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Eat Sleep Move

Posted by James on 05/14/2018 | Comment

Do you suffer from obstructive sleep apnea? Are you tired during the day? In middle-aged adults, the prevalence of obstructive sleep apnea is estimated to be 4%-9%, although the condition is often undiagnosed and untreated (1).

What is it? “Obstructive sleep apnea is defined by the occurrence of daytime sleepiness, loud snoring, witnessed breathing interruption, or awakenings due to gasping or choking in the presence of at least 5 obstructive respiratory events per hour of sleep,” (1). The number of apnea or hypopnea events per hour of sleep reflects the Apnea– Hypopnea Index (AHI), which classifies the severity of obstructive sleep apnea. An AHI of 5-15 is mild, 15-30 is moderate, and > 30 events per hour characterize severe sleep apnea (1).

What are the risk factors? Risk factors for obstructive sleep apnea are dependent on gender, age, weight, neck girth, snoring, and frequent breathing pauses. With that being said, obstructive sleep apnea is a risk factor in itself for a number of chronic diseases, such as hypertension, diabetes, stroke, and cardiovascular disease (1).

Can your diet really help improve your quality of sleep?

Fat. A recent publication (1) examined dietary intake in patients with newly diagnosed obstructive sleep apnea. Of particular interest was the percentage of fat contributing to their total caloric intake. Participants with a BMI < 30 kg/m2 who received 35% or more energy from fat had significantly higher AHI than those with less than 35% energy from fat (P = .022). Among those with BMI ≥ 30 kg/m2, elevated fat intake was associated with a higher AHI although the difference is not significant.

Processed meats. Although not significant, the intake of processed meats was associated with sleep apnea (P = .056)

Dairy. Low-fat dairy was found to be significantly associated with less severity of sleep apnea in overweight participants.

Snacks. Consumption of snacks was associated with increased apnea in subjects with BMI < 30 kg/m2 (P = .016 but not in participants with BMI ≥ 30 kg/m2.

Key Takeaways (1).

1. In overweight patients, severity of sleep apnea was related to an increased intake of saturated fats

2. Intake of processed meats was associated with sleep apnea

3. Low-fat dairy was associated with a decreased severity of obstructive sleep apnea on presentation.

Tart cherries and kiwifruit. Additional research found an association between consumption of fruit, specifically tart cherries and kiwifruit, and enhanced sleep in individuals with sleep disorders. This association may be due to the presence of antioxidants in cherries, which help to reduce oxidative stress in patients with obstructive sleep apnea. It is also important to note the influence of consumption time and quantity on total sleep time and sleep efficacy. The consumption of 2 kiwifruits, 1 hour before bedtime enhanced the sleep of individuals with sleep disorders (2).

What are the dietary recommendations if I suffer from obstructive sleep apnea (1)?

1. Fat intake should be less than 10% total calories per day

2. Encourage the consumption monounsaturated “healthy” fats and limit saturated “unhealthy” fats

3. If dairy products are eaten, they should be of the low-fat variety.

What about exercise?

As a whole, the scientific literature indicates improved clinical outcomes for obstructive sleep apnea patients who are physically active. These improved clinical outcomes include a “reduction in disease severity and in daytime sleepiness, as well as an increase in sleep efficiency and in peak oxygen consumption, regardless of weight loss,” (3). Furthermore, exercise has been shown to improve AHI and cardiorespiratory fitness in patients with obstructive sleep apnea (4,5).

Obstructive sleep apnea has become quite common in the United States and, just as with any other disease state or condition, nutrition and exercise can play a significant role in improving clinical outcomes. If you are suffering from obstructive sleep apnea and are looking for a longer and better-quality sleep, try to reduce fat to < 10% of your daily caloric intake and take part in at least 150 minutes/week of moderate-intensity, or 75 minutes/week of vigorous-intensity aerobic physical activity.


(1) Bove C, Jain V, Younes N, Hynes M. What You Eat Could Affect Your Sleep: Dietary Findings in Patients With Newly Diagnosed Obstructive Sleep Apnea. American Journal of Lifestyle Medicine 2018;

(2) St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. American Society for Nutrition 2016; 7: 938-949.

