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Instagram for Maintaining a Healthful Lifestyle

Posted by James on 11/07/2017 | Comment

Research from the University of Washington found benefits of Instagram users utilizing food photography as an approach to achieving and maintaining a healthful lifestyle. It promotes mindful eating among Instagram users, emphasizing the importance of eating with all five senses to create awareness towards positively nurturing your body. Food photography allows Instagram users to track and log their meals while going about their everyday lives, and has held Instagram users accountable for what, and how much, they eat.

There is an artistic element to photographing your food. It is an art in which anyone with a smartphone can succeed. The editing tools available create a world full of professional photographers. Enhancing the color, or changing the angle at which the photo is being taken, improves the creativity and quality of the photo.

Food photography creates a scene that endorses feelings around food by creating detailed imagery, such as the juice oozing from an orange, or even the crispness of your favorite apple. A picture of your mom’s casserole is so much more than just the actual casserole; it allows other Instagram followers to reflect on their favorite childhood dish. A picture is worth a thousand words, and Instagram followers are able to build off of other users to recreate old memories and experiences.

Achieving a healthful diet is one thing, but maintaining it is a completely different story. Many diet and weight loss programs fail, in regards to maintenance. However, Instagram’s visual inspiration is an effective approach towards achieving and maintaining a healthful lifestyle. It is a support program without the hassle of various program costs and unwanted public exposure. Using a variety of hashtags, such as #fooddiary or #foodjournal, draws like-minded followers together and promotes a supportive community, free of judgment. These communities support, encourage, and mentor each other to achieve one’s goals.

Instagram provides users with the opportunity to achieve and maintain a healthful lifestyle, in a way that is both artistic and enjoyable. Reflect on your current lifestyle and consider how Instagram and other social media sites may help to further improve it.


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

Dietary Nitrates

Posted by James on 11/07/2017 | Comment

Whether you are looking to decrease blood pressure or improve exercise performance, dietary nitrates have been the talk of the town. Although the research is in its early stages, the findings are promising.

When dietary nitrate is consumed, it is converted to nitric oxide (NO), resulting in increased vasodilation of the blood vessels supplying oxygenated blood to the exercising muscles. Research has shown that this process increases the volume and speed of oxygen and nutrient delivery to the muscles, resulting in an improved maximum oxygen uptake. Also, NO allows mitochondria within the muscles to operate more efficiently, producing more energy per unit of oxygen. Berry et al. (2015) explains this alternative pathway as a backup system for NO production during exercise.

Although the research of Berry et al. (2015), Vanhatalo et al. (2010), and Muggeridge et al. (2014) states no significant difference in heart rate, significant evidence suggests that the benefits of dietary nitrate can increase plasma nitrite, improve exercise performance, and decrease resting systolic and diastolic blood pressure (Berry et al., 2015). Other benefits include improved circulation, increased energy and brain activity, prevention of chronic disease, detoxification, boosted blood levels, delayed aging, improved mental health, and an increased ability to fight free radicals and inflammation (Berry et al., 2015).

Additionally, Vanhatalo et al. (2010) found that dietary nitrate supplementation may prove to be a therapeutic agent for the treatment of hypertension. Hypertensive participants have shown that a 5 mmHg reduction in blood pressure has the potential of reducing the incidence of stroke by 22% and coronary heart disease by 16%.

Efficacy of dietary nitrite supplementation is dependent on factors such as the age, health, diet, and fitness training status of an individual. Other factors include the intensity, duration, and nature of the exercise task.

Highest levels of dietary nitrate are found in vegetables, including celery, beets, arugula, and spinach. However, certain methods of preparing vegetables, such as boiling, may result in nitrate losses.

Increasing your dietary nitrate intake can be easily accomplished by adding beets to your smoothies, using spinach and arugula in your salad, snacking on celery and peanut butter, or stir frying root vegetables, such as carrots and broccoli.


Berry, M. J., Justus, N. W., Hauser, J. I., Case, A. H., Helms, C. C., Basu, S., & …Miller, G. D. (2015) Dietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patients. Nitric Oxide, 48(A critical examination of the ergogenic/therapeutic effects of supplementation to increase nitric oxide bioavailability), 22-30. doi:10.1016/j.niox.2014.10.007

Muggeridge, D. J., F. Howe, C. C., Spendiff, O., Pedlar, C., James, P. E., & Easton, C. (2014). A Single Dose of Beetroot Juice Enhances Cycling Performance in Stimulated Altitude. Medicine & Science in Sports & Exercise, 46(1), 143-150 8p. doi:10.1249/MSS.0b013e3182a1dc51

Vanhatalo, A., Bailey, S. J., Blackwell, J. R., DiMenna, F. J., Pavey, T. G., Wilkerson, D. P., & … Jones, A. M. (2010). Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. American Journal of Physiology (Consolidated),(4), 1121. doi:10.1152/ajpregu.00206.2010


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

Bone Health and Fall Prevention

Posted by James on 10/26/2017 | Comment

How can we reduce the incidence of bone fractures?

Can it be as simple as preventing a fall?

The most common sites of bone fractures are the spine, hip and pelvis, and the wrist. 90% of hip and wrist fractures and 50% of spine fractures are due to falls. Even more, 1 in 3 adults over the age 65 falls each year and 1 in 2 adults over 80 falls each year.

