Category Archives: Grains

Decepticon Promicor (soluble corn fiber), Op. 81

I heard a comedian say he wished exercise was like high school; once you get your diploma, that’s it.  You never need to do high school again.  Unfortunately, the same isn’t true with artificial nutrition.  the mad food scientists are at it again.

Enter: Soluble corn fiber (SCF), mass produced by Megatron Promitor

Over a decade ago, Atkins released low carb bars.  Well, they weren’t actually low carb per se, they were low sugar.  This was accomplished by replacing sugar with glycerol (a sugar alcohol) and polydextrose (a pseudo-fiber).  While their bars are made from cheap ingredients and low quality protein, sugar alcohols and pseudo-fibers are certainly better than sugar.

Later, sugar alcohols took off in popularity, appearing in Met-Rx Protein Plus, Detour Lean Muscle, Dymatize Elite Gourmet, etc., etc.  Glycerol was prominent in Labrada and Pure Protein bars.  Supreme Protein bars use glycerol and maltitol, and a LOT of ‘em.  Quest took a stand against glycerol and uses the lower calorie and more stomach-friendly erythritol (if it ends in “-ol,” its probably an alcohol).

More recently, the field took a considerable philosophical leap forward and starting using real fiber, good fiber.  Inulin appeared in some Atkins bars, VPX Zero Impact, and the original Quest bars.  Quest has since switched to another good fiber, isomalto-oligosaccharides.  Unfortunately no one is using GOS, yet, but they will … mark my words (that’s a prediction, or stock tip… not a threat).

But now the field has taken a turn and we have another artificial ingredient, a pseudo-fiber, with which to deal.  “Soluble corn fiber (SCF)” first appeared in Splenda Fiber packets and then in Promax LS bars.

If you’re like me, you’re asking yourself: what is this stuff?  Is it real fiber?  Is it like the super fibers inulin and GOS?  Hello Pubmed

Divide and conquer

Stewart (2010) compared SCF to 3 other fibers and maltodextrin, 12 g/d x 2 weeks =

Pullulan, a rather potent fiber, is not well-tolerated.  Resistant starch (an insoluble fiber), soluble fiber dextrin, and SCF were all OK.  The gut microbiota seemed to have no preference, as short chain fatty acid production was similar in all groups (perhaps 12 grams is subthreshold?).  Similarly, health biomarkers, hunger levels, and body weight were unaffected.

Boler (2010) compared a commercially available SCF preparation to polydextrose, 21 grams per day for 21 days in 21 healthy men (cute.)

NFC, no fiber control; PDX, polydextrose; SCF, soluble corn fiber

In this study, however, SCF didn’t do so well.  It caused gas and reflux.  Perhaps this wasn’t observed in Stewart’s study because of the lower dose (12 vs. 21 grams).  Furthermore, polydextrose reduced while SCF increased short chain fatty acid production, both of which resulting in a higher acetate:butyrate ratio.  So unlike 12 grams of any of Stewart’s fibers (including SCF), the gut microbiota seems to respond to 21 grams of SCF.  And they pooped more (both fiber groups).

Data are expressed as log cfu/g feces.

Interestingly, SCF was remarkably bifidogenic.  Much more so than PDX, MOS (see Yen et al., 2011), and inulin (see Menne et al., 2000), but WAY less than GOS (see Silk et al. 2009).

the holy grail

This same group reported a more detailed analysis of the gut microbiota which unfortunately did NOT exactly confirm their earlier finding (Hooda et al., 2012):

Data presentation is different in the two publications, and if both are true, then SCF selectively increases a few specific strains of bifidobacteria but reduces many others (enough to increase the total amount but decrease the variety).  The functional implications of this are unclear (to me).

In the meantime, SCF appears to be at most an OK pseudo-fiber substitute.  Megatron Promitor is not likely to test it against the super fibers (e.g., inulin, GOS, etc.) any time soon, so we won’t know if it’s an advance or simply a side-step.  Such is life.

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Gluten vs. gut bacteria, Op. 78

Whether it is being used to treat Celiac disease, autism, or Paleo-deficiency,  a gluten-free diet (GFD) is probably the most inconvenient diet.  There’s no health risk imposed by recreational gluten avoidance; actually, it might even be healthier.

