Feb 9 2010

Confused about nutrition? Eat food!

I can’t resist dealing with the questions just asked by Elliot and Johannes.  From Elliot:

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease (see: American Journal of Clinical Nutrition, January 13, 2010)…[but] in his book, Good Calories Bad Calories, Gary Taubes clearly attributes most of our chronic disease problems — including heart disease — to carbohydrates (see page 454).  In contrast, Colin Campbell in his book The China Study (pages 113-133) forcefully argues that animal proteins contribute to CVD.  Yet, Dr. David Katz in his book Nutrition in Clinical Practice (pages 130, 133) asserts that to prevent heart disease, “saturated and trans fat should be restricted to below 7% (or even 5%) of total calories . . . .”  Who’s right?  We badly need your unbiased wisdom on this topic.

Joannes says that according to the Weston A Price Foundation,

it seems as if (naturally-occurring) saturated fats are almost better for you than the unsaturated fats we get fed these days, which mainly consist of rancid oils which more than anything contribute to heart disease, whereas many saturated fats are actually quite beneficial.

OK.  Here’s my “unbiased wisdom” (if such a thing exists).  I like to ask: What do saturated fats, sugars, and animal proteins have in common as factors in the development of heart disease?   Answer: They are all single nutrients.

Recall that nutrition research is difficult to do because diets contain many foods, foods contain many nutrients and other chemicals that affect health, and other behavioral, socioeconomic, and genetic factors influence heart disease.  Studies of single nutrients take these chemicals out of their food, dietary, caloric, and lifestyle contexts and are, therefore, reductive.

Such studies tend to produce ambiguous results that demonstrate small differences, if any.  Small differences create situations ripe for interpretation.  Interpretation depends on the viewpoint of the interpreter.  That is why it helps to know who is doing the interpreting and who sponsored the studies.

Short of that, you would have to read every study cited by these authors and come to your own decision about how to interpret them – a daunting task.

My approach to conflicting research?  I look for points of agreement. The authors cited here do not disagree about the basic principles of healthful diets: variety in food intake, moderation in calories, largely plant-based (although not necessarily exclusively), and minimally processed.  Eat according to those principles and you do not have to worry about nutritional details.

All of that boils down to the advice I propose in What to Eat: eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.

Let the scientists and their interpreters fight it out over single nutrients.  Eat food and enjoy your dinner.

Comments

Wonderful answer. Sounds just like In Defense of Food, which everyone should read.

  • Gregor
  • February 9, 2010
  • 9:09 am

Where are there studies specifically on that advice, then? How do you know that it really works?

I mean, if people follow this advice, what happens? Why do we never see these studies in the paper.

[...] It was, in fact, Marion Nestle. [...]

Here’s what I know: diets don’t work – life change is required. Further, you have to eat to lose weight. Additionally, our food these days doesn’t have what our bodies need – supplementation is not only necessary, it’s mandatory.

I’m a wellness coach working with Herbalife International (#1 in direct sales, traded on the NYSE as HLF, and just celebrating 30 years in business).

I was a yo-yo dieter for over 20 years, but started using these fabulous products for weight management 11 years ago. I lost 24 pounds, have kept it off, feel fabulous every day and continually get told that I don’t look my age (54). I don’t take this for granted as i talk to people every day who have no energy, no hope for finding a way to safely control their weight, or have settled for feeling lousey as they age….

I coach locally, nationally, internationally.
Make it a GREAT day!
Lynn

p.s. And i’m actively looking for people who would be interested in learning about being a wellness coach.

Dear Marion et al.-

Happened to stumble upon this exchange courtesy of Google, and hope you don’t mind if I weigh in directly with two comments.

With regard to the saturated fat issue, here are some thoughts on the topic that may be of interest (sorry the link itself is a bit ponderous:

http://www.prevention.com/cda/expertblog/health/health.experts?plckController=Blog&plckBlogPage=BlogViewPost&newspaperUserId=d8aaf1b5-0074-4419-8bbf-c8c6b34222ad&plckPostId=Blog%3ad8aaf1b5-0074-4419-8bbf-c8c6b34222adPost%3a3b54d3af-0927-4cb3-8ae7-4725d2b2e13f&plckScript=blogScript&plckElementId=blogDest

And if I may, while in this mode, a second and more general point. Dr. Nestle and I agree entirely about the correct advice, namely- eat food. We borrow from Pollan (‘eat food, mostly plants, not too much’) for this elegant brevity, I suppose.

