For the last forty years we doctors have been telling people to eat a high fiber diet in order to avoid diverticulosis. Unfortunately, it appears that may be poor advice. In a study recently published in the journal Gastroenterology (doi:10.1053/j.gastro.2011.10.035), researchers from the North Carolina School of Medicine and the Albert Einstein College of Medicine sought to identify the relationship between the presence of diverticula and a person’s diet.

They recruited over 2000 people between the ages of 30 and 80 who had recently undergone a colonoscopy. This meant that they knew whether or not that person had any diverticula – and in some cases knew how many had been found in their colon. High Fiber Diets Don’t Prevent Diverticulosis

If you have children, however, I’m sure you’re thinking that the idea of hiding vegetables in other foods is all very well, but strategies to help those kids eat more vegetables when they look like vegetables would be far more helpful. The good news is that researchers at The Pennsylvania State University have found at least one way to do just that (Am J Clin Nutr 2012; 95:335-41).

They noted that when children are presented with an entree portion that is twice the size of their usual portion of that entree, they tend to eat as much as 40% more of it. On the other hand, increasing the amounts of vegetables served with a meal does mean that children eat more of the vegetables, but that increase isn’t nearly as significant as with the entree. Would controlling the size of the entree encourage children to eat more of the side dishes presented with the entree? How to get pre-schoolers to eat more vegetables

Researchers at the School of Nursing at The University of Texas wondered if those who ate out frequently could be helped to reduce the number of calories and amount of fat they ate when they did eat out. They devised a program they called “Mindful Restaurant Eating” and recruited 35 healthy, pre-menopausal women between the ages of 40 and 59 who ate out an average of more than 5 times per week. Reducing Weight Gain for Frequent Restaurant Eaters

In the last few years people have been looking more closely at red meat in an effort to determine if some red meats are better than others, and the good news is that recent studies have found that processed meats, such as bacon, salami, or hot dogs seem to be more closely linked to an increased risk of heart disease and diabetes than lean meats (Bite, 05/19/10).

In a study reported on in the American Journal of Clinical Nutrition(2012;95:9-16), researchers at Penn State compared four different diets on the cholesterol scores of 36 men and women between the ages of 30 and 65. All of the participants were nonsmokers who had no history of heart disease or diabetes, but all had high LDL cholesterol scores. Can Red Meat be Part of a Cholesterol-Lowering Diet?

The good news is that following a Mediterranean-style diet is easily sustainable for the average American (as well as the rest of the world). No foods are considered “bad,” or off-limits, although certainly some foods are to be eaten less often than others. For example, although red meat should not be eaten nearly as often as fish, that doesn’t mean you shouldn’t eat it at all: having a steak once every couple of weeks is fine. (Read more about the 9 principles of the Mediterranean Diet.)

A recent study performed in Sweden (AGE 2011;33:439-450) looked at the diets of over 1,000 men and women who responded to a detailed dietary questionnaire at the age of 70. The researchers were able to assign a 9-point Mediterranean Diet score to each participant, with a higher score meaning a better adherence to Mediterranean Diet principles. They were also able to analyze each person’s diet with respect to macronutrients such as total carbohydrates, fiber, and saturated and unsaturated fats. Macronutrients vs. Overall Diet: Which is More Important?

It’s true that there have been a limited number of studies of the effects of the Mediterranean Diet on blacks and Hispanics in the United States. Fortunately a study in the American Journal of Clinical Nutrition (2011;94:1458-64) seeks to close that information gap with a prospective (following people over time as opposed to asking them to recall past information) study involving over 2500 men and women living in Northern Manhattan in New York City.Mediterranean Diet not just for Mediterranean people

I’ve talked before about research that shows that those who gradually reduced the sodium level in their overall diet found that the same crackers tasted saltier after they’d become accustomed to a lower daily salt intake. Researchers in The Netherlands just published an interesting study in which they looked at people’s responses to reduced sodium levels in bread. You CAN get used to less salt!

Twenty-four healthy men and women between the ages of 20 and 46, who were also of normal to slightly overweight, participated in the study. The participants were randomly assigned to one of two standardized breakfasts: either whole grain rye porridge or the same number of calories in the form of whole wheat bread. For three weeks the participants ate their assigned breakfast meal each day, then returned to their regular diet for three to four weeks (this is what is known as a “washout period”). Then for an additional three weeks they switched to the other breakfast meal. Fiber for Breakfast Keeps You Satisfied

Adults, on the other hand, tend to choose portion sizes based on how satisfying they believe the food will be. Because they’re more familiar with so many more foods, predicting how satisfying a food amount will be (calories aside) can be pretty accurate for most adults. Researchers in the United Kingdom wondered how well children could predict how satisfying a food would be when it was a familiar food versus a more unfamiliar food (Am J Clin Nutr 2011; 94:1196-201).

