Some nutrient trends are like the hemlines of women’s skirts: they come and go from one season to the next and quickly fall out of favor. One trend that appears to be here to stay is that Americans are (or at least want to be) eating to improve their health. In fact, a 2008 consumer attitude survey shows that two out of three Americans (67%) are willing to change their diet specifically to improve their health (International Food Council [IFIC] 2008).
The results are in: many people have heard enough about what to cut out of their diets. Now they want to know exactly what foods they should be adding to their diet to better their health. When citing the changes they were making to enhance their diet in 2008, 37% of Americans said they were upping their intake of specific foods and beverages (compared with only 23% in 2006), while just 21% said they were decreasing consumption of specific items (IFIC 2008).
Plant sterols, sometimes called phytosterols, are the healthy compounds that occur naturally in a variety of plant foods. Small quantities of plant sterols can be found in vegetable oils, nuts, grain products, fruits and vegetables. The average intake of plant sterols in Western countries is approximately 150–350 milligrams per day (mg/day), far below the current federal recommendation for plant sterols (Trautwein 2003). These powerful nutrients are gaining widespread recognition for their proven role in lowering LDL (aka “bad”) cholesterol levels.
While the mechanism of action is not completely understood, it appears that plant sterols block the absorption of cholesterol in the intestine and expedite cholesterol removal from the body. Because plant sterols have a similar structure to cholesterol, one hypothesis is that they actually displace cholesterol, hindering its
absorption in the gut (Trautwein 2003; von Bergmann, Sudhop & Lutjohann 2005). Regardless of the mechanism, consuming plant sterols can reduce cholesterol absorption by 30%–40% (Normen 2000).
The National Cholesterol Education Program (NCEP) recommends eating foods that contain plant sterols as a way of effectively lowering LDL cholesterol levels. The NCEP advises adults with elevated cholesterol levels to consume 2 grams (g) of plant sterols per day (NCEP 2001).
In today’s fast-paced world, chances are good that your clients would welcome simple strategies for coping with stress. Recent research suggests that help could be a cup of tea away. L-theanine is an amino acid found almost exclusively in tea, which has been linked to improved cognitive function and a calmer, yet more alert, state of mind (Kelly et al. 2008; Owen et al. 2008). The effects of L-theanine appear to be even greater when combined with caffeine.
L-theanine is known to be absorbed by the small intestine and to cross the blood-brain barrier, affecting the brain’s neurotransmitters and increasing alpha brain-wave activity (Kelly et al. 2008; Owen et al. 2008). A cup of brewed tea typically contains 10–20 milligrams (mg) of L-theanine. Shortly after
L-theanine is consumed, blood concentrations increase and the brain’s alpha waves are impacted; the effect lasts about 3–4 hours (Kelly et al. 2008; Owen et al. 2008).
The results of a new controlled trial found that L-theanine—found in black, green, white and oolong tea—actively alters the attention networks of the brain (Kelly et al. 2008). The participants were classified into four groups: one group was given
L-theanine; another was given caffeine; a third was given a combination of L-theanine and caffeine; and the control group was given a placebo. Subjects were then asked to complete a variety of attention-related computerized tasks. Those who ingested the L-theanine and caffeine mix showed superior improvements in attention compared with the other groups, suggesting that the two compounds may work synergistically to allow the mind to focus and concentrate more (Kelly et al. 2008).
With all the buzz about dietary fiber, if your clients haven’t yet asked you about beta-glucan, chances are they will soon. Beta-glucan is a naturally occurring soluble fiber that has earned
attention from the U.S. Food and Drug Administration (FDA) for its LDL cholesterol–lowering benefits.
The way beta-glucan works is that the water-soluble fiber becomes thick when dissolved in the body, thereby helping to slow the passage of food from the stomach into the small intestine. Beta-glucan also binds to bile acids, which the liver produces using cholesterol in the bloodstream. Once bound, these bile acids help pass cholesterol from the body as part of normal excretion. Lower levels of bile acids in the blood stimulate the production of additional bile acid, further reducing blood cholesterol levels.
