Tag Archives: diet

Best Diets of 2023: Review of US News & World Report

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Everyone wants to know the best diet for health or weight loss, and more than half of all Americans followed some diet at some point in the past year, spending $33 billion dollars on diets. Instead of you spending hours reviewing diets to figure out the pros and cons, U.S. News and World Report do the work for you.

How do you choose which is best for you with hundreds of diets available?

Each year U.S. News and World Report puts together a panel of nationally recognized registered dietitians, nutritional epidemiologists, weight-loss researchers, and physicians who are experts in nutrition, weight management, food psychology, and chronic disease to rate selected diets. The panelists also develop an in-depth profile for each diet they review, explaining how the diet works, determining whether its marketing claims are realistic, scrutinizing it for possible health risks – and revealing what it’s like to live on the diet, not just read about it.

The diet review is based on questions you might be curious about yourself, including:

  • Are all food groups included in the diet?
  • Are nutrient-rich foods emphasized?
  • Does the diet require vitamins, nutrient supplements, fiber drinks or hard-to-find specialized products?
  • Does the diet encourage a healthy and realistic timeline for weight loss?
  • Is a plan for maintaining weight loss included?
  • Are the foods called for widely available and easy to procure?
  • Can the diet be modified to meet cultural, religious, or other personal preferences?
  • How time-consuming is the planning, shopping, and preparing meals and snacks?
  • Can the diet be easily adapted for the whole family?
  • Are age, body type, and activity level considered when recommendations are prescribed?
  • The expert panel also calculated the nutritional adequacy of each diet and considered how it might prevent or manage health conditions, including cardiovascular health, diabetes, inflammation, and bone and joint health.

Diets reviewed

This year 38 popular diets were reviewed and ranked based on a 5-star scoring system for overall health, weight loss, fast weight loss, and ease of following. The diets are ranked into 11 different categories:

  1. Best diets overall – #1 is Mediterranean Diet
  2. The best plant-based diet #1 is the Mediterranean Diet
  3. Best weight loss diets – #1 is WW (WeightWatchers)
  4. Best fast weight loss diets – #1 is Keto
  5. Best diet programs – #1 is WW
  6. Best diets for bone and joint health (a new category this year) – a tie for #1 with the DASH and Mediterranean diets
  7. Best family-friendly diets – a 3-way tie for #1 between Mediterranean, Flexitarian, and TLD diets
  8. Best heart-healthy diets – #1 is the DASH diet
  9. The best diet for diabetes – #1 is the DASH diet
  10. Best diets for healthy eating – #1 is the Mediterranean Diet
  11. Easiest diets to follow – a tie for #1 between Flexitarian and TLC diets

2023 Best Diets

Plant-based diets came out again this year, with the Mediterranean diet earning the best overall diet for the 6th year. The DASH and flexitarian diets tied for second place. It’s clear that choosing whole, less processed foods and filling your plate with more plants – fruit, vegetables, legumes, whole grains, nuts, and seeds – is a key strategy for good health.

The Mediterranean diet ranked in the top five in all categories except for fast weight loss which is why it came out on top.

The Mediterranean diet can easily be adapted to fit foods from other places in the world: for example, the Nordic diet swaps root vegetables instead of tomatoes and eggplant, and the Asian diet relies on rice, lentils, and sweet potatoes instead of grains.

The pros of the Mediterranean diet include the following:

  • A wide variety of foods to choose from, with no foods that are forbidden or off-limits
  • No counting carbs, points, calories, or macros – focus on fresh, whole foods
  • Proven health benefits from numerous research studies

The expert panel identified two negatives to the Mediterranean diet:

  • Requires meal planning and preparation (no relying on convenience foods)
  • No in-depth nutrition guidance – although many research studies have shown that when you focus on filling your plate with less processed and plenty of plant foods, you’re naturally getting the nutrients your body needs.

Where are the low-carb diets ranked?

Even though low-carb diets such as keto and Atkins are extremely popular, they aren’t top-ranked because they are restrictive, eliminate food groups known to provide health benefits, and are hard to follow. Even though the keto diet is ranked #1 and Atkins #2 for quick weight loss, most people find it impossible to stick with this plan long-term. They ended up ranked #20 and #21 overall.

What is the worst diet?

The Raw Food Diet ranked 1.7 out of 5, coming in last out of the 24 diets reviewed. The Raw Food Diet promotes consuming food that hasn’t been cooked, processed, microwaved, irradiated, genetically engineered, or exposed to pesticides or herbicides. Most of the foods are vegan, but some animal foods, such as raw unpasteurized milk and sashimi, can be included.

The positives to the Raw Food diet are:

  • No counting carbs, points, calories, or macros.
  • It’s high in fiber, so very filling.
  • However, there are more negatives than positives:
  • Eating out can be very limited.
  • Consuming all the nutrients your body needs for good health is challenging.
  • There is little research to back up the claims that cooking destroys most of the vitamins in food and nearly all of the immune-boosting plant nutrients.

Our take on the 2023 diet rankings

There aren’t any surprises here because a solid body of research shows that eating more plant-based foods and choosing less processed foods promotes good health. Plus, this way of eating can be easily adapted to include favorite cultural and regional foods and offers a lot of flexibility in meal planning. The U.S. News and World Report is a fantastic resource with in-depth explanations of each diet, health benefits, potential health risks, cost, how to adapt the diet to your budget, sample menus, and shopping lists.