For example, cereal fibre (aka whole grains) provides the majority of gluten in the Western diet.  I have not been shy about my stance on cereal fibre in the past.  In the seminal DART study (Burr et al., 1989 Lancet), people who were instructed to eat more cereal fibre had a higher mortality rate.  There are definitely many nuances and specifics, etc., yada yada yada, but this finding should be your mind’s pantheon for all-things-gluten.

gravitas

One example of how my brain organizes information:   gluten-free diets include GFCF (duh), Paleo, and Atkins.  The low FODMAPs diet is indirectly gluten-free because cereals and grains are excluded.  N.B. these are all healthy diets… I repeat: GFCF, Paleo, Atkins, and low FODMAPs are all healthy diets.  But don’t take my word for it, Miley Cyrus and Kim Kardashian are also gluten-free (so it MUST be true; there’s no hiding from the Glutenista!).  No grain, no pain!

A downside?  One possible side effect of gluten avoidance is potentially detrimental alterations in gut bacteria.  For example, de Palma and colleagues (2009) showed that a strict GFD significantly reduced bifidobacteria (one of the good guys) in healthy adults.  A GFD is the only clinically effective treatment for Celiac disease, but my gut tells me (no pun intended) that the beneficial effects are not due to reduced bifidobacteria… I’m waiting for a study where a GFD is supplemented with bifidobacteria and inulin/GOS to test this.

On the bright side, the anti-bifido effect of gluten avoidance is not universal.  De Cagno and colleagues (2009) showed that children with Celiac disease have less bifidobacteria in their gut and this is reversed by a GFD (phew!).

gluten - hiding in plain sight... everywhere

Crackpot theory of the week:  could inulin/GOS increase gluten tolerance?  He and colleagues (2008) gave lactose-intolerant patients supplemental bifidobacteria in the form of capsules (1.8×10^9  cfu B. longum) and yogurt (3×10^10 cfu B. animalis) which significantly improved their lactose tolerance (it nearly cured them).  In this study, yogurt provided the prebiotics necessary to ensure survival of the supplemental bifidobacteria.  I imagine inulin or GOS
would’ve had a more profound effect.

Celiac disease, lactose-intolerance, IBS, and veganism are all associated with reduced bifidobacteria and could theoretically benefit from inulin/GOS supplementation.  You could try a diet high in onions, garlic, and breast milk, but cost, availability, and potential for halitosis favor the supplemental route  (finally found a source of high quality GOS).   And it sure as hell beats eating shit.

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Gluten-free food pyramid

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a novel gut health diet paradox, Op. 75

The low FODMAPs diet

FODMAPS  – Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.  Basically, FODMAPs are a bunch of sugars that are poorly digested in some people and cause a fantastic variety of health problems ranging from bloating and abdominal pain all the way to chronic fatigue and anxiety.  AND a low FODMAPs diet seems to provide some relief (Ong et al., 2010; Staudacher et al., 2011).

Just like it’s weird name, it’s difficult to simplify the rules of the low FODMAPs diet, so here it is graphically:

FODMAPs vs. GFCF

Grains are excluded from GFCF due to gluten and from FODMAPs due to oligosaccharides.  Dairy is excluded from GFCF due to casein and from FODMAPs due to lactose (not sure where FODMAPs stands on fermented dairy like kefir or FAGE).  Thus, both GFCF and FODMAPs exclude grains and dairy.  However, GFCF doesn’t restrict fructose, which is excluded in FODMAPs (monosaccharide).  And last but not least, GFCF but not FODMAPs allows polyols, but as I’ll explain later, I don’t think polyols belong on this list (perhaps “FODMAPs” was just more pleasant-sounding than “FODMAs”).

"polyols"

FODMAPs vs. low carb

A low carb diet is low in both FODMAPs and gluten.  But perhaps similar to polyols, some leniency should also be applied to casein, as standard low carb diets don’t restrict casein but still improve a variety gastrointestinal symptoms (and quality of life in IBS patients; Austin et al., 2009).  Alternatively, a dairy-free low carb diet would cover all your bases.

or you could bring a gun to a knife fight, part I.

Alterations in gut bacteria are frequently associated with gastrointestinal problems, and two classes of nutritional supplements aimed at modifying the gut flora seem to help.  “Probiotics” contain the buggers themselves, while “prebiotics” contain their fuel.

divide and conquer

Bifidobacteria

With regard to the former, “bifidobacteria” seem to be the major player.  Bifidobacteria are the highest in the gut of breast fed babies and lowest in elderly folk.  They are lacking in IBS sufferers (Kerckhoffs et al., 2009; Parkes et al., 2012), and supplementation with bifidobacteria-containing probiotics improve a variety gastrointestinal symptoms (B. infantis 35624 [Whorwell et al., 2006]; B. animalis DN-173 010 [Guyonnet et al., 2007]; B. bifidum MIMBb75 [Guglielmetti et al., 2011])

B. infantis 35624 is found in Align.

B. animalis DN-173 010 is found in Dannon’s Activia yogurt.  But as with most yogurt products, it comes unnecessary added sugars.