And yet, the alarming statistics continue. As many as 20% will die within a year of suffering a hip fracture, 25% will no longer be able to live independently, and only 40% will regain pre-fracture level of independent movement.

Fall prevention can be accomplished by removing environmental hazards, having regular vision tests, reviewing medications with physicians, and engaging in regular exercise, including dance, tai chi, medicine ball tosses, Pilates, and heal raises, to improve flexibility and strengthen muscles.

Aside from fall prevention, promotion of bone health through diet and dietary supplements, exercise, and bone-sparing medication, are known to be beneficial. Specifically, dietary recommendations include eating sufficient food, ample protein, plenty of fruits and vegetables, soy foods, foods rich in omega-3 fatty acids, and an adequate calcium and vitamin D intake.

If you are curious about your risk of bone fracture, below are two predictive risk assessment tools:

Women’s Health Initiative Hip Fracture Risk Calculator at http://hipcalculator.fhcrc.org/
World Health Organization Fracture Risk Assessment Tool at http://www.shef.ac.uk/FRAX

Support your bones. They support you.


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

Less is More

Posted by James on 10/07/2017 | Comment

The less ingredients, the better.

Snacks with 5 Ingredients or Less

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


Posted by James on 10/07/2017 | Comment

Fat is commonly known to be stubborn, unwelcomed, and misunderstood. We tend to demonize fat and blame it for the high rates of obesity and diabetes. Is fat a scapegoat? Or is it truly something we should fear? Sylvia Tara, the author of, The Secret Life of Fat, explained her frustrations with watching people around her eat whatever, and whenever, they want, while preserving their thin stature. This motivated her to learn the ins and outs of fat. While speaking to Tom Ashbrook from On Point, she explained, “Fat is not just fat.” Fat is an endocrine organ that produces hormones that are vital to our health. She encourages working with your fat, rather than against it. David Ludwig, a professor at Harvard Medical School states, “Body fat is so much more than a passive calorie storage depot,” (The Secret Life of Fat, 2017). Fat has the unique ability to use stem cells to “regenerate, increase our appetite,…and use bacteria, genetics, and viruses to expand itself,” (The Secret Life of Fat, 2017). Our body needs fat and we possess many defense mechanisms to protect and hold on to it.

Fat releases a hormone, known as leptin, which regulates appetite and metabolism. A major reason why people lose weight and quickly gain it back is because once fat is lost, leptin levels decrease, resulting in an increase in appetite and a decrease in metabolism.

Therefore, maintaining weight loss is often harder than the actual process of losing weight. After losing weight, it is important to reduce caloric intake by 22% in order to keep off the weight. For example, take someone who is naturally 150 pounds and compare their overall caloric intake to someone who originally was 170 pounds but who lost 20 pounds and is now 150 pounds. The person who is naturally 150 pounds can have an overall higher caloric intake than the person who lost 20 pounds and currently the same weight.

Not only is fat an energy reserve for our body, but also is crucial for brain, immune, and reproductive health. Sylvia Tara explains how brain volume is related to fat. Brain growth and development relies on adequate leptin levels. Furthermore, behaviors can often be different in those with lower levels of leptin. So what causes leptin levels to deplete? Either the loss of fat through behavior and lifestyle change, or from a genetic defect.

Fat is also important for immune health. Immune cells, known as T cells, have receptors for the hormone leptin, which help increase activity and propagation of these immune cells. If there is a low level of leptin, there are fewer T cells, causing you to become more prone to infection. As previously mentioned, the reason for low levels of leptin is either behavioral or genetic.

Reproductive health is also dependent on fat because fat produces estrogen. Oftentimes, when there is too little fat, there is a delay in puberty or even a loss in menstrual cycles, resulting in the inability to conceive.

Other factors besides diet and exercise that effect fat, are age and gender. Typically, men are more prone to have less fat than women. Also, as you age, you begin to lose hormones that are important for burning fat. For instance, a 65 year old woman would have different needs than a 25 year old man.

Research on fat remains controversial, however, there are certain views that are agreed upon. Most health professionals agree with the following:

1) Saturated fatty acids should be limited to 10% of total calories

2) Saturated fat should be substituted for polyunsaturated fats

3) Replacing fat with refined carbohydrates can equally be, if not more so, damaging to the body.

It is important to note that the research is ambiguous. As health professionals, we do not hold all the answers, and that can be scary. But as the field of nutrition grows, and the science and technology improves, we will have a better understanding on fat. With that being said, be cautious of fat, but do not be fearful of it. Focus on your overall dietary pattern, rather than specific nutrients in each individual food, and remind yourself that fat is important.


New Research Reveals Deep Truths About Fat. (2017). Retrieved August 11, 2017, from http://www.wbur.org/onpoint/2017/01/03/weight-loss-fat-science

The Secret Life of Fat by Sylvia Tara PhD. (2017). Retrieved August 11, 2017, from http://thesecretlifeoffat.com/

Zelman, K. (2011). The Great Fat Debate: A Closer Look at the Controversy– Questioning the Validity of Age-Old Dietary Guidance. Journal of the American Dietetic Association, 111(5), 655-658. Retrieved August 11, 2017, fromhttps://doi.org/10.1016/j.jada.2011.03.026.

