Foodland Chronicles is a weekly blog focused on topics related to good health and yummy foods. Doctor Grandma and her team are strong proponents of the Mediterranean Style of Eating - advocating a shift from animal-based foods to plant-based foods and a shift from processed foods to whole, real foods.
When I was a girl I loved fairy tales; but as an adult dietitian I find food and nutrition fairy tales frustrating. Many people are getting their nutrition advice from unqualified sources and it often leads to less than optimal nutritional status. Be careful to whom you turn for nutrition advice; see my recently published MDs and Nutrition, that shows having an MD does not assure nutritional literacy, but it encourages guesswork based on flawed information. The following are a collection of eleven popular counter-productive nutrition ideas:
I’ll start with my very favorite. I have to admit an embarrassing event. I was waiting in line to check out, by myself at Sprouts, where I buy my vegetables and fruit, and then it hit. I got ambushed by a little laugh attack. Right by the end cap of the checkout aisle were gigantic organic candy canes. The person in front of me turned a little to see why I laughed out loud. I said something quick about the idea of the word ‘organic’ being plastered on a candy cane. They gave me a cursory smile, they probably thought I had some sort of psychological problem, and then turned around. Let’s face it, organic cheese puffs, the three flavors of organic Pringles – ready for flavor stacking, and organic potato chips are still junk food, regardless of all their organic ingredients. Is there not something just slightly humorous about the ingredients of organic candy bars with the first ingredient - organic dried cane syrup? Or is this only comedy for dietitians?
Shopping Only the Perimeter of the Store
Holy Mackerel! This one drives me absolutely crazy. How would you get the whole grain pasta, the brown rice, the canned beans, tuna, nuts, seeds and very importantly the spices that make foods taste so good, if you didn’t allow yourself to go to the aisles?
Deciding to eat gluten-free; then eating calorie and sugar-laden gluten-free cookies, gluten-free candy, gluten-free cake, and gluten-free bread. Check out the ingredients. Often tapioca or rice flour is added to make the breads or pastries taste more like the original version. The products often have more sugar and more fat than the gluten containing version. If you don’t have celiac disease or non-celiac gluten sensitivity, you may be decreasing the nutrition in your diet, when you choose to go gluten-free.
Although it’s been known for a long time that good fats (think olive oil; canola oil, avocados; nuts, seeds) are beneficial to our health; some people are still trying to cut back drastically on fat. But don’t forget my 2010 article Revisiting the Snackwell Syndrome. The point of that old article is that many processed foods that are low in fat are high in sugar. As with either of the above choices (gluten-free and fat-free) you may give yourself license to eat more. There are still calories and often increased artificial ingredients – nutritionally empty calories, like sugar.
You all know I embrace the Mediterranean Diet (or eating style, as I often call it). But there’s even a possible problem with it. Just because it includes the beneficial foods that contribute to health, doesn’t mean that you can eat unlimited amounts of those foods. For example, whole grain pasta, albeit a healthy choice, still has 159 calories for a cup. If you switch to extra virgin olive oil, wonderful, but olive oil has about the same calories as any oil – it is fat. Nuts are great, but keep in mind that they average about 800 calories per cup. The point is that portion control is an important aspect of healthy eating.
Eating vegetables is so often an admonition on this site, but some people decide to become vegetarians and then head to the soda cracker aisle of the market. If you’re eating white rice, mashed potatoes, fruit juice, lots of cheese, but no animal flesh, you may be shocked that you are headed down the way of malnutrition or at least, undernutrition. The crazy fact is that you may be doing that while increasing your calorie intake. A vegetarian diet can be very healthy, but you need a balance of foods – pasta, bread and juice are not going to do the job.
Have you heard that you should start juicing? Drinking only juice will leave you short of calories (and you’re thinking that’s good) unfortunately, it can also leave you short of nutrients that your body needs to function optimally. Let me remind you that your body has a wonderful self-cleaning system. If you’re consuming vegetables, whole grains, fruits, nuts, seeds and other fibrous foods and liquids, your self-cleaning system doesn’t need a juice cleanse.
It appears that Americans love the buzzword superfoods. The fact is that the superfood may be a healthy choice, but they are often no healthier than ordinary foods that you’ve eaten your entire life. Do you ever see oranges on the super food list? Me neither. But what a powerhouse of nutrition, not to mention flavor!
No Good Foods and No Bad Foods
This is a common statement by those not deep in real nutritional understanding. Get real! A 3 Musketeers Bar is not equivalent with a serving of spinach. Steering clear of frequent intake of saturated fats, simple carbohydrates – especially sugar and lots of processed foods is just plain smart. It’s a fact, that some foods are unhealthy. Now having said that, you know that I don’t believe in forbidden foods; I do strongly believe in controlling your environment (2016 – Down-Shifting Hedonic Hunger) and keeping them out of your mouth frequently.
Honey and Raw Sugar
Sure, use a little. But do know, sugar is sugar. The code words for sugar are summarized in my 2011 list of sugar in Getting Off Your SoFAS. If you’re counting your grams of sugar a day (24g for women – 6 teaspoons; 36g for men – 9 teaspoons) be sure to include all the syrup, honey and raw sugar – sugar is sugar, but by a thousand names.
Avoiding Fruit Because of Sugar
Yes, fruit has sugar, but it is mixed with fiber and a tremendous number of vitamins, minerals and phytonutrients. The sugar in fruit is not a processed sugar, like the type of sugar I’m referring to directly above. Like most everything …… all things in moderation. You don’t need 10 apples; but enjoy that juicy, tangy Honeycrisp.
If you’ve read this, maybe you too have discovered that you’ve out grown nutrition fairy tales.
Are you struggling to stick with the goal of diet improvement?
I get it! It’s much easier to stay with your old eating habits and take the supplement you just learned is related to better health than to go through the considerable effort (with its tasty, enjoyable, often beautiful, and healthy results) to eat the types of foods that supply the whole wide range of nutrients you need. Although I understand your rationale for picking the pill, I also know that it is a flawed rationale. Let me just choose magnesium to make my argument.
Magnesium is a metal and oxidizes easily. It may be silver-white. Magnesium salt tastes bitter. Too much can be harmful to your health. Why would anyone think of eating a magnesium supplement instead of choosing foods that contain it? Other supplements are like this; you wouldn’t think of eating them as a food, but scientific studies say they help the body in some way – mysterious until really costly and difficult research shows how a mineral or other supplement actually gets into the body the right way, in the right amount, and helps the body.