Personally, I’d recommend a blend like that found in Jarrow Bifidus Balance (which comes preloaded with its own stock of prebiotics, to be discussed later).

Back to the paradox (or a shameless teaser for next week’s episode): the low FODMAPs, GFCF, and low carb diets all have beneficial effects on gut health but reduce bifidobacteria.  Bifidobacteria supplements and bifidogenic prebiotics are also good for the gut.

a far more enigmatic paradox than the French one, IMO, to be continued…

 

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Candy in disguise, Op. 73

on the chopping block:To recharge between hunting, gathering, and avoiding predation, our Paleolithic predecessors snacked on gluten-free energy bars comprised of a variety of fruits nuts, and vegetable oils all stuck together with Mother Nature’s sweet sticky honey and dates.  <end sarcasm>

For the record, I’m not a card-carrying member of the Paleo community; just looking out for a respectable nutrition movement.

NoGii No Gluten Paleo Bars” should not be confused with anything healthy.

INGREDIENTS: Dates, Honey, Organic Cashews, Almonds, Apple Juice Sweetened Cranberries (Cranberries, Apple Juice Concentrate, Sunflower Oil), Sesame Seeds, Dried Unsweetened Tart Cherries, Sunflower Seeds, Unsulphured Dried Apples, Freeze-dried Strawberries, Strawberry Juice Concentrate, Organic Sunflower Oil. ALLERGENS: Contains Tree Nuts (Almonds and Cashews).

Full disclosure:

Case closed.

On a more positive note, NoGii No Gluten Paleo Bars have no added sugars.  Indeed, those were saved for their “NoGii Kids Bar.” 

INGREDIENTS: Soy Protein Crisps (Soy Protein Isolate, Tapioca Starch), Marshmallow Creme (Sugar, Brown Rice Syrup, Crystalline Fructose, Invert Sugar, Water, Egg Albumen, Agar, Gum Arabic, Natural Flavor), Brown Rice Syrup, Organic Brown Rice Crisps (Organic Brown Rice, Organic Brown Rice Syrup, Sea Salt), Rice Syrup Solids, Maize Dextrin (Dietary Fiber), Organic Canola Oil, Organic Agave Syrup, Whey Protein Isolate, Organic Palm Oil, Vanilla Yogurt Drizzle (Sugar, Fractionated Palm Kernel Oil, Whey Powder, Nonfat Dry Milk Powder, Cultured Whey, Soy Lecithin [emulsifier], Vanilla), Vegetable Glycerine, Natural Flavors, Sea Salt, Soy Lecithin, Mixed Tocopherols (Natural Vitamin E), Purified Stevia Extract, Lo Han Extract.

NoGii proudly advertises “NO HIGH FRUCTOSE CORN SYRUP” and “ALL NATURAL,” but this is despicable, ESPECIALLY because these are targeted at children.

Divide and conquer

  1. Agave syrup has MORE fructose than high fructose corn syrup (it’s like higher fructose corn syrup).  Why brag about “no high fructose corn syrup” if you’re only going to include a higher fructose substitute?
  2. Crystalline fructose.  (yes, that would be 100% fructose).
  3. Invert sugar is chemically virtually identical to high fructose corn syrup.  This is deceitful… it wouldn’t be so bad if they didn’t advertise (in all capital letters) “NO HIGH FRUCTOSE CORN SYRUP” directly on the website.
  4. Lastly, there’s nothing “Brown Rice” about “Brown Rice Syrup.”  It’s just plain syrup.  It may not have fructose, but it’s still just a blend of simple sugars.

NoGii is pulling no punches, so neither am I: they are trying to trick parents into feeding their kids something that they may not have had they known what was really in it.

NoGii.  Worst company of the week.  No, of the month, because they are targeting children.

A superior alternative:

Quest Low Carb Gluten Free Protein Bars

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Paleo schmaleo, Op. 69

Brief refresher:

Paleo: lean meat, fish, fruits, vegetables, potatoes, eggs, and nuts; NO grains or dairy

Paleo carbs: fruits, veggies, nuts, and beans… NO starches, cereals, whole grains, added sugars, etc.