The 70 participants in their study were 11 and 12 year old children enrolled in local schools who were willing to participate and whose parents consented to their participation. Kids need snack guidance

There has been some research indicating that giving rats the active ingredient in hoodia has led to loss in body weight and reduced food intake. An unpublished study from 2003 looked at twice-daily administration of a similar concentration of the active ingredient in hoodia to human subjects, who then ate about 30% less than those taking a placebo.

You might be convinced already that you should go out and buy some hoodia. Look again at the second sentence in the first paragraph, where it says, “its safety hasn’t been well investigated and its effects haven’t been sufficiently well established.” This is the issue with so many supplements: we don’t know for sure if they’re safe or even if there’s a safe dosage or an unsafe dosage. Another issue is that of manufacture: for example, all of the Web sites I looked at that sell hoodia pills claim that theirs is the best, purest form of the extract and that all others are inferior and do not work.Does Hoodia Gordinii Really Work?

It appears as though there will need to be even more research on the issue, as a recent article in the Journal of Nutrition and Metabolism appears to find the opposite – at least with regard to peanuts (technically legumes and not nuts, however) ( doi: 10.1155/2011/928352).

An international group of researchers recruited just over 100 men and women between the ages of 18 and 50 and in good health, whose weight was currently stable, not taking medications and who were not allergic to peanuts. The participants were randomly assigned to one of three test food groups: peanuts, snack mix, or snack mix including peanuts. Peanuts also great snacks

One of the drawbacks of the last few decade’s worth of nutrition research is that with all that we’ve learned about the importance of specific vitamins, people have become focused on specific nutrients rather than an overall healthy diet. And that’s likely the reason that more and more people are taking vitamin supplements, believing that they can enhance their health or even help prevent chronic diseases – heart disease being one example.

Unfortunately, it appears that not only is taking vitamins likely to be unnecessary, it may actually be harmful. Eat Your Vitamins

The bad news, however, is that research on coffee and blood pressure has largely been limited to those who do not already have high blood pressure. Fortunately, a group of researchers in Spain noticed this and looked at 15 different studies of coffee and caffeine intake in order to evaluate the effect of coffee on those with mild to moderate high blood pressure (Am J Clin Nutr 2011;94:1113-26).Coffee and High Blood Pressure

Researchers at Vanderbilt University designed a study to see if having something to eat or drink shortly before a meal (a “preload”) would affect weight loss. They decided to compare a fruit, a fruit juice and water, and chose grapefruit and grapefruit juice as their test items. (Grapefruit was chosen because of its high antioxidant levels and high water content.) A Little Something Before Meals

In the past thirty years or so we’ve seen fewer families eating dinner together regularly, and this has coincided with the increase in individual’s waistlines. Plenty of studies have looked at the relationship between family meals and weight in children, but few have looked at the family unit as a whole or at the weight of the various family members – not just children.

A recent study in the journal Appetite takes an initial look at family meals and family weight (2011;57:517-524). The researchers recruited 103 families who were visiting Cornell University in Ithaca, New York, in order to attend campus tours. (This meant that at least one person in the family unit was a young adult.) The family groups averaged just three people, so 327 persons participated in the study.Do family meals affect family weight?

But once you lose the weight, how do you keep it off? Studies show that about one-third of the average dieter’s total weight lost is regained within a year – and the rest comes back within 3 to 5 years. A team of researchers noted that the typical attitude toward weight maintenance is just that – maintaining the strategies that helped with weight loss over the long term. Given that so much of weight lost is eventually regained, it seems clear that just continuing those weight loss strategies doesn’t work. What does?

The researchers began by recruiting over 950 adult men and women who had lost at least 30 pounds and had been successful at keeping it off for at least 1 year (Am J Prev Med 2011;41(2):159-166). Through in-depth interviews, the researchers were able to identify 36 strategies that were most frequently used for weight loss or maintenance. Losing Weight vs. Keeping it Off: What Works?

We know that this is just as true for kids as it is for adults. But does it matter what they eat? Conventional wisdom says that sugary cereals are bad for kids and should be avoided. Leaving aside the question of whether sugary cereals in the morning can affect a child’s behavior, does it matter how much sugar is in a child’s cereal in terms of their overall health? Are children who eat sugary cereal in the morning more likely to be overweight or have a less nutritious overall diet?

In a study funded by General Mills (Nutr Res 2011;31:229-236), two General Mills nutrition researchers along with two researchers at Northeastern University made use of information gathered in the National Health and Nutrition Examination Survey (NHANES). Should you be concerned about the sugar in your kids’ cereal?

