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I think it goes without saying that the most fascinating and sought-after effect that caffeine offers the majority of its consumers is an increase in physical and/or mental performance.

It’s one of the world’s favourite pick-me-ups!

Yes, many of us indulge in our daily coffee and tea rituals because of the familiarity and joy it offers, but it’s hard to deny that we also like the increased alertness and wakefulness.

In this article, I will explain a little bit of the science behind caffeine and how it can be used strategically to help you stay fresh and focused at work while also being smart about portions to minimize any potential unwanted effects that could occur with excessive intake of caffeine containing products.

Caffeine In Your Body – How it Works

Step #1 – Drinking It

So what happens when you sip on your favourite drink? It doesn’t really matter if it’s coffee, espresso, tea, an energy drink or even some dark chocolate, caffeine works the same way, regardless of the source. So whether the caffeine is naturally occurring (in the case of coffee and tea) or added (in the case of sodas or energy drinks) – caffeine is caffeine!

Once it’s in your system, it is absorbed rapidly and it takes no more than an hour to reach peak levels in your bloodstream, which means it doesn’t take long for it to get to work.

Although it does vary from person to person based on bodyweight, genetics and other factors, caffeine generally stays in your system for several hours after ingestion.

Step #2 – The Physiological Effect

So how does caffeine work once it enters your blood stream?

On a cellular level, caffeine works by targeting and blocking what are known as “adenosine receptors”i.That might sound like a mouthful, but all you need to know is that these adenosine receptors are responsible for slowing things down in the body. They slow down heart rate, blood flow, muscle functioning and contribute to the tired feeling that many of us experience at different times throughout the day – think about that lag that you feel between 2-4pm.

Obviously, at the right time (such as bed time!), adenosine has a role to play. But that certainly isn’t useful right before the start of, or in the middle of a long shift.

That’s where caffeine comes in!

Because caffeine blocks these receptors that are responsible for slowing us down and making us tired, it stimulates us, helps us to feel awake, refreshed and focused.

That’s exactly why it’s known as a stimulant, because it gets things going!

Practical Implications – Caffeine When You Are Tired At Work

There is no such thing as a job in the real world that doesn’t require a good level of mental focus and clarity to perform well.

This is obviously where that shot of espresso, energy drink or cup of coffee comes in to save the day.

But contrary to popular belief, you don’t need a huge “hit” of caffeine to get the benefit of increased alertness and attentiveness it offers.

Effective portions may range as low as 40mg (what’s found in a cup of green tea), 80mg in a 250mL can of energy drink, or even up to 300 mg (a large cold brew) depending on how often you use caffeine and how your body metabolizes it, which varies from person to person.ii

People who drink caffeine regularly may need slightly larger amounts to get the energy they need. That also tends to be true of people who sleep less and are more tired, you may need more caffeine to get the desired effect. In general however, 75 mg caffeine is a level that will consistently work for most adults by increasing alertness and improving concentrationiii.

Remember though, being mindful or smart about the amount of caffeine you consume, and when you consume it, is very important, especially when it’s getting close to bedtime.

It’s up to you to monitor how different portions of caffeine may impact you because how caffeine impacts your sleep will depend on individual factors (like genetics) and how much you’ve consumed.i

So How Much Caffeine in Your Favourite Food & Beverages?

So what is considered a “large” dose of caffeine, and how closely should you be monitoring your intake to make sure that you get all the good stuff (wakefulness, enjoyment, alertness) and none of the bad (lack of sleep, anxiousness, jitters) that people associate with it.

Health Canada has determined that a safe, moderate amount of caffeine for the average healthy adult is 400 mg per day.ii

As far as single doses go, the European Food Safety Authority says that 200mg intake poses no safety concernsiii.

Depending on individual factors, such as tolerance levels and body weight, some people may be able to consume more in one serving without any negative consequences. At this average consumption level, the risk of negative health consequences from caffeine is very low, but there are a few exceptions to consider.

#1 – As per Health Canada, the safe, moderate number is lower for pregnant/breast feeding women and is set at 300mg per day.

#2 – People who are caffeine sensitive may experience side effects from caffeine intake at levels below 400 mg a day. If you find caffeine causes restlessness, anxiety, nervousness, insomnia or stomach pain, you may fall in this category and need to reduce your caffeine intake.

So what does the caffeine content of some everyday products look like?

1 can of Cola (355 ml) – 40 mg

1 cup of tea (237 ml, average, among caffeinated varieties) – 40 mg

1 can energy drink (250 ml) – 80 mg

1.5 shots espresso – 80 mg

1 bar of dark chocolate (100g) – 81 mg

1 cup (237 ml) brewed coffee – 135 mg

Certain specialty drinks may have more, and the size obviously matters. A medium cup of coffee at a chain store, for example, is actually equivalent to 2 cups of home brewed coffee.

It’s important to keep portion sizes in mind not only when calculating your daily caffeine intake, but more broadly when keeping your daily calorie intake balanced.

Why More Isn’t Always Better

Caffeine plays such an important role in the daily lives of people in this and so many industries but too much of a good thing does not lead to better outcomes.

In order to understand why this is, let’s talk about something known as the Yerkes-Dodson law, which says that there is a specific relationship that exists between stimulation and performance.

We know caffeine stimulates us and allows to improve our performance at work by enhancing our ability to focus. This effect is especially important on days when we aren’t feeling stimulated enough at work, perhaps because of a lack of sleep.

But, stimulation only helps our performance up to a point.

If we are too stimulated, perhaps due to excitement over some event, or because we’ve had too much caffeine, performance suffers because we aren’t able to focus that well.