Paleo is GFCF-friendly

Atkins is similar to Paleo but allows fewer carbs

Mediterranean diet (from last week): whole grains, low-fat dairy, vegetables, fruits, fish, oils, and margarines (the Paleo diet improved insulin sensitivity WAY more than the Mediterranean diet in patients with CHD).

Diabetic diet (this week; see below): vegetables, root vegetables, dietary fibre, whole-grain bread and other whole-grain cereal products, fruits and berries, and decreased intake of total fat with more unsaturated fat.

Paleo vs. the “diabetic diet” in type II diabetics (Jonsson et al., 2009 Cardiovascular Diabetology).  Lindeberg designed this particular Paleo diet with a much lower carb content (32% vs. 40%) than in the previous study with CHD patients.  A cynic, who might think that some of Paleo’s benefits are due to its low carb content, might think that since traditional Paleo and the comparison “diabetic diet” have a similar carb content (42% and 40%, respectively), Lindeberg intentionally modified Paleo for this study to make sure carbs were significantly lower than in the “diabetic diet” (stacking the deck in Paleo’s favor, according to the cynic).  I can’t find any reason to disagree with the cynic, but it didn’t work out so well for Lindeberg et al.

As detailed in a series of posts about crossover studies (part I and part II), this one was botched due to: 1) what appears to be improper randomization (baseline glucose values were 7.1 and 8.6 mM); and 2) a washout period that was too short to allow one of the primary endpoint variables (HbA1C) to return to baseline.  As such, data presentation was convoluted, which said cynic might think was intentional.  But if we take it at face value, Paleo still fails.  For example, according to this figure (which is NOT crossover data), although Paleo has a lower final HbA1C, the HbA1C reduction is much greater on the diabetic diet.Paleo: 0

Diabetic diet: 1

AND weight loss was similar despite Paleo dieters consuming significantly less food (1581 vs. 1878 kcal/d):So yes, in accord with the Jonsson study (above), Paleo may have been more satiating (i.e., spontaneously lower food intake), but no, this didn’t translate to greater weight loss.  Someone needs to measure energy expenditure in Paleo dieters because it looks like this pattern of food intake either lowers basal metabolic rate or simply makes people tired (though this conclusion would be vehemently denied by Paleo loyalists).  The reduced leptin levels (Jonsson study) may have caused lower energy expenditure, but this would not entirely align with my lower-leptin-equals-higher-leptin-sensitivity hypothesis and thus cannot POSSIBLY be true :/   Alternatively, perhaps the Paleo diet really does lower energy expenditure; this would’ve been irrelevant and possibly even beneficial in Paleolithic times because: 1) they would’ve conserved more energy for “hunting” (hunter-gathers) or fleeing; and 2) weight loss was much less a concern compared to starving or being predated.

The Paleo diet is interesting in that it eludes low-carb status by selectively excluding grains, and I’m pleased that high quality studies (randomized crossover) are at least being attempted, but data thus far suggest we haven’t found anything magical about Paleo (yet)… just need better studies, especially those controlling for total carb content.

Paleo:

+1 for excluding grains, but not much else

 

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Paleo vs. carbs (per se), Op. 68

The Paleo diet:

A)     the next big thing

B)      Atkins-lite

C)      Fail

D)     None of the above

While proponents of the Paleo diet take a page out of nutritionism‘s book and argue it’s about food choices, not macronutrients, my reductionism mandates inclusion of a comparative breakdown by protein, fat, and carbs.  In a recent publication, Lindeberg (a Paleo pioneer) compared Paleo to the Mediterranean diet in a cohort of CHD patients (Lindeberg et al., 2007 Diabetologia).  To make a long story short, Paleo came out on top in a variety of endpoint measures after 12 weeks.

Divide and conquer

The Paleo diet consisted of lean meat, fish, fruits, vegetables, potatoes, eggs, and nuts; grains and dairy were off-limits (Paleo is GFCF-friendly).  Paleo carbs include fruits, veggies, nuts, and beans… no starches, cereals, whole grains, added sugars, etc… FYI Atkins is very similar to Paleo but includes a lower absolute amount of Paleo carbs.  The Mediterranean dieters ate whole grains, low-fat dairy, vegetables, fruits, fish, oils, and margarines.  Both diets exclude processed junk food and both are relatively healthy diets.  

