes confusion, dizziness, and shakiness. In its later stages, it can be very dangerous -- possibly causing fainting, even coma.
Low blood sugar is common when people lose weight because cutting calories and weight loss itself affect blood sugar levels. If you don't reduce your insulin dosage or pills to match new blood sugar levels, you'll be risking high blood sugar.
High Blood Sugar (hyperglycemia) can develop when your body's insulin level is too low to control blood sugar. This happens when people on insulin or sugar-lowering medications don't take the correct dose or follow their diet.
The Effects of Exercise on Diabetes
One of the benefits of exercise is that it helps keep your blood sugar in balance, so you won't have to cut as many calories.
"Walk an extra 20 minutes a day, and you can eat a little bit more," Gerbstadt explains, and instead of cutting 500 calories, "you can cut back just 200 or 300 calories, and still get excellent results in weight loss. You'll also control your blood sugar. And the weight will be more likely to stay off if you lose it slowly, safely."
Top PicksType 2 Diabetes Health Check: Assess Your Symptoms Can Dietary Supplements Help Control Diabetes? Diabetes and Your Sex Life: Assess Yourself 18 Tips for Controlling Blood Sugar and Insulin 9 Painful Signs of Depression
Keep in mind: Each type of exercise affects blood sugar differently.
Aerobic exercise -- running or a treadmill workout -- can lower your blood sugar immediately.
Weight lifting or prolonged strenuous exercise may affect your blood sugar level many hours later. This can be a problem, especially when you're driving a car. It is one of the many reasons that you should check your blood sugar before driving. It's also a good idea to carry snacks such as fruit, crackers, juice, and soda in the car.
"With physical activity, you burn blood sugar as well as sugar stored in muscle and in the liver," explains Meneghini. "People using insulin or medications to simulate release of insulin should closely monitor blood sugar levels when they begin exercising more. Over time, as you exercise regularly, you can reduce doses of medications and insulin."
Getting Started on Your Diabetes Weight Loss Plan
Losing weight is never easy. That's where a diabetes educator or a nutritionist can help, advises Deeb A diabetes educator or nutritionist can develop a program that fits you and your lifestyle -- a program with realistic goals, he says.
"You will need a meal plan, one that you can follow every day. You'll need to know how to alter your insulin and medication based on what you're eating and whether you're exercising more," Deeb tells WebMD. "That's the safest way to lose weight."
A consultation with a diabetes educator or dietitian/nutritionist can cost from $60-$70. Typically, insurance covers the first two visits, but may not cover additional visits, says Meneghini.
Reasonably priced diabetes support groups and classes are available, frequently through hospitals. Ask your doctor or physician assistant for recommendations.
There are also diabetes web sites with in-depth exercise and weight loss information, including:
American Diabetes Association at http://www.diabetes.org
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) http://diabetes.niddk.nih.gov/
"Information is power, and the better informed you are, the better decisions you can make," says Meneghini.
SOURCES: Cathy Nonas, MS, RD, spokeswoman, American Dietetic Association. Christine Gerbstadt, MD, MPH, RD, LDN, spokeswoman, American Dietetic Association. Luigi Meneghini, MD, director, Kosnow Diabetes Treatment Center at the University of Miami School of Medicine. National Institute of Diabetes and Digestive and Kidney Diseases: "Taking Care of Your Diabetes at Special Times." Larry C. Deeb, MD, president-elect, American Diabetes Association. WebMD Medical News: "How to Avoid Diabetes -- Landmark Results Unveiled." American Diabetes Association: "Healthy Weight Loss." WebMD Medical Reference provided in collaboration with the Cleveland Clinic: "Diabetes." WebMD Medical Reference provided in collaboration with the Cleveland Clinic: "Weight Loss."
Thursday, December 16, 2010
The Truth Behind More Holiday Heart Attacks By Katherine Kam
Why cardiac problems spike during the holidays and how to stay heart healthy.
Your heart may leap with delight at the electronic gizmo or emerald bracelet that you’ve just unwrapped from under the Christmas tree. But you can’t say the same for that nasty holiday surprise known as the “Merry Christmas coronary” or “Happy Hanukkah heart attack.”
For many years, researchers have been intrigued by a disturbing pattern: Deadly heart attacks increase during the winter holiday season. One study even found distinct spikes around Christmas and New Year’s Day.
“We certainly know that there are certain risk factors for coronary artery disease. There’s obviously smoking, hypertension, dyslipidemia [high cholesterol], diabetes, lack of exercise, and age,” says Robert A. Kloner, MD, PhD, a researcher at Good Samaritan Hospital in Los Angeles and a professor at the Keck School of Medicine at the University of Southern California.
“But we’re also learning that there are certain triggers for cardiovascular events,” he adds, “including time of the year and seasons. If we can get a true handle on the seasonal variation, we could knock down death from coronary disease.”
Heart Attack Weather?
Coronary artery disease stems from atherosclerosis, a condition in which fatty plaques narrow the arteries to the heart. When a plaque ruptures, it can trigger a blood clot that leads to a heart attack.
In a national 2004 study published in Circulation, researchers at the University of California, San Diego, and Tufts University School of Medicine examined 53 million U.S. death certificates from 1973 to 2001. They discovered an overall increase of 5% more heart-related deaths during the holiday season. When researchers looked at individual years, they found varying increases in cardiac deaths for every holiday period they studied, except two.
Doctors have long known that cold weather is hard on the heart. Blood vessels constrict, which raises blood pressure. Blood also clots more readily. Frigid temperatures increase strain on the heart, and too much physical exertion can worsen the burden and trigger a heart attack. For example, doctors have treated many patients whose heart attacks followed strenuous snow shoveling.
Holiday Heart Attack Triggers
But cold extremes don’t really explain why fatal heart attacks peak on Christmas and New Year’s Day, especially among the most rapidly stricken patients. According to the Circulation study, “The number of cardiac deaths is higher on Dec. 25 than on any other day of the year, second highest on Dec. 26, and third highest on Jan. 1.”
Adding to the mystery, why do holiday heart attacks shoot up consistently across the country, even in balmy climes such as Los Angeles, where winter weather stays mild and no one ever wields a snow shovel?
In Kloner’s own research, he found one-third more coronary artery disease deaths in December and January than in June through September during a 12-year period in Los Angeles County.
In the Circulation study, researchers suggested people might delay getting treatment because they don’t want to disrupt Christmas and New Year’s festivities. Kloner, who did not participate in this study, agrees. “People just tend to put off seeking medical help during the holidays. They tend to wait till afterwards, which I think is a mistake,” he says. Or holiday travelers might take longer to find competent medical care, which heightens the risk. Also, hospitals may be short-staffed on major holidays.
Kloner believes other factors may play a role, such as emotional stress and overindulgence. During the holidays, legions of Americans eat too much and drink more alcohol -- while ditching their exercise routine. Needless to say, this combo isn’t healthy for the heart. “People tend to gain weight during the holiday season and take in more salt, which can put additional stress on a weakened heart,” according to Kloner.
Preventing Holiday Heart Attacks
While researchers are still trying to pinpoint the exact reasons for the Christmas coronary, Kloner recommends these common-sense measures during this special time of year:
Pile on the layers. Try to avoid exposure to very cold temperatures. Dress warmly.
Take a load off. Steer clear of heart stressors, including too much physical exertion (especially snow shoveling), anger, and emotional stress.
Make good choices. Avoid excess salt and alcohol. Too much drinking -- for example, binge drinking -- can lead to atrial fibrillation, an abnormal heart rhythm in which disorganized electrical signals cause the heart’s two upper chambers to contract irregularly. Atrial fibrillation increases the risk of stroke, heart attack, and heart failure.
Get a shot. Consider getting a flu vaccination. Infection and fever put extra stress on the heart.
Breathe. Go indoors during air pollution alerts but try to avoid breathing smoke from wood-burning fireplaces. If you’re visiting another home during the holidays, sit as far away as you can from a burning fireplace. Ultra-fine particles in the air can be bad for the heart.
Get help. If you feel chest pain or other symptoms, call 911 for emergency help. The stakes are high. So give yourself and your family a gift this season. Don’t postpone treatment because you don’t want to spoil the holiday merrymaking.
SOURCES:
Robert A. Kloner, MD, PhD, researcher with Good Samaritan Hospital in Los Angeles; professor at the Keck School of Medicine at the University of Southern California.
Phillips, D.P. et al., Circulation. 2004; 110:3781-3788.
Kloner, R.A. “Circulation. 2004;110:3744-3745.
National Heart, Lung and Blood Institute: “What Is Atrial Fibrillation?”
Your heart may leap with delight at the electronic gizmo or emerald bracelet that you’ve just unwrapped from under the Christmas tree. But you can’t say the same for that nasty holiday surprise known as the “Merry Christmas coronary” or “Happy Hanukkah heart attack.”