References

Author:  Lynn Grieger, RDN, CDCES, CPT, CHWC

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Activity Idea: Making MyPlate Plates

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MyPlate is an excellent tool to encourage balanced eating.

For visual learners, having an image of MyPlate is a great starting point on the road to healthful eating habits. You can take this image even farther in an interactive project. Not only will this project help cement the basics of MyPlate in the minds of your visual learners, but it will also draw in your kinetic learners as well. Almost everyone can benefit from learning by doing!

So, what’s the project? Making a physical MyPlate plate.

There are a bunch of ways to approach this, but I want to point you toward a few of my favorite styles…

Color a Paper PlateApproach #1: Color a Paper Plate

This one is pretty self-explanatory. Display an image of MyPlate and walk your clients through the basics of how and why the plate is divided. After that, you can distribute paper plates to each of your participants and let them create their own MyPlate plates with crayons or markers. They can draw their designs right on the plate!

Be sure to choose crayons or markers that are safe for kids — these won’t have harmful chemicals that could be dangerous to ingest. Not that a lot of anything would transfer from the plate to the food placed on it, but it’s best to play it safe.

If you’re distributing food as part of the activity, have people use their plates to portion out what they eat. They may want to make several MyPlate plates so that they can use the guide a few times. After all, paper plates don’t last past one meal.

Materials needed: A MyPlate image example, paper plates, and markers or crayons

Use the Plates Again and AgainApproach #2: Create Melamine Plates

To help your clients make MyPlate plates that they can use again and again, create melamine plates. These plates are embedded with the images that people draw, and they’re reusable. In fact, they can be treated just like regular plates — without fear of flaking, fading, or general destruction.

To create these plates, you’ll need a Make-A-Plate Kit with specialized markers. Hand out the plate papers from the kit to your clients after your discussion of MyPlate, and then let them use the markers to create their own MyPlate images.

This is a relatively inexpensive project that produces long-lasting results.

There is one thing to be aware of, however, and that is production delays. It often takes 2-3 weeks to return the MyPlate drawings as physical plates, so be sure to plan for this holdup.

Materials needed: A MyPlate image example, melamine plate kits, melamine plate markers, materials for shipping the plates

Approach #3: Paint Pottery Plates

For more immediate results and a long-lasting plate, there’s always painting pottery. Yes, this is a generally more expensive and involved approach than the other two, but it also often produces beautiful results. You can turn the project into a festive outing or party, and it makes a great end-of-session finale.

Hanging a MyPlate poster or enlarged drawing in the studio can help inspire your participants as they work. It also offers a great example to guide their painting.

Materials needed: MyPlate image example, a pottery studio, potted plates, paints and brushes

Try Word ArtDetails: Creating the Plates

Now that we’ve discussed a few general ways for your clients to make their own MyPlate plates, let’s get into the specifics of plate creation.

Make sure that there is an image of MyPlate available for your participants to look at as they create their plates. After all, the goal is to have an accurate guide to balanced eating available for their reference. A MyPlate with the wrong proportions on it is not helpful.

Now, when it comes to drawing the plate within the guidelines set forth by the USDA, there is plenty of room for innovation.

Yes, clients could copy the MyPlate image exactly “as is” from the USDA website, but they could also innovate when it comes to decorating the plates. For example, some participants could use pictures to highlight what goes in each section, drawing images of their favorite foods from each food group. Or each section of MyPlate could become a word cloud (as pictured here). This word cloud can also feature the foods that fit into each food group.

The possibilities are endless!

Examples, Giveaways, Prizes, Shortcuts, or Take-Home Ideas for Clients

Of course, if you’re looking for examples, giveaways, prizes, shortcuts, or take-home ideas for clients, then you need look no further than the Nutrition Education Store. At the store, you can purchase…

These are wonderful examples that people can pass around while they create their own MyPlate plates. The plates also make perfect prizes for giveaways and can be distributed as take-home ideas for clients. Plus, if you don’t have the time, budget, or resources to have participants make their own plates, these plates offer a fantastic shortcut.

So. There you have it. A bunch of ideas for a great MyPlate project. Enjoy!

By Judy Doherty, PC II and Founder of Food and Health Communications, Inc

There’s always more in the store. Check out these fantastic MyPlate resources!

MyPlate Poster

MyPlate Wristbands

MyPlate PowerPoint Presentation

MyPlate Handout for Kids

MyPlate Apron

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Nutrition Presentation Introduction Ideas

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We just heard a great new idea for nutrition presentation introductions! Diana Dyer, MS, RD, has developed a wonderful way to frame the idea of dieting. Check out the story, written in her own words…

The root of dietWhen I was on the speaking circuit, I always included a slide early in my talk that pre-empted — i.e. reframed — the word “diet” by showing people the root of the word. The root gives a much wider understanding of the original intent of the word, which is “a day’s journey.”

The way the word “diet” is used in our society today simply means disordered eating.