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

Eating in Season

Posted by James on 10/07/2017 | Comment

Why is it important to eat in season? It is important not only for our own health, but also for the health of our planet. Oftentimes produce that is not in season, travels long distances, decreasing its freshness. Furthermore, produce is often picked prematurely to prevent spoilage, causing vitamin degradation and nutrient loss. Common methods of transporting produce contribute to increased greenhouse gas emissions and air pollution. Even current farming practices strip the soil of minerals, which can have an effect on our health due to mineral deficiencies. Furthermore, increased use of chemicals and pesticides are dangerous to our health, and the health of our planet. Moral of the story? Eat local and eat seasonal produce.

10 Recipes for 30 Seasonal Fruits and Vegetables


Add or substitute kale with lettuce or spinach*

Substitute collard greens with turnips or swiss chard*




The Healthy Benefits to You of Eating Fruits and Vegetables In Season. (2011, September 20). Retrieved August 09, 2017, from https://bodyecology.com/articles/benefits_in_season.php

What’s In Season? Fall. (n.d.). Retrieved August 09, 2017, from http://www.fruitsandveggiesmorematters.org/whats-in-season-fall

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

Nutrition and Oral Health

Posted by James on 09/15/2017 | Comment

The relationship between nutrition, general health, and oral health is an important relationship for healthcare professionals and patients to understand. Oral diseases and disorders affect almost 4 billion people worldwide (Palmer & Stanski, 2015). The gravity of oral health on the overall health of our body is astronomical, and what we decide to eat, affects our oral health. “The oral cavity is a vehicle for the transmission of disease-causing microorganisms, as well as a portal, of entry for systemic infections. These pathogens or their cytotoxic by-products are known to cause dental caries, periodontal disease, and other local oral and pharyngeal infections. To boot, these pathogens and by-products can cause an immune response somewhere else in the body or assist in the progression of systemic disease (Palmer & Stanski, 2015).
As common as cavities are, many people do not know what they are, or why they form. Simply put, dental caries  form when bacteria plaque adheres and manifests on the tooth surface. Dental caries can be a result of a “cariogenic diet, inadequate fluoride exposure, a susceptible host, and the presence of caries-causing bacteria in the oral cavity,” (Researchers at University of Maryland, 2017).

Dental caries are extremely common in our sugar-infested food supply. A diet high in simple sugars serves as the primary food source for bacteria (Palmer & Stanski, 2015). As a result, acids are produced and cause the tooth enamel to demineralize. TO correct a common misconception, it is the amount of time that the dietary sugars are in contact with the bacteria, not the total amount of sugar consumed (Palmer & Stanski, 2015).

However, good oral hygiene and a healthful diet have not gone unnoticed. This relationship is attracting new research and consequently, new clinical applications.  New findings have shown a benefit of probiotics on immunity, urogenital, and the respiratory tract. Furthermore, probiotics are commonly used for the prevention and treatment of gastrointestinal infections and disease. In respect to oral health, lactobacilli and bifidobacteria are probiotic microorganisms helpful in the prevention and treatment off oral infectious diseases, including dental caries and periodontal disease. These microorganisms are thought to inhibit oral pathogens, withstand oral environment, and antimicrobial action (Rastogi et al., 2011).

Oral Health, Diseases, & Disorders

Immune compromising conditions, such as cancer, can result in oral manifestations such as mucositis, taste changes, xerostomia, and an increased risk in the development of dental caries. Malnutrition is a common diagnosis of those undergoing treatment since cancer therapies, such as chemotherapy, often alter an individual’s appetite and ability to chew, taste, and swallow. This, in turn, influences intake choice and frequency (Palmer & Stanski, 2015). Patients with oropharyngeal cancer (OPC), often undergo radiation to the oropharyngeal area, which can cause tooth loss, caries, painful stomatitis, xerostomia, fibrosis of the muscles of mastication, and loss of taste (Touger-Decker & Mobley, 2013). Furthermore, surgical procedures can affect mastication and swallowing function, which can also increase the energy and nutrient needs for healing.

Diets high in pickled vegetables, salted meat and fish, charcoal-grilled foods, alcohol, and smoking have been associated with increased oral cancer risk, while diets high in fresh fruits and vegetables have become associated with reduced risk, even accounting for smoking and alcohol use (Palmer & Stanski, 2015). Furthermore, an inverse relationship between fruit and vegetable consumption and risk of OPC was demonstrated (Touger-Decker & Mobley, 2013). The National Comprehensive Cancer Network recommends a team of registered dietitians, physicians, oral health care professionals, speech and language pathologists, and nurses, to ensure optimal treatment and management of cancer (Touger-Decker & Mobley, 2013).

Cardiovascular Disease
Inflammation seems to be a common theme of both periodontitis and cardiovascular disease. It is hypothesized that “localized chronic inflammation of periodontal tissues leads to systemic inflammation that can result in dyslipidemia and atherosclerosis,” (Palmer & Stanski, 2015). With that being said, Palmer & Stanski recommend smoking cessation, a well balanced diet and healthy body weight, and an increase in physical activity.