There’s some well-done broad-brush research that shows that people with higher magnesium intake have a lower risk of type 2 diabetes. It’s a useful kind of research that says that eating foods containing magnesium is beneficial, but it doesn’t even tell us that the magnesium was what made the difference. None the less, I can imagine, if I knew that there was type 2 diabetes in my family, I’d be tempted to hop in the car to go pick up my bottle of magnesium supplements. Heaven knows, I would want to do what I could to avoid joining the 100 million or more in the U.S. with diabetes or prediabetes. The CDC reported in 2017 that 9.4 percent of the U.S. population – have diabetes (30.3 million) and another 84.1 million have prediabetes. It’s no secret that uncontrolled diabetes raises risk for cardiovascular disease, strokes, skin problems, nerve problems, kidney problems, eye problems, some cancers, higher risk of infections, gastroparesis (delayed emptying of food from the stomach) and possibly Alzheimer’s disease. So clearly, I’d be motivated to avoid diabetes. But in reality, I do have relatives with type 2 diabetes, and I didn’t hop into the car. Read on to find out why not.
Losing weight and exercising more can lower your risk of type 2 diabetes; but getting more magnesium, in the right way and in the right combination with other things, and in the right amount, might help too. The snag of the study cited above, which involved 17,130 incident cases of type 2 diabetes over 28 years of follow-up is that the magnesium was coming from their food – not supplements. This type of study only makes a connection between a food containing the nutrient suspected to cause the effect. It may be magnesium or maybe not. The magnesium might help beta cells in the pancreas secrete insulin or it may make the cells in the body more sensitive to insulin, so the cells are more responsive to insulin. Those are just guesses. It would take well-designed studies to really know for sure. The study just cited provides no evidence that taking a magnesium supplement would help. There have even been studies showing that taking a single publicized nutrient as a supplement can makes things worse, not better.
One reason for this finding, in the case of magnesium, is that foods known to be rich in this nutrient have thousands of other nutrients as well. Good magnesium foods include green leafy vegetables, beans, nuts, seeds and whole grains. Obviously, these foods have many other nutrients in addition to magnesium. If you take magnesium supplements rather than the whole foods, you may miss out on what total set of nutrients in those foods is really causing, all together, the lower risk of type 2 diabetes. Moreover, you may also get the bad side effect of diarrhea. The great thing about getting magnesium from foods is that the risk of getting too much is essentially nonexistent. In addition to avoiding possible diarrhea, you can also avoid wasting your time, money, and effort if it proves to be some other micronutrient (a different mineral, vitamin or phytonutrient (which number in the thousands) – or some combination of them. Not only that, maybe it is magnesium, but perhaps the magnesium needs some phytonutrient to work with it. Or it’s involved with the plant fiber that is in the food. Being well-nourished is far more complex than popping some supplements. And with the whole foods, you are getting the magnesium in the very context that the study investigated –eating the magnesium-containing foods!
There are lots of good reasons to keep working on improving your diet and not trying to rely on supplements. Stick with your resolution to improve your diet this year. Keep chipping away at that worthy goal even though seems to take more effort than taking a small, but bitter, pill. It can be done.
The other day, in the course of having a little conversation with a friend, she told me that she takes supplemental enzymes orally that help her health. She believes that when she swallows the enzyme supplements that the enzymes do whatever they normally are supposed to do if they were injected into the bloodstream. She absolutely believes that this happens in her body and it improves her health. Frankly, I was surprised; but then I started thinking about it a bit and realized that supplement companies and cosmetic companies profit in a big way as long as people keep believing in this fallacy.
First, I began thinking about the skin care businesses that touts taking collagen supplements to improve the skin’s appearance. People buy the idea because we know that collagen is what keeps skin elastic and smooth. When you look in the mirror and discover that little lines are appearing all over, you may begin to spend a few more moments at the cosmetic counter or on the internet trying to discover how to make those lines go away. Heaven knows, we’d all like to fix the fragmented, frayed collagen that our older bodies perpetuate, especially those of our face. It would be nice if our collagen-making cells would perform like they did when we were young.
Unfortunately, we cannot simply eat brains if we want to become smarter; or heart if we want to have more courage; eating insulin will not make our blood sugar go down nor will our diabetes go away; eating collagen will not result in a smooth, young face. There is an important bodily function to understand that will help protect each of us from the charlatans.
When you digest protein, all proteins, whether they’re collagen, enzymes, insulin (a hormone, but still protein) they are broken down into two or three amino acids. We call these peptides. Peptides and amino acids can be absorbed across the intestinal wall, into our blood. Then, each group of specialized cells of our body uses the amino acids from the peptides to build the proteins, enzymes, hormones and connective tissues like collagen that those cells are designed to produce for us from the peptides.
Did you ever wonder why people with diabetes have to use a needle or a pump to get insulin into the blood? Why can’t they just take it orally? That’s because the insulin would be digested into peptides and amino acids and would not turn back into insulin; unless the cells of the pancreas work well enough to take the amino acids from all food and supplement sources to make the insulin from scratch. Note: Sometimes people get confused that oral medications that can help lower blood sugar or improve the ability of cells to absorb sugar are insulin. No, there are medications that cause the liver to produce less glucose (blood sugar), or improve the sensitivity of the cells to whatever insulin is still produced by the pancreas. These are NOT “oral insulin”. Metformin and other orally administered drugs that help keep blood sugar under control are not insulin.
The system of making all the protein-containing parts of our body is beautiful to to contemplate -- it even seems somewhat miraculous. That system is a fairly complex system, like most things that happen in the human body, with all kinds of regulatory systems governing it. But the take-away lesson is fairly simple. If we realize that taking protein like chicken, fish, beef, the protein in nuts, seeds, vegetables, and grains; or insulin; or collagen from a jar, or enzyme supplements –all of these are broken down into amino acids and peptides. Once we have learned this lesson, we will not allow supplement producers or anyone to swindle us.
We all have to eat; and if we eat a healthy diet containing protein, and with a few exceptions, most foods (not just meat) contain protein. Protein from all kinds of foods will give us the protein building blocks (amino acids) to make your enzymes, collagen, and all the rest of you. It is a mistake to pay the price of buying supplements.
For me, one of the most upsetting aspects of this type of fraud is the knowledge that some people who are spending money on this type of supplement, could buy better food with the money. They’re being led to believe, erroneously, that the protein supplements will assure them of better health or beauty. People are wasting their money.