Studies have shown that eating 3 g of soluble beta-glucan fiber every day—as part of a diet low in saturated fat and cholesterol—may lower LDL levels (ADA 2008). According to the FDA, beta-
glucan soluble fiber is the component in whole oats that is primarily responsible for that food’s cholesterol-lowering potential.
As if that were not enough, recent research suggests that beta-glucan may offer additional cardiovascular benefits by improving blood pressure (BP) control. A double-blind, randomized, controlled study on subjects with high BP compared the effects of eating whole-grain, oat-based cereals rich in soluble fiber with the effects of eating refined-grain, wheat-based cereals (Pins et al. 2002). Seventy-three percent of those in the oat group were able to stop or reduce their BP medication, compared with 42% in the other group. Oat-based cereal eaters whose medication was not reduced had substantial decreases in BP.
Research is providing more evidence that even the smallest nutrients can have a big impact on reducing the risk of heart disease. Two nutrients recently in the headlines are potassium and vitamin D. Both of these important nutrients are essential, meaning that the body cannot produce them on its own and they must come from external sources (i.e., diet and/or sunlight).
High BP affects about 73 million people in the U.S.—that’s nearly 1 in 3 adults (American Heart Association [AHA] 2008). The condition is associated with increased risk of death and illness from stroke, coronary heart disease, heart failure and end-stage renal disease. Diets high in potassium have been clinically shown to reduce BP, but most Americans consume only half the recommended daily intake of potassium (and twice the suggested limit for sodium).
Potassium can influence BP levels by increasing sodium excretion from the body. According to a recent review of micronutrients and BP (Houston & Harper 2008), increasing dietary potassium intake may stimulate the blood vessels to dilate, opening potassium channels. For the general healthy population with normal kidney function, a relatively high potassium diet does not pose any health concerns.
The Dietary Approaches to Stop Hypertension (DASH) trial has shown that a diet rich in potassium and other nutrients can lower BP (Appel et al. 1997). Significant reductions in BP levels were seen just 2 weeks into the DASH trial; participants with hypertension had an average decline in systolic BP of 11.4 milliliters of mercury (mm Hg) and an average decrease in diastolic BP of 5.5 mmHg, respectively (Appel et al. 1997).
The DASH trials provided the basis for the 2005 Dietary Guidelines for Americans, which include daily intake recommendations for potassium for different genders and ages (see the sidebar “Potassium and Vitamin D Guidelines”).
Vitamin D has also been in the news quite a lot lately. Besides being known to work with calcium in maintaining bone health,
vitamin D has recently been touted for playing a role in cardiovascular health (Wang et al. 2008; Giovannucci et al. 2008).
In a prospective study that followed 1,739 offspring from Framingham Heart Study participants for more than 5 years, subjects with low blood levels of vitamin D had twice the risk of having a cardiovascular event—such as a heart attack, heart failure or stroke—in the next 5 years compared with those who had higher levels of vitamin D (Wang et al. 2008).
Though it is difficult to assess vitamin D intake levels, low levels of vitamin D may be widespread in areas of the U.S. that do not get much sunshine. The typical American diet does not provide enough vitamin D, since few foods naturally contain the
vitamin (fish and fish liver oil are among the best natural sources). Getting lots of sunshine, eating fish and consuming plenty of vitamin D-fortified foods—such as milk, cereals and certain brands of orange juice—are keys to maintaining adequate vitamin D levels. Some people, especially those over 50, may need to take vitamin D supplements.
Recently, the American Academy of Pediatrics (AAP) doubled its previous recommendations for vitamin D daily intake for children and adolescents from 200 International Units (IU) to 400 IU (Wagner & Greer 2008). For specific intake recommendations for different genders and ages, see the sidebar “Potassium and Vitamin D Guidelines.”