Childhood obesity and dental caries share the causal commonality of excessive sugar consumption (Researchers at University of Maryland, 2017). Obesity and oral health has proven to be a good indicators of each other. Poor oral health is a good predictor of obesity (New Obesity Findings, 2016), while periodontal disease is more likely to occur in overweight and obese individuals, than normal healthy weight adults (Palmer & Stanski, 2015).

There is a relationship, not only between periodontal disease and cardiovascular disease, but also between periodontal disease and diabetes. Palmer & Stanski (2015) discussed research pertaining to an increased risk of periodontitis in those with diabetes, and the dependency of glycemic control on the severity of periodontitis. As a diabetic, oral manifestations, such as  xerostomia, oral candidiasis, glossopyrosis, impaired oral wound healing, recurrent oral infections, and acetone breath, can occur (Palmer & Stanski, 2015). Visiting your local dentist, orthodontist, and other oral health practitioners is an opportune location for diabetes screening. Early diagnosis and treatment can improve overall patient health and avoid or reduce diabetes-related complications  (Palmer & Stanski, 2015). Health practitioners in a dental setting can use two dental parameters, including the number of missing teeth and the percentage of deep periodontal pockets, to help identify pre-diabetes and diabetes (Lalla et al., 2016). Lifestyle interventions include losing a modest amount of weight, increasing physical activity, reducing calories and dietary fat, liming alcohol consumption, choosing whole grain or higher fiber carbohydrates in controlled quantities, and limiting refined carbohydrate sources (Palmer & Stanski, 2015).

Eating Disorders
Although discussions about eating disorders are often hush-hush, it is important to recognize the disorder and explain how it effects your general health and, for the sake of this article, oral health. Vomiting, due to bulimia, causes acidity in the mouth, resulting in demineralization of the tooth enamel, irritation of the mouth lining, enlargement of the salivary gland, dry mouth, and cheilosis, which is a condition characterized by red, dry, and cracked lips (Howat, Varner, & Wampold, 1990). Individuals suffering from anorexia are at risk of developing conditions, such as xerostomia (Touger-Decker & Mobley, 2013), mucositis, cheilitis, hypertrophy of salivary glands, and dental erosions (Ximenes, Couto, & Sougey, 2009).

Oral Health by Age

Infants and Children
Dental caries are extremely common in children. Factors involved in early childhood caries (EEC) include low socioeconomic status, minority status, older age, and sugared snack or beverage consumption. Consumption of sugar-sweetened beverages in children up to 24 months of age is a strong and identifiable predictor of ECC development. Frequent bottle feeding at night, or putting a baby to bed with a bottle, increases sugar exposure, resulting in tooth decay. Also, the extended and repetitive use of a training cup can cause the fluid to pool around the oral cavity and feed the acid-producing bacteria. Guidelines for infants include providing only water in bottles at nap time or bedtime, controlling the amount of sugar the child consumes, reducing intake of cariogenic foods, never dipping pacifiers in fermentable carbohydrates such as sugar, honey, or juice, introducing the cup at 6 months of age and begin to wean from the bottle, and cleaning their child’s teeth after each feeding.

Young and Elderly Adults
Although dental caries are more likely to occur in children, adults do not go unscathed, and sometimes, face other oral manifestations such as periodontal disease. Therefore, it is recommended for adults to limit excessive alcohol consumption, which can cause dehydration– reducing saliva flow and leading to tooth decay. As adults age, xerostomia, a common side effect of many prescription medications, increases the risk of developing dental caries. For those experiencing xerostomia, it is recommended you drink more water for oral lubrication, use sugar free gum to stimulate saliva production, and avoid foods and beverages that irritate dry mouths such as coffee, alcohol, carbonated soft drinks, and acidic fruit juices.
“For older adults, it is important to target individual needs based on concurrent systemic diseases and disabilities and associated oral manifestations relative to the disease and disability and its treatments,” (Touger-Decker & Mobley, 2013). Aging adults with tooth loss, dentures, or implants, lose the ability to bite and swallow food as efficiently. It is no surprise that malnutrition is common in those who struggle with masticating their food. Take a moment to imagine your chewing capacity with regular dentures versus your natural teeth. It is approximated that the chewing capacity is only 20-25% of natural teeth. Therefore it is important for healthcare providers to advise patients to use their dentures as their knife and fork as their teeth to cut food into smaller sizes. Implanted dentures have a greater ability to bite and chew food as compared to regular dentures.

Periodontitis of a pregnant mother is associated with preterm birth and low birth weight babies. If the mother has high levels of cariogenic bacterial in the oral cavity, their child will too develop dental caries (Nagi, Sahu, & Nagaraju, 2016). Vomiting, or morning sickness, can result in repeated enamel exposure to gastric acid. Furthermore, pregnancy is known to alter the eating habits and cravings of a pregnant woman, which could result in deficiencies and malnutrition. Malnutrition in pregnancy can have damaging effects on the child (Palmer & Stanski, 2015).

CoQ10 appears to be the last antioxidant defense and the highest concentration found in the oral tissues (Battino et al., 2005). According to the research of Nakamura et al. (1974), those with gingivitis or periodontitis, have a CoQ10 deficiency in their oral tissues. It has been shown that the greater the CoQ10 deficiency, the greater the chance of developing an oral condition, such as gingivitis or periodontitis. In order for oral tissue to heal and repair, it needs energy. Due to the role of CoQ10 on energy production, it is presumed that increasing your intake of CoQ10 through your diet or supplementation can help in the tissue repair process.