That’s exactly why playing with smart portions is so important to help you find that sweet spot in the middle that allows you to optimize performance, both at work and at play.

Bonus Content: Caffeine And Physical Performance

Physical activity is a very important component of maintaining a healthy body and mind and allowing you to perform your best both in and out of the workplace.

For many of us, the before or after work hours tend to be the most likely time where we can fit this in.

Caffeine has a role to play here too because in addition to helping us feel awake and stimulated, it’s known to improve our exercise capacity in both endurance and strength based workouts.vii

So, whether you want to go for a long run, or hit the gym, a nice cup of coffee beforehand, supported by ample water during and after your workout, could be just the thing you need to take your performance to the next level.

Final Thoughts The goal for this article is to help empower you to understand how to make the most of your caffeine intake by being smart with portions and knowing how different levels of caffeine can lead to different effects on your body. Learning the right balance is the key to enjoying all the benefits that caffeine has to offer while minimizing or even eliminating the unwanted side effects. Cheers! References

iS. Ferré Role of the central ascending neurotransmitter systems in the psychostimulant effects of caffeine J. Alzheimer’s Dis., 20 (2010), pp. S35-S49

iii https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2011.2054


vii https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4213371/

The post How Does Caffeine Work? Learning How To Use It Wisely appeared first on Andy The RD.

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Fresh off the presses, a Journal Of The American Medical Association (JAMA) paper has found that more eggs and especially more cholesterol in your diet increases risk of heart disease and death.

In what seems like one of the most contentious and controversial back and forth debates in contemporary nutrition, the authors of this study claim that they’ve done a better job than any previous papers when it comes to controlling for confounding behavioural and dietary factors ( ie: saturated fat consumption) in their analysis.

Cholesterol, for those who may not know, is a non-essential nutrient found exclusively in animal-based foods that is used for hormone production and other cellular functions.

A healthy human body manufactures its own cholesterol, meaning you don’t necessarily need to eat any amount from food to function properly.

You never hear of vegans taking a cholesterol supplement for this reason.

Eggs, Cholesterol And Your Heart

To cut right to the chase, the primary study finding is that each additional 300 mg of cholesterol consumed per day resulted in an increased risk of cardiovascular disease (~3% increase) and death by any cause (~4%).

The effect of having more total dietary cholesterol was much more relevant than the effect of having eggs specifically, but the topic of eggs remains relevant because 2 large eggs contain about 350 mg of cholesterol and  eggs are the number one contributor of cholesterol to the American diet ( 25% of total cholesterol), meaning that those with higher cholesterol consumption are also statistically more likely to be high egg consumers.

Foods of animal origin tend to contain some level of cholesterol, but on a per serving basis no conventionally consumed foods contain more than eggs.

Based on the data linked above, I calculated that another 25% of total cholesterol intake can be attributed to a group of foods that are individually lower than eggs in cholesterol but higher than eggs in at least one of three unfavourable categories: saturated fat, preservatives or sodium.

This list includes: beef, burgers, cheese, sausages, bacon, ribs, pork, and cold cuts.

Not necessarily foods we associate with good health outcomes, eh?

Eggs, as compared to the foods listed above, contain vitamin D ( which many people don’t get enough of) , anti-oxidants ( Lutein and zeaxanthin) and potentially a reasonable amount of omega-3 fatty acids ( depending on the egg variety).

You can take from that comparison what you will and it does not change the fact that eggs are the single largest cholesterol contributor to the American diet, but none the less, they do have something meaningful to offer from a nutritional perspective.

The story doesn’t end there though.

The Bigger Picture

Let’s run with the notion that high cholesterol consumption, which is not exclusively but more likely to be brought on by high egg consumption, does in fact modestly increase your risk of heart disease or death by any cause.

The next question to ask, I suppose, is whether or not that matters to YOU and then beyond that, to the public at large.

So let’s answer that question!

The foods that tend to be associated with reduced risk of death by any cause include: vegetables, fruit, legumes, nuts, seeds and fish.

Do you eat these foods regularly and in ample quantity?

If you do, then almost certainly the protection these foods offer against death and disease will render whether or not you have a few extra eggs a week much less relevant.

If you don’t ( which probably characterizes a fair portion of the population at large…), then almost certainly your energy should be spent, first and foremost, on incorporating these foods more regularly, independent of how high or low your cholesterol or egg intake may be.

Still Concerned About Your Cholesterol/Egg Intake?

Guess what dish has a similar amount of protein and iron to scrambled eggs, with a fraction of the saturated fat and sodium, NONE of the cholesterol, and the same great taste at the SAME COST per serving?

If you answered tofu scramble, we have a winner.

They say variety is the spice of life, and that it’s good for you, right?

So what’s holding you back from trying? I guarantee you it tastes better than you think.

I strongly believe that the single greatest thing that ANYONE can do to improve their health is alter their ratio of plant to animal-based protein.

And just in case you haven’t seen the new food guide yet, Health Canada tends to agree.

Let me ask you this:

How many eggs have you had in your life?

How many bricks of tofu have you had in your life?

Maybe it’s time to alter that ratio.

Until next time,

Andy De Santis RD MPH

The post Are Eggs & Cholesterol Officially Bad For You Again? appeared first on Andy The RD.

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For those that don’t know, March is indeed the most special month of the year for all the caffiends out there.

It’s Caffeine Awareness Month in North America!

And what better way to kick it off by becoming aware of MY OWN caffeine habits?

Today’s article is a fun, genuine and insightful exploration of me trying to figure out my average daily caffeine intake that was brewed in partnership with the Canadian Beverage Association.

