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9 February 12
Six Scientifically Validated Nutritional Tips for Heart Health: with Dr. Eric Ding
Guest post for MyNetDiary by Dr. Eric Ding 
February is National Heart Month
I believe in the importance of evidence-based translational medicine. There is so much fluff and false claims in the nutrition world that I want to make sure all claims are justified with strong body of consistently supported scientific evidence. I’m an epidemiologist and nutritionist - so I like to focus on evidence-based medicine in the realm of disease prevention, because an ounce of prevention is worth a pound of cure.

Long-running research from Harvard Medical School and Harvard School of Public Health’s Department of Nutrition have established that over 82% of total heart disease in American woman are likely due to lifestyle factors, most notably poor nutrition. Indeed, nutrition is one of the major clusters of risk factors that cause heart disease. However, what 10 nutritional factors could we highlight for people to improve their health? Let’s list a few and discuss.

1) I rank sugar sweetened beverages (SSBs) as one of the worst causes of heart disease. But it’s not the sugar per se, but rather liquid sugar intake such as in soda and sweetened juices, because liquid sugar is partially “invisible” to our hunger control system.Indeed, the difference between liquid sugar and solid sugar is best seen in an experiment between sugary beverages vs. jelly beans (with same number of calories). While jelly bean eaters become full and ate less food later in the day, liquid sugar drinkers were not fully satiated and become hungrier sooner and consumed more calories at the end of the day (compared to solid sugar eaters). This is why sugary beverages (but not sugar) are inherently dangerous (Read my recent piece for more info). For the same reason, parents should not give too much SSB to their children.

2) Additionally, inadequate intake of fruits and vegetables is another major cause of heart disease in America. Only a small segment of the population gets 5 servings of fruits and veggies a day — and this actually includes French fries, which nutritionists don’t really consider a vegetable (But how did the starch French fries get classified as vegetable by the USDA? It’s not hard to imagine what industry group had successfully lobbied USDA for the ‘French fry’ vegetable classification). 

3) Additionally, beyond SSBs and French fries, generally, high glycemic load refined starches are a cause of heart disease. Therefore look for whole grains instead of white bread, brown rice instead of white rice, and steel cut oats instead of instant oatmeal. And avoid mashed and baked potatoes - they have incredibly high glycemic index and glycemic load - they are equivalent to almost pure table sugar in spiking one’s blood sugar (and elevating heart disease risk).

4) Avoid trans-fats at all cost. Many years ago, before the nutrition and medical community realized the dangers, the emphasis had been on avoiding butter — and instead people were recommended to consume margarine instead back in the 1980s and early 1990s. However, the Department of Nutrition at Harvard School of Public Health discovered that trans-fats, high in margarine sticks, were even worse than the saturated fat in butter for increasing heart disease risk. This eventually led to trans-fat bans from restaurants in NYC, and then the rest of the country. Trans-fats are inherently bad for both their ability to increase bad LDL cholesterol, lower good HDL cholesterol, and increase inflammation - all of which increase heart disease substantially. Therefore, avoid it at all cost!

5) Avoid red and processed meats - which have been consistently shown to increase the risk of both Type 2 Diabetes and heart disease. Processed meats also often have nitrites which exacerbate diabetes, which in itself is a strong causal factor for heart disease as well. Also keep in mind, that pork is a red meat, regardless of what advertising may try to persuade people otherwise.

6) Cocoa flavonoids are good against heart disease. In multiple systematic reviews of dozens of randomized trials, cocoa flavonoids are shown to lower BP, lower bad LDL, raise good HDL, improve insulin sensitivity, and improve blood flow. Recent reviews of multiple long term studies have also shown benefits for lowering heart disease. However, interestingly, the benefits in the trials were observed with doses of around 400-500 mg/day, equivalent of 33 bars of milk chocolate or 8 bars of dark chocolate. Thus, because it is unreasonable to consume so much calories and sugar and fat to achieve these levels of cocoa flavonoids through just chocolate bars alone… supplements of cocoa flavonoids are needed to achieve the benefits discovered (supplements available commercially, e.g. Cocoawell). The key is getting the benefits of cocoa flavonoids for heart disease while avoiding the calories, and for that, chocolate bars are not the solution - supplements may be the best option.

About Eric Ding, MD:
ERIC DING, a nutritionist and epidemiologist, is member of the faculty at Harvard Medical School and Brigham and Women’s Hospital. He is also founder and Director of the Campaign for Cancer Prevention, and Director of Epidemiology for Microclinics International. His research primarily focuses on obesity and nutritional risk factors for diabetes, heart disease, and cancer, as well as translation of research for population-wide prevention. His specific research expertise include: fatty acids, sex steroid hormones, and vitamin D. His broader research also encompasses social network effects on health, and population nutrition and global health disease burdens. After completing his undergraduate degree at The Johns Hopkins University with Honors in Public Health and election to Phi Beta Kappa, he earned his dual doctorate in epidemiology and doctorate in nutrition at age 23 from Harvard University. At Harvard, Eric has taught and lectured in more than a dozen graduate and undergraduate courses, for which he received the Derek Bok Distinction in Teaching Award from Harvard College. 