Researchers have been divided on just why meal replacements work, however. Ordinarily reducing the number of calories at one meal results in increased consumption at the meals following, resulting in about the same number of calories consumed over the course of the day. Yet this wasn’t the case with high protein meal replacements: dieters would eat the meal replacement and would not compensate for the reduction in calories by eating more at subsequent meals. They would then lose weight.

Then other researchers noted that having a bowl of high-fiber cereal would yield the same results: a standard size bowl of cereal in place of a single meal again resulted in lost weight (think of those “Special K Challenge” ads).

Researchers at Cornell University theorized that it was simply the smaller portion size of these meal replacement drinks, bars and the like that was resulting in weight loss. Lose Weight with Portion Control

Researchers from Harvard University in Boston, funded by the National Institutes of Health, made use of data gathered during three large-scale, long-term studies of health professionals (doctors and nurses) in the United States. These studies included a combined total of over 120,000 adult men and women under 65 years of age who were not obese and were free of chronic diseases at the start of the studies. Height and weight were measured and a detailed diet and lifestyle questionnaire was administered at the start of each study, and every two years thereafter the questionnaire, including a question about current weight, was mailed to the participants for follow-up. The included portions of the three studies lasted 20, 12 and 20 years, respectively. Eat More of These Foods and Gain Less Weight

Researchers from Harvard University in Boston, funded by the National Institutes of Health, made use of data gathered during three large-scale, long-term studies of health professionals (doctors and nurses) in the United States. These studies included a combined total of over 120,000 adult men and women under 65 years of age who were not obese and were free of chronic diseases at the start of the studies. Height and weight were measured and a detailed diet and lifestyle questionnaire was administered at the start of each study, and every two years thereafter the questionnaire, including a question about current weight, was mailed to the participants for follow-up. The included portions of the three studies lasted 20, 12 and 20 years, respectively. Eat More of These Foods and Gain Less Weight

There aren’t many studies on the subject, however. Fortunately a pair of researchers at the University of Missouri and Purdue University recently teamed up to present an overview of the current research at a symposium. Should You Eat More Often?

Today I have another reason for you to treat these diets with some skepticism. An article published in the British Journal of Nutritiondescribes a small study performed in Finland that essentially compares the theory of the Glycemic Index with reality (2011;106:248-253). When the Glycemic Index Doesn’t Measure Up

I’m so excited that my new book, Just Tell Me What To Eat!: The Delicious 6-Week Weight Loss Plan for the Real World is now available. This is a 6 week plan that I’ve built over the last decade of working with patients to help them lose weight and improve their health. The program includes 6 weeks of menus, with recipes and all the information that you need to transform your health.

Get your copy today through your local bookstore, or buy online:
From DrGourmet.com |  From Amazon.com

Read More About the Mediterranean Diet – the Science Behind Just Tell Me What to Eat!

Mediterranean Diet Advantages Not Limited to Normal Weight
A lot of articles about research studies make it sound like overweight or obesity is a direct cause of conditions such as heart disease and diabetes. This isn’t true.

Mediterranean Diet Helps Prevent Central Fat Distribution
In last week’s Dr. Tim Says…. column I wrote about the effects of a Mediterranean-style diet on central adiposity – otherwise known as “belly fat.” I recently ran across a study conducted in Spain that compares three different diets head-to-head on their effects on the distribution of belly fat, so I thought I’d share it with you.

Mediterranean Diet and Heart Disease
I’ve reported on dozens of studies that have focused on the health benefits of the Mediterranean Diet and heart disease, but the vast majority of them have focused on the benefits of specific components of the diet, such as olive oil (Bite, 01/19/07), cereal grains (Bite, 06/16/06) or fish (Bite, 01/22/06). A recent study published in Nutrition, Metabolism & Cardiovascular Diseases looks at the effects of the Mediterranean Diet as a whole and its effects on the rates of heart disease and stroke in middle-aged adults.

About half of those women who experience chocolate cravings report that their cravings are related to certain points in their menstrual cycle. This has been of great interest to researchers, as you might imagine, but no evidence has been found of any biological reason for these cravings. The various hormones involved in the menstrual cycle have been fairly extensively studied with regard to the frequency and intensity of chocolate cravings and… nothing. Why Do You Crave Chocolate at That Time of the Month?