(3) de Andrade FM, Pedrosa RP. The role of physical exercise in obstructive sleep apnea. Jornal Brasileiro de Pneumologia 2016; 42(6): 457-464

(4) Aiello KD, Caughey WG, Nelluri B, Sharma A, Mookadam F, Mookadam M. Effect of exercise training on sleep apnea: A systematic review and meta-analysis. Respiratory Medicine 2016; 116: 85-92.

(5) Iftikhar IH, Kline CE, Youngstedt, SD. Effects of Exercise Training on Sleep Apnea: A Meta-analysis. Lung 2014; 192(1): 175-184.


Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Nutrition for Two

Posted by James on 05/14/2018 | Comment

…for moms-to-be

With the endless supply of information on what you “should” and “shouldn’t” do while pregnant, it is no surprise moms-to-be feel overwhelmed.

As a highly motivated mom-to-be, you want to do everything right. You want to eat the right things, do the right exercises, read every single pregnancy book, and buy all the right things! But, when all is said and done, you are going to make mistakes—and that’s okay. No one expects you to be perfect or suddenly know all the “ins and outs” of a healthy pregnancy.

With that being said, here are some important nutrition recommendations that may help put your mind at ease.

Here are the nitty gritty, straight-to-the-point, evidence-based recommendations:

Let’s start with CALORIE RECOMMENDATIONS. Most reasonably active reproductive-age females need about 2,100 to 2,300 calories each day. During your 1st trimester, YOU DON’T NEED ADDITIONAL CALORIES!! Shocking, I know. Yet, for the 2nd and 3rd trimesters, aim to increase your calories by 340 and 450 calories/day, respectively.


Protein. Prior to pregnancy, women should consume about 50 g/day protein, and during the 2nd and 3rd trimester of pregnancy, women should consume an additional 25 g/day.

Fat. Pregnant women should consume daily at least 300 mg of DHA—which is an omega-3 fatty acid. Furthermore, pregnant women should eat a total of 8 to 12 ounces of fatty fish each week to obtain omega-3 fatty acids, iodine, iron and choline.

However, the FDA cautions pregnant women and parents about avoiding fish with high levels of mercury. For detailed information, visit Eating Fish: What Pregnant Women and Parents Should Know

Carbohydrates. Pregnant women should ingest at least 175 g/day.


NEXT, THE VITAMINS. How much vitamin A do I need? 2500 IU/day but no more than 10,000 IU/day. Vitamin A is important during pregnancy HOWEVER, too much vitamin A can be dangerous for you and your baby.

How about vitamin D? 600 IU/day


Folic Acid. For healthy, reproductive-age women, 400 mcg/day. For pregnant women without a prior neural tube defect, 600 mcg/day. For women with a prior neural tube defect, 4000 mcg/day.

Cobalamin. How much do I need? 2.4 mcg/day prior to pregnancy and 2.6 mcg/day during pregnancy.

Choline. How much do I need? At least 450 mg/day during pregnancy and 550 mg/day when nursing.

MINERALS, such as calcium, iron, and iodine, are also important for pregnant women.

How much calcium do I need? 1000 mg/day.

What about iron? 18 mg/day prior to pregnancy and 27 mg/day during pregnancy.

…and iodine? Pregnant and lactating women need at least 220 and 290 mcg/day, respectively.


A recent systematic review included 17 trials with 137,791 pregnant women who incorporated multiple-micronutrient supplementation into their diet. The authors concluded that “pregnant women who received multiple-micronutrient supplementation had fewer low birthweight babies and small-for-gestational-age babies than pregnant women who received only iron, with or without folic acid,” (1).

Additionally, authors of a review article on micronutrient supplementation and placental function suggest micronutrient supplementation to be a “cost effective, applicable, and safe method of improving pregnancy outcomes for millions of women across the globe,” (2). For additional AND reputable resources, visit the World Health Organization, Academy of Nutrition and Dietetics, Centers for Disease Control & Prevention, or the U.S. Food and Drug Administration.


(1) Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2017.

(2) Richard K, Holland O, Landers K, Vanderlelie JJ, Hofstee P, Cuffe JSM, Perkins AV. Review: Effects of maternal micronutrient supplementation on placental function. Placenta. 2017; 54: 38-44.



Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University


Posted by James on 04/26/2018 | Comment

What is it?
You may be wondering, “What is kombucha?”. For starters, Kombucha is a recently popularized probiotic beverage consumed for its anti-inflammatory and antioxidant properties. Now you may be wondering, “What is a probiotic?”. The World Health Organization defines a probiotic as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.”
For a product to be considered a probiotic, Lynne McFarland, an associate professor at the University of Washington explains, “…they have to be alive. They can be a bacteria or a yeast. They have to be used in an adequate dose, and they have to have some proven beneficial health effect.”

How is it made?
Kombucha derives from a process known as fermentation. So, before we continue on about Kombucha, let’s explore this antique method for extending the life and safety of food.

Kombucha fermentation is an aerobic process in which sugar and tea are converted, in the presence of a SCOBY, or a symbiotic colony of bacteria and yeast, to “a lightly carbonated, slightly sour, and refreshing drink, which is composed of several acids, 14 amino acids, vitamins, and some hydrolytic enzymes,” (1). Specifically, Kombucha contains the following vitamins and minerals: Vitamins B1, B2, B6, B12, and C
Minerals Copper, Iron, Manganese, Nickel, and Zinc (1)

Preferable conditions for kombucha fermentation
Fermentation is influenced by many factors such as time, temperature, and pH. Therefore, any changes in the fermentation condition may affect the final product. With that being said, below are general recommendations based on the finding of current literature (1).
Time: Average of 15 days
Temperature: Generally, between 22-30 degrees Celsius
pH: No lower than 3

The science
Research has been conducted to examine antimicrobial, antioxidant, anti-inflammatory, and anticarcinogenic properties of Kombucha (1). The findings of one particular study is highlighted below. However, further research is warranted to better understand the characterization of its active components and their evolution during fermentation.

Anti-inflammatory properties (2)
• Fermented beverages of oak effectively down-regulated the production of nitric oxide
• Pro-inflammatory cytokines (TNF-alpha and IL-6) in macrophages were stimulated with lipopolysaccharide.
• Phytochemical compounds, present in kombucha analogues from oak, decrease oxidative stress.

Make your own!
Visit The Kitchn, an online food magazine, at https://www.thekitchn.com/how-to-make-kombucha-tea-at-home-cooking-lessons-from-the-kitchn-173858 for help on how to make your very own Kombucha.


(1) Villarreal-Soto SA, Beaufort S, Bouajila J, Souchard JP, Taillandier P. Understanding Kombucha Tea Fermentation: A Review. Journal of Food Science. 2018; 83(3): 580-588.
(2) Vázquez-Cabral BD, Larrosa-Pérez M, Gallegos-Infante JA, Moreno-Jiménez MR, González-Laredo RF, Rutiaga-Quiñones JG, Gamboa-Gómez CI, Rocha-Guzmán NE. Oak kombucha protects against oxidative stress and inflammatory processes. Chemico-Biological Interactions. 2017; 272: 1-9.
(3) Chakravorty S. Kombucha tea fermentation: Microbial and biochemical dynamics. International Journal of Food Microbiology. 2016; 220: 63-72.


Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Diet Adherence for Weight Loss

Posted by James on 04/26/2018 | Comment

Popular weight loss programs represent a multibillion dollar industry. A 2014 systematic review of 48 randomized control trials was conducted to compare weight loss outcomes with popular diets, such as Atkins, Weight Watchers, Ornish, Jenny Craig, Volumetrics, and Nutrisystem. Overweight or obese adult participants were randomized to a particular diet and were followed up with at 6 and 12 months. Of the 48 randomized control trials, 5 did not report weight loss at 6 months, and 23 trials did not report weight loss at 12 months (2).

At 6 and 12 months, low-fat and low carbohydrate diets resulted in the greatest weight loss compared to other diets, or no diet at all. Greatest weight loss at 6 months was seen with the Atkins diet (22.3 lbs), followed by the Volumetrics diet (21.7 lbs), and the Ornish diet (19.9 lbs). At 12 months, the Ornish, Rosemary Conley, Jenny Craig, and Atkins diets were associated with the greatest weight loss, at approximately 14 lbs. Although these diets were associated with the greatest weight loss at 6 and 12 months, approximately 2 to 4 lbs were regained by 12 months. In fact, all diets except Jenny Craig slightly decreased in their estimated effects at 12 months compared to 6 months (2).