Dietetic and Oral Health Practitioners

It is important for all healthcare professionals to acknowledge, and become familiar with other disciplines to promote optimal patient care. First clinical signs and symptoms of nutritional deficiencies and excesses, are usually seen in the oral tissues (Palmer & Stanski, 2015). Therefore, it is important for dietetic and oral health practitioners to communicate and work together in order to identify warning signs and symptoms. According to the Institute of Medicine, the four core competencies, in terms of recognizing oral disease risk, include assessments, provision of educational information on oral health, integration of oral health with diet counseling, and referrals as appropriate to oral health care professionals (Touger-Decker & Mobley, 2013). A 1990 survey concluded that dental practitioners had inadequate training in nutrition and did not consider nutrition to be important in their line of work (Stager & Levine, 1990) Alternatively, registered dietitians have also reported a lack of education and training on oral health screening. Dietetic practitioners in clinical practice are expected to include oral health as a component of their nutrition-focused physical examination, counseling, and monitoring of individuals. (Touger-Decker & Mobley, 2013). For dietetics practitioners, identifying non-normal oral conditions and providing referrals and education appropriate to any practice setting. It is important to seek continuing professional education on this topic or partner with an oral health care professional for hands on training to develop competency and proficiency. Oral health care professionals can provide baseline intervention to determine diet/nutrition risk, educate patients on diet relative to oral health, and, when in depth nutrition evaluation and diet counseling is needed, refer patients to an RD for medical nutrition therapy. (Touger-Decker & Mobley, 2013) However, neither oral health screening nor nutrition focused physical examination are cited as specific competencies or criteria in the Accreditation Commission for Education in Nutrition and Dietetics education standards for entry level practice.
Oral health and nutrition have a synergistic multidirectional relationship. Oral diseases, as well as other diseases with oral manifestations, impact an individual’s diet and nutritional status. Similarly, poor nutrition and diet can damage the oral cavity and expedite the progression of oral diseases (Tougher-Decker & Mobley, 2013). Therefore, it should be common practice, between dietetic and oral health practitioners, to screen, educate, and refer patients to promote optimal patient care.

Top 9 Foods That Damage Your Teeth (2017)

  1. Hard candies
  2. Chewing ice
  3. Citrus fruits and beverages
  4. Certain coffees
  5. Sticky foods such as dried fruits in trail mix
  6. Bagged chips
  7. Soda
  8. Alcohol
  9. Sport and energy drinks


Battino, M., Bompadre, S., Politi, A., Fioroni, M., Rubini, C., & Bullon, P. (2005). Antioxidant status (CoQ10 and vit. E levels) and immunohistochemical analysis of soft tissues in periodontal diseases. Biofactors, 25(1‐4), 213-217. doi:10.1002/biof.5520250126

Essex, G., Miyahara, K., & Rowe, D. J. (2016, December). Dental hygienists’ attitudes toward the obese population. Journal of Dental Hygiene, 90(6), 372+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA480593478&sid=summon&asid=fc12ec832812727c43c878a914fe0ca6

Fuchs, N. K. (2014, June). Ask your dentist if you have diabetes. Women’s Health Letter, 20(6), 4+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA372449701&sid=summon&asid=9e9c953375ac348276ad0e1c600133da

Hayes, M. J., Franki, J., & Taylor, J. A. (2016, February). The frequency of dietary advice provision in a dental hygiene clinic: a retrospective cross-sectional study. Journal of Dental Hygiene, 90(1), 12+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA447638203&sid=summon&asid=a6fa2eedff7329c39bd4aed8b3a8ecf9

Howat, P. M., Varner, L. M., & Wampold, R. L. (1990). The effectiveness of a dental/dietitian team in the assessment of bulimic dental health. Journal of the American Dietetic Association, 90(8), 1099+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA9329499&sid=summon&asid=290179fe9f1815129bb3763927ec64c6

Lalla, E., Kunzel, C., Burkett, S., Cheng, B., & Lamster, I. (2011). Identification of Unrecognized Diabetes and Pre-diabetes in a Dental Setting. Journal of Dental Research, 90(7), 855-860. doi:10.1177/0022034511407069

Nagi, R., Sahu, S., & Nagaraju, R. (2016). Oral health, nutritional knowledge, and practices among pregnant women and their awareness relating to adverse pregnancy outcomes. Journal of Indian Academy of Oral Medicine and Radiology, 28(4), 396. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA483684361&sid=summon&asid=6958060b9da52533d015a10bb53575bc

Nakamura, R., Littarru, G. P., Folkers, K., & Wilkinson, E. G. (1974). Study of CoQ10-enzymes in gingiva from patients with periodontal disease and evidence for a deficiency of coenzyme Q10. Proceedings of the National Academy of Sciences of the United States of America, 71(4), 1456-1460. doi:10.1073/pnas.71.4.1456

New Obesity Findings from School of Dentistry Described (Association between oral health status and central obesity among Brazilian independent-living elderly). (2016, December 17). Obesity, Fitness & Wellness Week, 207. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA473578473&sid=summon&asid=45173e0d21d0a192b8adc61914272374

