bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Will an avocado a day keep the doctor away?

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Avocado photo by Paree on Flickr. Used under a Creative Commons Licence.

Last week everyone was all excited about new research touting the health benefits of avocados. The gist of it being that everyone should eat an avocado a day to lower improve their cholesterol profile. Now, I love avocados, but I still had to take a look at the study myself.

The first thing I noticed was that the research was “supported by a grant from the Hass Avocado Board” and that the lead author, Dr Kris‐Etherton, is a member of the Avocado Nutrition Science Advisory. According to one of the news items I heard, she insisted that she still would have published the research if it had not shown avocados to impart special benefits on cholesterol levels. Despite this, it’s still a significant red flag to me that the research was supported by the Avocado Board.

This was also a rather small study, looking at 45 individuals over five weeks. While the results were interesting, a larger study would be needed to draw any definitive conclusions. What were these interesting results? Bearing in mind that dietary adherence was self-reported, 90% allegedly stuck to their prescribed diets, and all participants maintained their starting weights. Participants were assigned to one of three treatment diets: low-fat, moderate-fat, or avocado. All three diets were found to lower LDL-C and total cholesterol. However, the avocado diet decreased both (LDL-C and TC) significantly more than the low- and moderate-fat diets. The avocado diet was also the only diet found to decrease the number of small, dense LDL particles (the really bad guys).

Okay, so avocados may impart health benefits. Does this mean we should all exponentially increase our grocery bills and start eating an avocado a day? Probably not. The participants in the study were predominantly white, overweight and obese, healthy Americans. If you’re not part of that group, the results may not apply to you. The study also only ran for five weeks and did not incorporate other life style changes such as exercise and weight loss. We can’t say if eating an avocado a day would impart the same health benefits to someone of a lower weight, different ethnicity, or disease state. We also don’t know if the benefits would continue beyond five weeks or if eating an avocado every day would be more beneficial than increasing exercise and/or losing weight. What about the effects of all three of these together?

Avocados are delicious and full of good nutrients. I don’t want to discourage anyone from eating them if they enjoy them. However, they are expensive, and their use in the treatment of conditions such as elevated cholesterol needs further investigation before we start prescribing an avocado a day.


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I guess some RDs are sexy

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Eat big meals… Fat goes quick! Photo by L’imaGiraphe (en travaux) on Flickr. Used under a Creative Commons LIcence.

Right on the heels of my post about we dietitians not being sexy, this article comes out in the Daily Mail, and I’m forced to eat my words (good thing there are no forbidden foods!). Dietitian Trudi Deakin is proclaiming a high-fat, low-carb diet to be the be all and end all, and she’s written the book to “prove” it. Sigh.

Now, as you (my regular readers) know, I’m certainly not one to shy away from fat. New readers, My original by line was “real dietitians eat butter”. However, I also subscribe to the school of thought that says too much of anything is bad for you. Be it fat, salt, sugar, or carrots. You can have too much of a good thing. According to Trudi, saturated fat is the key. While it’s become widely accepted that saturated fat is not the demon it was once believed to be, that doesn’t mean that it’s suddenly a dietary super hero.

Trudi claims that her diet is 82% fat, and she’s never felt healthier. She alleges that high-carb diets are fuelling the obesity epidemic. The gist is that low-fat was wrong so low-carb must be right. Why do we have to go from one extreme to another? I’ll say the same thing about this that I said about demonizing sugar: blaming one nutrient for obesity or chronic disease isn’t getting us anywhere. These are complex problems that aren’t going to be remedied with simple solutions.

This 82% fat has me curious though. What would a diet that’s 82% fat look like? According to Trudi:

BREAKFAST: Three eggs cooked in the microwave with butter and cheese, like a souffle, served with oily fish – smoked salmon or mackerel – or avocado.

LUNCH:A bowl of berries with double cream or a homemade walnut scone, made with ground almonds rather than flour, served with double cream

DINNER: Meat or fish with a serving of vegetables cooked in butter 

Just for fun, I entered this meal plan into my fitness pal to find out the breakdown. Obviously without quantities, it’s near impossible to say exactly what caloric and macronutrient totals would look like. Based on one serving of each of the items listed above, I would only be consuming 995 kcal, and fat would account for roughly 40% of these. If Trudi’s diet is being accurately reported, she’s obviously consuming greater quantities than I recorded, particularly of the high-fat foods. Regardless, it doesn’t sounds overly appealing to me. I’d rather be a few pounds heavier and die a couple of years earlier than never have cereal for breakfast, never snack, and put butter on everything (as much as I love butter).

While Trudi may be content with this restrictive diet for now, it will be interesting to see what will happen with time. Most people following low-carb diets find them to be extremely difficult to follow over the long-term and usually relinquish them. Aside from the difficulty adhering to these low-carb, high-fat diets, there are other risk factors to consider.

Children with epililepsy following ketogenic diets provide us with some insight into the long term effects of a ketogenic diet. A study of children following a ketogenic diet found that poor growth was common. Other side effects were kidney stones and bone fractures.

There’s some other misinformation in the article. Trudi states that she consumes 30 grams of protein at breakfast because “your body doesn’t store it.” Um… I don’t know where this is coming from. While 30 calories at breakfast is certainly reasonable, excess calories, regardless of macronutrient, will be stored as fat.