Am I WAY over the limit? Well within it?

Let’s find out!

Andy The RD’s Caffeine Consumption Habits

Three things to keep in mind before we go any further:

#1 I both work and live within a 15 second walk from a major coffee chain.

#2 Health Canada’s safe, moderate daily intake threshold for caffeine is 400 mg per day (for an otherwise healthy adult)

#3 Cold brew, which is exceptionally high in caffeine, is my thing.

This should be fun…

How Much Caffeine Are YOU ( Am I..) Really Consuming?

Today’s article has nothing to do with population level consumption data of caffeine (my next article will talk about that).

Nope, this one is all about ME!

So, let’s say, for the sake of argument & averages, that the average cup of coffee house coffee (237 ml~) contains around 133 mg of caffeine ( varies depending on the variety ie: brewed, roasted, instant have different levels) which pretty much means that 3 cups a day puts you at Health Canada’s 400 mg figure.

But here’s a fun fact that I did not know until recently!

The average coffee chain size medium coffee order actually ends up being 473 ml, which is technically two cups of coffee.

Smalls on the other hand are around 350 ml, which is 1.5 cups.

So, if you are like me and consume a large portion of your coffee purchased out, you aren’t looking at 3 medium or even small sized coffees a day to stay below 400 mg of caffeine.

Good to know right?!

If I was oblivious to this I bet many of you were too, or maybe it was just me?

The plot thickens though, let’s take a look at my favourite drinks: iced coffee & cold brew.

The Cold, Liquid Truth?

With this wealth of information at my disposal, it’s finally time to make an objective assessment of my own caffeine intake.

Something that I’ve admittedly avoided for a very long time!!

My general caffeine consumption pattern usually goes one of three ways:

1 Large Cold Brew – contains appx 300 mg caffeine!

OR less often…

1 Large Cold Brew + 1 “small” coffee – 300 mg + ~175 mg – 475 mg caffeine

OR…. on a really long day..

2 Large Cold Brews – 600 mg caffeine

So, when I make an objective assessment of my own caffeine intake, I am a bump over the 400 mg moderate daily intake level, but given I’m not particularly sensitive to caffeine I would say my personal tolerance level is above the Health Canada guide for the general population of healthy adults (excluding pregnant women and children).

In other words, despite being a little over 400mg I’m good!

Try this activity for yourself to see where you stand! To help you get started, here’s the caffeine content for commonly consumed caffeine containing products (in order of lowest to highest caffeine content):

  • 1x355mL can of cola, 34mg

  • 1x250mL cup of black tea, 47mg

  • 1x250mL can of energy drink, 80mg

  • 1x250mL cup of Home brewed coffee, 95mg

  • 1x250mL (“small”) Coffee house coffee, 175mg

  • 1x355mL (“medium”) cold brew coffee, 300mg

  • 1x473mL (“large”) coffee house coffee, 360mg

I’m Caffeine Aware, Are You?

Today’s article is just the tip of the caffeine iceberg, I will be celebrating Caffeine Awareness Month in epic fashion with tons of great content coming your way in the days and weeks to come.

Until then,

Andy De Santis RD MPH

The post I Tracked My Caffeine Intake For One Week… Here’s What I Learned. appeared first on Andy The RD.

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Is breakfast everything we were told it was growing up?

Once regarded as gospel, questions now swirl around whether or not breakfast truly is the “most important meal of the day”.

I’m going to attempt to answer that question combining my own personal views, clinical insights from my practice and, of course, research data.

Today’s blog, which may seem simplistic on the surface, will aim to address one of the most frequent queries I receive from clients.

And hey, if they still have questions about it, it means you probably do to!

Let’s get started.

The Breakfast Blues

With the emergence of the popularity of intermittent fasting, which even I admit dabbling in from time to time, the popularity and perception of breakfast from the perspective of an otherwise healthy adult may not be what it once was.

Before we go any further though, let’s just lay it out there that breakfast eating has not been proven to be an effective strategy for losing weight.

That sentiment is echoed in a recent January 2019 publication out of the British Medical Journal.

In my view, the real question regarding breakfast is not whether it is THE most important meal of the but rather if it is YOUR most important meal of the day.

What do I mean by that?

Here are some signs that breakfast IS your most important meal of the day:

1. Mornings are better for you (mood wise, performance wise) when you eat a healthy breakfast

2. You might describe breakfast as your favourite or healthiest meal of the day

3. When you skip breakfast, you don’t feel as good as when you eat it ( you are hungry in the morning)

4. You eat certain foods at breakfast that you would not eat at other times during the day**

If the answer to any or all of these questions is a resounding YES…. does anything else really matter?

**The “Breakfast Nutrients” Problem

In regards to point 3 specifically, one of the issues with skipping breakfast is risking nutrient inadequacy in some of the nutrients that tend to be commonly available at breakfast.

Those who don’t eat breakfast, for example, are more likely to have lower levels of intake of magnesium and vitamin A.

Those who do not opt for cereal specifically at breakfast, which is so commonly consumed with some form of milk or fortified milk alternative, were more likely to have lower total intakes of fibre, calcium and vitamin D.

This is supported by A 2018 UK breakfast study from the Nutrients journal found that people’s breakfasts tended to be high in vitamin A, calcium, iron and magnesium.

These nutrients matter because some Canadians fall short in them, and you may be one of them.

Here are some signs that breakfast IS NOT your most important meal of the day:

1. There is no discernible difference in the quality of your morning whether you do or do not eat breakfast

2. You are confident that you get your “breakfast nutrients” elsewhere and are confident that the quality of your diet remains unimpaired by lack of a breakfast meal

3. You are not particularly hungry in the morning or find eating breakfast burdensome and would rather sleep ( which we all need more of!)