The authors of this systematic review concluded, “Because different diets are variably tolerated by individuals, the ideal diet is the one that is best adhered to by individuals so that they can stay on the diet as long as possible” (2).

To this point, a randomized control trial included in this meta-analysis assessed adherence and effectiveness of the Atkins, Zone, Weight Watchers, and Ornish diet, for weight loss and cardiac risk factors. Participants had a mean age of 49 and BMI of 35. Only 93 of the 160 participants completed the study, indicating a high dropout rate of 42%. Attrition rates were highest amongst the more extreme diets, the Atkins diet at 48%, and the Ornish diet at 50% (1).

Although both the Atkins and Ornish diets resulted in modest, statistically significant weight loss (10.6 lbs for Atkins, 13.2 lbs for Zone, 10.8 lbs for Weight Watchers, and 16.1 for Ornish) and improved cardiac risk factors at 1 year, these diets had poor sustainability and adherence rates which resulted in weight regain and worsening cardiac risk factors for each diet group as a whole (1). The research also found a strong association between weight loss and self-reported dietary adherence, but not with weight loss and diet type. This underscores the concept that adherence level, rather than diet type, is the key determinant of clinical benefits (1).

Johnston et al. (2014) concludes, “The weight loss differences between individual named diets were small with likely little importance to those seeking weight loss.” There is no need for a one-size-fits-all approach to dieting. Diet adherence alone is the basis to having the greatest success at weight loss.



(1) Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293(1): 43-53.

(2) Johnston BC, Kanters S, Bandayrel K et al. Comparison of weight loss among named diet programs in overweight and obese adults. A meta-analysis. JAMA. 2014; 312(9): 923-933.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

News Brief on Intermittent Fasting on Blood Glucose and Lipid Metabolism

Posted by James on 04/26/2018 | Comment

Intermittent fasting, for the purposes of weight loss, has taken over the dieting world. Instead of continuously restricting your diet on a daily basis, intermittent fasting entails intermittent periods of substantial energy restriction combined with periods of normal eating.

A recent study published in the March 2018 issue of the British Journal of Nutrition compared the effects of intermittent and continuous energy-restrictive diet groups on postprandial glucose levels and fat metabolism, following a 5% matched weight loss.

Summary of Results

 1. The elapsed time to achieve 5% weight loss, and the reduction of insulin in the blood were not different between diet groups

2. Reductions in triglycerides (the storage form of energy) and C-peptides (a byproduct of insulin production) were greater following intermittent versus continuous energy-restrictive diets

These findings highlight differences between both diet approaches, including a superiority of intermittent fasting in postprandial reduction of triglycerides in the blood.


 Antoni R, Johnston KL, Collins AL, Robertson MD. Intermittent v. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants. British Journal of Nutrition 2018; 119(5): 507-516.


Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Turmeric Craze

Posted by James on 04/06/2018 | Comment


As an antioxidant, polyphenol, and bioactive component of turmeric, curcumin has surely made a name for itself(1).

More than 300 bioactive compounds have been identified in turmeric but curcumin, is the most widely studied(2). Yet, turmeric is only 2-6% percent curcumin by weight, so the levels of curcumin in turmeric are not nearly as high as the doses tested in most studies. In addition to its low concentration, curcumin has a poor absorption rate(2).

Ready for the good news? Current research has explored the chemical and metabolic properties of curcumin to improve its bioavailability. With that came the patented and registered formulation of curcumin BCM-95®, a total curcuminoids complex with both enhanced bioavailability and sustained retention time in the body. Such a formulation can be found in Health Thru Nutrition’s Curcu-Gel Ultra, providing 650 mg of BCM-95®.


Acute and chronic inflammation play a pivotal role in various medical conditions and diseases, such as the progression of obesity, type 2 diabetes, cancer, pancreatitis, arthritis, neurodegenerative, cardiovascular, and metabolic diseases(3).

A recent publication from March 2018 found that daily ingestion of curcumin in 50-90-year-old adults led to significant benefits in memory and attention—with memory scores improving 28% over 18 months.

“Exactly how curcumin exerts its effects is not certain, but it may be due to its ability to reduce brain inflammation, which has been linked to both Alzheimer’s disease and major depression,” said Dr. Gary Small, the study’s first author(4).

