|
| Nutrition per serving | Original | Modified |
| Calories | 258 | 176 |
| Fat | 14.5 g | 6.5 g |
| Cholesterol | 82 mg | 73 mg |
| Sodium | 225 mg | 213 mg |
| Percent of Calories from fat | 52 | 34 |
Nutrition
Counseling, Avoiding the Pitfalls
If you're looking for reliable help with your dietary
problem, the yellow pages in the telephone directory are
not the best places to look. A study recently in 32
states found that less than half of the so-called
professionals listed under the headings
"nutritionists" and "physicians" are
sources of sound, scientifically based nutrition
information. This study found that some 70 percent of the
nutritionist "PhDs" listed had phony degrees or
delivered fraudulent information. Others carried
self-proclaimed titles like certified nutritionist (CN),
doctor of nutrimedicine (NMD), nutrition counselor (NC),
or a wide variety of other phony credentials. While 84
percent of the nutrition directory listings for
"dietitians" were found to be reliable, only 40
percent of those listed as "nutritionists" and
32 percent of those as "physicians" were
credible.
Many chiropractors also advise patients about nutrition and sell products in their offices as a lucrative sideline. Production costs for dietary supplements such as vitamins are minimal and high profit items. Chiropractic training can vary widely and practitioners are not generally recognized by other licensed professionals as being reliable sources of nutrition information.
In Kansas, the title "dietitian" is protected and no one can call him- or herself a dietitian without the proper credentials and meeting the educational requirements for registration and licensing (RD and LD). The Department of Hotel, Restaurant, Institution Management and Dietetics at Kansas State University, Manhattan (913) 532-5521 and the Department of Dietetics and Nutrition at the University of Kansas Medical Center in Kansas City, Kansas, (913) 588-7680 are the only institutions of higher learning in this state authorized to provide the advanced training required for RD and LD status. RDs must also participate in continuing education programs to keep their knowledge current. If you are interested in learning more about dietitians, training and areas of expertise, call the hotline of the American Dietetic Association at 1-800-366-1655 weekdays from 10 am to 5 pm eastern standard time. (MC)
Source: Turn the Yellow Pages with caution. Tufts University Diet and Nutrition Letter. 12 (4):1. June 1994.
Dietary
Supplement Update
Health food stores are a big and growing business. In
1993, 7,500 stores grossed over $4.5 billion, according
to the Health Foods Business publication (April, 1994,
page 30). This is an increase over 1991 when
approximately 7,300 stores took in nearly $3.9 billion.
The largest category of sales is vitamins and supplements
for an income of about $1.74 billion, i.e. 38% of sales.
Herbs account for another $678.6 million so that the
total from vitamins, supplements and herbs is 53% of
sales.
Professionals and consumers have been concerned about some of the health claims made by salespersons, on labels, in printed literature, and via radio and TV media. The 1990 Nutrition Labeling and Education Act (NLEA, P.L. 101-535) gave authority to the Food and Drug Administration (FDA) to regulate nutrition labeling, nutrient content, and health claims made for the products. FDA has taken the position that the supplement industry should follow the same rules as those established for food products. The health food and supplement businesses argue that their products are unique and should fall under less stringent rules. As an example of the need for dietary supplement regulation, FDA cites the 1989 case of the amino acid L-tryptophan that contributed to thousands of consumers becoming ill and three dozen deaths. It is still not certain whether it was the tryptophan or the contaminated pill due to faulty manufacturing practices that caused the problem.
The health food industry has lobbied hard to get the rules changed with Senator Orin Hatch of Utah being the chief spokesman. A number of supplement businesses are located in his state. In the last two Congresses, numerous bills have been introduced to ban FDA from regulating dietary supplements and one has been passed. It's the Dietary Supplement Health and Education Act of 1994: P.L. 103-417, the first major dietary supplement legislation since the adoption of section 411 of the Federal Food, Drug, and Cosmetic Act (FDCA) of 1976. Health food businesses lobbied hard to pass legislation that would exempt their industry from being regulated because their products were foods and should not be labeled as drugs.