We have presumably left behind the beliefs of the Dark Ages, when people believed that you could eat brain to be smart; and heart to have courage. Now we must leave behind he equally uninformed notion that we can eat enzymes and other specialized proteins and have the same benefit as if it were like insulin, injected into the bloodstream.
The human body and nature itself never cease to amaze me. It’s fascinating to me that so many times that we humans learn about something that is involved in human health, we end up thinking that we know more than we actually know. Our knowledge of our gut microbiome (formerly called gut flora), is the microbe population living in our intestine. The European Society of Neurogastroenterology & Motility reports it to contain tens of trillions of microorganisms, including at least 1000 different species of known bacteria with more than 3 million genes (150 times more than humans, who have less than 20,000 genes). Just the sheer number of microbes and genes is enough to lead us to believe that we’re just at the beginning of understanding our microbiome.
An intriguing recent story which came out of a study done in Israel and published in the journal Cell in September 6, 2018 has caught my attention. Many of you will want to read the study, but let me give you a quick layman’s idea of what was learned. The researchers were trying to learn if taking probiotics after being medicated with antibiotics was effective or not. They randomly assigned 21 healthy adults to three groups after a week on antibiotics. The three groups assigned to were:
They would get no additional treatment (the control group)
The second group got a fecal transplant, which was made from their own microbiome before they took the antibiotics
The third group took a probiotic for four weeks. The probiotic contained eleven of the most commonly used bacteria in the probiotics market.
Now here’s the interesting outcome:
The microbiome of the control group returned to their initial composition after four weeks.
The fecal transplant group was no different from its original composition just one day after transplantation.
The probiotic takers didn’t return to normal. “They had microbiome characteristics that were suggestive of pathological states, such as low bacterial diversity and sustained microbiome imbalance;” said Eran Elinav, a professor of immunology at the Weizmann Institute of Science where the research was done.
At first glance, you may say; obviously the fecal transplant is the best choice. But that is not something that you do at home after recovering from your infection and the antibiotic that cured it. Even more interesting is the fact that the researchers continued to test the probiotic group for six months after the course of antibiotics and that group’s microbiome never returned to normal. Although the researchers do not know what the changes mean for health, they believe that it’s not likely to improve it. Elinav was quoted by Nutrition Action Newsletter as saying; “Contrary to the current dogma, which says that probiotics are harmless and benefit everyone, our results point out that consumption of probiotics following antibiotics can delay the restoration of a person’s microbiome. If our intent is to restore the microbiome to its initial state, probiotics are clearly not the preferred means to achieve it. We need high-quality studies to further assess this potentially alarming adverse effect of probiotics after antibiotic use.”
I look forward to the results of the further research with larger and more diverse samples that should come from this work. Some questions that pop out of my head are:
What about populations that eat probiotics as staple foods? Certainly, many of them were eating the foods long before antibiotics were discovered. If this is all verified it seems that it opens a huge can of worms that need to be addressed.
A related question is: What about those that ate probiotic containing foods prior to the antibiotics?
If we eat a fairly common American diet, should we avoid live culture yogurt and cheese, after a round of antibiotics?
Some foods that contain probiotics are:
Yogurt with active or live cultures (all yogurt starts with live cultures, but sometimes in the processing the bacteria are killed. Note: Some yogurt is loaded with high amounts of added sugar.
Kefir is a fermented probiotic milk drink
Sauerkraut is fermented cabbage – nutritious, but very high in salt; pasteurized sauerkraut kills the live and active bacteria
Tempeh is fermented soybeans
Kimchi is spicy Korean fermented cabbage
Miso is fermented soybean paste, Japanese seasoning
Kombucha is fermented black or green tea
Pickles (that are fermented in salty water) it does not include those with vinegar, as vinegar kills bacteria
Buttermilk that is fermented (popular in India, Nepal and Pakistan) American cultured buttermilk does not have probiotic benefits
Natto is another fermented soy product popular in Japanese cuisine
Some types of cheese, including cheddar, mozzarella and gouda
Although the results of this study offer many questions, the small-sample research was well conceived and well done. If these results hold up with larger samples, it is more than worth-while knowing about the results, so the next time your physician says to load up on probiotics after a round of antibiotics, you will know to ask if he/she is familiar with this study.
The English Poet, Thomas Tusser is credited to have said; “Make hunger thy sauce, as a medicine for health.” I think what that is meant to denote is: if you’re hungry enough you’ll eat what is served no matter how plain it is; also, eat to provide the nutrients that keep you healthy, not for pleasure. I have quite a bit of English ancestry; but probably slightly more French (especially if you count the “English” that resulted from the Norman Conquest.) But back to sauce! Let’s face it, the English are known for many wonderful things, but cooking is not the top of the list. English food is often delicious, but simple and hearty. Daniel Boulud, a famous French chef and restaurateur in America and around the world, said; “Sauce is certainly ancestral to French cooking. The technique is very tricky, but it’s also very fundamental.”
There seems to be various stories of where mayonnaise began (even the ancient Egyptians and Romans); and there doesn’t seem to be any consensus about which story is fact. For those of us who have appreciated the culinary skills of the French, I’m going to err on the side of the French as to where mayonnaise began. One of the stories goes clear back to 1756 when the French were celebrating a victory over Mahon a city on an small Mediterranean island a little southeast of present day Barcelona, Spain. The story goes that the Duke’s chef had no cream and substituted olive oil, naming the sauce “Mahonnaise.” Some time around 1800, Marie-Antoine Careme, “The King of Chefs and the Chef of Kings,” created a lighter version of mayonnaise using vegetable oil instead of crème.
The funny thing about the history of mayonnaise is that in America it takes a big twist to a 1903 German emigrant to New York City. Richard Hellmann’s wife made the mayonnaise used at their deli and people enjoyed the mayo so much that he began selling the mayo in wooden boats – eventually selling it in jars. From 1912 to today, Hellmann’s was acquired by Best Foods, Inc., and Best Foods Inc was eventually, acquired by Unilever, an enormous Anglo-Dutch multinational corporation, in 2000. However we got mayonnaise, I’m full of gratitude for all involved.
Sure I know that there are lovers and haters of mayonnaise; and even those that are afraid of its fat; but if you’re a cook having mayonnaise in a jar is quite the time saver.