If you’ve ever suffered the consequences of a food-borne illness or taken a recalled product back to the store, you probably realize the impact of food safety. Indeed, in today’s climate of international trade and mass production, the likelihood of being affected by a tainted food is rapidly increasing. According to Pamela M. Nisevich, MS, RD, LD, an Ohio-based clinical dietitian who frequently treats patients afflicted with the symptoms of food poisoning, the two pathogens that typically make headlines in the United States are E. coli 0157:H7 and Salmonella. Nisevich says that both of these bacteria are common—and unremarkable until they build in numbers and destroy the healthy flora in one’s system, leading to gastrointestinal distress and illness. These pathogens enter the food supply through fecal contact with food somewhere along the path from field to table.
Food recalls have gotten a lot of negative attention of late. According to the “Recalls, Market Withdrawals, and Safety Alerts” section of the FDA’s website (www.fda.gov), when a product
regulated by this agency
is either defective or potentially harmful, recalling that product—
removing it from the market or correcting the problem—is the most effective means of protecting the public. To keep updated on food recalls and safety concerns, you can subscribe to the FDA’s e-list service at www.fda.gov/opacom/7alerts.html.
One of the easiest things
you can do to protect yourself and avoid passing along pathogens to unsuspecting individuals is to wash your hands more often. The 20 seconds you spend lathering up and rinsing off will be well worth the time you save at your local doctor’s office or in bed with a food-borne illness.
In addition to the scientific research findings that drive food trends, social movements also play a key role in shaping the way the public understands nutrition.
According to the U.S. Environmental Protection Agency (EPA), sustainability is all about meeting the needs of the present without compromising the ability of future generations to meet their own needs (EPA 2008). Sustainable agriculture has become increasingly important to producers and consumers in recent years as concern for the environment and the food supply’s safety rises.
Sustainable practices are being sought throughout the entire food production process. They include everything from producing organic and natural food, conserving natural resources and ensuring humane animal treatment to reducing reliance on fossil fuels and decreasing greenhouse gas emissions. The sustainability movement aims to help consumers understand problems associated with the food supply, such as the dangers of synthetic fertilizers and pesticides; the use of large amounts of water; and the impact of major transportation systems and factory-style practices for raising livestock.
According to its website, Sustainable Table is a group that “promotes the positive shift toward local, small-scale sustainable farming” (www.sustainabletable.org). Another prominent group is a nationwide partnership of people and organizations called the National Campaign for Sustainable Agriculture (www.sustainableagriculture.net). This organization’s goals include maintaining a safe food supply and encouraging farming and ranching practices that produce quality food while preserving open space, abundant wildlife and other forms of biodiversity.
Two other social movements that are generating changes in diet and attitude involve being more aware of what we eat and how it is produced. Both of these trends are driven by a desire to eat foods that are grown using humane practices and are produced locally.
According to its website (www.slowfood.com), Slow Food International is a “non-profit, eco-gastronomic member-
supported organization that was founded in 1989 to counteract fast food and fast life, the disappearance of local food traditions and people’s dwindling interest in the food they eat, where it comes from, how it tastes and how our food choices affect the rest of the world.”
What started as a small organization in Italy now has more than 85,000 members in 132 countries, including America (www.slowfoodusa.org). The organization focuses on enjoying food that is “created with care,” while supporting communities and the environment by
reconnecting people with the regional diversity of their food traditions, plants, animals, fertile soils and waters related to the food they eat.” Slow Food International has delineated its goals as follows:
- celebrating food, community and regional agricultural diversity
- producing nutritious food that is as good for the planet as it is for our bodies
- making food accessible to all, regardless of income, and having it be produced by people who are treated humanely
The term locavore refers to individuals who make an effort to eat only foods grown or harvested within a 100-mile radius of their home (www.locavores.com). The purpose of the locavore movement is to cut the number of miles food travels before reaching the plate—thereby decreasing associated air pollution and loss of family farms while increasing dollars going into the local economy. The locavore movement encourages consumers to support farmers’ markets or, if possible, to grow their own food.
As a health and fitness professional, it’s important for you to stay up-to-date on trends and hot topics while also being able to put them in perspective and view them in the context of overall health. With knowledge and practical experience, you can help your clients reach their wellness goals through proper nutrition.