For many years, researchers have been intrigued by a disturbing pattern: Deadly heart attacks increase during the winter holiday season. One study even found distinct spikes around Christmas and New Year’s Day.
“We certainly know that there are certain risk factors for coronary artery disease. There’s obviously smoking, hypertension, dyslipidemia [high cholesterol], diabetes, lack of exercise, and age,” says Robert A. Kloner, MD, PhD, a researcher at Good Samaritan Hospital in Los Angeles and a professor at the Keck School of Medicine at the University of Southern California.
“But we’re also learning that there are certain triggers for cardiovascular events,” he adds, “including time of the year and seasons. If we can get a true handle on the seasonal variation, we could knock down death from coronary disease.”
Heart Attack Weather?
Coronary artery disease stems from atherosclerosis, a condition in which fatty plaques narrow the arteries to the heart. When a plaque ruptures, it can trigger a blood clot that leads to a heart attack.
In a national 2004 study published in Circulation, researchers at the University of California, San Diego, and Tufts University School of Medicine examined 53 million U.S. death certificates from 1973 to 2001. They discovered an overall increase of 5% more heart-related deaths during the holiday season. When researchers looked at individual years, they found varying increases in cardiac deaths for every holiday period they studied, except two.
Doctors have long known that cold weather is hard on the heart. Blood vessels constrict, which raises blood pressure. Blood also clots more readily. Frigid temperatures increase strain on the heart, and too much physical exertion can worsen the burden and trigger a heart attack. For example, doctors have treated many patients whose heart attacks followed strenuous snow shoveling.
Holiday Heart Attack Triggers
But cold extremes don’t really explain why fatal heart attacks peak on Christmas and New Year’s Day, especially among the most rapidly stricken patients. According to the Circulation study, “The number of cardiac deaths is higher on Dec. 25 than on any other day of the year, second highest on Dec. 26, and third highest on Jan. 1.”
Adding to the mystery, why do holiday heart attacks shoot up consistently across the country, even in balmy climes such as Los Angeles, where winter weather stays mild and no one ever wields a snow shovel?
In Kloner’s own research, he found one-third more coronary artery disease deaths in December and January than in June through September during a 12-year period in Los Angeles County.
In the Circulation study, researchers suggested people might delay getting treatment because they don’t want to disrupt Christmas and New Year’s festivities. Kloner, who did not participate in this study, agrees. “People just tend to put off seeking medical help during the holidays. They tend to wait till afterwards, which I think is a mistake,” he says. Or holiday travelers might take longer to find competent medical care, which heightens the risk. Also, hospitals may be short-staffed on major holidays.
Kloner believes other factors may play a role, such as emotional stress and overindulgence. During the holidays, legions of Americans eat too much and drink more alcohol -- while ditching their exercise routine. Needless to say, this combo isn’t healthy for the heart. “People tend to gain weight during the holiday season and take in more salt, which can put additional stress on a weakened heart,” according to Kloner.
Preventing Holiday Heart Attacks
While researchers are still trying to pinpoint the exact reasons for the Christmas coronary, Kloner recommends these common-sense measures during this special time of year:
Pile on the layers. Try to avoid exposure to very cold temperatures. Dress warmly.
Take a load off. Steer clear of heart stressors, including too much physical exertion (especially snow shoveling), anger, and emotional stress.
Make good choices. Avoid excess salt and alcohol. Too much drinking -- for example, binge drinking -- can lead to atrial fibrillation, an abnormal heart rhythm in which disorganized electrical signals cause the heart’s two upper chambers to contract irregularly. Atrial fibrillation increases the risk of stroke, heart attack, and heart failure.
Get a shot. Consider getting a flu vaccination. Infection and fever put extra stress on the heart.
Breathe. Go indoors during air pollution alerts but try to avoid breathing smoke from wood-burning fireplaces. If you’re visiting another home during the holidays, sit as far away as you can from a burning fireplace. Ultra-fine particles in the air can be bad for the heart.
Get help. If you feel chest pain or other symptoms, call 911 for emergency help. The stakes are high. So give yourself and your family a gift this season. Don’t postpone treatment because you don’t want to spoil the holiday merrymaking.
SOURCES:
Robert A. Kloner, MD, PhD, researcher with Good Samaritan Hospital in Los Angeles; professor at the Keck School of Medicine at the University of Southern California.
Phillips, D.P. et al., Circulation. 2004; 110:3781-3788.
Kloner, R.A. “Circulation. 2004;110:3744-3745.
National Heart, Lung and Blood Institute: “What Is Atrial Fibrillation?”
Wednesday, December 15, 2010
Foods That May Worsen Pollen Allergies By Neil Osterweil
What do yet get when you cross a cantaloupe with a ragweed plant, or an apple with a birch tree? An itchy mouth.
For many people with hay fever, eating cantaloupe can cause itching or hives in their mouths. Eating uncooked apples may do the same to people with birch pollen allergy.
They have oral allergy syndrome. So do up to a third of pollen allergy patients, notes the American Academy of Allergy, Asthma, & Immunology (AAAAI).
Most cases are mild. But some can be an early warning sign of a serious or even life-threatening allergic reaction called anaphylaxis.
Oral Allergy Syndrome: What Happens
You can blame oral allergy syndrome on the immune system trying a little too hard to protect the body.
In hay fever (seasonal allergies), the immune system treats certain inhaled pollen proteins as foreign invaders. It prompts sneezing, runny nose, watery or itchy eyes, and other unpleasant symptoms to flush the intruder out of the body.
In oral allergy syndrome, the immune system treats proteins similar to those in pollen that are sometimes found in fruits or vegetables the same way. It's as if it says, “Close enough!” and attacks it. That's called cross-reactivity.
Foods to Watch Out For
Here are foods that may have proteins that cross-react with pollen proteins:
Ragweed Allergy: “Ragweed, in theory, cross-reacts with bananas and melons, so people with ragweed allergies may react to honeydew, cantaloupe, and watermelons, or tomatoes,” says Warren V. Filley MD, from the Oklahoma Allergy & Asthma Clinic in Oklahoma City.
Zucchini, sunflower seeds, dandelions, chamomile tea, and echinacea also go on that list, notes the AAAAI's web site.
Birch Pollen Allergy: People with birch pollen allergies may react to kiwi, apples, pears, peaches, kiwi, plums, coriander, fennel, parsley, celery, cherries, carrots, hazelnuts, and almonds.
Grass Allergy: People with grass allergy may react to "peaches, celery, tomatoes, melons, and oranges," the AAAAI states.
Latex Rubber Allergy: Like pollen allergy, people allergic to latex rubber may react to "bananas, avocados, kiwi, chestnut, and papaya," the AAAAI states.
Hannelore A. Brucker, MD, of the Southdale Allergy & Asthma Clinic in Minneapolis, often asks her allergy patients about possible oral symptoms.
“I ask if they have itching in the mouth when they eat apple, and if they say 'No' and then I see a skin test and it’s high-positive for birch, I ask again,” Brucker tells WebMD.
Oral sensitivity tends to develop over time, with repeated exposures to inhaled pollens. Brucker says most of her patients with oral allergy syndrome are in their 20s and 30s.
Filley's advice: See a board-certified allergist. "It could be oral allergy or could be something more serious," Filley says.
You may get a skin-prick test. A bit of the suspected trigger goes on a light scratch on your back or forearm. If that spot turns red or swells in about 15 minutes, it's an allergic reaction.
Next, the doctor has to analyze the problem. Either this is mainly oral allergy and not to worry, or this could be more serious and [you need to] take more precautions, such as carry epinephrine with you," Filley says.
A recent study shows that in about 2% of patients with oral allergy syndrome, oral allergy symptoms could progress to anaphylactic shock, a serious reaction that could be deadly without immediate treatment such as an epinephrine shot.
Treating by Not Eating Trigger Foods
The basic rule: If a food makes you uncomfortable, don’t eat it!
Cooking may help. It often breaks down or alters the trigger proteins so that the immune system doesn't target them.
Peeling fruits such as apples may also help some people, because most trigger proteins are in the peel. Canning also breaks down those proteins, so canned fruit may be an option.
SOURCES:
Hannelore A. Brucker, MD, Southdale Allergy & Asthma Clinic, Minneapolis.
Warren V. Filley, MD, Oklahoma Allergy & Asthma Clinic, Oklahoma City.
National Institute of Allergy and Infectious Diseases.
American Academy of Allergy, Asthma & Immunology.
Webber. C.. The Annals of Allergy, Asthma and Immunology, February 2010; vol 104: pp 101-182.
For many people with hay fever, eating cantaloupe can cause itching or hives in their mouths. Eating uncooked apples may do the same to people with birch pollen allergy.
They have oral allergy syndrome. So do up to a third of pollen allergy patients, notes the American Academy of Allergy, Asthma, & Immunology (AAAAI).
Most cases are mild. But some can be an early warning sign of a serious or even life-threatening allergic reaction called anaphylaxis.