As such, both groups lost weight; slightly more on Paleo but this was probably due to reduced caloric intake (not uncommon for Paleo dieters; see below and also Osterdahl et al., 2008 EJCN):But the benefits of Paleo were much more robust WRT insulin sensitivity, which was markedly improved on Paleo but not Mediterranean.

Paleo: 1

Mediterranean: 0

With a 4% weight loss, why didn’t glucose tolerance improve in the Mediterranean dieters?  … weight loss is almost always accompanied by improved glycemic control…   The biggest difference in “foods” consumed by the two groups was cereals: 18 grams per day on Paleo vs. 268 on the Mediterranean diet… over 14 times more!  As I’ve discussed at length with gravitas, a high intake of cereals (aka grains aka fibre [in the figure below]) does not bode well for insulin sensitivity, inflammation, and outright all-cause mortality:

As such, Paleo does well to exclude grains.  Furthermore, Paleo is higher in protein and fat and lower in carbs- all good things.  A more interesting analysis showed that waist circumference (visceral fat) was associated with grain intake even when controlled for carbohydrates.  In other words, the detrimental impact of whole grains goes beyond their intrinsic carbohydrate content. (whole grains … insulin resistance … visceral fat)

Back to those calorie data for a moment, given that they were probably just as important as cereal exclusion in determining the results.  Why did Paleo dieters spontaneously eat so much less?  In a follow-up publication, Jonsson and colleagues assessed leptin and satiety in both groups (2010 Nutrition & Metabolism) and showed that despite eating less and losing more weight (things that should increase hunger and decrease satiety), Paleo actually did the opposite (hint: something to do with whole grains, perhaps?).

While the Paleo meals were smaller (5th and 6th rows) and contained fewer calories (3rd and 4th rows), they were just as satiating as Mediterranean diet meals (7th through 9th rows), leading the authors to conclude Paleo is more satiating calorie-for-calorie and pound-for-pound.  And if that isn’t enough, Paleo dieters also experienced a significantly greater reduction in leptin! (probably caused by their reduced food intake and body weight loss)  While the general consensus is that such a change in leptin should enhance hunger, as discussed previously I think lower leptin in this context reflects enhanced leptin sensitivity, which also helps to explain the improved insulin sensitivity.  Last but not least, WRT the Mediterranean diet I suspect reduced calories explains the weight loss, but the abundance of whole grains explains the blunted glycemic improvements.  (hint: whole grains … leptin resistance … insulin resistance) … (whole grain exclusion … leptin sensitivity … insulin sensitivity)

Paleo, the next big thing?  I’m holding out for a one-on-one with low-carb proper to exclude the role of Paleo’s lower carb content.  The whole grains issue requires no further confirmation IMO (e.g., Burr et al., 1989 LancetJenkins et al., 2008 JAMA, etc.).

The Paleo diet:

A)     the next big thing

B)      Atkins-lite

C)      Fail

D)     None of the above

might be considered “Atkins-lite,” probably not “the next big thing,” definitely not “fail.”

+1 for excluding grains

 

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USDA vs. nutrition, round II

The school lunch program is screwed.

First the USDA modifies the definition of a vegetable to include pizza.  Now they significantly altered their standards for school lunches to include fewer healthy foods and more USDA-approved ones (see report at the USDA’s website).  In brief, this move further reduces the nutrition of school lunches and will likely do more harm than good.  Here’s why:

In this cross-sectional Swedish study, parents recorded 7-day food diaries for their 4-year old children who then went in for a regular checkup.

Metabolic markers in relation to nutrition and growth in healthy 4-y-old children in Sweden (Garemo et al., 2006 AJCN)

On a 1,400 kcalorie diet, these children were consuming roughly 15% protein, 33% fat, and 52% carbs (about 20% of which came from sucrose).  That seems like a lot of calories, but besides playing all day, 4 year old children are also growing at an incredible rate.

Interesting finding numbers 1 & 2:  Children who got most of their calories from fat had the lowest BMI (i.e., they were the leanest), and the opposite was observed for carbs.

When divided into groups of normal weight vs. overweight and obese, some interesting and non-intuitive patterns emerged.  For example, lean kids don’t eat less food; but they do eat fewer carbs and less sucrose (and make up the difference by eating more fat and saturated fat).

