Monday, October 31, 2016

Here's step one! Get moving.

So my first step to getting healthy was to do 10,000 steps a day. How do you do this being stuck indoors in winter weather? Walk on the spot or get a exercise mini trampoline. I find the time goes fast with the rebounder in front of the TV. Then you can watch your favorite shows while getting your 10,000 steps. For motivation I watch health and fitness shows like the Biggest Loser but anything that helps you stay there to get your steps will work.

In the past I have wasted lots of money on lots of exercise and equipment, you may have too. I have used the Orbitrek, treadmills, gone to gyms, fitness classes locally, group trainers, curve and more. They all help but for people looking for excuses to not exercise you will find them. They cost money, time, opportunity (it is raining, I don't want to catch a cold from the others indoors), they are inconveniently placed (Orbitrek is in the garage and I can't use it, I need to pull it inside or elsewhere to use it) I have no space indoors for the treadmill, I have placed the Orbitrek and treadmill in convenient places indoors but then resent the space they take up and get guilty when I give up using them. My foot gets numb on the treadmill after a while and I find I don't want to use it. Gym classes are 15 mins away and I need to go on their schedule and work my week around this. Group trainers are great but expensive. You get the point, excuses can be many and go on and on.

Get any mini trampoline that works for you, do make sure it can hold your weight though and I have a link on my page for one that is heavy duty. If you are thinner then the rebounders are built cheaper and cost less too, again find something that will work for you. You can find specials for rebounders from $30-90 or more depending on features, quality and weight restrictions. The one I suggest is very reasonably priced yet heavy duty for most customers. But 'caveat emptor' either way.

Get a pedometer, anyone will work, I use and love the fitbit (mine costs $100, but I got it from my credit card thank you points) and that costs from $50-120 but any pedometer will also work. Keep your pedometer on all the time, yes it will alert you to how little you may move every day. But keep it on, it will propel you to do your workouts and to not avoid reality. It is easy to fool yourself in to thinking that you get more steps than you actual do. Obesity does that to you, kind of like addictions (you are sometimes in denial). I got my fitness tracker last Mothers Day 2014 and I was excited to do my steps in the beginning, then once I got too busy I realized how few steps I actually did. Now I want to stay at the 10K steps range to lose weight.

Find a time that will work for you, I have tried all sorts of different times through out the day and have found it the easiest to stay the course if I get started the first available opportunity as early as possible in the day. If you are not a morning person, then try to have a routine where you do your steps as soon as you get home in the afternoon. I find if I don't do my steps as early as possible that there will be ALL sorts of distractions later on. Someone will have an urgent issue that keeps me busy, something else will come up or I will be tired later on.

You can wear fitness clothes but really no special clothing or shoes are required. If you walk on the spot then sneakers are recommended but not necessary. Rebounders are easier without shoes so no additional purchase is required.

The next steps is to repeat this activity EVERY DAY. It doesn't matter if you don't feel like it and there will be days that you will miss but unless you force yourself to do this every day then you won't get anywhere fast. Things that work are to make yourself put your exercise clothes on and get on the trampoline even if you don't feel like it, in fact you won't feel like it most of the time but do this anyway even if you don't want to. Then put your show on and get walking, doesn't matter how fast or slow just get moving. Might take a couple of episodes in the beginning to get your 10K steps in and I was looking at the pedometer all the time to check steps, but stay there till you get as many steps as you can.

One thing that propelled me to lose weight is a photo taken of me and my cousin. I hate taking photos of me and this may also be connected to the denial linked to obesity. I can be in denial if there is no proof. So if you find you can't make yourself get on the rebounder, get someone to take a photo of you, you will surely get on the next available time. Keep doing this or anything else that makes you keep getting on the trampoline EVERY single day. Yes you will get sick and can't etc. But get on asap the next best available opportunity.

I don't weigh myself regularly as it makes me sad and then I overeat but I have noticed I feel MUCH better. I have more energy, get up easier in the morning, can do my daily tasks without too much trouble, can take a walk without getting winded, get a surge of feeling well (what is the word I am looking for?) right after my workout and much much more.

Let me know how you do! Any other advice or tips? Are you joining me in my journey or just getting inspired?


What is a Mediterranean diet and how did I get it so wrong?