Palmer, C., & Stanski, R. (2015). Oral health and nutrition as gatekeepers to overall health: We are all in this together. European Journal of General Dentistry, 4(3), 99. doi:10.4103/2278-9626.163319

Rastogi, P., Saini, H., Dixit, J., & Singhal, R. (2011). Probiotics and oral health. National Journal of Maxillofacial Surgery, 2(1), 6. doi:10.4103/0975-5950.85845

Researchers at University of Maryland Release New Data on Obesity (Introduction to proceedings of healthy futures: engaging the oral health community in childhood obesity prevention national conference). (2017, May 20). Obesity, Fitness & Wellness Week, 3964. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA491680036&sid=summon&asid=b5e40f6c05bdceb59e2fc19e4c67f29f

Stager, S. C., & Levine, A. M. (1990). The need for nutritionists: a survey of dental practitioners. Journal of the American Dietetic Association, 90(1), 100+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA8350897&sid=summon&asid=ec1d5425a651102095044f2f4f34ad3a

Touger-Decker, R., & Mobley, C. (2013). Position of the Academy of Nutrition and Dietetics: Oral Health and Nutrition. Journal of the Academy of Nutrition and Dietetics, 113(5), 693-701. doi:10.1016/j.jand.2013.03.001

Top 9 Foods That Damage Your Teeth. (n.d.). Retrieved August 11, 2017, from http://www.mouthhealthy.org/en/nutrition/food-tips/9-foods-that-damage-your-teeth

Ximenes, R., Couto, G., & Sougey, E. (2009). Eating disorders in adolescents and their repercussions in oral health. International Journal of Eating Disorders. doi:10.1002/eat.20660

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

The Smoothie Selection Guide

Posted by James on 09/15/2017 | Comment

It is important to keep in mind that many smoothies contain ice cream, sweeteners, and fruit juices. Make sure to read the ingredients and look for smoothies containing whole fruits and vegetables, nonfat yogurt or milk, and little to no added sugar. Nutrient dense smoothies can also be found by looking at the amount of fiber and protein. For example, Smoothie King’s Vegan Dark Chocolate Banana Wellness Blend Smoothie has 11g fiber and 11g protein, while Tropical Smoothie Café’s Kiwi Quencher Classic Smoothie has 1g fiber and 2g protein. Portion size is also important, so try and choose the smallest size. Furthermore, do not be deceived by smoothies with describing words, such as “The Hulk” or “Detox” or “Powerhouse”, in its name.

If you are looking for an afternoon snack, choose a smoothie low in calories and sugar. Good examples include Planet Smoothie’s Frozen Goat Smoothie or Planet Smoothie’s Lean Green Extreme Smoothie. If you are looking for a smoothie to serve as your breakfast, choose a smoothie high in protein and fiber. Good examples include Starbucks’ Chocolate Smoothie or Smoothie King’s Vegan Dark Chocolate Banana Wellness Blend Smoothie.

From a nutritional standpoint, the smoothies in green font indicate the best options, and the smoothies highlighted in yellow indicate the worst options. Without question, Planet Smoothie wins the Restaurant award for “Best Selection of Healthful and Nutritionally Dense Smoothies”.

Did you know that there is a “Blue Apron” for Smoothies? If you are unfamiliar with Blue Apron, it is a food delivery service that provides its consumers with all the ingredients needed to make a delicious meal in exactly the right proportions. Greenblender follows the same concept, but they deliver all the ingredients needed to make delicious smoothies. If you are interested in learning more, or in subscribing for their weekly ingredient deliveries, visit https://greenblender.com/.

McIndoo, H., MS, RD. (2017, April). The Buzz on Smoothies. Environmental Nutrition: The Newsletter of Food, Nutrition, & Health, p. 5.


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

Artificial Pancreas for Diabetes

Posted by James on 09/15/2017 | Comment

In September of 2016, a major breakthrough developed in the treatment of Type 1 Diabetes. The first artificial pancreas, known as the Medtronic’s MiniMed 670G System, was approved by the FDA. This hybrid, closed loop system, includes a glucose meter, a continuous glucose monitor (CGM), and an insulin pump. The first component, a glucose meter, is used to calibrate the CGM. The second component, the CGM, evaluates blood glucose throughout the day. The last component includes a motorized infusion pump that delivers either insulin or glucagon. However, Medtronic’s MiniMed 670G System still relies on diabetics to closely count carbohydrates in their food and then enter these amounts into their system.

A fully automated, closed loop system, such as iLet, senses rising glucose levels, particularly at mealtimes, and adjusts insulinautomatically (Diabetes Week, 2017). This automated medical device eliminates the carbohydrate counting process for diabetics. Although it has not been FDA approved, it is currently being tested in various trials funded by the National Institute of Health (NIH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This CGM and pump system consists of an insulin-only system, as well as a system that uses two hormones–glucagon and insulin–within the pump system, in conjunction with the CGM (Appold, 2017).

The CGM is constantly collecting blood sugar values in order to achieve better control. These values determine whether or not the pump should administer insulin to decrease glucose values, or administer glucagon to increase glucose values.