This is why Waist to Hip Ratio is becoming the more favored method of estimating body fat, better than Body Mass Index. Body Mass Index only looks at weight in relation to height, which is a good indicator of overweight and obesity for most people, but it is limited by being unreliable for children, the elderly, people under 5 feet tall, and those who are very muscular. Waist to Hip Ratio, on the other hand, tells us physicians far more about where your body fat is deposited, which we are finding is far more of an indicator of increased health risks and is relevant for everyone. Whole Grains and Belly Fat

There’s been some concern about the long term health risks of such diets. We’ve seen that those eating higher protein diets that were also high in saturated fat were more likely to develop heart diseasethan those whose higher protein diet came from vegetable protein sources. Such extremely-low-carbohydrate diets also seem to affect your thinking abilities. Low-Carb Diets and Type 2 Diabetes

Researchers in England took another approach towards researching how much people eat at meal times. Their theory was that how much people eat at a meal is largely determined before someone sits down to eat. Plan to Clean Your Plate

Obviously, the whole point of food commercials is to get you to buy the product. Researchers in The Netherlands wondered if watching food commercials would actually affect how much you ate while you were watching television. Snack Food Commercials

It’s natural for Celiac patients to focus on simply avoiding gluten-containing products in their diet. Researchers in the United Kingdom, however, looked beyond simply treating Celiac Disease with a gluten-free diet and wondered if the gluten-free diet was actually nutritionally sound. Are those with Celiac Disease getting enough calcium, Vitamin D or other macro- and micronutrients in their gluten-free lifestyle? Beyond the Gluten-Free Diet

She felt that “gluten sensitivity” implied that Celiac is not a serious disorder. While I understood her reasoning (and still do), at the time the jury was still out as to whether there were those whose symptoms, including fatigue and Irritable Bowel Syndrome, were improved on a gluten-free diet. I therefore chose to have the label we used be as inclusive as possible.

Recently a group of researchers in Australia designed a study to test whether those who did not have Celiac Disease – but felt better on a gluten-free diet – would experience symptoms if they consumed gluten without their knowledge. ‘Non-Celiac Gluten Intolerance’: Does it Exist?

But what if these foods might be contaminated during processing, or even in the field? Schar, a food manufacturer specializing in gluten-free foods (we’ve reviewed some of their foods, including a gluten-free pizza crust), worked with an independent nutritional consultant to gauge the amount of gluten contamination, if any, in foods that under the proposed rule would be considered gluten-free. Is it Really Gluten-Free?

In devising a research strategy, they also noted that other research suggests that people believe that participating in positive (healthy) behaviors can serve to offset the effects of negative (unhealthy) behaviors later. (Makes sense: how often have you thought something to the effect of, “I’ll take this long walk so I can have ice cream later.”)

Even further, Wansink and his colleagues theorized that just thinking about exercise – not actually doing any – could affect how much food a person served themselves afterwards. Just Thinking About Exercise

The researchers recruited 29 men and women with newly-diagnosed, biopsy-proven Celiac Disease who had also experienced reflux symptoms, including heartburn or acid regurgitation, which had recurred at least three times per week for six months or more. They also recruited 30 men and women without Celiac Disease who also had experienced the same symptoms to serve as a control group. Celiac Disease and GERD

He and his staff recruited 37 undergraduate men and women who were told that they would watch a television comedy and then answer questions about it. While they watched the show, they were given prepackaged crackers to eat as snacks. These crackers were prepackaged in one of two ways: in one large bag or in four smaller bags. Those 100-Calorie Snack Packs

An interesting pilot study out of the University of Minnesota looked at the intersection between breakfast, whole grains (in terms of the Glycemic Index) and blood sugar control (an important element in preventing or managing diabetes). More on Breakfast and Blood Sugars

A recent study published in the journal Appetite suggests that a Mediterranean Diet may help improve more than just your body’s health - it may help improve your mood.

But would eating more whole grains and legumes actually help you lose weight? A group of researchers in the United Kingdom and New Zealand designed a study to shed some light on the subject. Slim Your Waist with Whole Grains and Legumes

A researcher in Thailand noted that most of the research on GERD and IBS focuses on a Western diet and wondered if two of the major features of the Thai diet – rice and spiciness – would have a positive impact on either disorder. In an article in the Journal of Neurogastroenterology and Motility (2010;16:131-138) he reviews the available research. Rice, Chilis, GERD and IBS

Dr. Harlan’s newest diet book, Just Tell Me What to Eat!: The Delicious 8-Week Weight-Loss Plan for the Real World, is being published in April, 2011, and you can be part of it!

Have you used The Dr. Gourmet Diet and lost weight, improved your cholesterol scores, or even avoided going on diabetes medication? Maybe you just feel better or discovered that there are some vegetables you do like? If you’ve had success with The Dr. Gourmet Diet, tell us about it and your comments may be used in the book!

Send your stories to success@drgourmet.com and if you are quoted in the book, you’ll receive a free copy of the book, signed by Dr. Harlan. We’d love to hear from you!

But it’s important for kids, too, and not just for the same reasons that it’s important for adults. Start Your Kids Out Right

Dr. Harlan’s newest diet book, Just Tell Me What to Eat!: The Delicious 8-Week Weight-Loss Plan for the Real World, is being published in April, 2011, and you can be part of it!