If Dr. Nestle and I disagree at all- in a spirit of respect and affection, I hasten to add- it is with regard to what it will take to help people find their way back there (i.e., to food) through the clutter of the modern food environment, and perhaps the even greater, more cacophonous clutter of the modern food information environment. If much modern food is questionable at best, much of the wildly proliferated modern food for thought on the topic of food is downright unpalatable- but only to those who can tell the difference. And let’s face it, anyone who stops by this blog to tune in or speak up is, just about ipso facto, a nutrition elite compared to the average citizen! Yet, the average citizen deserves the benefits of ‘eating food’ too, right? The children of average citizens deserve to avoid adult onset (aka, type 2) diabetes before their 10th birthday, right?

So…my thoughts on what it will take to help get people- ordinary people!- there from here:

http://www.prevention.com/cda/expertblog/health/health.experts?plckController=Blog&plckBlogPage=BlogViewPost&newspaperUserId=d8aaf1b5-0074-4419-8bbf-c8c6b34222ad&plckPostId=Blog%3ad8aaf1b5-0074-4419-8bbf-c8c6b34222adPost%3a57347708-78a9-4b55-9dd9-415bf44088c6&plckScript=blogScript&plckElementId=blogDest

Best regards to all-
David Katz

David L. Katz, MD, MPH, FACPM, FACP
Director, Prevention Research Center
Yale University School of Medicine

  • Anthro
  • February 9, 2010
  • 11:58 am

Dear Ms. Johnson,

Here’s what I know:

You shouldn’t use a blog post to hawk your wares.

Supplements won’t help you lose weight on their own.

If you follow Marion’s sensible advice and don’t exceed the calories your body can use, you will lose weight–without supplements.

I lost 45 lbs and have kept all but 5 lbs. off for three years with no “coach”, no supplements, and no special anything. I don’t eat meat as a rule, so I get a bit more of other things, but this is not required. I only get 1000 to 1200 calories a day and I often feel hungry, but I am not starving and have become accustomed. The health benefits have more than compensated for the occasional tummy rumble. I walk–briskly– two to three miles most days. I take the stairs whenever I can find them and I shovel my snow with a shovel. I grow a garden and keep four hens. I live in the city on a normal lot.

  • Anthro
  • February 9, 2010
  • 12:08 pm

Johannes:

In your original post you mention Weston Price Foundation. Please check out this essay from Dr. Barrett at QuackWatch:

http://www.quackwatch.org/01QuackeryRelatedTopics/holisticdent.html

  • Subvert
  • February 9, 2010
  • 1:01 pm

And Mr Katz wants us all to navigate “…through the clutter of the modern food environment, and perhaps the even greater, more cacophonous clutter of the modern food information environment” by following his marketing tools to shop. Great..!

See how easy this is to understand:

“Grandma’s Casserole” is a baked pasta casserole, complete with tons of vegetables, tomatoes and mozzarella cheese.

How does Grandma’s Casserole stack up on the NuVal scale? If you choose the top-scoring items for each ingredient in the recipe, it does very well.

The butter is the only item that does not score so well. Land o’ Lakes Sweet Cream butter scores a 2.

The score for whole canned tomatoes can vary. Melissa chose one of the highest scoring brands: Price Chopper Whole Tomatoes with No Salt Added with a score of 82.

Tomato sauce is another product that can vary greatly. There are some very high-scoring varieties and some very low-scoring brands. One of the best highest scoring is Pastene’s “The Chateau” Marinara Sauce, which gets a 66 on the NuVal scale.

For the pasta, Melissa chose one of her favorite high-scoring brands: Barilla Plus Elbows. They get an amazing 91.

For the mozzarella cheese, she used Sorrento’s Part-Skim mozzarella with a score of 22.

Other than the cheese and the butter, both of which are under control, portion-wise, this is a very high-scoring, nutritious meal that your whole family will love!”

…OK, so does that really teach you anything about nutritional value of foods, general eating guidelines, or navigating the food environment? No – it is a color by the numbers, ‘food consuming for dummies’ approach. Will the brands with the highest scores cost more? Hmm, I wonder – it sure does open that door, doesn’t it Dr Katz? This is all a bit too much like ‘Good Source’ claims, “Smart Choices”, or traffic-light labels.