Six Scientifically Validated Nutritional Tips for Heart Health: with Dr. Eric Ding

Guest post for MyNetDiary by Dr. Eric Ding 

February is National Heart Month

I believe in the importance of evidence-based translational medicine. There is so much fluff and false claims in the nutrition world that I want to make sure all claims are justified with strong body of consistently supported scientific evidence. I’m an epidemiologist and nutritionist - so I like to focus on evidence-based medicine in the realm of disease prevention, because an ounce of prevention is worth a pound of cure.

Long-running research from Harvard Medical School and Harvard School of Public Health’s Department of Nutrition have established that over 82% of total heart disease in American woman are likely due to lifestyle factors, most notably poor nutrition. Indeed, nutrition is one of the major clusters of risk factors that cause heart disease. However, what 10 nutritional factors could we highlight for people to improve their health? Let’s list a few and discuss.

1) I rank sugar sweetened beverages (SSBs) as one of the worst causes of heart disease. But it’s not the sugar per se, but rather liquid sugar intake such as in soda and sweetened juices, because liquid sugar is partially “invisible” to our hunger control system.Indeed, the difference between liquid sugar and solid sugar is best seen in an experiment between sugary beverages vs. jelly beans (with same number of calories). While jelly bean eaters become full and ate less food later in the day, liquid sugar drinkers were not fully satiated and become hungrier sooner and consumed more calories at the end of the day (compared to solid sugar eaters). This is why sugary beverages (but not sugar) are inherently dangerous (Read my recent piece for more info). For the same reason, parents should not give too much SSB to their children.

2) Additionally, inadequate intake of fruits and vegetables is another major cause of heart disease in America. Only a small segment of the population gets 5 servings of fruits and veggies a day — and this actually includes French fries, which nutritionists don’t really consider a vegetable (But how did the starch French fries get classified as vegetable by the USDA? It’s not hard to imagine what industry group had successfully lobbied USDA for the ‘French fry’ vegetable classification). 

3) Additionally, beyond SSBs and French fries, generally, high glycemic load refined starches are a cause of heart disease. Therefore look for whole grains instead of white bread, brown rice instead of white rice, and steel cut oats instead of instant oatmeal. And avoid mashed and baked potatoes - they have incredibly high glycemic index and glycemic load - they are equivalent to almost pure table sugar in spiking one’s blood sugar (and elevating heart disease risk).

4) Avoid trans-fats at all cost. Many years ago, before the nutrition and medical community realized the dangers, the emphasis had been on avoiding butter — and instead people were recommended to consume margarine instead back in the 1980s and early 1990s. However, the Department of Nutrition at Harvard School of Public Health discovered that trans-fats, high in margarine sticks, were even worse than the saturated fat in butter for increasing heart disease risk. This eventually led to trans-fat bans from restaurants in NYC, and then the rest of the country. Trans-fats are inherently bad for both their ability to increase bad LDL cholesterol, lower good HDL cholesterol, and increase inflammation - all of which increase heart disease substantially. Therefore, avoid it at all cost!

5) Avoid red and processed meats - which have been consistently shown to increase the risk of both Type 2 Diabetes and heart disease. Processed meats also often have nitrites which exacerbate diabetes, which in itself is a strong causal factor for heart disease as well. Also keep in mind, that pork is a red meat, regardless of what advertising may try to persuade people otherwise.

6) Cocoa flavonoids are good against heart disease. In multiple systematic reviews of dozens of randomized trials, cocoa flavonoids are shown to lower BP, lower bad LDL, raise good HDL, improve insulin sensitivity, and improve blood flow. Recent reviews of multiple long term studies have also shown benefits for lowering heart disease. However, interestingly, the benefits in the trials were observed with doses of around 400-500 mg/day, equivalent of 33 bars of milk chocolate or 8 bars of dark chocolate. Thus, because it is unreasonable to consume so much calories and sugar and fat to achieve these levels of cocoa flavonoids through just chocolate bars alone… supplements of cocoa flavonoids are needed to achieve the benefits discovered (supplements available commercially, e.g. Cocoawell). The key is getting the benefits of cocoa flavonoids for heart disease while avoiding the calories, and for that, chocolate bars are not the solution - supplements may be the best option.