Aside from curcumin’s cognitive benefits deriving from its anti-inflammatory brain effects, it may also be attributed to its antiamyloid effects(4). Amyloid plaques are the sticky buildup of proteins that accumulate outside nerve cells. When the protein folds improperly, it forms amyloid deposits that are associated with brain inflammation. Therefore, in this particular study participants with daily curcumin showed less amyloid activity in the brain than those without daily curcumin. These specific regions of the brain are known as the amygdala and hypothalamus, which control several memory and emotional functions.


Aside from its role in promoting mental health among aging adults, curcumin has also been studied for its role in the treatment of cancer. Statistically, cancer occurs in 14.1 million people in the world annually. In the last few decades, more than 10,200 research publications and 258 clinical studies have been conducted to investigate the relationship between curcumin and cancer(5).

A 2016 review article determined that the anticancer effects of curcumin are multi-targeted in nature. “It can modulate all kinds of cancer hallmarks, including cell proliferation, cancer signaling pathways, transcription factors, tumor angiogenesis, and metastas”(5). With that being said, Pandima Kasi and colleagues concluded that curcumin could be used for the treatment of different types of cancer(5).


Adding to the list of benefits, a 500 mg dose of curcumin in the form of BCM-95® was found to significantly improve disease activity and severity of inflammation in patients with rheumatoid arthritis(6).

Research was also conducted in middle-aged patients with osteoarthritis, demonstrating significant improvements in pain scores and range of movement, after ingesting a 500 mg BCM-95® and Boswellia serrata formulation(7).


Aside from its benefits, research has also explored the safety of curcumin. The USDA has approved curcumin as a “Generally Regarded As Safe” compound and the daily intake of curcumin at a dose of 0.1-3 mg/kg body weight has been considered an acceptable dose by the Joint FAO/WHO Expert Committee on Food Additives (1996)(1).


(1) Ghosh S, Banerjee S, Sil PC. The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update. Food and chemical toxicology. 2015; 83: 111-124.

(2) Moore HG, Spiro A. Can turmeric really prevent cancer? British Nutrition Foundation. 2017; 42: 141-147.

(3) Shehzad A, Rehman G, Lee YS. Curcumin in inflammatory diseases. BioFactors. 2013; 39(1): 69-77.

(4) Small GW, Siddarth P, Li Z, et al. Memory and Brain Amyloid and Tau Effects of a Bioavailable Form of Curcumin in Non-Demented Adults: A Double-Blind, Placebo-Controlled 18-Month Trial. The American Journal of Geriatric Psychiatry. 2017; 26(3): 266-277.

(5) Kasi PD, Tamilselvam R, Wozniak KS, et al. Molecular targets of curcumin for cancer therapy: an updated review. Tumor Biol. 2016; 37: 13017-13028.

(6) Chandran B. A Randomized, Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis. Phytotherapy Research. 2012; 26(11): 1719-1725.

(7) Kizhakkedath R. Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis. Molecular Medicine Reports. 2013; 8(5): 1542-1548.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

News Brief on Vitamin D and Cancer

Posted by James on 04/06/2018 | Comment

Vitamin D can have protective effects against cancers at many sites, according to a recently published study in the BMJ.

This large prospective study cohort aimed to evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site-specific cancer in 40-59 year-old Japanese adults over the course of 16 years.

3,301 incident cases of cancer and 4,044 randomly selected subcohort participants were included in this study, and the incidence of overall or site-specific cancer was recorded and analyzed.

Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer and liver cancer. Although these findings are statistically significant, it is important to note that this study cannot prove causality.

In their closing remarks, Budhathoki et al. (2018) reported, “…although maintaining an optimal 25-hydroxyvitamin D concentration is important for the prevention of cancer, having a concentration beyond this optimal level may provide no further benefit. Future studies are needed to clarify the dose-response pattern and the optimal concentrations for cancer prevention.”

Budhathoki S, Hidaka A, Yamaji T, et al. Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort. BMJ. 2018;360:k671

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Nuts about Nuts

Posted by James on 03/04/2018 | Comment

Nuts about Nuts? Should nuts be consumed to reduce risk of chronic disease?