Dr Katz, isn’t the post you dropped here just a bit selfish? Hawking this NuVal system waiting for mega-grocers and food companies to jump on your band wagon so you can sit back and rake in the cash? C’mon now… :) All is not lost though; you may have hit it big today! By way of posting here, you pseudo-connected with Lynn
(above), and I hear she is looking for buy-in on her Herbalife pyramid marketing scheme…

  • Erin
  • February 9, 2010
  • 2:28 pm

Thank you to Subvert for breaking down Dr. Katz’s system so eloquently. Though I agree to some extent that we all need a GPS navigate the current food landscape, I strongly oppose any complicated “system” that is supposed to solve all of our nutrition woes in the blink of an eye.

In an age where we are inundated with conflicting nutrition information, I just don’t see how it makes things easier to follow a yet another complicated system based on what little science really knows, at this point, about nutrition. Moreover, do we want a population so dependent on some “system” that they cannot make informed choices on their own if they don’t have their trusty NuVal guide with them or see some NuVal stamp of approval on their food?

I just don’t see how it gets any more simple than Michael Pollans mantra “Eat Food, Not too Much, Mostly Plants,” or his recommendations to avoid anything with ingredients you don’t recognize the names of or can’t pronounce. In my world, it’s not that hard to follow Michael Pollan’s recommendations or in Dr. Nestle’s similar recommendations stated above: eat variety, in moderation, mostly plant-based foods, and with minimal processing. Reading the labels on food takes about as much time as figuring out some fancy system, and lets me make my own informed choices on what I buy.

To believe that the population at large is too busy or too stupid to learn how to do the same is really quite condescending, at least in my opinion.

  • Emily
  • February 9, 2010
  • 3:56 pm

Cheers to Anthro (as always) and Subvert! It’s really not hard, and it’s what Michael Pollan says: Eat food. Not too much. Mostly plants. I’ve been following this very sound advice for several years now, and have never been healthier or slimmer. And at nearly 40, I have way more energy than I ever had at 20.

Thanks to Subvert and Anthro for calling out the Hawkers. Its tiresome to weed thru pitches all the time for new systems and products.

As for Katz’s and other systems out there, having a GPS does not enable you to read a map or find your way around on your own. We’ve got to get back to becoming our own inner experts on food. I think Anthro is on his/her way to becoming an expert via gardening, raising hens and shoveling snow. Its not rocket science, its not high tech. Its basic nourishment!

Bravo to Marion Nestle for taking more of a systems approach to food. The reductionist model of macro and micro nutrients has gotten us into big trouble over the years. We should not need a PhD to eat well!

Read all comments. agree with Subvert.
looked & QuackWatch by Anthro: o boy! they are so behind. it is embarrassing .
Studied nutrition and studied it again. can not agree more with this statement by Marion Nestle: “variety in food intake, moderation in calories, largely plant-based (although not necessarily exclusively), and minimally processed.”!!

  • Anthro
  • February 9, 2010
  • 5:13 pm

Thanks for the kudos fellow readers. Sometimes I think I’m just talking to the wall and it’s good to know someone is reading!

Anthro is very much a “she” with four grown kids, and six grandkids–and still shoveling the snow–all 14 inches of it today!

I want to second Erin’s remarks as well–I have a daughter named Erin–and this sounds like something she would say. There is nothing complicated about all this. Marion’s book “What To Eat” is wonderful and offers all the information anyone needs to “eat well”. What is surprising is that she needed to write it at all. I have been practicing her basic tenets for most of my adult life, perhaps because I read a lot (I don’t have a TV either).

  • L.C.
  • February 9, 2010
  • 6:13 pm

After having read Pollan’s books and Marion Nestle’s “What to Eat” I felt a vast, dark, anxious cloud lift in my life. That cloud was made, for lack of better metaphors, of whirling particles of food anxiety. Today’s entry is -exactly- the thing people need to hear, especially when caught up in the net of arguments based on single-nutrient studies. The “points of agreement” among these seemingly contentious folks and their agendas really are the news that I’d wish the media would focus on.

“All of that boils down to the advice I propose in What to Eat: eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.”

Precisely, exactly, elegantly and simply so! Thank you.

