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NIFS Healthy Living Blog

Sabrina Goshen

Recent Posts by Sabrina Goshen:

Does Cranberry Really Cure Urinary Tract Infections?

GettyImages-1193255058Cranberries and cranberry-derived products are commonly used as a remedy for urinary tract infections, especially among women. Cranberries contain proanthocyanidins (PACs), specifically A type (PAC-A). It is argued that this component of cranberries fights and prevents UTIs, just as an antibiotic would. However, there is much controversy on this topic.

Clinical Trials and Studies on Cranberry for UTIs

Freire Gde C. completed a large review of 24 studies totaling 4,473 participants. In the research, there was minimal evidence suggesting that cranberry products prevented UTIs. Within those studies, cranberry juice decreased the number of UTIs in women who had recurring UTIs; however, the studies that showed a significant efficacy were small trials. When studies grew in size, the difference between the placebo groups and the cranberry groups shrank.

Furthermore, a Stapleton AE et al study completed a randomized control trial of 176 participants, of whom 120 were taking cranberry juice and 56 were given the placebo over the course of 168 days. The adherence to instruction was similar between both groups (91.8% and 90.3%). However, cranberry juice did not significantly reduce UTIs.

The Maki KC et al study argues that cranberry juice intake does indeed lower the number of UTI episodes in women with a UTI history. In their RCT, 185 women were given 240-mL cranberry juice each day for 24 weeks, while 188 women were given the placebo. The cranberry group had 39 UTIs, while the placebo group had 67 UTIs. This makes the differences significant, meaning cranberry juice did indeed work.

So, why do some trials show significance while others do not? Occhipinti A et al1 suggests this is due to the lack of authentication of cranberry products used (some are not really cranberry-derived). Thus, the products used do not contain PACs-A, which are what scientists claim fight the UTI. In their study, they authenticated and measured the PCAs-A in the cranberry product given. They gave one group a cranberry product with 36 mg PACs-A two times daily and another group with the same number of participants a product with no PACs (placebo). After 7 days, a significant difference in colony forming unit/mL counts (via urine cultures) was found between the placebo and the PACs-A group. The PACs-A group had significantly fewer colonies. The argument here is that for cranberry products to work, the cranberry product must be carefully authenticated to ensure that it indeed contains PACs-A, which is a component typically lost in processing.

The argument here is that for cranberry products to work, the cranberry product must be carefully authenticated to ensure that it indeed contains PACs-A, which is a component typically lost in processing.

Drug Interactions, Additive Effects and Side Effects

Lexicomp, a drug database used by medical professionals, still advises people to monitor cranberry intake while taking warfarin; however, there is little research to suggest the two adversely interact. Since cranberry juice is acidic, it is important to avoid drinking it within 2 hours of taking erythromycin, a common antibiotic, because it will decrease metabolism of the drug.

Common side effects of cranberry are nausea, vomiting, tightness in the chest, itching, cough, swelling of the face or lips, seizures, GI upset, and loose stools.

The Clinical Bottom Line

There is little evidence that suggests cranberry products decrease UTIs, mainly because the PACs-A have been lost in the processing. Although people are welcome to use cranberry-derived products, I would warn about the GI upset that can occur with excessive use, the cost of cranberry tablets, lack of authentication of the products, and added sugar content in the juices. Because of the lack of evidence, I would not advise individuals to spend their money on cranberry tablets. I would also argue that the risks associated with added sugars in the juices outweigh the small chance of preventing a UTI. If you insist on using cranberry for UTIs, be sure that it contains the bioactive PACs-A.

Further Research Is Needed

Much of the research done to prove cranberry juices and products prevent UTIs fails to address the authentication of the products used, and whether they even contain the bioactive PACs-A. I think further research should include authentication of the products used. If they do that, they may see that cranberry can indeed reduce and treat UTIs.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition supplements fruits and vegetables dietary supplements food as medicine infections cranberry home remedies juice

Can Vitamin D Protect You Against COVID-19? The Latest Studies

GettyImages-1280576988Healthcare providers and scientists are all working diligently to find ways to prevent, treat, and cure COVID-19. Many of us are eager for answers and probably getting tired of not knowing what to believe. One of the hot topics floating around is about Vitamin D’s role in preventing COVID-19. Can Vitamin D really protect us against COVID-19 or at least lessen the effects? Let’s take a look.

The Role of Vitamin D

Vitamin D serves many purposes in the body, the most commonly known purpose being assisting calcium absorption and bone mineralization for good bone health. It is less well known that Vitamin D plays an essential role in immunologic function—keeping your immune system strong. Vitamin D inhibits both B cell and T cell (lymphocyte) proliferation/rapid increase, affects T cell maturation, and facilitates the induction of T regulatory cells. It also helps regulate monocytes production of inflammatory markers and inhibits dendritic cell (DC) differentiation and maturation. All of this leads to a decreased production of inflammatory markers and an increase in anti-inflammatory markers. In short, it has an anti-inflammatory role.

Vitamin D and COVID

Now that you understand the role of Vitamin D in immune support, let’s look at the link between that and COVID-19. When healthcare providers check your Vitamin D levels, they request a lab called 25-hydroxyvitamin d. This is the circulating Vitamin D in your body. Ideally, we want to see that number be at least 30 ng/dL. In theory, having enough circulating Vitamin D should reduce complications by preventing the “cytokine storm” that providers are seeing in response to COVID-19 infection. The cytokine storm is when the level of inflammatory proteins rapidly rises to dangerously high levels. It is what leads to complications such as ARDS, myocarditis, and acute renal and heart failure, especially in those elderly patients with previous cardiovascular comorbidity. Researchers have started requesting this lab from patients with COVID-19.