By contrast, the food I eat is one part of that day’s journey toward health, the ultimate goal. I learned to get that concept in early to give my audience time to reflect and then see the full day’s journey (as I talked about much more than food) and also to head off the very first question I used to get which was always “do you ever cheat on your diet?”

I then learned to talk about how the word “cheat” is not in my vocabulary and not on my radar screen. That’s because I choose to eat with intention, intentionally (i.e. thinking about) feeding either body or soul toward health.

Once that’s established, it’s all about portion size. After all, life without Thin Mints is not worth living. However, with my goal being overall health, I knew I could eat them (feeding my soul) but I also knew that I no longer needed to eat the entire box. Savoring 1 or 2 was plenty. Then I felt fine pitching the rest into my compost pile!

By Diana Dyer, MS, RD
Author: A Dietitian’s Cancer Story – www.dianadyer.com
The Dyer Family Organic Farm – www.dyerfamilyorganicfarm.com

Salad Bar Tabletop Sign

MyPlate Handout Tearpad

Change It Up Poster

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Motivation Tip: Use a Reward Chart

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Reward Chart Poster

One of the most popular tools in my nutrition educator’s bag of tricks is a good reward chart. It helps with motivation, makes it easier to celebrate important milestones, and adds a sense of fun to a new endeavor.

That’s why I created the Reward Chart poster. I wanted a resource that would help people focus on important health goals, and it has been flying off the shelves since its introduction to the store.

Today, because I love ya, I’m giving away the handout that comes with this poster, for free.

Yes, you read that right!

In order to further boost motivation, the Reward Chart poster comes with a simple handout about selecting rewards and the evaluating the impact of healthful choices. I’ve copied that information below and slipped in a free downloadable PDF of the handout too…

Choosing Rewards:

When it comes to choosing rewards for your achievements, it’s important to choose options that will encourage your efforts. Skip food or drink rewards. Instead, try one of these options…

  • High FiveHand weights
  • Resistance bands
  • Yoga mat
  • Swim goggles
  • Running shoes
  • Movie passes
  • New cooking equipment
  • Sharp knife
  • Colorful cutting board
  • Nonstick skillets
  • Fresh herbs
  • New spices
  • New workout clothes
  • iPod or other digital music device
  • A deposit in a savings account for a vacation
  • A trip to a museum or art exhibit

The Benefits of Your Decision:

There are tons of benefits to good health.

A balanced diet and exercise plan will reduce your risk of…

  • Family JogDiabetes
  • Heart disease
  • Stroke
  • Certain cancers
  • Metabolic syndrome
  • Obesity

At the same time, making healthful diet and exercise choices will provide the following benefits…

  • Increased stamina
  • Better sleep
  • Improved mood
  • Increased flexibility
  • Stronger bones
  • Higher energy levels

Congratulations on starting down the road to good health.

You can do it!

And, as promised, here is the PDF handout that’s (usually) only available to people who already bought the Reward Chart poster. I hope you like it!

Reward Chart Handout

Last but not least, we have some other great resources in the Nutrition Education Store — they’re sure to give your clients a motivation boost!

Save Calories with 7 Simple Steps Poster

Reward Chart Sheet

Poster: How Much to Work it Off?

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Sneak Peek: Weight Management PowerPoint Show

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It’s time for an exclusive look at of the most popular new presentations in the Nutrition Education Store. The Just Lose 10% PowerPoint presentation covers ways to live a healthful lifestyle while successfully managing your weight. Emphasizing the latest health and nutrition research, this life-changing presentation has been a hit for many dietitians and other health educators.

Today this blog will feature 2 of the sections in this show, just for you, for free. The full rundown includes…

  • Assess Your Weight
  • Set Your Goal
  • Benefits of 10% Loss
  • Weight Control 101

This post features the Set Your Goal and Benefits of 10% Loss sections. Are you ready for this?

Why Choose 10%

Speaker’s Notes: Okay, first things first. Why choose 10%? Why is this the goal of the show? Well, the answer is twofold. One, if you’re overweight or obese, losing only 5-7% of your current body weight can prevent or delay the onset of type 2 diabetes. And two, losing 10% of your body weight can decrease your heart disease risk. Both of these are key for a long and healthy life. Improve your health with a little weight management!

The First Attainable Goal

Speaker’s Notes: Another reason to set “lose 10% of your body weight” as a weight management goal is that successful weight loss requires a sustained effort over time. Quick fixes are often hard to keep up and make it easy to backslide into less healthful habits. That’s why setting a goal is so important – it gives you something to strive for. And losing 10% of your body weight is attainable and will make a significant difference to your health.

Benefits of Weight Management

Speaker’s Notes: Let’s take a closer look at the benefits of managing your weight well.

What's In It for You?

Speaker’s Notes: So, what’s in it for you? Why is it so important to reduce your weight if you’re overweight or obese? The short answer is that it’s key for your health. When you get your weight into a healthy zone, you reduce your risk of heart diseases like hypertension or even a heart attack. You also reduce your risk of stroke, certain cancers, and type 2 diabetes. This in turn means that you are more likely to live longer, while being less likely to have to take medications to combat these chronic conditions. Getting to skip those medications further improves your quality of life.

