Could Your Eating Speed be Connected to Your Weight?

It has been suggested that the faster we eat, the more likely we are to eat more. One study included 70 participants in which half were obese and the other half were within suggested normal weight ranges. Both groups underwent 2 scenarios:
-Participants were encouraged to take small bites of their lunch meal, chew slowly, and put their spoon down between bites 
-Participants were encouraged to eat lunch under a time constraint and were told that they needed to take large bites and chew quickly

Results showed that normal weight participants ate fewer calories when eating slowly while obese participants' caloric intake did not differ based on eating speed. Researchers found that both groups drank more water when eating slowly and participants reported feeling full for longer after eating slowly. Interestingly, it was also found that participants in the obese group ate fewer calories that those in the normal weight range (possibly due to feeling self-conscious).

Another study investigated 529 male workers in Japan in 2000 and 2008. Data such as alcohol consumption, self-reported speed of eating, weight, and height were collected in both years and compared. Results showed that fast-eating participants had greater average weight gain of 1.9kg than slow/medium speed eating participants who gained an average of 0.7kg. Results were statistically significant for participants in the 20-29 year age group and when  researchers adjusted data to not be biased for age, smoking, drinking, and exercise, a relationship between eating speed and rate of weight gain was still suggested.
Additionally, a New Zealand study of women aged 40-50 years suggested that faster eating was associated with higher body mass index (BMI); a 2.8% increase in BMI was observed for each increasing category of speed of eating.
Furthermore, Dr. Arya Sharma, a leading obesity expert from Edmonton, Alberta suggests that speed of eating at the age of 4 years old could be a predictor for obesity, and that it could also be pre-determined by our genetics.

So, what to make of all this? Studies suggest that there may be a link between speed of eating and weight gain. If you've been struggling with your weight, becoming aware of your eating speed, attempting to slow down with smaller bites, taking sips of water during meals, and putting the fork down after each bite may be techniques that help you prevent over-eating, manage your weight, and allow your body enough time to recognize when it's full. Remember, the successful weight management/ loss game is always about adopting healthy habits that can be easy enough to follow for a life time!


Information Sources:
http://www.sciencedirect.com/science/article/pii/S0195666311001383
http://www.nlm.nih.gov/medlineplus/videos/news/Eat_Speed_123013-1.html
http://www.sciencedirect.com/science/article/pii/S0002822311005840
http://www.slideshare.net/Aryasharma/slow-eating-protects-from-childhood-obesity

What About Stevia?

The use of sugar substitutes is becoming more and more popular these days as low or zero calorie sweeteners can be quite appealing to those attempting to lose weight, manage their blood glucose or minimize dental carries.
Stevia comes from the sweet leaves and extract of the plant Stevia rebaudiana. Originating in South America, stevia is sold under brands such as PureVia and Truvia. Purified stevia extract (>95% pure) known as steviol glycoside is 200 times sweeter than sucrose (table sugar) and has been approved by Health Canada as a table top sweetener and food additive in some foods such as cereals, nut spreads, baking mixes, chewing gum, and unstandardized beverages, condiments and candy.
It is important to understand that whole stevia leaves and crude extracts have not yet been approved by Health Canada or the FDA due to incomplete scientific data on the safety of their use; purified stevia/ steviol glycosides/ rebaudioside A are versions that have been approved as safe for use. The U.S Food and Drug Administration has considered rebaudioside A "generally recognized as safe" since 2009.
Now that I've gotten you confused, lets confuse you some more! Although purified extracts have been approved by Health Canada and the FDA, the Center of Science in the Public Interest (CSPI) suggests a need for further research to determine the safety of stevia. The CSPI suggests that guidelines require new food additives to be tested on rats and mice for 2 years. Rebiana (high purity rebaudioside A) had been tested only on rats and not mice, and some studies found rebiana-related substances to cause DNA damage in rats.
Ovcourse, just because high doses of a related substance may cause toxic damage in rats, does not mean that similar affects would be seen in humans. Stevia has been used for years in South America, Central America, and Japan, however, whether or not it is associated with negative side effects in humans remains unclear with some critics.
In the end, choosing conventional sugar or sugar substitutes is always up to you. Extensive use of sugar or sugar substitutes could create a preference for sweeter foods, increase cravings for these foods, and make it more difficult to manage weight and/or diabetes. And don't forget, conventional sources of sugar are still an option if you can manage how much you use and how often you use it!