Study Shows Decreased Risk for Adverse Affects

One cross-sectional study of 235 individuals showed that patients with at least 30 ng/dL had a significantly decreased risk for adverse effects, such as hypoxia (low oxygen levels), death of individuals over 40, and unconsciousness. Serum C-reactive protein (an inflammatory marker) was lower and lymphocyte percentage was higher in Vitamin D–sufficient COVID-19 patients. In the study, 67.2% of the 235 COVID patients had Vitamin D levels less than 30 ng/dL. The study saw no significant difference in hospitalization duration, ICU admissions, Acute Respiratory Distress Syndrome (ARDS), and intubation between insufficient and adequate Vitamin D levels.

Similarly, a study showed Vitamin D levels were significantly lower in COVID patients with severe symptoms than those with mild symptoms or no COVID at all. Of the symptomatic patients, 54 were admitted to the ICU due to ARDS—all of whom had lower Vitamin D levels than the patients not needing the ICU. Sadly, 19 patients died, and again they found that these patients had lower Vitamin D levels than the ones who survived.

Another Study Finds Lower Levels of Vitamin D in Hospitalized Patients

A study of 216 COVID-19 patients and 197 population-based controls saw significantly lower levels of Vitamin D in the patients hospitalized due to COVID-19 than the controls (of similar age and sex), which lines up with the previous studies. On the contrary, they did not find a relationship between severity of infection and Vitamin D levels like the other studies found.

Study Finds People with Vitamin D Deficiency More Likely to Test Positive

Another study of 489 patients found that those with Vitamin D deficiency (<20 ng/dL) were 1.77 times more likely to test positive for COVID-19 than those with sufficient Vitamin D levels. The study above by Hernandez et al supports this finding, showing that 82.2% of COVID-19 cases were deficient in Vitamin D compared to the population-based controls, where only 47.2% were deficient (which is significant).

Correlation Is Not Causation

Something to note: These studies are observational studies. Thus, we cannot determine a cause-and-effect relationship between vitamin D deficiency and COVID-19 infection outcomes. Correlation is not synonymous with causation. So, while these results are important and useful, we must be careful to not go as far as saying, “Vitamin D can protect me from COVID-19 or lessen the impact if I get sick with COVID-19.”

Further research is being conducted since we do have strong observational support that suggests low Vitamin D levels may favor respiratory dysfunction and even death in those with COVID-19. Several Randomized Control Trials are in process. Many are trialing high-dose Vitamin D in those with COVID-19, such as the registered study by University Hospital in Angers (France). One has already concluded, but it was small with only 50 hospitalized patients being given a high dose of Vitamin D (calcifediol) and 26 not given a high dose of Vitamin D. Only 1 of the 50 high-dosed patients needed ICU treatment, whereas 13 of the 26 not given Vitamin D needed ICU treatment. 

GettyImages-1147455976Vitamin D Recommendations

Let me be real clear: You do not need to start taking a megadose of Vitamin D! Doing so can actually lead to toxic effects because it is a fat-soluble vitamin. The goal is to prevent deficiency to help keep your immune system strong.

I do suggest reflecting on your Vitamin D intake and exposure. Do you get out in the sun 10–30 minutes several times weekly? Sun exposure is less common in the winter, which hints at why more people are Vitamin D deficient in the winter months. When the sun’s UV rays hit our skin, Vitamin D3 (cholecalciferol) synthesis can occur. Do you eat Vitamin D–rich sources? If not, start to add some foods that are rich in Vitamin D. This will help you reach the RDA of 600 IU for young adults under 70 years old and 800 IU for adults older than 70 years old.

Here are some Vitamin D–rich foods:

  • Trout, rainbow, cooked (3 oz = 648 IU)
  • Pink salmon, cooked (3 oz = 444 IU)
  • Halibut, Atlantic or Pacific, cooked (3 oz = 196 IU)
  • Portobello mushrooms (1/2 cup = 316 IU)
  • Canned tuna (3 oz = 228 IU)
  • Milk, whole, 1%, 2%, and nonfat (1 cup = 115–128 IU)
  • Yogurt, various types and flavors (8 oz = 80–120 IU)
  • Soy milk (1 cup = 116 IU)
  • Orange juice, fortified (1 cup = 100 IU)
  • Eggs (1 large = 44 IU)

If getting your RDA by eating these foods is not realistic for you, I would suggest a Vitamin D3 (cholecalciferol) supplement to help increase your intake. A Registered Dietitian can help you adapt your nutrition regimen to meet Vitamin D requirements.

Finally, speak with your healthcare provider. They can always request that your 25-hydroxyvitamin d (circulating Vitamin D in your body) lab be checked. If you’re found to be deficient, you may require larger doses for treatment.

The Bottom Line

We do have strong observational support that suggests low Vitamin D levels may favor respiratory dysfunction and even death in those with COVID-19. However, we simply do not have enough strong data to conclude that Vitamin D sufficiency can treat or prevent COVID-19 infection until Randomized Control Trials are complete.

In the meantime, the best thing to do is continue to stay healthy (or improve your health) and keep your immune systems strong, which includes eating enough Vitamin D or having adequate Vitamin D exposure.

As always, please reach out to a NIFS Registered Dietitian for any nutrition support you need.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition immunity vitamins vitamin D registered dietitian covid-19 pandemic

Busting Salad Myths: Eat a Well-Built Salad (If You Want To)

  • “I am going to eat a salad because I’m on a diet.”
  • “I am going to eat a salad to clean my pipes.”
  • “I am going to eat a salad because that’s the only way I know how to eat my veggies.”
  • “I am going to eat a salad because I hear that’s how I can be healthy.”