Even More Health Benefits

Speaker’s Notes: These are all benefits that accompany a healthful lifestyle and gradual weight loss. When you adopt a healthful lifestyle in your quest to manage your weight, you are more likely to sleep better, have more stamina, have more energy, improve your flexibility, and find it easier to do the things you love.

Do you like what you see? There’s a lot more in the show — over 35 slides of the latest research about weight management, health, and wellness. Check out the full presentation!

And here’s a PDF copy of the slides we featured today…

Just Lose 10%

 

Remember, we’re here to help you look your very best, right now. Don’t miss these other great weight management resources…

12 Lessons of Wellness and Weight Loss

Weight Control Poster Value Set

PowerPoint: Exercise to Lose and Control Weight

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Avocados: Yea or Nay?

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“They’re high in calories.”
“They’re high in fat.”
“But it’s a good fat.”

Those are all statements I frequently hear about the avocado.

What about you? Do you shy away from avocados because of the fat or calories? Or do you make them a part of your diet?

Today, let’s take a look at the pros and cons of the humble avocado.

Pile of Goodness

An avocado is nutrient dense. Nutrient-dense foods provide substantial servings of vitamins, minerals, and other nutrients in proportion to the number of calories they contain. Although avocados are high in fat, most of that fat is heart-healthy monounsaturated fat.

According to the Centers for Disease Control and Prevention, avocados are loaded with dietary fiber, vitamin B6, vitamin C, vitamin E, vitamin K, magnesium, and folate. They’re also cholesterol- and sodium-free. One avocado contains about 700 milligrams of potassium. In fact, avocados have more potassium gram for gram than bananas! Furthermore, avocados are loaded with the phytochemicals that are thought to reduce the risk of some types of cancers and other chronic diseases.

So what about the calories?

The calories in an avocado are not messing around. Two tablespoons of mashed avocado (that’s 1/5 of the whole thing or about 1 oz) provide about 55 calories. So, if you eat a whole avocado, then you’re getting about 275 calories. That’s a lot of calories, especially if you’re on a calorie-restricted diet.

However, the key word is moderation.

A little avocado can add some real nutrition and variety to a meal. Plus, sometimes avocado can offer a nutrient-rich alternative to another less-healthful fat. Try slicing and spreading 2 tablespoons of avocado on your sandwich instead of mayo or butter. This will save you almost 40 calories! Yes, you get the fat, but it’s definitely a better-for-you fat than those other spreads. And you really can’t beat the flavor it adds.

Avocados for Everyone!

When buying avocados, pick fruits that have firm skins, but which yield to gentle pressure and have no soft spots. These are the kind of fruits that will ripen after they’re picked. Put unripe avocados in a paper bag at room temperature and they will ripen in the next 2-5 days. If you want them to ripen more quickly, add a ripe banana or apple to the bag. Why? These fruits give off a natural ethylene gas that helps to ripen the avocados. Once they’re ripe, use them right away. You can also put them in the refrigerator, where they will last for a couple days.

So, when you ask whether you should make avocados a part of your diet, I say yea!

By Cheryle Jones Syracuse, MS, Professor Emeritus at The Ohio State University

Looking for more cooking and nutrition resources? Look no further! We’ve got you covered! We are here when you want to look your very best right now.

Drinks, Portion, Whole Grains, Fruit and Vegetables, and Nutrient Alphabet

Nutrition Poster Set

MyPlate Wristband

Real Food Grows Banner

You made it all the way to the end! For your persistence, please enjoy a brand-new free handout! It’s the perfect guide to avocados.

Avocado Handout

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Weight Control Marketing Terms that Raise Red Flags

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WhichFoodsAreHealthful“Fast, easy weight loss without exercise!”

“Lose weight while you sleep.”

“Enjoy your favorite foods and lose weight. Effortlessly.”

These claims have to be true because I : (a) read it in my local newspaper, (b) saw it online, (c) heard it on my favorite radio station.

Right?

Wrong!

We know better, but wouldn’t it be great if there really was a product that produced these types of results?

The Federal Trade Commission (FTC), the nation’s consumer protection agency, published “Gut Check: A Reference Guide for Media on Spotting False Weight-Loss Claims” in January 2014. This guide lists seven weight loss claims that experts agree are false and misleading, and which should prompt a “gut check.”

What’s a gut check? It’s a second look to make sure that publishers are not running advertisements with claims that are known to be false.

The FTC uses these guidelines to enlist the help of media professionals, asking them to prevent false claims from ever appearing. Even though the truth in advertising laws prohibit false or misleading advertising claims, obviously these claims still exist. Under the law, advertisers have two choices:  either the results in the ad must be typical of what other consumers can expect to achieve or the ad must clearly and conspicuously disclose the typical results.

The FTC created a teaser website http://www.wemarket4u.net/fatfoe/index.html that promotes FatFoe™, a revolutionary (and fake) product that produces amazing weight loss results. They built this website to demonstrate false advertising claims to consumers. Click on the ‘order now’ button and you are transferred to a site that explains how you’ve been duped and how to spot false weight loss claims.

So. How can you best put this information to use for your clients? Have them use the seven gut-check claims and examples of the fictitious yet all-too-believable FatFoe™ advertisements to avoid falling prey to wild and unrealistic claims. Here are a few examples — the more familiar your clients are with these compelling (yet false!) claims, the less likely they are to be duped by a sneaky product…

Don'tBeFooledClaim #1: Causes weight loss of two pounds or more a week for a month or more without dieting or exercise.

