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Category: Nutrition

Unscrambling Eggs: Nutrition Science

A recent article published through National Public Radio analyzes and assesses one of humankind’s most reliable source of calories: eggs, which have historically been obtained “with minimal exertion and zero horticulture skills.”

In the late 1970s, specifically, the appreciation of eggs was at an all-time high, as physicians began to realize that excess cholesterol is a strong predictor for a higher risk of cardiovascular disease. Subsequently, many doctors assumed that eating high-cholesterol foods like meat, butter, and eggs would likely have a negative impact on health, and should thus be avoided.

Yet the nutritional science behind eggs, and foods generally high in cholesterol, is more nuance and complex. While cholesterol objectively can contribute to heart disease by literally blocking the body’s blood vessels, and eating foods high in cholesterol can raise its levels in the blood, an emerging and growing body of research has shown that the consumption of sugar, transfats, and excessive saturated fat is far more harmful to cholesterol levels than actual dietary cholesterol.

Studies and scientific research have gradually come to the consensus that some degree of cholesterol consumption is harmless—if not outright healthy—and that eggs should not be feared and avoided at all costs. Conversely, experts worry that if science is ‘misinterpreted and spun by the media,’ both the egg industry and opportunistic doctors will spin through the perpetual cycle of self-help revenue that is the foundation of diet science.

Dr. Walter Willett, chair of the Harvard T.H. Chan School of Public Health’s Nutrition Department, was one of the first U.S. physicians to determine that while previous findings have demonstrated that cholesterol in the blood has a correlation with a higher risk of heart disease, no studies had indicated that cholesterol consumption actually increases blood levels. Remember: correlation does not necessarily indicate causation.

Willett and his colleagues have since studied thousands of patients for years, and have found no evidence that moderate dietary cholesterol or egg consumption increases the risk for heart disease and stroke—except in people with a particularly strong genetic risk for high cholesterol. These findings reiterate and reaffirm those from a 2013 published study, which report that eating one egg per day is not associated with impaired heart health.

Further complicating this, however, is an abundance of studies funded by the egg industry that support egg consumption, which loosely interpret scientific data in the interest of profit. While there is no strong data upon which to base a specific numerical limit to a dietary cholesterol intake, guidelines continue to recommend that cholesterol intake should be as low as possible, and part of a generally healthy diet that is primarily rooted in fruits, vegetables, nuts, and whole grains—all thought to lower blood cholesterol and the risk of cardiovascular disease.

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Study Confirms Necessity of Nutrition Education

Necessity of Nutrition Education-04Recent statistics show that more than two-thirds of Americans are considered to be overweight or obese, generating a global obesity epidemic. With diabetes and obesity continuously on the rise, in addition to spikes in other lifestyle-related diseases, it has become critical to highlight the necessity of self-care and healthy living habits. Yet while physicians are generally considered to be reliable sources regarding nutrition, more than 50% of graduating medical students continue to rate their knowledge as ‘inadequate,’ and only one in eight patients receives counseling from their doctors on dietary health benefits.

A study designed to quantify the required number of hours of nutrition education at U.S. medical schools, in addition to an investigation regarding the types of courses offered, reaffirmed the supposition that medical students receive an inadequate amount of nutrition education. Only 27% of surveyed schools required a course dedicated to nutrition; on average, U.S. medical schools only offer 19.6 hours of nutrition education—across four years of medical school. Other informal polls and anecdotes uphold the studies’ findings, as students assert that nutrition education throughout medical school is, at best, minimal.

Throughout the past several decades, there has been a push towards improving the medical nutrition education that students receive. With suboptimal knowledge about dietary habits, future physicians are selling both themselves and their patients very short. It is imperative to equip health practitioners with the necessary tools and information that they can utilize in their practices, ultimately addressing the root causes of real, pervasive problems. Medical schools have the burden of responsibility to arm their graduates with the tools to tackle the biggest, most acute global health challenges: including obesity and nutrition problems.

All of our conferences this year highlight this topic, through specific sessions that discuss the need for nutritional education and awareness. At Regionals, we are hosting “Comprehensive Weight Loss Management in Primary Care Practice to Reduce Cardiometabolic Risk.” Our Annual event’s second session is dedicated to lifestyle management of cardiovascular disease, including “Cardiometabolic Disorders: Diet Quality, Quantity and Beyond,” “Sleep Science: Effect of the Circadian Rhythm on Obesity and CVD,” and “Lifestyle and Obesity Management in the Cardiometabolic Patient.” View the annual agenda, and learn more about our regional conference series.