What the Dietary Supplement Act does is to define supplements, places the burden of proof for safety on FDA, sets standards for the distribution of third party literature, allows statements of nutritional support under certain conditions, specifies the supplement ingredient and nutrition labeling information and requires the establishment of good manufacturing practices. It also creates a commission to make recommendations as to how to settle disputes and an office in the National Institutes of Health for overseeing supplement research and provide advice about these products to other federal agencies. While the law is an improvement in some areas, it is more restrictive in others.
Overall, the new legislation does not fully protect the consumer and anyone who consumes these products must assume a certain amount of risk. Health professionals are concerned that the burden of proof for safety is on FDA rather than the manufacturer and distributor and that the manufacturer does not need to show that the product is effective.
The leading organized group dedicated to protecting the public is the National Council Against Health Fraud, Inc. (NCAHF). It seeks to combat the widespread health fraud, misinformation, and quackery that's prevalent in health-related matters. If you believe that you have had some ill effects from supplements or seek to become a part of this organization, you can contact them at P.O. Box 1276, Loma Linda, CA 92354-9983. Newsletter subscriptions are $15 and a professional membership is $30. The Resource Center is directed by John Renner, M.D., and located at 3521 Broadway, Kansas City, MO 64111, (800) 821-6671.
Of course, everyone is a consumer and has a stake in maintaining high standards in the health marketplace. Professionals dealing with food, nutrition and health matters all have some responsibility in educating consumers on how to protect themselves against deception and exploitation by the unscrupulous. Most of the ingredients in supplements are relatively harmless and the major danger they pose is to your pocketbook. Sometimes supplement users delay medical treatment until it is too late or the condition worsens. (MC)
Sources: NCAHF Newsletter, March/April 1992 and July/August 1994, and Special Report, Dietary Supplements: Recent Chronology and Legislation, Nutrition Reviews. 53 (2): 31-36, February 1995.
Grain-based
Meals
The newest trend in good nutrition is based on
old-fashioned common sense. Grain-based menu planning-an
easy way to pack in needed nutrients while cutting back
on fat-may sound trendy, but it follows tenets
nutritionists have advocated for years.
Nutrition experts say the healthiest diet is one based on 6 to 11 daily servings of carbohydrate-rich grain foods, including bread, cereal, pasta, rice and crackers. Replacing dietary fat with carbohydrates improves health and helps reduce the risk of disease.
But this food group may be one of nature's best-kept secrets. Although grains have valuable carbohydrates, dietary fiber, essential vitamins and minerals, and the added bonus of being naturally low in fat, Americans don't eat enough of them.
- A recent Gallup survey shows:
- Ninety-one percent of Americans report eating less than the recommended 6 to 11 servings.
- Although most claim they eat enough grains, 71 percent have had only half enough, reporting they eat three or fewer grain servings each day.
- And, 62 percent of parents incorrectly think their kids are getting enough bread and grain foods.
When it comes to grains, experts agree. Basing your menu plans on grains is a smart way to start. Grains help obtain the recommended 55-60 percent of total calories from carbohydrates. Round out the menu by obtaining 10-15 percent of calories from protein and 30 percent or less from fat.
So how do you translate a grain-based diet into balanced meals on the table? Relax, there is a way to eat right without memorizing long lists of nutrients, counting grams or figuring percentages for every food you eat.
Use the Food Guide Pyramid. It takes the guesswork out of feeding your family and makes meal planning easier. It's a simple way to add carbohydrates while subtracting the fat, without doing the math.
To follow the Food Guide Pyramid, build meals around grains (at least two servings per meal, per person). Then round out the menu with fruits and vegetables and accessorize with meats, fish or poultry and dairy products.