GettyImages-1176386162Come on. We've all heard this before—from friends, from coworkers, and possibly from our own mouths. I swear, salads are easily the most famous “diet food.” Why is that? Do we really have to eat salads to lose weight, clean out our “pipes,” or be healthy? In this blog I break down each of these claims and then talk about ways to improve your veggie game!

“I am going to eat a salad because I’m on a diet.”

This is usually said when someone is trying to lose weight or be “super healthy.” First, to lose weight, it is widely understood that we must burn more calories than we eat. Thus, we try to minimize our calories to lose the weight. Second, people think that if they eliminate all “processed foods,” they will automatically become healthy. The idea behind salads is that they’re “healthy,” “low-calorie,” and blah blah blah.

Guess what? Salads can quickly turn into a high-calorie snack or meal and become full of unhealthy saturated fats and sodium. For example, let’s look at the Southwest Avocado Chicken Salad from Wendy’s. Sounds healthy, right? They even market this salad as healthy. A full salad has 530 calories with 34 grams of fat, only 15 grams of carbs, 43 grams of protein, and 1060mg of sodium. First off, that’s not a big salad for all those calories—which will make maintaining a caloric deficit (for weight loss) difficult. Finding foods that can be eaten in large volumes for lower calories tends to help satiety during weight loss attempts. Also, 34 grams of fat is a lot for one meal. The RDA for a full day is 44–77 grams for someone eating 2,000 calories. Now look at the sodium: 1060 mg of sodium is close to half of the RDA for sodium. Yikes. Hey, at least the salad has protein. They got that part right.

In addition, health is not just about physical well-being. Salads, if built correctly, can most certainly offer physical benefits. But health includes mental and social well-being too. Think for a moment. Does the salad taste good? Am I satisfied? Can I keep this up forever? Am I happy with this? If the answer is “no,” consider a different approach. Any change you make should be one that is sustainable for life. In the midst of making these changes, you must evaluate your physical, mental, and social health at all times. How can you improve one part of well-being without sacrificing another? Finding that balance is the key to SUSTAINABLE, healthful lifestyle changes, which ultimately leads to lifelong results.

“I am going to eat a salad to clean my pipes.”

Fiber does wonderful things. There are two types of fiber: soluble and insoluble. Soluble fiber is found in oats, beans, peas, berries, apples, plums, and sweet potatoes—all of which can be found in salads. This type of fiber helps absorb water, which adds bulk to stools. There is also insoluble fiber, which helps to get things moving in the GI system, thus helping to relieve constipation. Insoluble fiber is typically found in whole grains, the skins of fruit, skins of beans, seeds, spinach, carrots, cucumbers, lettuce, celery, zucchini, and tomatoes. These foods are even more common in salads, which gives you a hint as to why having a bowel movement after eating salad is not uncommon.

Fruits and vegetables, particularly lettuce, have high water content. It’s no secret that water assists in the digestion process. In this case, fiber works best when it absorbs water. This makes your stool soft and bulky.

“I am going to eat a salad because that’s the only way I know how to eat my veggies.”

This is valid. Vegetables can be super boring. Finding new ways to enjoy veggies can be a challenge. However, there are ways to eat veggies without having to eat a salad. Raw veggies with dip, grilled, steamed, and roasted are all ways to have veggies. Do not skimp on the spices and seasonings, such as garlic powder, onion powder, cumin, Italian seasoning, and ginger. I promise that makes the veggies taste 100,000 times better.

“I am going to eat a salad because I hear that’s how I can be healthy.”

Read above. I think you got the point.

Bottom line: You do not need a salad to be healthy, lose weight, or clean your pipes. If you like salads, eat them! But be careful of the added fats that tend to sneak into salads. If you do not like salads, find another way to eat your vegetables. Roasted, steamed, raw, and grilled are all yummy ways to eat veggies. Check out my recipe page for more ways to cook veggies. Remember, it’s important to like and enjoy the foods you eat.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition weight loss healthy eating digestion fiber fat fruits and vegetables salad

Healthy Holiday Eating: The Practical Way

GettyImages-495329828The holidays are HERE! We all know what happens around the holidays. I see two extremes in my practice as a Registered Dietitian:

  • The vicious cycle of dieting all year to lose the “holiday weight” or to get bloodwork back to normal after all the holiday meals. People accomplish their goals just in time for the holidays to start again—and gain back the weight and drive our doctors nuts with outrageous bloodwork again.
  • The person who is terrified to “lose all their progress,” brings their own “healthy” meal to the gathering, and completely avoids the yummy meal—even at the cost of social, mental, and emotional health. Let’s be honest: that behavior distances people socially, and not having Grandma’s famous pie is just sad. 

Honestly, both are unhealthy approaches and they are, frankly, unnecessary. Let me be real clear: what we do consistently over time is what has the greatest impact on our health, not what we do on one day, two days, or a couple holidays. We can break these cycles! You don’t have to gain weight or ruin your bloodwork over the holidays. You also do not have to bring your own “healthy” meal, avoid Grandma’s cooking, and face a socially awkward and sad situation.

There is a way to enjoy the holiday food with family and friends all while pursuing your health goals. Here are the action steps.

Be Active

Get up and moving. This can be as simple as taking a walk with family, going on a morning stroll before the gathering, walking the dog, or playing a game that has you up and moving (such as Wii, tag, Twister, or Simon says). You can also get in a quick 20–30-minute workout before all the festivities start that day, or wake up early to get in a full lifting session. Don’t overthink this; a short 20–30-minute workout with high intensity is very effective! (Here are some workouts you can do when traveling.)