Information Sources:
http://www.dietitians.ca/Nutrition-Resources-A-Z/Factsheets/Food-Safety/Artificial-Sweeteners.aspx
http://www.hc-sc.gc.ca/fn-an/securit/addit/list/9-sweetener-edulcorant-eng.php
http://www.hc-sc.gc.ca/fn-an/securit/addit/sweeten-edulcor/index-eng.php
http://www.cspinet.org/stevia/
http://www.healthcastle.com/diabetes_stevia.shtml

What is the Deal with Sodium?

The other day I had a really great question from a friend, she asked me "why is salt so bad for you?" I informed her that over the long term, high salt intake can promote our bodies to hold onto a greater amount of fluid. If our bodies are carrying more fluid, this can increase blood pressure, and then this high blood pressure over time can damage blood vessels and lead to heart disease. However, I had a feeling this explanation didn't quench her need for a more detailed explanation, so here we go!
We normally need 1500-2300mg of sodium/day. Foods such as deli meats, canned soups, sauces, cheese, pickles, pizza, and fried foods can have up to or more than 1000mg of sodium per serving~the equivalent of more than half of our sodium needs for the entire day!
The kidneys in our body function to filter our blood, remove toxins, and remove excess fluid. By the process of osmosis and a balance between sodium and potassium, extra water is drawn out of our blood and removed as urine. If we have a long-term diet high in sodium, this can increase the sodium levels in our blood. In response, to keep our sodium in balance our bodies attempt to dilute this high salt, hold on to fluid, and make it more difficult for the kidneys to draw water out of the bloodstream. This extra fluid in the bloodstream can increase blood pressure and can cause extra strain on the vessels of the kidneys. Over time, high blood pressure can permanently damage the kidneys and lead to kidney failure. In later stages of kidney failure, toxins and fluids build up and cannot be removed by the body; this build up can poison the body and external removal through dialysis may be needed.
High blood pressure also strains arteries. In response to the pressure, artery walls can become thicker and  harder which can make the space inside the artery even smaller (picture a garden hose that gets thicker and more rigid over time). High pressured blood flowing through a tight restricted space, can further increase blood pressure. Over time the pressure can cause arteries to burst or become clogged, limiting blood flow and oxygen to the heart, brain, and other parts of the body. This limited blood flow can result in heart attack, dementia, and/or stroke, where parts of our heart and brain die due to the lack of oxygen from blood.
I normally don't go into such physiological detail, and in no way am trying use physiology as a scare tactic, but the easiest thing you can do to protect your kidneys, arteries, heart and brain is to become more aware of your daily salt intake and consider alternative, lower sodium options.

For low sodium food ideas take a peek at the detailed Edmonton Southside PCN Low Sodium Brochure

Information Sources:
http://www.mayoclinic.com/health/sodium/NU00284
http://www.bloodpressureuk.org/microsites/salt/Home/Whysaltisbad/Saltseffects
http://www.cdc.gov/salt/

Astragalus

This post was motivated by a patient who chose to take astragalus supplements instead of receiving steroid-based medication to treat a flare up of their inflammatory bowel disease. Whatever treatment you choose, the choice is yours in the end. But you deserve to have all the information you need to make an educated decision.
Since I hadn't heard much about this supplement, I decided to conduct a bit of research to assess the scientific evidence behind the use of this product.
Astragalus can be found as a supplement from the plant Astragalus membranaceus. It has been used in traditional Chinese medicine for immune system support; In China it has been used for chronic hepatitis, colds, upper respiratory tract infections, cancer therapy, and heart disease. The root of plant is often used in soups, teas, extracts, or capsules.