The approximate annual cost of treatment for both pre-diabetes and diabetes in the United States is an astonishing $322 billion (Appold, 2017). However, major strides in the technological development and treatment of diabetes can indirectly help to reduce overall treatment costs. NIH research found that automatic basil insulin delivery, can help reduce diabetes complications, including nerve, eye, and kidney diseases. This delivery system helps to tightly regulate and control blood sugar levels, decreasing the amount of hospital visits, and therefore reducing overall treatment costs.

Below is a timeline of events that are historic to the technological advancements and treatment of diabetes. To see an extensive version of this timeline, please visit http://www.diabetes.org/about-us/75th-anniversary/timeline.html?loc=75.


75th Anniversary Timeline. (n.d.). Retrieved July 24, 2017, from http://www.diabetes.org/about-us/75th-anniversary/timeline.html?loc=75

Appold, K. (2017). Diabetes improvements: Innovations shake up the industry. North Olmsted: Advanstar Communications, Inc.

Beta Bionics | Introducing the iLet. (n.d.). Retrieved July 24, 2017, from https://www.betabionics.org/

Center for Devices and Radiological Health. (n.d.). Recently-Approved Devices – The 670G System – P160017. Retrieved July 24, 2017, from http://wayback.archiveit.org/7993/20170111141252/http:/www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm522764.htm

Iturralde, E., Tanenbaum, M. L., Hanes, S. J., Suttiratana, S. C., Ambrosino, J. M., Ly, T. T., . . . Hood, K. K. (2017). Expectations and attitudes of individuals with type 1 diabetes after using a hybrid closed loop system. The Diabetes Educator, 43(2), 223-232. doi:10.1177/0145721717697244

Nutritional and metabolic diseases and conditions – type 1 diabetes mellitus; artificial pancreas benefits young children, trial shows. (2017). Diabetes Week

Nutritional and metabolic diseases and conditions – type 1 diabetes mellitus; four pivotal NIH-funded artificial pancreas research efforts begin. (2017). Diabetes Week


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



Posted by James on 08/01/2017 | Comment

Sugar. It is everywhere and in everything, including a variety of sauces, dressings, and other common condiments such as ketchup and gravy (Cording, 2016).

The 2015 Dietary Guidelines recommends Americans limit added sugar, including syrups and other caloric sweeteners, to no more than 10% of their daily caloric needs. To put this into perspective, the daily limit for someone on a 2,000 calorie diet is approximately 12 teaspoons of sugar (Cording, 2016). Sugar intake and highly processed foods play a major role in diabetes, heart disease, and extra body fat. But should we be treating sugar as our one and only arch nemesis? Yes and no.

Although it is important to limit and control your sugar intake, abruptly removing sugar from your diet is not recommended because it can cause sugar dependency and consequently lead to episodes of binging (Is sugar really addictive?, 2002). Furthermore, forbidding sugar from your diet will only create a greater temptation. We live in a world where sugar is considered to be a mouth-watering treat, implying that everything else we eat, including fruits and vegetables, is not (Fabricant, 1992). Our mindset is skewed to associate vegetables with feelings of disgust and chocolate with feelings of deliciousnessAt the end of the day, we are afraid to acknowledge and appreciate the pleasure and taste of food (Fabricant, 1992).

With that being said, pleasure and taste must not be forgotten when trying to promote a healthier lifestyle. Taste is one of the most satisfying and enduring bodily experiences, and much of what we can taste is associated with smell (Hess, 1997).

There are four primary tastes, including sweet, salt, sour, and bitter. Umami has also been accepted as an additional primary taste, and it is best described as being savory. Taste buds function differently depending on whether they are sensitive to sour, bitter, or sweet foods. Taste buds sensitive to sour tastes detect the degree of acidity in foods. Sensitive taste buds to bitter tastes can detect poisons in wild plants, and taste buds sensitive to sweet tastes are known to have helped animals determine whether unknown foods are poisonous (Hess, 1997).

At birth, we naturally prefer sweet substances. Our brain is programmed to seek out sweet substances because “In nature,” as David Levitsky, PhD, a professor of nutritional sciences and psychology at Cornell University states, “there are very few sweet things that don’t have a large amount of energy. That’s how we developed a basic biological function to prefer sweet tastes,” (Is sugar really addictive?, 2002).

Hess (1997) also explains the difference between “supertasters” and “non-tasters“. “Supertasters” do not require the intense taste of refined sugar to satisfy them, while “non-tasters” require stronger tastes for a fuller taste sensation. Furthermore, the response to taste is more intense at the beginning of eating, rather than towards the end of eating, when both taste and smell fatigue set in. Challenging and surprising your sense of smell and taste, by having a varied diet, maximizes the sensory impact and reduces the sensory fatigue while eating (Hess, 1997).

In a clinical setting, medications, chronic disorders, and radiation therapy are commonly known to alter taste perception, resulting in a loss of appetite. Certain endocrine dysfunctions, cystic fibrosis, Addison’s disease, Cushing’s syndrome, and hypertension have been reported to affect taste perception. An altered taste perception can also lead to food poisoning due to the inability to determine whether a food has been spoiled (Hess, 1997).