- Tips for delicious grain-based meals
- Start with grain foods, at least two servings at every meal. Combine bread, cereal, pasta, rice, or any grain with one or two vegetables. Then add beans or small amounts of meat, poultry, fish, egg or low-fat cheese for the main dish.
- Size up recipes according to food groups. A favorite spaghetti and meat sauce recipe probably has ingredients from the grain group (pasta), vegetable group (tomato sauce) and meat group (ground meat).
- Experiment! Serve stir-fried chicken and vegetables over pasta. Try a bean filling for burritos. Enjoy waffles for a quick high-carb dinner.
- Encourage kids to snack. Healthful carbohydrate-rich-mini-meals of grains, fruits and vegetables provide the fuel children need to keep energized.
- Tempt kids with foods they like-a good strategy for keeping a picky eater happy. Gallup found that kids' three favorite grain foods are cereal, bread and pasta.
- Place a basket of bread on the table. A slice of bread or a roll before or during mealtime fills you up and cuts down on higher-fat foods. (MC)
Source: Wheat Foods Council, Ready to Use Handouts, March 31, 1995
Noshing
in the `90s
Many Americans are learning to rethink the way they eat,
control their weight and energize their active
lifestyles. They're taking a fresh approach to outmoded
and unrealistic perceptions. As a result, we're
experiencing a more relaxed, more sensible, healthier
eating style. Here's the latest on food, fitness and
fueling_'90s style.
Out: "Good"
food, "bad" food biases.
In: Moderation. Nutritionally speaking, there
aren't any "good" or "bad" foods.
When eaten in moderation, all foods fit. Because no
single food provides all the nutrients our bodies need,
it's important to eat a variety of wholesome foods each
day.
Out: Counting calories
as equals.
In: Looking at where calories come from.
All calories are NOT created equal! Bite for bite,
complex carbs like those in grain foods have four
calories per gram whereas fat has nine.
Out: Avoiding starches
or grain foods.
In: Enjoy grains to fuel an active, low-fat lifestyle.
Complex carbohydrates found in grains are one of the main
sources of energy for working muscles. Health experts
recommend eating 6 to 11 servings of grain foods each
day.
Out: Broccoli bashing.
In: Thriving on five servings of fruits and vegetables
each day.
Fruits and vegetables help keep you healthy and reduce
risk of disease. They are naturally low in calories, fat
and sodium, cholesterol-free and generally rich in
vitamin A, vitamin C and fiber.
Out: Skipping meals.
In: Eating regular, balanced, low-fat,
high-carbohydrate meals.
Severe calorie restriction actually undermines weight
loss efforts by reducing body metabolism. The result? You
tend to lose muscle, not fat, and you rob your body of
essential nutrients.
Out: Complicated diet
plans.
In: Budgeting fat.
Keep your diet lean and healthful by replacing high-fat
foods with low-fat, high-carbohydrate foods. For example,
if you have bacon and eggs for breakfast, choose
lower-fat options the rest of the day.
Out: Weight loss, fad
and crash diets.
In: The Food Guide Pyramid.
The Pyramid shows the kinds of foods you should eat (and
in what proportions) to look and feel your best. The
goal: Eat more of the foods at the base, while limiting
fat to less than 30 percent of total calorie intake.
Out: Running on empty.
In: Body fueling
. Keep tabs on food intake and activity level. The goal
is to eat often enough to provide a steady supply of
carbohydrates, essential nutrients and fiber. Complex
carbohydrates provide a slow, sustained release of
energy.
Out: Protein centered
meals.
In: Grain-based menus.
Move grains to the center of the plate. Shift meat,
poultry and fish to side dish or accompaniment status.
Round out the menu with plenty of vegetables, fruits and
low-fat dairy products. Plan at least two servings of
grains at each meal.
Out: Dairy Fat.
In: Dietary calcium.
Dairy foods are among the best sources of calcium for
building and maintaining strong bones and healthy teeth.