Oral Allergy Syndrome: What Happens
You can blame oral allergy syndrome on the immune system trying a little too hard to protect the body.
In hay fever (seasonal allergies), the immune system treats certain inhaled pollen proteins as foreign invaders. It prompts sneezing, runny nose, watery or itchy eyes, and other unpleasant symptoms to flush the intruder out of the body.
In oral allergy syndrome, the immune system treats proteins similar to those in pollen that are sometimes found in fruits or vegetables the same way. It's as if it says, “Close enough!” and attacks it. That's called cross-reactivity.
Foods to Watch Out For
Here are foods that may have proteins that cross-react with pollen proteins:
Ragweed Allergy: “Ragweed, in theory, cross-reacts with bananas and melons, so people with ragweed allergies may react to honeydew, cantaloupe, and watermelons, or tomatoes,” says Warren V. Filley MD, from the Oklahoma Allergy & Asthma Clinic in Oklahoma City.
Zucchini, sunflower seeds, dandelions, chamomile tea, and echinacea also go on that list, notes the AAAAI's web site.
Birch Pollen Allergy: People with birch pollen allergies may react to kiwi, apples, pears, peaches, kiwi, plums, coriander, fennel, parsley, celery, cherries, carrots, hazelnuts, and almonds.
Grass Allergy: People with grass allergy may react to "peaches, celery, tomatoes, melons, and oranges," the AAAAI states.
Latex Rubber Allergy: Like pollen allergy, people allergic to latex rubber may react to "bananas, avocados, kiwi, chestnut, and papaya," the AAAAI states.
Hannelore A. Brucker, MD, of the Southdale Allergy & Asthma Clinic in Minneapolis, often asks her allergy patients about possible oral symptoms.
“I ask if they have itching in the mouth when they eat apple, and if they say 'No' and then I see a skin test and it’s high-positive for birch, I ask again,” Brucker tells WebMD.
Oral sensitivity tends to develop over time, with repeated exposures to inhaled pollens. Brucker says most of her patients with oral allergy syndrome are in their 20s and 30s.
Filley's advice: See a board-certified allergist. "It could be oral allergy or could be something more serious," Filley says.
You may get a skin-prick test. A bit of the suspected trigger goes on a light scratch on your back or forearm. If that spot turns red or swells in about 15 minutes, it's an allergic reaction.
Next, the doctor has to analyze the problem. Either this is mainly oral allergy and not to worry, or this could be more serious and [you need to] take more precautions, such as carry epinephrine with you," Filley says.
A recent study shows that in about 2% of patients with oral allergy syndrome, oral allergy symptoms could progress to anaphylactic shock, a serious reaction that could be deadly without immediate treatment such as an epinephrine shot.
Treating by Not Eating Trigger Foods
The basic rule: If a food makes you uncomfortable, don’t eat it!
Cooking may help. It often breaks down or alters the trigger proteins so that the immune system doesn't target them.
Peeling fruits such as apples may also help some people, because most trigger proteins are in the peel. Canning also breaks down those proteins, so canned fruit may be an option.
SOURCES:
Hannelore A. Brucker, MD, Southdale Allergy & Asthma Clinic, Minneapolis.
Warren V. Filley, MD, Oklahoma Allergy & Asthma Clinic, Oklahoma City.
National Institute of Allergy and Infectious Diseases.
American Academy of Allergy, Asthma & Immunology.
Webber. C.. The Annals of Allergy, Asthma and Immunology, February 2010; vol 104: pp 101-182.
Monday, December 13, 2010
Healthy Eating: Easy Tips for Planning a Healthy Diet and Sticking to It
By Gina Kemp, M.A., Maya W. Paul, Certified Holistic Health Counselor, and Robert Segal, M.A.
Healthy eating is not about strict nutrition philosophies, staying unrealistically thin, or depriving yourself of the foods you love. Rather, it’s about feeling great, having more energy, and keeping yourself as healthy as possible– all of which can be achieved by learning some nutrition basics and using them in a way that works for you.
Healthy eating begins with learning how to “eat smart”—it’s not just what you eat, but how you eat. Your food choices can reduce your risk of illnesses such as heart disease, cancer, and diabetes, as well as defend against depression. Additionally, learning the habits of healthy eating can improve your health by boosting your energy, sharpening your memory and stabilizing your mood. Expand your range of healthy food choices and learn how to plan ahead to create and maintain a satisfying, healthy diet.
Healthy eating tip 1: Set yourself up for success
To set yourself up for success, think about planning a healthy diet as a number of small, manageable steps rather than one big drastic change. If you approach the changes gradually and with commitment, you will have a healthy diet sooner than you think.
* Simplify. Instead of being overly concerned with counting calories or measuring portion sizes, think of your diet in terms of color, variety and freshness—then it should be easier to make healthy choices. Focus on finding foods you love and easy recipes that incorporate a few fresh ingredients. Gradually, your diet will become healthier and more delicious.
* Start slow and make changes to your eating habits over time. Trying to make your diet healthy overnight isn’t realistic or smart. Changing everything at once usually leads to cheating or giving up on your new eating plan. Make small steps, like adding a salad (full of different color vegetables) to your diet once a day or switching from butter to olive oil when cooking. As your small changes become habit, you can continue to add more healthy choices to your diet.
* Every change you make to improve your diet matters. You don’t have to be perfect and you don’t have to completely eliminate foods you enjoy to have a healthy diet. The long term goal is to feel good, have more energy and reduce the risk of cancer and disease. Don’t let your missteps derail you—every healthy food choice you make counts.
Think of exercise as a food group in your diet.
Find something active that you like to do and add it to your day, just like you would add healthy greens, blueberries or salmon. The benefits of lifelong exercise are abundant and regular exercise may even motivate you to make healthy food choices a habit.
Healthy eating tip 2: Moderation is key
People often think of healthy eating as an all or nothing proposition, but a key foundation for any healthy diet is moderation. Despite what certain fad diets would have you believe, we all need a balance of carbohydrates, protein, fat, fiber, vitamins, and minerals to sustain a healthy body.
* Try not to think of certain foods as “off limits.” When you ban certain foods or food groups, it is natural to want those foods more, and then feel like a failure if you give in to temptation. If you are drawn towards sweet, salty or unhealthy foods, start by reducing portion sizes and not eating them as often. Later you may find yourself craving them less or thinking of them as only occasional indulgences.
* Think smaller portions. Serving sizes have ballooned recently, particularly in restaurants. When dining out, choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything. At home, use smaller plates, think about serving sizes in realistic terms and start small. Visual cues can help with portion sizes—your serving of meat, fish or chicken should be the size of a deck of cards. A teaspoon of oil or salad dressing is about the size of a matchbook and your slice of bread should be the size of a CD case.
Healthy eating tip 3: It's not just what you eat, it's how you eat
Healthy eating is about more than the food on your plate—it is also about how you think about food. Healthy eating habits can be learned and it is important to slow down and think about food as nourishment rather than just something to gulp down in between meetings or on the way to pick up the kids.
* Eat with others whenever possible. Eating with other people has numerous social and emotional benefits—particularly for children—and allows you to model healthy eating habits. Eating in front of the TV or computer often leads to mindless overeating.
* Take time to chew your food and enjoy mealtimes. Chew your food slowly, savoring every bite. We tend to rush though our meals, forgetting to actually taste the flavors and feel the textures of what is in our mouths. Reconnect with the joy of eating.
* Listen to your body. Ask yourself if you are really hungry, or have a glass of water to see if you are thirsty instead of hungry. During a meal, stop eating before you feel full. It actually takes a few minutes for your brain to tell your body that it has had enough food, so eat slowly.
* Eat breakfast, and eat smaller meals throughout the day. A healthy breakfast can jumpstart your metabolism, and eating small, healthy meals throughout the day (rather than the standard three large meals) keeps your energy up and your metabolism going.
Healthy eating tip 4: Fill up on colorful fruits and vegetables
Eat a rainbow of fruits and vegetables every day—the brighter the better. Fruits and vegetables are the foundation of a healthy diet—they are low in calories and nutrient dense, which means they are packed with vitamins, minerals, antioxidants and fiber. Fruits and vegetables should be part of every meal and your first choice for a snack—aim for a minimum of five portions each day. The antioxidants and other nutrients in fruits and vegetables help protect against certain types of cancer and other diseases.
Eat a rainbow of fruits and vegetables every day—the brighter the better.
The brighter, deeper colored fruits and vegetables contain higher concentrations of vitamins, minerals and antioxidants—and different colors provide different benefits. Some great choices are:
* Greens: Greens are packed with calcium, magnesium, iron, potassium, zinc, vitamins A, C, E and K, and they help strengthen the blood and respiratory systems. Be adventurous with your greens and branch out beyond bright and dark green lettuce—kale, mustard greens, broccoli, Chinese cabbage are just a few of the options.