Have you used The Dr. Gourmet Diet and lost weight, improved your cholesterol scores, or even avoided going on diabetes medication? Maybe you just feel better or discovered that there are some vegetables you do like? If you’ve had success with The Dr. Gourmet Diet, tell us about it and your comments may be used in the book!

Send your stories to success@drgourmet.com and if you are quoted in the book, you’ll receive a free copy of the book, signed by Dr. Harlan. We’d love to hear from you!

Unlike an overview, which details the results of many studies on an individual, study-by-study basis, a meta-analysis combines the results and data of several studies to yield results as if they were all one study. (Those of you with a science background will recognize that this explanation is rather simplified.) The strength of a meta-analysis lies in the fact of its aggregate size: the larger and longer a study is, the more reliable are its results. The drawback, of course, is that this is a grouping of studies, all performed by different people with different standards and methods. More on Sugary Beverages and Your Health

Recently a team of researchers at Harvard published an overview of current research on sugar-sweetened beverages and obesity, type 2 diabetes and other metabolic disorders in the journal Physiology & Behavior.

Here are just a few highlights of the articles they mention which cite large-scale studies: Sugary Beverages and Your Health

Fortunately, a recent study published in the American Journal of Clinical Nutrition looks at the relationship between following a Mediterranean style diet and the fourth most common cancer worldwide: stomach cancer (gastric adenocarcinoma). Stomach cancer is also the second leading cause of death from cancer, after lung cancer. Mediterranean Diet and Stomach Cancers

The physicians contacted to respond to the survey were affiliated with the University of Michigan and were those who could be (broadly) considered “primary care” physicians: internists, family practitioners, endocrinologists and cardiologists. Between March and April of 2009, nearly 200 of these physicians responded to an emailed survey. Doctors, Exercise and Nutrition

We also know that high-fiber foods are more satisfying than the same types of foods with less fiber: whole wheat bread is more satisfying than white bread, for example. During times of energy restriction (read: dieting), however, studies have shown that eating protein helps people feel more satisfied than even whole grains and fiber. So should you be eating protein at breakfast if you’re trying to lose weight? Feel Fuller While Dieting

A group of researchers in Scotland recently published a study focused on the effect of higher whole-grain food intake on fairly healthy individuals. Whole Grains and Heart Disease Risk

In the face of growing obesity rates, this is just one of the strategies that are being used to help people make better choices at the supermarket. And it’s one of the cheapest, too. Individual lifestyle counseling is expensive and time-intensive, so it’s reasonable to assess more cost-effective strategies that may help larger groups of people eat better. The problem is that studies actually evaluating whether these approaches actually work are still limited. Grocery Store Shelf Tags for Better Food Choices

We know that following a Mediterranean style diet is linked with lower incidence of heart disease, high blood pressure, and cancers. Until recently, few studies have looked specifically at the Mediterranean Diet and the risk of breast cancer. Those studies that have been published have looked at only olive oil and breast cancer, or have taken place in the United States, where most people do not adhere to a Mediterranean Diet. What has been lacking has been a study focused on the Mediterranean Diet in a country where the Mediterranean Diet is the dominant style of eating. Fortunately, a study just published in the American Journal of Clinical Nutrition does just that. Mediterranean Diet and Breast Cancer Risk

Of course we know what the outcome is of such overeating: holiday weight gain followed by a New Year’s resolution to diet and exercise.

A group of Swedish researchers looked at the long term effects of such overeating in a small study that was just released by the journal Nutrition & Metabolism. Short Term Splurge – Long Term Fat

Every now and then I’ll hear someone who is overweight say, “I can’t lose weight. My whole family is overweight. It’s genetic.” An interesting article in the International Journal of Obesity says that while that may be true for some people, it doesn’t appear to be an unavoidable fate. Exercise Trumps Heredity

Many women with fibrocystic breast disease are told to avoid caffeine because this seems to help minimize the symptoms of the disease, which include lumps in the breast and sometimes pain and swelling. Accordingly, one theory is that avoiding caffeine may help women avoid breast cancer.

The problem, however, is that the results from the many different studies that have been done are mixed. Most studies seem to show no connection, but some smaller studies show a weak positive link, while others….

Recently a brief article in The Annals of Internal Medicine featured The Joy of Cooking. Brian Wansink, a food researcher at Cornell University, and his staff surveyed the seven editions of The Joy of Cooking and found that only 18 recipes have appeared in all seven editions (disappointingly, the letter does not list which ones they are). Right Size Your Recipes

So what? Of course your food comes from what you have at home. Researchers at Rutgers University wondered if there was a difference in what foods were actually in the home between those families with overweight members and those families who were all of normal weight. If It’s In the House….