Of course, there are sauces unlimited that can be purchased today as ready to use: (spaghetti sauce; Hollandaise sauce; Alfredo sauce; soy sauce; hot sauce; applesauce; marinara sauce; Tabasco; Worcestershire sauce; curry sauces; catsup; tartar sauce; cocktail sauce; Béchamel; Veloute; sweet sauces; brown sauces; butter sauces; white sauces and of course, secret sauce. That’s a start.) But mayonnaise is a parent of sauces; so let me share a bit about it.
Because mayonnaise is an emulsion, it requires whipping and whipping to make a sizable batch. If you’re not a cook, you may have never felt the burn in your bicep. Cooks have been celebrating the ease of opening the jar for over a hundred years; since the first days that mayonnaise could be purchased. But now days when many people own food processors; there’s no worry about running out of mayonnaise. You can whip up a batch of mayo in minutes. Like Daniel Boulud said, it is a little tricky; but if you know the tricks you can make it the way you like. The biggest trick is not to add too much oil in the beginning because your mayo will “split” or “separate.” Splitting can also happen in the fridge, if you don’t completely emulsify it. What that means is that it kind of curdles into a lumpy mess. You can maybe save your split mess, by blending again with a few drops more lemon juice or water. But if you follow directions you probably won’t have to deal with this problem.
The cool thing about making your own mayo is that you can find egg-free recipes, if you’re a vegan; olive oil recipes, if olive oil is your oil of choice; or maybe avocado oil; or some combination of mustard and mayo; or have actual control of the eggs used in making the mayo.
There are many recipes and YouTube demos for making mayo. I’m only going to include three here:
The second is famous chef Gordon Ramsay’s (award-winning famous British chef) method – also using a food processor.
The last is Jamie Oliver’s method (another famous chef and restaurateur); whisking it by hand with vinegar or both lemon juice and vinegar.
Did you think that I would never make it to a few words about the nutrition of mayo?
Sure, you can get low fat mayo; my taste buds rebelled; but maybe the 15 calories instead of the regular 90 to 100 calories per tablespoon is worth the loss of better flavor for some. The mayos with 60 calories have a better flavor. You’ll have to experiment with your own taste buds. You can still get the flavor of the full fat mayo, by replacing part of the mayo with lemon juice; pickle juice or Greek yogurt.
If you’re a vegetarian, but not really a vegan; or you’re trying to not consume too much cholesterol, you may be tempted to buy the egg-free vegan version of mayo. But check out the amount of egg in the regular mayo before you spend extra at the market for less egg. There’s only 5 mg of cholesterol in a tablespoon of the full fat and egg recipe of Best Foods/Hellmann’s. Oil and water are the first ingredients in the mayo (mostly oil and water, then eggs). One large egg has 185 mg of cholesterol. So, one egg makes 37 servings of commercial regular mayo; by the way there are only 30 servings in the one jar of mayo.
If you’re concerned about how the chicken is treated that produces the one egg that makes 37 servings (81% of one egg that makes one jar). Some mayo brands like Kraft (who plaster on the front of the jar: “Made with cage free whole eggs.” commit to only use 65% cage free eggs of that 81% of one egg. Just under a half (49%) of one cage free egg per jar.
If you’re trying to keep your saturated fat under control, realize that mayo only has about 1.5 grams of saturated fat (for the full fat version) per serving. It’s mostly oil and water, with a little egg, vinegar or lemon juice (if you make it yourself) and salt. The salt is surprisingly low; most brands are between 70 to 130 milligrams – not bad. Even the added sugar is less than half a gram per tablespoon, which is so insignificant that it shows up as zero added sugar on the label.
One cool thing about mayo is that the usual oil is soybean; and that, of course, is an unsaturated fat. If you’re choosing mayo made with avocado oil (usually a small jar [12 oz.] can cost between $7 to $10); or canola oil; you have to be fairly dedicated to that purchase because of the price. Two thoughts: One, check the label; some state in great big letters on the front of the jar, an oil you might recognize as expensive; then on the back is the additional fact that it is blended with another cheaper oil. Don’t forget that the first item on the list is, by weight, the most abundant ingredient in the jar. So if it’s blended with soy oil, you’re probably getting mostly soy oil anyway. Second, think about your application. If you’re just using a couple of teaspoons (2/3 serving) of mayo on your sandwich; is it really worth the extra money? I use some of my homemade pickle relish and some store bought mayo to make tartar sauce; I don’t think the price of the bit of oil in the specialty mayo is worth the price difference. The same goes for whisking a tad of mayo into your homemade salad dressing to add a little creaminess and emulsify it a bit (keep it from separating/splitting). In this circumstance, it’s really not worth the extra price – in my mind.
Lastly, mayo is actually a helpful ingredient in egg salads and chicken salads. Contrary to popular folk tales, the vinegar in mayo lowers the pH and makes the food safer than without mayo. Yes, you can use straight vinegar or lemon juice to accomplish the same thing.
I guess that my last word is that mayo does have calories and you naturally will want to limit how much you use – just to keep the calories under control.
But all in all, a jar of mayo is freedom from sore biceps as a result from all the whisking. As a final word, in the spirit of the French chef, Daniel Boulud, it’s “fundamental” to cooking. Mayonnaise – you’re the sauce!!!
February is dedicated to the emotional heart and, certainly The American Heart Association has not missed the chance to connect the emotional heart and the physical heart. That said, I think I’ll follow their lead and use the Valentine Day Month as a good time to share some information about the physical heart – heart health.
Learning that heart health was definitely related to our lifestyle and especially to what kind of fat we ate began clear back in 1947 when Ancel Keys observed seemingly healthy men dying of heart attacks in America. He took a sabbatical from Oxford and headed for Italy; because a colleague claimed that the Italians rarely had heart attacks. That was the beginning of the Seven Countries Study - SCS (USA, Finland, Netherlands, Italy, Greece, Former Yugoslavia, Japan). Out of this early work a recognition of an eating pattern central to the promotion of a healthy heart was accepted and became known as The Mediterranean Diet (just this year found to be the best diet of 2019.) The SCS were in essence all observational studies; the data did not PROVE anything – but, it was a great place to start figuring out what to prove. In the past seventy years, hundreds of studies have been conducted that help us recognize that eating too much saturated fat is a big problem for our heart (now we’re also learning that saturated fat consumption affects other diseases too). Interestingly, clear back in 1965 when the original studies were being analyzed it was beyond a reasonable doubt that replacing saturated fats with mono and polyunsaturated fats, resulted in a substantial lowering of cholesterol and ultimately improved heart health.