* Sweet vegetables: Naturally sweet vegetables add healthy sweetness to your meals and reduce your cravings for other sweets. Some examples of sweet vegetables are corn, carrots, beets, sweet potatoes or yams, winter squash, and onions.
* Fruit: A wide variety of fruit is also vital to a healthy diet. Fruit provides fiber, vitamins and antioxidants. Berries are cancer-fighting, apples provide fiber, oranges and mangos offer vitamin C, and so on.
Don’t forget to shop fresh and local whenever possible
The local farmer’s market, fruit stand or Community Supported Agriculture (CSA) group are great ways to get access to fresh, local produce. To find local growers, farmer's markets, and CSAs in your area, visit Local Harvest.
Avoid: Fruit juices, which can contain up to 10 teaspoons of sugar per cup; avoid or dilute with water. Canned fruit is often in sugary syrup, and dried fruit, while an excellent source of fiber, can be high in calories. Avoid fried veggies and those with dressings or sauces—too much unhealthy fat and calories.
Water—a vital part of a healthy diet
Water makes up about 75% of our bodies and helps flush our systems of waste products and toxins. Yet many people go through life dehydrated—causing tiredness, low energy and headaches.
Caffeinated beverages, in particular, actually cause the body to lose water. Fresh fruits and vegetables, on the other hand, contain plenty of water and can help with hydration, especially when you are looking for an alternative to your eighth glass of water for the day.
Healthy eating tip 5: Eat more healthy carbs and whole grains
Choose healthy carbohydrates and fiber sources, especially whole grains, for long lasting energy. In addition to being delicious and satisfying, whole grains are rich in phytochemicals and antioxidants, which help to protect against coronary heart disease, certain cancers, and diabetes. Studies have shown people who eat more whole grains tend to have a healthier heart.
A quick definition of healthy carbs and unhealthy carbs
Healthy carbs (sometimes known as good carbs) include whole grains, beans, fruits, and vegetables. Healthy carbs are digested slowly, helping you feel full longer and keeping blood sugar and insulin levels stable.
Unhealthy carbs (or bad carbs) are foods such as white flour, refined sugar and white rice that have been stripped of all bran, fiber and nutrients. Unhealthy carbs digest quickly and cause spikes in blood sugar levels and energy.
* Include a variety of whole grains in your healthy diet, including whole wheat, brown rice, millet, quinoa, and barley. Experiment with different grains to find your favorites.
* Make sure you're really getting whole grains. Be aware that the words stone-ground, multi-grain, 100% wheat, or bran, don’t necessarily mean that a product is whole grain. Look for the new Whole Grain Stamp. If there is no stamp look for the words “whole grain” or “100% whole wheat,” and check the ingredients.
* Try mixing grains as a first step to switching to whole grains. If whole grains, like brown rice and whole wheat pasta, don’t sound good at first, start by mixing what you normally use with the whole grains. You can gradually increase the whole grain to 100%.
Avoid: Refined grains such as breads, pastas, and breakfast cereals that are not whole grain.
Fiber: An essential component of a healthy diet
Dietary fiber, found in plant foods (fruit, vegetables and whole grains) is essential for maintaining a healthy digestive system. Fiber helps support a healthy diet by helping you feel full faster and for a longer amount of time, and keeping your blood sugar stable. A healthy diet contains approximately 20-30 grams of fiber a day, but most of us only get about half that amount.
The two types of fiber are soluble and insoluble.
* Soluble fiber can dissolve in water and can also help to lower blood fats and maintain blood sugar. Primary sources are beans, fruit and oat products.
* Insoluble fiber cannot dissolve in water, so it passes directly through the digestive system. It’s found in whole grain products and vegetables.
Healthy eating tip 6: Enjoy healthy fats & avoid unhealthy fats
Good sources of healthy fat are needed to nourish your brain, heart and cells, as well as your hair, skin, and nails. Foods rich in certain omega-3 fats called EPA and DHA are particularly important and can reduce cardiovascular disease, improve your mood and help prevent dementia.
Add to your healthy diet:
* Monounsaturated fats, from plant oils like canola oil, peanut oil, and olive oil, as well as avocados, nuts (like almonds, hazelnuts, and pecans) and seeds (such as pumpkin, sesame).
* Polyunsaturated fats, including Omega-3 and Omega-6 fatty acids, found in fatty fish such as salmon, herring, mackerel, anchovies, sardines, and some cold water fish oil supplements. Other sources of polyunsaturated fats are unheated sunflower, corn, soybean, and flaxseed oils, and walnuts.
Reduce or eliminate from your diet:
* Saturated fats, found primarily in animal sources including red meat and whole milk dairy products.
* Trans fats, found in vegetable shortenings, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with partially hydrogenated vegetable oils.
Healthy eating tip 7: Put protein in perspective
Sizzling Salmon Protein gives us the energy to get up and go—and keep going. Protein in food is broken down into the 20 amino acids that are the body’s basic building blocks for growth and energy, and essential for maintaining cells, tissues and organs. A lack of protein in our diet can slow growth, reduce muscle mass, lower immunity, and weaken the heart and respiratory system. Protein is particularly important for children, whose bodies are growing and changing daily.
Here are some guidelines for including protein in your healthy diet:
Try different types of protein. Whether or not you are a vegetarian, trying different protein sources—such as beans, nuts, seeds, peas, tofu and soy products—will open up new options for healthy mealtimes.
* Beans: Black beans, navy beans, garbanzos, and lentils are good options.
* Nuts: Almonds, walnuts, pistachios and pecans are great choices.
* Soy products: Try tofu, soy milk, tempeh and veggie burgers for a change.
* Avoid salted or sugary nuts and refried beans.
Downsize your portions of protein. Most people in the U.S. eat too much protein. Try to move away from protein being the center of your meal. Focus on equal servings of protein, whole grains, and vegetables.
Focus on quality sources of protein, like fresh fish, chicken or turkey, tofu, eggs, beans or nuts. When you are having meat, chicken, or turkey, buy meat that is free of hormones and antibiotics.
Complete, incomplete and complementary proteins
* A complete protein source—from animal proteins such as meat, poultry, fish, milk, cheese and eggs—provides all of the essential amino acids.
* An incomplete protein—from vegetable proteins like grains, legumes, nuts, seeds and beans—is low in one or more essential amino acids.
* Complementary proteins are two or more incomplete protein sources that together provide all of the essential amino acids your body needs. For example, rice and dry beans are each incomplete proteins, but together they provide all of the essential amino acids.
* Do complementary proteins need to be eaten in the same meal? Research shows that your body can combine complementary proteins that are eaten within the same day.
* Why are complete and complementary proteins important? Complete and complementary proteins that provide all of the essential amino acids will fill you up longer than carbohydrates because they break down more slowly in the digestive process.
Healthy eating tip 8: Add calcium & vitamin D for strong bones
Dairy products, which come already fortified with vitamin D Calcium and vitamin D are essential for strong, healthy bones—vitamin D is essential for optimum calcium absorption in the small intestine. Recommended calcium levels are 1000 mg per day, 1200 mg if you are over 50 years old. Take a vitamin D and calcium supplement if you don’t get enough of these nutrients from your diet.
Great sources of calcium include:
* Dairy products, which come already fortified with vitamin D.
* Dark green, leafy vegetables, such as kale and collard greens
* Dried beans and legumes
See Osteoporosis, Diet and Calcium for more about the role of calcium in your diet.
Healthy eating tip 9: Limit sugar, salt, and refined grains
If you succeed in planning your diet around fiber-rich fruits, vegetables, whole grains, lean protein, and good fats, you may find yourself naturally cutting back on foods that can get in the way of your healthy diet—sugar, salt and refined starches.
Sugar and refined starches
It is okay to enjoy sweets in moderation, but try to cut down on sugar. Sugar causes energy ups and downs and adds to health problems like arthritis, diabetes, osteoporosis, headaches, and depression.
* Give recipes a makeover. Often recipes taste just as good with less sugar.
* Avoid sugary drinks. One 12-oz soda has about 10 teaspoons of sugar in it! Try sparkling water with lemon or a splash of fruit juice.
* Eliminate processed foods. Processed foods and foods made with white flour and white sugar cause your blood sugar to go up and down leaving you tired and sapped of energy.
Salt
Salt itself is not bad, but most of us consume too much salt in our diets.
* Limit sodium to 2,300 mg per day, the equivalent to one teaspoon of salt. Most of us consume far more than one teaspoon of salt per day.
* Avoid processed, packaged, restaurant and fast food. Processed foods like canned soups or frozen meals contain hidden sodium that quickly surpasses the recommended teaspoon a day.
Healthy eating tip 10: Plan quick and easy meals ahead
Healthy eating starts with great planning. You will have won half the healthy diet battle if you have a well-stocked kitchen, a stash of quick and easy recipes, and plenty of healthy snacks.
Plan your meals by the week or even the month
One of the best ways to have a healthy diet is to prepare your own food and eat in regularly. Pick a few healthy recipes that you and your family like and build a meal schedule around them. If you have three or four meals planned per week and eat leftovers on the other nights, you will be much farther ahead than if you are eating out or having frozen dinners most nights.
