bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Greens vs Grains

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Yes, I can get behind the statement that “we can all benefit from more veggies in our diet”. After that, I diverge from this weekly nutrition challenge. I don’t think that replacing grains with greens makes nutritional sense. Maybe if all of your grains are refined baked goods. Otherwise, there are nutrients in both grains and greens and replacing all of your grains with vegetables isn’t necessarily a nutritional win.

Grains tend to provide more fibre than vegetables. They’re also a good source of B vitamins and minerals such as iron and magnesium. The fibre in grains can help promote digestive health, lower LDL, and feeds the probiotics in our intestines. The gut microbiota is a fascinating emerging area of research. There seems to be many relationships between the bacteria living in our digestive tracts and other aspects of our health. Fibre also contributes to satiety. Sure, greens have lower caloric density than grains but they also don’t keep you feeling full.

Greens provide you with plenty of other nutrients. It doesn’t have to be an either or situation. I don’t understand why so many people want to attach guilt to specific foods or food groups. Grains and greens can both co-exist in a healthy balanced diet. Yes, even some refined grains.

In my mind, challenging people to eliminate food groups is not a sensible or sustainable challenge. But what do I know, I’m just a dietitian; not a “strength coach, nutritional expert and practitioner of Chinese medicine”. And greens for grains is pretty catchy. I guess catchy is more important than realistic, sound nutrition advice.


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Blog by request: folate

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Lacking in blogspiration, I went back through my inbox and realised that I had a few topic suggestions that I’d never written about. While this isn’t my usually ranting hopefully it will be useful information to some!

So… folate/folic acid, what is it?

Folate refers to the generic name for the vitamin as well as the various forms found naturally in foods. Folic acid is the form of the vitamin found in supplements and fortified foods. Naturally occurring folate usually has additional glutamate molecules attached that can reduce absorption as they need to be removed before the folic acid can be absorbed in the intestine.

What does folic acid do?

The main reason that the government introduced mandatory fortification of white flour with folic acid is due to the role it plays in preventing neural tube defects in infants. While prenatal vitamins contain folic acid many women don’t begin taking them until after they learn that they’re pregnant. This is often too late to promote proper neural tube development. However, as bread and other refined grains are widely consumed, the government decided to have it added to most refined grain products.

Folic acid plays an important role in DNA synthesis and repair as well as in the formation of neurotransmitters. It’s also involved in amino acid metabolism and blood pressure normalization.

How much folate do I need?

The RDA (recommended Dietary Allowance) for adults is 400 mcg a day. However, about 10% of the North American population has a defect in folate metabolism and may need up to twice the RDA to compensate. The RDA is based on the amount of folate needed to maintain normal blood concentrations as well as to prevent neural tube defects during fetal development.

Where do I get folate?

As mentioned above, most refined grain products and flours are fortified with folic acid. This includes breakfast cereals and dried pasta. Foods naturally containing folate include dark leafy greens (e.g. asparagus, spinach, romain lettuce, broccoli, brussels sprouts, and kale), lentils, peas (black-eyed peas, chickpeas), beans, turnips, beets, orange juice, sunflower seeds, avocado, edamame, okra, artichoke, potatoes, papaya, marmite and vegemite, and everyone’s faves: fried liver and brewer’s yeast.

This list, while extensive, may not include all food sources of folate. You can search for food items using the USDA Nutrient Database to find out how much folate they contain. Yes, Canada has a similar database but I’m not confident it’s entirely up to date and I find it  little bit more frustrating to use.

What happens if I don’t get enough?

Folate deficiency can result from low intake, inadequate absorption (often due to alcoholism), increased need (often due to pregnancy), poor utilization (often due to vitamin B12 deficiency), excessive excretion (often due to long-standing diarrhea), and the use of certain chemotherapy medications.

One of the first signs of folate deficiency is a form of anemia called megaloblastic anemia. It may also result in persistent diarrhea and decreased immune function.

If insufficient folate is consumed or absorbed during the first 28 days of pregnancy there is an increased risk of the infant experiencing neural tube defects (i.e. spina bifida or anencephaly).

Can I get too much folate?

The upper level for synthetic folic acid is set at 1000 mcg due to its ability to mask B12 deficiency when consumed in high doses. There is no upper level given for folate naturally occurring in foods as absorption is limited.


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Is 63 grams of liquid sugar the answer to high cholesterol?

A friend recently shared this tweet with me:

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She had asked the tweeter for more details but hadn’t received a response. My response: “Ugh. No wonder so many people don’t trust us as dietitians”.

Of course, it’s Florida orange juice that imparts these benefits. Because oranges from other locales couldn’t possibly impart the same benefits (<— please note this should be written in the yet to be developed sarcasm font). Even so, is the benefit even all that meaningful? I’d argue no.