Nutrition Action Newsletter posted a quote from Frank Sacks, professor of cardiovascular disease prevention at the Harvard T.H. Chan School of Public Health. “If you look at the four highest-quality trials together, they provide direct evidence that replacing a diet high in saturated fat with a diet high in polyunsaturated fat prevents heart attacks and strokes.”
Nuts, seeds, olives, fatty fish, avocado and poly and mono unsaturated fats – yea Love it!
Cheese, butter, heavy cream – Limit it!
Artificial trans fats, hydrogenated oils, and tropical oils (coconut oil) Lose it!
It’s interesting to me that beef, a food that provides so much saturated fat to the American population is not listed in the “Love it; Limit it; and Lose it” list from the American Heart Association. My first guess is this may be because there are cuts of beef that are low in saturated fat e.g. eye of the round. Since the list is only addressing saturated fats, that may be the reason to leave beef off the list. But, unfortunately, there is a stack of evidence that beef consumption is related to heart disease and even some other health risks. But it may not be the saturated fat alone, so the cause of increased risk is sitting in the “wait and see” basket.
As almost always, I focus on food/nutrition, but the fact is that we need to move our bodies in addition to eating healthily (lots of veggies, fruit, whole grains, nuts, seeds, and fish – and limiting saturated fat, sugar, and red meat). For optimal health, we must also be physically active; get sufficient sleep, manage our weight and maintain positive social connections.
Being kind to our hearts and the hearts of those whom we love has a potential for a truly big payoff. We only need to observe our friends and family and the heart-breaking disabilities that come with heart disease to realize that protecting our hearts on the front end, through diet, exercise, and social connections is worth our effort.
Can you believe we almost polished off the first month of 2019? It seems to fly by, doesn’t it? On December 6, 2018 an article was published by Jason Fung MD, What Your Doctor Doesn’t Know About Nutrition. I’ve known for decades about this issue regarding the lack of real training in nutrition of the medical schools, and was impressed with Dr. Fung’s article enough to save it for this week’s post. I still remember when I had recently graduated from UCLA with my Master’s in Public Health Nutrition. I worked with two physicians. I still recall my frustration at learning that one of the physicians was telling my patients, that they should go to Sizzler and eat the all-you-can-eat breaded fried shrimp; and other invalid directives. Regarding Fung’s article, the fact that it is written by a medical doctor was especially gratifying for me. I especially like these comments: “As a result, doctors can be trained to believe that nutrition and weight loss are simply not part of the problems they deal with or should care about.” Also, “What drugs or surgery should I give to patients after they have their heart attack?” And lastly, “Should you talk to your doctor about weight loss? Would you ask your plumber to remove your wisdom teeth?”
When you go to a physician, you want him to be secure in his knowledge of medicine. Unfortunately, that issue sometimes get scrambled with a physician feeling that he needs to know everything about every branch of health; and then giving advice that he’s not really qualified to be giving. Certainly, many physicians have reconciled their lack of nutrition training wisely and refer their patients to Registered Dietitians., but many others have not.
The fact is, that there is a group of educated competent professionals who are qualified to help the physicians, and of course, their patients, with nutrition. Registered Dietitians, spend at the very minimum, four years in obtaining their degrees and registration. Actually, I don’t know anyone who can get through the programs in four years, without attending summers. Master’s degrees in nutrition are very common with Registered Dietitians. In addition, many of us have doctoral degrees, also. It would be extremely difficult for those who design the training for medical doctors to add all that is taught to Registered Dietitians to the MD’s training. That’s the way it is for many areas of study in the health professions. So much more is known now, that specialty fields are needed to study and do the work. Dietitian’s have an extremely large variety of specialties within their field alone. Not in the least, are the skills that help translate the very complex field of scientific nutrition to everyday language to help individuals and groups understand and learn skills that support being well nourished. In addition, there are almost endless niche specialties, for those with special nutritional needs.
Ultimately, I agree with Dr. Fung. I don’t believe that you should go to a medical doctor if you need help with your diet. Find a Registered Dietitian who is specifically trained in whatever your need is.
Last week I wrote about what is considered the best diet in 2019 – the Mediterranean Eating Style; which of course, is full of whole grains, fruits and vegetables, legumes, nuts and seeds, resulting in lots of dietary fiber. This week I want to write about the low carbohydrate (low carb) eating style (it comes by many names (Keto; Atkins, Paleo, Last Chance Diet, Optifast, Stillman and so on) and how that relates to newly released research.
It is indeed fascinating to see how a combination of popular presentation from influencers with large audiences, mixed in with deceptive science reporting and appeal to the human desire for quick fixes, can so quickly promote something harmful to large audiences. Only one so far, the promoter of the Last Chance Diet, has been held accountable in part, but not in proportion to the documented deaths. It is also sobering to see the estimate of $5 Billion as the worth of the industry with so many components promoting it.
Let me clarify one issue quickly, here toward the beginning. The low carb/keto diets can support rapid weight loss; there is no question about that. But being well-nourished is a major goal of my nutrition advice and there are short falls with the low and very-low carb eating styles. The low carb eating styles are, in my mind, not an optimal eating strategy for the general public. When I managed clinical nutrition at Children’s Hospital Los Angeles, we had children with uncontrolled seizure disorder who were closely supervised by Registered Dietitians who were specifically trained in the ketogenic diet, neurology specific nursing and neurologists – medical doctors. There was, of course, a very serious reason to consider a ketogenic diet for these children. The concern for the general public is the emphasis on foods with saturated fat and the lack of nutrients. We’re just beginning to have some research that has justified people like me, who have been apprehensive about the low carb eating plans in spite of the obvious benefits (reduced hunger, increased focus and rapid weight loss) of the ketogenic diet. Some of the new research is helping me answer the big question: Can you stay on a low carb/keto diet for years and be healthy in the long run?
The first study that caught my eye recently was pooled research presented at the European Society of Cardiology’s 2018 Congress in August. It concluded that low carbohydrate diets areunsafe and should not be recommended. The lead author Maciej Banach, of the Medical University of Lodz Poland, said: “We found that people who consumed a low carbohydrate diet were at greater risk of premature death. Risks were also increased for individual causes of death including coronary heart disease, stroke, and cancer. These diets should be avoided.” Those in the study who had the lowest carbohydrate intake had a 32 percent higher risk of all-cause mortality over an average of 6.4 years follow-up, while the risk of mortality due to cardiovascular disease, cerebrovascular disease, and cancer increased by 50 percent, 51 percent, and 35 percent, respectively. Let’s face it; those are not small numbers.