Aim for three servings of calcium-rich foods every day_no
matter what your age. Select lower-fat choices such as
skim milk, low-fat cheese, non-fat yogurt and the new
drinkable yogurts.
Out: Three
"squares" per day_no matter what.
In: Personal eating styles.
Nibbling on a number of small meals throughout the day
helps maintain a sensible weight and keeps us energized
more effectively than eating three larger meals. (MC)
Source: Wheat Foods Council, Ready to Use Handouts, March 31, 1995
What is
Success in Obesity Intervention?
According to a recent commentary in the Journal of the
American Dietetic Association, success in obesity
intervention continues to be measured by the amount of
weight loss in a short, predetermined period. This
approach is inappropriate from a behavioral perspective,
and ethically unacceptable. Treatment that focuses on
short-term weight loss is not helping to solve the
obesity problem in the U.S., and may be contributing to
it.
Research shows that most weight loss does not result in improved weight maintenance. Moderate weight loss can provide notable health benefits. Gradual weight change is reported by many to be sustained and more desirable than rapid weight loss.
Determining success by measuring weight loss is inappropriate from a behavioral perspective. The behavioral management technique of positive reinforcement is misused when weight loss programs reward persons for weight loss. Any event is positively reinforcing if it increases the occurrence of the behavior that immediately precedes it. Weight loss is not a behavior, but the outcome of complex interactions of many behaviors over time. Reinforcing the outcome of weight loss does not provide a person with direction for making appropriate choices for healthful lifestyle change.
The more serious consequence of defining success in terms of weight loss involves the reinforcement of our cultural obsession with slimness and strengthening of social prejudice against obesity. The majority of adolescent and young adult women believe themselves to be fat even when they are not. Psychologists propose that an emphasis on dieting and weight loss may be contributing to the increase in eating disorders.
Success in obesity treatment needs to be redefined. The repeated weight cycling may have potential dangers to health. Weight loss programs should be replaced by health-oriented, lifestyle change programs. Treatment for obesity should "focus on approaches that can reduce risks independently of weight loss". Long-term improvement of medical problems and health risks and improved quality of life (with or without weight loss) are the most important measures of success. Short- and medium- term changes such as decreased reliance on medications, increased physical activity, and reduced fat intake should be defined and measured regularly during treatment. Attention also needs to be directed towards "normalizing" food intake. This can be done by establishing regular meal patterns and separating emotional from physiological hunger. Success in a weight loss program should not be claimed unless such loss is maintained for a minimum of 5 years.
Consideration of psychological functioning needs to be part of a weight loss program. Recent studies suggest that people seeking treatment for obesity may be more psychologically distressed than the general obese and nonobese populations. Binge eaters who constitute 20% to 45% of those in weight control programs appear to have higher levels of psychological dysfunction than nonbinging obese and persons who have never been obese. For some people a history of sexual, physical, or emotional abuse may prevent sustained behavior change as unhealthful lifestyle patterns can have powerful adaptive benefits. For these, confronting and overcoming the barriers is a true measure of success whereas weight cycling with dietary restriction can only lead to more shame and repeated failure.
The "blame" for the obesity problem must be placed squarely on the shoulders of a culture that promotes sedentary living, high-fat eating, and (especially for women) tremendous psychological and social pressure to be thin. Interventions based on blame, shame, and starvation have failed and may be contributing to the increase of obesity in the U.S. (JD)
Source: Robison, et al, Redefining Success in Obesity Intervention: The New Paradigm, Journal of the American Dietetic Association, April 1995, p 422-23.
Update:
Trends in Fetal Alcohol Syndrome_United States, 1979-1993
Fetal Alcohol Syndrome (FAS) is one of the most common
preventable causes of birth defects and childhood
disabilities. It is the result of the mother drinking
alcohol during pregnancy and is totally preventable by
abstaining from alcohol throughout pregnancy. The
syndrome consists of a whole range of disabling
conditions, depending on the level and timing of alcohol
exposure, and includes cognitive and behavioral problems
as well as the characteristic physical abnormalities.