The National Center for Complementary and Alternative medicine suggests that the evidence to support health claims for this product is lacking. They also state that the supplement is safe for most adults, but certain species that are not usually in supplement, can be toxic. There is a possibility that astragalus may interact with medications that suppress the immune system and may affect blood sugar and blood pressure.

Some studies (not on humans) have found astragalus to inhibit human gastric cancer cell growth in lab. Another study on humans suggested it could have potential in treatment of cancer-related fatigue. While a 2011 study of 90 participants suggested that daily astragalus + perindopril improved heart contraction. However, this study did not include a control group which was not receiving astragalus (to compare results to). In addition, it is not clear if positive results obtained could also be related to the medication perindopril (medication used to manage blood pressure and promote blood to flow more smoothly).

The American Cancer Society suggests that "the ability of astragalus to enhance the immune system and fight diseases, including cancer and heart disease, comes mostly from lab and animal studies."
It is important to understand that it cannot be assumed that effects seen in a test tube in a lab or in animals would be the same as in humans. The Cancer Society concludes that "available scientific evidence does not support claims that astragalus can prevent or cure cancer in humans or decrease the toxic effects of chemotherapy or other cancer treatments." More experiments in humans are needed to determine if there are benefits to the use of astralagus.

If you're still interested in using astragalus, speak with your physician and pharmacist first to ensure its safety. Doses found to be safe by Health Canada can be found on their 2010 Astragalus Monograph.

Information Sources:
http://nccam.nih.gov/health/astragalus
http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/astragalus
http://webprod.hc-sc.gc.ca/nhpid-bdipsn/monoReq.do?id=36&lang=eng
http://www.ncbi.nlm.nih.gov/pubmed/24152941
http://www.ncbi.nlm.nih.gov/pubmed/22309959
http://www.ncbi.nlm.nih.gov/pubmed/21390582
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a602017.html

Pumpkin Spice Latte

As the days get a bit cooler and we get closer and closer to winter, I notice an increase in advertising for the beloved pumpkin spice latte. The latte is available not only at Starbucks now, but at many other cafes such as Second Cup. Today I thought to break things down and let you know what is really in your pumpkin spice latte, and how a few, small, changes could make a big difference!

A grande, 16oz Pumpkin Spice Latte, made with 2% milk and whipped cream contains:

• 380 calories (average person is recommended to have 2000 calories/day)
• 49 grams sugar (more than 12 tsp sugar)
• 220 mg sodium (sodium should be limited to 2300mg/day)
• 50 mg cholesterol (American Heart Association suggests that people with high LDL ("bad" cholesterol) to limit intake to 200mg/day)
• 8 grams saturated fat (recommendations from the American Heart Association are to limit saturated fat to less than 14g/day)
• 14g protein

If we take replace 2% milk with skim milk, remove the whipped cream, and switch to a tall 12oz pumpkin spice latte, the drink contains:

• 200 calories
• 37 grams sugar (more than 9 tsp sugar)
• 170 mg sodium
• 5 mg cholesterol
• 0 grams saturated fat
• 11 grams protein

Approximately 16 grams of the sugar in this 12oz beverage comes from natural lactose in milk while the remainder comes from the pumpkin spice syrup.
Each pump of syrup contains approximately 5 grams of sugar. If you are interested in managing your sugar intake, asking for 1 or 2 less pumps would decrease the sugar content another 5-10 grams.

There are many ways to control what goes into your body. Choosing a smaller beverage size, opting for skim milk, requesting less pumps of syrup, trying a flavorful full leaf tea, having a plain latte with a small amount of honey or adding cinnamon and/or nutmeg for flavor are all steps in direction of making sure your comforting drinks aren't packed with calories, sugar, and fat.
You can even play around with the cafe's websites, searching for nutritional information in order to make more informed choices the next time you're in that cafe!

Nutritional Information for Starbucks beverages and food can be found at:
http://www.starbucks.com/menu/catalog/nutrition?food=all#view_control=nutrition

Nutritional Information for Second Cup Lattes can be found at:
http://www.secondcup.com/best-latte/?nutcat=5

Information Sources:
http://www.mayoclinic.com/health/heart-healthy-diet/NU00196
http://www.starbucks.com/menu/drinks/espresso/pumpkin-spice-latte

Will PGX Solve My Problems?