My parents are Greek and love to hold their traditions and pass them on to their kids. However I grew up in Australia where I wanted to be just like everyone else and eat their foods. So I was brought up with Greek dinners but packed a regular lunch to school and often had cereal for breakfast. Snacks were western local types too.

Here is what is a a Greek type of diet:

  • Lots of meals with vegetables as their base
  • A lot of those meals have tomato sauce bases which are rich in Lycopene
  • Greeks love herbs, particularly oregano, dill, parsley, basil and put them in their cooked meals and fresh salads
  • Main fats are olive oil (extra virgin of course) and a little margarine
  • Meat isn't the main dish but incorporated into other dishes, such as stuffed peppers etc.
  • Roasts and meat main courses are for special occasions
  • Feta goes with everything, but only a little piece, perhaps one or two serves
  • Fruit is mainly for children but adults can eat a serve often after meals
  • Fruit juice is not encouraged, but sour cherry or tart cherry drinks are common for special occasions.
  • Breakfast is often coffee or milk with bread or pastry or piece of fruit
  • Lunch is at home and not packed, kids at school used to eat tiropita (cheese puff pastry) to hold them over till they get home for lunch usually by 1
  • Lunch is the main meal of the day
  • Rests often occur after lunch
  • Dinner is small and accompanied by a walk in town afterwards by the whole family
  • Snacking is usually seeds (or a few nuts), ie pumpkin seeds but they buy them unshelled and shell them while eating. This forces you to slow down and give you something to do
  • Milk is mainly for babies or young children
  • Yogurt can be a light meal or snack, usually plain with a touch of drizzled honey, delicious
  • Meals are a group affair with other people or often crowds
  • Fish is plentiful served more often than meat and served to even very young children
  • Wine used to be made at home and everyone can have a sip even children
  • A small glass is used for wine and you can have a little at meals
  • Bread is allowed and served as an extra at meals but you only eat it for saucy dishes or if you weren't full with the veggie main
  • Legumes are very popular and incorporated into soups, bakes, dishes and more
  • Rice is used for a side for saucy dishes or in the stuffed vegetables and in soups or bakes
  • Greeks eat bulgar, a cracked whole wheat
  • Goat and lamb was the usual meat back in the day
  • Sweets are for children or only in small quantities for special occasions
  • Fasting from meats, dairy and oils was common before special occasions
  • You have to sit down and eat, with no distractions just company, eating on the run is rude and uncouth
  • Tea was popular and served often
  • Chocolate was ONE piece wrapped and was delicious but overeating wasn't allowed
  • Overeating or drinking too much were akin to sins and rude/crude behavior
  • If you find that you aren't getting full by eating a regular portion then stop anyway, it isn't food that is the problem
  • Water is served with all meals and for all visits
Read how I got it wrong in this post.

Health to Happiness

Nourishment while losing weight

I wanted to type 'diet' but it shouldn't be called diet cause of the negative connotations. And nutrition sounded official and clinical, of which I am neither. So the title 'nourishment' fits the bill.

I suspect that part of obesity is the expansion of the stomach. I am not a doctor and can't elaborate here, but my suspicion (cause of my health and fitness journey) leads me to believe that I eat more cause I don't get the 'full' feeling sooner. It is so hard to stop eating before you get the full feeling. However I suspect that I need to stop at 75-80% (almost) full at 20 mins post meal. That is also hard to do, eat for 20 minutes or slowly to register the almost full feeling and then stop. A lot of us eat so quickly and read/watch tv or otherwise distract ourselves while eating. No wonder we don't get the 'full' feeling sooner. Eating with others and focusing on your meal will allow you to register the almost full feeling sooner.

I don't always diet as I have tried and failed with a lot of them. However I think it is critical to feed ourselves well while trying to loose weight. If I don't feed myself sufficiently and well then I will reach for the chocolate bar. It is very important to eat plant based foods at every meal and your body will recognize them and reward you with the sufficiently full feeling sooner than any other type of food. If I can't get full during a meal I will try to eat an apple, cut fruit, more vegetables and other plant foods. Then I feel satiated.

A lot of times I am too lazy to make myself a meal, lunch for instance, since I am home often during the day. Then I find I crave sweets and chocolate, it is like my body is trying to get satiated without a meal and chocolate will do the trick. Anyway chocolate and cravings and other addictive foods will be mentioned in another post. I just want to mention that we need to feed ourselves healthily with plant and other foods and to not neglect or starve ourselves regardless of where we are, who we are with etc.