The unfortunate thing about most weight management research is that “long term” equals several months to a year. While someone might experience weight loss, and find a high-fat diet relatively easy to adhere to for a few months, years, or a lifetime, are a far different story. Trudi’s been following this diet for less than year. Let’s see the tune she’s singing in a decade. Until then, you might want to take her high-fat diet with a grain of salt, or better yet, a baked potato.


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Why you shouldn’t make any nutrition New Year’s Resolutions

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Are you making any New Year’s resolutions for 2015? Have you made resolutions in the past? Have you ever had success?

Many people (roughly half of us) make New Year’s resolutions. How many of us actually keep those resolutions? Only about 8%! Not exactly a resounding success. And this is why, I, a registered dietitian, am urging you not to make any dietary resolutions this year.

I know that a lot of people resolve to: lose weight, stop eating chips, eat less, give-up chocolate, etc. The number one resolution for 2014 was to “lose weight”. Usually these resolutions are made stoically following holiday eating and drinking extravaganzas. We’re left feeling tired, deflated, and sometimes gross after parties, turkey and stuffing sandwiches, and seemingly bottomless stockings crammed with chocolate oranges. It’s a Brand New Year. What better time to turn over the proverbial kale leaf and dive into a sea of green smoothies? Well, actually, pretty much any other time of year is better and we can’t survive on green smoothies alone (or has Rob Rhinehart finally perfected soylent?). Winter, at least in Canada, can be one of the hardest times of year. We see little sun, it’s cold, icy, snowy, rainy. The perfect recipe for baked macaroni and cheese, you know the one, oozing with three kinds of cheese and buttery bread crumbs on top. It’s not exactly the time of year that screams fresh salads.

It should go without saying that I want you to be healthy and happy. I want you to eat a healthy diet, exercise regularly, and get enough sleep. It’s because I want all of these things for you that I don’t want you to resolve to do them tomorrow. Resolving implies a certain level of gritting your teeth and forcing yourself to go through with something that you don’t really want to. Part of living a healthy life is being happy. How happy can you be if you’re forcing yourself to do things you hate and avoid things that you love? Why not wait for the glitter from New Year’s Eve settle and then starting figuring out how you can make the best, and the healthiest, choices for yourself.

Some of us, yeah, that 8% might be able to choose resolutions that we’re able to stick with. Maybe you’re part of that 8%. If you are, kudos. But let’s just pretend that you’re not. What are you going to resolve this year?


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Can yoghurt prevent diabetes?

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A friend of mine recently shared the news of a new study reporting an association between yoghurt consumption and decreased risk of type 2 diabetes.

The study was actually a meta-analysis of three large studies. Meta-analyses always make me a little nervous due to the ease of cherry picking and interpreting the results to yield the desired effect. The results of a meta-analysis can only be as good as the results of the original studies on which they’re based. I’m not saying this was the case here, just that it’s something to bear in mind when reading about meta-analyses. The researchers do have on their side the fact that all three studies had large sample sizes. After examining the results of these three studies, they added an additional 11 prospective-cohort studies for their meta-analysis.

The researchers controlled for a number of potential confounders. However, there’s always a remaining risk that an unaccounted for confounding variable might be the true reason for any observed effect. While the researchers reported a significant decreased risk of type 2 diabetes in regular yoghurt consumers they were also quick to acknowledge that this does not indicate causation. Yes, people who consume yoghurt appear to be less likely to develop type 2 diabetes than people who don’t. However, the studies all relied upon self-reported food frequency questionnaires and they were observational. It is possible that there is some unaccounted for variable that’s reducing the risk of type 2 diabetes in yoghurt consumers other than the yoghurt.

The researchers do make an interesting suggestion that the probiotics in yoghurt may be responsible for the decreased risk of type 2 diabetes. I do wonder about the validity of this as many yoghurts contain limited live bacteria due to their processing. In addition, it’s unlikely that many probiotics in yoghurt survive the acidic stomach environment to make their way to the intestines. Perhaps it’s the by-products of the bacteria in the yoghurt (e.g. vitamins, lactic acid) that are responsible for decreased risk of type 2 diabetes. Just postulating here. I would love to see a study in which participants are prescribed diets containing either yoghurt with live bacteria, yoghurt without live bacteria, and no yoghurt. Yes, it would take a long time to determine if the yoghurt reduced the risk of type 2 diabetes but other effects could be examined as well and it would be interesting to see what the true effects of  regular yoghurt consumption are on health.


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Follow Friday: the Dartmouth Community Health Board

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My apologies to non-Dartmouth residents. However, if you live in Nova Scotia, you’ll have a community health board for your district. Other provinces and places in other countries may have equivalent bodies and it’s worth checking into.

I’m shamelessly promoting the DCHB, of which I’m a volunteer member, as I think they’ve done (and we’re doing) great work in the community. We’re here to work toward improving the health of Dartmouthians and to act as the liaison between residents and Capital Health. We do this through advocacy, education, events, various other activities, and reporting to Capital Health.

Did you know that we offer grants to non-profit organizations in Dartmouth? We do this twice a year, once in the fall, and once in the spring. Find out more here. We also give a monthly award to an outstanding volunteer in our community. Do you know someone who is making a difference in Dartmouth through volunteer work? Just send off a quick email to info@dchb.ca with the name of the person you’d like to nominate, where they volunteer, and why they’re so great.

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Free Community Skate – December 2014