Folks: interesting exchange. Two comments:

A reminder that those of you batting ideas back and forth in Marion’s nutrition blog are unlikely to be the ones who need help the most. I work in underprivileged neighborhoods in New Haven and Bridgeport, CT; in a blue collar community in the middle of Missouri. As a public health practitioner working with community members in such places, I can tell you that ‘eat food’ works fine here- but means nothing whatsoever out there. You may feel that we should stick to purity even if it is ineffective, but I confess to being more of a pragmatist than that. I would like to do what works, then move toward ‘purity.’ In the interim, I am not comfortable making perfect the enemy of good.

I add to that our efforts to combine use of NuVal with a free school program, Nutrition Detectives (I reiterate: freely available to all; see my second comment below)- which teaches both children and their parents the clues that guide them to ‘food,’ and teaches WHY some foods are more nutritious than others. Success to date with the program is now in press at the Journal of School Health. Why not guide people to better nutrition even as we teach them to guide themselves there? What makes the two mutually exclusive? Why let them succumb to diabetes in the interim if we don’t have to?

The second comment regards the clear disparagement of referencing a financial interest. This is a charge that has been levied against Al Gore for investing in clean technology companies whose work he promotes. His response? He didn’t advocate for companies because he had invested in them; he invested in the companies doing the work for which he had been advocating. He just put his money where his mouth was: first he advocated for a general concept; then he praised the companies that were doing the work he believed was needed; and then he invested in them, to support them, and profit from the very efforts for which he has long been advocating. Is this really a problem? Don’t we ask people to put their money where their mouths are? And not to put too fine a point on it, but does Dr. Nestle give her books away? Doesn’t she deserve to be compensated for pouring her expertise and hours of effort into them?

When the NuVal algorithm was completed, my first meeting was with the FDA- with the intent of giving it to them. They were not ready at the time, and it was a FDA scientist who advised an academic/business partnership as a means to get the tool where consumers could use it. That I wound up with a business interest in NuVal was incidental, not by design. But my situation is much like Gore’s: I advocated for a solution, then helped to develop one, then wound up with a stake in the commercial enterprise putting it to use. Because we found other means of disseminating our school programming, all of it is free. If inclined, see ABC for Fitness (http://www.davidkatzmd.com/abcforfitness.aspx) and Nutrition Detectives ( http://www.davidkatzmd.com/nutritiondetectives.aspx).

We seem to live in a rush-to-judgment, assume-the-worst, invoke-the-ulterior-motive society. I hope we might agree that it’s possible- at least in theory- to do well by doing good. I am trying.

It’s an idea. It’s just as free if you buy it, as if you don’t.

  • Johannes G
  • February 9, 2010
  • 6:32 pm

Marion,
It’s amazing how easy it sometimes is to overthink problems. Thanks for pointing out the elegantly simple answer. It’s easy to get caught up in one thing, and focusing exclusively on that. Sometimes it takes an outside mind to remind yourself that you need to focus on the broad spectrum of things rather than one thing.

Anthro,
Thanks for the link, and I hope that you, as I, take everything you read with a grain of salt, or at least with a second thought. Barrett raises some valid points, however, I also believe that there are lots of valid points raised by folks on the Weston A Price side of things. Come to think about it, in light of Marion’s reply, I realize that the writings of those folks do in effect continuously say the same thing over and over, and that is the fact that it’s not simply one nutrient which causes changes in our bodies; it’s our entire diet and how we live our lives.
I don’t necessarily believe that “holistic” thinking is quack – I have met plenty of people in my own life who have tried unsuccessfully with conventional, modern medicine, however have had very high success with “holistic” medicine. The opposite is also true.

  • Erin
  • February 9, 2010
  • 7:26 pm

@Johannes I agree completely that articles like the one posted should be taken with a large grain of salt. While there may not be any scientific proof behind claims of holistic healing, the fact is that whatever the mechanism behind it, it has worked for some people. By that same token, just because science claims to have “proven” something works, our knowledge of how the human body work is so limited that what we think works or is healthy today today will be “proven” to not work or to be unhealthy tomorrow.

This is why I tend to follow the guidelines of Michael Pollan and Dr. Nestle over the science of micro and macro nutrients and the latest, greatest nutritional guidelines and systems. Neither the “holistic” approach of herbs and supplements nor the ever changing scientific algorithm of what I should eat is going to reliably prevent and cure all ills. Sure, each approach has its benefits and relative legitamacy, but at the end of the day, nothing is simpler, and in my mind, more reliable, than eating a relatively unprocessed variety of fruits, vegetables, grains, and lean proteins.