Some of the weaker correlations showed:
-total calorie intake was associated with growth (logical)
-total carbohydrate intake was associated with increased fat mass (unfortunate yet also logical)
-total fat intake was associated with decreased fat mass (interesting)

And those who ate the most saturated fat had the least amount of excess body fat. (more on this below)

Fortunately, in a young child, a poor diet hasn’t had enough time to significantly impact their metabolic health; as such no macronutrient was associated, either positively or negatively, with insulin resistance [yet].

In a more appropriately titled follow-up, Swedish pre-school children eat too much junk food and sucrose (Garemo et al., 2007 Acta Paediatrica), Garemo reported that most of their carbs came from bread, cakes, and cookies, while most of the sucrose came from fruit, juices, jam, soft drinks, and sweets.  And WOW, go figure- most of the fat came from meat, chicken, sausage, liver, eggs, and dairy; NOT vegetable oils.

And in a mammoth dissertation, Eriksson (2009) confirmed many of these findings in a larger cohort of 8-year old Swedish children and had this to say about dairy fat:

The open boxes represent overweight kids, the closed boxes are lean kids.  Going from left to right, in either the open or closed boxes, BMI declines with increasing intake of full fat milk (perhaps parents should reconsider skim milk?).  Eriksson also confirmed that saturated fat intake was strongly associated with reduced body weight.  Interestingly, she mentioned that food intake patterns are established early in life, so it might be prudent to remove sugars and other nutrient poor carb-rich foods, and introduce nutritious whole foods as early as possible.  I’m not exactly sure how she assessed patterns of food intake establishment, but it seems logical.  Especially in light of the following study… we’ve seen 4 year olds, 8 year olds, and now we have 12-19 year olds.  The relationship between diet and health is consistent across all age groups.

Virtually all of the above data in Swedish children seem to suggest dietary saturated fat, whether it’s from beef, sausage, eggs, whole fat dairy, or liver (i.e., WHOLE food sources; NOT hydrogenated vegetable oils), is associated with reduced fat mass.  Metabolic abnormalities were not present, probably because the children were simply too young (although body weight seems to respond relatively quickly, other downstream effects of poor nutrition take years to accumulate before symptoms develop).

An American study about nutrient density and metabolic syndrome was recently published.  These kids were exposed to poor nutrition for just long enough to experience some of those malevolent effects.

Dietary fiber and nutrient density are inversely associated with the metabolic syndrome in US adolescents (Carlson et al., 2011 Journal of the American Dietetic Association)

The figure below divides fiber (a proxy for good nutrition; i.e., leafy vegetables, beans, etc.) and saturated fat into groups of least and most amounts comsumed. The lowest fiber intake was 2.9 grams for every 1,000 kcal, and 9.3% of these kids already had metabolic syndrome; the highest fiber intake was 10.7 grams / 1,000 kcal and 3.2% had metabolic syndrome.  Thus, consuming a fiber-rich [nutrient dense] diet is associated with a significantly reduced risk of metabolic syndrome.

The next rows are saturated fat.  The lowest saturated fat intake was 6.9 grams / 1,000 kcal and 7.2% had metabolic syndrome; the highest saturated fat intake was 18 grams / 1,000 kcal and 6.7% had metabolic syndrome…. huh?  While it didn’t reach statistical significance, the trend for saturated fat paralleled that of a “nutrient dense” diet.  Is it possible that saturated fat might be part of a nutrient dense diet?   if saturated fat comes in the form of red meat, liver, eggs, etc., then yes, it is part of a nutrient dense diet.  This conclusion evaded both the study authors and the media.

In 4 and 8 year old Swedish children, those who ate the most saturated fat had the least excess fat mass.  In 12 – 19 year old American adolescents, those who ate the most saturated fat had the lowest risk for metabolic syndrome.

Is it too much of a stretch to connect these ideas by saying that in the short run, a low saturated fat (nutrient poor, carb-rich) diet predisposes to obesity; and in the long run it predisposes to metabolic syndrome  ???

Collectively, these data suggest a diet based on whole foods like meat and eggs, including animal fats, with nutrient dense sources of fiber (e.g., leafy vegetables) but without a lot of nutrient poor carb-rich or high sugar foods, may be the healthiest diet for children.  

Flashback: recap of “USDA vs. nutrition, round I”
USDA: 1
Nutrition: 0
They made pizza a vegetable and insiders suspect that next they’ll try to make it a vitamin.