Although the research was based in the UK, Poland, Sweden, and Greece, 24,825 participants were Americans. In addition to the primary study, the researchers also performed a meta-analysis of seven prospective cohort studies (totaling 447,506 participants); which validated their own findings.
Now let me share one of my big concerns – the relatively low amount of fiber in the low carb/keto diets. Interestingly, a brand-new meta-analysis of 40 years’ worth of research, commissioned by the World Health Organization (WHO) has just been published in The Lancet. The lead researcher and colleagues examined the data which included 185 observational studies (the number of person years added up to 135 million; and also included were 58 clinical trials (the clinical trials involved over 4,600 people).
What they found was that the people who consumed the most fiber in their diet were 15 to 30 percent less likely to die prematurely from any cause or a cardiovascular condition, compared with those who eat the least fiber. Fiber-rich foods include whole grains, fruit, vegetables, peas, beans, lentils, chickpeas, nuts, and seeds; of course, many of these foods are not included on the low-carb/keto diets.
Here’s the wake-up call: the analysis revealed that the amount of fiber that people should consume daily to reap the benefits is 25 to 29 grams. Unfortunately, adults in the US, on average, consume 15 grams. Although the researchers say 25 to 29 grams can do the job, they also said that people should not be limited by the 29 grams of fiber and more may be beneficial. For every additional 8 grams of dietary fiber a person consumes, the risk of non-communicable disease (heart disease, stroke, type 2 diabetes, and/or colon cancer drop by another 5 to 27 percent.) Note: If a person has an iron or other mineral deficiency, they should probably talk to a registered dietitian prior to a big increase in fiber in their diet.
The researchers say that their findings “provide convincing evidence for nutrition guidelines to focus on increasing dietary fiber and on replacing refined grains with whole grains. This reduces incidence risk and mortality from a broad range of important diseases.” (Jim Mann, University of Otago, in New Zealand) Because of the design of the study, the researchers cannot really say if the entire effect is from the fiber or the nutrients that come with foods that provide the fiber. Just think of all the thousands of phytonutrients that come with the same foods that contain fiber. In addition to the direct benefits of fiber in the diet, there is also the fact that fiber is what your microbiome (talking the gut bacteria, here) munches on. Maybe it’s complex; it may include the nutrients from the fibrous foods, the nutrients produced by the microbiome and the benefits of the structure of the fiber itself. That’s what I expect. So, don’t run out and buy a bottle of Metamucil for fiber, but continue eating the same diet of high animal products and processed food, and call it good.
Andrew Reynolds, the lead author of the fiber study, said; “The health benefits of fiber are supported by over 100 years of research into its chemistry, physical properties, physiology and effects on metabolism.” This is not a new idea – that fiber benefits human life; it’s just quantifying the facts.
Moving off the very low carb or keto diet, would be a great first step toward decreased health risks; and a wonderful second step might be to get on a Mediterranean-style menu that will help you get the fiber and nutrients that you need to keep your risk low.
I’ve been promoting the Mediterranean diet for well-over a decade; so, you can probably imagine why I’m doing a jig around my desk. The Mediterranean diet has won first place as 2019’s best overall diet. Last year it was tied for the #1 slot, but this year it took home the gold.
On January 2, 2019, the U.S. News and World Report published the newest Best Diets. The Mediterranean Diet not only won the number one slot for best overall diet of the 41 eating plans analyzed, but in addition, was number one for: Easiest Diets to Follow, Best Diabetes Diets, Best Diets for Healthy Eating, Best Heart-Healthy Diets, and Best Plant-Based Diets.
I mentioned in my Christmas Day article The Best Eating Style for you May Be a Customized Plan “My guess is that it (Mediterranean diet being tied for #1 last year.) is not going to vary wildly from this past year; because part of the evaluation is based upon substantial nutritional research on the healthfulness of the foods they recommend.” Since the Mediterranean diet reduces the risk for diabetes, high cholesterol, dementia, memory loss, depression and breast cancer, it’s no surprise that it was chosen as number one for the best diet for healthy eating. I’m always glad to have a large panel of nutrition experts validate my recommendation.
You’ll note in my posts over the past decade that I often refer to the Mediterranean diet as an eating style, rather than a diet; the reason is that I believe that many people think of a diet as a rather specific plan such as: eat a cup of this and 4 ounces of that; have an afternoon snack of one small piece of fruit or 8 ounces of yogurt. The Mediterranean eating style has meals that focus on plant-based foods (Fruits, vegetables, whole grains, beans, seeds and nuts, and extra virgin olive oil – these foods are linked with reducing inflammation, reducing oxidative stress, balancing our gut bacteria, essentially getting at the base of the cause of disease.); the style is low in refined sugar and flour, except as occasional desserts; fish is commonly served – with red meats only served occasionally or as a minor ingredient in a recipe; dairy, eggs and poultry are served, but in smaller portions than common in the traditional Western diet. This is not a strict “diet” and should be initiated with the intent of making a life change in eating style, getting a balance of plant-based foods in different categories, and keeping meats in a greatly reduced role. It should not be initiated as something to discontinue when some weight or health goal is reached.
I definitely say that if you decide to go from a traditional Western diet to a Mediterranean eating style, think of it as a process. Study the eating plan, and decide what you enjoy and how to make it work for you. Give yourself the time to make the transition. Consider going back and reading the Christmas Day post to get yourself headed in the right direction.
And when you try it, you might heed these cautions: the Mediterranean diet encourages extra virgin olive oil (EVOO); EVOO is like all fat and essentially contains 9 calories/gram. The point is that even good oil/fat supplies calories and if you are too liberal with the EVOO it may be too many calories. So certainly, use EVOO but don’t start pouring it generously on everything, especially if you’re struggling with weight management. Ditto for super healthy avocados, seeds and nuts. Eat them, but don’t sit down to a 2-hour movie with a five pound can of cashews next to you on the sofa.
The Mediterranean diet embraces whole grain pasta; but the recommendation follows the same line of reasoning as the nuts and EVOO. Even whole grain pasta is starchy and has about 110 calories/ounce; it is a good food, but use portion control. Likewise, with beans. If you’re eating lots of vegetables, you will discover that it’s easy to be satiated with a controlled amount of EVOO, avocadoes, pasta, or beans. These all have condensed calories. It is very difficult to take in too many calories from the vegetables alone.
So obviously with the latest list from U.S. News and World Report, you can clearly see that I’m not going out on a limb in telling you that the Mediterranean style of eating is a great choice, if you’re looking to trade up your eating style during 2019. Customize it to fit your likes/dislikes and enjoy your 2019.