Shop the perimeter of the grocery store
In general, healthy eating ingredients are found around the outer edges of most grocery stores—fresh fruits and vegetables, fish and poultry, whole grain breads and dairy products. The centers of many grocery stores are filled with overpriced, processed foods that aren’t good for you. Shop the perimeter of the store for most of your groceries (fresh items), add a few things from the freezer section (frozen fruits and vegetables), and the aisles with spices, oils, and whole grains (like rolled oats, brown rice, whole wheat pasta).
Cook when you can
Try to cook one or both weekend days or on a weekday evening and make extra to freeze or set aside for another night. Cooking ahead saves time and money, and it is gratifying to know that you have a home cooked meal waiting to be eaten.
Have an emergency dinner or two ready to go
Challenge yourself to come up with two or three dinners that can be put together without going to the store—utilizing things in your pantry, freezer and spice rack. A delicious dinner of whole grain pasta with a quick tomato sauce or a quick and easy black bean quesadilla on a whole wheat flour tortilla (among endless other recipes) could act as your go-to meal when you are just too busy to shop or cook.
Stock your kitchen to be meal ready
Try to keep your kitchen stocked with recipe basics:
* Fresh and frozen fruits and vegetables.
* Recipe and soup starters such as garlic, onions, carrots, and celery.
* Healthy staples like brown rice, white Basmati rice, whole-wheat pasta, quinoa, and wild rice.
* Whole wheat bread and tortillas for healthy sandwiches and wraps.
* Beans such as lentils, black beans, chickpeas, black-eyed peas, kidney beans, fava beans, and lima beans.
* Frozen corn, peas, and other vegetables to add to recipes or for a quick vegetable side dish.
* Frozen fruit and berries to make smoothies or frozen desserts.
* Dark greens for salads, plus salad add-ins like dried fruit, nuts, beans, and seeds.
* Fresh and dried herbs and spices.
* Healthy fats and oils for cooking, such as olive oil and canola oil. You can also try specialty oils like peanut, sesame, or truffle oil for adding flavor.
* Unsalted nuts for snacking, like almonds, walnuts, cashews, peanuts, and pistachios.
* Vinegars, such as balsamic, red wine, and rice vinegar for salads and veggies.
* Strong cheeses, like aged Parmesan or blue cheese for intense flavor in salads, pasta, and soups.
Healthy eating is not about strict nutrition philosophies, staying unrealistically thin, or depriving yourself of the foods you love. Rather, it’s about feeling great, having more energy, and keeping yourself as healthy as possible– all of which can be achieved by learning some nutrition basics and using them in a way that works for you.
Healthy eating begins with learning how to “eat smart”—it’s not just what you eat, but how you eat. Your food choices can reduce your risk of illnesses such as heart disease, cancer, and diabetes, as well as defend against depression. Additionally, learning the habits of healthy eating can improve your health by boosting your energy, sharpening your memory and stabilizing your mood. Expand your range of healthy food choices and learn how to plan ahead to create and maintain a satisfying, healthy diet.
Healthy eating tip 1: Set yourself up for success
To set yourself up for success, think about planning a healthy diet as a number of small, manageable steps rather than one big drastic change. If you approach the changes gradually and with commitment, you will have a healthy diet sooner than you think.
* Simplify. Instead of being overly concerned with counting calories or measuring portion sizes, think of your diet in terms of color, variety and freshness—then it should be easier to make healthy choices. Focus on finding foods you love and easy recipes that incorporate a few fresh ingredients. Gradually, your diet will become healthier and more delicious.
* Start slow and make changes to your eating habits over time. Trying to make your diet healthy overnight isn’t realistic or smart. Changing everything at once usually leads to cheating or giving up on your new eating plan. Make small steps, like adding a salad (full of different color vegetables) to your diet once a day or switching from butter to olive oil when cooking. As your small changes become habit, you can continue to add more healthy choices to your diet.
* Every change you make to improve your diet matters. You don’t have to be perfect and you don’t have to completely eliminate foods you enjoy to have a healthy diet. The long term goal is to feel good, have more energy and reduce the risk of cancer and disease. Don’t let your missteps derail you—every healthy food choice you make counts.
Think of exercise as a food group in your diet.
Find something active that you like to do and add it to your day, just like you would add healthy greens, blueberries or salmon. The benefits of lifelong exercise are abundant and regular exercise may even motivate you to make healthy food choices a habit.
Healthy eating tip 2: Moderation is key
People often think of healthy eating as an all or nothing proposition, but a key foundation for any healthy diet is moderation. Despite what certain fad diets would have you believe, we all need a balance of carbohydrates, protein, fat, fiber, vitamins, and minerals to sustain a healthy body.
* Try not to think of certain foods as “off limits.” When you ban certain foods or food groups, it is natural to want those foods more, and then feel like a failure if you give in to temptation. If you are drawn towards sweet, salty or unhealthy foods, start by reducing portion sizes and not eating them as often. Later you may find yourself craving them less or thinking of them as only occasional indulgences.
* Think smaller portions. Serving sizes have ballooned recently, particularly in restaurants. When dining out, choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything. At home, use smaller plates, think about serving sizes in realistic terms and start small. Visual cues can help with portion sizes—your serving of meat, fish or chicken should be the size of a deck of cards. A teaspoon of oil or salad dressing is about the size of a matchbook and your slice of bread should be the size of a CD case.
Healthy eating tip 3: It's not just what you eat, it's how you eat
Healthy eating is about more than the food on your plate—it is also about how you think about food. Healthy eating habits can be learned and it is important to slow down and think about food as nourishment rather than just something to gulp down in between meetings or on the way to pick up the kids.
* Eat with others whenever possible. Eating with other people has numerous social and emotional benefits—particularly for children—and allows you to model healthy eating habits. Eating in front of the TV or computer often leads to mindless overeating.
* Take time to chew your food and enjoy mealtimes. Chew your food slowly, savoring every bite. We tend to rush though our meals, forgetting to actually taste the flavors and feel the textures of what is in our mouths. Reconnect with the joy of eating.
* Listen to your body. Ask yourself if you are really hungry, or have a glass of water to see if you are thirsty instead of hungry. During a meal, stop eating before you feel full. It actually takes a few minutes for your brain to tell your body that it has had enough food, so eat slowly.
* Eat breakfast, and eat smaller meals throughout the day. A healthy breakfast can jumpstart your metabolism, and eating small, healthy meals throughout the day (rather than the standard three large meals) keeps your energy up and your metabolism going.
Healthy eating tip 4: Fill up on colorful fruits and vegetables
Eat a rainbow of fruits and vegetables every day—the brighter the better. Fruits and vegetables are the foundation of a healthy diet—they are low in calories and nutrient dense, which means they are packed with vitamins, minerals, antioxidants and fiber. Fruits and vegetables should be part of every meal and your first choice for a snack—aim for a minimum of five portions each day. The antioxidants and other nutrients in fruits and vegetables help protect against certain types of cancer and other diseases.
Eat a rainbow of fruits and vegetables every day—the brighter the better.
The brighter, deeper colored fruits and vegetables contain higher concentrations of vitamins, minerals and antioxidants—and different colors provide different benefits. Some great choices are:
* Greens: Greens are packed with calcium, magnesium, iron, potassium, zinc, vitamins A, C, E and K, and they help strengthen the blood and respiratory systems. Be adventurous with your greens and branch out beyond bright and dark green lettuce—kale, mustard greens, broccoli, Chinese cabbage are just a few of the options.
* Sweet vegetables: Naturally sweet vegetables add healthy sweetness to your meals and reduce your cravings for other sweets. Some examples of sweet vegetables are corn, carrots, beets, sweet potatoes or yams, winter squash, and onions.
* Fruit: A wide variety of fruit is also vital to a healthy diet. Fruit provides fiber, vitamins and antioxidants. Berries are cancer-fighting, apples provide fiber, oranges and mangos offer vitamin C, and so on.
Don’t forget to shop fresh and local whenever possible
The local farmer’s market, fruit stand or Community Supported Agriculture (CSA) group are great ways to get access to fresh, local produce. To find local growers, farmer's markets, and CSAs in your area, visit Local Harvest.
Avoid: Fruit juices, which can contain up to 10 teaspoons of sugar per cup; avoid or dilute with water. Canned fruit is often in sugary syrup, and dried fruit, while an excellent source of fiber, can be high in calories. Avoid fried veggies and those with dressings or sauces—too much unhealthy fat and calories.
Water—a vital part of a healthy diet
Water makes up about 75% of our bodies and helps flush our systems of waste products and toxins. Yet many people go through life dehydrated—causing tiredness, low energy and headaches.
Caffeinated beverages, in particular, actually cause the body to lose water. Fresh fruits and vegetables, on the other hand, contain plenty of water and can help with hydration, especially when you are looking for an alternative to your eighth glass of water for the day.