About Eric Ding, MD:

ERIC DING, a nutritionist and epidemiologist, is member of the faculty at Harvard Medical School and Brigham and Women’s Hospital. He is also founder and Director of the Campaign for Cancer Prevention, and Director of Epidemiology for Microclinics International. His research primarily focuses on obesity and nutritional risk factors for diabetes, heart disease, and cancer, as well as translation of research for population-wide prevention. His specific research expertise include: fatty acids, sex steroid hormones, and vitamin D. His broader research also encompasses social network effects on health, and population nutrition and global health disease burdens. After completing his undergraduate degree at The Johns Hopkins University with Honors in Public Health and election to Phi Beta Kappa, he earned his dual doctorate in epidemiology and doctorate in nutrition at age 23 from Harvard University. At Harvard, Eric has taught and lectured in more than a dozen graduate and undergraduate courses, for which he received the Derek Bok Distinction in Teaching Award from Harvard College. 

10 February 11

Metabolic Efficiency Training: Teaching the Body to Burn More Fat

Guest post for MyNetDiary Blog by Bob Seebohar, MS, RD, CSSD, CSCS, a Board Certified Specialist in Sport Dietetics and former Sport Dietitian for the US Olympic Committee.

Ready for a change? Tired of not attaining your nutrition goals? Do you gain weight when you start exercising or training for an endurance event? Well keep reading then because I have some valuable information to share with you. I would like to change your paradigm of thinking about nutrition so you can teach your body to use the right nutrients at the right times to improve your health and exercise better.

I am not proposing a complete nutrition makeover. I believe that the more complex you make something, especially nutrition, the less likely you will follow it. If it’s simple, it’s sustainable.

Enter the topic of metabolic efficiency. From a nutrition perspective, being metabolically efficient means being able to burn more fat, period. At any given time, you have about 1,200-1,800 calories stored in your body as carbohydrate but upwards of 80,000 calories stored as fat. There is a huge opportunity to teach your body to use more of its internal fat stores and preserve carbohydrates!

Why Be More Metabolically Efficient?

I’ve been working with recreational and competitive athletes for many years and whenever I ask them about their short and long-term goals, I typically receive the same two responses: lose weight and decrease body fat. Of course you know that manipulating your body weight and composition in a favorable direction can have a positive impact on your health and exercise program. The first step in

doing this is changing your nutrition paradigm and how you approach food, not about how much you exercise. Controlling blood sugar is your first step.

Carbohydrates are a staple in our eating plan and for good reason. They provide the energy that is needed to fuel the body during exercise. But sometimes, eating a higher carbohydrate diet can lead to weight and body fat gain. This happens quite frequently to new exercisers when they first begin a program and quite often, these people tend to gain weight in the early phases of exercise. Often times, this is simply a mismatch of the calories that you eat with the calories you are burning. It is important to understand that in the beginning weeks of an exercise or training program, you do not need to significantly increase your daily food intake because your energy expenditure is not extremely high.

In this scenario, a person usually overeats carbohydrate rich foods and forgets about the other two macronutrients-protein and fat. Eating too much of any one macronutrient can lead to metabolic inefficiencies. Focus too heavy on one macronutrient and a state of imbalance occurs. Eat a combination of foods and you will remain in balance.

Controlling blood sugar becomes your first order of business. When your blood sugar is high, so is the hormone insulin. When insulin levels are high, this decreases your body’s ability to use its internal fat stores as energy. Controlling your blood sugar will keep you fuller longer and reduce your food cravings.

As you approach your food selection and preparation, prioritize your meals and snacks. First on your plate should be a source of lean protein and healthy, omega-3 rich fat. Second up is a healthy portion of fruits and/or vegetables. Then, if you have room on the plate (no more than ¼ of the plate), add a few whole grains. Following this approach ensures that you obtain balance without overdoing it on the carbohydrates. Focus on color. Your plate should be oozing with vibrant colors such as green, red, purple, orange and yellow. Limit the browns, light yellows and tans.

This should not be too difficult. It will take preparation and commitment on your part but remember, this is a behavior change and can take a few weeks to adopt. Start now and remember to allow yourself some times where you will take a few steps backwards. It’s all part of the process of improving your nutrition plan!

For more information about this topic, refer to Bob’s book, “Metabolic Efficiency Training: Teaching the Body to Burn More Fat,” available at www.fuel4mance.com or in Kindle format on Amazon.

Bob Seebohar, MS, RD, CSSD, CSCS, is a Board Certified Specialist in Sport Dietetics, an exercise physiologist, strength and conditioning specialist and triathlon coach. He was formerly the Director of Sports Nutrition at the University of Florida and recently was a Sport Dietitian for the US Olympic Committee where he traveled to the 2008 Summer Olympics as the Team USA Sport Dietitian. 

Contact Bob at coachbob@fuel4mance.com or www.fuel4mance.com.

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