  • Subvert
  • February 9, 2010
  • 7:47 pm

Dr Katz,

We agree to disagree. Nutrition education is great, but the whole ‘this is better than that’ grading system just seems to have some disaster written on it – with lots of potential abuse by the partners buying in.

It is interesting that federal agencies recommend that you partner up with industry. Maybe it was the fact that they were not being paid to institute something. You may in fact have better luck with the corporate players who have much more to gain from this grading system. These partner$ may be able to grea$e the legi$lative wheel$ too, if you know what I mean ;)

If you go the industry route, it will no longer be about your original intent of a greater good, and will probably turn out to be another marketing tool to borage people with ‘nutraceuticals’, juices with no real juice, super fruits, and other food that people don’t necessarily need to put into their grocery basket.

Best of luck to you!

To Dr Katz
Few thoughts on idea of NuVal

1. I talked to a store owner once on the topic of health food and he said that the best selling items In his store are: junk food, chips, Coca-Cola, organic turkey, frozen dinners and Clorox. I do not think that he will put happily NuVal-0 on his best sellers. So… you may meet great deal of resistance there.

2. Evaluating food on the base of its label is not 100% reliable idea. As you may know, food manufactures are not obligated to put all ingredients on the label, as a result, food additives, coloring agents and preservatives often are not mentioned or just labeled as a “natural substances”. Good example of this is MSG. how do you plan to evaluate them? They are actually harmful chemicals. They subtract from total nutritional value of food.

3. If I’m a junk food manufacturer, I ‘ll be very much against the NuVal. You have to overcome enormous resistance on this front too. Remember,…. who has the money.
good luck

P.S. you are in Bridgeport, CT, interesting, i’m in Bridgeport too.

  • Louis Collins
  • February 10, 2010
  • 1:06 am

Dr. Katz asks: “Is this really a problem? Don’t we ask people to put their money where their mouths are?”

Yes, Dr. Katz, it really is a problem, a very well-documented problem that is rampant in many areas where science and business intersect and is a particular problem with practicing physicians today. To imply you’re not aware that this might be a problem is strange. Also, your wanting to compare yourself with Al Gore is an unnecessary distraction. It would be better and certainly more relevant if you were comparing yourself to a doctor whose research became a product or service. There really are plenty of other people in your own profession for comparison.

As for asking people to send their money after their mouths, it is not always desirable and definitely not when it comes to public policy advice. Such advice is supposed to come from independent minds not subject to financial influence, either from government which may have to implement policy or industries affected by it.

Certainly you are right in that there is a great deal of cynicism as regards those who are very much in the public eye and are already highly compensated for their work. Based on the cash-cow model of so many doctors promoting so many things besides medicine these days, can you blame such a bad attitude arising in the public mind? When one sees you teeming up with the very industry that you believe you can change, the outcome is not promising. History is betting against you.

And regarding the remuneratively noble sentiment of “doing well by doing good,” how “well” does one need to do? You are tenured, wealthy and held in high regard. You really need further personal enrichment? History shines with brilliant, generous and kind people who dedicate their lives to improving the lives of others, and the best ones lived relatively simple lives in the hopes that what would be excess to them might instead be vital to someone else. Will you settle for being good or will you strive to be the best?

Lastly, your comments in general are quite clever. I compliment you on your powers of persuasion and hope that you are successful in using them to make real change in our odious industrial food system. I really do hope that -something- will finally crack the system of profitable bad food at the expense of the nation’s health and well being. I am rooting for you, I really am!