It is easy to forget about pleasure and taste when focusing on health and nutrition, but it is important to find a balance. Hess (1997) notes that 88% of consumers rate taste as very important in shopping for food. The American Institute of Wine and Food’s ongoing program, “Resetting the American Table,” states “In matters of taste, consider nutrition, and in matters of nutrition, consider taste. And in all cases, consider individual needs and preferences.”

“Taste is personal. Flavors are pleasing and displeasing based on physiologic, psychological, and cultural variables,” (Hess, 1997). Therefore, it is important for dietitians and other health professionals to take these variables into account. Dietary recommendations are not black and white. Compromise and adaptation will promote a healthful lifestyle that is both sustainable and cumulative. “Individualizing nutrition advice, with consideration of taste, health needs, and personal preferences, is a “signature dish” of quality dietetics practice,” (Hess, 1997).

Mintz (1985) discusses how the environment has led to the rise of sugar and its impact on recent dietary changes, including the decline of three meal a day eating pattern, the dependence on prepared foods, and the prevalence of eating out. Richard Mattes, PhD, RD, a professor of foods and nutrition at Purdue University explains, “when we are young, we learn to seek out sweets as a reward or bribe for doing something good,” (Is sugar really addictive?, 2002).

Aside from the environmental factors, it is important to acknowledge the physiological aspects of what and why we eat. Although the external environment influences what and why we eat, basic biology is critical to understanding taste and certain flavors. Steiner (1977) and Mennella and Bobowski (2015) support the importance of basic biology as it relates to basic tastes. However, Mennella and Bobowski (2015) explains how the food environment of commercially prepared, sugar-rich foods, extenuate the basic biology of children and their want for sweets. Therefore, having a better understanding of this may promote healthier eating.

The first step to reduce your sugar consumption, starts in the grocery store. It is recommended to use fruits and vegetables, that are naturally sweet, when baking or cooking. For example, you can add a mashed banana to your oatmeal in the morning and microwave it for a minute, which naturally adds sweetness to the oatmeal (Cording, 2016). According to Julie Davis (2017), satisfying a craving for sugar can be accomplished by resetting your taste buds, or by exercising. Exercising can lower your desire for unhealthy, high-calorie foods. However, using artificial sweeteners have not shown to suppress sugar cravings.

By increasing attention to taste, the effectiveness of nutrition counseling can be increased. Below are suggestions on how to focus on taste (Hess, 1997):

  1. When shopping, choose foods that are beautiful, fresh, and full-flavored.
  2. In planning a menu, choose foods of different shapes, colors, and textures. Foods with eye appeal elicit more saliva. Visual appeal is essential. Food arrangements on the plate and garnishes can improve food intake and eating enjoyment.
  3. Recommend foods that are ethnically appropriate and that can be prepared with familiar seasonings.
  4. Experiment with flavor enhancers and with balancing flavors.
  5. Encourage clients to take time to smell their food and to savor its flavor.
  6. Advise clients to chew their food thoroughly to release its flavor molecules. Chewing also forces odors into the nasal cavity.
  7. Maximize flavor by providing a variety of foods within each meal. Switching from food to food throughout a meal reduces taste bud fatigue.
  8. Serve foods hot or warm to increase their volatile smells.
  9. Choose foods with what flavor researcher Inglis Miller calls “flavor gestalt” (2). Garlic, onions, citrus, and ripe berries pack a lot of flavor. Reserve fat for maximum flavor impact, and use as little as possible to create the flavor effect.

Cording, J. (2016). Looking to Reduce Your Family’s Intake of Added Sugars? Here’s How. Kids eat right.Retrieved from http://www.eatright.org/resource/food/nutrition/dietary-guidelines-and-myplate/looking-to-reduce-your-familys-added-sugar-intake-heres-how

Davis, D. (2017). Reset your Taste Buds for Less Sugar. HealthDay. Retrieved from https://consumer.healthday.com/diabetes-information-10/sugar-health-news-644/reset-your-taste-buds-for-less-sugar-723399.html

Fabricant, F. (1992, January 21). Remember Red-Meat Orgies In the Cave? Your Taste Buds Do. Retrieved July 21, 2017, from http://www.nytimes.com/1992/01/22/garden/remember-red-meat-orgies-in-the-cave-your-taste-buds-do.html

Hess, M. A. (1997). Taste: the neglected nutritional factor. Journal of the American Dietetic Association,97(10), S205+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=AONE&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA20343026&sid=summon&asid=4fc9eac70143efa243b9c04ebd1b697e

Is sugar really addictive? (2002, October). Tufts University Health & Nutrition Letter, 20(8), 1+. Retrieved from http://go.galegroup.com.eduproxy.tc-library.org:8080/ps/i.do?p=HRCA&sw=w&u=new30429&v=2.1&it=r&id=GALE%7CA92588968&asid=c8f7fd78a3fe59a1a9c26d715e18f606

Mennella, J. A., & Bobowski, N. K. (2015). The sweetness and bitterness of childhood: Insights from basic research on taste preferences. Physiology & Behavior, 152, 502-507. doi:10.1016/j.physbeh.2015.05.015

Mintz, S. W. (1986). Sweetness and Power. Penguin Books.Steiner, J. E. (1977). Facial expressions of the neonate infant indicating the hedonics of food-related chemical stimuli. Taste and development: The genesis of sweet preference, 173-188.


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