Healthy eating tip 5: Eat more healthy carbs and whole grains
Choose healthy carbohydrates and fiber sources, especially whole grains, for long lasting energy. In addition to being delicious and satisfying, whole grains are rich in phytochemicals and antioxidants, which help to protect against coronary heart disease, certain cancers, and diabetes. Studies have shown people who eat more whole grains tend to have a healthier heart.
A quick definition of healthy carbs and unhealthy carbs
Healthy carbs (sometimes known as good carbs) include whole grains, beans, fruits, and vegetables. Healthy carbs are digested slowly, helping you feel full longer and keeping blood sugar and insulin levels stable.
Unhealthy carbs (or bad carbs) are foods such as white flour, refined sugar and white rice that have been stripped of all bran, fiber and nutrients. Unhealthy carbs digest quickly and cause spikes in blood sugar levels and energy.
* Include a variety of whole grains in your healthy diet, including whole wheat, brown rice, millet, quinoa, and barley. Experiment with different grains to find your favorites.
* Make sure you're really getting whole grains. Be aware that the words stone-ground, multi-grain, 100% wheat, or bran, don’t necessarily mean that a product is whole grain. Look for the new Whole Grain Stamp. If there is no stamp look for the words “whole grain” or “100% whole wheat,” and check the ingredients.
* Try mixing grains as a first step to switching to whole grains. If whole grains, like brown rice and whole wheat pasta, don’t sound good at first, start by mixing what you normally use with the whole grains. You can gradually increase the whole grain to 100%.
Avoid: Refined grains such as breads, pastas, and breakfast cereals that are not whole grain.
Fiber: An essential component of a healthy diet
Dietary fiber, found in plant foods (fruit, vegetables and whole grains) is essential for maintaining a healthy digestive system. Fiber helps support a healthy diet by helping you feel full faster and for a longer amount of time, and keeping your blood sugar stable. A healthy diet contains approximately 20-30 grams of fiber a day, but most of us only get about half that amount.
The two types of fiber are soluble and insoluble.
* Soluble fiber can dissolve in water and can also help to lower blood fats and maintain blood sugar. Primary sources are beans, fruit and oat products.
* Insoluble fiber cannot dissolve in water, so it passes directly through the digestive system. It’s found in whole grain products and vegetables.
Healthy eating tip 6: Enjoy healthy fats & avoid unhealthy fats
Good sources of healthy fat are needed to nourish your brain, heart and cells, as well as your hair, skin, and nails. Foods rich in certain omega-3 fats called EPA and DHA are particularly important and can reduce cardiovascular disease, improve your mood and help prevent dementia.
Add to your healthy diet:
* Monounsaturated fats, from plant oils like canola oil, peanut oil, and olive oil, as well as avocados, nuts (like almonds, hazelnuts, and pecans) and seeds (such as pumpkin, sesame).
* Polyunsaturated fats, including Omega-3 and Omega-6 fatty acids, found in fatty fish such as salmon, herring, mackerel, anchovies, sardines, and some cold water fish oil supplements. Other sources of polyunsaturated fats are unheated sunflower, corn, soybean, and flaxseed oils, and walnuts.
Reduce or eliminate from your diet:
* Saturated fats, found primarily in animal sources including red meat and whole milk dairy products.
* Trans fats, found in vegetable shortenings, some margarines, crackers, candies, cookies, snack foods, fried foods, baked goods, and other processed foods made with partially hydrogenated vegetable oils.
Healthy eating tip 7: Put protein in perspective
Sizzling Salmon Protein gives us the energy to get up and go—and keep going. Protein in food is broken down into the 20 amino acids that are the body’s basic building blocks for growth and energy, and essential for maintaining cells, tissues and organs. A lack of protein in our diet can slow growth, reduce muscle mass, lower immunity, and weaken the heart and respiratory system. Protein is particularly important for children, whose bodies are growing and changing daily.
Here are some guidelines for including protein in your healthy diet:
Try different types of protein. Whether or not you are a vegetarian, trying different protein sources—such as beans, nuts, seeds, peas, tofu and soy products—will open up new options for healthy mealtimes.
* Beans: Black beans, navy beans, garbanzos, and lentils are good options.
* Nuts: Almonds, walnuts, pistachios and pecans are great choices.
* Soy products: Try tofu, soy milk, tempeh and veggie burgers for a change.
* Avoid salted or sugary nuts and refried beans.
Downsize your portions of protein. Most people in the U.S. eat too much protein. Try to move away from protein being the center of your meal. Focus on equal servings of protein, whole grains, and vegetables.
Focus on quality sources of protein, like fresh fish, chicken or turkey, tofu, eggs, beans or nuts. When you are having meat, chicken, or turkey, buy meat that is free of hormones and antibiotics.
Complete, incomplete and complementary proteins
* A complete protein source—from animal proteins such as meat, poultry, fish, milk, cheese and eggs—provides all of the essential amino acids.
* An incomplete protein—from vegetable proteins like grains, legumes, nuts, seeds and beans—is low in one or more essential amino acids.
* Complementary proteins are two or more incomplete protein sources that together provide all of the essential amino acids your body needs. For example, rice and dry beans are each incomplete proteins, but together they provide all of the essential amino acids.
* Do complementary proteins need to be eaten in the same meal? Research shows that your body can combine complementary proteins that are eaten within the same day.
* Why are complete and complementary proteins important? Complete and complementary proteins that provide all of the essential amino acids will fill you up longer than carbohydrates because they break down more slowly in the digestive process.
Healthy eating tip 8: Add calcium & vitamin D for strong bones
Dairy products, which come already fortified with vitamin D Calcium and vitamin D are essential for strong, healthy bones—vitamin D is essential for optimum calcium absorption in the small intestine. Recommended calcium levels are 1000 mg per day, 1200 mg if you are over 50 years old. Take a vitamin D and calcium supplement if you don’t get enough of these nutrients from your diet.
Great sources of calcium include:
* Dairy products, which come already fortified with vitamin D.
* Dark green, leafy vegetables, such as kale and collard greens
* Dried beans and legumes
See Osteoporosis, Diet and Calcium for more about the role of calcium in your diet.
Healthy eating tip 9: Limit sugar, salt, and refined grains
If you succeed in planning your diet around fiber-rich fruits, vegetables, whole grains, lean protein, and good fats, you may find yourself naturally cutting back on foods that can get in the way of your healthy diet—sugar, salt and refined starches.
Sugar and refined starches
It is okay to enjoy sweets in moderation, but try to cut down on sugar. Sugar causes energy ups and downs and adds to health problems like arthritis, diabetes, osteoporosis, headaches, and depression.
* Give recipes a makeover. Often recipes taste just as good with less sugar.
* Avoid sugary drinks. One 12-oz soda has about 10 teaspoons of sugar in it! Try sparkling water with lemon or a splash of fruit juice.
* Eliminate processed foods. Processed foods and foods made with white flour and white sugar cause your blood sugar to go up and down leaving you tired and sapped of energy.
Salt
Salt itself is not bad, but most of us consume too much salt in our diets.
* Limit sodium to 2,300 mg per day, the equivalent to one teaspoon of salt. Most of us consume far more than one teaspoon of salt per day.
* Avoid processed, packaged, restaurant and fast food. Processed foods like canned soups or frozen meals contain hidden sodium that quickly surpasses the recommended teaspoon a day.
Healthy eating tip 10: Plan quick and easy meals ahead
Healthy eating starts with great planning. You will have won half the healthy diet battle if you have a well-stocked kitchen, a stash of quick and easy recipes, and plenty of healthy snacks.
Plan your meals by the week or even the month
One of the best ways to have a healthy diet is to prepare your own food and eat in regularly. Pick a few healthy recipes that you and your family like and build a meal schedule around them. If you have three or four meals planned per week and eat leftovers on the other nights, you will be much farther ahead than if you are eating out or having frozen dinners most nights.
Shop the perimeter of the grocery store
In general, healthy eating ingredients are found around the outer edges of most grocery stores—fresh fruits and vegetables, fish and poultry, whole grain breads and dairy products. The centers of many grocery stores are filled with overpriced, processed foods that aren’t good for you. Shop the perimeter of the store for most of your groceries (fresh items), add a few things from the freezer section (frozen fruits and vegetables), and the aisles with spices, oils, and whole grains (like rolled oats, brown rice, whole wheat pasta).
Cook when you can
Try to cook one or both weekend days or on a weekday evening and make extra to freeze or set aside for another night. Cooking ahead saves time and money, and it is gratifying to know that you have a home cooked meal waiting to be eaten.
Have an emergency dinner or two ready to go
Challenge yourself to come up with two or three dinners that can be put together without going to the store—utilizing things in your pantry, freezer and spice rack. A delicious dinner of whole grain pasta with a quick tomato sauce or a quick and easy black bean quesadilla on a whole wheat flour tortilla (among endless other recipes) could act as your go-to meal when you are just too busy to shop or cook.