Many consumers believe that rapid weight loss is the norm, and are unhappy with losing the 1-2 pounds per week that experts believe is both safe and sustainable.

“Finally there’s FatFoe™, an all-natural weight loss compound so powerful, so effective, so relentless in its awesome attack on bulging fatty deposits that it eliminates the need to diet.” (Note the consumer endorsement: “I lost 36 pounds in 5 short weeks”).

Remember, don’t be fooled.

Claim #2: Causes substantial weight loss no matter what or how much the consumer eats.

Changing food choices and eating habits, especially eating smaller portions, is one of the keys to lasting weight loss. Unfortunately, it’s also a behavior change that many people find extremely difficult.

Watch out for claims like, “This revolutionary product lets you enjoy all your favorites – hamburgers, fries, pasta, sausage, and even gooey desserts – and still lose weight. One FatFoe™ tablet before meals does the work for you and you’ll lose all the weight you want.”

Claim #3: Causes permanent weight loss even after the consumer stops using the product.

Maintaining weight loss requires continuing the same behavior changes in food choices and physical activity that produced the initial weight loss.

How does this false claim get used? “Thousands of people have used FatFoe™ and kept the weight off for good” is just one example.

GetInBalanceClaim #4: Blocks the absorption of fat or calories to enable consumers to lose substantial weight.

Even legitimate medications that block fat absorption need to be used within an overall lower-calorie, healthful diet.

“The safe, all-natural active ingredient in FatFoe™, auberginium, binds with food to block the absorption of fat, carbs, AND calories. Lose up to 10 pounds per week – with no sweat, no starvation!”

Don’t fall for it!

Claim #5: Safely enables consumers to lose more than three pounds per week for more than four weeks.

Losing weight rapidly over a longer period of time can lead to gallstones and possibly other health complications. Weight loss should be closely managed by a physician.

So, when you see something like “Even if you have 40, 50, 60 or more pounds to lose, doctors recommend Fat Foe™ as the no-risk way to blast off the weight and inches in a few short months. Just in time for bikini season or that class reunion,” then you know to run for the hills.

Claim #6: Causes substantial weight loss for all users.

Individual rates of weight loss are all different, and there is no one established method that leads to weight loss for every person.

“FatFoe™ is guaranteed to work for you. Melt away the pounds regardless of your body type or size.”

Claim #7: Causes substantial weight loss by wearing a product on the body or rubbing it into the skin.

There is no research that shows any product worn on the skin or applied externally leads to weight loss.

Throw that “Bonus offer! Order now and get a free 60-day trial of FatFoe™ UltraThin Gel. Target the stubborn fat on your hips and thighs with this proven flab fighter.” into the trash!

So. There you have it. The 7 gut-check claims and some examples of how sneakily they can be used. Help your clients steer clear of this nonsense by sharing this post or sending them a copy of this free weight control handout.

Gut Check Handout

By Lynn Grieger RDN, CDE, CPT, CWC

References:

  1. Federal Trade Commission, Bureau of Consumer Protection. Gut Check: A Reference Guide for Media on Spotting False Weight-Loss Claims. http://www.business.ftc.gov/documents/0492-gut-check-reference-guide-media-spotting-false-weight-loss-claims#claims January 2014. Accessed 9-8-2014.
  2. Federal Trade Commission. With FatFoe™ Eggplant Extract You Can Kiss Your Dieting Days Good-bye. http://www.wemarket4u.net/fatfoe/index.html Accessed 9-8-2014

You guessed it! There’s more in the store! Check out these healthful weight management resources…

Weight Control Poster Set

Weight Management Brochure Set

12 Lessons of Wellness and Weight Loss Program

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Heart Attack Prevention: Are Statins or Eating Habits More Important?

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Medication or Diet?If elevated low density lipoprotein cholesterol (LDL-C) levels were the only source of cholesterol deposited in the artery wall, then high doses of potent statins should be reversing (rather than reducing) the build-up of atherosclerotic plaques, largely eliminating deaths from coronary heart disease (CAD). Sadly, the number one cause of death in Americans taking statins to lower their elevated LDL-C to prevent heart attacks is still heart attacks?

Yes, statin drugs are very effective for reducing high LDL-C levels, and they do slow the progression of cholesterol-filled plaques. However, they rarely reverse the build-up of cholesterol in the artery wall. More importantly, statin drugs alone do not come close to eliminating the risk of heart attacks and most strokes despite impressive reductions in LDL-C levels. Research now shows that other lipoproteins besides LDL particles can and do carry cholesterol from the blood into the artery wall, promoting the growth of cholesterol-filled plaques and CAD. These lipoproteins are neither LDL-C or high density lipoprotein cholesterol (HDL-C), but rather consist of the cholesterol-rich remnants of triglyceride-rich lipoproteins produced by the liver (VLDL) and the small intestine (chylomicrons)(1). Both genetic factors and dietary factors influence the amount of these triglyceride-rich lipoproteins produced and also the amount of cholesterol-rich remnant particles derived from each of them in the blood. Fat and cholesterol-rich meals can dramatically increase the production of chylomicrons and lead to greater amounts of cholesterol-rich chlyomicron remnants in the blood for several hours after each fat-rich meal (2).