You can't feed yourself well if you don't have good food at hand. A huge part of eating well, is getting in to a food shopping routine, find a favorite store, finding a shopping list that works for you and sticking to it. If you take your favorite junk foods off the list then make sure you have something to substitute them with. Don't deprive yourself of nutrients and nourishment. Buy lots of plant based foods, whether fresh (important to have something fresh at every meal cause it helps the gut), frozen, or canned/processed. Get in to a grocery shopping routine to make sure you can nourish yourself well. There are lots of options for groceries these days if you don't or can't shop often. Shop Amazon - Subscribe & Save is great for bulk & staples, Peapod is very reasonable (they also take coupons) and in most neighborhoods nowadays, and there is the store pickup options at lots of local stores (they will collect your items and you just need to pay and take items home). Those conveniences may be worth it in saving time & money, and avoiding temptations.

Do you have something that works? Share below.


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Saturday, August 20, 2016

Exciting Alzheimers update!

If you have been reading my blog for a while, you may remember my post on Alzheimers. New Alzheimers study now recruiting for cutting edge treatment.

Well I was excited to read that now an Alzheimers drug has now gotten approval from the FDA and has been released to the public thru doctors prescriptions. This is a great step forward to finding cures or treatment for diabetes and Alzheimers.

Read about it and let me know what you think!

Apologies for the delays in the blog, it always happens when the kids are off school.

Wednesday, June 1, 2016

Dietary Cholesterol

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The body uses cholesterol for physiological and structural functions but makes more than enough for these purposes. Therefore, people do not need to obtain cholesterol through foods.
The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM,[24] individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern. In general, foods that are higher in dietary cholesterol, such as fatty meats and high-fat dairy products, are also higher in saturated fats. The USDA Food Patterns are limited in saturated fats, and because of the commonality of food sources of saturated fats and dietary cholesterol, the Patterns are also low in dietary cholesterol. For example, the Healthy U.S.-Style Eating Pattern contains approximately 100 to 300 mg of cholesterol across the 12 calorie levels. Current average intake of dietary cholesterol among those 1 year and older in the United States is approximately 270 mg per day.
Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of dietary cholesterol are associated with reduced risk of CVD, and moderate evidence indicates that these eating patterns are associated with reduced risk of obesity. As described earlier, eating patterns consist of multiple, interacting food components and the relationships to health exist for the overall eating pattern, not necessarily to an isolated aspect of the diet. More research is needed regarding the dose-response relationship between dietary cholesterol and blood cholesterol levels. Adequate evidence is not available for a quantitative limit for dietary cholesterol specific to the Dietary Guidelines.
Dietary cholesterol is found only in animal foods such as egg yolk, dairy products, shellfish, meats, and poultry. A few foods, notably egg yolks and some shellfish, are higher in dietary cholesterol but not saturated fats. Eggs and shellfish can be consumed along with a variety of other choices within and across the subgroup recommendations of the protein foods group.


Healthy intake: The scientific consensus from expert bodies, such as the IOM, the American Heart Association, and Dietary Guidelines Advisory Committees, is that average sodium intake, which is currently 3,440 mg per day (see Chapter 2), is too high and should be reduced. Healthy eating patterns limit sodium to less than 2,300 mg per day for adults and children ages 14 years and older and to the age- and sex-appropriate Tolerable Upper Intake Levels (UL) of sodium for children younger than 14 years (see Appendix 7). Sodium is an essential nutrient and is needed by the body in relatively small quantities, provided that substantial sweating does not occur.[25] Sodium is primarily consumed as salt (sodium chloride).
The limits for sodium are the age- and sex-appropriate ULs. The UL is the highest daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population. The recommendation for adults and children ages 14 years and older to limit sodium intake to less than 2,300 mg per day is based on evidence showing a linear dose-response relationship between increased sodium intake and increased blood pressure in adults. In addition, moderate evidence suggests an association between increased sodium intake and increased risk of CVD in adults. However, this evidence is not as consistent as the evidence on blood pressure, a surrogate indicator of CVD risk.
Calorie intake is highly associated with sodium intake (i.e., the more foods and beverages people consume, the more sodium they tend to consume). Because children have lower calorie needs than adults, the IOM established lower ULs for children younger than 14 years of age based on median intake of calories. Similar to adults, moderate evidence also indicates that the linear dose-response relationship between sodium intake and blood pressure is found in children as well.
Adults with prehypertension and hypertension would particularly benefit from blood pressure lowering. For these individuals, further reduction to 1,500 mg per day can result in even greater blood pressure reduction. Because of the linear dose-response relationship between sodium intake and blood pressure, every incremental decrease in sodium intake that moves toward recommended limits is encouraged. Even without reaching the limits for sodium intake, strong evidence indicates that reductions in sodium intake can lower blood pressure among people with prehypertension and hypertension. Further, strong evidence has demonstrated that adults who would benefit from blood pressure lowering should combine the Dietary Approaches to Stop Hypertension (DASH) dietary pattern with lower sodium intake (see Dietary Approaches to Stop Hypertension call-out box).
Considerations: As a food ingredient, sodium has multiple uses, such as in curing meat, baking, thickening, enhancing flavor (including the flavor of other ingredients), as a preservative, and in retaining moisture. For example, some fresh meats have sodium solutions added to help retain moisture in cooking. As discussed in Chapter 2, sodium is found in foods across the food supply, including mixed dishes such as burgers, sandwiches, and tacos; rice, pasta, and grain dishes; pizza; meat, poultry, and seafood dishes; and soups. Multiple strategies should be implemented to reduce sodium intake to the recommended limits (see Chapter 3. Everyone Has a Role in Supporting Healthy Eating Patterns).