Dear Dr. Nestle,
I have taken advantage of snowmageddon to read “What to Eat” and have found it supremely helpful – you can see my latest blog post on why. However I do have a question…in “what to eat” you come across as much more concerned about saturated fats from animal products than in your most recent post. Could you please clarify your position?
Thanks,
Jenna

To reiterate what Dr. Katz has noted….
I recently embarked on a diet, and over the course of 6 months lost 45 lbs. I have kept it off an additional 6 months so far. I work in a big office building that is part of NIH actually, and have receive probably hundreds of questions about how I did it. No one believe the “diet and exercise” answer I gave. At any rate, I’ve been giving some advice to some of the security staff, and when I would say things as simple eat more vegetables, not too much high-fat meat, and limit portion size in general I was SHOCKED at how that advice was both new information and enthusiastically absorbed. People who read this blog do not need easy numbering systems, but MANY many overweight people do. To the extent that Nuval helps people make basically good decisions I applaud it. The only thing I don’t understand is how to provide one system to all foods – for example, lean turkey is a great food, but not if you’re not also eating fiber, veggies, etc. How does the system ensure that foods are eaten from all food groups – to use a out of fashion term?
Jenna

  • Anthro
  • February 10, 2010
  • 11:05 am

Johannes and Erin:

I am a confirmed skeptic and subscribe to the premise that there is no such thing as alternative medicine because if a treatment is proven to work, then it is adopted by medicine. Anything else is a placebo effect, which is fine, but no one should pay a practitioner for a placebo effect, or avoid getting life-saving treatment because they relied on anecdotes to form their “beliefs”.

Yes, science is self-correcting; it admits it’s errors when the evidence points in that direction and moves forward in fits and starts, but it does move forward and has given us an unprecedented lifespan and quality of life. Any doctor will tell an overweight patient to “eat less, move more,” but few heed the advice so the doctor is stuck treating the resulting lifestyle diseases and gets called a “pill pusher”. The alt. practitioners make billions pushing “natural” pills and concoctions for weight loss that rarely happens and is not required to prove anything. He or she provides all manner of scientifically dubious advice, often implying that there is some magical combination of isolated nutrients that will “burn fat” or “regulate metabolism”.

When I lost weight I got the same questions as the poster who responded to Dr. Katz. How did you do it!? When I told them that I ate less, they would not accept it. I began telling people that I had taken a magic pill and that I would sell them a bottle of it for $200 and their eyes would widen briefly before my expression revealed that I was, of course, joking.

I realize the term “quack” may seem derisive to some, but when people sell remedies or treatments that are not demonstrated by standard scientific principles to work, they are taking your money simply because you have “faith” in them–which can induce a placebo effect and cause you to temporarily feel better. Most of the anecdotes offered by such people have ever been subjected to any kind of basic scrutiny. People are said to have recovered from cancer, but no one really knows if the person ever really had cancer. Anecdote does not equal evidence.

Stick with the simple advice given here at no charge and give Marion’s book “Food Politics” a read for a modest investment and some insights into some of this.

Dear Anthro, you are saying that : “The alt. practitioners make billions pushing “natural” pills and concoctions for weight loss that rarely happens and is not required to prove anything. He or she provides all manner of scientifically dubious advice…”

i hope that you do not mean naturpathic physicians. i ‘m the one. every ND first looks and talks to a patient about their diet and exercise. if patient has borderline blood pressure, for example,or has any other problem, i can not ignore that and i’ll recommend some supplements: magnesium, potassium, arginine, low salt diet and Rauwulfia for a period of time till patient on the right track with the right diet and exercise and loosing weight. but the goal with every ND is: cut down on all pill: drugs and supplement.s, get healthier.
often at the first visit i look @ the patients supplements(they come with huge bags) and discontinue 95% of them(i call it green poly-pharmacy). they take them because they find on the web or someone promised them a miracle, if they take th substance.

Naturopathic physicians are not associate with any pharmaceutical or supplement producing companies, however , we have preferences. health restoration by natural means is the goal with every ND. we are trying to eliminate obstacles and educate patients how to get healthier.
To all my healthy patients a recommend only one supplement:good quality multi-vitamins. why, see my opinion on my blog:
http://naturesmed.blogspot.com/2008/06/to-take-or-not-to-take-supplements.html
anyway, pleas, feel free to ask me a questions about naturopathic medicine and NDs

I had ducked out of this exchange- to shoot the Dr. Oz Show today, in fact, following a rather harrowing drive through today’s snowstorm, and try to squeeze my day job in; but Jenna asked me to return and post a response to her query.