While I can’t be certain that the study I found is the one the tweeter was referring to it was the top hit and was sponsored by Tropicana orange juice so it fits the bill. The study looked at a very small group of individuals with elevated cholesterol. There were only 25 participants, 16 healthy men, and 9 post-menopausal women. This means that the results cannot be extended to apply to pre-menopausal women or “unhealthy” individuals. There were additional strict criteria that participants had to meet: 1. have initial fasting plasma triacylglycerol (blood lipid) concentrations in the normal range, 2. be habitual or occasional orange juice drinkers, 3. be free of thyroid disorders, kidney disease, and diabetes, 4. have an alcohol intake of ≤2 drinks/d, 5. not be receiving hormone replacement therapy if female. With such a small sample size of people meeting such precise criteria, no concrete conclusions can be drawn from this study.

However, the researchers still drew conclusions. Namely that three cups of orange juice a day can lower LDL and increase HDL blood levels. They found that HDL levels were increased by 21% and the HDL-LDL ratio was decreased by 16%. That sounds fairly impressive but is it really? Well, no, not really. The average HDL level increased from 1.0 to 1.3. Anything over 1.0 is good anyway so they weren’t all that badly off to begin with. The HDL-LDL ratio really only changed because of the increase in HDL as LDL levels went from an average of 3.6 to 3.5. Not a significant change.

What the study doesn’t tell you is that cholesterol recommendations are only made in relation to risk of cardiovascular disease. If your risk level is low then an LDL of under 5.0 is fine. If your risk is high then an LDL of less than 2.0 is ideal. Risk level is determined by family and medical history. None of these factors were discussed in the current study despite the fact that the cholesterol levels measured are essentially meaningless without being placed in the context of CVD risk.

Can we just go back to that THREE cups of OJ a day again? The researchers found no significant change in cholesterol levels at one or two cups of OJ a day. Only at three cups a day. That’s a considerable amount of orange juice. Considering that a serving size of juice is 1/2 cup and most dietitians recommend no more than one serving per day I find it hard to fathom recommending 6 servings of juice every day for a slight increase in HDL levels. The researchers note that as OJ increased fibre intake decreased. They didn’t mention any other aspects of diet. There was no comparison to consumption of whole oranges, other fruit or vegetable juices, or any other dietary changes. Based on this study alone I would absolutely not advise anyone wishing to improve their blood cholesterol levels to drink 63 grams (more than 15 teaspoons) of liquid sugar daily.


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Grocery store lessons: Natural Peanut Butter

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I know that “natural” is a meaningless marketing term. It still drives me nuts when peanut butter that consists of any ingredients other than peanuts is described as “natural”. So, what got me going this time? The Kitchn’s peanut butter taste test purporting to test seven natural peanut butters. But just how natural are all of those peanut butters?

1. Smucker’s Natural Creamy Peanut Butter

INGREDIENTS: PEANUTS, CONTAINS 1% OR LESS OF SALT.

Not too bad. Although that 1% of salt amounts to 105 mg of sodium in a two tablespoon serving. Compare that to 0 mg of sodium in a truly natural peanut butter.

2. Justin’s Classic Peanut Butter

INGREDIENTS: Dry Roasted Peanuts, Palm Fruit Oil*.

I’m not sure why there’s an asterisk on the palm fruit oil as it doesn’t appear to lead to anything. Strangely, that addition of oil doesn’t appear to increase the fat content in comparison to a peanut butter that’s 100% natural.

3. Brad’s Organic Peanut Butter

INGREDIENTS: Organic Peanuts

Thumbs up for this one!

4. Whole Foods Creamy Peanut Butter

INGREDIENTS: Organic dry-roasted peanuts, organic palm oil, organic pure cane sugar, sea salt

Face palm. There is nothing natural about this. Organic ingredients and sea salt do not a natural product make. Thumbs way down.

5. Trader Joe’s Creamy Unsalted Peanut Butter

INGREDIENTS: Organic Peanuts

Another thumbs up. Funnily enough, I noticed that this is a product of Canada but we don’t have Trader Joe’s here.

6. Skippy Natural Peanut Butter

INGREDIENTS: Roasted peanuts, sugar, palm oil, salt

Skippy didn’t even bother to trick people into thinking their ingredients are healthy by using organic ones. Another faux natural peanut butter.

7. Smart Balance Natural Creamy Peanut Butter

INGREDIENTS: Peanut butter (peanuts, dried cane syrup, salt, molasses), natural oils (palm fruit and flax seed oils)

Is there something less than thumbs down? I give this one that rating. Two added sugars, two added oils, and salt. Pass.

If you want a natural peanut butter you’re going to have to look beyond the marketing terms on the front of the label. Check the ingredients. If you see anything other than peanuts it’s not truly “natural” and you need to decide if those extra ingredients are worth the extras (i.e. sugar, sodium, fat) they bring with them.