USDA vs. nutrition, round II

USDA: replacing normal milk with low fat milk
nutrition: full-fat milk was associated with lower BMI in both lean and obese children (see the Eriksson figure above)

USDA: increasing nutrient poor carb-rich options
nutrition: this was associated with increased fat mass in children (Garumen et al., see figures above)

USDA: reducing saturated fat as much as possible
nutrition: reduced saturated fat was associated with excess fat mass in children and metabolic syndrome in adolescents.

Such changes will have an immeasurable long-term impact if children grow up thinking these are healthy options.  Finally, this blog post does not contain a comprehensive analysis of saturated fat intake and health outcomes in children, but the USDA’s new regulations should have been accompanied by one.  In other words, these regulations should not have been based on the studies discussed above, but the studies discussed above should have been considered when the USDA was crafting their recommendations.  Obviously, they weren’t.

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pizza on the docket

they’re all crooks!

or

a slice of pizza does not count as a serving of vegetables. Period.

not the worst thing for you, really just a bunch of empty calories.  definitely NOT a serving of vegetables.

The government-sponsored school lunch program is designed to provide nutrition and improve the health of our children.  And they get around 11 billion dollars (i.e., $11,000,000,000) every year to do so.  Due to the recent surge in obesity, Congress acted fast!  School lunch programs do not closely follow the dietary guidelines.  To us taxpaying voters, $11,000,000,000 of our taxes are being wasted AND our kids are suffering.   Therefore, Congress quickly changed the status of pizza to “vegetable.”  Many schools serve pizza, and thus are now more closely in line with the dietary guidelines; so our taxes are being less-wasted and our children are healthier because they are eating more vegetables! To be clear: now that pizza is a vegetable, your children are healthier.

You can’t make this shit up – it is what happens when government gets involved in nutrition.  Please, ignore the Dietary Guidelines, they are horribly misguided.  And be extremely wary of electing anyone who wants to control nutrition; or vote with your dollars, don’t buy processed food!  The message is almost always wrong and both our bank accounts and our health suffer the consequences.  I would suggest supporting nutrition education programs, but NOT IF THEY SAY PIZZA IS A VEGETABLE.  If anything, a slice of pizza should count as dessert plus 3 servings of grains :/

Isn’t it bad enough that French fries, or crisps, count as vegetables?

Admittedly, claiming “the Dietary Guidelines are horribly misguided” is a strong statement, especially when said guidelines direct how a portion of our taxes are spent AND which foods are made available to our children.  This is important.

 

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QLSCD II (or Grains IV)

WRT the Quebec Longitudinal Study of Child Development (QLSCD), I failed to adequately emphasize one major implication of their findings.  It is a point that completely and wholly illustrates the disconnect from data, empirical science, and all common sense exhibited by mainstream beliefs in calories and dieting.   gravitas

Higher intakes of energy and grain products at 4 years of age are associated with being overweight at 6 years of age (Dubois, Porcherie et al., 2011 Journal of Nutrition)

Divide and conquer

Exhibit A

 

The table above shows the percentage of underweight, normal weight, and overweight children consuming the recommended number of servings for each food group.  15.5% of underweight children, 19.1% of normal weight children, and 42.6% of overweight children meet the recommended ?5 servings of grains per day.  Grains comprise [sic]: “breads, pastas, cereals, rice, and other grains”

There is a direct relationship between body weight and the percentage of children consuming ?5 servings of grains per day, i.e., more grains equals greater chance of being overweight.

Exhibit B

 

This table shows the odds for being overweight at 6 years of age in increasing quintiles of how many calories consumed daily two years earlier.  The crude odds risk (first column) shows a poor relationship between calorie intake at 4 years old and risk of being overweight 2 years later.  I say “poor” because the risk is non-significantly lower in the second quintile, higher in the third, lower in the fourth, but much higher in the fifth quintile (3.15x more likely to be overweight for the biggest eaters compared to the littlest eaters).  These data are unadjusted and could be confounded by a variety of factors.  Thus, the significance level of the trend is high p=0.0007.

The second column is similar to the first, but is adjusted for many known confounders: birth weight, physical activity, mother’s smoking status during pregnancy, annual household income, and number of above normal weight parents.  As such, the degree of statistical significance was reduced from 0.0007 to 0.001.

The third and most important column is further adjusted for body weight at 4 years of age, and shows that calorie intake is no longer associated with body weight at 6 years of age.  In other words, being overweight at 4 years old predicted being overweight at 6 years old better than calorie intake (and physical activity).