I am a pretty good amateur carpenter, and have a lot of very good tools- but no one tool is right for every job. I would say the tools for helping people eat better are like that. NuVal, for instance, will very reliably guide you to the most nutritious loaf of bread, or box of cereal, or pasta sauce…or whatever, but won’t tell you how much of each to eat, or how best to combine them. That task is addressed by MyPyramid, and the Dietary Guidelines (and by Dr. Nestle, among others), with which NuVal is fully compatible. Also, the NuVal program- in stores (note: it is posted on supermarket shelves, so is NOT dependent on the manufacturers who sell junk food- we score their products with no need for their involvement or consent) and on the web comes with education about how to use the tool- including what it DOESN’T do. It would be the height of folly to think that any one tool could do every part of a complex job, and getting people to eat better proves to be a complex job.

That said, researchers at Harvard will soon be publishing research that shows when NuVal scores are aggregated to the diet level- in 110,000 people- they predicted all-cause mortality and total chronic disease slightly better than USDA’s Healthy Eating Index-2005. So there is clearly a link between nutritious foods, and how they add up to make a more healthful diet. But both the individual choices, and the pattern of those choices, have to be ‘right’ for there to be a true health benefit.

Finally, we are currently in advanced testing of an ONQI algorithm derivative to score the quality of the overall diet. It includes the initial measure of the overall nutritional quality of individual foods used in NuVal, but then adjusts for variety, balance, and distribution- using the Dietary Guidelines and reference ranges from the Institute of Medicine. We will be testing its performance against health outcomes in large cohort studies, and anticipate it being used in an interactive Web environment in particular. It could be used to track your diet over time, and with each addition of a day’s intake, learn immediately if the overall diet quality is rising, falling, or stable.

I hope this fully addresses your question, Jenna- thanks for the interest.

All best,
DK

  • Jenna
  • February 10, 2010
  • 4:37 pm

Dear Dr. Katz,
Thanks so much for the clarification. That is very helpful. While I think I have my own food intake pretty much figured out, I eagerly await your new tools as I think there exists a gaping hole right now, in helping people easily make good choices. I spent two years reading a lot of books but most people do not have the proclivity to do so. I hope that general portion sizes become better understood, as well as what a balanced diet means. Thanks for your contributions thus far.
Jenna

  • Anthro
  • February 10, 2010
  • 7:32 pm

Ms. Waks, ND

I am glad to hear that you appear to run an honorable practice, but I get the same advice from my MD and insurance covers it. I think ND’s can be of help to people who are reluctant to seek medical treatment by steering them there when necessary. If you are able to get people with borderline bp to dump the supplements and adopt healthy food in proper amounts, I applaud you and you are probably ahead of the MD’s on that.

Thanks for the response.

  • Hominid
  • February 10, 2010
  • 7:55 pm

Dr. Katz

What is so complicated about: Eat fresh fruits and vegetables, whole grains and small servings of lean meat if you want to?

Who needs an algorithm for that? Who does not have access to that information if he or she wants to know? I am not discounting the problems of “food deserts” and such, but I think the First Lady is on the right path with the idea of providing support to harried parents as a part of the mix.

If someone needs NuVal to decide what to eat, we have a long way to go in basic education.

[...] get over that hump, everything falls into place pretty quickly, and then you just get to relax and Eat Food. Lots of it. Yummy, home-cooked food. If you do this right, portions control themselves, and all [...]

If there’s a single nutrient that deserves a closer look, it is omega-6 fat. Back in mid October of 2009 the Department of Defense sponsored a two day workshop on the effects of omega-6 supplementation on the physical and mental performance of soldiers. On day two Dr. Bill Lands spoke for 37 minutes on “Why Omega-6 Fats Matter for Your Health.” http://videocast.nih.gov/summary.asp?live=8108

About ten weeks ago, after watching the above videocast, I stopped consuming peanut butter. Ever since my discharge from the service in 1972, I’ve been eating a peanut butter sandwich for lunch 5 or 6 times a week.

I’ve known for 16 years that too much omega-6 can hammer ones immune system. I used to consume quite a bit of mayonnaise and cold pressed soy oil in the form of vegetable dip and salad dressing. A skin ulcer on my shin eventually persuaded me to abandon those sources of omega-6.

While eliminating those sources of omega-6 was helpful, I still must have been consuming too much because over the past decade I’ve gradually lost strength and flexibility in my limbs. In addition, I’ve experienced considerable pain in my shoulders and legs. However, since deleting peanut butter from my daily regimen, there’s been dramatic improvement. I can now get up from a chair without thinking about it. If progress continues, I should be able to run freely in a month or so.

Leave a comment