Now it seems that a Mediterranean diet may be linked to a lower risk of depression. Eat Well, Feel Better

White rice is essentially brown rice that has been processed to remove the outer bran and germ parts of the rice. This is why brown rice is considered a “whole grain” and white rice is not. There’s a lot of research showing that eating more whole grains can help you reduce your risk of diabetes, high blood pressure and overweight. One of the reasons for this appears to be that eating refined grains leads to a higher spike in blood sugars than eating whole grains. This higher response is measured using a system known as the glycemic index (GI), and a higher-GI diet has been shown in many studies to be linked with a higher risk of type 2 diabetes.

We don’t eat all that much brown rice here in the United States, although if you’ve been following Dr. Gourmet for a while, you know that I recommend switching from white rice to brown rice as well as from plain pasta to whole wheat pasta. Researchers at Harvard Medical School noted that our rice consumption is rising, however, and decided to look specifically at brown vs. white rice with regard to the risk of type 2 diabetes. More Brown, Less White

Researchers affiliated with Harvard Medical School and Tongji Medical College in Hubei, China noted that whole grains tended to help reduce the risk of diabetes and wondered what effect eating more whole grains might have on those who already have diabetes. Whole Grains, Bran Fiber and Diabetes

A recent study published in the journal of the American Heart Association, Circulation, takes a closer look at the connection between red meat, processed meats, and heart disease and diabetes. Red Meat is Fine! Redux

We’ve known for a while that nuts are great for you, and not just because eating nuts in place of other snacks won’t result in weight gain. There are many studies on the effects of eating many different nuts on cholesterol levels. Recently a team of researchers in Barcelona, Spain and in Loma Linda, California pooled the results of 25 different studies on nuts and cholesterol to see if the type of nut made a difference in the cholesterol-lowering effects of eating nuts. Nuts and Cholesterol

At this time the only way to definitively diagnose Celiac Disease is by doing a biopsy of the small intestine, which is where Celiac Disease does its damage to the body. That said, in this health care environment we doctors can’t just send everyone with abdominal pain to have a small bowel biopsy – the current estimate is that less than 1% of the population has true Celiac Disease. Better to do other, less invasive tests first. Fortunately, there are several blood tests available, but they are not as definitive as a biopsy. They do yield some false positives and sometimes false negatives. Testing for Celiac Disease

Most of the salt in our diets comes from the processed food we eat. Several countries, including Finland, the United Kingdom and Australia, have instituted government and food-industry-led strategies to reduce the amount of sodium in processed foods, with some success: the UK has managed to reduce their overall average salt intake by about 10% (from 9.5 to 8.6 grams per day). Recently a team in Australia assessed the amount of salt in over 7,000 processed foods sold in Australia as part of their effort to gather information on the current status of their food industry. Assessing the Salt Content of Processed Foods

Researchers in Italy tried to improve on previous studies by recruiting 200 women who were actively being treated with assisted reproduction techniques, either In-Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). These women were paired with a control group of 200 women with no complaint of reproductive problems who had already had one child. Celiac Disease and Infertility in Women

The only treatment for Celiac Disease is to avoid gluten in the diet. While it’s obvious that those with Celiac Disease need to avoid almost all bread products, newly-diagnosed patients are also taught to recognize the “hidden” gluten in many commercially prepared foods. Even restaurant or home-cooked meals that are (presumably) prepared fresh from gluten-free products are considered suspect if they are prepared in a kitchen that also contains gluten products due to the risk of cross-contamination: a cooking utensil could carry gluten molecules from a food containing gluten to an otherwise gluten-free food.

To avoid that risk, many of those with Celiac Disease are extremely cautious about eating in restaurants or kitchens not their own and will often prepare and take their own food when dining with friends or family. This is reasonable, given that the prevailing teaching is that products with “more than 20 parts per million (ppm) of gluten” will cause damage to their small intestine. Is Any Amount of Gluten Safe for Those with Celiac Disease?

That’s a tablespoon and a half (4.5 teaspoons), for men, and about 1 tablespoon of salt (3 teaspoons) for women.

We know that reducing the amount of salt we eat can help reduce blood pressure and your risk of heart disease – from stroke to heart attack. If everyone in the United States over 35 years old reduced their salt intake by only 3 grams per day, what kind of impact would that have on our country’s overall health? Quantifying the Effects of Less Salt

Researchers at the University of Missouri noted that both resistance training and weight loss – independent of each other – are known to help improve both abdominal obesity as well as insulin resistance, both risk factors for diabetes and heart disease. They also noted that most overweight and obese persons who lose weight tend to gain at least some of that weight back. Could resistance training help those who regain some weight hang on to some of the benefits of weight loss? Turning Fat Into Muscle

While it’s easy to know which is which when you’re following a structured plan like The Real World Diet, most people don’t consciously plan their meals. When you buy a 400-calorie package of cookies from the vending machine or eat a plate of finger foods at a company cocktail party, do you consider those “snacks” or “meals”? You might eat more later if you’ve mentally tagged that food a “snack.” Is It a Meal, or Is It a Snack?