Now look, don’t get me wrong it is not necessarily that straightforward for the average person to discern that any of the 3 of these points above are true or false.

A dietitian can obviously help with that, but these are the types of questions that I work through with my clients when I try to help them answer whether or not eating breakfast is optimal for them.

What Makes A “Healthy” Breakfast?

A nutrient dense and satisfying breakfast can come in many shapes, sizes and involve vastly different preparation times ( because yes, that is relevant).

When I personally think of breakfast as it relates to my clients who want my feedback on it I generally break it down into 4 components.

#1 Fruit/Veggie: Is there some sort of fruit or vegetable present?

#2 “Healthy Fat”: Although I hate to use the word, is there something along the lines of some form of nut, seed, nut or seed butter, or avocado present?

#3 Protein: Is there a protein source such as soy milk, tofu, eggs or some form of dairy present?

#4 Whole Grain: Is there some form of oatmeal, high fibre cereal or whole grain bread present?

In my book a truly healthy, balanced breakfast would check at least two, if not 3-4 of these boxes.

Does Yours?

Breakfast And Type 2 Diabetes Risk

The Canadian Diabetes Association identifies a number of risk factors for type 2 diabetes that may be related to your diet including elevated blood lipids ( cholesterol, triglycerides) and blood pressure, among a host of others that are unrelated to diet such as age, ethnicity and so on.

Although skipping breakfast isn’t among them, I could not help but notice a trend in the literature that breakfast skipping, in multiple observational studies(1,2,3), was associated with an increased risk of type 2 diabetes.

The reason for this is not abundantly clear, but for now it is something that those with multiple diabetes risk factors may want to be wary of, and certainly a topic of study warranting further exploration.

Breakfast And Focus At Work

Although you are probably the one who will be able to best answer how breakfast, or lack there of, impacts your focus at work, some evidence does appear to suggest that those who eat breakfast may enjoy small cognitive advantages (such as improved memory).

Final Thoughts

I’ve certainly given you some food for thought ( pun intended) when it comes to the importance of breakfast.

I stand by my statement that, what matters most, is whether or not breakfast is YOUR most important meal of the day, rather THE most important meal of the day.

In the face of a growing body of research around meal timing ( particularly intermittent fasting) we certainly cannot dismiss it as irrelevant, but the foods you choose to eat, rather than when you choose to eat them, will almost always be the ultimate determinant of your physiological health

Until next time,

Andy De Santis RD MPH

The post Is Breakfast The Most Important Meal Of The Day? appeared first on Andy The RD.

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As many of you may recall from my previous article on the topic, there is an emerging body of evidence suggesting that a daily serving of 5 California prunes can improve bone health by reducing physiological markers of bone turnover in post-menopausal women.

But what is the science behind this effect?

In celebration of March being Nutrition Month, it only seemed fitting that I took a little bit of time to more closely explore some of the unique blend of healthful compounds in prunes and how they impact our bodies for the better.

As with my previous posts on prunes and bone health, today’s article is sponsored by the California Prune Board.

Now let’s dig into some prune science!

In their 2017 review of the evidence out of the Nutrients journal, Arjmandi et al described prunes as a promising functional food for bone health.

Functional Foods, for those that may not know, are a generally described as foodstuffs which contain compounds that exert a specific benefit to the human body.

Tomatoes, for example, contain lycopene which has been increasingly linked with prostate cancer prevention.

So what bioactive compound(s) do prunes contain and how do they work towards improving bone health?

Bioactive Compounds In Prunes

Prunes are known to contain a specific group of polyphenols known as cholorgenic acids as well as proanthocyanidins and several other similar compounds which may confer benefits to bone health due in part to their strong antioxidant and anti-inflammatory capacities.

Prunes are also among the fruits richest in vitamin K, boron and potassium, all of which are known to play a physiological role in supporting the structure of strong bones.

So it is not necessarily that prunes have one specific compound that other fruits do not, rather they appear to have something of a “perfect storm” in the sense that they contain a variety of components that offer a strong synergistic effect on our bones.

Case in point, when researchers compared the effect of dietary supplementation with prunes vs dried apples in post-menopausal women, they found evidence to suggest prunes had greater impact on bone health across the following indicators:

1. The prune group experienced a significant increase in bone mineral density in the ulna and spine.

2. The prune group more strongly suppressed the production of a compound known as RANKL and reduced blood levels of Sclerostin, which both play a role in promoting bone resorption (removing calcium from bones – bad).

3. The prune group also more strongly promoted the production of a compound known as OPG, which suppresses the bone resorption compounds above, thus helping to maintain more calcium in the bone and promoting overall bone health and strength.

Precisely how the cocktail of healthy compounds in prunes work towards these outcomes in the human body remains an area of great interest but suffice to say that these dried fruits will continue to remain a topic of great interest in the field of bone health for years to come.

Final Thoughts

Prunes contain a variety of healthful bioactive compounds which appear to have a synergistic effect on minimizing bone loss in post-menopausal woman who consume as few as 5 a day.

Today’s article gave you a glimpse of some how and why they are able to exert this effect, even if scientists still have more to learn.

I hope you found it insightful!

Until next time,

Andy De Santis RD MPH

The post The Science Behind Prunes And Bone Health appeared first on Andy The RD.

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The potential health benefits associated with intermittent fasting continue to be a topic of great interest to myself, my clients and the public at large.