In the authors’ own words [sic]: “The only food group significantly related to overweight was grains.”  No association was observed for overweight risk with vegetables and fruits, milk products, or meat and alternatives.

IMHO, the observation that being overweight at 4 years old was the best predictor for being overweight 2 years later is remarkable… body weight status at 4 years old is a more important risk factor than both physical activity and calorie intake.  The only ‘controllable’ variable  is grains; i.e., you can’t change whether or not your child was overweight at 4 years of age, and physical activity and calorie intake doesn’t matter.  But grain consumption seems to matter, and it is something that can be controlled.

What is it about grains?  I don’t know, exactly, but it’s not simply that they’re carbohydrates because elevated carbohydrate intake didn’t increase risk for being overweight.

Exhibit C

 

 

“Eating less and moving more” is not the answer.  Nutrition matters, not the guidelines.

 

calories proper

 

 

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Grains III

Grains, gluten, and kids.  And I go WAY overboard on Table 4.

This topic has special relevance because grains provide more calories (31%) than any other food group.  And they are probably the most detrimental.

Higher intakes of energy and grain products at 4 years of age are associated with being overweight at 6 years of age (Dubois, Porcherie et al., 2011 Journal of Nutrition)

The Quebec Longitudinal Study of Child Development (QLSCD) assessed food intake and lifestyle variables in ~1,000 Canadian kids born in 1998 for 2 years.  The data came primarily from mothers but also daycare attendants when necessary, and their method for assessing food intake was pretty good- “multiple-pass” 24-h dietary recall interviews conducted in the home, and they double-checked by re-questioning a huge subgroup (~50%!, kudos).

Methodological peculiarities:

1)      Food groups consisted of

  1. Grains (e.g., breads, pastas, cereals, rice, etc.)
  2. Fruits and vegetables
  3. Dairy
  4. Meat and alternatives (e.g., meat [duh], lentils, tofu, and peanut butter)

What is the rationale for grouping lentils, tofu, and peanut butter 1) together, and 2) with meat?  IOW, data regarding the consumption of “meat and alternatives” will be difficult to interpret.

2)      Divisions between underweight, normal weight, and overweight were based on percentiles as opposed to absolute values.  For adults, BMI<20 = underweight, 20-25 = normal weight, 25-30 = overweight, and >30 = obese, regardless of the weight of their friends, colleagues, and neighbors.  By using percentiles: if the entire cohort is heavier than average, then overweight kids will be classified as normal weight because they are “normal” relative to the rest of the kids in the study, who are heavier than average.  So it’s not a debilitating methodological peculiarity, it just changes the definitions with which we are accustomed… so when they start out their results by stating [sic]: “20% of the children were overweight,” it doesn’t mean they have an unusually lean cohort, it actually tells us nothing.

Divide and conquer

Here’s what these kids were eating, in total and broken down by body weight groups:

 

Heavier kids ate more carbohydrates and less fat, and protein intake was relatively constant.  No big surprises, except that none of this reached statistical significance despite being true across all three quintiles… the lack of statistical significance is most likely due to the small sample size, and I suppose we’ve been spoiled lately with studies that included much larger subjects.  FTR, the carbs and fat data are probably the most relevant finding WRT feeding your kids.

Table 2 showed macronutrients and total energy, while Table 3 shows the breakdown by food groups (see Methodological Pecularity #2 above).

 

THIS is troubling.  Grain consumption is highly adherent to the guidelines, but the more the guidelines were adhered to, the fatter the kids got.  Combined with the amount of calories grains contribute to overall energy intake, this provides a fairly clear explanation for the childhood obesity epidemic.  IOW, these data strongly suggest the guidelines are wrong.

The long-awaited Table 4.  (did you feel the suspense?)

 

This table shows the odds for being overweight in increasing quintiles of total calorie intake.  The first and second columns show what everyone normally expects: more calories consumed = more chance of being overweight.  And it’s highly statistically significant.  But here’s the kicker: the third column adjusts for body weight at 4 years of age and the association is abolished.  !!!  That means being fat at 4 years old was a more important predictor of being fat at 6 years old than calorie intake.  Chubby 6 year olds were overweight because they were chubby when they 4 years old, NOT because they ate too much !  Excessive inactivity is ruled out because these data were adjusted for physical activity.

“Eating less and moving more” is not the answer.  Nutrition matters.  Don’t feed your kids grains, regardless of the guidelines.

 

calories proper

 

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