Dr. Borge Nordestgaard’s recent study followed nearly 12,000 people with established CAD in Denmark and found that each 1 mmol (38.7 mg/dl) increase in non-fasting remnant cholesterol caused 2.8 times greater risk of a CAD event that was independent of HDL-C levels. The increased causal risk of CAD from elevated cholesterol remnant particles appeared much stronger than for changes in either LDL-C or HDL-C levels (3). Most doctors (MDs) now check only fasting blood lipids and focus largely on LDL-C and HDL-C to assess their patient’s future CAD risk. This was based on the simplistic notion that it was only the LDL-C particles delivering cholesterol to the artery wall, making it the “bad” cholesterol, while the HDL-C particles were removing the cholesterol from the artery wall and bringing it back to the liver, making their cholesterol content “good”. Of course, we now know HDL-C particles can actually become proinflammatory and proatherogenic “bad” HDL particles, perhaps partly in response to biochemical changes in the HDL particles triggered in part by chylomicrons and other remnant cholesterol particles in the blood.

Chylomicrons and their cholesterol-rich remnants remain in the blood for several hours after each fat-rich meal and likely play a major role in promoting inflammation (by increasing IL-6 & CRP), thrombosis (by activating clotting factor VII), and atherosclerosis (by delivering more cholesterol-rich remnant particles to the artery wall). The fact that damage to the endothelium (inside “skin” of the artery wall) as evidenced by reduced flow mediated dilation (FMD) occurs to a much greater extent after a single fat-rich meal than after a meal high in carbohydrate points to the fact that pathological changes must be occurring in the artery wall in response to fat and cholesterol-rich particles coming from the intestines (4). Indeed, this reduced FMD is likely the main reason why many people with angina tend to experience far more chest pain after a large, fat-rich meal than they do after a meal high in carbohydrate-rich plant foods. The only legitimate debate is not whether LDL-C or other cholesterol-rich remnant particles promote atherosclerosis and increase the risk of CAD, but rather which is more atherogenic. Clearly both LDL-C and other remnant lipoprotein particles deliver cholesterol to the artery wall and promote foam cell formation and atherosclerosis. Unlike LDL-C particles (which must first be oxidized), remnant cholesterol particles are readily taken up by scavenger receptors of macrophages in the cell wall to form foam cells (5,6). Increasing evidence suggests that damage to the artery wall from cholesterol-rich remnant particles appears to be at least as important as either fasting LDL-C or HDL-C levels for predicting future CAD events.

It should be noted that diets high in refined carbohydrates (particularly large amounts of refined sugars) combined with inactivity can contribute to a marked increase in the liver’s production of VLDL particles because the liver converts some of the excess carbohydrate (especially fructose) into triglyceride. This leads to more triglyceride-rich VLDL particles being released into the blood, which then degrade into cholesterol-rich remnant particles and eventually also LDL particles. This is particularly true in people who are genetically prone to develop insulin resistance and type 2 diabetes and who experience significant increases in fasting triglyceride levels as visceral fat stores accumulate.

Bottom Line: Reducing LDL-C levels with statin drugs alone is insufficient for stopping and reversing CAD and preventing most heart attacks and strokes. A diet low in fat, salt, cholesterol, and refined carbohydrates coupled with increased activity and loss of excess weight may also be necessary to stop and reverse CAD in part by reducing remnant cholesterol levels in the blood.

By James J. Kenney, PhD, FACN

Sources:

  1. Mark Nordestgradd BG, Freiberg JJ. Clinical relevance of nonfasting and postprandial hypertriglyceride and remnant cholesterol. Curr Vasc Pharm. 2011;9:281-6
  2. Mark Cesar TB, et al. High cholesterol intake modifies chylomicron metabolism in normolipidemic young men. J Nutr 2006;136:971-6
  3. Mark Varbo A, et al. Remnant cholesterol as a causal risk factor for ischemic heart disease. J Am Col Cardiol. 2013;61:427-36
  4. Mark Tomaino RM, Decker EA. High-fat meals and endothelial function. Nutr Rev. 1998;56:182-5
  5. Mark Zilversmit DB. A proposal linking atherogenesis to the interaction of endothelial lipoprotein and triglyceride-rich lipoproteins. Circ Res.1973;33:633-8
  6. Mark Nakajima K, Nakano T, Tnaka A. The oxidative modification hypotheis of atherosclerosis: the comparison of atherogenic effects of oxidized LDL and remnant lipoproteins in plasma. Clin Chim Acta. 2006;367:534-42

Looking for fun ways to improve your clients’ understanding of cholesterol and its health risks? Check out this free handout: Cholesterol Puzzle.

Cholesterol Puzzle Handout

And, as you well know, there are tons of other heart health education materials available in the Nutrition Education Store. Pay special attention to the posters, which have been flying off the shelves lately!

LDL Cholesterol Poster

Premium Heart Health Education Kit

Heart Health Brochure: Lower Your Heart Attack Risk

Blood Pressure Poster

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Diet and Exercise: How Does It Work?

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Balancing ActIf I exercise every day, does that mean I can eat whatever I want?