Dietary Approaches to Stop Hypertension (DASH) 

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Monday, May 30, 2016

Saturated Fats, Trans Fats, and Cholesterol

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Saturated Fats

Healthy intake: Intake of saturated fats should be limited to less than 10 percent of calories per day by replacing them with unsaturated fats and while keeping total dietary fats within the age-appropriate AMDR. The human body uses some saturated fats for physiological and structural functions, but it makes more than enough to meet those needs. Individuals 2 years and older therefore have no dietary requirement for saturated fats.
Strong and consistent evidence shows that replacing saturated fats with unsaturated fats, especially polyunsaturated fats, is associated with reduced blood levels of total cholesterol and of low-density lipoprotein-cholesterol (LDL-cholesterol). Additionally, strong and consistent evidence shows that replacing saturated fats with polyunsaturated fats is associated with a reduced risk of CVD events (heart attacks) and CVD-related deaths.
Some evidence has shown that replacing saturated fats with plant sources of monounsaturated fats, such as olive oil and nuts, may be associated with a reduced risk of CVD. However, the evidence base for monounsaturated fats is not as strong as the evidence base for replacement with polyunsaturated fats. Evidence has also shown that replacing saturated fats with carbohydrates reduces blood levels of total and LDL-cholesterol, but increases blood levels of triglycerides and reduces high-density lipoprotein-cholesterol (HDL-cholesterol). Replacing total fat or saturated fats with carbohydrates is not associated with reduced risk of CVD. Additional research is needed to determine whether this relationship is consistent across categories of carbohydrates (e.g., whole versus refined grains; intrinsic versus added sugars), as they may have different associations with various health outcomes. Therefore, saturated fats in the diet should be replaced with polyunsaturated and monounsaturated fats.
Considerations: As discussed in Chapter 2, the main sources of saturated fats in the U.S. diet include mixed dishes containing cheese, meat, or both, such as burgers, sandwiches, and tacos; pizza; rice, pasta, and grain dishes; and meat, poultry, and seafood dishes. Although some saturated fats are inherent in foods, others are added. Healthy eating patterns can accommodate nutrient-dense foods with small amounts of saturated fats, as long as calories from saturated fats do not exceed 10 percent per day, intake of total fats remains within the AMDR, and total calorie intake remains within limits. When possible, foods high in saturated fats should be replaced with foods high in unsaturated fats, and other choices to reduce solid fats should be made (see Chapter 2).