Stock your kitchen to be meal ready
Try to keep your kitchen stocked with recipe basics:
* Fresh and frozen fruits and vegetables.
* Recipe and soup starters such as garlic, onions, carrots, and celery.
* Healthy staples like brown rice, white Basmati rice, whole-wheat pasta, quinoa, and wild rice.
* Whole wheat bread and tortillas for healthy sandwiches and wraps.
* Beans such as lentils, black beans, chickpeas, black-eyed peas, kidney beans, fava beans, and lima beans.
* Frozen corn, peas, and other vegetables to add to recipes or for a quick vegetable side dish.
* Frozen fruit and berries to make smoothies or frozen desserts.
* Dark greens for salads, plus salad add-ins like dried fruit, nuts, beans, and seeds.
* Fresh and dried herbs and spices.
* Healthy fats and oils for cooking, such as olive oil and canola oil. You can also try specialty oils like peanut, sesame, or truffle oil for adding flavor.
* Unsalted nuts for snacking, like almonds, walnuts, cashews, peanuts, and pistachios.
* Vinegars, such as balsamic, red wine, and rice vinegar for salads and veggies.
* Strong cheeses, like aged Parmesan or blue cheese for intense flavor in salads, pasta, and soups.
New Food Allergy Guidelines Out By Kathleen Doheny
Comprehensive Guidelines Aim to Help Doctors Diagnose, Treat Food Allergies
Dec. 6, 2010 -- Comprehensive new guidelines on food allergies are out from the National Institute of Allergy and Infectious Diseases (NIAID).
The new guidelines are directed at doctors to help them diagnose and manage food allergies.
Experts say food allergies appear to be on the rise, affecting nearly 5% of children younger than 5 and about 4% of teens and adults.
''We hope the guidelines will help patients and family members work better with their physician'' to identify the causes of food allergies, said Matthew Fenton, PhD, chief of the asthma, allergy, and inflammation branch of the division of allergy, immunology and transplantation at NIAID. He spoke at a Friday news conference detailing the new guidelines and led the guidelines development project for NIAID.
The guidelines address diagnostic tests, treatment, and prevention, among other areas.
While the guidelines are aimed at doctors, it will help parents and those with food allergies to be aware of their existence, said Hugh Sampson, MD, professor of pediatrics at the Mount Sinai School of Medicine in New York, who serves on the guidelines coordinating committee and also spoke at the news conference. "When they see their physician or request a referral to an allergist, they should know what type of questions will be asked of them and have some idea of what kind of tests their physician will be doing."
Food Allergy Guidelines: Back Story
A coordinating committee representing 34 professional medical organizations, advocacy groups, and federal agencies oversaw the guidelines development.
Then, a 25-member expert panel was selected; it pored over published literature and drew on clinical opinions to draft the guidelines.
Public comment was invited before the final guidelines were issued.
Food Allergy Guidelines: Definitions and More
The guidelines define food allergy as "an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food."
It distinguishes allergies from intolerances. Foods that cause the same reproducible adverse reaction but don't have a likely or established immune system response are not considered allergies, but rather intolerances.
For instance, someone allergic to cow's milk due to an immune system response to milk protein has a food allergy. But someone who has a difficult time drinking milk due to an inability to digest the lactose in milk has a food intolerance.
Among the most common food allergies are reactions to:
* Peanuts
* Tree nuts
* Seafood
* Milk
* Eggs
Anaphylaxis, a serious allergic reaction that comes on rapidly and may cause death, can occur in response to food. Up to 65% of anaphylaxis cases are thought to be due to food.
Food Allergy Guidelines: Diagnosis
Under the new guidelines, the panel of experts recommends that intradermal or skin testing should not be used to make a diagnosis of food allergy.
The experts recommend skin puncture tests, in which a small amount of the extract of a suspected food in placed on the skin, then the skin is punctured through the droplet, to help identify possible troublesome foods but not to make a diagnosis based on it alone.
It also recommends against the routine use of measuring total blood IgE, the antibody formed in reaction to an allergen.
It recommends allergen-specific IgE blood testing but cautions that the test results alone are not enough to make a diagnosis.
Food elimination diets -- taking away one or a few specific foods to see if the reaction disappears -- may help.
Oral food challenges -- exposing the person to the suspected food under medical supervision -- are thought to be helpful.
If exposure to a certain food triggers symptoms, the doctor should then see if that finding matches with lab tests and medical history.
Food Allergy Guidelines: Management
Avoidance is best, the experts agree. They write: "There are nomedications currently recommended by the EP [expert panel] to prevent IgE-mediated food-induced allergic reactions from occurring in an individual with existing food allergies."
When food allergies trigger anaphylaxis, the experts recommend epinephrine injections first.
Food Allergy Guidelines: What About Prevention?
While some pregnant women may hope restricting their diets during pregnancy or during breastfeeding may help their children avoid allergies, the experts disagree and don't recommend this.
They don't recommend soy formula as a strategy for preventing the development of allergies, either.
Outgrowing Food Allergies
A child with food allergies may outgrow them, Sampson said.
It depends on the food, partially. “If their child is allergic to egg, for example, chances are very good that children will outgrow it,” he said. “We know that about 80% will.” According to the guidelines, most children will eventually also tolerate milk, soy, and wheat.
Outgrowing tree nut and peanut allergies is much less common.
Dec. 6, 2010 -- Comprehensive new guidelines on food allergies are out from the National Institute of Allergy and Infectious Diseases (NIAID).
The new guidelines are directed at doctors to help them diagnose and manage food allergies.
Experts say food allergies appear to be on the rise, affecting nearly 5% of children younger than 5 and about 4% of teens and adults.
''We hope the guidelines will help patients and family members work better with their physician'' to identify the causes of food allergies, said Matthew Fenton, PhD, chief of the asthma, allergy, and inflammation branch of the division of allergy, immunology and transplantation at NIAID. He spoke at a Friday news conference detailing the new guidelines and led the guidelines development project for NIAID.
The guidelines address diagnostic tests, treatment, and prevention, among other areas.
While the guidelines are aimed at doctors, it will help parents and those with food allergies to be aware of their existence, said Hugh Sampson, MD, professor of pediatrics at the Mount Sinai School of Medicine in New York, who serves on the guidelines coordinating committee and also spoke at the news conference. "When they see their physician or request a referral to an allergist, they should know what type of questions will be asked of them and have some idea of what kind of tests their physician will be doing."
Food Allergy Guidelines: Back Story
A coordinating committee representing 34 professional medical organizations, advocacy groups, and federal agencies oversaw the guidelines development.
Then, a 25-member expert panel was selected; it pored over published literature and drew on clinical opinions to draft the guidelines.
Public comment was invited before the final guidelines were issued.
Food Allergy Guidelines: Definitions and More
The guidelines define food allergy as "an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food."
It distinguishes allergies from intolerances. Foods that cause the same reproducible adverse reaction but don't have a likely or established immune system response are not considered allergies, but rather intolerances.
For instance, someone allergic to cow's milk due to an immune system response to milk protein has a food allergy. But someone who has a difficult time drinking milk due to an inability to digest the lactose in milk has a food intolerance.
Among the most common food allergies are reactions to:
* Peanuts
* Tree nuts
* Seafood
* Milk
* Eggs
Anaphylaxis, a serious allergic reaction that comes on rapidly and may cause death, can occur in response to food. Up to 65% of anaphylaxis cases are thought to be due to food.
Food Allergy Guidelines: Diagnosis
Under the new guidelines, the panel of experts recommends that intradermal or skin testing should not be used to make a diagnosis of food allergy.
The experts recommend skin puncture tests, in which a small amount of the extract of a suspected food in placed on the skin, then the skin is punctured through the droplet, to help identify possible troublesome foods but not to make a diagnosis based on it alone.
It also recommends against the routine use of measuring total blood IgE, the antibody formed in reaction to an allergen.
It recommends allergen-specific IgE blood testing but cautions that the test results alone are not enough to make a diagnosis.
Food elimination diets -- taking away one or a few specific foods to see if the reaction disappears -- may help.
Oral food challenges -- exposing the person to the suspected food under medical supervision -- are thought to be helpful.
If exposure to a certain food triggers symptoms, the doctor should then see if that finding matches with lab tests and medical history.
Food Allergy Guidelines: Management
Avoidance is best, the experts agree. They write: "There are nomedications currently recommended by the EP [expert panel] to prevent IgE-mediated food-induced allergic reactions from occurring in an individual with existing food allergies."
When food allergies trigger anaphylaxis, the experts recommend epinephrine injections first.
Food Allergy Guidelines: What About Prevention?
While some pregnant women may hope restricting their diets during pregnancy or during breastfeeding may help their children avoid allergies, the experts disagree and don't recommend this.
They don't recommend soy formula as a strategy for preventing the development of allergies, either.