I’ve admitted in a previous blog post that, although I don’t regularly adhere to fasting principles, I do engage in fasting on occasion if I feel like my hunger levels are lower than I’d like them to be.

I use it infrequently and primarily as a tool to build up my hunger for a larger meal later in the day, not for any supposed or potential health benefits it may offer.

Funnily enough, I’ve actually written previously on the potential metabolic effects of fasting as well.

I certainly recommend you check that one out as well, but the reason I am back talking fasting again today is that I received a suggestion from a reader that perhaps there were some facets to fasting that I missed.

And so here I am re-visiting the topic!

Intermittent fasting is a VERY popular subject area and so I really have no issue kicking off round two exploring the literature for high quality human evidence on the metabolic benefits of fasting.

Let’s take a look at what I came up with this time.

Why Do You Want To Fast?

Before we go any further I think it’ very important to address the why.

Many of my clients express interest in learning more about fasting and potentially trying it for themselves.

To this query I must always ask why?

If fasting represents a gimmick or means to achieve some short-term goal,that right there is a sign that it is not a good choice for you.

If, however, intermittent fasting is an area of interest that fits within the context of your lifestyle, is enjoyable to you and supports you eating a high quality nutrient dense diet, then you find yourself in a situation where it could be worth a try.

Theoretical Benefits Of Fasting

Intermittent fasting, like anything else, comes stocked with a list of theoretical benefits that may be partially supported by some level of literature evidence in either animals or humans.

These include:

1) Improved Fat Loss:  In theory, because your body prefers to “burn fat” for fuel in a fasted state, it has been suggested that intermittent fasting may be superior to standard calorie reduction in supporting reductions in body fat.

I’ve not found any high quality human studies which suggest this to be the case but when it comes to general weight loss using intermittent fasting there are some things to keep in mind:

A systematic review and meta-analysis of human intervention studies using intermittent fasting as a weight loss treatment found it no more effective than continuous energy restriction.

There is also little evidence that intermittent fasting is superior at modulating resting energy expenditure(REE). REE, in essence, is the amount of energy a body expends at rest and not including other activities that would also require energy.

Some have suggested that fasting “boosts” your metabolism and one potential way to assess that is by measuring changes in resting energy expenditure in people doing intermittent fasting vs more conventional caloric reduction strategies.

No high quality evidence so far to show a compellingly differential effect.

2) Metabolic Flexibility: Because your body flips to fat metabolism in a fasted state, alterations occur on the cellular level ( including to your mitochondria) which some scientists suggest can promote what is known as metabolic flexibility, ultimately improving the health of your metabolism and functioning of your body on a metabolic level. Some believe, for example, that lacking metabolic flexibility contributes to insulin resistance in the long-term. Much more human evidence on the effects of fasting on this phenomenon will be required before firm conclusions can be drawn in this area.

3) Cellular & Metabolic Revitalization: This one is interesting and quite hard to prove with the current state of evidence, but some scientist suggest that the stress induced by fasting actually helps your bodily systems in the long-term. You can think about this along the same lines of taking a cold shower or an ice bath. It may not be particularly pleasant in the moment, but there are benefits to be had after it’s over.

Obviously further exploration and evidence will be required in this area but, to say the very least, the first meal one enjoys post-fast is highly enjoyable and reward on a number of levels ( speaking from limited experience!).

Does Really High Quality Human Evidence On Intermittent Fasting Even Exist?

A very salient quote from a 2015 paper:

[W]hether fasting actually causes improvements in metabolic health, cognitive performance, and cardiovascular outcomes over the long term; how much fasting is actually beneficial; and where the threshold of hormesis resides (i.e., a balance between long-term benefit from fasting compared with harm from insufficient caloric intake) remain open questions. Unfortunately, the vast majority of human studies of a fasting intervention were weight-loss studies using single-arm, nonrandomized approaches or multiple intervention arms with no control.

For fasting to be more than a weight-loss fad, greater scientific rigor is needed from interventional trials than is found in the literature. Whereas enthusiasm for fasting is increasing, clinical relevance remains low because of insufficient human data, including almost nonexistent controlled trials

Intermittent Fasting And Diabetes-related Indicators

Insulin Resistance

Despite similarities in body fat loss between intermittent fasting and continuous energy restriction, there is some evidence to suggest that those who engage in fasting experience greater reductions in insulin resistance, which is a very fascinating consideration.


A 2018 randomized trial published in JAMA following patients with T2DM over 1 year period showed that intermittent fasting is no more effective than continuous energy restriction at reducing A1C ( a marker of blood sugar control).

Benefits Independent Of Weight Loss

So many people think of intermittent fasting purely as a means to an end when it comes to weight loss, but a very exciting new study has shown that fasting may offer health benefits independent of changes in weight.

A 2018 study out of Cell Metabolism explored, for the first time through a controlled trial, if fasting had metabolic benefits independent of weight loss.

They used a specific time of fasting ( early time-restricted feeding – eating early in day to align with circadian rhythm – finished eating by 3pm) and found it improved insulin sensitivity and blood pressure and reduced oxidative stress.

Final Thoughts

Today’s article is another step towards a better understanding of the potential benefits of intermittent fasting on human health.

There are certainly areas of interest that exist in this subject area, but higher quality evidence will be required before more firm claims can be made.

If you enjoy fasting and it helps you support feeling and eating well, it may offer additional metabolic benefits.

We cannot say, however, it is a one stop shop to fix all of the world’s health problems.

Until next time,

Andy De Santis RD MPH

The post Intermittent Fasting: Are There Any Benefits? appeared first on Andy The RD.