I don't know how many commercials I've seen for the weight loss product PGX. So today I thought to take a look into what is in PGX and if the product itself has evidence to support its claims of weight loss and feeling full for longer.
PGX or PolyGlycoplex states that it will "change your life." It technically is a viscous fiber (polysaccharide) supplement.

One study including 10 subjects found that small quantities of this supplement before meals can decrease glycemic index of common foods (meaning that it can limit blood sugar spikes).
Another study of 64 subjects involved 32 obese Japanese participants taking 15g of PGX per day for 14 weeks, and another 32 participants taking an placebo. After 14 weeks, the PGX group showed a greater decrease in LDL (bad cholesterol) and waist circumference. However, it is difficult to say that 32 Japanese people could represent the entire population.
Finally, a third study of 35 participants was conducted over 3 days. Women were on a strict 1000calorie/day diet; one group received 5g of PGX at breakfast, lunch, and supper, while another group received a placebo. The PGX group reported decreased appetite, hunger, and desire to eat. However, the study didn't assess what would happen with this strict decrease in calories over a long period of time.

An adverse affect of overloading your body with a high quantity of fiber supplements may be symptoms of bloating, abdominal discomfort, gas, diarrhea, and/or constipation. On the other hand, if you were to use a small quantity of this supplement between meals, or before meals you may be likely to eat less because you feel more full from the fiber.

From a dietitian's perspective, I wouldn't openly recommend this product to my patients due to the lack of enough studies with large amounts of participants. However, if you really want to try PGX, your could double check with a member of your healthcare team and trial small quantities to see how you tolerate it. If you are unsure about the product, my personal recommendation would be utilize high fiber grains, vegetables, and plant sources of protein (beans, peas and legumes) to make you feel full for longer. These foods also provide additional antioxidants, vitamins, and minerals that cannot be found in a pill. If this is combined with exercise, your odds of losing weight and keeping it off go higher.

Remember, a powder, a pill, a magic drug, or a sports drink shouldn't be responsible for changing your life, you are! If you lose weight, it is because of your efforts; so be sure to recognize small, healthy, changes as successes along your path and use your healthcare team of dietitians, doctors, and friends for education and support.

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/22017917
http://www.ncbi.nlm.nih.gov/pubmed/23512917
http://www.theglobeandmail.com/life/health-and-fitness/ask-a-health-expert/will-fibre-capsules-help-me-lose-weight/article4182609/

Vitamin B and Stroke Prevention?

Today I'm going to look into a new review that suggests that taking Vitamin B supplements may reduce risk of stroke. In the review, 14 studies were analyzed including nearly 55,000 participants who were followed for at least 6 months. Participants were separated into 2 groups, one group was given a placebo while the other was given a Vitamin B supplement. Over this time, nearly 2500 strokes occurred and a 7% reduced risk of stroke was seen in participants taking B vitamin supplements. However, no changes were seen in the severity of strokes or in risk of death from stroke in the supplemented group.
In this study it was suggested the folic acid (Vitamin B9) supplements reduced beneficial affects of Vitamin B supplementation while Vitamin B12 supplements had no affect on stroke risk.
On the other hand, a 2007 meta-analysis by Wang et al. suggests that folic acid supplementation over 36 months may help decrease stroke risk.

What to make of this information? A 6 month trial doesn't tell us how long people should take these supplements for, nor does it tell us what the results of long-term supplementation are. In addition, some studies that suggested folic acid reduces stroke risk looked at changes in an amino acid, homocysteine, to predict stroke risk. High homocysteine can indicate risk of heart disease, but reducing its levels is not currently believed to be linked to reducing risk of heart disease or stroke. Therefore, the reliability of studies only looking at changes homocysteine is unclear.