Short Answer: No. Food choices and physical activity are both necessary for promoting overall good health.

Long Answer: The 2010 Dietary Guidelines for Americans report begins with, “Eating and physical activity patterns that are focused on consuming fewer calories, making informed food choices, and being physically active can help people attain and maintain a healthy weight, reduce their risk of chronic disease, and promote overall health.” According to the National Weight Control Registry, people who successfully lost weight and then maintained that new weight for at least 5 years reported that they did 60 minutes of moderate intensity physical activity per day. Additional healthful habits included eating a low-calorie, low-fat diet, eating breakfast, weighing themselves regularly, and maintaining a consistent eating pattern across weekdays and weekends. A combination of daily physical activity and healthful eating can lead to long-term weight management success.

Why bother with maintaining a healthful diet and being physically active?

The scientifically-supported data indicates that if you do these things, you will have a lower risk of…

  • Early death
  • Coronary heart disease
  • Stroke
  • High blood pressure
  • Type 2 diabetes
  • Certain cancers
  • Depression

Key Message: Some physical activity is better than no physical activity. Accumulate a minimum of 20 minutes of moderately intense exercise every day for overall good health.

By Lynn Grieger RDN, CDE, CPT, CWC

Sources:

  1. Dietary Guidelines for Americans, 2010. http://www.health.gov/dietaryguidelines/2010.asp Accessed 4-22-14.
  2. Long-term weight loss maintenance. Rena R Wing and Suzanne Phelan. Am J Clin Nutr July 2005 vol. 82 no. 1 222S-225S.
  3. Physical Activity Guidelines. US Department of Health and Human Services. http://www.health.gov/PAGuidelines/guidelines/ Accessed 4-22-14.

This post is excerpted from the Communicating Food for Health Newsletter. For more details or to read the unabridged post, sign up for a membership today!

Communicating Food for Health Member Newsletter

But wait, there’s more! Check out these amazing new arrivals…

2015 Food and Health Calendar Poster

Healthier Choices 1-2-3 Banner and Stand

Exercise to Lose and Control Weight Poster

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The Mediterranean Diet: 7 Things I Learned

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Have you tried Mediterranean food?

HummusI have always loved meals from the Mediterranean region. One of my favorite restaurants in Miami served the most exquisite baba ganoush, hummus, falafel, and fattoush dishes that I have ever eaten. Once I tried them, I couldn’t get enough.

Because I loved Mediterranean food so much, I sought out ways to learn more about it. I made major strides in my study of and recipe development for the Mediterranean area in 2005. That was after I took a class at the Culinary Institute of America as part of my continuing education and ProChef II exam preparation.

The class was a 5-day intensive course on Mediterranean cuisine with Certified Master Chef Ken Arnone, CMC. Chef Arnone has spent a great deal of time in the Mediterranean and is one of the most passionate and detail-oriented chefs I have ever known. The 5-day course covered key foods from Provence, Sicily, Morocco, Tunisia, Spain, Greece, and Turkey. In that class, I worked with a group of chefs from all over the country. We spent hours learning about the history, ingredients, and cuisine of a particular Mediterranean region every day. After that, we would cook the food as a class and end the day with a huge feast.

MediterraneanVegetablesThat may sound like a walk in the park, but the course was intense. Every day, we worked in teams to prepare a staggering number of dishes. Each one required extraordinary levels of mis en place. It was certainly a restaurant-style experience that involved sharing stoves, grills, and prep table space while working on a tight timeline. You see, Chef Arnone wanted all the food served at 6 pm sharp.

Now, once all the work was done, it was tons of fun to sit down and eat everything family-style in a large group. I remembered grabbing small portions of everything and making copious notes about what I liked in each dish.

If anything, that class increased my fascination with cooking foods from the Mediterranean region. When I got home, I bought tons of Mediterranean cookbooks. Then I read, studied, experimented, and read some more, cooking an endless parade of new dishes in my kitchen. After all, my ProChef II exam was just around the corner, and since the test was going to be a mystery basket with a 3-hour time limit and a specific serving time that needed to be hit precisely, I wanted to have as much practice as I could get.

MediterraneanFruitsFor the exam, I would draw a card out of a stack. That card would contain the name of a country, a type of protein, and a cooking method. I then would have to prepare a dish that matched the criteria on the card, which meant that I really had to study all of the countries and their cuisine, being able to make a dish from scratch in the time allotted — all with a master chef and other judges observing my process and technique.

The exam day arrived, and so did the moment of truth. I drew a card. Greece, lamb, and grilling.

What a wonderful Mediterranean surprise! I won’t keep you in suspense — the final dish was a smashing success. My score was one of the highest in the class and my examining chef told me that my dish made him think that he was in a café in Greece!

Okay, that’s enough about my time with the ProChef II exam (though if you’d like to read more, it’s all in the post, CIA ProChef 2 Story).

Let’s get back to the Mediterranean.

MediterraneanDishIn 2014, I was approached by a book publisher who wanted me to write a Mediterranean cookbook. Unfortunately, the deadline was tight and the budget was scarce, so I had to turn it down. After that conversation, I started thinking about how I would outline my own book and what I would want to teach in order to help people learn about this wonderful region and its ingredients. I knew that I didn’t want to make just another cooking tour or gourmet encyclopedia. People are busy, so I wanted to make sure that I told them about the health benefits, ingredients, and popular dishes — all the keys, none of the wasted time.