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I find that many people underestimate how valuable soy (and particularly tofu) is as a culinary tool to help increase plant-based protein intake.

Don’t believe that tofu is truly versatile enough to replace animal protein in a dish? An extra firm brick of tofu contains a comparable amount of protein and iron to 6 large eggs, for a similar cost per serving. Just in case you needed proof, pictured here is a gorgeous recipe featuring tofu as a plant-based alternative to animal protein.

Today’s post is one of two tofu-based recipes featured on my site and sponsored by Archer Daniels Midland. All opinions about soy are genuine and my own.

Tofu Stir-Fry Buddha Bowl

Recipe prepared by Emily Rykaczewski

Tofu may be one of the most underrated proteins on the market. Well-prepared tofu can be a great addition to any dish. There are multiple forms of tofu, including silken, soft, firm, and extra firm. The firmer the tofu, the less water it contains and the more protein per serving. Firm and extra firm tofu are ideal for stir-frys due to their ability to stay together.

Some tofu varieties also come fortified with vitamins! This American brand is fortified with B2, B6, B12, & D – crucial vitamins for people that don’t eat fish or meat!


1 package tofu (~12 oz)

5 garlic cloves, minced and divided

7 tablespoons reduced sodium soy sauce, divided

1 cup brown rice

1 yellow bell pepper, chopped

1 cup onion, chopped

1 cup kale, finely chopped

1 cup sugar snap peas

1 cup mushroom, sliced

1 ½ tablespoons olive oil

 Yield: 2 servings


  1. Drain tofu and squeeze with paper towels to soak up excess liquid. (The more liquid that is drained, the more flavor will be absorbed).

  2. Chop tofu into 1-inch cube pieces and place on a tray.

  3. Mince 2 cloves of garlic and mix with 7 tablespoons of reduced sodium soy sauce.

  4. Drizzle mixture onto tofu and cover completely.

  5. Set aside to let flavor marinate for at least an hour (not necessary, but pumps up the flavor)

  1. Boil brown rice as per package instructions. Once done remove and place in bowl.

  2. Chop onion, yellow bell pepper, and kale (finely), and mince one clove of garlic. Set aside.

  3. Add 1 minced clove of garlic, add with ½ tablespoon olive oil, and sugar snap peas in pan on medium heat; sauté for 2-3 minutes; remove from pan and place in bowl once done.

  4. Put ½ tablespoon of olive oil, onion, yellow bell pepper, kale, mushrooms, and 1 last clove of minced garlic; sauté approximately 2-3 minutes, remove from pan and place in bowl once done.

  5. Increase heat of pan to high and add ½ tablespoon of olive oil. Add tofu to pan and sauté for 2-3 minutes. Remove from pan and place in bowl once done.

  1. Construct Buddha bowl by placing rice (to taste, recommend 1/2-1 cup cooked) in bottom of the bowl. Add 1/2 of the available tofu, sautéed veggies, and sugar snap peas in perimeter of bowl

  2. Enjoy!

The post Learning To Love Soy Part II: Tofu Buddha Bowl appeared first on Andy The RD.

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Now that it is legal in Canada, there is no use tiptoeing around the subject of marijuana and health.

As a dietitian, my professional activities are centred around empowering people to make decisions within their own contexts to achieve the best possible health, whatever that may mean to them.

Before legalization in 2012, more than 1 in 10 Canadians reported using marijuana and time will tell how legalization affects this statistic and how it is captured.

This number is similar in medical students, 1 in 3 which claim they have used cannabis.

That is just to say that cannabis use, as it may be sometimes perceived, is far from reserved for “troubled youths”, or whatever the case may be.

A recent survey suggested that half of Canadians asked expressed interest in edible marijuana products.

Suffice to say, the consumption and health effects of marijuana is a very relevant topic.

But when I look to Health Canada’s informational page on marijuana, I noticed they paint a pretty grim picture in terms of the negative aspects of marijuana use.

Is it all grim? Why legalize it then?

That brings us to today’s article, a review of the relevant literature on the health outcomes associated with marijuana/cannabis use.

Chronic Pain

Probably the most compelling body of evidence supporting a helpful effect of cannabis use is in the management of chronic pain.

Cognitive Functioning

Cognitive functioning, especially in adolescents, seems to be a real sticking point in the anti-weed argument.

It has long been suspected that regularly smoking marijuana can negatively impact problem solving, emotional control, decision making and other cognitive functions (Crean et al) as well as memory and even academic performance (Volkow et al).

And yet a recently published 2018 paper out of JAMA Psychology suggests that earlier studies on the level of effect that cannabis actually has on the cognitive functioning of adolescents has been overstated, meaning that it may not be as bad as we thought.

During Pregnancy

Marijuana use during pregnancy is associated with an increased risk of low birth weight and birth complications.

Type 2 Diabetes

Although no association exists between cannabis use and type 2 diabetes risk, a 2013 observational study out of the American Journal Of Medicine found that marijuana use was associated with lower fasting insulin levels.

Lung Health

A recent and comprehensive review out of the Journal of Cancer found little evidence that habitual marijuana smokers ( whether short or long-term) were at an increased risk of lung cancer.

There is, however, some suggestion that long-term marijuana use could damage the lungs in other ways.

This 2011 review out of the Expert Review Of Respiratory Medicine journal had the following to say:

There are consistent findings that smoking cannabis is associated with large airway inflammation, symptoms of bronchitis, increased airway resistance and lung hyperinflation. The evidence that smoking cannabis leads to features of chronic obstructive pulmonary disease, such as airflow obstruction and emphysema is not convincing.