Recently a brief article in The Annals of Internal Medicine featured The Joy of Cooking. Brian Wansink, a food researcher at Cornell University, and his staff surveyed the seven editions of The Joy of Cooking and found that only 18 recipes have appeared in all seven editions (disappointingly, the letter does not list which ones they are). Right Size Your Recipes

With this in mind, researchers in New York, New York sought to find out if the amount of exercise an individual participated in would also have any effect on their risk of Alzheimer’s Disease. Exercise for Your Brain

Researchers from the Centers for Disease Control worked with scientists at the German Institute of Human Nutrition on a study that included over 23,000 men and women between the ages of 35 and 65. At the start of the study, each person received a score of 1 or 0 (yes or no) on four positive health factors. Sometimes It’s Just That Simple

One major sedentary behavior is television watching. In fact, according to Neilsen Inc. the average American adult watches television for almost 5 hours per day. Not only is it sedentary, but we also know that distractions while you are eating, such as television, lead to eating more and weighing more (News Bite 11/07/06). Researchers at the University of Vermont devised a study to find out if reducing the amount of television a person watched would actually reduce their caloric intake or their weight. Try Turning Off the Television

Soy foods, in particular, are naturally high in these isoflavones, and there has been some controversy over whether breast cancer survivors should avoid soy foods and whether their estrogen-receptor status, whether positive or negative, should make a difference. Good Food News for Breast Cancer Survivors

So what? Of course your food comes from what you have at home. Researchers at Rutgers University wondered if there was a difference in what foods were actually in the home between those families with overweight members and those families who were all of normal weight. If It’s In the House….

Studies have shown that drinking moderate amounts of alcohol has helped those with heart disease avoid heart attacks as well as improving their cholesterol scores. Red wine, in particular, contains a high amount of antioxidants called polyphenols. Red Wine Good for Old and Young

Every now and then I’ll hear someone who is overweight say, “I can’t lose weight. My whole family is overweight. It’s genetic.” An interesting article in the International Journal of Obesity (2009;33:29-36) says that while that may be true for some people, it doesn’t appear to be an unavoidable fate. Exercise Trumps Heredity

In a review of 12 studies, researchers compared the effects of taking vitamin D supplements with the effects of taking calcium alone or calcium and vitamin D together or a placebo (Arch Intern Med 2009;169(6):551:561). They chose to focus on people who were 65 years of age or older, likely because the elderly are more at risk of long-term consequences when they break bones. What’s the Best Supplement for Your Bones?

Of course, another strong indicator of bone mineral density in women after menopause is… wait for it… their bone density before menopause. Some studies have indicated that the amount of fatty acids in a woman’s diet can have negative effects on her bone density. What about other variables, such as Body Mass Index, hormone levels or even ethnicity? Researchers at the University of Texas Medical Branch designed a study to assess womens’ bone density in relation to these and other factors. Leaner Body, Stronger Bones

Researchers at Harvard University in Boston, Massachusetts partnered with researchers at Louisiana State University in Baton Rouge, Louisiana to create a study (N Engl J Med 2009; 360:859-73) that they hoped would overcome all of those barriers to quality research – and maybe even answer the question of what combination of protein, fat and carbohydrates would be best for long term weight loss.

“The approved foods include those that derive less than 35% of their total calories from fat and less than 10% of calories from saturated fats. They should be trans-fat free, get less than 35% of their total calories from sugars (with an exception made for certain types of yogurt), and contain less than 200 milligrams of salt per serving.”

Clearly the goal in limiting children’s access to these unapproved foods was to improve their diet. Faced with fewer junk food options, however, did they make better choices?

Needless to say, with an increasingly elderly population it is important to find ways to help prevent bone loss. We do know that eating more fruits and vegetables is linked to higher bone density, but what we don’t know is exactly what in those fruits and vegetables is responsible. It appears that Vitamin C, as an antioxidant and an essential factor in bone formation, may be important. Is there a straightforward link between Vitamin C intake and bone density? Drink Your Juice and Protect Your Bones

The University of Nebraska has nutrition information listed for many of the foods at four of their six dining halls. The information is posted in front of the food in question and lists some of the information on a typical nutrition label, including calories, fat (but not saturated fat or trans-fats), protein, vitamins, ingredients, and whether the food is suitable for a vegetarian diet. Eat Healthy: Read Nutrition Information

Leaving aside for the moment the medical terms, just look at what’s being researched and upon whom: alcohol-free beer and elderly women. You have to ask yourself: where did these researchers find a group of elderly women to drink alcohol-free beer? Alcohol-Free Beer: an Antioxidant?