Follow Your Eating Routine

Forget the “don’t eat anything to save calories for all the food tonight” method. That leads to a very hungry person, which makes overeating at the gathering much easier. Go about your morning as you normally would. Eat breakfast (if you eat breakfast). Have your typical snack and lunch. Fill up on fiber-rich sources, such as fruit and veggies, along with lean proteins. All these options will help fill you up and nourish your body. You will walk into the gathering satisfied and ready to eat your Grandma’s holiday meal.

Hydrate 

Be sure to stay hydrated with plenty of non-caloric fluids (mainly water) the days before, the day of, and the days after holiday gatherings. Liquids take up room in your stomach, meaning staying hydrated contributes to proper regulation of hunger/satiety cues. Again, this helps reduce overeating. Additionally, holiday foods tend to be high in sodium. You will want plenty of water to offset the negative effects that a high sodium intake has on your hydration status. Trust me, you will feel much better if you stay hydrated.

Eat the Holiday Meal

For heaven’s sake, do not bring your own meal, measuring cups, or scales to the gathering! Eat the holiday meal. Fill up your first plate with all your favorites—the ones that grandma and momma only cook once or twice a year. Be mindful of portion sizes. Then, if you want, go back for a second plate. For that plate, pick two or three more things that you want some more of. Take a portion of each and enjoy it.

Enjoy the Meal

Sit down with each plate. Take a nice deep breath. Start eating. Chew each bite thoroughly. Slow down your eating. Be present at each bite, soaking in all the yummy goodness of that home cooking. Don’t be afraid to pause between bites and converse with family around the table. This not only helps you enjoy family around you and to be present in that moment, but it also gives your body time to send you satiety cues. When we eat super-fast, we do not allow our body enough time to signal “I AM FULL.” Be present and listen to what your body is telling you.

Have a Conversation

During the meal, talk with your family and friends, even if you are the one having to initiate conversation. DO IT! Think about one of the true reasons for the season. Hint: it is not food and gifts. Sure, food is a huge part of it. But we gather to be with family and friends to celebrate our blessings, our year, and our religion, and to give thanks. Conversing really embraces what holidays are all about and shifts your focus to more than just the heap of food in front of you.

Eat Dessert

Find your favorite deserts and eat a serving. I promise, eating dessert will not derail your health goals. I’d argue this action will actually help your health goals because Grandma’s famous pie sure does positively contribute to mental and emotional health.

Get Right Back to Your Typical Regimen the Next Day

Wake up the next day and get back to your typical routine. Exercise as you normally would. Eat your normal meals and snacks. Honor your physical health with nutritious options. Sleep. Do this on the days you are not at a holiday gathering. Back to the idea of consistency, there are more non-holiday days than there are holiday days and gatherings. Be on your game and remain consistent during those weeks and days, knowing that another gathering full of food and fun is right around the corner. Repeat steps 1–7 during the next gathering.

HAPPY HOLIDAYS!

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: healthy eating snacks holidays breakfast hydration Thanksgiving christmas meals emotional blood sugar dinner

Tips for a Healthy Halloween

GettyImages-1267397092Halloween is a day full of fun, costumes, treats, friends, and family! With all the food and candy, is it even possible to be “healthy” and still enjoy the festivities? The answer is YES. Take a look at these SPOOK-tacular tips to keep you and your family in good health.

Find a Balance

Halloween comes around once a year. It’s a time to feed your social and mental health, which may require easing up on the physical health guidelines for a moment. Remember, any decision you make for your physical health that comes at the expense of your social and mental health may not be all that great after all.

Let’s be honest, Halloween is FUN. The candy is FUN. Trick-or-treating is FUN. All this feeds our mental and social health. Plus, think about it: daily nutritional choices consistently over time have the greater impact on your health than nutrition choices on one holiday.

What does this “balance” look like? Keep reading.

Use portion control and omit the “off-limits” mentality.

All foods in moderation can fit into a healthy regimen. Instead of making candy off-limits, work it into your established routine. Still have breakfast, lunch, and dinner. Make those meals nutritious, including fruits, veggies, whole grains, and lean proteins. At each meal, offer one serving of Halloween candy to everyone. Instead of the full-size pieces, make them like the “fun-size” or “snack-size.” This allows everyone to enjoy a sweet, while filling up on the nutritious foods that are important for physical health.

Make festive, healthy options.

On the day that you all go trick-or-treating, really get into the spirit! Make nutritious meals that are Halloween themed. Some examples include:

  • Green-goop smoothie with Halloween straws: Include low-fat Greek yogurt, spinach, chia seeds, pineapple, and low-fat milk of choice. Try this recipe.
  • Monster teeth: Slice a green apple. Smear peanut butter on one side of a slice (bottom lip of the mouth). Stick yogurt-covered raisins in the peanut butter. Smear a little more peanut butter on another apple slice and place on top of the raisins for the top lip.
  • Boo-nana pops: Cut bananas in half and place a stick in the end as a handle. At the tip of the banana, add two chocolate chips as eyes. Serve frozen, cold, or at room temperature.
  • Devil spiders: Make deviled eggs. On the top, put an olive in the center for the spider’s body. Then put slices of olives around the outer edge of the egg for the legs.
  • Cute pumpkins: Peel Cuties/clementines/mandarins. Slice celery into small sticks. Place a celery stick at the top of each mandarin for the pumpkin stem.
  • Yo-yo graveyard: Scoop nonfat Greek yogurt into cups. Crumble some chocolate cookies on top (just a thin layer to cover the top) for the dirt. Write “Boo” on graham crackers for tombstones. Place one tombstone in each yogurt cup.
  • Spider sandwich: Make a sandwich of choice. Cut the sandwich into a circle. Place chocolate chips as the eyes (use peanut butter to help them stick). Use pretzels as the legs, sticking them into the bread or middle of the sandwich, with the tips sticking out.
  • Ghost cheese sticks: Get individually wrapped mozzarella cheese sticks. Take a sharpie and make black dots for the eyes and a block dot for an open mouth. These make perfect snacks while you are out and about trick-or-treating.