The precise effect of smoked marijuana on lung health and long-term outcomes remains unclear and conclusions differ among the studies I was able to access.

Generally, however, there is little dispute in the literature regarding the fact that cannabis smoke is far less damaging than tobacco smoke.

DP Tashkin said this in a 2013 paper:

The accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared with the grave pulmonary consequences of tobacco

Blood Pressure & Cardiovascular Health

High blood pressure, which I wrote a book about, is one of the most common reasons why Canadians are prescribed medication.

Although there appears to generally be insufficient evidence to draw conclusions about marijuana use and long-term cardiovascular health outcomes, there is some concern that marijuana use may modestly increase blood pressure in the short-term and even increase risk of death from hypertension in the long-term.

This relationship remains observational, inconclusive and worthy of further exploration.

Testicular Cancer

Men who smoke marijuana for a >10 year duration appear to be at a higher risk of testicular cancer.

Current, chronic and frequent cannabis use, as compared to never using it, increases your risk.

Interestingly and perhaps unexpectedly, however, men who use or have used marijuana were found to have higher sperm counts and concentrations.

Inflammatory Bowel Disease

Cannabis use is common in people suffering from IBD (crohns & colitis).

There is some evidence to suggest that cannabis use in people with crohn’s disease may improve sleep and appetite, although further data will be required before firm conclusions can be made.

This 2016 review out of the Gastroenterology and Hepatology journal summarizes it best:

It has yet to be determined in human populations whether cannabinoids have therapeutic anti-inflammatory effects in IBD or are simply masking its many debilitating symptoms.

Body Weight & Appetite

An interesting and complex relationship exists between body weight, appetite and marijuana use.

Obviously increased appetite is a well recognized acute symptom of marijuana use, and yet marijuana users tend to have lower body weights than non-users.

This relationship is certainly multi-factorial, none the less marijuana may be a useful appetite stimulant in those who struggle with meeting their caloric needs.

Intake & Nutritional Status

Interestingly enough, observational studies show that marijuana users tend to have higher energy intakes despite their lower body weights.

Despite higher consumption of foods such as soda, alcohol and high sodium snacks, the nutritional status of marijuana users was similar to non-users although serum carotenoid levels were lower in marijuana users.

For reference purposes foods such as tomatoes, spinach, broccoi, carrots and kale are examples of excellent sources of dietary caretonoids.

Athletic Performance

There is only minimal and low quality evidence to support the use of marijuana as truly effective when it comes to improving physical performance.

It appears better data will be needed before firm conclusions can be drawn.

Sleep Apnea

The American Academy Of Sleep Medicine (AASM) suggests that there is insufficient evidence to support the use of cannabis in the treatment of sleep apnea.

Concluding Remarks

Today’s article was meant to serve as a neutral and objective exploration of what we currently know about the connection between marijuana use and health outcomes.

As you could probably tell, we still have a lot to learn.

Until next time,

Andy De Santis RD MPH

Bonus Content: CBD And Anxiety

Some of you may have hard of or be familiar with CBD, also known as Cannabidiol, which is essentially a cannabis component that lacks THC ( aka none of the the stuff that gets you “high”).

It is available in a variety of forms, including oils and capsules, and has been increasingly studied for it’s potential health effects, especially as it relates to anxiety.

Although research in this area is in its relative infancy, it does appear that oral doses in the 300-600 mg range is effective at reducing anxiety specifically in Seasonal Affective Disorder (SAD).

More research will be required to determine how far reaching this potential benefit is and how it is modulated between acute and chronic exposure to CBD across a variety of anxiety-related conditions.

The post Is Smoking Cannabis Good For Your Health? appeared first on Andy The RD.

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One of the biggest goals and perhaps revelations of the latest edition of the Canadian Food Guide is that it leans towards more plant-based eating.

But why the sudden change on the part of Health Canada?

Are they out to get the beef and dairy industries? Are they in the pockets of big kale? Maybe they just actually care?

In my view, pretty much each and every one of us could benefit from increasing our consumption of whole, unprocessed plant-based foods such as fruits, vegetables, whole grains, legumes nuts and seeds.

2017 American Journal of Clinical Nutrition study revealed that people who ate more of those foods tended to have a lower risk of premature death ( fish made the list too).

Contrarily, people who ate more red and processed meat tended to have an increased risk of premature death.

 When you eat more plant based, two things happen.

#1 You get less of the stuff that you DON’T need more of:

  • Saturated Animal Fat
  • Animal Protein
  • Cholesterol
  • Preservatives ( in the case of processed meat)
  • Unhealthy compounds that form when meat is cooked/charred at high temperatures ( ie: BBQ)

#2 You get more of the stuff you DO need more of:

And what happens to your body when you get more of the stuff you need, and less of the stuff you don’t?

People who eat more plant foods and less animal foods tend to have:

That’s a whole lot of benefits.

Health Canada knows that:

And, with the changes to the new food guide, took action from a public health perspective to work towards solving that problem.

Andy De Santis RD MPH

The post Why Does Health Canada Want You To Eat More Plant-Based? appeared first on Andy The RD.

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“Food is symbolic of love when words are inadequate.” —Alan D. Wolfelt

What a coincidence it is then that the annual holiday of love that we celebrate on February 14th each year, was actually originally a feast celebrating a Saint by the name of Valentine.

In fact, there is nothing coincidental about the connection between food, love and romance and the connection between these perennial entities is never  stronger than on Valentine’s Day.

Acknowledging this fact as a male dietitian, I decided to reach out to my fellow nutrition colleagues (who, unlike myself, are pretty much all women) to learn about the unique definitions nutrition professionals attribute to Valentine’s Day.