A recent study known as the ARIC study included over 14,000 African-American and white men and women between the ages of 45 and 64 (J Am Diet Assoc 2008;108:1881-1887). At the beginning of the study, in 1987, the participants completed a food questionnaire that asked how often they ate specific foods or beverages. Less of This, More of That

Weight Loss Affects Your Partner, Too

We know that it’s common for couples to gain weight after marriage and for the weights of partners to be correlated at the start of marriage. There’s also research to show that the weight of both partners in a marriage change in a similar way over time. So it’s reasonable to think that if one spouse tries to lose weight, that might have an effect on the weight of the other spouse.

A multi-university group of medical and psychiatric researchers decided to examine that very question as a subset of an ongoing study known as Look AHEAD (Action for Health in Diabetes). That study focuses on the effect of weight loss on cardiovascular disease in overweight people who have type 2 diabetes. Weight Loss Affects Your Partner, Too

Tea, similarly, appears to be protective in moderate amounts, helping to prevent the cognitive impairment that goes along with aging. But too much of tea’s polyphenols, at higher concentrations (like what you might find in supplements), appear to have a damaging effect on the body’s cells. Good News for Those Who Love Chocolate, Wine or Tea

All Other Things Being Equal, Have Some Fruit

I recommend that my patients eat fruit for snacks because they’re delicious and have lots of fiber, so they’re satisfying. They’re also low energy density foods: they have comparatively few calories for their weight. This idea of energy density is really important to keep in mind when you’re trying to lose weight, because you can eat more of a low-energy-density food and still eat the same number of calories as those in a high-energy-density food like cookies or potato chips.

On the other hand, weight loss is basically burning more calories than you consume. So you’d think that it wouldn’t matter what, exactly, you eat, as long as you eat fewer calories than you burn. Right?

Maybe not. All Other Things Being Equal, Have Some Fruit

Obesity and Subclinical Heart Disease

When a patient meets certain set criteria for a disease or condition, we doctors say that they have clinical [disease or condition]. For example, the World Health Organization and the National Institute of Health have designated a Body Mass Index of 30 or more as clinically obese. On the other hand, with some conditions a patient might have the condition, yet not show symptoms, and that is called subclinical [condition]. I have heard, for example, of marathon runners and dedicated bicyclists who dropped dead of heart attacks because they had subclinical heart disease.

But runners and bicyclists who still have heart disease despite their healthy lifestyle are the exception rather than the rule. A study published in the Archives of Internal Medicine (2008;168(9):928-935) looked at the relationship between subclinical heart disease and Body Mass Index across several ethnic groups. Obesity and Subclinical Heart Disease

Antioxidant Supplements May Be Bad For You

We know that a diet high in fruits and vegetables can help you avoid heart disease as well several different types of cancers, including oral cancer, skin cancer, prostate cancer and colon or rectal cancers (News Bite 12/12/07). We also know that a diet rich in fruits and vegetables can help you avoid Alzheimer’s Disease (9/05/06). But what is it, exactly, that’s so protective? Some studies suggest that the protective substances are the antioxidant vitamins, which include vitamins A, C, and E along with beta-carotene and selenium.

If that’s true, then it would be reasonable to believe that antioxidant supplements in pill form would help protect you from illness or even make you better, right? After all, we know that the omega-3 fatty acids in fish oil supplements seem to work just as well as eating fish (4/30/08). We in medicine know, however, that it’s always wise to check our assumptions and look for evidence – that’s why we call it “evidence-based medicine.” Antioxidant Supplements May Be Bad For You

Low-Carb Diets Affect Your Brain

Low-carb diets seem like an easy way to lose weight: just cut out all carbs. No worrying about portion size, balanced meals or avoiding low-quality, fatty foods – it’s “dieting without hunger!” Still, you’ve probably heard that low-carb diets may not be good for your liver.

They don’t appear to be good for your brain, either. Your brain runs primarily on glucose, which comes mostly from the breakdown of carbohydrates in your stomach and intestines. From there the glucose is circulated through the bloodstream to the brain and other organs.

The liver has its own enzymes to help it break down amino acids (proteins) and fats into glucose, but the brain does not. Low-Carb Diets Affect Your Brain

Researchers at the University of Minnesota and the Minneapolis Heart Institute Foundation rounded up the results of 12 studies that incorporated weigh-ins into the studied weight loss or weight maintenance strategies. Weigh More… Weigh Less

Another study has been published in the journal Appetite (2009; 52:39-43) which focuses on television and food intake. Researchers in the school of Psychology at the University of Birmingham, United Kingdom, formulated a theory which described why people might eat more when they eat while watching television.