This ensures everyone is filling up on nutritious options high in fiber and protein, which leaves less room for tons of candy. Now, do not mistake this for “NO ROOM” for candy. There is still room, but not as much. You are just making sure everyone is properly nourished and still having fun in the process.

When you get home that night, enjoy a few pieces of candy with the kiddos, then put it in a non-accessible place. You are in control of when and how much the kids get. You are also in control of when and how much you get as well. Refer to what I said about portion control to plan your approach here. Remain consistent so that you and the kids both have a clear understanding of when candy will be served. For example, one individual piece will be served with each meal. It gives both you and the kids something to look forward to and does not make candy off-limits, but instead teaches proper portion control and provides a positive relationship with all foods. In the long run, this reduces binging or obsessing over any one food.

Stay active.

One of the best things you can do is to get everyone moving and active. Be sure to get in a workout on the big day, even if it is a quick 20-minute HIIT session at home, or try this spooky workout. Get the kiddos moving with you! Walk from house to house instead of driving during trick-or-treating. Go on a walk in your costumes if you are not trick-or-treating this year. Or just go on a walk in your regular clothes and enjoy all the house decorations. You can also play games:

  • Monster Tag: The tagger is a monster and anyone they tag becomes the monster.
  • Monster vs. Ghost Freeze Tag: If the monster tags you, you become frozen until one of your ghost teammates unfreezes you. The goal is for the monster to freeze all the ghosts!

ENJOY HALLOWEEN!

Have fun with your family. Soak in the moments. Laugh a lot. Feed your mental and social health, knowing it will benefit your physical health in the long run and that choices you make consistently over time matter the most. Stay safe.

As always, reach out to your NIFS Registered Dietitian if you need some holiday nutrition support.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

 

Topics: staying active healthy eating holidays kids sugar halloween

8 Low-Cal Pumpkin Spice Drinks at Starbucks

GettyImages-856503922Pumpkin season is officially here, and I am SO excited! Call me “basic”—you would not be wrong. Starbucks has launched their pumpkin drinks. Food bloggers, including myself, are basically turning their kitchens into giant pumpkins. It is a whole thing.

Here is my hiccup with pumpkin season and all the yummy beverages: THEY ARE FULL OF SUGAR AND CALORIES. Basically, we drink this little serving that takes up a huge portion of our daily calories yet contributes very little to improving our satiety. When you combine no fiber, little protein, and minimal volume you get “hangry” feelings and a higher risk of overeating later in the day. This makes weight-loss attempts and health goals harder to accomplish.

Now, don’t get me wrong—I am one who believes all foods and beverages can fit into a healthy nutrition regimen, even the high-sugar drink from time to time. However, I also believe in finding alternatives that are lower in sugar and calories when possible. Don't worry, these “alternatives” I speak of MUST taste yummy or else I would just stick with having the “real deal” in moderation.

Here are 8 DELICIOUS Starbucks Pumpkin Spice drink orders that won’t take up the bulk of your calorie budget and are low in sugars.

Hot Options

Pumpkin Spice “Latte”

Order: Grande blonde coffee with 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, 2 shots espresso, and 1 cup steamed almond milk (or about half-full of steamed skim milk)

Nutrition Facts: 95 calories, 14g carbs (9g sugar), 4g fat, 3g protein

Pumpkin Spice Americano

Order: Grande blonde caffe Americano with 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, and light splash of half & half. Ask to put in a venti cup to allow room for the add-ins.

Nutrition Facts: 75 calories, 12g carbs (7g sugar), 2g protein, 3g fat, 255mg caffeine

Pumpkin Chai Tea “Latte”

Order: 1 venti brewed chai tea. Add steamed skim milk, 4 Splendas, and 1 pump pumpkin sauce

Nutrition Facts: 65 calories, 12g carbs (12g sugar), 4g protein, 0g fat

Pumpkin Spice Coffee

Order: Grande blonde coffee with 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, and light splash of half & half. You can add Splenda for a little sweeter taste with no additional calories.

Nutrition Facts: 65 calories, 9g carbs (7g sugar), 2g protein, 3g fat

Cold Options

Iced Pumpkin Spice Latte

Order: Grande iced coffee with no classic syrup. Add 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, 2 shots espresso, and 1 cup steamed almond milk (or about ½ full of steamed skim milk)

Nutrition Facts: 95 calories, 14g carbs (9g sugar), 4g fat, 3g protein

Iced Pumpkin Cinnamon Coffee

Order: Grande iced coffee with no classic syrup. Add 1 pump pumpkin sauce, 2 pumps sugar-free vanilla, and a light splash of half & half.

Nutrition Facts: 65 calories, 9g carbs (7g sugar), 2g protein, 3g fat

Pumpkin Cold Brew with Cinnamon Almondmilk Foam

Order: Grande Cold Brew with Cinnamon Almondmilk foam. Add 1 pump pumpkin sauce and 1 pump sugar-free cinnamon dolce syrup.