Using my social media connections, I asked a number of dietitians & nutrition professionals to define their ideal romantic meal, there answers confirmed what I suspected; the way to a woman’s heart is through her stomach.

“Because every aspect of my life revolves around food, it makes sense that I would express my adoration for another in food as well!”

“The way to my heart is definitely my stomach”

Note: Italicized quotes represent responses from participants.

Let’s take a look at the major themes I retrieved from my respondents.

1. It doesn’t need to be anything fancy: One of the major themes that I encountered in my participants responses is a dismissal of the notion that fancy elaborate dinners are a perquisite for a happy and healthy valentines day. In fact,  many of these simpler dishes that were suggested weren’t necessarily all that healthy either.                          

“ Honestly, if a guy took me out for a really great hamburger for Valentines’ Day and he was ok with me getting a little food on my face, maybe even thinks it’s cute. That’s a winner”

“ You can’t go wrong with classic spaghetti and meatballs”

 “I think eating in a fancy restaurant takes away the whole romantic factor. Cooking with my significant other a meal we both love is my idea of romantic… Spaghetti and meatballs with garlic bread and of course red wine!”

“Im a sucker for simplicity , so overly elaborate dishes aren’t the only way to woo someone”

“ It doesn’t have to be fancy or extravagant, or even come with gestures or gifts. For me, that extra attention and mindfulness is what keeps romance going for the long run”

2.… Unless you know for sure she likes it fancy: This should come as no surprise, but certain people have very specific tastes. There were a group of respondents who had a very clear idea of the precise meal they considered romantic. Here are some quotes:

“My idea of a romantic meal would start of with some grilled asparagus drizzled wit olive oil followed by a seafood pasta, either linguni or spaghetti, with shrimps and scallops.”

“A  Mediterranean small plate, or meze, can be a wonderfully romantic meal. The med cuisine offers rich flavours in order to that the taste buds, while a small plate style dinner lends its hand to moderation.”

“I would love a petite prime filet, roasted asparagus and a tater of some sort”

3. Cheese, Wine & chocolate covered strawberries are a must: Talk about recurring themes… Cheese, wine and chocolate covered strawberries look like they are absolutely essential components of a romantic valentines day.

“Additionally a romantic meal must include a generous glass of fine wine”

 “ Beside champagne and chocolate? Perroer Jouet and Dark Chocolate”

 “ Fondue! Like legit fondue- French alps style. Vacherin fribuorgeious + gruyere with the whole spread Wine”

 “For dessert, chocolate mousse, duh.”

4. It should be light & healthy (duh): It should come as no surprise that dietitians and nutrition students would value a healthy meal for Valentine’s Day. Although it was not a must for all the respondents, several indicated healthy food was a key component of their ideal romantic meal.

“Entrée would be seafood- whole grilled fish or mussel/sscalops and a simple side of grilled asparagus or roasted vegetables”

 “Heart healthy salmon and leafy greens topped with walnuts.”

“Gotta get those veggies in”

 “I think a romantic meal should be warm and cozy without leaving you feeling heavy. Include lots of roasted veggies”

5. It should be apparent that time, effort and consideration went into the meal: This was a big one. My respondents really valued the notion that a great deal of time and consideration put into planning the meal, and that also be apparent to them in the final product. The take home message here?  Put a ton of thought into the meal and make sure it is apparent to your significant other ( without having to tell them explicitly!!).

 “For me personally I find having a man make the effort to cook a meal intentionally with me in mind romantic. So I think as long as it looks good, taste good and uses fresh ingredients I would be impressed.

 “I love it when someone cooks for me.”

 “The idea that someone has had to spend the time thinking, shopping and preparing food for a picnic means a lot to me and how I show my affection. Time, effort and consideration for one another has had to happen and that is a lovely feeling!”

6. Just being together is the most important thing: No theme was more apparent than the importance of being and doing things together.This point really speaks to just how valuable it is to be there for someone, all the other stuff aside. Maybe all the rest doesn’t even matter that much?!

“Making dinner together at home. Ideally, we’d chat about the menu ahead of time to make a meal we both love and go shoping together.”

“Being there with the person I love is the perfect dinner for me”

“I think no matter what you decide to make on v day, cooking the meal together will make the date more fun an if your not that into cooking”

“ Anything you make with the love for your sig other, can be a crappy homemade meal but its always the thought that counts”

7. Acknowledge the individuality of your partner: Knowing your partner and doing the things for that person that you know they would appreciate is the final important theme that was apparent to me in my participant’s responses. Being able to reflect the uniqueness of the person and your relationship is obviously a logical course of action to take to make them feel special. This theme is somewhat related to theme #5, but also slightly distinct, enough so that I gave it it’s own category.

“I guess the best romantic meals would be reflective of the person youre cooking for, taking the time to tailor it to them.”

 “I would prepare a bunch of different foods that our favourites and also that reflect our special moments”

Well, there you have it folks. The 7 critical themes that I have arrived at shedding light on the individual nutrition-oriented females perspective on what a romantic meal means. I think it is safe to say that whether your special someone is a dietitian or not, there are certainly some valuable insights to be gleaned from today’s article.

I want to thank the 20 colleagues and social media friends who gave me the feedback I needed to put this article together. I appreciate your participation and also the love and support that you provide me via social media on a regular basis. Your importance has not gone unnoticed or unappreciated this Valentine’s Day! Thank you!

Have a great day,

Andy De Santis RD MPH

The post The 7 Things That Make A Meal Romantic appeared first on Andy The RD.

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