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World Diabetes Day

diabetesToday marks World Diabetes Day, a commemoration of the disease that affects over 29 million Americans: 9.3% of the country’s population. November 14th also coincides with the birthday of Frederick Banting, the first physician and scientist to use insulin on human patients—and the youngest Nobel laureate in the area of physiology and medicine.

Diabetes manifests in two major forms; Type 1 is characterized by a lack of insulin production—the cause is unknown, and unpreventable. Type 2 diabetes, which is more common and accounts for approximately 90% of diabetics worldwide, is often preventable: it results from the body’s ineffective use of insulin. Because the pancreas generates little to no insulin, or the cells cannot utilize the insulin efficiently and effectively, glucose cannot enter the cells and builds up in the blood. Read more

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Medical Schools Are Still Largely Ignoring Nutrition Education, Leaving HCPs to Take Their Own Initiative

Despite the well-known fact poor nutrition is a major contributing risk factor for chronic diseases, medical schools are still failing to adequately prepare healthcare professionals for nutrition challenges in clinical practice.

It has become a well known fact that poor nutrition and lifestyle choices play a large role in the development of most chronic conditions, including cardiovascular and metabolic diseases – and cardiometabolic conditions such as diabetes and obesity continue to accelerate at an alarming pace. Yet, the teaching of nutrition in most US medical schools has been recognized for decades as being inadequate. How can healthcare professionals (HCPs) effectively treat their patients without proper education to recognize and treat the nutritional root causes? Read more

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Updated Dietary Guidelines Limit Added Sugars, Emphasize Healthy Eating Patterns

The newly released 2015 Dietary Guidelines by the US Departments of Health and Human Services (HHS) and of Agriculture (USDA) recommend fewer than 10% of calories per day come from added sugars and place an emphasis on healthy dietary patterns. According to the guidelines, “Eating pattern may be more predictive of overall health status and disease risk than individual foods or nutrients.” Additional recommendations include limiting saturated fat intake to fewer than 10% of calories per day and sodium to less than 2300 mg/day. Former guidelines restricting cholesterol to 300 mg/day have been eliminated but because the updated recommendations limit saturated fat, dietary cholesterol is consequently reduced due to the commonality of food sources.

Although some experts are critical of the guidelines and believe they could have been written with more clarity, other experts and organizations, such as the American Medical Association (AMA), are praising them. According to Steven Stack, MD, AMA president, “With obesity and its associated health consequences–namely type 2 diabetes and cardiovascular disease–on the rise throughout our country, the AMA is extremely pleased that the new recommendations call for significantly reducing the amount of added sugars and sugar sweetened beverages from the American diet.”

Learn more at the inaugural CMHC West being held March 4-5, 2016 at the Marriott Marquis, San Francisco, where “Food is Medicine–Building Nutritional Interventions Into Your Practice,” will be presented.

References:

2015 Diet Guide Departs From Recommendations–new guidelines add focus on dietary patterns and cap sugar. MedPage Today. January 7, 2016.

2015 Dietary Guidelines for Americans.

AMA Supports Newest Dietary Guidelines for Americans to Improve Public Health.

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Including Walnuts in Daily Diet Improves Health in Adults at Risk for Diabetes

Researchers randomized 112 participants, 31 men and 81 women, ranging in age from 25 to 75 years with multiple risk factors for diabetes (overweight, high blood sugar, blood pressure, or cholesterol, or excess fat around the midsection) to follow a reduced calorie diet with or without nutrition counseling. Within these groups, half were randomly assigned to add walnuts to their daily diet (about 2 ounces/day) for 6 months. After a 3-month break, researchers then switched the groups. Participants were assessed for diet quality, body composition, and cardiac risk measures.

Study results showed that walnuts, with or without nutrition counseling, significantly improved diet quality as measured by the Healthy Eating Index 2010. Endothelial function and total and LDL-C significantly improved from baseline; other factors such as BMI, percent body fat, visceral fat, fasting glucose, glycated hemoglobin, and blood pressure, did not change significantly.

Read the full study here.

References:
Njike V et al. Walnut ingestion in adults at risk for diabetes: effects of body composition, diet quality, and cardiac risk measures. BMJ Open Diab Res Care. 2015;3:e000115 doi:10.1136/bmjdrc-2015-000115.

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