Nutrition Facts: 65 calories, 14g carbs (12g sugar), 1g protein, 1g fat

Pumpkin Cold Brew with Dark Cocoa Almondmilk foam

Order: Grande Cold Brew with Dark Cocoa Almondmilk foam. Add 1 pump pumpkin sauce and 1 pump sugar-free vanilla syrup.

Nutrition Facts: 65 calories, 13g carbs (10g sugar), 1g protein, 2g fat

Extra Hacks

Want more pumpkin? You can certainly add another pump of the pumpkin sauce. One pump of the pumpkin sauce is an additional 25 calories, 6g carbs (6g sugar), 0g fat, and 0g protein.

Want more sweetness? You can add a packet or two of Splenda for a noncaloric sweetener. No, this will not cause cancer. Research does not support that claim. So, if you want Splenda to help sweeten your beverage, add it.

Want more cream? Have them add a creamy milk, such as oat milk or almond milk. Both are fairly low calorie. Skim milk is great and offers more protein, but it is not as creamy.

Those are my tricks. And if you’re still hungry for pumpkin and that other fall treat, apples, check out these recipes. I hope you enjoy these drinks and ultimately have a great PUMPKIN SEASON while still reaching your health goals! Enjoy!

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: calories weight management sugar caffeine coffee fall pumpkin spice

Should You Take CoQ10 for Heart Health? A Look at the Research

GettyImages-940463278Coenzyme Q10, also known as ubiquinone, is a commonly used supplement by those with cardiovascular risks and disease, and especially those using statins. CoQ10 acts as a carrier in our cells to assist in oxygen utilization.  It also assists enzymes in the mitochondria. This allows the production of energy in a cycle referred to as the Krebs Cycle, and hints at why the mitochondria are the “powerhouse of the cell.” Some believe that those with heart failure have a buildup of reactive oxygen species (ROS), which can lead to adverse effects. Furthermore, they suggest CoQ10 antioxidant properties can combat the buildup of ROS. Additionally, CoQ10 is thought to balance calcium-dependent ion channels within the heart, which is critical for heart function. As far as supplementation with statins goes, people are led to believe that supplementing CoQ10 is essential because statins block the pathway that leads to CoQ10 production.

Researchers looked into these claims. Some found many studies that showed CoQ10 had no clear effect on how much blood the heart was able to pump (left heart ejection fraction), and other studies were inconclusive with poor research design. On the other hand, a Large study (a meta-analysis of clinical trials) revealed that those who supplemented CoQ10 had lower risk of death and increased exercise capacity, but no correlation between CoQ10 and how much blood the heart was able to pump. Lastly, another study observed those with heart failure receiving medical therapy. In addition to medical therapy, some of the participants received a placebo and some received Coenzyme Q10. Although the concentration of CoQ10 in the blood serum increased dramatically, those patients saw no greater effect in ejection fraction, peak oxygen consumption, and exercise duration. 

Drug Interactions and Additive Effects

CoQ10 has been known to interact with Vitamin K Antagonists, such as warfarin, a commonly prescribed drug in cardiovascular disease cases. Some cases have shown that CoQ10 blocks the anti–blood clotting (aka anticoagulant) effect of Vitamin K Antagonists, especially warfarin, which can lead to fatal blood clotting (according to Lexi-Drugs Online). On the other hand, some studies have shown that CoQ10 has done the complete opposite to Vitamin K Antagonists and actually enhanced the anti-blood-clotting effect, which leads to excessive bleeding.

Side Effects

Some side effects reported include severe gastrointestinal (GI) bleeding, allergic reactions, headaches, vomiting, urine discoloration, and abdominal pain.

Further Research

Much of the research that shows a positive outcome when supplementing CoQ10 had small trial groups (not enough people). The number of participants in the trials, known as sample size, is too small for the evidence to be conclusive. Moving forward, is it possible to get a bigger sample size that can give conclusive results? As of now, many are torn on this topic.

The Clinical Bottom Line

There is not enough evidence to support the use of CoQ10 for treating heart failure or even lessening the risk of muscle weakness (myopathy) in those taking statins. Until more research emerges, I would suggest those with cardiovascular disease not take CoQ10, especially if they are taking a Vitamin K Antagonist. If you are torn about taking CoQ10, consider speaking with your Primary Care Provider and Registered Dietitian to see if it's right for you.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition cardiovascular supplements drugs heart health dietary supplements cardiovascular disease

Choosing and Using Probiotics for Gut Health

Screen Shot 2020-07-21 at 12.20.41 PM“Take a probiotic; it helps with your gut.” We have all heard it from friends, doctors, and Registered Dietitians. Is it really that simple, though? It is no secret that probiotics really do help with a variety of gastrointestinal (GI) issues. However, did you know that there are specific strains of probiotics that help with specific symptoms, and while one strain may help with one GI symptom, it may not help with another? Not all probiotics are created equal, and not all supplements labeled “probiotic” will yield health benefits.

What Are Probiotics and Prebiotics?

Probiotics are live microorganisms (tiny living things), mainly bacteria and sometimes yeast, and are intended to have health benefits when ingested. They are similar to the helpful microorganisms naturally found in the gut. Probiotics are found in supplements and fermented foods, such as Greek yogurt with added Lactobacillus and Bifidobacterium, kombucha, tempeh, kefir, and sauerkraut.