Outgrowing Food Allergies
A child with food allergies may outgrow them, Sampson said.
It depends on the food, partially. “If their child is allergic to egg, for example, chances are very good that children will outgrow it,” he said. “We know that about 80% will.” According to the guidelines, most children will eventually also tolerate milk, soy, and wheat.
Outgrowing tree nut and peanut allergies is much less common.
Thursday, December 9, 2010
Feeding Baby: How to Avoid Food Allergies by Louise Chang, MD
Starting to feed a baby solid foods is an exciting milestone for parents -- and one that also comes with a lot of new questions and concerns. What’s the best way to avoid food allergies once your baby has mastered single-grain cereals and is ready to move on to new foods? What foods are most likely to cause allergies in babies?
Start Gradually to Identify Any Food Allergies
It’s important to introduce baby to new foods gradually, and one at a time, in case of food allergies. Otherwise, you’ll have trouble tying an allergy to a specific new food. For example, if you give your baby three new foods over the course of a day and she develops an allergic reaction, you won’t know which of the foods provoked it.
It doesn’t matter all that much which foods you introduce to your baby, or which order you introduce them in, as long as the foods you are offering are healthy and well-balanced. But each time you offer a new food, you should wait three to five days before adding another to the menu. Don’t eliminate all the other foods your baby is already eating during that time -- just don’t add anything else new.
Babies and Allergies: The Top 8 Allergenic Foods
With each new food, you’ll want to be on the lookout for allergic reactions. There are more than 160 allergenic foods, but these eight foods and food groups are the culprits 90% of the time. You may want to wait until baby is older to try some of these foods, especially peanuts. In fact, many experts suggest waiting until your child is 3 before trying peanuts. Ask your pediatrician if you have any questions about a food.
* Milk
* Egg
* Peanuts
* Tree nuts (such as walnuts or almonds)
* Fish
* Shellfish
* Soy
* Wheat
Food Allergy Symptoms to Watch for in Your Baby
Food allergy symptoms usually appear very soon after the food is eaten -- within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:
* Hives
* Flushed skin or rash
* Face, tongue, or lip swelling
* Vomiting and/or diarrhea
* Coughing or wheezing
* Difficulty breathing
* Loss of consciousness
Severe Food Allergy Symptoms: When to Call 911
If your baby is having trouble breathing, has swelling on her face, or develops severe vomiting or diarrhea after eating, don’t take time to call your pediatrician. Call 911 immediately. Severe allergic reactions can be fatal very quickly.
Dealing With Mild Food Allergies in Baby
If you see mild symptoms, such as hives or a rash, contact your pediatrician, who will make an appointment for allergy testing for your child. Once your baby’s specific allergies are identified, the doctor will give you an action plan for managing the allergies (usually, eliminating the food from your baby’s diet) and dealing with accidental exposures.
Remember, just because a baby’s initial allergic reaction to a new food may be mild, it may not stay that way. Talk to your pediatrician about any food allergy symptoms in baby.
Some allergies go away with time. Peanut, tree nut, and shellfish allergies tend to persist, while egg and milk allergies often go away as children get older.
The Family Food-Allergy Connection
Until very recently, the American Academy of Pediatrics recommended that parents wait until age 1 to introduce dairy products, age 2 to introduce eggs, and age 3 to add peanuts, tree nuts, and fish. In early 2008, however, the AAP amended these recommendations, which were based on expert opinion rather than specific evidence.
The new AAP guidelines say that unless there is a significant history of food allergies in a child’s family, there’s no evidence that waiting until after a year to introduce these foods reduces her risk of developing allergies. In fact, there is some evidence that early introduction of some of these foods, such as peanuts, may make your child less likely to become allergic. Ask your pediatrician for guidance.
Protecting Baby Against Food Allergies: Easy Does It
Many pediatricians still recommend waiting until your baby is a bit older -- 9 or 10 months -- before offering these foods. Even if there’s no added risk of causing an allergy, they note that an allergic reaction may be easier to manage in an older baby. And some pediatricians, concerned about the particular severity of allergic reactions to peanuts and shellfish, still suggest staying away from them until your child is up to 3 years old.
Whole cow's milk should not be given to babies younger than 1 year old because the proteins in whole milk can irritate the stomach. Yogurt and soft cheeses are fine, however, because the proteins in these dairy products are broken down and less likely to cause tummy trouble. You should also still wait until at least 1 – some experts say 2 -- to introduce honey, which can cause a potentially serious disease called infant botulism.
SOURCES:
American Academy of Pediatrics: "Starting Solid Foods."
Rachel Lewis, MD, assistant professor of clinical pediatrics, Columbia University College of Physicians and Surgeons, New York.
American Medical Association: "Allergic reaction: Food allergies increasing, especially among children."
Medline Plus Medical Encyclopedia: "Food Allergy."
Reviewed by Louise Chang, MD on July 08, 2010 WebMD
Start Gradually to Identify Any Food Allergies
It’s important to introduce baby to new foods gradually, and one at a time, in case of food allergies. Otherwise, you’ll have trouble tying an allergy to a specific new food. For example, if you give your baby three new foods over the course of a day and she develops an allergic reaction, you won’t know which of the foods provoked it.
It doesn’t matter all that much which foods you introduce to your baby, or which order you introduce them in, as long as the foods you are offering are healthy and well-balanced. But each time you offer a new food, you should wait three to five days before adding another to the menu. Don’t eliminate all the other foods your baby is already eating during that time -- just don’t add anything else new.
Babies and Allergies: The Top 8 Allergenic Foods
With each new food, you’ll want to be on the lookout for allergic reactions. There are more than 160 allergenic foods, but these eight foods and food groups are the culprits 90% of the time. You may want to wait until baby is older to try some of these foods, especially peanuts. In fact, many experts suggest waiting until your child is 3 before trying peanuts. Ask your pediatrician if you have any questions about a food.
* Milk
* Egg
* Peanuts
* Tree nuts (such as walnuts or almonds)
* Fish
* Shellfish
* Soy
* Wheat
Food Allergy Symptoms to Watch for in Your Baby
Food allergy symptoms usually appear very soon after the food is eaten -- within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:
* Hives
* Flushed skin or rash
* Face, tongue, or lip swelling
* Vomiting and/or diarrhea
* Coughing or wheezing
* Difficulty breathing
* Loss of consciousness
Severe Food Allergy Symptoms: When to Call 911
If your baby is having trouble breathing, has swelling on her face, or develops severe vomiting or diarrhea after eating, don’t take time to call your pediatrician. Call 911 immediately. Severe allergic reactions can be fatal very quickly.
Dealing With Mild Food Allergies in Baby
If you see mild symptoms, such as hives or a rash, contact your pediatrician, who will make an appointment for allergy testing for your child. Once your baby’s specific allergies are identified, the doctor will give you an action plan for managing the allergies (usually, eliminating the food from your baby’s diet) and dealing with accidental exposures.
Remember, just because a baby’s initial allergic reaction to a new food may be mild, it may not stay that way. Talk to your pediatrician about any food allergy symptoms in baby.
Some allergies go away with time. Peanut, tree nut, and shellfish allergies tend to persist, while egg and milk allergies often go away as children get older.
The Family Food-Allergy Connection
Until very recently, the American Academy of Pediatrics recommended that parents wait until age 1 to introduce dairy products, age 2 to introduce eggs, and age 3 to add peanuts, tree nuts, and fish. In early 2008, however, the AAP amended these recommendations, which were based on expert opinion rather than specific evidence.
The new AAP guidelines say that unless there is a significant history of food allergies in a child’s family, there’s no evidence that waiting until after a year to introduce these foods reduces her risk of developing allergies. In fact, there is some evidence that early introduction of some of these foods, such as peanuts, may make your child less likely to become allergic. Ask your pediatrician for guidance.
Protecting Baby Against Food Allergies: Easy Does It
Many pediatricians still recommend waiting until your baby is a bit older -- 9 or 10 months -- before offering these foods. Even if there’s no added risk of causing an allergy, they note that an allergic reaction may be easier to manage in an older baby. And some pediatricians, concerned about the particular severity of allergic reactions to peanuts and shellfish, still suggest staying away from them until your child is up to 3 years old.
Whole cow's milk should not be given to babies younger than 1 year old because the proteins in whole milk can irritate the stomach. Yogurt and soft cheeses are fine, however, because the proteins in these dairy products are broken down and less likely to cause tummy trouble. You should also still wait until at least 1 – some experts say 2 -- to introduce honey, which can cause a potentially serious disease called infant botulism.
SOURCES:
American Academy of Pediatrics: "Starting Solid Foods."
Rachel Lewis, MD, assistant professor of clinical pediatrics, Columbia University College of Physicians and Surgeons, New York.
American Medical Association: "Allergic reaction: Food allergies increasing, especially among children."
Medline Plus Medical Encyclopedia: "Food Allergy."
Reviewed by Louise Chang, MD on July 08, 2010 WebMD
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