Alarmingly, incidence of FAS seems to be on the rise according to data from the national Birth Defects Monitoring Program. The rate of reported cases in 1993 was 6.7 per 10,000 live births, compared to a rate of 1.0 per 10,000 live births in 1979. Some of this could be due to increased awareness and diagnosis of FAS.
Several studies have been done or are currently being conducted to characterize the magnitude of FAS and to determine population subgroups that may be at increased risk. One of these studies looked at age, race, education, income, martial status, smoking status, and prenatal care and their effect on risk for FAS. They classified women as prenatal drinkers if they drank any alcohol during the 3 months before they learned of their pregnancy or during their pregnancy. They were classified as frequent drinkers if they had six or more drinks per week during their pregnancy.
Reported prenatal drinking increased with age through the age group 30-34 years. It was highest among white, non-Hispanic women, women with greater than or equal to 16 years of education, and among women with annual household incomes of greater than or equal to $40,000. It was reported by 38% of women who smoked greater than 10 cigarettes per day and by 17% of women who were nonsmokers.
Frequent prenatal drinking was more prevalent among women aged greater than or equal to 35 years, women in all racial/ethnic groups other than white, and in those with annual household incomes less than or equal to $10,000. The number of frequent drinkers increased as smoking level increased. Frequent drinking was three times higher among women who received no prenatal care than among those who did receive prenatal care.
The risk for FAS increases with the amount of alcohol consumed, so the groups with higher rates of frequent prenatal drinking are more at risk. But adverse physical and neurobehavioral effects have been found at low levels of alcohol intake. In 1988 the US Surgeon General issued an advisory for women who are pregnant and for those trying to become pregnant not to drink alcohol. This warning was reiterated in 1990 by the Secretary of Health and Human Services.
Obviously, drinking during pregnancy continues to be a problem. Those of us that work with women who are pregnant or trying to become pregnant need to increase our efforts to advise them against drinking. (PP)
Sources: Health Info-Com Network Medical News Digest, Vol. 8, Issue 4, April 11, 1995. CDC. Fetal alcohol syndrome_United States, 1979-1992, MMWR 1993; 42: 339-41. NCHS. National Maternal and Infant Health Survey. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1988. Office of the US Surgeon General. Surgeon General's advisory on alcohol and pregnancy. FDA Drug Bulletin 1981; 11:9-10. USDA/HHS Nutrition and your health: dietary guidelines for Americans. 3rd ed. Washington, DC: USDA/HHS, 1990: 25-6.
Physical
Activity by Women
According to the 1992 Behavioral Risk Factor Surveillance
System (a phone survey of American adults) age, race,
education and income influence how much women exercise.
Activity among women tended to decline with age, with 26%
of women age 18 to 34 reporting no leisure-time activity
compared with 42% of women age 65 and over.
Regular exercise was defined as either 20 minutes of vigorous exercise three times or more per week, or 30 minutes of moderate exercise at least five days per week. White women were more likely to participate in regular activity (29%), compared with Hispanic (25%), and black (18%) women. Almost half of women with less than a high school education were not active compared to 22% of women with a college education. And only 20% of the women in the lowest income category (less than $15,000) exercised regularly, compared to 35% of women in the highest income category ($50,000 and up).
Physical activity data were collected in a similar survey in Kansas in 1992. In this state, 31% of women reported no physical activity, 19% reported some, 19% reported regular and sustained physical activity, and 12% reported regular and vigorous physical activity. Although the data for women were not broken down by age, race, income or education; among men and women together, physical activity increased as education level increased.
One of the Year 2000 health objectives for physical activity is to reduce the number of people who engage in no leisure time physical activity to no more than 15%. We have a way to go in the next five years, at least with women. (PP)
Sources: Nutrition Week, Community Nutrition Institute, March 24, 1995. Health Risk Behaviors of Kansans 1992, Kansas Department of Health and Environment, 1994.