Do not confuse these with prebiotics, which are the food source for the “good” bacteria in our GI tract. Prebiotics are “a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon the host’s well-being and health.” They are carbohydrate compounds, primarily oligosaccharides, that withstand digestion in the GI tract and reach the colon where they then are fermented by the gut microflora, helping the good bacteria to grow. In short, they fall under the categories of soluble fiber and fermentable fiber. This is important, because even if you are taking a probiotic or eating foods rich in probiotics, you may not be receiving the maximum amount of benefits if you are not eating enough prebiotics (soluble and fermentable fiber). Foods rich in prebiotics include green bananas, onion, garlic, asparagus, artichokes, and leeks.

How Do Probiotics Work?

The human GI tract is colonized by many microorganisms, such as bacteria, viruses, fungi, archaea, and protozoa. The totality of these organisms is known as the gut microbiota, microbiome, or intestinal microflora and can affect the health and disease state of a human. Probiotics typically work in the GI tract to alter the intestinal microflora, adding good bacteria to the microbiome. The mechanism of action depends heavily on the species and strains because different species and strains have different effects. Some of the known mechanisms include the following:

  • Inhibit the growth of some pathogens (microorganisms causing disease or sickness).
  • Help with vitamin synthesis (B vitamins and vitamin K).
  • Increase absorption of protein.
  • Reinforce the gut barrier, keeping food and other GI contents from leaking into the bloodstream.
  • Neutralize toxins.
  • Lower the pH in the colon, which could help speed up stool for those who are constipated.
  • Replenish good bacteria after taking antibiotics, which may help resolve diarrhea from antibiotics.

Probiotics and Gut Health

The gut microbiota is the center of much current research. Researchers are suggesting that an imbalance in the gut microbiota could lead to several health issues including immune dysfunction, infection, obesity, and GI problems. The imbalance can come from medical conditions, stress, and antibiotic usage (which destroys bad and good bacteria).

Using a probiotic to restore balance has been shown to alleviate symptom persistence in irritable bowel syndrome (IBS) by 21% using both single-strain and multiple-strain supplements, with the mixtures being most effective. Studies also found symptom relief in ulcerative colitis, reduction in acute diarrhea duration and frequency, and lower risk of diarrhea from antibiotic use by 51% or clostridium difficile infection.

A healthy gut with plenty of good bacteria has also been shown to improve the immune system, combat inflammation, and potentially reduce bad cholesterol (total and LDL cholesterol).

Picking Probiotic Supplements

Remember, not all probiotic strains and species are created equal. Trying to figure out exactly what strain, species, and genus of probiotic will work for you and your needs can be tedious, because there are thousands upon thousands of variations. It may take some trial and error to finally find a probiotic that meets your needs.

The good news is that both Lactobacillus and Bifidobacterium are the most studied probiotic genera. There are several studies of strains from these two genera that have produced positive results. Below is a list of conditions with the genus and strain of probiotic that has shown promise in helping with the condition.

  • Acute diarrhea: Lactobacillus paracasei or Lactobacillus rhamnosus or Saccharomyces boulardii
  • Antibiotic-associated diarrhea: Lactobacillus casei, Lactobacillus bulgaricus, Lactobacillus acidophilus, Lactobacillus rhamnosus
  • Overall symptoms of IBS: Bifidobacterium bifidum, Escherichia coli
  • Abdominal pain: Bacillus coagulans, Bifidobacterium bifidum, Lactobacillus plantarum
  • Bloating/distention: Bifidobacterium animalis, Bifidobacterium bifidum, Lactobacillus reuteri
  • Constipation: Bacillus coagulans, Bifidobacterium animalis, Oligofructose (prebiotics)
  • Lactose maldigestion: yogurt with Lactobacillus delbruecki susp bulgaricus and Strepococcus thermophilus
  • High Cholesterol and LDL: Lactobacillus acidophilus, a mixture of Lactobacillus acidophilus and Bifidobacterium lactis, Lactobacillus plantarum (more research is needed here)

If you are struggling with GI symptoms and considering a probiotic supplement, it is important to talk this over with your Registered Dietitian (RD) and primary care provider. They can help to identify the correct genus, strain, species, and dose you need.

Feed Your Gut

For those healthy individuals, you most likely do not need a probiotic supplement. If you really want to help your gut, follow these tips:

  • Eat foods rich in probiotics. When seeking foods with probiotics, the product must have active and live bacterial culture and indicate that on the label. A good rule of thumb is at least 1 billion colony-forming units or 1 billion CFUs, containing the genus Lactobacillus, Bifidobacterium, or Saccharomyces boulardii. Probiotic-rich examples include Greek yogurt, kombucha, tempeh, kefir, and sauerkraut. Be sure to check the label for the specific genus of probiotics(s) in the products, as they will differ. Also note that the starter cultures in Greek yogurt are Streptococcus thermophilus and Lactobacillus bulgaricus, but these are often destroyed by our stomach acid and offer no benefits. Get the Greek yogurt brands that add extra bacteria to the starter cultures (check the label).
  • Feed your probiotics with prebiotics to help the probiotics multiply in your microbiome.
  • Sleep at least 7–8 hours each night.
  • Maintain a healthy weight and body fat percentage.
  • Manage stress.
  • Balance your diet, keeping it loaded with fruits, veggies, lean proteins, fiber, and whole grains.

As always, reach out to the NIFS Registered Dietitian for nutrition help, including nutrition management of gut-related issues. We are here for you.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition digestion gut health supplements dietitian probiotics dietary supplements

Taking Dietary Supplements Safely: Advice from a NIFS Dietitian

GettyImages-505820296Dietary supplement usage is reaching an all-time high. The 2019 Consumer Survey on Dietary Supplements revealed that 77% of Americans consume supplements. This is a dramatic increase from the 53% reported by the NHANES in 2010. Americans are spending $38.8 billion a year on supplements, with more than 85,000 supplements on the market. Reasons for consumption are widespread, ranging from athletes hoping to boost performance to people who need more Vitamin D for bone health.