Here are the federal guidelines for daily Adequate Intakes (AI) of potassium and vitamin D:
Sources: Institute of Medicine, 1997; IOM 2004; Wagner & Greer 2008.
Increasingly, people eager to improve their health want to know what to add to their diet—even more than what to avoid. Here is a list of nutrients to focus on, along with a look at their respective benefits and food sources.
The U.S. Food and Drug Administration classifies each food recall according to the item’s potential to cause harm. There are three hazard levels:
Class I. This classification applies to dangerous or defective products that could predictably cause serious health problems or death. Examples include food found to contain botulinum toxin, food with undeclared allergens, a label mix-up on a lifesaving drug, or a defective artificial heart valve.
Class II. Class II products might cause a temporary health problem or pose only a slight threat of a serious nature. An example would be a drug that is under-strength but is not used to treat life-threatening conditions.
Class III. Products in this category are unlikely to cause any adverse health reaction, but do violate FDA labeling or manufacturing laws. Examples include a minor container defect or lack of English labeling on a retail food.
American Heart Association (AHA). 2008. Heart disease and stroke statistics 2008 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 117, e25–e146.
Appel, L.J., et al. 1997. The DASH Collaborative Research Group. A clinical trial of the effects of dietary patterns on blood pressure. The New England Journal of Medicine, 336 (16), 1117–24.
Environmental Protection Agency (EPA). 2008. Facts on sustainability. www.epa.gov/stainability; retrieved Nov. 2, 2008.
Giovannucci, E., et al. 2008. 25-Hydroxyvitamin D and risk of myocardial infarction in men: A prospective study. Archives of Internal Medicine, 168 (11), 1174–80.
Houston, M.C., & Harper, K.J. 2008. Potassium, magnesium and calcium: Their role in both the cause and treatment of hypertension. Journal of Clinical Hypertension, 10 (7 Suppl. 2), 2–11.
Institute of Medicine (IOM). 1997. Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy of Sciences. Institute of Medicine.
Institute of Medicine (IOM). 2004. Food and Nutrition Board. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride and Sulfate. Washington, DC: National Academies Press.
International Food Information Council (IFIC). 2007. 2007 food and health survey: Consumer attitudes toward food, nutrition & health. www.ific.org/research/2007foodandhealthsurvey.cfm; retrieved Jan. 13, 2009.
International Food Information Council (IFIC). 2008. Food and health survey: Consumer attitudes toward food, nutrition & health. www.ific.org/research/foodand healthsurvey.cfm ; retrieved Dec. 21, 2008.
Kelly, S.P., et al. 2008. L-theanine and caffeine in combination affect human cognition as evidenced by oscillatory alpha-band activity and attention task performance. Journal of Nutrition, 138, 1572S–77S.
National Cholesterol Education Program (NCEP). 2001. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (adult treatment panel III). The Journal of the American Medical Association, 285, 2486–97.
Normen, L., et al. 2000. Soy sterol esters and beta-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. American Journal of Clinical Nutrition, 71 (4), 908–13.
Owen, G.N., et al. 2008. The combined effects of L-theanine and caffeine on cognitive performance and mood. Nutrition Neuroscience,11 (4), 193–98.
Pins, J.J., et al. 2002. Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? Journal of Family Practice, 51 (4), 353–59.
Trautwein, E. 2003. Proposed mechanisms of cholesterol-lowering action of plant sterols. European Journal of Lipid Science & Technology, 105, 171–85.
von Bergmann, Sudhop, T., & Lutjohann, D. 2005. Cholesterol and plant sterol absorption: Recent insights. The American Journal of Cardiology, 96 (1), 10–14.
Wagner, C.L., & Greer, F.R. 2008. Prevention of rickets and vitamin D deficiency in infants, children and adolescents. Pediatrics, 122 (5), 1142–52.
Wang, T.J., et al. 2008. Vitamin D deficiency and risk of cardiovascular disease. Circulation, 117, 503–11.
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