Around this time, I started teaching an advanced pastry course at Johnson and Wales University. During that course, I learned that photos of beautiful dishes motivate students to create their own masterpieces. I knew that I would want to carry that information into my Mediterranean project too.

From there, I started planning a multimedia class for the clients of Food and Health Communications, Inc. and the Nutrition Education Store. My plan was set into motion when our client, Michelle Ernanga, MS, RD, sent in a request for a Mediterranean Diet PowerPoint. I decided that this PowerPoint was a great place to start my larger project, because it is a lot more visual and interactive than a book. The infographics, research summaries, photos, and video make it very easy to learn all anyone would need to know about the health benefits, key ingredients, featured countries, and easy recipes of the Mediterranean.

Mediterranean HerbsThe point of the new Mediterranean Diet Class PowerPoint and Handout Set was to present the research, show the ingredients, and provide a look at a few popular dishes, along with exploring everyday substitutions that people could make in order to shift to a healthful plant-based diet.

Thus the Mediterranean PowerPoint was born.

I would like to thank Lynn Greiger, RD, LD, for her tireless research on the health benefits of the Mediterranean diet, and Victoria Shanta Retelny, RD, for her contributions about the flavors and health benefits of this diet as well. I would also like to thank my editor, Stephanie Ronco, who was flexible, organized, and very detail-oriented. And of course I would like to give a shout-out to my son, Nicholas, who was very good at tasting and critiquing the finished dishes. Mostly, he clamored for more!

Creating this nutrition PowerPoint was an intense and wonderful experience, and I certainly learned a lot. Here’s my list of the 7 most important lessons that I took away from this project.

Mediterranean Spices1. The ingredients overlap. The ingredient lists for many dishes from a variety of Mediterranean regions actually overlap! Yes, the dishes are different, but many of the base ingredients are the same. The whole point to cooking in a Mediterranean style is to use all of the delicious, highly-flavored and beautifully-colored fruits, vegetables, nuts, and beans that are so prevalent in all cuisines in the Mediterranean region.

2. Mediterranean dishes are based on vegetables. Vegetables are the key, which makes this is a whole new world of cooking. I hadn’t realized how much I had painted myself into a corner by relying solely on old favorites until I started creating hundreds of delicious vegetable dishes and salads based on Mediterranean ingredients.

3. Sardines are delicious. No, really! I had read about them before, but I never really ate them until I created the Sicilian fennel, olive, and sardine salad. Sardines aren’t that high in sodium, they’re inexpensive, and they keep for a long time (in their cans). Plus, sardines are not on the big list of fish that can contain a lot of mercury, and yet they are a good source of omega-3 fatty acids. Of course, they also add a lot of flavor. You don’t need that many sardines in order to add rich flavor to many dishes. I had never added them to a salad or veggie dish before, but now I really like using them.

LetsGrill4. Grilling is prevalent but easy. You can create a whole dinner on a grill. Grilling is popular in the Mediterranean, and it has been popular for a long time. This has a lot to do with the history of the area, where fresh water is often sparse. Many dishes are made over a small wood fire, and many of the protein and vegetable components are grilled.

5. Tagines are awesome. A tagine is a Moroccan stew pot with a funny lid that’s conically-shaped. I originally bought one for learning about Moroccan stews. The thing I love the most about a tagine is that you can cook with a tiny amount of water and the meat and vegetables will cook very well. The stew can also cook on very low heat without burning.

6. Olive oils come in many flavors. I have since started shopping in olive oil boutiques and I am amazed at the variety of flavors. Some are bitter, some are smooth, some are grassy, some are acidic. And there are a million variations on a ton of flavor combinations. It’s always fun to come home with a new olive oil!

MediterraneanGrains7. There are so many new grains to try. Where to start? Bulgur and couscous cook so quickly. And I love working with Valencia rice for paella. Risotto is also very delicious. Farro is a new-to-me grain with a crunchy, nutty flavor and texture. And pasta is always fun — I love to buy new shapes. The best part is that cooking grains Mediterranean-style is fast and easy. People will gather around the stove to watch you make paella and they will remember it for a long time.

Of course, the show is full of great lessons in health, easy cooking, and nutrition. You can get a sneak preview today — all 100+ slides are featured in the flash version, so take a look and let me know what you think!

I’ve also added tons of new recipes to the Mediterranean recipe database, which is totally free and always available.

Mediterranean cuisine is constantly growing and changing. The region is home to the Modernist Cuisine movement, which was started by Barcelonan Chef Ferran Adria, who founded elBulli in the 1980s. Although he closed the restaurant in 2011, Chef Adria is starting a foundation to record, preserve, and create new cooking methods and presentations.

How will you try Mediterranean meals?

By Chef Doherty, PC II

Get the Mediterranean PowerPoint and Handout Set today! And there are lots of other nutrition education resources in the Nutrition Education Store!

Mediterranean Diet Class with PowerPoint, Handouts, and Leader Guide

Kids Activity with MyPlate Bookmark

Freedom from Chronic Disease Poster

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