In a Nutshell discusses whether or not nuts are all they are cracked up to be. Nuts are advertised as a great source of protein and unsaturated fats. Although this may be true, other sources of protein have much fewer calories, such as beans, tofu, Greek yogurt, milk, fish, and poultry. Due to its caloric density, serving size recommendations for nuts may just seem nuts. Just one serving of brazil nuts (6-8 nuts) equates to 150 to 200 . So maybe we shouldn’t be nuts about nuts.

Reasons to go nuts about nuts. Nuts are known to be a good source of protein, especially for those who do not consume animal protein. An ounce of most nuts has 4 to 6 grams of . Nuts are also a good source of dietary fiber, polyunsaturated fats (also known as the “good” type of fat), and antioxidants, such as vitamin E. Such a nutrient dense composition may reduce risk of cardiovascular disease by reducing insulin resistance, cholesterol concentrations, lipid peroxidation, and oxidative . “Nuts also contain other bioactive compounds…which may reduce cancer risk by inducing cell cycle arrest, apoptosis, inhibiting cell proliferation, migration, invasion, and angiogenesis”.

A randomized controlled trial design, comparing participants on either a control diet or a Mediterranean diet, with either nuts or olive oil, found the lowest total mortality risk associated with those who were on a Mediterranean diet, consuming nuts greater than 3 servings/week at . However, who is to say that this association was attributed to the Mediterranean diet and not the actual nut consumption?

The New England Journal of Medicine published the findings of a cohort study, which examined the association between nut consumption and total mortality amongst nurses and other health . This study found that nut consumption was inversely associated with total mortality among both women and men. Specifically, significant inverse associations were observed between nut consumption and deaths due to cancer, cardiovascular disease, and respiratory . In agreeance with Bao et al. (2013), Aune et al. (2016) found a reduced risk of developing cancer, specifically colorectal cancer. Furthermore, current literature suggests a reduced risk of coronary heart , and type 2 diabetes

Research also demonstrates an association between nut consumption and blood cholesterol—specifically lowering LDL, or the “bad” , and elevating HDL, or the “good” cholesterol.

O’Neil et al. (2015) conducted a cross-sectional study, examining the association between nut consumption, weight, and cardiovascular risk factors. Findings indicated a lower BMI and waist circumference, and a lower likelihood of obesity in those consuming tree nuts. To further strengthen these findings, Aune et al. (2016) also found a better weight status among those who consumed tree nuts.

Although it is safe to say that much of the current research supports the notion of “going nuts for nuts”, it is important to realize the limitations of existing studies and other contradictory findings. For example, O’Neil et al. (2015) states that previous research has shown inconsistencies in the association of tree nut consumption with risk factors for cardiovascular disease and metabolic syndrome. With that being said, nut consumption and reduced risk of chronic disease is not a “black and white” issue—hence its ongoing controversy.

Not-so-nutty tips for nut eaters. Rather than eating nuts out of a bag, grab a quick handful, put the bag away, and be done with it. Also, purchase nuts low in sodium and sugar. Look for words such as, “unsalted” or “lightly salted” and try to avoid nuts smothered in chocolate or yogurt. Nuts can also serve as a good substitute for less healthful foods. For example, instead of croutons, sprinkle toasted nuts on your salad. Or, replace a sugary cereal with a whole grain cereal, and add your own nuts and fresh


(1) Hurley J and Liebman B. In a Nutshell: Are nuts all they’re cracked up to be? Nutrition Action Health Letter. October 2015.

(2) Aune D, Keum N, Giovannucci E, et al. Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies. BMC Medicine; 2016: 14: 207-220.

(3) Guasch-Ferre M, Bullo M, Martinez-Gonzalez AM, et al. Frequency of nut consumption and mortality risk in PREDIMED nutrition intervention trial. BMC Medicine. 2013; 11: 164. Abstract Only.

(4) Bao Y, Han J, Hu FB, Giovannucci E, Stampfer MJ, Willett WC, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med. 2013; 269: 2001-2011. Abstract Only.

(5) O’Neil Ce, Fulgoni VL, Nicklas TA. Tree nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in US Adults: NHANES 2005-2010; Nutrition Journal. 2015; 14: 64-71. Abstract Only.


Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Going Gluten Free

Posted by James on 03/04/2018 | Comment

Why are we so hung up on the gluten-free diet?