I’m going to lose ‘X’ (a big number) of pounds. I going to eat healthier in the New Year. I’m going off sugar. I’m going to eat vegan. I’m going to change my eating style. Have you discovered yet that changing your eating style in a big way on January 1st to a completely new style in one fell swoop is an unrealistic idea? Now, having said that, I want you to know that I do believe in goal setting/resolutions. I have a deep belief that we can improve ourselves and that goal setting/resolutions can be a powerful technique to achieve improvement. I personally think an honest evaluation, and plans for creating new habits is well-worth our efforts. I will disclose up front, that it does take effort. Changing an eating style is a relatively complex goal; but it is doable. So, let’s discuss some issues that can help you succeed.
So why doesn’t the ‘one fell swoop’ technique work? For one, attempting an extreme makeover is psychologically daunting; it frequently fails to even launch. Let’s say you decide to be vegan; you run to the store; buy a bunch of veggies; get home; eat vegetables for a day or two; realize that you can eat candy and many cookies and be vegan; discover that you’re fatigued and eventually malnourished because you’re not getting all the nutrients you need. You realize that you need to learn more and take steps prior to such a big change. Working toward small, attainable goals throughout the year, one step at a time, is more sensible than a singular, overwhelming goal, according to psychologist Lynn Bufka. This is true for most major dietary changes, not just becoming vegan.
Second, it’s important to know yourself. You many think that sounds a little goofy; but how many times do people make goals from someone else’s directions or list? Going by someone else’s goals is not generally helpful. For example, if one’s goal is to first get the soda, ice cream, candy, French fries, and chips out of their eating pattern, and you never eat those items – will you just waste the time going by their pattern? The previous example is easy to follow; but really, doing some introspection is very valuable. Do I really want to give up sugar? All sugar? Do I really want to do all that’s involved to be a healthy vegan? Why waste the time and the possible negative self-talk, if you try it and are not fully committed?
Third, get rid of the vague goals. “I’m going to eat healthy.” I’m going to exercise more.” “I’m going to cook all meals at home.” “I’m going to eat vegan; Mediterranean; no sugar; and so on;” with no idea what’s involved, or the skills of how to do it. How about, I’m going to have one serving of vegetables every day with my lunch? Then follow up planning on what vegetables and how they will be served or packed. Specificity will spell success; not vagueness.
There’s plenty of research that points to choosing mini goals/resolutions with frequent resets, if you lapse. According to some psychologists, making mini-resolutions (weekly or monthly) goals makes it more likely to succeed. The idea is that you can discover what works (and what doesn’t) quickly. If the goal was not attainable, you can reconsider; maybe redesign the goal; adjust; reset. If you choose to start or continue a new goal each Monday, for example, you don’t have to say “I’ve failed” and wait for another New Year. You can begin again the following Monday. In my experience, it’s even better to begin again immediately. It’s a new habit that you’re trying to make. Just chalk it up to – that didn’t work. But immediately, go back to the goal. Some people like the Monday (or whatever day is chosen) restart. But if you can get past guilting yourself with a failure, then start immediately; call it ‘real life.’ Either way (Monday or immediately), you don’t need to wait till the next year. Once you feel confident in the skill, you add a new skill or goal to focus on for the next week. You can choose to build on the first skill in a related way or choose a completely new skill. It’s a little like juggling. You’ve got one ball going and then you add another. The once a week style of goal setting is a way of easing yourself into a new healthier lifestyle; instead of trying to change too many things at once, which almost always ensures failure.
The other outcome of using the mini-resolutions is that you have the opportunity to create more positive outcomes. Recognizing the positive outcomes can be empowering. Succeeding at the mini-resolutions generates a sense of achievement, feeling positive about accomplishment generates more feelings of triumph. It’s creating a positive cycle. If you’d like to learn more about Monday reset and national Monday programs, you can watch a very short video called Happy New Year on YouTube. The point of mini goals/resolutions is progress oriented; it’s a refining; a revising of habits approach. It’s likely to stick if you do the work.
The more exactly you define your goal the better you’ll do. For example, if you’ve decided to get sugar out of your life (maybe not entirely, but maybe in a big way), these steps will increase your chance of success. First, it may be helpful to decide where you want to start and what’s in and what’s out. You may be tempted to just say, “I want all sugar out of my life;” but be clear what that involves. Will you have sugar in your lemonade, coffee or tea? Will you eschew all cereals with any amount of added sugar? Will you give up on catsup, peanut butter, and processed sauces with added sugar? Will you use syrup, honey, or products with other types of added sugar? How about sweetened yogurt, jam, nut breads, muffins, many commercial breads, granola bars, or foods using ingredients like grape and apple juice concentrate? Please notice, there are many questions to answer when making a single decision about sugar. Maybe you want to break a decision like this down in to more than one single decision. Maybe you want to become familiar with the labels of the products that you generally use. Maybe you want to do more food prep in your own home to avoid the amount of processed foods that you are currently consuming – essentially decreasing sugar. Maybe you decide that you don’t use too many processed foods and a little sugar as an ingredient is fine with you. YOU are the one that decides and sets yourself up for success by making the decisions ahead.
If you make a give up all sugar type of goal and discover that some item had a little sugar, do you give up on your goal? Or do you focus on the wonderful progress that you’re making? Thinking ahead about the details of this type of decision can be very valuable. Cutting way down on the consumption of simple sugar can be a very valuable goal. So, if you’ve decided to make a goal to cut back on sugar, go for it; you can do it! It is possible! I’m just trying to illustrate, that it may be a more complex decision than you realize. Maybe you finally decide to give up desserts or regulate the frequency of desserts or sweet snacks. Maybe you decide to eat fewer processed foods containing sweeteners. Maybe it doesn’t need to be all or nothing. Remember the article aboutModerators and Abstainers? You decide what style goal is best for YOU.
Let me share that there are almost endless variations that you can consider. The point is that you design a simple, doable, but specific plan that feels good to you – one that you feel you can be successful with. I’ll share a couple of examples here. One is red meat. At our home we ordinarily do not eat red or processed meat. But if we are served red meat at someone’s home we eat it and enjoy it. We don’t order red/processed meat at restaurants; but if a meal is served to a group, we eat and enjoy. I even will cook red meat for others in my home from time to time. The point is that your resolution can be situational. You’re doing the designing and deciding.