Trans Fats

Individuals should limit intake of trans fats to as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils in margarines, and by limiting other solid fats. A number of studies have observed an association between increased intake oftrans fats and increased risk of CVD. This increased risk is due, in part, to its LDL-cholesterol-raising effect.
Trans fats occur naturally in some foods and also are produced in a process called hydrogenation. Hydrogenation is used by food manufacturers to make products containing unsaturated fatty acids solid at room temperature (i.e., more saturated) and therefore more resistant to becoming spoiled or rancid. Partial hydrogenation means that some, but not all, unsaturated fatty acids are converted to saturated fatty acids; some of the unsaturated fatty acids are changed from a cis to transconfiguration. Trans fatty acids produced this way are referred to as “artificial” or “industrially produced” trans fatty acids. Artificial trans fatty acids are found in the partially hydrogenated oils[23]used in some margarines, snack foods, and prepared desserts as a replacement for saturated fatty acids. Although food manufacturers and restaurants have reduced the amounts of artificial transfats in many foods in recent years, these fats can still be found in some processed foods, such as some desserts, microwave popcorn, frozen pizza, margarines, and coffee creamers.
Naturally occurring trans fats, known as “natural” or “ruminant” trans fats, are produced by ruminant animals. Natural trans fats are present in small quantities in dairy products and meats, and consuming fat-free or low-fat dairy products and lean meats and poultry will reduce the intake of natural trans fats from these foods. Because natural trans fats are present in dairy products and meats in only small quantities and these foods can be important sources of nutrients, these foods do not need to be eliminated from the diet.


Alcohol is not a component of the USDA Food Patterns. The Dietary Guidelines does not recommend that individuals who do not drink alcohol start drinking for any reason. If alcohol is consumed, it should be in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.[6] There are also many circumstances in which individuals should not drink, such as during pregnancy. For the purposes of evaluating amounts of alcohol that may be consumed, the Dietary Guidelines includes drink-equivalents. One alcoholic drink-equivalent is described as containing 14 g (0.6 fl oz) of pure alcohol.[26] The following are reference beverages that are one alcoholic drink-equivalent: 12 fluid ounces of regular beer (5% alcohol), 5 fluid ounces of wine (12% alcohol), or 1.5 fluid ounces of 80 proof distilled spirits (40% alcohol).[27] The amount of alcohol and calories in beverages varies and should be accounted for within the limits of healthy eating patterns so that calorie limits are not exceeded. See Appendix 9. Alcohol for additional information.



[6] It is not recommended that individuals begin drinking or drink more for any reason. The amount of alcohol and calories in beverages varies and should be accounted for within the limits of healthy eating patterns. Alcohol should be consumed only by adults of legal drinking age. There are many circumstances in which individuals should not drink, such as during pregnancy. See Appendix 6. Alcohol for additional information.
[8] Institute of Medicine (IOM) and National Research Council (NRC). Weight gain during pregnancy: Reexamining the guidelines. Washington (DC): The National Academies Press; 2009.
[9] Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985-3023. PMID: 24239920. Available at:
[10] Definitions for each food group and subgroup are provided throughout the chapter and are compiled in Appendix 3.
[11] In the form of provitamin A carotenoids
[12] American Academy of Pediatrics. Healthy Children, Fit Children: Answers to Common Questions From Parents About Nutrition and Fitness. 2011.
[13] In the form of provitamin A carotenoids
[14] Products that bear the U.S. Food and Drug Administration (FDA) health claim for whole grains have at least 51 percent of the total ingredients by weight as whole-grain ingredients; they also meet other criteria.
[15] Foods that meet the whole grain-rich criteria for the school meal programs contain 100 percent whole grain or a blend of whole-grain meal and/or flour and enriched meal and/or flour of which at least 50 percent is whole grain. The remaining 50 percent or less of grains, if any, must be enriched. Accessed October 22, 2015.
[16] Adapted from the Food Safety and Inspection Service (FSIS) guidance on whole-grain claims. Available at Accessed November 25, 2015.
[17] State and local advisories provide information to guide consumers who eat fish caught from local waters. See the EPA website, “Fish Consumption Advisories, General Information.” Available at Accessed September 26, 2015.
[18] Cooked, edible portion
[19] The U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) provide joint guidance regarding seafood consumption for women who are pregnant or breastfeeding and young children. For more information, see the FDA and EPA websites
[20] The term “fats” rather than “fatty acids” is generally used in this document when discussing categories of fatty acids (e.g., unsaturated, saturated, trans) for consistency with the Nutrition Facts label and other Federal materials.
[21] It is not recommended that individuals begin drinking or drink more for any reason. The amount of alcohol and calories in beverages varies and should be accounted for within the limits of healthy eating patterns. Alcohol should be consumed only by adults of legal drinking age. There are many circumstances in which individuals should not drink, such as during pregnancy. See Appendix 9. Alcohol for additional information.
[22] For more information, see: FDA. High-Intensity Sweeteners. May 19, 2014. [Updated November 5, 2014.] Available at: Accessed October 19, 2015. This page provides a link to “Additional Information about High-Intensity Sweeteners Permitted for use in Food in the United States” which includes more information on types and uses of high-intensity sweeteners and the scientific evidence evaluated by the FDA for safety for the general population.
[23] The FDA has determined that partially hydrogenated oils, which are the primary dietary source of industrially produced trans fats, are no longer generally recognized as safe (GRAS), with compliance expected by June 18, 2018. FDA. Final Determination Regarding Partionally Hydrogenated Oils. Federal Register. June 17, 2015;80(116):34650-34670. Available at: Accessed October 20, 2015.
[24] Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington (DC): The National Academies Press; 2002.
[25] The IOM set an Adequate Intake (AI) level for sodium to meet the sodium needs of healthy and moderately active individuals. Because of increased loss of sodium from sweat, the AI does not apply to highly active individuals and workers exposed to extreme heat stress, estimated to be less than 1 percent of the U.S. population. Institute of Medicine. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington (DC): The National Academies Press; 2005.
[26] Bowman SA, Clemens JC, Friday JE, Thoerig RC, and Moshfegh AJ. 2014. Food Patterns Equivalents Database 2011-12: Methodology and User Guide [Online]. Food Surveys Research Group, Beltsville Human Nutrition Research Center, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland. Available at: Accessed November 3, 2015. For additional information, see the National Institute on Alcohol Abuse and Alcoholism (NIAAA) webpage available at:
[27] Drink-equivalents are not intended to serve as a standard drink definition for regulatory purposes.
[28] Some dietary supplements such as energy shots also contain caffeine, but the amount of caffeine in these products is not required to be disclosed.
[29] Caffeine is a substance that is generally recognized as safe (GRAS) in cola-type beverages by the U.S. Food and Drug Administration for use by adults and children. Code of Federal Regulation Title 21, Subchapter B, Part 182, Subpart B. Caffeine. U.S. Government Printing Office. November 23, 2015. Available at:

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Saturday, May 28, 2016

Limits on Calories That Remain After Food Group Needs Are Met in Nutrient-Dense Forms

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The USDA Food Patterns are designed to meet food group and nutrient recommendations while staying within calorie needs. To achieve this goal, the Patterns are based on consuming foods in their nutrient-dense forms (i.e., without added sugars and in the leanest and lowest fat forms, seeAppendix 6). For nearly all calorie levels, most of the calories in the USDA Food Patterns are needed for nutrient-dense food choices, and only a limited number remain for other uses. These calories are indicated in the USDA Food Patterns as “limits on calories for other uses.” For example, after food group needs are met in the Healthy U.S.-Style Eating Pattern from 1,000 to 1,600 calories, only 100 to 170 calories per day remain within the limit for other uses. In the 2,000-calorie pattern, the limit for other uses is 270 calories and in the 2800-calorie pattern, 400 calories (see Appendix 3Appendix 4, and Appendix 5). Calories up to the limit for the specific pattern can be used to eat foods that are not in nutrient-dense forms (e.g., to accommodate calories from added sugars, added refined starches, or solid fats) or to eat more than the recommended amount of nutrient-dense foods. If alcohol is consumed, calories from alcoholic beverages should also be accounted for within this limit to keep total calorie intake at an appropriate level.
As discussed in Chapter 2, in contrast to the healthy choices that make up the Patterns, foods from most food groups as they are typically consumed in the United States are not in nutrient-dense forms. In addition, foods and beverages are consumed that are primarily composed of added sugars and/or solid fats, and provide excess calories without contributing to meeting food group recommendations. The excess calories consumed from these sources far exceed the limited number of calories available for choices other than nutrient-dense foods in each food group.
From a public health perspective, it is important to identify the calories that are needed to meet food group needs to help inform guidance on limits from calories from added sugars, solid fats, alcohol[21], or other sources, in order to help individuals move toward healthy eating patterns within calorie limits. The USDA Food Patterns can be used to plan and serve meals for individuals, households, and in a variety of organizational settings (e.g., schools, worksites, and other community settings). The limit on calories for other uses can assist in determining how to plan and select foods that can fit within healthy eating patterns, such as how many calories are available to select foods from a food group that are not in nutrient-dense forms. As discussed in the next portion of the chapter, additional constraints apply related to other dietary components when building healthy eating patterns.