The gluten-free diet craze

Have you ever stopped to wonder why the gluten-free diet has become one of the most popular diets in the United States?

Claims have been made that gluten-free diets can help you lose weight and improve overall health and exercise performance (1). Even a wide range of books, magazines, and TV shows indicate a correlation between gluten ingestion and a multitude of health concerns (1). The research to back these claims? None.

Yet, the findings of a 2015 survey (figure 1) are astonishing. Over 50% of the 1,500+ American adults who completed the survey, purchase gluten-free foods for either “no reason”, or because they believe it to be a “healthier option” (2).

Figure 1 Results from a 2015 survey of more than 1500 American adults explaining the reasoning behind selecting gluten-free foods (7)


Is your diet free of just gluten?

Just by its name, one can presume a gluten-free diet is, in fact, free of gluten. Yet, if gluten is tossed out the window, are other important nutrients to follow?

A growing body of evidence (1, 3, 4, 5) suggests nutritional inadequacies among those following a gluten-free diet. This diet excludes gluten-containing foods that are major sources of energy, carbohydrates, iron, calcium, zinc, magnesium, and B vitamins (6) and replaces them with excessive amounts of fat (4) and sugar (5, 7).

A recent case-control, cross-sectional study, published in the Journal of Pediatric Gastroenterology and Nutrition, contributes to this growing body of evidence by showing a more unbalanced diet in participants with celiac disease than control participants in terms of added sugars, total fat, and micronutrient consumption (6).

Norelle Reilly, a MD from the Division of Pediatric Gastroenterology at Columbia University Medical Center, explains, “…apart from the treatment of specific disease or symptoms, [a gluten-free diet] may carry more risk than benefit for children” (3).

What if You or Your Child Has Celiac Disease?

If you or your child has celiac disease, the only current treatment is strict gluten avoidance (1). The following table summarizes the potential outcomes of a gluten-free diet. Although there are disadvantages and risks, proper guidance from a registered dietitian can help foster a healthy and balanced diet, rich in vitamins and minerals.

Summary of potential gluten-free diet outcomes (3)

If a gluten-free diet is the right fit for you or your child, the following tips and kid-friendly gluten-free recipes can be of help.

Helpful Tips and Gluten-Free Recipes for Children and Families

  1. For those picky eaters who gravitate towards white rice, try mixing in some millet.
  2. Try quinoa, or if you are really feeling adventurous, try buckwheat!
  3. Build strong and healthy bones by adding protein, calcium, magnesium and potassium to your diet with greek yogurt. Check out these fun recipes your family will love.
  4. Let your child help wash and prepare vegetables. They will be more willing to try them—and may even like them!
  5. Try gluten-free banana walnut oat waffles for a Sunday morning special treat.
  6. Gluten-free oats and a nut butter can be used to make zinc and iron-rich Oat Balls or Energy Bars
  7. On a budget? Use frozen instead of fresh fruit and vegetables to create a deliciously nutritious smoothie for you and your child.

For additional gluten-free recipes, visit http://melissashealthyliving.com/category/recipes/gluten-free/


Final Thoughts and Reminders

  • Go for the naturally gluten-free grains, such as millet, quinoa, and buckwheat, for its fiber and energy content to promote a healthy gut and immune system.
  • In addition to avoiding gluten, focus on promoting a balanced and healthy diet.
  • Seek advice from a registered dietitian or health professional to ensure your gluten-free diet is not lacking in important nutrients.

Focus on what you can eat rather than what you can’t eat.