Sometimes I find it easier to go back to basics.
If you can control any of the better known risks of stroke such as smoking, high trans fat/ saturated fat diet, lack of exercise, high blood pressure, obesity and/ or high cholesterol, that may be a good starting point.

And  lets say you do your own research and find that you'd like to have more Vitamin B in your diet, take a look at the list below. Rich food sources of B Vitamins include (but are not limited to):

• Turkey, poultry, tuna, liver, beans, lentils, eggs, fish, shellfish, nuts
• Whole grains, enriched cereals
• Milk, cheese, yogurt

If choosing to take a Vitamin B supplement, be sure to check with your physician, pharmacist, and/or dietitian to find the safest dose for you!

Information Sources:
http://circ.ahajournals.org/content/106/3/388.full
http://www.sciencedirect.com/science/article/pii/S014067360760854X
http://www.nlm.nih.gov/medlineplus/news/fullstory_140788.html
http://www.healthcastle.com/nutrition101_vitaminB6.shtml
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Homocysteine-Folic-Acid-and-Cardiovascular-Disease_UCM_305997_Article.jsp 

What is The Deal with Vitamin Water?

Many of us have considered, or currently choose to drink vitamin water instead of regular water. My own husband has a flat of it in our pantry, so today is the day I give you (and my husband) the scoop on what is in Vitamin water (this has been a long time coming).

Vitamin water falls under the "natural health product" category, therefore, a nutrition facts table is not required. Today I'm looking at Glaceau Vitamin water which states it contains 120 calories/bottle. The fluid and vitamins are not a source of calories, therefore these 120 calories likely come from sugar, suggesting that the 591mL bottle contains approximately 30 grams of sugar. 

30 grams, what does that even mean? One can of regular Coca-cola contains 39g sugar, so we're not far off from the amount of sugar in one can of coke. If quantifying the amount helps, 30g of sugar is 7.5 teaspoons of sugar (4g sugar= 1 teaspoon). Even I found this to be surprising because if you've tasted this Vitamin water, its actually kind of bland!

Now onto the vitamins. The bottle in my hands contains:

• 375 mcg RAE (Vitamin A)
• 5 mg Vitmin B3
• 2.5 mg Pantothenic acid
• 0.5 mg Vitamin B6
• 1.5 mcg Vitamin B12
• 150 mg Vitamin C
• 3.4 mg Vitamin E
• 100 mg Calcium
• 100 mcg Folate

Now lets look at how much of these vitamins and minerals we need in a day.

Health Canada's Daily Recommended Dietary Allowance of these vitamins and minerals for the typical adult age 19-50 is:

• Vitamin A-   700-900 mcg RAE
• Vitamin B3-   14-16 mg
• Panthothenic Acid-   5 mg
• Vitamin B6-   1.3-1.7 mg
• Vitamin B12-   2.4 mcg
• Vitamin C-   75-90 mg
• Vitamin E-   15 mg
• Calcium-   1000 mg
• Folate-   400 mcg

So what does this tell us? Yes, vitamin water contains vitamins, however, it also contains sugar, artificial colour, natural flavours whose source and contents are unknown, and other additives. An interesting point was that on the bottle I was analyzing, it also stated "made for coca-cola refreshments canada company."

In my professional opinion, if a vitamin "boost" is what you're looking for, then taking a daily multivitamin may be a better idea. The best option would be to simply eat the foods that contain many of these minerals and vitamins, as drinking this vitamin water would not provide the fibre natural food sources would contain. 

Water or milk may be better beverage options, but as long as you understand what is in what you're drinking, the choice is up to you. Remember, any foods or drinks can fit into a diet, the key is always how much and how often!

Information Sources:

http://www.healthcastle.com/water-vitamins-or-just-plain-liquid-calories

http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/nutrition/dri_tables-eng.pdf

Update

After a whirlwind 6-8 months I'm finally back! Needless to say the last few months of my life have been extremely fast paced and exciting. Traveling through Europe, attending a wonderful friend's wedding in Hawaii and organizing and having my own wedding and moving to another province have all come and gone. Now back to sharing what I know and learn, and turning the focus back to food, nutrition, health, and positivity.