One other example is with sweets. I eat a dessert on Friday and Sunday. Or if there is an event on another day and I really want to indulge in the sweets offered, I will trade my Friday or Sunday dessert for that day’s offering. You could call your plan, “planned indulgences.” It can work for any food that you identify as “not an everyday food.” Let’s say that you want a juicy burger as a special treat but not everyday; just plan for it. One way to do that is to give yourself a certain number of “Planned Indulgences” – or free passes. Again, your resolution can be written any way that YOU want to design it.
If you want to get down to the nitty gritty and are wondering where to start, then let me share a few ideas:
Begin by controlling your environment
If you have decided to eat healthier in the year, maybe a good first week goal could start with:
Overhauling your pantry, refrigerator, freezer, snack closet and spend a little time choosing a couple of recipes that will support your new eating style. One thing that happens around our home is that all kinds of goodies seem to pile up around the holidays. I’ll freeze a few special treats for those two dessert nights; but we try to clear out surplus sweets. You can read some of my old posts to learn more aboutcontrolling your environment. Little word of caution: be careful not to buy too many veggies and fruit on week one. If you’re not used to eating them, it may be difficult to get them used up before they spoil. Maybe tough it out and shop twice in the first couple of weeks – just to get a handle on how much fresh produce you can manage in a given period. If you’re having to move the amount up each week or two, you’ll know that you’re being successful at getting more fruits and veggies into your diet.
Increasing home cooking
By cooking at home more often you will likely gain more control of the portions you eat and the ingredients. This is the best way to cut down on foods with artificial and undesirable ingredients. If you’re presently not cooking, a realistic goal would be to make a goal to prepare and cook one meal a week. That goal quickly translates to two, if you make enough for two meals. The main goal is to make the goal realistic. You can make a different meal each week or every other week or even monthly. It’s a success any way you look at it. All along the way you are gaining new skills. In a month or two, you may feel comfortable with making two meals each week (which, of course, can translate to 4 meals). See how successful this small goal can be? Do you have the ingredients? Do you have the cooking utensils? Choosing recipes with not too long of an ingredient list, may be an issue that will support your success. Choosing a recipe with cooking techniques that are familiar, may also be helpful. Note: you can learn many skills on YouTube; for example, knife skills,stir fry (note: I never put sugar in my stir fries), and making soup (many very healthy and easy recipes – much lower in salt than canned).
If you’re starting from rarely ever cooking at home, make it easy on yourself. Prepare to feel successful right away. One way might be a jar of Thai simmer sauce. Just take a package or two of frozen vegetables (like mixed veggies; chopped kale or spinach; peas; green beans or carrots) and a can or two of chicken breasts; or cook some frozen chicken tenders or shrimp. You can add a chopped onion if you like. Microwave the veggies or cook in the sauce. Serve the mixture over brown rice and you’ve made a homemade meal in a very short time. I’ve found some nice sauces at the new Trader Joe’s in our community.
Marking your cooking day on the calendar makes it more likely that you will achieve your goal. In addition, you may want to mark your calendar the day before the cooking day, to check the recipe to see if you need to shop for any ingredients. If you say I want to cook once a week, for example, and don’t have a specific day chosen, it increases the likelihood that you’ll get to the weekend and will not have done the needed shopping. That’s only bad, of course, if you’re trying to increase weekday cooking. So again, you choose.
A more fruits and veggies goal or moving toward a plant-based diet
Today I’m not writing about all the reasons you may want to move toward a plant-based diet (lower risk of hypertension, heart disease, obesity, type 2 diabetes and cancer); but if you want to know more about that you can go back and read some of the posts that explain plant-based eating. You don’t need to become a vegan (no animal products) to benefit from eating a diet higher in plant-based foods. Even having a meatless day one time a week is a terrific goal. When you’re preparing your food environment, consider being sure to have a stock of beans, tofu, nuts, seeds, whole grains, veggies, fruits, spices herbs, and healthy oils.
Sometimes all it takes is to switch out the meat. For example, if you/your family likes tacos, you can crumble tofu and/or add black beans or mushrooms to chili/taco seasoning to substitute for the meat. If you, decide to leave out the cheese – great! If you’re really going all out, you may consider using non-fat Greek yogurt instead of sour cream (with its saturated fat). If you want a little more creaminess make chopped avocado available. If you already cook, you may decide to have a goal of trying a new meatless recipe each month or week, whatever seems realistic.
Of course, one of the outcomes of moving to a diet higher in plants is that fruits and vegetables are lower in calories than most other food choices. If you’re thinking about adding more fruits or vegetables to your eating style, thinking about it specifically as possible will set you up for success. If you don’t generally have a fruit or vegetable with your breakfast, or you want to get off of fruit juice (raises blood sugar rapidly), then make a goal to have whole fruit each morning. If you have cereal or yogurt for breakfast, just add the fruit to the cereal/yogurt. If you take the train/bus maybe grab a piece of fresh fruit to eat on the way. Give it a little thought; I bet you can find ways to increase your fruit and vegetable consumption. Having a salad lunch several times a week is one thought; or a little dish of fruit with dinner is another. Double up on your vegetable servings. If time is a big concern, consider checking out what kind of veggies come already cleaned and chopped in the frozen food section of your market. If you’re concerned about using frozen produce, you may want to review an article posted in June of 2018.
Hydration - Last general idea More water.
If you’ve been using sweetened soda pop to stay hydrated, think about what that really means. Only one 12-ounce soda pop a day (150 calories) translates into about 54,750 calories a year. That one decision alone (switch one can of soda pop to water) could result in about a 15-pound weight loss in a year; if, of course, you don’t eat something to make up for the deleted soda. Since thirst can be mistaken for hunger, it’s worth thinking about your water intake. Staying hydrated can support satiety. This past year, I bought a pitcher with an infuser tube. It works nicely to give water a nice fresh taste. We’ve used strawberries, cucumbers, lemons and limes. It’s nicer than plain water. I find that just putting a thin slice of lemon in a glass of ice water is refreshing, and fast too. If you need a little review regarding the amount of liquid to take in a day you may enjoy Staying Hydrated.
No matter which improvements to your dietary health you desire, you can increase your chance of achieving your goal by deciding on an attainable goal by knowing yourself; getting rid of vague goals and being specific with goals setting; choosing mini goals/resolutions with frequent resets, which create more positive outcomesthat can be so empowering. The more exactly you define your attainable goals, the more likely you will begin recognizing success and creating a lasting new and improved eating style.