  1. Babio N, et al. Patients with Celiac Disease Reported Higher Consumption of Added Sugar and Total Fat Than Healthy Individuals. Journal of Pediatric Gastroenterology and Nutrition. 2017;64(1), 63-69.
  2. Reilly NR. The Gluten-Free Diet: Recognizing Fact, Fiction, and Fad. Journal of Pediatrics. 2016; 175, 206-208.
  3. Newberry C, McKnight L, Sarav M, Pickett-Blakely O. Going Gluten-Free: the history and nutritional implications of today’s most popular diet. Curr Gastroenterol Rep. 2017; 19: 54.
  4. Kulai T, Rashid M. Assessment of nutritional adequacy of packaged gluten-free food products. Can J Diet Pract Res. 2014; 75: 186-190.
  5. Wild D, Robins GG, Burley VJ, Howdle PD. Evidence of high sugar intake, and low fibre and mineral intake, in the gluten-free diet. Aliment Pharmacol Ther. 2010; 32: 573-581
  6. Zuccotti G, Fabiano V, Dilillo D, Picca M, Cravidi C, Brambilla P. Intakes of nutrients in Italian children with celiac disease and the role of commercially available gluten-free products. J Hum Nutr Diet. 2013; 26: 436-444
  7. Becker B. Gluten Free Trend. www.hartman-group.com/hartbeat-acumen/120/gluten-free-trend. Updated September 3, 2015. Accessed February 16, 2018.
  8. Nutrient Recommendations: Dietary Reference Intakes (DRI). National Institutes of Health. 2011. Available at: https://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx. Accessed February 16, 2018.


Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Microbiome and Gut Health

Posted by James on 01/17/2018 | Comment

The human microbiome is a collective term for all the microorganisms, such as bacteria, fungi, and viruses, living in and on the human body. Microbes are the microorganisms that interact in the microbiome. Just like organisms in Earth’s ecosystems, our microbial population changes when our environment changes. The microbes that are the best equipped to live in a particular environment, are the microbes that survive.

Within a few years after birth, we are covered in thousands of different microbes, and they colonize the entire body. Microbe variation is highest during childhood, and gradually decreases with age. Even still, the microbiome continues to change in response to events like illness, disease, antibiotic treatment, fever, stress, injury, and changes in diet.

Of all the human microbial communities, the gastrointestinal (GI) microbiota has the most significant effect on human physiology because of its influence on the development and maintenance of the immune system.

The GI microbiota is a complex ecosystem comprised of tens to hundreds of trillions of microbes that are distributed throughout the gut. Within this structure, the majority of the GI microbiota are bacteria—containing over five million genes that code for the production of specific proteins or enzymes that initiate particular physiologic functions in the host.

Disruptions of GI microbiota are linked with a wide range of health disorders including obesity, hypertension, and diabetes. Alternately, the structure of the microbial communities can positively modulate energy extraction, glucose metabolism, vitamin production, and host immunity.

Our microbes vary with gender, diet, climate, age, occupation, and hygiene. However, long-term diet is believed to be the environmental factor with the most significant impact on the gastrointestinal microbiota.

Manipulating the microbiome to improve health status is becoming increasingly common. For example, metabolic or endocrine disorders may be a potential target for using the GI microbiome to individualize dietary interventions. In GI conditions, such as Irritable Bowel Syndrome, an opportunity may exist to reduce symptoms severity by manipulating the bacteria present in the gut.

Utilization of the microbiome in specific clinical situations also has the potential to improve clinical outcomes in diabetes management, cardiovascular disease, obesity, and potentially nonalcoholic fatty liver disease. Dietary intervention in nonalcoholic fatty liver disease is one area that could particularly benefit from incorporating features of the microbiome into its assessment. Altering the substrates used by the bacteria in the gut may alter the metabolites produced and reduce liver damage.

Dietary fiber has been shown to promote diversity of the microbiome, which gives reason to encourage patients to increase their fiber intake. Furthermore, incorporating a wider range of fiber sources provides a greater range of substrates for the microbiome, giving the opportunity for a wider range of bacteria to become established in the gastrointestinal tract.

Knowledge of the GI microbiome provides an opportunity to promote individualized nutritional advice to enhance overall health and wellbeing. Specifically, it shows promise for those with a metabolic, endocrine, and/or gastrointestinal disorder.


Chung, S., Ravel, J., & Regan, M. (2018). Clinical relevance of gastrointestinal microbiota during pregnancy: A primer for nurses. Biological Research for Nursing, 20(1), 84-102. doi:10.1177/1099800417732412

Harvie, B. (2017). Using the Human Gastrointestinal Microbiome to Personalize Nutrition Advice: Are Registered Dietitian Nutritionists Ready for the Opportunities and Challenges? Journal of the Academy of Nutrition and Dietetics, 117(12), 1865-1869.

Your Changing Microbiome. (n.d.). Retrieved January 10, 2018, from http://learn.genetics.utah. edu/content/microbiome/changing/


Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University