What
Americans Think About Eating Well -- (Results of 1995
Gallup Poll)
Recently the Gallup Organization was commissioned by the
Wheat Foods Council and the American Bakers Association
to survey Americans to find out how well we eat and how
we think we should be eating. Although the main focus of
the survey was on the grain group, general questions on
how our daily intake measures up to the Food Guide
Pyramid were also asked.
Almost 60% of Americans think they get too much fat in their diet. Forty percent think they need more fiber, while only 24% think they need more complex carbohydrates, a good source of dietary fiber. Increased servings from the bread, cereal, rice, and pasta group would help Americans both cut down on fat and increase their fiber intake, yet the average reported intake of foods from this group was three servings per day. Over 90% reported eating less than the 6 to 11 servings recommended per day, but only 11% of Americans think they need more. Even though people seem to know that they need less fat and more fiber in their diets, nutritionists obviously haven't done a good job in educating people on how to accomplish this.
Thirty percent of those surveyed were not at all familiar with the Food Guide Pyramid and another 12% knew it by name only. Those who were familiar with the principles of the Pyramid seem to be using that knowledge. This group ate more grain products on average, and had a better understanding of nutrients. For example, 66% of those very familiar with the Pyramid knew that starches belong in the diet, compared with only 56% of those not familiar with the Pyramid.
Older Americans (ages 50 and over) ranked their nutrient intake as being about right more often than 18- to 34-year olds. Half of the younger group said they needed more fiber, while only 30% of the older group indicated that need. And more of the younger group said they ate too much sugar compared to the older group.
As is apparent from the results of this survey, Americans still need help in understanding the principles of the Food Guide Pyramid. They also need help in knowing how to make dietary changes. A first step might be adding a couple more servings of bread, cereal, rice or pasta every day. (PP)
Source: What America thinks about eating right. A Gallup opinion survey. American Bakers Association and the Wheat Foods Council. March 1995.
May
6th, International No-Diet Day
More than 100 groups from over 10 countries, including
the Council on Size and Weight Discrimination have formed
a coalition to sponsor "No-Diet Day." These
groups are attempting to educate the public about the
futility and ineffectiveness of dieting, i.e. using low
calorie diets for weight loss. They have outlined the
"Top Ten Reasons to Give Up Dieting:"
#10 Diets Don't Work. Even
if you lose weight, you will probably gain it all back,
and you might gain back more than you lost.
#9 Diets Are Expensive. If you didn't buy special
diet products, you could save enough to get new clothes,
which would improve your outlook right now.
#8 Diets Are Boring. People on diets talk and
think about food, and practically nothing else. There's
a lot more to life.
#7 Diets Don't Necessarily Improve Your Health.
Like the weight loss, health improvement is temporary.
Yo-yo dieting can actually cause health problems.
#6 Diets Don't Make You Beautiful. Very few people
will ever look like models. Glamour is a look, not a
size. You don't have to be thin to look attractive.
#5 Diets Are Not Sexy. If you want to feel and be
more attractive, take care of your body and your
appearance. Feeling healthy makes you look your best.
#4 Diets Can Turn Into Eating Disorders. The
obsession to be thin can lead to anorexia, bulimia,
bingeing, compulsive eating, and compulsive exercising.
#3 Diets Can Make You Afraid of Food. Food
nourishes and comforts us, and gives us pleasure. Dieting
can make food seem like your enemy, and can deprive you
of all the positive things about food.
#2 Diets Can Rob you of Energy. If you want to
lead a full, active life, you need good nutrition, and
enough food to meet your body's needs.
#1 Learning to love and accept yourself just as you
are will give you self-confidence, better health, and
a sense of well-being that will last a lifetime. (PP)
K-State Research and Extension is a short name for the Kansas State University Agricultural Experiment Station and Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well-being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices, experiment fields, area Extension offices and regional research centers statewide. Its headquarters is on the K-State campus, Manhattan.