Other Dietary Components

In addition to the food groups, it is important to consider other food components when making food and beverage choices. The components discussed below include added sugars, saturated fats, transfats, cholesterol, sodium, alcohol, and caffeine. For each component, information is provided on how the component relates to eating patterns and outlines considerations related to the component. SeeChapter 2 for a further discussion of each of these components, current intakes, and shifts that are needed to help individuals align with a healthy eating pattern.

Added Sugars

Healthy intake: Added sugars include syrups and other caloric sweeteners. When sugars are added to foods and beverages to sweeten them, they add calories without contributing essential nutrients. Consumption of added sugars can make it difficult for individuals to meet their nutrient needs while staying within calorie limits. Naturally occurring sugars, such as those in fruit or milk, are not added sugars. Specific examples of added sugars that can be listed as an ingredient include brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose, molasses, raw sugar, sucrose, trehalose, and turbinado sugar.
Healthy eating patterns limit added sugars to less than 10 percent of calories per day. This recommendation is a target to help the public achieve a healthy eating pattern, which means meeting nutrient and food group needs through nutrient-dense food and beverage choices and staying within calorie limits. When added sugars in foods and beverages exceed 10 percent of calories, a healthy eating pattern may be difficult to achieve. This target also is informed by national data on intakes of calories from added sugars, which as discussed in Chapter 2, account on average for almost 270 calories, or more than 13 percent of calories per day in the U.S. population.
The USDA Food Patterns show that an eating pattern with enough foods from all food groups to meet nutrient needs without eating too many calories has only limited room for calories from added sugars. At most lower calorie levels (i.e., 1,200 to 1,800 calories), the calories that remain after meeting food group recommendations in nutrient-dense forms (“limits on calories for other uses”) are less than 10 percent per day of calories; however, at higher calorie levels, the limits on calories for other uses are more than 10 percent per day. The recommendation to limit added sugars to no more than 10 percent of calories is a target that applies to all calorie levels to help individuals move toward healthy eating patterns within calorie limits.
Although the evidence for added sugars and health outcomes is still developing, the recommendation to limit calories from added sugars is consistent with research examining eating patterns and health. Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of sources of added sugars are associated with reduced risk of CVD in adults, and moderate evidence indicates that these eating patterns are associated with reduced risk of obesity, type 2 diabetes, and some types of cancer in adults. As described earlier, eating patterns consist of multiple, interacting food components, and the relationships to health exist for the overall eating pattern, not necessarily to an isolated aspect of the diet. Moderate evidence indicates a relationship between added sugars and dental caries in children and adults.
Considerations: Added sugars provide sweetness that can help improve the palatability of foods, help with preservation, and/or contribute to functional attributes such as viscosity, texture, body, color, and browning capability. As discussed in Chapter 2, the two main sources of added sugars in U.S. diets are sugar-sweetened beverages and snacks and sweets. Many foods high in calories from added sugars provide few or no essential nutrients or dietary fiber and, therefore, may contribute to excess calorie intake without contributing to diet quality; intake of these foods should be limited to help achieve healthy eating patterns within calorie limits. There is room for Americans to include limited amounts of added sugars in their eating patterns, including to improve the palatability of some nutrient-dense foods, such as fruits and vegetables that are naturally tart (e.g., cranberries and rhubarb). Healthy eating patterns can accommodate other nutrient-dense foods with small amounts of added sugars, such as whole-grain breakfast cereals or fat-free yogurt, as long as calories from added sugars do not exceed 10 percent per day, total carbohydrate intake remains within the AMDR, and total calorie intake remains within limits.
It should be noted that replacing added sugars with high-intensity sweeteners may reduce calorie intake in the short-term, yet questions remain about their effectiveness as a long-term weight management strategy. High-intensity sweeteners that have been approved by the U.S. Food and Drug Administration (FDA) include saccharin, aspartame, acesulfame potassium (Ace-K), and sucralose.[22] Based on the available scientific evidence, these high-intensity sweeteners have been determined to be safe for the general population. This means that there is reasonable certainty of no harm under the intended conditions of use because the estimated daily intake is not expected to exceed the acceptable daily intake for each sweetener. The FDA has determined that the estimated daily intake of these high-intensity sweeteners would not exceed the acceptable daily intake, even for high consumers of each substance.

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