With the rise in supplement usage, it is important to be an informed consumer. While there are numerous reasons for this, one of the biggest is that supplements are loosely regulated by the FDA, meaning labels may not display what is truly in the supplement. Also, claims marketed about the benefits of a supplement may be false because companies are not required to obtain authorization from the FDA prior to making such nutritional support claims.

How can you know whether what you’re taking is safe and effective? Let’s dive in!

What Is a "Dietary Supplement?"

According to the Dietary Supplement Health and Education Act of 1994 (DSHEA), a dietary supplement means “a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following ingredients:

  • Vitamin
  • Mineral
  • Herb or other botanical
  • Amino acid
  • A dietary supplement used by man to supplement the diet by increasing dietary intake
  • A concentrate, metabolite, constituent, extract, or combination of any ingredient described in the above.”

Are Dietary Supplements Regulated? Can Supplements Be Trusted?

Technically, yes, supplements are regulated by the FDA under the DSHEA. However, there are loopholes to consider:

  1. The FDA does not inspect products before they are sold, nor do they require registration unless the supplement contains a new ingredient not yet on the market.
  2. The only formulation standard is the Current Good Manufacturing Practice (GMP); however, 2013 report by the FDA revealed that 70% of inspected manufacturers were in violation of GMPs. Not all products even get inspected after being on the market. The FDA states the manufacturer is responsible for ensuring safety and quality, but clearly some manufacturers are doing a poor job, and the FDA is only catching some.
  3. Nutrition supplements may not claim to diagnose, cure, prevent, or treat diseases. Sure enough, some manufacturers have managed to ignore this. A 2003 study found that 81% of 338 herbal supplement retail websites made one or more health claims, and 55% claimed to diagnose, cure, prevent, or treat specific diseases.

What Can You Do to Be Safe When Taking Supplements?

Blind trust in supplements is unwarranted; however, there are steps you can take to ensure your safety while taking them.

  • Check the label for a stamp indicating third-party verification. Independent third parties are hired by manufacturers to thoroughly test products, ensuring accuracy of ingredients, potency, and amounts; absence of toxic compounds; and production in compliance with FDA GMPs. Credible third parties include NSF International and US Pharmacopeia (USP).
  • Athletes: look for the NSF Certified for Sport stamp. The USA Doping Agency (USADA) has recognized this program as best suited to assist athletes in choosing supplements that do not contain banned substances for sports.
  • Download the NSF International App. It shows which products are NSF approved—right at your fingertips anytime, anywhere.
  • Check out the Dietary Supplement Fact Sheets published by the National Institutes of Health: Office of Dietary Supplements. This government agency has quick fact sheets about a variety of dietary supplements, including vitamins, minerals, probiotics, botanicals and herbs, and more.

Speak with a Registered Dietitian for supplement guidance and which supplements may (or may not) be right for you. NIFS Registered Dietitians are available to help you!

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: NIFS nutrition supplements dietitian drugs sports nutrition dietary supplements registered dietitian

Using Peppermint Oil for Irritable Bowel Syndrome

GettyImages-1030882342Peppermint oil is a commonly used nutrition remedy for Irritable Bowel Syndrome (IBS), other digestive problems (abdominal pain), the common cold, and headaches. We will focus on gut health in this blog. This remedy has been mentioned in records from ancient Greece, Rome, and Egypt and is becoming more popular in the modern age.

It is suggested that peppermint oil in enteric-coated capsules may improve IBS-related symptoms, such as abdominal pain. A meta-analysis evaluated 726 patients across nine studies, all of which were assessing the use of peppermint oil for treatment of IBS. All the studies showed a significant improvement in IBS symptoms and abdominal pain. The only adverse effect commonly noted was heartburn. Furthermore, another study was done where 65 IBS patients completed the study. There was a placebo group and a group treated with peppermint oil. Over the course of six weeks, those taking peppermint oil said abdominal pain (upset stomach, bloating, and gas) markedly improved, whereas the placebo group saw no significant changes. No other IBS symptoms improved. Two weeks after trials ended, the pain score increased back to the normal (same report as prior to treatment).

Drug Interactions and Additive Effects

According to the literature, the most common drug interaction is enteric-coated peppermint oil capsules taken at the same time as antacids. It is suggested that the two not be taken together, because the enteric coating will be broken down too quickly, which can result in heartburn.

Side Effects

Peppermint oil has been recognized as safe. Possible side effects associated with peppermint oil include allergic reaction and heartburn. The most common side effect associated with peppermint oil supplementation is heartburn, especially among those with IBS.

The Clinical Bottom Line

A significant amount of research shows that peppermint oil supplementation in those with IBS helps reduce abdominal pain. Additionally, it is safe. I would suggest someone struggling with IBS take peppermint oil. However, if they begin to experience excessive heartburn, I would suggest not taking peppermint oil or making sure they are not taking it with an antacid. Furthermore, it is important to remember that peppermint leaf is NOT the same thing as peppermint oil. Peppermint oil is going to be more concentrated and has the research to back up the benefits. On the contrary, peppermint leaf will be less toxic and does not have the research to support usage. 

Further Research

Much of the research done to prove peppermint oil helps with IBS was short term. Not many studies have looked into the long-term effects and safety of supplementing peppermint oil. Thus, I believe future research should look into that.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: digestion supplements illness prevention dietary supplements IBS irritable bowel syndrome